For three years, dozens of cancer patients at St Vincent’s hospital in Sydney had been receiving low doses of chemotherapy, leading to deaths of a variety of reasons. They had been kept in the dark about it until now.
The news came to light with a government-ordered review by Cancer Institute NSW CEO Professor David Currow, commissioned by the NSW Health Secretary, which also revealed that the misdiagnoses were made by a particular doctor - Dr John Grygiel.
The hospital was found to have made ‘factual errors’ and ‘key omissions’ after it was revealed that 78 patients were given the low dose chemo drug carboplatin, including 30 people that had died.
This was from a period of 2012-2015, but the report will carry through to the past decade of patients treated by Dr Grygiel at three different hospitals, including two in western NSW.
St Vincent’s had previously said that a recurrence in cancer only came in five of the 78 patients and that only two had died.
The hospital also claims that only 70 patients were involved, and despite the mistreatment, they suffered no “negative impacts”.
There have been no studies by the hospital to prove their statement.
The new report could not link the underdosing to deaths, “it would be expected that on a population basis, a failure to adhere to protocols is likely to result in higher rates of local recurrence and higher overall mortality”.
The 100mg dose of carboplatin that was prescribed was around half to one-third less than what should have been prescribed to a head and neck cancer patient.
“Junior pharmacists, nurses and doctors who have practised in medical oncology at St Vincent’s Hospital during these years have either challenged the practice or sought an explanation for it,” the report said.
“The practice was widely known and senior pharmacy and nursing staff either knew, or should have known, it was occurring.”
Dr Grygiel was stood down in February and is currently overseas. According to St Vincent’s, he was “immediately counselled and placed under supervision” after the news of the report came to light but the review found this to be untrue.
The hospital knew about the findings for six months but didn’t alert patients and their families until a media report in February.
There was no urgency from the hospital when they did learn the news, and they failed to consider “clinical outcomes such as survival or cancer recurrence”.
“Given that the review was generated in part by the concerns about the rate of recurrence of people with head and neck cancers, it is not clear why the internal review failed to define relevant clinical and patient factors,” Prof Currow found.
The report also found “public statements by St Vincent’s Hospital … contained important factual errors ... as well as key omissions.”
Dr Grygiel has been overseas and therefore has been unable to be interviewed over the matter, but will return this month to assist with a final report due out in July.
In February, he told The Daily Telegraph about the original ABC report: “I know that the patients weren’t harmed and they suffered no damage from the lower dose that was administered, so there’s nothing to apologise for.”
This scandal can open the hospital to potential lawsuits.
St Vincent’s CEO Toby Hall issued this apology: “We should have had better systems to pick up the treatment regimen he was following. It was clearly a flawed model of treatment and we absolutely apologise to patients for our failure to pick this up earlier.”
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