Review questions out-of-hours testing at Kerry hospital

HSE report finds radiologists carried out all ultrasound referrals by GPs after 5pm

A higher number of out-of-hours radiological tests were carried out at University Hospital Kerry last year than in other similar hospitals across the State, a Health Service Executive review states.

The confidential review, carried out by senior HSE executives, found that all ultrasound referrals by GPs at the hospital were carried out by consultant radiologists after 5pm.

The review accepted that the Tralee hospital’s radiological department, which is now facing questions because of the work of one consultant, needed more staff but it also argued that significant changes to work practices were required.

More than 46,000 scans related to some 27,000 patients of University Hospital Kerry are being re-examined after it emerged that a number of serious cancers were missed by one radiologist in the department. The scans concerned were produced by the consultant between March 2016 and July of this year.

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Diseases were missed in the cases of seven patients. A further 21 people have been brought back to the hospital due to concerns about original scans but they have since been given the all-clear.

The total of 46,000 scans indicate that the consultant examined 3,000 scans per month or more than 150 per day – even though the standard number dealt by a consultant would rarely exceed more than 12,500-15,000 annually.

Team of five

The number of cases handled by all radiologists at the hospital is now being examined after local politicians questioned the workload of the consultant whose work is now being reviewed.

“Is nearly everyone in Kerry being scanned?” asked Independent TD Danny Healy-Rae, who said he was waiting for a breakdown of the figures from the hospital’s management.

University Hospital Kerry, which serves Kerry, parts of northwest Cork and west Limerick, had a team of five consultant radiologists to interpret images taken by radiographers and write reports before the consultant in question was placed on administrative leave in July.

Fergal Grimes, general manager at the hospital, last night said the numbers were being compiled. However, he warned that the issue is complex since there is "huge variability" in radiological work

The radiologist at the centre of the controversy is a graduate of an Irish medical school and has been on the Medical Council’s specialist register for radiology for 10 years.

The seven mistakes so far found by the review out of roughly 20,000 are in in line with international failure rates for radiologists making subjective judgments on scans.