Smear Test Scandal

SEPT 23 1989

These are our mothers wives sisters and daughters we are talking about here the bedrock of families and some faceless group around a table made this decision that has and will destroy thousands of lives and not just our women directly effected

A few life sentences handed down would change the faceless unaccountable culture of decision making in this country forever

facehugger99

I have absolutely no problem with my taxes going to a compensation scheme for affected women. My issue is that this appears to be the standard response by our politicians.

I like to see people in the HSE held to account or for politicians to introduce systemic changes in the HSE - or indeed other branches of the public service.

Nope, it's far easier to open the purse strings and hand out our money.

Discodog

There needs to be a criminal offence of withholding information that can cause harm or death.

Wheeliebin30

Unfortunately it’s been used as a political football by opposition groups.

No shame.

irishrebe

Dog walker 1234 wrote: »

OP, you seem to be totally missing the point. This is a major incompetence issue. People have died and more will die because of it. People who did nothing wrong, still haven't been given the full facts of their illness. I wonder if you were affected would you have the same attitude?

But he won't be affected ever, because he doesn't have a cervix. He's one of those men who have zero empathy for women and dismiss women's issues as timewasting nonsense.

goat2

Listening to the news this morning, the numbers are going up drastically, this is frightening

Samuel T. Cogley

It's not just a failed test, there was yet another HSE cover up. This harks back to the blood transfusion scandal; it's ridiculous that something like this should be allowed to happen. Typical 'Compo begrudgery' without any empathy or thought as to the nuances involved.

SEPT 23 1989

can the thread title be changed from "and BANDWAGON" to just Scandal please

Hitman3000

Sam Quentin wrote:

So are we about to have another enquiry? It's already taking up valuable time in the Dail,.. with the 'opposition' parties shouting and blaming everyone but themselves!? When at the end of the day nobody as such is to blame, nothing is fool proof.. Cant we just be glad that the smear tests globally have saved millions of lives.....

I'm guessing A= you are not directly impacted , or B= are involved but wish it would just go away with no accountability.

seamus

Hammer89 wrote: »

Yes but they could and should have saved millions of lives plus another 17, which is sort of the issue. One inaccurate diagnosis is inexcusable; 17 is an abomination.

I disagree.

This is not really about misdiagnoses or delayed diagnoses. False negatives are impossible to eliminate. You cannot have medical testing without false negatives. Equipment or personnel failures are virtually impossible to eliminate; you can tighten up procedures, add in all sorts of checks and cross-checks, but human incompetence knows no bounds.

The inexcusable part here is the reaction. Errors should be acknowledged immediately. Doctors should be obliged to ensure that patients have been directly informed of all matters that affect them.

Failure to do either is a malice that comes second only to deliberate malpractice. When a lab or a medical body tries to cover up errors, or a doctor deliberately doesn't provide a patient with all of the information relevant to them, that should be the end of the line. No second chances, no slap on the wrists. The lab should be blacklisted, every executive and manager fired, and doctors struck off.

This is the opposite of what happened here. Everyone covered up the errors. From the lab, to the HSE, to doctors. All people who should know better, but put their personal pride above their professional integrity. Inexcusable.

Trust in the system is a core component of medical tests. If patients and doctors don't believe that the tests will be conducted with the utmost honesty and transparency, then they're worthless. What use is a test if you can't be sure the outcome is valid?

Not only that, if patients don't trust doctors to be upfront and honest with them, then they will go off and find out quack solutions. A patient should never leave an appointment thinking that information has been withheld, or that the doctor hasn't been honest. Aside from the obvious affront to personal autonomy, it damages public faith in medicine.

Deise Vu

Discodog wrote: »

There needs to be a criminal offence of withholding information that can cause harm or death.

I would imagine that would be covered under existing manslaughter legislation if it happened.

I was going to avoid this topic because it is a lose lose to go against the rabid herd but I can't let that comment go. There is definitely an impression out there that the HSE knew people had undetected cancer and deliberately didn't inform them. What actually happened in the case of Vicky Phelan was that she had her second test as scheduled in 2014. That test, tragically, revealed an aggressive cancer for which she was treated unsuccessfully. The HSE then went back to her original test to ascertain why the cancer was so advanced and, with presumably with the benefit of hindsight, they spotted signs in the first test. Maybe other cases were different. I am sure we will find out in 10 years after the next tribunal.

The dilemma after discovering a false negative is do you inform someone who is receiving debilitating cancer treatments such as Chemo and radiation that, you know what, we should have spotted this three years ago when it would have been relatively straight forward to treat. Would that have helped her or depressed her? I don't know the answer to that and we obviously should develop a protocol around it.

Instead the HSE told individual doctors that they would leave it up to them to decide if the patients should be told. That is being reported on as being callous in the extreme when, to me it seems eminently sensible that some people might be too fragile mentally to be told that and it might set them back. (I also wouldn't want to have to make that decision).

My heart goes out to Vicky Phelan. She is facing her ordeal with courage and grace and has done us all a favour in exposing the inadequacies of the screening programme. But is there any chance we could sit down and analyse where we can improve it, and leave the outrage at home.

Squatter

Rubberchikken wrote: »

Every stupid thing is discussed in the dail. Why shouldnt a scandal of enormous inepitude not be discussed?
Women who put thrir trust in a system supposedly there to help protect them has instead through incompetence and immorality, failed them.
I dont think the irish answer of yet anothet expensive enquiry is the solution.
Heads should roll and publicly.
People should be made to answer and explain how this has been allowed. But no. Leo will hold an expensive money and time wasting enquiry and we'll be none the wiser at the end because yet another cockup will have reared its ugly head.

The Taoiseach won't be able to "hold an expensive money and time wasting enquiry" unless that is the decision of the majority of TDs in the Dáil. Hence, if a majority of TDs oppose the enquiry then it won't happen.

seamus

seamus wrote: »

I disagree.

This is not really about misdiagnoses or delayed diagnoses. False negatives are impossible to eliminate. You cannot have medical testing without false negatives. Equipment or personnel failures are virtually impossible to eliminate; you can tighten up procedures, add in all sorts of checks and cross-checks, but human incompetence knows no bounds.

The inexcusable part here is the reaction. Errors should be acknowledged immediately. Doctors should be obliged to ensure that patients have been directly informed of all matters that affect them.

Failure to do either is a malice that comes second only to deliberate malpractice. When a lab or a medical body tries to cover up errors, or a doctor deliberately doesn't provide a patient with all of the information relevant to them, that should be the end of the line. No second chances, no slap on the wrists. The lab should be blacklisted, every executive and manager fired, and doctors struck off.

This is the opposite of what happened here. Everyone covered up the errors. From the lab, to the HSE, to doctors. All people who should know better, but put their personal pride above their professional integrity. Inexcusable.

Trust in the system is a core component of medical tests. If patients and doctors don't believe that the tests will be conducted with the utmost honesty and transparency, then they're worthless. What use is a test if you can't be sure the outcome is valid?

Not only that, if patients don't trust doctors to be upfront and honest with them, then they will go off and find out quack solutions. A patient should never leave an appointment thinking that information has been withheld, or that the doctor hasn't been honest. Aside from the obvious affront to personal autonomy, it damages public faith in medicine.

Fully agree. Lack of acknowledgement is the real problem

I learned this week, in the Western world, the third biggest killer after

Cancer
Heart Disease

is

Medical error

Consider that for a moment.

Pinch Flat

Methinks OPs interest might be suddenly peaked if a loved one is impacted by this. Otherwise, it’s just a rant.

LirW

If I wouldn't just be out of the hospital after a treatment I'd get myself re-tested asap.

The whole thing is a farce and what's even worse is that the whole thing in the first place happens because it is all about money. According to my gyn back home cervical cancer usually develops slowly but it happens to a lot of women having abnormal cells in their lifetime and it's important to observe them once they're there. In a lot of cases they disappear on their own.
The truth is that an annual smear is the way to go to catch abnormalities effectively, because once cancer is there it gets nasty because it's an absolute b1tch to treat. I remember a few months ago there was talk about extending the timeframe to 5 years between the smear tests "because it's not necessary to get tested that often". Yes it absolutely fcuking is. The horrible thing about cervical cancer is that it doesn't show signs until a very late stage and when women are admitted with symptoms of the cancer it is incurable in most cases. This particular cancer is a silent killer and pretty much the whole population is exposed to the virus that's causing it.

I really hope that someone is forced to take responsibility for it. I really hope that the Lab is stripped of their contract and it won't be outsourced again. I really hope that all women affected from this scandal get compensated.

I had a smear mess up once too, I called the gyn's office for some trivial appointment months after my smear and the receptionist told me casually that I have pre-cancerous cells. Why did nobody tell me?? She tried to play it down, I was crying for days, I've never been so scared in my life. I went to another gyn for a biopsy and it came back as all clear. I was absolutely terrified and I can't even imagine how Vicky Phelan or other affected women must feel.

Lackey

Deise Vu wrote: »

The dilemma after discovering a false negative is do you inform someone who is receiving debilitating cancer treatments such as Chemo and radiation that, you know what, we should have spotted this three years ago when it would have been relatively straight forward to treat. Would that have helped her or depressed her? I don't know the answer to that and we obviously should develop a protocol around it.

There is no dilemma here
She absolutely had the right to know
The decision that was made was not in the patients best interest,
Nor was it to made to protect her, For someone to believe that they knew what is better for someone else is niave at best, and conceited at worst.

This was done to cover their arse...not some kind of misguided moral decision.

joe40

My understanding of this is as follows, and I could be wrong, so please let me know.
A screening service is not the same as a diagnosis, and there will always be an unavoidable percentage of false negatives. (Possibly false positives also) Even if this % is overall low, since the numbers getting screened are very high the actual number of false positives will be high.

In this case however there were issues surrounding the quality of the screening, which meant the number of false positives were higher than they should have been. Apparently we used American labs which work on the basis of yearly tests but faster throughput therefore more false positives, but this would even out since the tests would be done more often, so a false positive one year would more than likely be rectified the following year.

We used 3 year screening therefore more robust quality assurance was required with the screening test. There would still have been false positives but there should have been less.
There were resignations over this in 2008. That is one issue that needs to be addressed.
I think it is accepted that false positives are unavoidable so a screening result never provides 100% reassurance but is still much better over a population than no screening.

The other issue was informing the women involved. Again my understanding is that the women already had a cancer diagnosis, so when the false positive was discovered it would have no further impact on the treatment being given.
Obviously if the screening been correct initially, it would have been massively important but if you are in that statistically chance of a false positive it can't be avoided. Obviously this is cold comfort to the individual but does not necessarily mean the screening is at fault - so long as the incidence of false positives is as low as possible. 
The real damage will be if people don't take part in the screening process, despite these tragic stories it has still saved many lives. The HPV vaccine also needs better uptake to tackle this dreadful cancer.

Also the women should have been informed as soon as possible, it was their right to know

Deise Vu

Lackey wrote: »

There is no dilemma here
She absolutely had the right to know
The decision that was made was not in the patients best interest,
Nor was it to made to protect her, For someone to believe that they knew what is better for someone else is niave at best, and conceited at worst.

This was done to cover their arse...not some kind of misguided moral decision.

It is undoubtedly a very convenient situation for the HSE if nobody had ever found out about the errors and absolutely, definitely the patient has the right to know everything about their dealings with the HSE. However, I cannot see any positive benefit for someone hearing that their cancer should have been detected earlier but wasn't and I can definitely think of people who would have struggled mentally with the ordeal of aggressive cancer treatment who would get even more down, knowing they might not have had to undergo the treatment at all.

Can you outline to me the positive benefits of knowing you are possibly dying because of an error by someone else? I said in my post that I didn't know the answer and we should develop a protocol around it. If that protocol is that the patient is informed immediately, then so be it. I would welcome any hard and fast rule that takes judgement and ambiguity out of our health system. I have long felt we much prefer to personalise our multiple health crisis rather than deal with them logically and methodically so one less grey area would be a bonus in my view. I just am not sure if this is the issue that requires a hard and fast rule so I look forward to your list of the positive benefits to enlighten me.

Hitman3000

This and the many scandals that have predated it, shows the absolute necessity for mandatory reporting.

Odhinn

Sam Quentin wrote: »

So are we about to have another enquiry?
It's already taking up valuable time in the Dail,.. with the 'opposition' parties shouting and blaming everyone but themselves!? When at the end of the day nobody as such is to blame, nothing is fool proof.. Cant we just be glad that the smear tests globally have saved millions of lives.....

Seriously, GTF.

Graces7

Deleted User wrote: »

Fully agree. Lack of acknowledgement is the real problem

I learned this week, in the Western world, the third biggest killer after

Cancer
Heart Disease

is

Medical error

Consider that for a moment.

That all but cost me my life and damaged my health permanently . I wold think it is higher up than third place frankly.

retro:electro

I’m sure it’s one “bandwagon” some woman would rather not hop on.
Just when you think you’ve seen enough pig ignorance in AH.

c68zapdsm5i1ru

Sam Quentin wrote: »

So are we about to have another enquiry?
It's already taking up valuable time in the Dail,.. with the 'opposition' parties shouting and blaming everyone but themselves!? When at the end of the day nobody as such is to blame, nothing is fool proof.. Cant we just be glad that the smear tests globally have saved millions of lives.....

There are many things I begrudge my taxes going to. Compensation to those who are terminally ill due to ineptitude on behalf of the HSE is not one of them.

Sofiztikated

Sam Quentin wrote: »

Of course some system or check needs to be looked at and investigated thoroughly.. But isn't that an internal matter with the HSE and the company the work was 'outsourced' to..
Like why is it being used as 'ammunition' and brownie point gathering by opposition parties, and aired across Irish tv for the foreseeable future...
Also it should be a private matter for the ladies it effects..

In other words, shush up and go away, don't make a scene.

Lackey

Deise Vu:
Some of the benefits of full disclosures are

To stop it happening again by correcting previous errors.

Financial compensation to help the affected party and their families who may be left behind
(little solice to the patient and family but will at least remove the financial burden.)

Making people aware that they will be held accountable for their actions if they cover up failings in this or any system, thus ensuring errors are fixed before anyone one else is effected.

How can anyone learn from previous errors if they are hidden?

A sense of justice.

How, after everything in the past (not just this) can you think its a good idea to hide the truth?
When ever has a story broke have people said 'Ide rather we had just buried this'?
(unless of course they were involved in the cover up)

Deise Vu

Lackey wrote: »

Deise Vu:
Some of the benefits of full disclosures are

To stop it happening again by correcting previous errors.

Financial compensation to help the affected party and their families who may be left behind
(little solice to the patient and family but will at least remove the financial burden.)

Making people aware that they will be held accountable for their actions if they cover up failings in this or any system, thus ensuring errors are fixed before anyone one else is effected.

How can anyone learn from previous errors if they are hidden?

A sense of justice.

How, after everything in the past (not just this) can you think its a good idea to hide the truth?
When ever has a story broke have people said 'Ide rather we had just buried this'?
(unless of course they were involved in the cover up)

Maybe you misunderstood the question. I asked what personal benefit is there for the person who finds themselves in the truly awful situation that they are receiving Chemo and radiation treatment and surgery to discover that they might have avoided it. Obviously we need transparency when it comes to the overall running of the system.

meep

Lackey wrote: »

Deise Vu:
Some of the benefits of full disclosures are

To stop it happening again by correcting previous errors.

Financial compensation to help the affected party and their families who may be left behind
(little solice to the patient and family but will at least remove the financial burden.)

Making people aware that they will be held accountable for their actions if they cover up failings in this or any system, thus ensuring errors are fixed before anyone one else is effected.

How can anyone learn from previous errors if they are hidden?

A sense of justice.

How, after everything in the past (not just this) can you think its a good idea to hide the truth?
When ever has a story broke have people said 'Ide rather we had just buried this'?
(unless of course they were involved in the cover up)

I've thought about this a lot over the past few days.

If I was terminally ill, I would prefer not know that a review of a screening test prior to my illness revealed that the result was incorrectly reported.

Of course, I would prefer that the test was more accurate and that my potential illness had been picked up in time to allow treatment. But if it was too late, I think the knowledge that it could have been prevented would add additional anguish.

Maybe that's just me and of course such informatiuon should be used to better the process but trying to put myself in that kind of sitution, I don't think I'd want to know.

Foxhound38

Sam Quentin wrote: »

I'm very sorry for you Dara.. I really am.
But this newest 'scandal' as it's referred to, should not be taking over our Dail and it should not be costing any of us a penny. It should be looked at by HSE and 'fixed' or re-contracted.

The State is the one with the responsibility Sam - and yes, these women should be getting paid.

And you mention that it shouldn't be taking over the Dail. 17 women are dead - what would you prefer them to discuss? Have they been debating anything of more import of late?

Lollipops23

I am attending Holles St for a string of abnormal smears; this entails getting a camera shoved up my hoo-hah once a year.

I also lost a friend to cervical cancer at age 30.

I want heads to roll over this incompetence. It's the anti-D scandal all over again.

joe40

Even Vicky Phelan has accepted that false positives are unavoidable in a screening system.
The system must ensure the false positives are at a minimum, but they can't be eliminated. That is true for all screenings. The Screening system is still beneficial over a large population but there will be errors. A screening is not a medical diagnosis.
In this case the delay in informing the women was wrong and it would appear that the quality assurance was not good enough. However the existence of false positives does not necessarily mean the system is at fault, 100% accuracy is not possible.
Maybe an annual screening schedule would work better.