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Radiologists sought beefed-up standards a year ago

Ultrasound at 18 weeks (Globe Files)

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The British Columbia Radiological Society had been advocating beefed-up quality assurance for medical scans before problems related to the tests emerged in three separate health authorities this month.

A quality assurance initiative, launched more than a year ago, is part of a broader continuing education program and was driven in part by high-profile instances of botched medical tests in Saskatchewan and Newfoundland, BCRS president Emil Lee said on Tuesday.

"There is a push across Canada – really around the world – for medical quality assurance," Dr. Lee said. "So we said, 'rather than wait for this to happen, let's see what's out there and try and help the process along.' "

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The College of Physicians and Surgeons of British Columbia – the group that registers and licenses doctors in the province – has been involved in talks about quality assurance, as has the provincial Health Ministry, Dr. Lee said. One tool being considered is peer review of test readings.

The experience and credentials of radiologists that read CT scans and ultrasounds have been in the spotlight since Friday, when Health Minister Colin Hansen announced a sweeping investigation into medical scans after learning of problems with test readings in Powell River and the Fraser Valley.

A third case, involving a radiologist in Comox, came to light on Monday.

Asked about radiologists' concerns around quality assurance, Mr. Hansen on Tuesday said they will be covered in a provincial review headed by Doug Cochrane, chair of the Canadian Patient Safety Institute.

"I don't know the context of how that may have been communicated to government, but again within the scope that Dr. Cochrane has been given, he has full latitude to look at all those issues," Mr. Hansen said.

The government has not satisfactorily explained why several months went by before health authorities told the Health Ministry of problems concerning test results, said New Democratic Party interim leader Dawn Black.

"Why would it take the government four months to be informed about this?" Ms. Black said. "The issue is a very serious one."

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People should not jump to conclusions about what health authorities did or didn't do before notifying the Health Ministry, Mr. Hansen said, adding that Dr. Cochrane would look at health authorities' responses as part of his review.

In the Powell River incident, a full-time radiologist at Powell River General Hospital read CT scans and obstetrical ultrasounds without being authorized by the B.C. College of Physicians and Surgeons to do so, according to the province.

Vancouver Coastal Health Authority, which oversees the Powell River hospital, began looking into concerns relating to the radiologist last October but did not inform the Health Ministry until this month.

Of nearly 900 patient cases whose CT scans were reviewed in the Powell River incident, about 134 were flagged as requiring further contact and of those, about 30 were described as warranting "more immediate attention."

Follow-up for those patients is being arranged as quickly as possible, VCH says.

The Powell River radiologist also read nearly 2,300 obstetrical scans since 2002. Women who are still pregnant are being referred to St. Joseph's hospital for repeat tests.

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CT scans are still being performed at the Powell River hospital, but the tests are being read by radiologists at Lions Gate Hospital in North Vancouver.

The Fraser Valley incident concerns a radiologist who worked for about a month last year in two area hospitals and may not have had sufficient experience to interpret CT scans, according to the province.

After reviewing records for 170 patients, Fraser Health determined that 10 reports contained "major discrepancies." Fraser Health is following up with those patients.

In the third case, "significant errors" were found in readings performed by a long-time radiologist at St. Joseph's General Hospital in Comox, the province says. It's not yet known how many patients may have been affected.

With a report from Justine Hunter in Victoria

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