09/27/2011 08:15 EDT | Updated 11/27/2011 05:12 EST

Quality of medical scans, radiologists, under microscope in B.C. review

VANCOUVER - Three died and another nine patients were harmed after misdiagnosis by unqualified radiologists, a review of thousands of medical scans in British Columbia has found, prompting the province's health minister to offer a profound apology.

B.C. Health Minister Mike de Jong released the review Tuesday and said the scandal caused hundreds of other patients to worry over whether they too were affected.

"All of that occurred at a time when they should have been able to solely focus on getting well. To all of those patients and their families, I, we, are very, very sorry," de Jong said.

Health officials reviewed almost 8,000 tests such as mammograms, obstetrical ultrasounds, X-rays and CT scans after the quality of the work of four radiologists was questioned.

The Health Ministry was alerted in February to discrepancies in scans found as far back as October 2010 when some patients were told they had a disease or problem when they didn't, or were told they were OK when they weren't.

Dr. Doug Cochrane, the chairman of the BC Patient Safety and Quality Council who conducted the review, found none of the four were qualified to read the scans they were interpreting.

Cochrane said the inadequacies were unique for each of the radiologists, who practised in Powell River, Comox and the Fraser Valley.

One technician was practising outside the scope of his licence, another had no feedback or review of his tests to know he wasn't diagnosing scans properly and another was hired even though he didn't have the necessary skills for the job, the report said.

Cochrane said in just under half of the tests, the results reviewed were within the standard of a one per cent discrepancy rate. However for another 4,200 tests, that rate rose to as high as 17 per cent. All the problematic results were with CT scans.

Through a review of documents and talking to families, Cochrane said there were people harmed by the misdiagnoses, "both from whether patients died as a consequence of this or had their treatment delayed in a substantial way."

"No one died as a direct result of imaging misinterpretation." Cochran said. "But their treatment was changed."

De Jong confirmed three people with errant test results died, but he couldn't say to what degree the misreading of the tests contributed to those deaths.

Cochrane singled out failures of the accreditation and review processes of the College of Physicians and Surgeons and B.C.'s health authorities as one of the main problems.

"In most situations, there was no credible monitoring process in place that would have detected these deficiencies and addressed them at an early stage."

De Jong called the results of the review "troubling" and said the government is working on strengthening hiring and oversight of caregivers.

The action plan includes establishing a peer review system to enhance oversight of newly privileged radiologists, setting up an electronic provincial physician registry and creating consistent rules around communication and patient notification.

Three of the radiologists are no longer working in B.C. and the fourth is working under the guidelines he has been licensed under.

The college said in a statement that it is already working towards implementing the provincial government's plan.

"The college also embraces periodic physician assessment as an important performance monitoring tool," the college said.

As part of the routine accrediting program, the college noted that it recently uncovered some concerns with interpretation of tests by two doctors at a sleep lab in Kelowna, B.C.

Random testing found concerns with about 50 per cent of a small number of files that were reviewed.

Now the Interior Health Authority has notified almost 1,000 patients that their results may have been misinterpreted.

De Jong said B.C. has always been known as a leader in the health-care field and the changes will put the province in the forefront of oversight and monitoring.

The report makes 35 recommendations for change aimed at provincial health authorities, the College of Physicians and the Ministry of Health, to ensure doctors who want to practice in B.C. are screened appropriately and that their skills are assessed continually.