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Province launches sweeping review after another doctor misreads test results

December 31, 2011
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EDMONTON – Health Minister Fred Horne launched an unprecedented, provincewide review Thursday of Alberta’s systems for diagnosing cancer and other illnesses after it was revealed more patients have been misdiagnosed.

The review will look at the province’s “pathology testing” practices, which are used to identify cancer, and its “diagnostic imaging” processes, which involve the use of X-rays, CT scans and other machines to look inside the body for clues about illness.

Horne announced the review Thursday morning, minutes after Alberta Health Services detailed a third incident in which an Alberta physician misdiagnosed more than two dozen patients, throwing hundreds of additional patient diagnoses into question.

“This is a proactive, system-wide exercise that will provide me and all Albertans with the necessary assurance that system-wide checks and balances to prevent errors are in place,” Horne said.

“These three incidents have caused stress for patients, families and staff alike, and Albertans deserve answers. I apologize to those who have been affected.”

Horne has asked the Health Quality Council of Alberta to work with the College of Physicians and Surgeons as well as Alberta Health Services to recommend a plan of action. The investigation will include outside experts and the resulting report will be made public, Horne said.

The government will release more information about the process in the coming weeks.

The case that triggered the sweeping review happened in Drumheller, a town of 8,000 about 135 kilometres northeast of Calgary.

Alberta Health Services CEO Dr. Chris Eagle said a patient complaint in early December prompted a review of nearly 250 X-rays, ultrasounds and CT scans conducted by the hospital’s radiologist over a six-week period.

The review found 34 “interpretation errors,” Eagle said. Doctors are now in the process of contacting affected patients.

As a result of those mistakes, Eagle said health services has launched a review of all CT scans performed at the Drumheller Hospital in the past six months. This larger review will affect approximately 1,300 patients who received scans during that time.

“We are committed to transparency and immediate disclosure and action any time concerns are raised about quality of care,” Eagle said. “(We) acknowledge when an error has occurred, investigate immediately and keep patients informed as soon as we have information about their care.”

Trevor Theman, registrar of the College of Physicians and Surgeons, said the college accredits diagnostic labs throughout the province. Currently, he said each lab is accredited every three years, when a committee double-checks roughly two dozen cases. Drumheller Hospital was last accredited in 2009, he said.

The Drumheller doctor at the centre of the controversy is out of the country on vacation and will not be allowed to practise when he returns, Eagle said.

The physician had extensive experience and had practised in the community for a significant period of time, but Eagle declined to release additional details.

The province has set up a special phone line for patients affected by the latest review. The number is 1-866-301-2668, and anybody from the Drumheller region who received diagnostic imaging of the past six months can call.

The Drumheller region includes Trochu, Three Hills, Hanna and communities within that area. Diagnostic imaging includes X-ray, ultrasound and CT scans.

The Drumheller incident is the third such case in two months.

On Dec. 3, health officials announced they would review more than 1,700 diagnoses made by an Edmonton pathologist who misdiagnosed dozens of cancer patients at the Royal Alexandra Hospital.

The list of those misdiagnosed included 29 men who may have missed out on months of prostate cancer treatment due to misdiagnoses of their biopsies that mistakenly found no cancer or underestimated the severity of their illness. In addition to the prostate biopsies, 1,568 non-prostate specimens the pathologist examined are also being reviewed.

On Nov. 2, the province announced a review of 31 pathology tests conducted at Rockyview General Hospital, in a lab run by Calgary Laboratory Services.

Eagle said at the time there was no evidence of false diagnoses having taken place, but that there were concerns about the equipment that merited further scrutiny.

All three cases will now be rolled into one major review, Horne said.

David Eggen, executive director of the advocacy group Friends of Medicare, said the reason there have been three such incidents is because the province has failed to implement effective oversight mechanisms.

“This is clearly a serious organization problem,” said Eggen, who will run for the NDP in Edmonton-Calder in the next election. “It begs the question: why was there no system in place before to review testing?”

Elisabeth Ballermann of the Health Sciences Association of Alberta has previously suggested the misdiagnoses could be caused by increasing strain on the system, as doctors are currently conducting a record number of pathology tests.

“We know there are capacity issues all over the system. As people are trying to do more and more, that may be an issue,” Ballerman said earlier this month after the case at Royal Alexandra Hospital came to light. “It’s one of the things the Health Quality Council may want to look at.”

Eagle compared the government’s review announced Thursday to B.C.’s Cochrane Report, which was released in August. That report was the product of a six-month review of B.C.’s diagnostic imaging practices, and resulted in 35 recommendations including an electronic registry of radiologists, a new provincial peer-review system and performance monitoring.

The B.C. and Alberta inquiries come six years after the 2005 case in which Newfoundland health officials reviewed 1,013 breast cancer tests and eventually determined that 383 of those patients were misdiagnosed and did not get adequate treatment as a result.

Of those 383 women, 108 had already died.

kkleiss@edmontonjournal.com

twitter.com/ablegreporter

Article source: http://ca.news.yahoo.com/province-launches-sweeping-review-another-doctor-misreads-test-025540200.html

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