Probe of suspect CT scan readings hits more Fraser hospitals

New review targets radiologist at Maple Ridge, who also worked in Langley, Valley

More than 2,000 additional CT scan results are now in question at multiple Fraser Health hospitals as a result of a new investigation into the work of another B.C. radiologist.

A second radiologist who practised at Fraser Health hospitals – this time at Ridge Meadows Hospital in Maple Ridge – is under investigation for inaccurately reading diagnostic scan results.

And because he previously worked in the Fraser Valley, the findings of nearly 2,000 additional scans are being called into question at hospitals in Abbotsford, Chilliwack and Langley.

“It is entirely possible there are serious conditions that have not been diagnosed,” said Dr. Andrew Webb, Fraser Health’s vice-president of medicine.

“We will not know until we complete the review of those scans whether or not that is the case.”

The South African-trained radiologist worked at Ridge Meadows Hospital under a provisional licence from November 2010 until March 4, when a required quarterly review turned up errors in his CT scan interpretations.

A total of 407 CT scans read by the doctor at Ridge Meadows are under review and nine out of 197 checked so far have turned up “significant discrepancies” in the interpretations.

The reading errors did not result in any of those nine patients being improperly treated, the authority said.

“For that 197, they’re all in the clear,” Webb said.

A review of the remaining 210 CT scans is underway.

And Fraser Health is also now reviewing X-rays and 184 mammograms that were also interpreted by the same radiologist at Ridge Meadows, who is not currently practising while the investigation proceeds.

Because the radiologist previously worked from November 2008 to October 2009 in the eastern Fraser Valley, another 1,933 CT scans he interpreted in that period will also be reviewed.

They include 1,158 CT scans performed at Abbotsford Regional Hospital, 679 at Chilliwack General Hospital and 96 at Langley Memorial Hospital.

As at Ridge Meadows, the radiologist could only read scans with the oversight of a supervisor and with quarterly reviews of his work.

His second quarterly review while based in Abbotsford turned up concerns in 38 of his mammography findings, Webb said.

Two “significant discrepancies” then included one missed cancer, although Webb said those patients ultimately got the right treatment.

The supervisor refused to continue to oversee the radiologist, Webb said, so he could no longer practise at Abbotsford and headed to Europe.

The radiologist got more training while in Ireland and then came back to B.C., this time to Ridge Meadows.

But his new supervisor at Ridge Meadows wasn’t told of the problems in Abbotsford or that the supervisor there stopped dealing with the radiologist.

“There does seem to be a disconnect of information,” Webb said. “The information in Abbotsford was in Abbotsford. And there was a disconnect between physicians in Abbotsford talking to physicians in Ridge Meadows.”

Fraser Health was still operating as 12 independent hospitals in 2009, Webb said, but added a new centralized information system that was set up last summer that should ensure proper information flow.

The B.C. College of Physicians and Surgeons, which licenses doctors to practise in B.C., was also notified in 2009 of the concerns in Abbotsford at that time.

Webb could not say how long it will take to review the more than 1,900 scans performed in 2008 and 2009.

“It will take some time to complete,” he said. “I can’t answer how long. It depends on how many radiologists are doing the work.”

It’s the second disclosure to rock patients in Fraser Health, after the authority revealed last month it was reviewing scans read by a locum radiologist who worked at Abbotsford and Chilliwack from mid-August to mid-September last year.

Fraser’s CEO initially said cancers may have gone untreated in a few patients scanned at Abbotsford as a result.

The authority now says significant errors were found in 11 patients scanned at Abbotsford out of 170 patients whose scans were reviewed.

Webb said it does not appear the errors made any difference in the care patients ultimately received, because doctors rely not just on the results of a scan but a variety of other clinical evidence in diagnosing a patient, although one case is still under review.

Webb called the problems uncovered by the dual investigations a “huge opportunity” to improve practices.

He said a system of peer review of images will be introduced for all radiologists so a random sample of each doctor’s work is reviewed by another.

Also planned are changes to the way hospitals award privileges for radiologist.

Fraser Health says all patients affected by the medical imaging reviews are being contacted directly, but anyone with questions specific to their case can phone 604-851-4700 ext. 646617.

The Ridge Meadows doctor is the fourth radiologist in B.C. whose work has been under investigation in recent weeks. Thousands more scans are being reviewed in Comox, Powell River and Dawson Creek.

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