May 26, 2010

USA: Heart Tests at Hospital Went Unread

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NEW YORK, NY / The New York Times / TimesPeople / New York Region / May 26, 2010

Heart Tests at Hospital Went Unread

By Anemona Hartocollis

Nearly 4,000 tests for heart disease performed over the last three years at Harlem Hospital Center — more than half of all such tests performed — were never read by doctors charged with making a diagnosis, hospital officials acknowledged Tuesday.

The echocardiogram tests, a type of ultrasound used to evaluate heart muscle and valve functions, were ordered by doctors at the hospital. The tests were stored on a computer and basically forgotten, officials said.

The lapse occurred because the cardiology service at the hospital had developed a system by which technicians were given the responsibility to scan all tests and flag any that looked abnormal, so that they would be given priority when doctors read them.

It appears, officials said, that the tests that were not flagged were put aside and forgotten.

The city’s Health and Hospitals Corporation, which runs the public hospital system, including Harlem Hospital, and Columbia University, whose medical school supplies the cardiologists who work at Harlem Hospital Center, acknowledged the problem in a joint statement on Tuesday, after being asked about it by The New York Times.

Seniors World Chronicle
invites readers to visit the
Harlem Hospital Center's website
to view this presentation by
Alvin D. Aviles
on  the hospital's
Safety Story titled
BELIEVING


“While the process the doctors followed may have alerted cardiologists to those echocardiograms that were most likely to be abnormal, the failure to read the echocardiograms in a timely manner is inexcusable and may have placed patients at risk,” Alan D. Aviles, hospitals corporation president, said in the statement.

It was unclear who developed the screening system, hospital officials said.

Mr. Aviles said he had fired the clinical director of Harlem Hospital’s department of medicine, Dr. Alfred Ashford, and demoted the medical director, Dr. Glendon Henry, to attending physician at another hospital. The two doctors were also reported to the state Office of Professional Medical Misconduct for further investigation, the statement said.

Reached at home Tuesday evening, Dr. Ashford said: “I can’t help you at this time. I have to see what’s going on tomorrow myself.” Asked if he had been fired, he said, “That’s what I’m hearing, also.”

Dr. Henry was not home when called there on Tuesday night.

Hospital officials said the backlog was discovered during a routine review of records by Columbia University’s affiliation staff, and reported to the city hospitals corporation on Thursday. A team of 15 to 20 doctors from other city hospitals was assembled to begin reviewing the records on Friday. By Tuesday, they had reviewed 1,500 and found no patients who needed treatment, officials said.

All patients will be notified of the problem and told if they need follow-up treatment, officials said. Harlem Hospital conducts about 2,500 echocardiograms a year, officials said, which means more than half the tests conducted in the past three years were never reviewed by cardiologists.

Corporation officials said the system of having technicians screen test results and prioritize them for doctors to review was unique to Harlem Hospital.

The corporation has an affiliation contract with Columbia, which provided a number of doctors to Harlem Hospital, including Dr. Ashford and Dr. Henry, officials said. Columbia hires and manages those doctors.

In 2008, Columbia announced that Dr. Ashford, a graduate of Georgetown University School of Medicine, had been appointed senior associate dean of the Harlem Hospital Center affiliation, overseeing clinical operations, academic and research programs, and administrative management for the affiliation.

To prevent anything similar in the future, the city and Columbia have revised their policy to require that all echocardiograms are reported to physicians within two working days, the hospital corporation said. The hospital’s medical director will make monthly reviews of the number of unread tests and report those numbers to the corporation’s board every three months.

The corporation said other disciplinary action could be taken after the investigation had been finished.

Patients who have received an echocardiogram at Harlem Hospital can call the city’s 311 hot line to learn the results or to confirm any results already received, hospital officials said.  [rc]

Copyright 2010 The New York Times Company