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Alberta to review pathology testing after questions at three different hospitals

12/29/2011 01:54 EST | Updated 02/28/2012 05:12 EST
EDMONTON - Alberta's health minister has ordered a review of diagnostic imaging and pathology testing in the province after inaccurate results surfaced in three different hospitals over the last two months.

Fred Horne said Thursday he wants to make sure that all of the procedures in place for detecting errors are working as they should. Details of the review are to be released in the coming weeks.

"This is not about blaming the people that deliver the care," said Horne. "This is about answering some very fundamental questions about checks and balances in our health-care system. It has to do with the organization of the health-care system as opposed to the specific delivery of care that we experience each day."

The latest problems surfaced at the hospital in Drumheller, where 34 patients are being contacted because of mistakes discovered in the reading of their CT scans, which are used to help diagnose a wide range of ailments including appendicitis, strokes and cancer.

The scans were misinterpreted by the sole radiologist at the hospital, said Dr. Chris Eagle, president and CEO of Alberta Health Services.

He said the radiologist, with many years of experience in the field, is now on holiday but will not be allowed to work until the matter has been resolved.

"Right now our process is to re-look at those 34 films, confirm the diagnosis, talk to the attending physicians, and then to work with the patients — is there a change in the course of treatment required or not?"

Concerns were raised in early December regarding the radiologist's interpretation of one X-ray, Eagle said. Nearly 250 of his past cases were examined next and "considerable concerns" were raised with the 34 CT scans.

Eagle said 1,300 of the radiologist's cases from the past six months will now be re-read over the next several weeks. Priority will be made to first look at the more serious files, including those concerning cancer.

CT scans examine different parts of the body. Eagle said patients who get a scan have ailments from headaches to sore knees.

Earlier this month, health officials announced mistakes were made in pathology tests checking for prostate cancer in 29 patients at the Royal Alexandra Hospital in Edmonton.

In November, a review was also launched into pathology testing done at Rockyview Hospital in Calgary after 31 tests were called into question due to equipment malfunctions and procedural irregularities.

Horne said that while people can be reassured by the mistakes being caught, the situations have caused stress for patients and Albertans deserve answers.

He said he's confident managing the health-care budget did not contribute to the errors.

"I can't fathom that cost has anything to do with this whatsoever," Horne said."This is a question of the organization of the health-care system and what checks and balances are in place to ensure these sorts of errors can be prevented."

He said other jurisdictions in the country are similarly reviewing their safeguard practices.

In B.C., three patients died and another nine were impacted when their medical scans were read by unqualified pathologists. A recent review made several recommendations, including random double checks of health scans.

Eagle said that should also be considered in Alberta.

"It's always good to have two pairs of eyes when it's a life and death decision," said Opposition Alberta Liberal Leader Raj Sherman, an emergency room doctor.

He said health care is not a perfect science. But he's not surprised testing mistakes have been uncovered in the province and expects more will come to light.

He said too many layers of government bureaucracy and too much management shuffling has weakened the checks and balances in the system.

The College of Physicians and Surgeons of Alberta and Health Quality Council will be involved in the review process.

Dr. Linda Slocombe, president of the Alberta Medical Association, said the review is needed to pinpoint areas of concern.

"Do we need to change the process? Do we need to do something about technology, equipment issues? Are there work-load issues?" she asked. "How do we create safeguards to make sure this sort of thing doesn't happen again?"

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