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Call for probe in new cancer controversy
[Posted: Thu 11/09/2008 by Niall Hunter, Editor www.irishhealth.com]
Another patient safety controversy has erupted in the mid-west, with a husband calling for an independent probe into the treatment of his wife, who died aged 53 of breast cancer in April of this year having reportedly been given three 'all-clears'.
Karl Henry, who lives in Ennis, Co. Clare, and who has a 13-year-old son, says his wife, Ann Moriarty, was erroneously given the all-clear for breast cancer twice by Ennis General Hospital and also once at St James's Hospital in Dublin in 2007.
Mr Henry told irishhealth.com that after frustrating communication with the HSE on his wife's treatment, the HSE has refused to arrange an independent inquiry into her care.
"My dealings with the HSE have been nightmarish and I feel every attempt has been made to fob me off."
He had asked for an independent inquiry to look into his wife's treatment at the two hospitals and whether other patients may have been been adversely affected by similar reported failures as those relating to his wife's care.
He is now seeking a personal meeting with Health Minister Mary Harney and is considering referring his wife's case to the Health Information and Quality Authority.
Mr Henry says during 2007 Ann was the victim of a number of incidences of serious misdiagnoses and administrative errors in Ennis hospital, and these were confirmed in an internal inquiry into her treatment.
He said this inquiry confirmed that two chest x-rays on his wife had been misread and that abnormal blood test results showing signs of cancer had been produced but were not acted upon. Mr Henry said he was not asked to contribute to the inquiry.
Mr Henry said St James's Hospital also had serious questions to answer about his wife's treatment there, as following a mammogram at the Dublin hospital in April 2007 she had been given the all-clear for cancer,
but was diagnosed as being terminally ill four months later.
He said he is concerned that other patients may also have been incorrectly diagnosed in x-rays at Ennis hospital and felt he now had no choice but to go public in an attempt to resolve the issues relating to his wife's treatment and its implications.
Ann Moriarty initially developed breast cancer when living in Dublin in April 2005, following which she received successful treatment at St James's, including a single mastectomy.
Karl and Ann moved to Ennis in 2006 and continued to attend St James's for check-ups. Up to and including April 2007 she was reported as being free of the cancer recurring.
According to Mr Henry, following admission to Ennis hospital in June 2007 with a fever, Ann had a chest x-ray and after an 'all-clear', was discharged four days later.
Following further concerns about her health, Ann had more tests in Ennis on August 11 including another x-ray, and she was once again gave the 'all-clear'.
She was given a prescription for a stomach disorder drug and told she was fine. "We were naturally thrilled that the cancer had apparently not returned," according to Karl.
However, he had to take his wife to her GP two days later as she was still not well. A second opinion was sought and following admission to the private Galway Clinic, Anne and Karl were told that her cancer had returned and that it had spread elsewhere and was very serious.
Says Karl: "Nobody could begin to imagine the nightmare that was beginning to unfold. Within days of that diagnosis Ann was transferred to St James's and she was declared to have untreatable and terminal cancer."
Ann received palliative care for six months before dying on April 25, 2008.
Karl then made representations to the HSE, which carried out an internal inquiry involving two separate reports relating to Ann's treatment in Ennis.
In its investigation, the HSE stated that there was clear evidence that the radiologist who reported on the X-ray on June 11 2007 failed to pick up a three-centimetre poorly-defined opacity highly suggestive of a metastatic lesion (secondary tumour).
Mr Henry said Ennis would have been fully aware of his wife's previous history of breast cancer and should have been alert to any sign of a recurrence.
He said the possibility that errors in diagnosis may also have been made at St James's cannot also be excluded, as it is difficult to see how his wife could have been given the all-clear following a mammogram in April 2007, when her cancer appeared to be visible on an X-ray in June, and Ann was diagnosed as terminally ill the following August with widespread secondary tumours.
Mr Henry has requested a copy of the St James's April 2007 mammogram but has been told it cannot be found.
He says his attempts to resolve the matter with corporate HSE have proved fruitless, and his requests for an independent investigation were refused.
He said one of the two independent reports drawn up by the HSE into his wife's treatment at Ennis hospital
raised more questions than it answered and was superficial and unsatisfactory.
Mr Henry also says at one stage HSE told him that his wife's case had been referred to HIQA, but this turned out not to be the case, and the HSE explained this as a 'misunderstanding'.
He says he is determined to discover how and why 'a catalogue of errors' led to an entirely avoidable or untimely death.
Mr Henry wants an independent inquiry into his wife's treatment at Ennis hospital and into her care at St James's. The probe should, he said also investigate how his queries about this wife's care were dealt with.
He also wants the findings and recomendations of any investigation to be applied generally across the whole breast cancer care area.
"In the case of other persons who received treatment at Ennis General Hospital, we are also determined to ensure that there is now an agreed independent and retrospective review, to include all relevant files, x-rays and mammograms taken at the hospital."
Mr Henry said he is not asking for perfection in breast cancer services but wants improvements to be implemented to ensure that patients in such a serious condition as his wife was are not given false 'all-clears'.
He said he felt the Department of Health and the HSE had learned nothing from previous breast cancer scandals.
So far this year there have been three inquiry reports released into breast cancer misdiagnosis and treatment of patients from the mid-west, all of which were critical of the HSE and hospitals.
See also, 'Misdiagnosis report critical of hospital'...http://www.irishhealth.com/index.html?level=4&id=14223
lisann Posted:
11/09/2008 11:55 |
| i just received several emails from reliable sources that death rates go down when doctors and consultants go on strike. does that not tell you something? |
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Trinity Posted:
11/09/2008 12:40 |
| like all the other misdiagnosis, I doubt any individual or individuals will be held accountable. They should be made an example of and there is more than 1 person to blame. These misdiagnosis' have gone to far now, what happens next? It seems nothing is learned from other disasters, lets just all pray we don't get sick. |
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frankie Posted:
11/09/2008 15:04 |
| This did not happen when the old health boards were in place, Mary Harney and Brendan Drumm have made a total sham of the health service in Ireland. |
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JamesH Posted:
11/09/2008 15:33 |
| Lisann. You say" i just received several emails from reliable sources that death rates go down when doctors and consultants go on strike. does that not tell you something?" Yes it does tell me something, your sources are not as reliable as you think and they have a childish motive to make fun of doctors. So Lisann are you seriously saying that you would prefer not to be treated by doctors when you are sick. Nobody is putting a gun to your head forcing you to go. |
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JamesH Posted:
11/09/2008 15:49 |
| Trinity, you are correct that this is another disaster. However much is being learnedf from these diasters. It is evident that the current system of trying to have cancer diagnosis and treatment in every local hospital just does not work. That is why the cancer strategy which is being implemented by Prof Tom Keane is centralising cancer diagnosis and treatment to eight specialist centres with properly functioning multidisciplinary teams and sufficent volume of cases to build up expertise to minimise these types of disasters. |
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t Posted:
11/09/2008 21:59 |
| I'm sorry Jamesh but your "STOCK" answer just does not fit the bill here.This lady returned to her CENTRE OF EXCELLENCE 4 months before being diagnosed with terminal cancer.Her mammogram has vanished mysteriously into the ether and so we can not say if in fact it was clear. This lady attended ennis because she was ill and not attending for cancer treatment.The problem here is that again the work of a locum has come under scrutiny.Despite the DOHC and the HSE having to undertake reviews of 2 locums in the last 12 months and concerns being raised for a long time about the dependence on locums in all areas of health care.The fact that apart from the newly formed HIQA there is no patient safety authority and if you read the papers today serious concerns that had there been a fully resourced and staffed xray dept AND a functioning ct scanner in ennis this misdiagnosis might not have occured.Is that the ct scanner the one that the community paid for and the hse refuse to staff??? i think it may be!!mistakes do happen but when underfunding ,under resourcing and lack of qualified or audited professionals are to blame the blame lies in hawkins house and no where else. |
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Chrissie Posted:
12/09/2008 02:19 |
| I believe it's an outright insult to call Medical Negligence a "DISASTER". Disasters in my world as I see it are unexplainable deaths due to Floods, aeroplane crashes car and bus crashes etc. While Mary Harney, Brendan Drumm and Prof. Tom Keane are trying to put together these 8 Centres of Excellence for such a long time, much too long. When will all these promises materialize and they are trying to put across to us they will be able to save much more Breast Cancer Patients, and other types of cancer. In the meantime until this happens how many more women will die from misdiagnosis? It seems they can do what they like, when they like, and how they like, they are untouchable. Do those who have read this Report, and heard Mr. Henry speaking on the 6:01 News yesterday think that it's really unbelievable Mr. Henry's Late Wife's Mammogram done in April 2007 cannot be found in St. James's Hospital. I for one don't believe this. Hospitals do keep films of any tests carried out for up to 25 years, I know this for certain. Mr. Henry could go public with this with concrete evidence that his late Wife was neglected (this is my words) they found cancer again, report was put in the intray but never emerged to the outray to inform her oncologist of their findings, Why oh Why is this allowed to happen? I don't make light of this, I believe it's because Brendan Drumm won't ever go over his damned budget for Medical Care, they won't get more Consultants, Oncologists, Radiologists, more beds. I am very angry at the way in which the H.S.E. is handling our so called Department of Health. |
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Nuala Posted:
12/09/2008 11:02 |
| Frankie, I am amazed by your statement. You cannot seriously suggest that the old health board structure was anything better than HSE?? What about Dr Neary??! We are probably only at the tip of the iceberg in terms of discovering serious errors and, worse, serious cover-ups, by the old establishment. The situation with the health system is very similar to what happened with the Catholic Church - another formerly "untouchable" pillar of Irish society is going to be pulled apart and a lot of serious questions asked. This, and the establishment of the Health Information Quality Authority - and let's give them a chance before we all start knocking them - are to be very much welcomed. I feel desperately sorry for this man and his young son. My mum is currently being treated for advanced breast cancer and please God none of this will happen to her. |
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Trinity Posted:
12/09/2008 13:44 |
| Well let's hope Prof Tom Keane sorts out this mess. I don't see any room for error in cases like these. |
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CATHY Posted:
12/09/2008 22:57 |
| Cmon guys,Prof Keane or Prof whatever{HSE or old health boards} cannot work miracles, every hospital needs funding, big or small or centres of excellence. As long as these services are run by lazy management who have no clue of clinical situations, mistakes will happen and are happening. Funding and staff are essential. Anyone who over works will miss things. A patient is looked after by many doctors, it is unfair to point at one particular specialty. If a referring Surgeon or GP is concerned about a patient, he or she should discuss the case with other teams including Radiologists. You don't need to wait for meetings to discuss cases. Junior docs should discuss with their consultant and so on-- but lack of senior docs onsite causes a lot of problems. HSE are reluctant to appoint consultants in spite of several reminders. hospitals run with locums will not get the same input as permanent staff. Old records are not available. We still depend on old paper work, which go missing. Which reminds me James's have a digital system, so technically "films" or images cannot go missing!! |
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Anonymous
Posted:
13/09/2008 00:19 |
| what is the legal situation with one's medical records? If one asks hospital for them is hospital legally obliged to provide them? |
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JamesH Posted:
13/09/2008 15:45 |
| T, I agree with everything that you say about St James. The file missing from St James is the last straw in this particular case. Unless this file is located it is impossible to know whether there were visible signs at Mrs Henry’s last visit to St James or whether this was a very aggressive fast moving form of cancer. If the file is not found to my eyes there will always be a suspicious doubt. On this I would agree with you and also Chrissie. The one thing is that officially there are no centres of excellence at this point in time, but rather St James is one of the proposed locations for a centre of excellence. Regarding Ennis, I would disagree totally. The evidence is that cancer care works best in a large volume setting and that is why 8 centres have been chosen that cover approx half million of the population each. Ennis is not one of those. |
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Rep Posted:
14/09/2008 09:10 |
| It seems the HSE inquiry has missed the wood for the trees. Mrs Moriarty was under the care of St James's for her breast cancer till just April 2007. Therefore just two months before her attendance to the Emergency Department in Ennis Mrs Moriarty was given the all-clear from St James. Where is that crucial mammogram?, and more importantly, where are the CT scans and bone scans that would have documented that Mrs Moriarty was free of disease in April 2007? Mrs Anne Moriarty presented to the Emergency Department in Ennis in June with fever, and a chest radiograph performed on admission showed up a shadow in her lung, the radiologist called this a pneumonia. Is that surprising? Fever + Shadow = Pneumonia, unless proven otherwise, every medical student know that. Commonest things occur most commonly. A solitary lung shadow in a patient with fever is less likely to be cancer, and more likely to be a pneumonia. Why was this labelled a radiological misdiagnosis? Who labelled it as such, and what was the motive of such labelling? What did Mrs Anne Moriarty's ultrasound show in June? Did the medical team in Ennis have the medical details of Mrs Moriarty's previous cancer history? Was this communicated to the physician and the radiologist involved? If Mrs Anne Moriarty's chest radiograph in August showed up a suspicious lesion why wasn't an urgent and immediate ultrasound and Ct scan performed in the hospital in the regional hospital in Limerick, the closest imaging center in Ennis? Why did the patient require to travel to Galway to get her CT scan? These are the real hard questions that should be answered. Mr Karl Henry is right to call for wider enquiry into his wife's management, both in St James's and in Ennis, as well as her what happened in the regional hospital in Limerick where the regional Ct scans are performed. Such an enquiry should also look at where the deficiencies really lie and why a locum radiologist was scapegoated in this instance, and who was behind this deviation from the real hard issues in this case. The enquiry should also look at the deficiencies in her care in St James's, in particular the missing mammogram and her discharge from St James' care with an all-clear in April 2007. And finally the enquiry should investigate why Mrs Anne Moriarty's chest radiograph lay around in the hospital for 22 days before being reported , and also why a follow-up Ct scan in Limerick Hospital was not performed in order to assess the abnormality seen on Mrs Anne Moriarty's chest radiograph in June, and later on in August. |
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ursula(WCS75180) Posted:
14/09/2008 17:37 |
| I was deeply saddned at the latest "disaster" in the medical services in this country but not surprised -how many more of these cases are never brought to light. I think the whole medical profession should wake up and take note that they are supposed to be PROFESSIONALS and are in very priviliged position. We are not talking about accountancy or building we are talking about human lives. The core problem is when a mistake is made- I have never heard of a profession that delivers 100%- it is ignored, files go missing, brick wall etc etc. Take responsiblily for your actions. When one mistake is made it is past on until it is usually too late for some poor divil. Simply be honest in all your dealings- it is simply the only credible way a medical system can work. Dont tell me this is all based on claims etc. We know if only we were given reasonable explanations we would never want to sue. Nobody can expect mistakes never to be made so maybe the medical services should realise the the general public deserve to be treated with respect and honesty. |
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brandy Posted:
15/09/2008 15:09 |
| ursula(WCS7180), Well said....we all know that human error may never be avoided...and more honesty is needed. However..... when mistakes are made...I am increasingly of the opinion that serious (life-threatening) mistakes seem to be 'focused' within the public health services. The unmistakeable implication in this... is that it means that best practice (ie the 'best' professionals/diagnoses etc) is reserved for those that can afford them. To expand/explain...if you got very seriously ill on a Saturday/Sunday morning in Ireland.... Would you wish to be 'treated' in a provincial hospital (where there always seems to be a 'skeleton' staff ).....or....in a 'centre of excellence' like St.Vincents private/Bon Secours/Blackrock Clinic....where the likelihood is that your life threatening condition will be treated by the best/most experienced (though most expensive) that exists in Ireland??? I'm guessing that you'd wish to be treated in the best available in Ireland...yes? But, ursula.... there's the difficulty (corruption) in our 'wonderful' Ireland at the present time; those that can afford the private-care at crucial times in their lives....will survive....the poorest are going to die.....because...and only because....the wealthiest in society include the people in power who could change all this....do you think they will ?? |
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CATHY Posted:
15/09/2008 20:35 |
| brandy, do you mean to say that the Private clinics like Vincents private/Bons/Blackrock are centres of excellence!! You must be joking!! These hospitals are "manned" by junior docs mostly, the high charging consultants only come in when called, or for their rounds , there is never a full time consultant there, and everytime they are hello -you are charged!!! Centres of money minting. These hospitals are only for the rich. Provinicial hospitals are doing a great job, and will do better if the HSE provides adequate funds/staff/ provide latest diagnostic machines. This is your local hospital, the first port of call, patients deserve better. Build centres of excellence, no problem there, just hurry up.But that does not mean the small hospitals should be scapegoats and crucified all the time. HSE and HArney should wake up from their stupor and do the right thing |
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ursula(WCS75180) Posted:
16/09/2008 09:53 |
| Brandy, I agree with most of what you say. I would be quite optimistic rather than throw my hands in the air at the whole health services. I believe change can come and it will - just how long it will take depends on political will and cooperation all round. I think there are a great many people working in the health services and I know that they want to be preceived as honest professionals as do all decent people. I think that there is a serious problem with old fashioned ways that have to be got rid of. I think it is only good that these latest cases are coming to light - so sad for the families involved - but it will only serve other patients in the long run. |
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Nok Posted:
17/09/2008 11:44 |
| Well said t, and it is true with regard to all the negligence in relation to missing files. hrissie I see what you mean about calling it a disaster but for her family it is just that. Anonymous ,you are legally entitled to all medical data pertaining to you - or copies of such data - except in cases of children (those under 16) and those judged not to be in a fit state to handle them (where the diagnosis may have an extreme effect on the patient) and where the patient is judged not to be medicallly competent - for example in cases where the patient has been diagnosed with alzeihmers. This is as I understand it. Rep, if a patient is diagnosed with pneumonia when thy had cancer, that IS misdiagnosis, nothing else. But provincial hospitals are hardly doing a great job or anything like when horrific disasters like this happen. No woinder people want to be treated in larger private hosptials like Brandy says. |
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Anonymous
Posted:
17/09/2008 14:08 |
| Nok, Thank you for answering my query regarding medical records. Several years ago my gp said to me we get the service we deserve, if we accept arrogance, indifference, sloppy service we will continue to get it. So complain, complain complain and question, question, question everything. Perhaps then the medical service will stop playing God with us and know that they will be accountable for their actions or non actions. |
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