Radiology review spreads to mammograms, ultrasounds

The health authority has begun re-reading more than 2,700 CT scans, as the work of a radiologist who has been at St. Joseph's General Hospital for more than 30 years is being investigated.
The initial review, which began this weekend, impacts 2,723 CT scans involving 2,490 patients, according to a news release from the Vancouver Island Health Authority (VIHA).

The health authority has begun re-reading more than 2,700 CT scans, as the work of a radiologist who has been at St. Joseph’s General Hospital for more than 30 years is being investigated.The initial review, which began this weekend, impacts 2,723 CT scans involving 2,490 patients, according to a news release from the Vancouver Island Health Authority (VIHA).Other scans read by the radiologist under investigation, who has been identified in the media as Dr. Jose Zanbilowicz — such as ultrasounds and mammograms — will be reviewed as well.VIHA anticipates that the CT scan review and notification process will be completed by March 31 at the latest.VIHA is supporting St. Joseph’s General Hospital (SJGH) with the review process — which was announced early last week — including carrying out secondary reads of scans, analyzing the results and notifying patients and physicians as required and as appropriate, according to the release.Computed tomography (CT) scans are the primary focus of the review, but it will include other scans as a precaution.”While there is no indication of any pattern of errors made in other modalities (X-ray, mammography, plain film, ultrasound) read by this radiologist at this time, a quality assurance review will be undertaken to assure patients that these scans were read correctly,” stated the release.This process will follow the CT scan look back, according to VIHA.Zanbilowicz has been reading mammograms for the BC Cancer Agency’s Screening Mammography Program (SMP) since 1999, according to BC Cancer Agency spokesperson Lubna Ekramoddoullah.”The radiologist in question had no issues in his most recent review, and we’ve had no issue with him in the 11 years he’s been with the Screening Mammography Program,” she said.The BC Cancer Agency asked Zanbilowicz to step down from reading mammograms shortly after his privileges were removed from St. Joseph’s in mid-January.”We didn’t ask him to step down because we had concerns over the quality of of scans,” said Ekramoddoullah. “We just asked him to step down because he wouldn’t be available to read them.”Two radiologists have been administering the SMP program in Comox, which covers St. Joseph’s and Campbell River, she explained.Since the need for a CT scan review was first announced Feb. 14, VIHA and St. Joseph’s have been working with Dr. Doug Cochrane, chair of the BC Patient Safety and Quality Council, to determine the scope of the review and timelines of scans to include.Based on the advice of Cochrane, the initial review at St. Joseph’s will include CT scans performed in January 2011 and back to August 2009.The review only includes scans read by the one specific radiologist, and, if required, it could be extended further back in time, according to VIHA.The secondary reads of CT scans are being carried out by fully qualified and credentialed VIHA radiologists who are performing the reads in an anonymous fashion — meaning they do not have access to the original CT scan report, according to VIHA.The secondary read report is then sent, along with the original report, to a third radiologist. This third radiologist acts as an “adjudicator” by reviewing both scans and determining if a discrepancy exists, noted the release.As assessments are completed, patients or next of kin will be notified by registered mail. The patient’s family physician and the physician who ordered the CT scan will be notified by fax and by registered mail or courier. Patients who do not receive a letter are not impacted by the review process.Cumberland’s Yvonne Kafka is calling for a full judicial inquiry into radiology in B.C., but Comox Valley MLA Don McRae is eager to see what Cochrane will recommend as the next step.”At this stage, one of the big problems we have is all the facts are not known,” he said. “Colin Hansen has asked Dr. Cochrane for a report within the month that will include all of the training and procedures taking place. Judicial inquiries can cost millions of dollars and take lots of time, and it’s very important before we decide anything to have all the facts.””I’m very hopeful Dr. Cochrane’s report will be very all-inclusive and will have very solid recommendations people can see us act on,” he added.Patients with questions or concerns about medical scans are encouraged to call their doctor or referring medical specialist. Patients can call St. Joseph’s at 1-877-336-1406 or HealthLink BC at 8-1-1. Concerns about mammography can be directed to the SMP at 1-604-877-6200.writer@comoxvalleyrecord.com