Mecklenburg County’s health director acknowledged Wednesday the agency may have failed to tell dozens more low-income patients about abnormal Pap smear results than previously disclosed.
Dr. Marcus Plescia told the Observer that officials are looking into as many as 100 additional cases after more records were reviewed.
Plescia also said his agency suffered past lapses informing patients who took HIV tests. Workers sent incorrect results to up to five people and took as long as two weeks to correct the error, he said.
Public notification of the problems came Tuesday night when County Manager Dena Diorio said 185 patients seen at clinics on Beatties Ford in west Charlotte and Billingsley Road in southeast Charlotte were not notified for as long as eight months about Pap smear exams. A nurse was supposed to inform the women immediately.
Early detection is considered key to preventing cervical cancer.
Wednesday’s disclosures intensified questions about what happened and who should be held accountable for the errors. County Commissioner Bill James said board members have been receiving phone calls and emails from Health Department employees, warning about problems that extend beyond the cervical screening program.
Commissioners said most of the women affected were Hispanic and some were undocumented immigrants, making it difficult to locate them. The county still hasn’t contacted 20 of the women whose test show potentially serious problems that need additional attention.
“Do we think this would have happened if these people lived in Myers Park or southeast Charlotte?” Commissioner Pat Cotham said. “This is a core responsibility. We have got to do better.”
Plescia apologized publicly Wednesday in a news conference for the error, but said he could not explain in detail what went wrong, in part because of personnel policies.
As a result, four people have left the health department, he said, but he would not identify them or say whether they were fired or allowed to resign.
Plescia blamed the mistake on a nurse whose job it was to talk to clients about their cervical cancer tests and on lax supervision.
“This was a person in charge of this particular task who was not doing what we needed them to do,” Plescia said.
“All I can tell you are four people are no longer with our clinical division as a result of this,” he said.
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.”
Finding the patients
In a press conference Wednesday, 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.
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.
But 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.
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.
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.
But he acknowledged “isolated” mistakes in past that he described as common to public health agencies.
Soon after starting his job three years ago, Plescia said officials learned that patients who took HIV tests were given the wrong results. That meant that people who were healthy where told they were HIV positive and others who were infected were left unaware, Plescia said.
He said officials corrected the mistakes in less than two weeks, meaning the issue was not systemic.
Some commissioners, however, want more assurance. The board voted Tuesday to bring in a third-party to investigate why patients were not informed about Pap smear results.
“The fact it occurred over an eight-month period tells me it was a breakdown in process and management,” Commissioner Jim Puckett said. “I have no confidence that other tests aren’t falling by the wayside. It’s illogical to say this is a single-case problem.”
Clasen-Kelly: 704 358-5027; @FrederickClasen
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 contact the agency at 704-336-4700 to receive them.
Have you been impacted by missteps in how the county handled test results? Contact reporter Fred Clasen-Kelly at 704-358-5107 or firstname.lastname@example.org