ERRORS BY two consultant pathologists at Galway’s University College Hospital in 2003 and 2005 resulted in a five-year delay in a patient being diagnosed with prostate cancer.
The patient was finally diagnosed last year following an internal review by the hospital.
The review states that on the basis of the information available at present, there appears to have been little or no impact on his health. This may be because cancer of the prostate can progress very slowly.
Prof Martin Cormican, clinical director of laboratory medicine at Galway University Hospital, said the errors made by the two consultants were “isolated” mistakes and they had therefore not been reported to the Medical Council.
The details of the delay are contained in a report published by the Health Service Executive yesterday which indicated that a sample of the work of these two consultants and 17 others, including full-time and locum staff, had been undertaken on foot of concerns raised by callers to a helpline.
The helpline was set up by the hospital in 2007 and 2008 after an investigation into laboratory services at the hospital following the misdiagnosis of a breast cancer patient was announced by the Health Information and Quality Authority (Hiqa).
A total of 268 specimens from 130 patients were reviewed on foot of calls to the helpline and one patient was found to have had a delayed diagnosis. This was the man whose prostate cancer went undiagnosed for five years.
Meanwhile, the HSE report states that an internal review, also at Galway University Hospital, has found an unacceptable number of errors were made by another consultant pathologist who worked at the hospital for six weeks in 2004.
As a result of errors he made, two other patients had their diagnosis of prostate cancer delayed for two years until 2006. A third patient underwent unnecessary surgery to remove more skin than was necessary as a result of a mistake he made.
This locum, referred to in the report as Dr E, was responsible for reporting on 982 specimens ranging from cervical smears and breast tissue to bowel and thyroid gland samples. Some 58 errors were found in his work, affecting the care of just three patients.
The report says this locum left Ireland in 2004. The Galway hospital began considering a review of his work in December 2007 after it received a call from Britain saying he had been suspended from the medical register there for 18 months for “professional related issues”.
The latest review states references were obtained before the locum was employed in Galway and “there was no basis for concern regarding the competence of Dr E at the time of his appointment”. However, it points out that a more robust recruitment procedure is now applied.
Prof Cormican says candidates must now appear in person for interview rather than remotely and references must be obtained from their most recent employer.
In addition, multidisciplinary team meetings now take place to minimise the risk of errors going undetected.
The report notes some patients were angry that while the hospital began to consider the review in December 2007, they were not informed for over six months later that they were part of it. It says this was because it took time to agree a review process, but the hospital accepts “it was a reasonable expectation that the process could have been dealt with more quickly”.
The report notes that there will always be errors but Dr E’s error rate was above the norm. The review has been forwarded to the Medical Council and the hospital has apologised to all the patients.
The HSE revealed it was reviewing the work of Dr E last July after a report into the work of two other pathologists (not those referred to earlier) who were employed at the Galway hospital was published by Hiqa.
The other two included Dr Antoine Geagea, who worked at the hospital from September 2006 to March 2007. He had made a significant number of errors that resulted in a delayed diagnosis or delayed treatment for 12 patients.
The other consultant made an error in reading a biopsy in September 2005 which contributed to an 18-month delay in the diagnosis of a 51-year-old Tipperary woman with breast cancer.