Mecklenburg County’s health director apologized for the error but repeatedly said Wednesday that he could not disclose exactly what had caused the agency’s failure to notify about 200 women of abnormal Pap smears.
“This was a person in charge of this particular task who was not doing what we needed them to do,” said Dr. Marcus Plescia in a press conference.
“All I can tell you are four people are no longer with our clinical division as a result of this,” he said.
Citing personnel policies, Plescia would not identify the workers or their positions or say whether they had been fired or left voluntarily.
“We are we are very, very concerned about this and apologize for this lapse. This is not acceptable,” Plescia said. “This is certainly inconvenient for the people affected.”
Plescia said the department is making special efforts to reach the women whose results indicated they should get follow-up tests including calling their phone numbers night and day and sending certified letters to them. Health workers will be sent to their addresses next week if they cannot be found through other means he said.
But Plescia stressed repeatedly that none of the women affected had Pap smear results at a stage requiring urgent follow up and none of them had cervical cancer, which typically takes years or decades to develop.
Plescia said that the failure to notify patients came to the department’s attention from a health-care provider for one of the women. He indicated that when the agency looked into the lapse, it was discovered that other women had not been notified of irregular results.
Plescia said it was discovered that one nurse in charge of follow ups was responsible. “A number of cases had piled up,” he said. “That’s all we know.”
Plescia said that the nurse should have been better supervised.
“There have been a number of breakdowns,” he said, without giving details. “There should have been more immediate supervision of her.”
County auditors were called in weeks ago to examine the agency’s practices with an eye to improving services. He also said steps have been taken to ensure there is no recurrence of the problem, but he gave no details.
Plescia also said that consultants may be called in to see how the department’s practices stack up against national standards.
Plescia’s remarks came after revelations this week that 185 low-income patients in Mecklenburg’s cervical cancer screening program last year were not told of abnormal test results up to eight months – even though they should have been contacted immediately when results were known.
Plescia said that reaching some patients is problematical because many of the department’s clients are low income and some are in transient lifestyles. Their phone numbers may have changed over the months the results sat undisclosed or the clients moved to new homes.
He said about 75 of the patients involved had symptoms considered mild to moderate on the Pap smears and needed follow-up examinations through time. About 55 of those have been scheduled, he said.
In an unusual move, a gynecologist was hired on contract by the department to examine the women affected by the notification failure to expedite their treatment, Plescia said. She started Monday.
Two clinics cited
On Tuesday, County Manager Dena Diorio told members of the Board of Commissioners that since discovery of the error, the Health Department has tried to contact the women and set up appointments.
But some patients who were seen at clinics on Beatties Ford Road in west Charlotte or Billingsley Road in southeast Charlotte have not been found, leaving them unaware that they may face potential health risks.
Tuesday was the first public notification of a lapse in the program, which was disclosed privately to commissioners in January. It came publicly after The Charlotte Observer began inquiring about potential failures on Monday.
Diorio did not identify the four employees no longer working for the department or say whether they had been fired or allowed to resign.
Commissioner Bill James said Tuesday that officials discovered the mistake when they “stumbled” across the fact that a stack of notifications for a nurse to follow up on “was just huge” with unanswered notifications. It took the county eight months to discover what went wrong, James said.
Health department clinics serve predominately low-income residents and are supposed to notify patients quickly about abnormal results from Pap tests. Plescia has said the department considers even a one- or two-week delay unacceptable.
Missing your results?
If you were given a Pap smear by the Mecklenburg County Health Department in the last year and did not receive notification of results, please notify the agency at 704-336-4700.