ABLEnews World Desk

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    Flawed System Sends False Signals to Cancer Patients
    
The medical records of more than 300,000 Scottish women are to be
checked after a breast cancer clinic sent an all-clear letter to a
patient suffering from advanced cancer.
   
It was two years before the woman, who wishes to remain anonymous,
went for a routine check at Dundee Royal Infirmary last December and
discovered that she had breast cancer.
   
She had surgery but remained unaware of the "all-clear" mistake until
two days ago. Doctors said it took several weeks to investigate what
had gone wrong and they did not want to tell of the mistake until she
had undergone treatment.
   
The woman is receiving chemotherapy treatment and a spokesman for
Ninewells Hospital in Dundee said: "She is very ill." Dr Alan Clark,
director of the East of Scotland Breast Screening Centre in Dundee,
said: "She is annoyed and upset. These are the words that I have from
her. She is now fully aware of the situation, that a mistake was
made."
   
Another five women who previously had abnormalities were also sent
all-clear letters. Four have been checked and no traces of cancer
found. A fifth patient refused to be examined. The centre has checked
all its 40,000 patients in Tayside and Fife, but records of 305,465
women at Scotland's other six breast screening centres are also to be
examined.
   
    Patients were sent the wrong letters
    
Mr. Derek MacLean, medical director of Dundee Teaching Hospitals NHS
Trust, said the system was found to be flawed. Two radiologists
normally read mammograms and record their findings. If there is any
abnormality the patient should be recalled for examination and
treatment.
   
An investigation found there was a mistake in the way the information
was entered in a logbook and on computer. This meant the patients were
sent the wrong letters.
   
"The original record says this patient should have been recalled. But
the logbook entry and the computer were wrong. A normal letter was
sent out in error," said Mr. MacLean.
   
He said that systems in hospitals and breast screening centres across
Britain should be checked.
   
"The system has been flawed. The letter was not checked against the
original source document. Had that been done it would have been far
less likely that this type of error would have passed unnoticed," he
said.
   
Last night Lord Fraser of Carmyllie, Scottish health minister, said a
review of the system in Scotland would be carried out. The mistake had
happened before a review of procedures last year. Tighter procedures
were introduced in all seven Scottish centres in February 1994, but
these may now be changed.

[300,000 Face Cancer Check After Error, Ray Clancy, London Telegraph,
March 3, 1995]

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