The independent body responsible for monitoring safety and accountability in the health services was first made aware of a problem with a backlog of X-ray reviews at Tallaght hospital as early as April of last year, it has emerged.
The Health Information and Quality Authority (Hiqa) was responding to yesterday’s disclosure that almost 58,000 X-rays of adults taken over a four-year period were never reviewed by a consultant radiologist.
Two cancer patients received a delayed diagnosis as a result of the error. One of these patients has since died, while the other is being treated at the hospital.
Minister for Health Mary Harney, who is in New Zealand, said today that while she had first learnt of the issue in December last, it was only yesterday that she became aware of the scale of the problem.
The Health Service Executive (HSE) said it would conduct and investigation that would be independent both of the executive and of Tallaght hospital.
In a statement this evening, the HSE said it was satisfied with the response to the backlog that has been put in place at the hospital since the appointment of chief executive designate Prof Kevin Conlon.
It said it had received assurances from Tallaght Hospital that every patient’s x-ray is now being reported in a timely manner by a radiologist since December 2009.
It reiterated that the build up of over 57,000 x-rays was “totally unacceptable”. "While resource pressures and surges in demand can lead to short-term delays the level of backlog at the hospital was not acceptable,” it said.
In a statement earlier, HIQA said it received a “concern” raised by a local general practitioner on June 24th 2009 “which suggested that there was a problem with unopened orthopaedic referral letters and a backlog of radiology reporting at the hospital”.
The authority said it wrote to the former chief executive of the hospital, Michael Lyons, on May 8th last year requesting a meeting on the issue.
Staff from the authority met Mr Lyons on June 24th, Hiqa said. At that meeting, it was indicated that there were about 4,000 unreported X-rays and that these were “primarily check-and-repeat X-rays” or X-rays of a type that would not normally be reported by a radiologist, such as dental X-rays.
The authority was assured there were no GP or emergency department X-rays unreported.
“Furthermore, the authority was informed by the former chief executive that this was a historic problem and that currently all X-rays were being reported.
“The chief executive advised the authority of the measures that were being taken by the hospital and that the reporting of the backlog of 4,000 X rays would be completed by the end of July 2009.”
Hiqa said the chief executive also informed it at that meeting that one delayed diagnosis for a patient had been identified, but that the delay had not affected the clinical outcome for the patient concerned and that the family had been informed.
On June 30th, the authority wrote to the chief executive stating that a further meeting would be needed to assess progress with addressing the issues. It said it met Mr Lyons and then medical director Prof Conlon in August.
“At that meeting the authority was given assurances that the backlog was being reduced. Following the meeting, the authority wrote to the chief executive on
September 8th, 2009 requesting a written report and followed this up with letters to the chief executive in October and again November 2009 repeating this request.
“In December 2009 the former chief executive [Mr Lyons] retired and the authority had immediate discussions with the new chief executive-designate Professor Kevin Conlon. Two further meetings were arranged in December but were postponed.”
Hiqa said a meeting took place on January 14th with Mr Conlon to discuss progress. It was then informed that the scale of the backlog was “much greater than previously indicated and in the region of 57,000", it said.
“The chief executive informed the authority that these xrays included interoperative orthopaedic xrays which were reviewed by the orthopaedic surgeons, cardiac catheterisations which were reviewed by the cardiologists and repeat chest xrays which were reviewed by the relevant consultants.
“The hospital set out the action plan that the chief executive had put in place since coming into post, which included additional radiology staffing.”
Hiqa was told at that stage that the backlog of X-ray reporting would be removed by the end of March. “The authority made it clear it would require a written report on progress.”
The authority wrote to the chief executive in January and again on March 4th, last Thursday, requesting such a report. The last letter asked for receipt of the report by March 12th.
“The authority will continue to engage with AMNCH Tallaght and the Health Service Executive (HSE), to ensure that any potential risks to patients are being managed and that this backlog of reporting is resolved as soon as possible.
“Furthermore, the authority will require assurances that this type of backlog is not a problem in other hospitals and will be requesting the HSE to take steps to provide those assurances.”
It was also claimed today that radiologists concerned about the delays sent over 40 letters to management at the hospital.
Tallaght hospital has set up a freephone helpline for patients and their families who may be concerned. It can be accessed at 1800 283 059. Lines are open from 9am to 5pm.