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HSE announces probe of Tallaght scandal
[Posted: Wed 10/03/2010 by Niall Hunter, Editor www.irishhealth.com]
The HSE has announced that an independently-chaired investigation will be carried out into the x-ray scandal at Dublin's Tallaght Hospital.
It was revealed yesterday that nearly 60,000 x-rays at the hospital were not reviewed or reported on by consultant radiologists at Tallaght over a four-year period up to September of last year. The x-rays were reviewed by non-radiologists.
To date, two delayed misdiagnoses have been identified as a result of the x-ray backlog. In one of the cases, the patient died last summer and the other patient is being treated for cancer at present.
A further 23,000 x-rays relating to 14,000 patients have still to be checked as the hospital tries to clear the backlog. This process is not expected to be completed until May.
Meanwhile, a number of questions have been raised today on how long Tallaght management, the HSE and the Department of Health knew of the extent of the x-ray problem and why it took so long for the issue to be addressed.
Local Tallaght GP and TCD Professor of General Practice Dr Tom O'Dowd told Today with Pat Kenny on RTE Radio this morning that he alerted the Chairman of Tallaght Hospital to the unreported x-ray in issue April of last year. He said he received no response.
Prof O'Dowd said he then raised the issue with the independent health service safety body, HIQA. It is understood that HIQA subsequently visited the hospital's radiology department to look into the matter, but no report from this review has been published as yet.
The hospital's recently-appointed CEO, Prof Kevin Conlon said he only became aware of the extent of the x-ray problem when he was appointed on December 14 last. He said the HSE and HIQA were informed that week.
However, HIQA has said it had already at that stage previously visited the hospital twice and met with officials on foot of Prof O'Dowd's concerns.
HIQA is to issue a statement on the Tallaght situation later today.
Questions are now being asked about why the HSE did not make the Tallaght situation public despite apparently knowing the extent of the problem for three months, or whether the issue would have ever been revealed or investigated fully it if had not come to light in the media.
It has emerged that only the relatives of the patient who died and the patient having treatment for cancer have to date been told about the scandal.
The hospital has indicated that there may be a number of reasons for the large number of unread x-rays, including resourcing issues.
Health Minister Mary Harney, speaking on Morning Ireland this morning, said that while she had first learned of the Tallaght x-ray issue last December, it was only yesterday that she became aware of the scale of the problem.
The Minister said last night patients have a right to expect the highest standards of diagnosis and treatment at all stages of their care.
"In particular, patients are entitled to expect that clinical standards in radiology are consistently implemented in our hospitals. In this instance, the hospital management identified a practice that was below the clinical standards we expect."
The Minister said she had been informed that the x-rays concerned would have been seen by doctors involved in their care.
"However, x-rays would normally also be seen and formally reported on by a consultant radiologist. Since that does not appear to have happened, all the relevant x-rays are being examined by consultant radiologists on a precautionary basis."
She said her Department had worked with the HSE on developing a serious incident management protocol and she expected it to guide the management of this issue. The incident is to be fully assessed by the HSE, which will make all the relevant information available to her Department "as part of our ongoing work to ensure the highest standards of patient safety."
This serious incident protocol stipulates that in any major incident, patients will be communicated with first before information is made avalable to the public, the media or the Oireachtas.
In the Tallaght case, it appears the hospital only spoke to the family of the dead patient yesterday, as the scandal was breaking in the media.
The HSE said today that Dr Barry White, its director of quality and clinical care, and a consultant radiologist at St Vincent's Hospital, Dr Risteard O'Laoidhe, along with other HSE staff, will visit Tallaght today to ensure that the processes underway to review outstanding x-rays are operating to maximum capacity.
It said it would carry out an investigation into the circumstances which led to the accumulation of unreported x-rays (not read by radiologists) at Tallaght.
The HSE said in addition, it would carry out an investigation into the circumstances which led to the backlog of unreported x-rays, and this will be chaired by a person independent of Tallaght Hospital and the HSE.
The Tallaght Hospital helpline for concerned patients and relatives is: 1800 283 059
CATHY Posted:
10/03/2010 23:03 |
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Unreported films since 2005!!! Why were the GPs and clinical teams not concerned about their patients since 2005? If they had referred a patient for a investigation, why did they not raise concerns? How did they manage to treat patients without a diagnosis? 5 years is a long time to wait, even the CEO had did not act since it was highlighted in Dec 2009-- why the wait for three months? Why did not the previous CEOs do something? In many teaching hospitals, many of the films are also reported by Registrars-not just Consultants. Only two cases of delayed diagnosis in 58,000 cases is probably not true-- in a teaching hospital with teritary referrals the delay in diagnosis{ not just cancer} will probably be more than made public It also highlights the lack of leadership in departments, serious lack of interaction between different departments for patient diagnosis and management It also highlight the fact-- mistakes happen even in the major hospitals
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