Concerns about hospital scan unit raised six years ago
26,000 SUSPECT PATIENT SCANS STILL TO BE REVIEWED
SERIOUS concerns about the staffing and work of the Radiology Unit at University Hospital Kerry were raised in the Dáil six years ago.
The hospital has been engulfed in scandal since it emerged that 46,000 patient scans are being reviewed after a former locum in the unit missed seven serious cancer diagnoses.
In 2011, Sinn Féin Deputy Martin Ferris called for a full enquiry into the case of a patient whose cancer diagnosis was allegedly delayed for eight months in 2009 due to an error in the Radiology Unit.
Also in 2011, Fine Gael’s Brendan Griffin warned then Health Minister James Reilly about an ‘impending crisis’ in the unit.
AS the fallout from the scan review at University Hospital Kerry continues, several serious questions have arisen about the system of safety checks that were in place at the hospital’s scandal hit Radiology Unit.
The key question relates to the circumstances that saw a single radiologist examine 46,302 scans – relating to 26,751 patients – apparently without proper oversight.
Following a similar scandal in 2015 – which involved a review of 7,700 scans examined by three locum radiologists who had worked at Kerry, Bantry and Cavan Monaghan General Hospitals – the HSE introduced guidelines aimed at insuring all scans are reviewed by several people before a diagnosis.
This does not appear to have happened in University Hospital Kerry.
According to the HSE, the process of ongoing audits is “inbuilt into radiology practice in Irish hospitals and peer review takes place continuously when radiologists review older scan images while reporting on newer ones.”
Furthermore, the HSE said in 2015 that “radiology departments participate in multidisciplinary team meetings where images are reviewed by teams who decide on the course of treatment a patient should receive”.
Under its National Quality Assurance Programme for Radiology (NQAPR), the HSE recommends that all Radiology Departments should hold regular “discrepancy meetings” where “there is open discussion of cases”.
Given that over 46,000 scans examined by the locum at the centre of the current crisis were apparently not viewed by other radiologists, it suggests the HSE’s recommendations were not being followed in all cases.
The sheer number of scans examined by the locum also raises major questions.
The locum Radiologist in question worked at UHK for 16 months and during that time examined over 46,000 scans.
According to Dr Niall Sheehy, a Radiologist at St James’s Hospital and the Secretary of Ireland’s Faculty of Radiologists, the average number of scans examined by a single doctor in one year would typically be between 7,000 and 15,000.
This would depend on the complexity of the scans with broken bones, for example, often far quicker to diagnose than a tumour.
The Radiologist at UHK examined more than three times the average and would – based on the time-frame and number of scans involved– have been signing off on well over 100 scans a day.
Senior management at UHK admitted to The Kerryman that they were aware – while the locum was employed at the hospital – that the individual had been processing a “very high volume of scans”.
It seems unusual that a red flag was never raised regarding the number of scans the locum was processing and, consequently, the level of attention each scan was receiving.