Hospital defends misdiagnosis review

St James’ Hospital has defended its decision not to extend a review of the work of a pathologist whose failure to detect invasive breast cancer in a woman left with lifelong health problems.

Hospital defends misdiagnosis review

In a statement, the hospital said “no evidence of further missed diagnosis had arisen” in the near eight years since a pathologist incorrectly told Alison McCormack, then aged 35, her breast cancer was non-invasive.

Alison featured in an interview with the Irish Examiner in 2011, the year after she was diagnosed at St James’ with DCIS (Ductal carcinoma in situ), a localised form of breast cancer.

She spoke of being admitted to hospital on her 36th birthday for a mastectomy, the prospect of which terrified her. After surgery, which included breast reconstruction, she spoke of how grateful she was “to be in the position I am in now”.

She didn’t require chemotherapy because her cancer was non-invasive, in fact she was told it was at Stage 0 “actually precancerous”.

However, as RTÉ Investigates reported last night, Alison was far from out of the woods and was back in St James’ in October 2012 with a lump in her neck.

Initially, she was told her original cancer was back and a year-long treatment plan then commenced, including aggressive chemotherapy.

RTÉ Investigates said the treatment has left Alison with lifelong health issues, including lymphedema, which results in severe swelling of her right arm. Alison went back to the hospital to see if anyone could explain why her cancer had come back.

She met with the hospital in November 2013 where she was informed, for the first time, her cancer had been misdiagnosed.

Later that month, St James’ gave her a copy of a report into her missed diagnosis. It then became clear the hospital had been aware of her misdiagnosis since February 2013 but had not informed her.

The hospital had begun a review of the pathologist’s work in February 2013 upon receipt of an adverse incident report. The review involved a 100% review of the particular type of misdiagnosed cancer and a 10% review of all breast pathology cases reported by the pathologist in question.

Of 39 cases reviewed, two were found to have been misdiagnosed, including Alison’s case and another unidentified patient. However, both cases came from the DCIS category only, meaning the pathologist had misdiagnosed two out of nine cases.

The review concluded that identification of Ms McCormack’s particular type of cancer “is a difficult diagnostic area which challenged both the individual pathologist and the wider pathologist group”.

Moreover, “the pathology conclusion is that this error could equally have been made by any other competent pathologist and does not represent incompetency on the part of the individual pathologist or a departmental systems failure”.

Consequently the hospital was of the view that any further review of the remainder of the pathologist’s work was not warranted.

The hospital has apologised unequivocally to Ms McCormack.

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