UPDATED – A Powell River resident received two contradictory letters last week from Vancouver Coastal Health concerning a CT scan read by Dr. M. (Charlie) Parmar.
Powell River Brain Injury Society executive director Debbie Dee told the Peak that the resident who received the two letters is a a client of the society. For his own privacy, the man did not wish to be named. Dee explained that he went for a CT scan last August to determine whether an aortic aneurism had shrunk or grown larger. His doctor told him that the CT scan showed that the aneurism was smaller, good news at the time.
The two letters are both dated February 8 and are both signed by the same physicians. Both explain that his CT scan had been read by an unqualified radiologist and both assure him that VCH is doing all they can to rectify the situation. One letter states that no discrepancies were found between the two readings of his scan and that the man has no reason to worry. The other letter reads that a discrepancy has been found that “could potentially be significant.”
Dee said the man is stressed about his health now and is questioning what information to trust. The man also has a brain injury and is not able to quickly make sense of problems or make plans. He is seeing his doctor on Friday, February 18 and hopes he will help him make sense of his situation.
“He said ‘I don’t believe either one now and now how am I going to believe anything about the CT scans?’” said Dee. “In trying to mitigate the outcome of a problem, they’ve created more of a problem.”
NDP interim leader Dawn Black and Sunshine Coast-Powell River MLA Nicolas Simons addressed questions about the letters in legislature today Thursday, February 17, to Minster of Health Colin Hansen. Black asked for an apology from Hansen to the constituent and demanded an explanation, asking “what on earth is going on?
“Can you imagine? Can you imagine for a minute what this patient is actually going through?” Black asked Hansen. “How is he supposed to have any confidence in his care?”
Hansen said that he was not aware of the letters, but agreed that their recipient deserved an apology from the ministry, VCH and the physicians involved. He gave assurance that the review by BC Patient Safety and Quality Council chair Dr. Doug Cochrane would look into questions surrounding the handling of the situation.
“I do give my full apology,” said Hansen, “and we will certainly be following up to make sure that all patients that have been involved in this get access to the medical care that they need and they deserve.”
In another case, Laura Bazille-Moser, daughter of John Moser who died in January and potentially had a CT scan misread by Parmar, has come forward about a letter of her own concerning another CT scan read by the rdidologist.
Bazille-Moser had her back scanned on August 11, 2010, the day after her father had his own scan over concerns of cancer. She had been having chronic pain since an injury sustained at work. She had an operation but after the pain began to get worse, she went in for a CT scan. Her doctor told her that nothing came up in the scan and that her back was no worse then before.
The pain worsened over time to the point that Bazille-Moser started to lose feeling in her lower body, a problem compounded by her diabetes. She said she has been told by doctors since her CT scan showed that there is nothing wrong, that stress is causing her pain. At one point doctors prescribed her antidepressants, which she took for a short time before deciding to stop.
Her letter from VCH told her that a discrepancy had been found between Parmar’s original reading of her CT scan and a new reading given during its review process. Bazille-Moser has an MRI booked for March, at which time she hopes to find out the real cause of her pain. The stress of her father’s death, the news that a misread CT scan may have contributed to the spread of his cancer and now her own health concerns has left Bazille-Moser without any trust in the health care system.
“I want those accountable to be accountable. I really do,” said Bazille-Moser. “I want the people who are accountable to come clean and actually take responsibility....whatever they have to do, do the right thing.”
She said that she is considering legal action. She hopes that others affected by this situation will come together to form a class action suit.
BC launches probe into radiologists - Hundreds of CT scans and ultrasounds in question
Wednesday, February 16 – Patients who had CT scans and obstetrical ultrasounds read by an unauthorized radiologist in Powell River are demanding to know how this happened.
On Friday, February 11, the ministry of health services and Vancouver Coastal Health (VCH) announced at a press conference in Vancouver that a Powell River General Hospital radiologist was not authorized by the BC College of Physicians and Surgeons to read either tests.
Dr. Mansukhlal Mavji (Charlie) Parmar had been a radiologist at Powell River General Hospital since August 2002. After the hospital’s former radiologist retired, it took more than a year of searching to fill the position. As a condition to obtaining his licence to practice in BC, Parmar volunteered to the college that he would not be reading CT scans or obstetrical ultrasounds.
Despite the voluntary restrictions, VCH confirmed that Parmar had been reading and administering obstetrical ultrasounds throughout his tenure at the hospital and had been reading CT scans since the arrival of the CAT scanner in April 2010. According to VCH, concerns were raised by hospital staff in October 2010, at which time Parmar was no longer allowed to perform those duties. He was kept on at the hospital until the day before the ministry’s announcement, when he “voluntarily stepped down.” In that time he had been performing duties that he was qualified to do, such as reading X-rays and performing other types of ultrasounds.
During his tenure at the hospital Parmar read around 900 CT scans and 2,300 obstetrical ultrasounds, according to Dr. David Ostrow, VCH president and chief executive officer. Of those 900 CT readings taken between April and October 2010, Ostrow said that 28 had major discrepancies between Parmar’s reading and an independent second reading undertaken during VCH’s review of the situation. He confirmed that some of those patients may have been misdiagnosed. Three patients were identified as requiring “further action.” All patients with discrepancies in their scans have been notified.
“There’s still a lot of unanswered questions, but I think the patients in British Columbia who need to be concerned have been notified and their family doctors have been notified,” said Colin Hansen, minister of health services, at the press conference. “There is not a reason for the general public or others that have been treated in these health authorities to have concerns if they have not been directly notified.”
Janet Baird lost her father, John Moser, 76, on January 2, 2011 and is among those who have been notified by VCH that there may have been a misreading of a CT scan. Moser overcame esophageal cancer in 2006. During the summer of 2010 Moser fell ill again. He had a CT scan in August, which he was told came back negative. His condition worsened, he lost a considerable amount of weight and came back for another CT scan in December.
This scan, read in North Vancouver and not by Parmar, revealed Moser’s body to be riddled with cancer. Moser had spots on his ribs, his liver, his lungs and his skull. Baird said that she was told to take her father home to die. On February 11, just over a month after Moser passed away, the call came from VCH. Baird said the news has traumatized the family, who are left to wonder what could have happened if the cancer had been detected back in August. At the very least Baird wonders whether they could have made him more comfortable in his final months instead of taking him from test to test, even a psychiatrist, trying to figure out what, if not cancer, was wrong.
“This is due diligence?...This is people’s lives that they’re screwing around with. They don’t have a right to do this,” said Baird. “We’re in shock. It was bad enough what he went through, that was the biggest nightmare, watching what my dad went through. Then to have this on top of it.”
Ostrow said at the press conference that about 70 patients died in Powell River between April and October and that they are investigating whether “any potential misinterpretation may have contributed to their death.” For now the focus is on living patients and VCH is contacting all family doctors and patients who had scans read by Parmar. All pregnant women who had ultrasounds from Parmar are also being notified and referred to Comox for a new ultrasound if still pregnant.
Powell River-Sunshine Coast MLA Nicholas Simons received a letter from a constituent in December 2008 complaining about Parmar and questioning his abilities as a radiologist. Simons passed this letter on to then minister of health George Abbott who said he passed the complaint along to the college of physicians and surgeons, who responded that they would contact the doctor in regard to the complaint, Simons said.
Simons wrote in his letter to Abbott that it “is a story of multiple misdiagnoses, repeated disbelief, filing of second opinions, shock, major surgery, continuing rehabilitation and frustratingly inaccurate medical records.”
The ministry has ordered an independent two-part investigation into the issue, to be led by the chair of the BC Patient Safety and Quality Council, Dr. Doug Cochrane. The investigation will first ensure that all radiologists currently working in BC are certified to perform their duties. From there the investigation will look into Parmar’s case along with another one linked to a temporary radiologist who practiced briefly in the eastern Fraser Valley in the fall and a third involving a radiologist at St. Joseph’s General Hospital in Comox who has now been stripped of his privileges.
None of the radiologists in question are currently practising in BC.
Trudi Beutel, spokesperson for VCH, said that the investigation will determine why Parmar was allowed to perform the readings for so long.
Hansen said that the concerns have not been public until now in order to avoid unnecessary anxiety and he reiterated that all those who need to be contacted have been. Hansen said that his concerns over how the situation was handled prompted the independent review.
CT scans are still being performed in Powell River but are being sent to North Vancouver for interpretation. All ultrasounds are being administered in Comox.
VCH has established a toll-free line for general questions at 1.877.993.9199. People can also email [email protected]. As well, VCH has assigned a dedicated patient care coordinator for patients affected by this situation.
Any Powell River residents affected by this situation can call Kyle Wells, Peak reporter, at 604.485.5313, or Simons office, 604.485.1249, to share their stories.
