X-ray films and scans belonging to more than 100,000 patients were dumped in cardboard boxes lining a dirty hospital corridor and lay unchecked for years. Now the senior doctor who revealed the scandal that exposes the dire state of NHS diagnostic services has been sacked.
Radiologist Dr Otto Chan has spoken for the first time about the discovery that led to his dismissal. On two separate occasions, some 15,000 packets of films and scans were kept in corridors as the hospital had neither the manpower nor the money to analyse them all. It is estimated that only half of the films and scans were ever seen by a specialist meaning thousands of patients and their doctors will never know whether or not their images showed any signs of disease.
At one stage in 2002, the packages of films were locked away in a storeroom shortly before an official inspection visit. On other occasions, consultants would keep patients' x-ray films in their car boots because they were so worried they would go missing.
Each x-ray or scan should be read, or 'reported' by a radiologist trained to detect early signs of illness and infection, under medical royal college guidelines. But at Chan's hospital, Barts and the London NHS Trust, there was no computer system in place to count or record the images in question, so staff had no way of knowing how many images were stored or of cross-checking them with patients' records.
Dr Chan, 49 and a father of six, was suspended 18 months ago, and then dismissed last month - a decision he is now fighting. 'I believe I was sacked because I was marked out as a whistleblower and a troublemaker, and that's because I refused to accept that thousand of films lying jumbled up in a corridor constituted good patient care,' he said.
He revealed to The Observer that from 2000 the number of films started to accumulate in the Royal London. 'At first it was just few packets from outpatients and inpatients but gradually they built up. By 2001, it was 10,000 packets of film (each packet contains up to eight images) and by 2002, it was up to 15,000 packets. They were stuffed into boxes and kept in the corridor.
'One day I turned up and they had all disappeared. I tracked them down to a storeroom which had been locked, and it transpired that the inspectors from the Commission for Health Improvement [now the Healthcare commission] were coming round on a visit.' Managers at the time said that the move was taken to protect safety of patient records.
These films were finally read at the end of 2002 after Chan demanded action, and threatened to go public with it. But the hospital administration then allowed a second backlog of another 15,000 packets of film to build up between 2003 and 2004. This time, there was no agreement to read all of them. Apart from chest X-rays the second pile of films was never checked by radiologists.
The scandal may now be investigated by the Healthcare Commission, which looks at issues of patient safety. Charles Blakeney, a radiologist at the Royal London who worked for years with Chan, said: 'The way in which he [Chan] has been victimised is to my mind, disgraceful. He raised the issue of the unread films because it mattered to him that patient safety was being compromised. I was shocked beyond belief, as were many others, when he was dismissed.'
In January 2005, Chan was suspended and accused of professional misconduct. The trust, under threat of legal proceedings from Chan, appointed an internal investigation panel headed by a QC which took 12 days of evidence about the saga, and which included other doctors' accounts of the piles of films. The findings of the panel remain confidential but it is understood that in April this year, they concluded that although there were 'serious deficiencies' in his behaviour towards managers, he had made a 'very substantial contribution' to the trust, and they should consider re-employing him under a different structure.
Chan was therefore shocked to be told on 7 June that he was 'summarily dismissed'. His suspension and dismissal has cost the NHS some £1.5m but the amount will rise if the case goes to appeal.
In a statement last night, Dr Charles Gutteridge, medical director of the trust, said: 'It is true that at times in the past our radiology service experienced considerable pressure, due to the volume of films and a national shortage of qualified radiologists and radiographers. It should be emphasised that the images concerned were from patients with the lowest clinical risk. Patients with the highest clinical risk have always been reported urgently.'
He said that robust new protocols for reporting were introduced in 2004. 'The introduction of state-of-the-art digital imaging this summer will radically transform the way we capture, store and distribute images and reports.'
The trust management said that the recent dismissal of a consultant for gross misconduct followed a 19-month investigation, which included a formal hearing by an independent panel. 'The panel concluded that there were grounds for dismissal. The dismissal was in no way connected with issues with our radiology processes in the past.'
