Healthy patients given cancer therapy 40 errors found in diagnoses at British hospital

August 27, 1993|By Carl Schoettler | Carl Schoettler,London Bureau

LONDON -- Disclosure of the misdiagnosis of two children subjected to painful chemotherapy for cancers they didn't have has sparked a review of 1,800 bone tumor cases at a hospital in Birmingham, Britain's second-largest city.

In addition to the 9-year-old boy and 14-year-old girl whose blundered diagnosis led to an investigation at the Royal Orthopedic Hospital, errors have been identified in 40 other cases so far.

In at least six, patients have had unnecessary surgery, X-ray therapy or chemotherapy. Some patients had all three treatments.

"Two years ago doctors . . . told us she was dying," said the father of the 14-year-old girl, Debbie Leary. "They told us that they might have to amputate her legs."

"We still don't know what side effects her incorrect treatment may have caused," Roy Leary told London's Evening Standard.

An interim report by a panel of inquiry named by the South Birmingham Health Authority was released yesterday after leaked details were published by the Birmingham Post.

The hospital, one of only two in Britain specializing in bone cancers, treats patients from throughout the country.

Questions about diagnoses had been raised as long ago as 1985 but remained unanswered until the panel was formed in June.

The report did not say whether anyone had died because of the errors. Nigel Hastilow, editor of the Post, told BBC radio: "It implies very strongly that is the case."

The report says diagnostic errors "may have had irreversible consequences."

But Dr. Bernard Crump, public health director for the South Birmingham authority, which finally launched the inquiry, said he was "unaware" of any deaths because of unnecessary or delayed treatment.

"The review panel has told us the number of errors is unacceptable," he told a news conference.

He said that delays in reporting errors that doctors already knew about were of "great concern."

Health Secretary Virginia Bottomley immediately named Dr. Kenneth Calman, her chief medical officer, to review guidelines on how doctors should deal with professional incompetence.

"People rightly expect the highest standards of health care," she said. "Doctors have a duty to inform managers if they believe a colleague is making decisions which could harm patients."

The report blames the errors on Dr. Carol Starkie, a pathologist, according to the Press Association. Dr. Starkie, who has multiple sclerosis, is on sick leave and is expected to retire.

The report declined to speculate on whether her health problems "contributed to or caused the errors."

The panel reviewed all of Dr. Starkie's cases between June 1, 1992, and May 24, 1993, when she went on sick leave.

Tissue samples from 473 patients were sent to an independent pathologist for a second opinion. Of 192 reviews done so far, the independent pathologists agreed with 168 diagnoses but disagreed on 24.

In 16 of the 24 cases, Dr. Crump said there seemed to be no incorrect treatment.

In the others, two patients had unnecessary chemotherapy, three had unnecessary radiotherapy, one had a delaying treatment, one had unnecessary surgery and one had unnecessary surgery and chemotherapy.

The errors were revealed initially when a tissue sample from 9-year-old Matthew Guest, then receiving chemotherapy, was sent to another pathologist for a second opinion.

When the doctor found no evidence of malignancy, Matthew's treatment was stopped.

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