Irregularities in a clinician's cases prompt 15-month lookback

St Vincent’s Hospital Sydney has issued a statement detailing a 15-month lookback review of more than 1640 medical records in its cancer genetics service.

Genetic testing is offered at St Vincent’s for those interested in understanding whether they have gene mutations that carry a higher risk than others of developing into certain types of cancers. Often, these types of tests are used to help people learn about, or clarify, their potential cancer risk in the future. St Vincent’s stressed that these were not tests to detect if cancer is present.

St Vincent’s said that in September 2023 it became aware of some irregularities in the medical records of three patients in this service. The records related to a clinician who largely saw patients from his private office or rooms via telephone during the COVID-19 pandemic.

“As a result of those early irregularities, St Vincent’s initiated a formal ‘lookback’ review across more than 1640 medical records — a deeper and broader examination of the clinician’s cases — to understand the impact, if any, on patients, and which covered the period April 2022 to June 2023,” St Vincent’s said in its statement.

“To date, that review has determined there has been an adverse clinical health outcome for a single patient following the provision of incorrect advice by the clinician. The patient has been informed of the review. The process of confirming what took place and providing all necessary support for this patient is ongoing.”

From the review, no errors or irregularities were detected in the records of approximately 1100 patients; matters such as poor clinical documentation, incomplete correspondence and a lack of genetic counselling were discovered in approximately 520 records; and errors that carried potential risk — even if, ultimately, there had been no harm to these patients — such as providing incorrect information and advice were discovered in approximately 20 records.

“St Vincent’s contacted the patients in this latter group as they were identified, to inform them of what had happened, to apologise, and to provide follow up support as needed,” the statement read. “St Vincent’s has been contacting the broader group of patients to inform them of the lookback, and apologise for any inconvenience and stress caused by the review or its outcomes.” St Vincent’s also said it is offering further advice and consultation to patients as required.

Having not worked at the hospital since mid-2023, St Vincent’s said it referred the clinician to the Australian Health Practitioner Regulation Agency and first reported the matter to NSW Health in October 2023, shortly after becoming aware of the irregularities. St Vincent’s added that it has been regular updates on developments to NSW Health since then.

“St Vincent’s Hospital Sydney is committed to reviewing all the clinician’s patient records to the beginning of the COVID pandemic, when he began making changes to the service model and seeing patients without the involvement of other clinicians,” it said in its statement.

“Since mid-2023 and the clinician's departure, St Vincent’s has re-established the model of care at its cancer genetics service that was in place prior to the COVID pandemic, to ensure these irregularities will not happen again. This includes re-establishing patient oversight by multiple clinicians to provide rigorous checks and balances.”

Image credit: iStock.com/Valerii Apetroaiei