B.C. hospital fails to warn woman of potential lung cancer for 11 months
NDP health critic blames Liberal government for 'unacceptable' and 'avoidable' delay
It took almost a year for a Vancouver hospital to contact Jenny Reiderman to tell her a suspicious nodule had been spotted on one of her lungs.
She received the crucial results from an emergency room doctor 11 months after having an X-ray.
Further tests revealed she has lung cancer, which has spread to her lymph nodes.
Now the 63-year-old is wondering if she'll see her 64th birthday.
She is also left wondering if earlier detection would have prevented the cancer from metastasizing.
"I really want to survive,"Reiderman says, gently touching her hair, now thinning from radiation and chemotherapy treatments.
In August 2014, Reiderman was feeling dizzy, and a blood pressure test at a local pharmacy was sky high, so she went to the emergency department at Vancouver General Hospital, where an ER doctor ordered a chest X-ray.
"And then they sent me home," she says. "They didn't tell me anything about the X-ray."
To her surprise, 11 months later a letter from the ER doctor arrived at home, saying "there is a suggestion on the X-ray that there may be a lung nodule."
The attached X-ray report noted a six-millimetre nodule and recommended a follow up CT scan.
Reiderman says she is "heartbroken" the doctor took so long to contact her, and feels the letter downplayed the seriousness of the X-ray results.
"You don't have to be a professor to know what happens when you leave the cancer untreated," she says. "So ... it is devastating."
Doctor reluctant to leave voicemail
Reiderman asked the hospital to explain why it took 11 months to be notified of such a serious finding.
In a letter of response written by the emergency room physician, Dr. Heather Lindsay says she doesn't remember the specifics of the case, but admits there are some "pitfalls in the overall system."
She says she received the radiology report "through interdepartmental mail."
But because Reiderman didn't have a family doctor, Lindsay says she likely tried calling the patient "for several months," never leaving a message due to privacy concerns.
Nine months after the X-ray, Lindsay wrote a letter, which took another two months to arrive in Reiderman's mail.
"Jenny basically is with her phone 24/7 because she works on-call," says Reiderman's friend Michael Cowan.
"How hard is it to leave your name, and a phone number? And say, 'Please call back at your earliest convenience.' That's just...not acceptable," Cowan says.
"It could have saved my life," Reiderman adds.
Go Public's request to speak with the physician was denied by Vancouver Coastal Health, the health authority responsible for the hospital.
No one from Vancouver Coastal Health would agree to an interview, either.
Early detection crucial
Lung cancer expert Dr. Karen Kelly treats patients at California's UC Davis Medical Center.
She says early investigation of a lung nodule is critical, in case it is cancerous.
"There's no question about it," says Kelly. "The outcome is definitely better if we can catch it as early as possible."
No one knows whether Reiderman's cancer had already spread at the time of the X-ray, because further testing wasn't done right away.
It's also hard to know what happened to Reiderman's file — whether it lingered in the hospital's radiology department, or sat on the ER doctor's desk for months.
"The system shouldn't allow people to make these mistakes," says Reiderman. "There must be certain protocol."
In an email, a spokesperson for Vancouver Coastal Health says the hospital is working to improve communication between radiology and emergency departments, and that radiology is moving to a new computer system that will have better alerts for physicians, "using a stoplight-style system with reports coded green, yellow and red ... to better support timely care decisions."
Delay was avoidable
"What happened is completely unacceptable," says MLA Judy Darcy, the NDP's health critic. "It is tragic that this woman waited 11 months, and in the meantime, her cancer got worse."
Darcy says having an electronic health record system in place at the hospital would have alerted the ER physician to the urgency of Reiderman's case — much like the hospital's computerized "stoplight" system that's supposed to roll out in the fall.
"What we have in this situation is someone in a hospital not communicating with someone else in a hospital ... quickly," says Darcy. "An electronic health-record system would mean that everybody is being communicated with, instantaneously."
Darcy points to Ontario, where every hospital can share diagnostic images and reports digitally with other departments, other hospitals and health-care providers within their region.
B.C. Liberal Health Minister Terry Lake told Go Public that an electronic system for sharing crucial health data is key.
"So we are moving in that direction," says Lake. "But there's not a jurisdiction yet — whether it's in the United States, or Canada — that has all of that integration."
B.C. lags behind other provinces
Go Public checked with health ministries in Ontario, Alberta, Manitoba, Quebec and Nova Scotia, and despite challenges, all those provinces have some form of integrated electronic health-record system, where tens of thousands of health-care providers have instant access to shared patient information.
Hospitals in all five provinces can already share diagnostic images, lab results and other clinical information. In February, eHealth Saskatchewan announced a pilot project that would let some patients access their medical records online.
The B.C. government promised an integrated e-health record system in 2006, but 10 years and almost $200 million later, there is still no widespread system in place.
"This woman's life is at risk because of serious, serious failing in the health-care system," Darcy says.
A spokesperson for the B.C. Ministry of Health downplayed the importance of an e-health record system in this case, saying there wouldn't have been an alert mechanism that would have made a difference.
Vancouver Coastal Health has launched a patient review as a result of Reiderman's experience, and says the results will be shared with other health authorities in B.C.
Reiderman hopes it will all lead to change.
"I thought that maybe my story will help make sure that it won't happen to somebody else," she says. "I felt like I was just left for dead."
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With files from Enza Uda