Sunday 19 August 2018

Hospital at the centre of cancer errors rules out review of patients' tests

Alison McCormack. Photo: courtesy Irish Examiner
Alison McCormack. Photo: courtesy Irish Examiner
Eilish O'Regan

Eilish O'Regan

A review of the breast cancer test results for around 270 patients has been ruled out despite the doctor involved in their care misdiagnosing two other women with the disease.

St James's Hospital, in Dublin, which has the country's largest cancer centre, has refused to investigate the tests of the women, despite the call being made to Health Minister Simon Harris.

The decision follows revelations a former locum pathologist at the hospital misdiagnosed the type of cancer Dubliner Alison McCormack had in 2010, finding she had a form known as ductal carcinoma in situ (DCIS), which is not invasive.

Ms McCormack, then 35, went on to have her breast removed and a reconstruction, but doctors said she did not need chemotherapy, 'RTÉ Investigates' revealed last night.

The young mother was relieved when doctors told her she was lucky "as it's a cancer curable by surgery".

However, two years later she discovered a lump on her neck and she went back to St James's for more tests.

Rachael Liston. Photo: Anthony Woods
Rachael Liston. Photo: Anthony Woods

"I was told it was the original cancer that was back. It was a DCIS but was spread to my lymph nodes and up to my neck. She said it was very rare to come back."

She had a year of treatment including six months of chemotherapy, the removal of lymph nodes and five-and-a-half weeks of radiation.

It was not until later in 2013 that she had the strength to ask questions and after a meeting was arranged was shown into a boardroom with various medics who revealed she had been misdiagnosed in 2010. The type of cancer she had in 2010 was more serious than DCIS but the pathologist had misinterpreted her test results.

She learned the hospital knew of the misdiagnosis for nine months without telling her.

Her solicitor Rachael Liston said that if Ms McCormack had not asked questions she would never have found out she was misdiagnosed in 2010.

An internal hospital report concluded the "error could have been made by any competent pathologist".

The hospital conducted a limited review of the more than 300 breast cancer tests examined by the pathologist. They looked at 39 results with nine DCIS cases he was involved in.

The review found a second woman had also been given the wrong diagnosis.

Asked for his opinion, Prof Ian Ellis, a pathologist at Nottingham City Hospital, said two out of nine are "red flag type of errors" and a concern.

He said he would recommend a re-examination of all the breast cancer test results read by the pathologist.

Ms Liston told the Irish Independent she took the unprecedented step of writing to Mr Harris last July to alert him to the public health concern and the need to review other cases. She received an acknowledgement but no information of any follow-up.

The minister forwarded the letter to his relevant officials and contact was made with the HSE. "The HSE advised that the look back exercise found no evidence of incompetence on behalf of the pathologist involved" and a wider review was not warranted.

The HSE yesterday said the hospital's response was appropriate.

Asked if the second patient whose cancer was misdiagnosed had been informed, a spokesman for the hospital said that "all relevant elements of the patient's care were discussed with the patient at the time of diagnosis and eight years later the patient remains in normal active clinical review".

Irish Independent

Editor's Choice

Also in Irish News