CANCER REPORT:SEVERAL MORE patients than had previously been known about had their cancer diagnosis delayed as a result of errors made by a locum consultant who worked in the laboratory of University College Hospital Galway (UCHG) in 2006 and 2007, it emerged yesterday. The discovery was made following a review of the work of the Finnish pathologist by the Health Information and Quality Authority.
Its investigation began last year after it emerged that a 51-year-old Tipperary woman had her breast cancer diagnosis delayed by 18 months. Two biopsies taken from her had been analysed at UCHG and reported on inaccurately.
The first was taken in September 2005 and was reported on as benign by a pathologist at UCHG, not the Finnish pathologist. A wider review of his work by the authority found no other errors.
The second biopsy from the woman was wrongly reported as benign in March 2007 by Dr Antoine Geagea, the Finnish pathologist. He is not named in the report published yesterday, however his name was already in the public domain.
The authority found a significant number of errors had been made by him. Its report noted the error rate in his diagnostic cytology work was "five-six times greater than the accepted range".
His error rate in terms of failing to identify breast cancer malignancies, the report says, was "more than six times the accepted threshold of 6 per cent".
It says the authority reviewed 747 cases dealt with by Dr Geagea and "49 discrepancies were identified" between his findings and those of the investigation team.
This discrepancy had an impact on the care of 12 patients. These included a patient who had a nine-month delay in the diagnosis of thyroid cancer, a patient who had a 16- month delay in getting a diagnosis of carcinoma in-situ of the bladder and a patient whose bladder cancer was not diagnosed for 17 months.
Seven other patients experienced delays ranging from 12 to 14 months in the instigation of further urology investigations, the management of one patient's benign thyroid disease was delayed by eight months and one patient experienced a month's delay in the diagnosis of a benign salivary gland tumour.
Dr Michael Jeffers, a consultant pathologist from Tallaght hospital, who was on the investigation team, said these 12 patients were still "alive and well". There was no change in the management of care or outcome in the 37 other cases followed up. He confirmed "several" of these were dead.
Some 123 cervical smear tests reported on by Dr Geagea were also reviewed and it was decided a precautionary follow-up should be carried out on 45 women. This is now being done. Twenty smears reported as "low grade" by Dr Geagea were "high grade" on review.
Dr Tracey Cooper, chief executive of the Health Information and Quality Authority, said UCHG had no specific procedures for the recruitment of locum consultants and its procedures were "flawed".
It emerged last year that Dr Geagea, who went from UCHG to work in the laboratory of Cork University Hospital, had been sanctioned by the Finnish equivalent of the Irish Medical Council in 2004 and 2006 over the misdiagnosis of two women with breast cancer.
Whether the Irish Medical Council was aware of these sanctions when it registered him to work here in September 2006 is not addressed. The report says UCHG checked to see if he was registered with the medical council before employing him. He was dismissed by Cork University Hospital after seven weeks as a locum in last August after information about his work at UCHG became known.
In relation to the misdiagnosis of the Tipperary woman, the report says the errors made by the two pathologists in her case might have been picked up earlier if her case had been discussed at multidisciplinary team meetings.
Dr Geagea could not be contacted for comment yesterday.