Smear Test Scandal

11-05-2018 10:09AM

Amirani wrote: »

If that's how the health service actually worked then nobody would be a doctor or work in a medical laboratory.

Explain that I don't understand, surely the lab is accredited and employs competent people. I do understand that no screaming test is perfect.

inter arma · 11-05-2018 10:10AM

Tony O'Brien is only the tip of the iceberg. The HSE is a corrupt, putrid, rotten organisation that prioritizes its own PR and management before the public is it supposed to care for. The HSE needs a big clean out of its rotten management.

Amirani · 11-05-2018 10:16AM

mariaalice wrote: »

Explain that I don't understand, surely the lab is accredited and employs competent people. I do understand that no screaming test is perfect.

If labs or doctors were held criminally negligent for misreading a smear result or for giving an incorrect diagnosis generally, then it would be crazy to work in the area. Medicine isn't a perfect science, you make determinations based on imperfect information in good faith.

I don't think anyone here has intentionally tried to cause a worse clinical outcome for patients. Medical professionals are doing their best, they shouldn't be accused of attempted murder for doing so.

11-05-2018 10:24AM

Amirani wrote: »

If labs or doctors were held criminally negligent for misreading a smear result or for giving an incorrect diagnosis generally, then it would be crazy to work in the area. Medicine isn't a perfect science, you make determinations based on imperfect information in good faith.

I don't think anyone here has intentionally tried to cause a worse clinical outcome for patients. Medical professionals are doing their best, they shouldn't be accused of attempted murder for doing so.

But who is responsible for making sure the reading from the smears is correct, accountable is not the same as accusing a doctor of attempted murder.

wrangler · 11-05-2018 10:29AM

Uriel. wrote: »

I have absolutely no idea what this is supposed to mean.

Are you serious....guards claiming breath tests that they're not actually doing,
This smear test scandal, there's loads more ,if you had someone affected by ether of these even you wouldn't have to ask.
What's the point of firing the boss when the messers that caused it are still allowed to carry on.

Amirani · 11-05-2018 10:31AM

mariaalice wrote: »

But who is responsible for making sure the reading from the smears is correct, accountable is not the same as accusing a doctor of attempted murder.

The person reading the smears is ultimately responsible. But it's an imperfect science and it's completely normal that many cancers aren't spotted - it happens in every laboratory in the world doing this.

We all make errors or misjudgments in our jobs, it's human. The consequences of these errors are just far graver, but there's not really anything that can be done about this.

I'm not a doctor but I have close relationships with a few of them, and they're all pretty disillusioned with how the media and certain politicians have framed this issue.

inter arma · 11-05-2018 10:34AM

Amirani wrote: »

We all make errors or misjudgments in our jobs, it's human. The consequences of these errors are just far graver, but there's not really anything that can be done about this.

Rubbish. Where there are lives at stake, checks, double-checks and even trebble-checks need to be in place to make sure any potential errors are seen and corrected.

11-05-2018 11:05AM

inter arma wrote: »

Rubbish. Where there are lives at stake, checks, double-checks and even trebble-checks need to be in place to make sure any potential errors are seen and corrected.

Even doing that no diagnostic test is perfect.

Amirani · 11-05-2018 11:11AM

inter arma wrote: »

Rubbish. Where there are lives at stake, checks, double-checks and even trebble-checks need to be in place to make sure any potential errors are seen and corrected.

You're just showing that you don't really know how screening tests work, hence you shouldn't really comment on what procedures should be.

"Errors" may be the wrong word to use here generally. "Misinterpretation" may be a better word - this is going to happen no matter how many times checks are done.

inter arma · 11-05-2018 11:18AM

Amirani wrote: »

You're just showing that you don't really know how screening tests work, hence you shouldn't really comment on what procedures should be.

"Errors" may be the wrong word to use here generally. "Misinterpretation" may be a better word - this is going to happen no matter how many times checks are done.

You are full of ****.

RebelButtMunch · 11-05-2018 11:19AM

inter arma wrote: »

You are full of ****.

He's not

Do your research. There is an acceptable error rate with this screening. Horrible as that may sound, its a fact

jmayo · 11-05-2018 11:36AM

iamwhoiam wrote: »

I will get out and march if its organised.

Likewise.

And it is disappointing that we have had people out screaming on the streets about a court case in another jurisdiction and the rights of women and yet not one peep out of them about the death of women in this state.

Amirani wrote: »

...
I don't think anyone here has intentionally tried to cause a worse clinical outcome for patients. Medical professionals are doing their best, they shouldn't be accused of attempted murder for doing so.

Well put quite simply their best is not good enough.

Amirani wrote: »

The person reading the smears is ultimately responsible. But it's an imperfect science and it's completely normal that many cancers aren't spotted - it happens in every laboratory in the world doing this.

We all make errors or misjudgments in our jobs, it's human. The consequences of these errors are just far graver, but there's not really anything that can be done about this.

I'm not a doctor but I have close relationships with a few of them, and they're all pretty disillusioned with how the media and certain politicians have framed this issue.

You don't say.

One would never have thought that from your posts for the most part defending the HSE and our screening services.
Not to mention the odd pop at the victims. :mad:

Well pity for them for being disillusioned.

Now just imagine how disillusioned the general public are with a system that hides and covers up it's mistakes and mismanagement, that drags dying women into court so that they can't spend time trying to fight a terminal illness and have a bit more time with their loved ones and then when they do win the same system tries to gag them into submission.

You have fooking neck like a jockeys boll** to come on here and lecture us about how disillusioned that medical profession are with how this is playing out.
Those same medical professionals are a part of a system totally unfit for purpose and when anyone has tried to change it they more often than not through their toys of the pram threatening armageddon.

inter arma wrote: »

You are full of ****.

No they are not, but they are spinning furiously some legitimate facts to try make this whole sorry saga seem not so bad after all.

irishproduce · 11-05-2018 11:38AM

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.

All manner of stuff is discussed in the dail, yes. But it normally is moved off the agenda quickly enough once a plan of action is decided or the item is dismissed.
I think the other posters are berating the fact that this is going on for the bones of a month almost now and (Maybe a bit cynical) but a lot of politicians and failed politicians in the Seanad are getting on board. There is point scoring going on here, while others are jumping on to be seen to do something and be a part of it.
Just a thought, but maybe the HSE should get on with investigating what has gone on, then when the facts are available, let them be examined the committees and plans of action made to stop it happening again.
We don't need the daily outrage and distracting arguing going on.
Yes, we have a problem, sort it then. There are lot's more problems that need equal attention.
Please do not for a second read this post as a dismissing of what the patients have been subjected to. I have nothing but the greatest of sympathy for them and their families. My post is about the hangers on and time it is being given.

jmayo · 11-05-2018 12:01PM

irishproduce wrote: »

All manner of stuff is discussed in the dail, yes. But it normally is moved off the agenda quickly enough once a plan of action is decided or the item is dismissed.
I think the other posters are berating the fact that this is going on for the bones of a month almost now and (Maybe a bit cynical) but a lot of politicians and failed politicians in the Seanad are getting on board. There is point scoring going on here, while others are jumping on to be seen to do something and be a part of it.
Just a thought, but maybe the HSE should get on with investigating what has gone on, then when the facts are available, let them be examined the committees and plans of action made to stop it happening again.
We don't need the daily outrage and distracting arguing going on.
Yes, we have a problem, sort it then. There are lot's more problems that need equal attention.
Please do not for a second read this post as a dismissing of what the patients have been subjected to. I have nothing but the greatest of sympathy for them and their families. My post is about the hangers on and time it is being given.

Problem with letting the HSE do an internal investigation is they can't be trusted.

They had done an investigation into the screening service and as evidenced by the internal memos they did a VW/BMW on it and tried to manage the release of the detail.

In other words they tried to hide the fooking detail and when cases were taken they were party to gagging orders.

If the HSE and DOH was fit for purpose we would not be here in the first place, because when errors were detected in the screening service they would have held their hands up and have immediate disclosure.

And the reason that this is dragging on is that there is a drip drip feed of information from HSE and Dept of Health and recently some patients still hadn't been informed they were incorrectly diagnosed.

You claim you care about the patients, but in the same sentence you claim it is been given too much time and what is all the outrage about.

Fooking hell I would hate to see what you thought if you didn't care about the patients. :rolleyes:

Martina1991 · 11-05-2018 12:48PM

As many people have said here, no screening test is 100% successful at detecting disease.

However, the Irish smear screen system involved reading smears for a longer period of time than they do in the USA. Irish scientists were getting through 25-30 smears a day while American staff were looking at 80-100 a day. They simply were not reading the smears long enough to detect the abnormal cells. This is why annual screens are performed in the USA while it is every 3 years here.

The Medical Laboratory Scientists Association (Body that all medical scientists work under) warned the HSE and the Cervical Screening Service in 2007 of the risk of outsourcing our smear to the USA due to the different testing protocols and the disconnect between their screening program and our clinical services for women.
These smears were outsourced due to the large volume of patient samples and lack of staff to deal with the workload. If our Irish labs were not understaffed we could have dealt with the workload and not have had to outsource our screening service.

http://www.thejournal.ie/smear-tests-outsourced-missing-3985784-Apr2018/

irishproduce · 11-05-2018 12:55PM

Martina1991 wrote: »

As many people have said here, no screening test is 100% successful at detecting disease.

However, the Irish smear screen system involved reading smears for a longer period of time than they do in the USA. Irish scientists were getting through 25-30 smears a day while American staff were looking at 80-100 a day. They simply were not reading the smears long enough to detect the abnormal cells. This is why annual screens are performed in the USA while it is every 3 years here.

The Medical Laboratory Scientists Association (Body that all medical scientists work under) warned the HSE and the Cervical Screening Service in 2007 of the risk of outsourcing our smear to the USA due to the different testing protocols and the disconnect between their screening program and our clinical services for women.
These smears were outsourced due to the large volume of patient samples and lack of staff to deal with the workload. If our Irish labs were not understaffed we could have dealt with the workload and not have had to outsource our screening service.

http://www.thejournal.ie/smear-tests-outsourced-missing-3985784-Apr2018/

Excellent post.

So it seems that the problem here is that the Irish examiners spend more time per test, therefore get through x amount per day.
The American system spends less time time per test and as a result are able to get through y amount per day.
The HSE it can be argued then, outsourced to USA because they were getting more examinations for the same money. But the examinations were not the same. Someone should have known this.
Either that was not made clear to the team who agreed the contract or the team who agreed the contract were aware and did nothing.

On the subject of having more screenings examined here. That obviously isn't possible.
Where will the money come from to train/ employ more examiners at 30-40 tests per day?
Should there be a charge for the screening program?

Malayalam · 11-05-2018 01:01PM

I didn't hear her interview but Emma Mhic Mathuna's "In her own words" on page 3 of today Irish Times would break your heart.

Martina1991 · 11-05-2018 01:04PM

irishproduce wrote: »

The HSE it can be argued then, outsourced to USA because they were getting more examinations for the same money. But the examinations were not the same. Someone should have known this.
Either that was not made clear to the team who agreed the contract or the team who agreed the contract were aware and did nothing.

On the subject of having more screenings examined here. That obviously isn't possible.
Where will the money come from to train/ employ more examiners at 30-40 tests per day?
Should there be a charge for the screening program?

I don't know if it had anything to do with cost, but more so the work load. If we kept the Irish service the way it was, it would take months to get a smear result back.

It was made clear by the MLSA and Doctor David Gibbons (the chair of the cytology/histology group in the quality assurance committee of the National Cervical Screening Program) that it was not a good idea.

We all hear about the shortage of nurses to care for patients, well there is a shortage of Mecial Scientists to carry out the smear service. The money would have to come from the HSE to employ more staff.

Auguste Comte · 11-05-2018 01:09PM

irishproduce wrote: »

Excellent post.

So it seems that the problem here is that the Irish examiners spend more time per test, therefore get through x amount per day.
The American system spends less time time per test and as a result are able to get through y amount per day.
The HSE it can be argued then, outsourced to USA because they were getting more examinations for the same money. But the examinations were not the same. Someone should have known this.
Either that was not made clear to the team who agreed the contract or the team who agreed the contract were aware and did nothing.

On the subject of having more screenings examined here. That obviously isn't possible.
Where will the money come from to train/ employ more examiners at 30-40 tests per day?
Should there be a charge for the screening program?

They were warned by the very people who know about these things.

Doctor 'predicted cervical smear test issues 10 years ago'
Doctor 'raised concerns about outsourcing of Irish smear tests'
Dr Gibbons said he predicted problems would arise 'in 10-12 years time'
Explains how US screening does not suit Irish testing system
Doctor said he resigned from committee after concerns were allegedly dismissed.

arybvtcw0eolkf · 11-05-2018 01:11PM

Malayalam wrote: »

I didn't hear her interview but Emma Mhic Mathuna's "In her own words" on page 3 of today Irish Times would break your heart.

Here ya go. Grab some tissues. This is the saddest voice you'll ever hear.

The sadness is gut wrenching.

jmayo · 11-05-2018 01:15PM

Malayalam wrote: »

I didn't hear her interview but Emma Mhic Mathuna's "In her own words" on page 3 of today Irish Times would break your heart.

Actually heard live on air yesterday morning and as a parent it was gut wrenching.

I have to say it is one of the most powerful pieces of radio I have ever heard and I don't think ever heard an interviewer basically in tears.

Once that piece went onto the national airwaves o'brien's cards were stamped as there was no way in hell politicians could back him.

What has really saddened me is that there are posters here and elsewhere taking pops at this lady as being ridiculous for going to the Gardabout making a criminal complain or for the fact she sounded a bit unhinged in another interview.

It takes some lack of empathy not to feel for the woman.

One of the things she has said is she worries that her 2 year old will never remember her and that her 6 year old is asking when she will come back after she dies.

It really is sad and she is way more emotive than Vichy Phelan has been.
But how can one can blame her for being emotive as her 5 children are effectively going to be orphaned in the very near future.

Graces7 · 11-05-2018 01:19PM

jmayo wrote: »

Problem with letting the HSE do an internal investigation is they can't be trusted.

They had done an investigation into the screening service and as evidenced by the internal memos they did a VW/BMW on it and tried to manage the release of the detail.

In other words they tried to hide the fooking detail and when cases were taken they were party to gagging orders.

If the HSE and DOH was fit for purpose we would not be here in the first place, because when errors were detected in the screening service they would have held their hands up and have immediate disclosure.

And the reason that this is dragging on is that there is a drip drip feed of information from HSE and Dept of Health and recently some patients still hadn't been informed they were incorrectly diagnosed.

You claim you care about the patients, but in the same sentence you claim it is been given too much time and what is all the outrage about.

Fooking hell I would hate to see what you thought if you didn't care about the patients. :rolleyes:

HSE is not run for the patients, but for itself.

Amirani · 11-05-2018 01:23PM

jmayo wrote: »

What has really saddened me is that there are posters here and elsewhere taking pops at this lady as being ridiculous for going to the Gardabout making a criminal complain or for the fact she sounded a bit unhinged in another interview.

It takes some lack of empathy not to feel for the woman.

One of the things she has said is she worries that her 2 year old will never remember her and that her 6 year old is asking when she will come back after she dies.

It really is sad and she is way more emotive than Vichy Phelan has been.
But how can one can blame her for being emotive as her 5 children are effectively going to be orphaned in the very near future.

Her situation is unimaginably terrible and I have massive sympathy for her and her family. I completely understand her actions.

However, this is an online messageboard and I'm not talking directly to her. We can discuss this in a slightly less emotive way. The notion that the people in the HSE be arrested for attempted murder is ridiculous in my opinion.

Malayalam · 11-05-2018 01:24PM

Thanks for link, M. I will listen when I have access - phone is ancient, doesn't cope. Her story is archetypal and will linger in folk memory as a wakening moment, not that such can console her or her family. Heart wrenching indeed

Lackey · 11-05-2018 01:24PM

They knew damn well what would happen
Some very intelligent people quit their jobs in protest over the decision to outsource testing.

I hate our light judiciary.
and I call bullsh!t on every excuse, everyone knows if I do X ...Y could happen:

'I drank ten pints and got in me car but I didn't meant to kill them with me car'
'I played football with his head ...but didn't mean to kill him'

'I outsourced important testing to save money instead of spending money to hire more qualified staff to read the tests correctly. But I didn't mean for anyone to die'

Bullsh!t attempted murder... I sat why not?

seamus · 11-05-2018 01:28PM

iamwhoiam wrote: »

Do you know that sometimes even if you think something its best left unsaid .
This womans mind must be in total turmoil and her anger is completely and utterly understandable .To judge her now and to make her look small really only reflects on you to be honest

I don't judge her personally, but I do question the wisdom of the media plastering her interview everywhere yesterday, 24 hours after she received the news that her cancer is terminal.
It's understandable that she would want to shout it out loud and call out the error that's left her in this situation. But that doesn't mean the media should run with it.

IMO, it seems very ill-advised and they should have asked her to come back in a week or so, give her some room to gather her thoughts. To me there's some kind of morbid voyeurism in publishing such a raw interview.

arybvtcw0eolkf · 11-05-2018 01:35PM

jmayo wrote: »

What has really saddened me is that there are posters here and elsewhere taking pops at this lady as being ridiculous for going to the Gardabout making a criminal complain.

I read that post.

That person is beneath contempt, lording it over the thread trying to belittle people. Best ignored.

Just sat here listening to Emma's interview again (after posting the Podcast). I'm not one for showing my emotions or even posting about them here but I can't listen to her, that sadness without tearing up.

I can accept that there's a margin for error in these things, but when there was a cover up to protect a brand and when that cover up kills people (which is what's going to happen to these girls) then no one is being ridiculous leveling blame at Tony OBrien or anyone else involved.

I can't imagine the anger these women and their families are feeling.

Last May I was diagnosed with type II diabetes. During the initial diagnoses I asked how come I had diabetes in May and I was non diabetic on my annual medical in Dec (my job requires an annual medical).

The doctor looked back, asked about what I was told in Dec. I was told I was ok, I ask ever year because my father is diabetic.

The doc then tells me I was type II last December and for two years before that. Another doctor had read all my medicals and never informed me I was diabetic.

Now I won't die as a result, but I'm persuing that doctor for answers (can't get into the specifics here, sry). But had I seen that doctor that day I can't say that I wouldn't have tore lumps off him with the rage I was in.

More heads than O'Brien's must roll for this.

Amirani · 11-05-2018 01:41PM

Kaylee White Cherry wrote: »

I can accept that there's a margin for error in these things, but when there was a cover up to protect a brand and when that cover up kills people (which is what's going to happen to these girls) then no one is being ridiculous leveling blame at Tony OBrien or anyone else involved.

The problem with this is it's just factually incorrect. Any cover up didn't impact patient diagnosis and treatment, the audit of previous smears only happened after the cancer diagnosis.

ChikiChiki · 11-05-2018 01:43PM

Lackey wrote: »

They knew damn well what would happen
Some very intelligent people quit their jobs in protest over the decision to outsource testing.

I hate our light judiciary.
and I call bullsh!t on every excuse, everyone knows if I do X ...Y could happen:

'I drank ten pints and got in me car but I didn't meant to kill them with me car'
'I played football with his head ...but didn't mean to kill him'

'I outsourced important testing to save money instead of spending money to hire more qualified staff to read the tests correctly. But I didn't mean for anyone to die'

Bullsh!t attempted murder... I sat why not?

After a phone call yesterday I actually emailed loads of links of articles related to this scandal to a lawyer friend who specialises in medical law in Singapore.

She sent me a note earlier and is adament that there is a definitive strong case for gross negligent manslaughter here and it should be pursued. Said she was in tears reading about them mothers and the questions their kids were asking.

That radio broadcast is haunting. Been playing in my head all day. The voice of a woman with a death sentence. :-(

ChikiChiki · 11-05-2018 01:49PM

seamus wrote: »

I don't judge her personally, but I do question the wisdom of the media plastering her interview everywhere yesterday, 24 hours after she received the news that her cancer is terminal.
It's understandable that she would want to shout it out loud and call out the error that's left her in this situation. But that doesn't mean the media should run with it.

IMO, it seems very ill-advised and they should have asked her to come back in a week or so, give her some room to gather her thoughts. To me there's some kind of morbid voyeurism in publishing such a raw interview.

Now is the best time. Let the raw emotion shine through. The real pain needs to be displayed for change to happen. Government spin doctors would have done their utmost to quieten her over the week.

Smear Test Scandal

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