Mecklenburg County manager Dena Diorio on Friday defended her handling of the health department’s failure to notify 185 women of their test results for cervical cancer and announced a three-pronged review of department practices.
Some county commissioners question whether their first briefing on the matter, in January, should have been behind closed doors and suggest the county meant to hide embarrassing information. Diorio publicly revealed the issue on Tuesday after Observer inquiries.
At a press briefing, Diorio said she didn’t disclose the problems sooner because not all the women affected had been contacted – all but 20 now have been – and she didn’t want to alarm them.
“If we had gone out with this early on, there would have been scores of women out there who would be wondering if it was them that had been impacted,” she said. “We didn’t want to create a public health scare by putting information out there without understanding what the scope was. We really made a concerted effort to hold back the information until we had an opportunity to contact every single patient who was impacted.”
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Diorio said commissioners’ briefings on Jan. 10 and Feb. 7 were closed, on legal counsel’s advice, because an employee investigation was underway. It’s not necessary that the names of the four health department employees implicated be revealed at the meeting – they weren’t – to legally close it, she said.
Diorio said there was no “attempt on my part to hide, deceive or cover up anything.”
Jonathan Jones, director of the N.C. Open Government Coalition at Elon University, has said if specific names weren’t shared, the personnel exception to the state’s open meetings law would not apply.
Changes are underway at the health department, Diorio said. All women will now get test results within 30 days. Two additional staffers will be hired to ensure timely followup of all test results, including Pap smears for cervical cancer. A clinic manager to oversee operations is expected to start work in April.
An internal audit to identify potential patient care problems will be completed by spring. The North Carolina Division of Public Health will assess the department’s compliance with state and federal standards, and an independent consultant will look at all clinic operations.
Four people have left the health department because of the error, including the triage nurse authorities blame for the delays in notifications. The county, citing personnel confidentiality requirements, has not identified them.
County officials say they believe they now have a full accounting of all the women affected. The triage nurse in question was preceded by a woman with 20 years of experience and in whom Dr. Marcus Plescia, the county health director, said Friday he had “complete confidence.”
Problems in Pap smear notifications at the department appear to have been occurring for about eight months. Early detection is considered key to preventing cervical cancer.
Plescia said that while some of the affected women need followup treatment, none showed signs of cancer. “I understand this could cause people a great deal of anxiety, but there were no other medical concerns,” he said.
The department has verified that an additional 115 women who were documented to have been notified of test results actually got them, Plescia said.
Notifications from public health clinics were not sent to women – many of them poor or Hispanic and some undocumented – who needed follow-up care or counseling because of abnormal results. Public health employees are knocking on doors to try to find the final 20 who have not been contacted, Diorio said.
Health clinic workers discovered that the notifications had not been made Dec. 12, Diorio has said. She said she and Plescia, the county health director, were not informed until Jan. 4.
Commissioners debated the issue publicly Tuesday night, voting for Diorio to seek an independent review of the county’s actions and report back to the board.