15 May 2008
The HSE has instigated a look-back review of all chest x-rays and CT scans reported on by one locum consultant radiologist, who worked in Our Lady of Lourdes Hospital in Drogheda and Our Lady’s Hospital, Navan between August 2006 and August 2007. This review is being done as a precaution and as a reassurance for both our patients and for our hospitals.
The review we are carrying out relates to the re-checking of a large number of routine chest x-rays (approximately 6,000) and a small number of CT scans (approximately 70). Based on expert assessment, non-chest x-rays reported by this radiologist have been excluded from this look back review.
An expert team of radiologists are working to ensure that all the x-rays/CT scans are reviewed carefully and in as short a timeframe as possible. It is expected that all reviews will be complete within the coming eight weeks. The expert team of radiologists is made up of an internal/external mixed panel of radiologists from Louth Meath and Northern Ireland.
The look back review commenced on 15th May 2008 and it is expected that it will be completed within eight weeks.
Spokesperson Stephen Mulvany, Hospital Network Manager in the North East today said ‘We perform up to 200,000 radiology examinations every year in the three Louth Meath hospitals, on about 120,000 patients. This look back relates to a much smaller number of cases, reported on by a single radiologist among a team of eleven.
He went on to say, ‘Chest radiographs are performed for many reasons – most are done for respiratory tract infections, bronchitis, asthma, pneumonia, accidents, injuries, chest pain and heart failure. A small number would have been done for possible lung tumours, but the majority of patients who are being checked are extremely low risk and included as a measure of prudence. Our priority is, and will remain, the welfare of our patients and our responsibility to inform them about their care and this issue. ’
The HSE has over the last few weeks been working to check all patient files, and has now established a detailed and validated database of the patients who need to be included in the look-back review.
Information for Patients and Families
Detailedletters were posted on 14th May 2008 from the hospitals to all of the patients involved, advising them that their chest x-ray or CT scan is being reviewed as part of this look back. The letters explain the reason for the look back, and confirm that each patient will be sent the result of their chest x-ray/CT scan review as soon as it is complete, over the coming 8 weeks.
We have also written to GP’s and hospital consultants in the region to advise them of the review.
While we understand that receipt of these letters will cause concernfor patients and their families, it is of paramount importance that we inform patients of the situation at hand, and what the hospital is doing to respond. We would like to again assure our patients that the review we are carrying out is precautionary in nature.
Patients involved in the review have been invited to contact the HSE information line at 1850 24 1850, 10am to 6pm. Patients can call this number to enquire about the review and to ask any questions they may have. Their call will be taken by our consumer care staff.
All patients will be contacted again by letter as soon as their chest x-ray/CT has been reviewed. The HSE will contact every patient and their doctor immediately if an issue is identified that could affect that patient’s care. Where any issue is identified, the patient affected will be delivered a defined care plan by a range of clinical and support staff, including the patient’s General Practitioner and Hospital Consultant.
The radiology equipment in the five hospitals in the North East is modern and up-to-date. It is regularly inspected and approved by the Radiological Protection Society of Ireland and the Department of Biophysics at St. James's Hospital.
Chest radiographs are performed for many reasons. Most chest radiographs are done for respiratory tract infections, bronchitis, asthma, pneumonia, accidents, injuries, chest pain and heart failure. A small number would have been done for possible lung tumours
It should however be noted that individual diagnostic tests are not the only means by which a patients need for treatment is identified and dealt with.
This look back review follows on from concerns raised that a very small number of patients in two Louth/Meath Hospitals during 2006/7 had their diagnosis delayed, due to an abnormality on their chest x-ray not being noted on initial examination. These patients were subsequently diagnosed with lung cancer by follow-up x-rays and have all passed away.
The HSE has asked for these cases to be reviewed by external experts. This review has commenced and will allow the HSE to establish if there was a clinical significance in the delayed diagnoses. The HSE has made contact with the families concerned and remains in regular contact with them to update them on progress and to offer any appropriate supports.
Incidence of Lung Cancer
Based on the summary data from the national cancer registry (1994 -2004), the number of new cases of lung cancer identified in a year for the residents of the North East (Cavan, Louth, Meath and Monaghan) on average is 128.
HSE Information Line: 1850 24 1850, open from 10am to 6pm,
HSE Area Communications Manager,
DublinNorth East, Kells
Tel: 046 9280576/ 087 8291416 email; firstname.lastname@example.org
Notes for Editors
The chest x-rays/CT scans being reviewed relate to approximately 4,590 patients. Some patients would have more than one x-ray or scan taken.
Since this matter came to the attention of the HSE, the hospitals have been working to assess the situation and to identify as quickly as possible the nature and extent of the issue.
A robust look back methodology is in place. As part of this methodology there is a quality assurance process which would be standard for any such review.
Following this statement, our communication with patients on this matter will take precedence over all other updates or public statements.
Last updated on: 15 / 05 / 2008