The West Island Health and Social Services Centre announced that it will be proceeding, in the coming weeks, with the recall of colonoscopies of 684 patients who underwent this examination between 2009 and 2012 at the Lakeshore General Hospital.
“The recall of these examinations comes as a result of a detailed evaluation carried out by the West Island HSSC (done in April) which indicated that colonoscopies carried out by a doctor practicing within the organization during this period may be incomplete,” said president of the HSSC’s council of physicians, dentists and pharmacists (CPDP) Dr. Richard Germain.
A colonoscopy is a test that allows physicians to examine the inside of the colon. “The colonoscopy enables the physician to detect problems such as areas of inflammation, lesions, bleeding or abnormal masses,” explained Dr. Nadeem Ahmed, gastroenterologist at the HSSC.
A single physician identified as Dr. Gilles Bourdon handled the botched colonoscopies. Germain mentioned he quit the hospital in late January for reasons other than the colonoscopy problem. The staff of the HSSC isn’t able to assess whether the exams were done completely or not based on the evidence they possess. Germain suggested Wednesday that Bourdon might have missed some landmarks during the exams given the information the HSSC has in hand.
The HSSC estimates that up to six per cent of patients (41) could have received a negative diagnostic meaning a cancer could have went undetected for those.
Normally, during a colonoscopy, the colon is examined in its entirety with a camera and it is recognized that the doctor has reached the end of the colon by locating certain landmarks. What's generally accepted is that by seeing these landmarks, you can make photographic confirmation, providing photographs which are appended to the colonoscopy report.
If one is not able to conclusively see those landmarks, one might consider that they haven't examined the entire colon. If one doesn't provide photographic evidence of that, if the physician isn't confident he has examined the entire colon, there are further evaluations which can be done including a barium enema or a CAT-scan colonoscopy which can be done as a supplemental exam to confirm that the entire colon has been examined.
The analysis pursued by the CNDP in April suggests that the proper follow-ups weren't done to the incomplete colonoscopies.
"Making an incomplete colonoscopy is not an exceptional situation in itself but when this happens, when we are faced with such an incomplete exam, a follow-up is necessary. Lack of information in the medical records does not allow us to conclude in this case that the follow-ups were conducted, "said Germain.
"Sometimes a colonoscopy is conducted in an incomplete fashion because of patient discomfort, poor preparation that does not remove all feces from the intestine or a tortuous colon which makes the examination difficult. In the case where the test cannot be performed in full, the doctor must provide a monitoring procedure to examine the portion of the large intestine that could be seen as an enema or virtual colonoscopy," said Ahmed.
On her part, Geraldine Matthews, specialized units coordinator, wished to reassure patients last Wednesday: “All concerned patients have already been contacted this week (last week) by registered letter and we will determine with each of them the appropriate time to repeat their examination. This colonoscopy repeat is carried out as a preventive measure to dissipate any worries or questions that patients or their physicians might have. Our concern is to offer the best possible care.”
In order to accelerate the colonoscopies and avoid wait times, the patients concerned will be seen evenings and weekends by a team at the West Island HSSC. They can also be referred to other Montreal hospitals with which agreements were made.
Patients or their loved ones who have questions regarding this matter may contact the HSSC at the information line dedicated to the recall at 514-630-2105.