Tests missed 12 cases of bowel cancer; One death may have been avoidable

A recall of around 600 patients who had undergone bowel screening at Wexford General Hospital found that 12 cancers had been missed including one death which may well have been avoidable.

Health Minister Leo Varadkar has criticised the delay for the review of the cases to be published with a spokesman saying he is “conveying to the HSE the need to improve quality assurance so that lessons can be learned and mistakes not repeated”.

In late 2014, Wexford General Hospital became aware that two patients presented with “interval” cancers — those that were detected between screenings — after having colonoscopies in the hospital in the preceding 18 months.

The hospital then carried out a review of all the colonoscopies within the National BowelScreen programme carried out at the hospital.

It looked at a series of records at that point and felt some showed what has been described as poor documentation of “completion” of the test — reaching the end of the bowel, an area called the caecum.

There are certain “landmarks” which should be looked for in that area. In the case of 118 patients, the documentation was felt to be poor and all of those patients were asked to return for a review.

However, when that part of the recall programme was completed, it was felt there may be concerns with the quality of a number of the colonoscopies apart from the “completion” issue.

Therefore a further 210 patients were recalled for a new colonoscopy to check on their quality.

As well as the patients who had received a colonoscopy as part of the natioanl BowelScreen programme, others who had separately received the test because they had been referred with disease symptoms needed to be considered.

When those were added, the total needing re-screening reached in the region of 600.

The period covered by the queried tests was April 2013 to November 2014 and one particular consultant and their team were at the heart of the controversy.

That individual was put on leave until the completion of the review. It was unclear last night whether that consultant is still employed at the hospital.

Ireland East Hospital Group said last night: “The recall of patients that arose from a recheck of Bowel Screen colonoscopies at Wexford General Hospital in 2014 has been thoroughly and comprehensively investigated. Throughout the process, patients and their families have been provided with full information, appropriate follow up and treatment as needed in a timely manner. The subsequent report and its findings are now in the final stages of preparation.”

A spokesman for Mr Varadkar said the minister was aware of the issue which, he said, he had been briefed on since early 2015. “He is concerned primarily that any cancers may have been missed,” the spokesman said. “He extends his sympathy to the families involved and in particular to the family of the deceased.

“The minister is also concerned about the length of time the review has taken and is conveying to the HSE the need to improve quality assurance so that lessons can be learned and mistakes not repeated.

“He has been assured that there has been full open disclosure in these cases.”

The Irish Patients Association said it was disappointing that the report was still not complete almost 15 months since the problem was first identified.

“While respecting the rights of any named hospital staff, or indeed other HSE personnel, arising from the step back review and report, patients, the public and the healthcare system should at the least be provided with an interim report without naming individuals to expedite awareness and learnings as may already be identified,” said the association’s chairman Stephen McMahon.