The Irish government announced on April 30th that it was opening an official inquiry and setting up phone help lines and emergency testing after it emerged that a publicly funded smear test program had mistakenly cleared at least 208 women who later received diagnoses of cervical cancer.
The 208 women received false negatives between 2010 and 2014. At least 17 of these women have since died, Irish officials said, although they added that they could not confirm the causes of death.
Prime Minister Leo Varadkar said Monday that he was “very angry” and “saddened” by the case. He said the government would investigate what he described as “appalling communication failures” and examine the testing process.
The government is contacting all affected, including survivors of the 17 deceased women, to inform them of the mistaken tests and of a 2014 review that identified the lapses but did not become public until recently. The government is also considering a plan to automatically compensate those survivors, so that their families do not have to go through the courts.
The scandal came to light when it emerged from court proceedings that an American company to which some tests had been outsourced, Clinical Pathology Laboratories Inc. of Austin, Tex., had reached a settlement worth 2.5 million euros (about $3 million) with Vicky Phelan, 43, a terminally ill woman from County Limerick.
In 2011, Ms. Phelan was given a negative result after a smear test taken that year was negative, but a second test done in 2014 revealed a diagnosis of cancer. Her previous negative test was then reviewed, in accordance with standing procedure, and was found to have in fact strongly indicated the presence of cancer.
“If she had been diagnosed in 2011, there would have been a 95 percent chance of a cure,” said her lawyer, Cian O’Carroll. “Instead she is left with what is now an incurable cancer.”
In 2014, a review found that 208 women had received false negative results since 2010, but only 46 of those women were informed.
Ms. Phelan only learned of the earlier false result last September. In January, she was told she had only six months to a year to live.
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The Nova Scotia Health Authority says it’s business as usual at the Victoria County Memorial Hospital in Baddeck. Concerns were raised in recent weeks about the possibility of the local hospital’s laboratory service closing at the end of the year, however the health authority confirmed that won’t be the case.
“There is no intent to take lab services away (at Victoria County Memorial Hospital),” said Shauna Thompson, senior director of pathology and laboratory medicine for the health authority.
“As far as blood collection services for patients, we have no intentions to change any of that and physicians will still have access to testing and will ensure that we provide results in an appropriate turnaround time.”
Although there will be no disruption in blood collection at the Baddeck facility, Thompson said how the health authority delivers the services may look different in the future. “(It will be) behind the scenes (changes), patients using our services for blood collection won’t see any noticeable differences, physicians will still get their results in an appropriate turnaround time and they will still have access to whatever testing that they need,” she said.
“I can use examples from other jurisdictions where we’ve changed their service delivery model in response to shortages of staff, so we put the service in place to ensure that the stat and urgent testing needed to support onsite clinical services are there and available — that’s just an example.”
Laboratory service at the hospital will not be outsourced, but some routine, non-urgent, testing will continue to be referred to the Cape Breton Regional Hospital in Sydney.
All urgent testing required to support onsite clinical services will still be performed at the Victoria County hospital and right now there are no plans to change it.
“It’s really about improving the sustainability and ensuring that into the future that testing needs for the community are provided and for patients that they have access to blood collection services,” said Thompson.
“We’ll ensure that tests are available onsite that need to remain onsite.”
The Canadian parliament has issued a new report that calls on the country's public health agency to speed up development of a plan to address antimicrobial resistance (AMR) and urges more federal leadership and coordination on the issue.
The report from the House of Commons Standing Committee on Health comes after 2 years of study, during which members of the committee heard from government officials, academics, international organizations, and various stakeholders in both human and animal health. It summarizes the scope of the issue in Canada and the challenges the country faces in addressing AMR, and makes recommendations to address those challenges.
"The committee agrees that Canada has made significant efforts to tackle AMR," committee chair Bill Casey writes. "At the same time, the committee stresses that more needs to be done, particularly with respect to federal leadership and coordination and investment in research and innovation."
The recommendations are geared toward the Pan-Canadian Framework for Action, a strategic plan released in 2017 that is intended to serve as a guide for coordinated efforts by the government and human and animal health and agriculture sectors to address AMR. The four main focus areas of the framework are surveillance, infection prevention and control, stewardship, and research and innovation.