Terrace radiologist facing more reviews
A Terrace radiologist who made hundreds of errors when reading X-rays, ultrasounds and CT scans over a four-month period is now the subject of two more reviews — one by the College of Physicians and Surgeons of B.C. and another delving into all the work he did at a hospital in the Northwest Territories before he moved here.
Last month, Vancouver General Hospital radiologists completed reinterpretations of 8,400 X-rays, CT scans and ultrasounds originally read by Dr. Claude Vezina in Terrace. They found a “clinically significant” (diseases might have been missed or misdiagnosed) discrepancy rate of 10.3 per cent. Northern Health sent letters to 700 patients to tell them they should follow up with their doctors, so they can explore whether their diagnosis or treatment needs to be changed.
Vezina, who has been on leave for the past four months, took the job at Mills Memorial Hospital in Terrace last fall. All of his work — 8,400 X-rays, CT scans and ultrasounds involving nearly 6,000 patients — was reinterpreted by 30 VGH radiologists and they reached significant and different conclusions in 10.3 per cent of the scans. That is at least double the desired norm when such peer reviews are done.
There are now more than 2,000 images being reread in Yellowknife after the College of Physicians and Surgeons of B.C. notified jurisdictions where Vezina has previously worked. As well, the college said Wednesday its inquiry committee is also reviewing Vezina. The committee is charged with gathering information related to complaints and the disciplinary process.
Northern Health spokeswoman Eryn Collins said Vezina’s “status” at the Mills Memorial Hospital is still unresolved because of procedures that must comply with medical staff bylaws. Vezina worked at Stanton Hospital in Yellowknife over two periods in 2015 and ’16; the 2,400 images he read there are reportedly being redone by a team of visiting radiologists. For many years before moving west, Vezina worked at a hospital in Timmins, Ont. He couldn’t be reached for comment.
Meanwhile, a spokeswoman for the College of Physicians and Surgeons of Ontario (CPSO) said she’s aware that Vezina’s practice has been under review in B.C. “and we are monitoring the outcome.” Vezina is still licensed to practise medicine in Ontario, but doesn’t have hospital privileges there.
A former Ontario radiologist who asked not to be named told Postmedia News he filed an 18page complaint to the college in Ontario several years ago regarding the quality of Vezina’s work, but nothing came of it. The college confirmed Vezina hasn’t been disciplined in Ontario; spokeswoman Kathryn Clarke added this:
“Until recently, only complaints that resulted in allegations of professional misconduct or incompetence being referred for a discipline hearing were public. Now, in addition to discipline-hearing outcomes, other investigative outcomes are now public, such as when the CPSO directs a physician to undertake remedial activity or when a physician is cautioned regarding some aspect of the care they have provided or regarding their conduct.”
According to Collins, doctors applying to work in B.C. are supposed to disclose “any history of formal investigations, of disciplinary proceedings or censure.”
Dr. William Siu, past-president of the B.C. Radiological Society, said since news of the reviews emerged, radiologists, hospitals, health authorities and the Ministry of Health have been in continuing “debriefing” talks about how to avoid such scenarios in the future. “That might mean more sharing of information between regulatory bodies, but there’s a fine line between a witch hunt and protecting individuals’ privacy. In this case, someone had the courage to go public with a complaint to protect the public and the right process was followed.
“At this point, we don’t have all the facts we need in order to say how we can learn from it. But this is not isolated to radiology,” he said, referring to the fact radiology reviews tend to garner a lot of media attention.
In 2010, thousands of images were reread after doubts were raised about the competence of four radiologists working in Powell River, Comox and the Fraser Valley.
An investigation found that errors led to delayed treatments, misdiagnoses and contributed to the deaths of at least three B.C. residents. Dr. Doug Cochrane, chair of the B.C. Patient Safety and Quality Council, led a major review and Mike de Jong, then health minister, apologized.
We don’t have all the facts we need in order to say how we can learn from it. But this is not isolated to radiology.