Test result error margin ‘must be internationally acceptable’

THE leading representative body for Irish pathologists has said test result errors will always be made, but every effort must be made to ensure the error margin is kept within internationally acceptable standards.

The Faculty of Pathology at the Royal College of Physicians of Ireland was responding to the HIQA report, published this week, which found a locum pathologist at the centre of the University College Hospital Galway breast cancer misdiagnosis scandal had an error rate that was six times the accepted rate.

Vice Dean of the faculty, Dr Conor O’Keane, said pathology services in Ireland were “broadly speaking under resourced”, but that it was not believed that understaffing led to the Galway errors.

“Consultant staff figures had increased in Galway. New posts had been approved, but they weren’t filled yet as the process of filling positions is very lengthy. As the report shows, at one point, three out of eight pathology posts were held by locums or temporary staff as they couldn’t get the permanent staff in fast enough.

“The recruitment process was also even more protracted because of the ongoing negotiations over the consultant’s contract which meant new contracts couldn’t be handed out as they didn’t know what contract to appoint them to,” Dr O’Keane said.

The Faculty of Pathology said the errors in diagnosis were compounded by a failure to hold multidisciplinary team meetings where health professionals of different specialities could query results.

The HIQA investigation team found that in Ms A’s case, two errors were made in the examination and interpretation of her pathology specimens by two different pathologists at the hospital.

The faculty has said it is working with Prof Tom Keane of the National Cancer Control Strategy on a range of initiatives to monitor and improve quality assurance at pathology laboratories in Ireland.

“These include external quality assurance; dissemination of guidelines for internal and external quality assurance; competence assurance systems for pathologists; and the establishment of expert pathology panels in a range of cancer areas,” the spokesman said.

According to the HSE, over the past year, huge strides have been achieved in improving quality control at the hospital.

A quality manager has been designated in every department in the laboratory and progress has been made in putting in place quality management systems. Sections of the laboratory have obtained external accreditation or have applied for accreditation and the target is for all departments to have fully implemented a quality management system and applied for accreditation within the next year.