180 breast cancer patients will receive compensation from Khoo Teck Puat Hospital (KTPH) for the misdiagnosis they received due to lapses made by staff members at the healthcare institution.
The independent review committee convened by the National Healthcare Group (NHG) had found that a suboptimal human epidermal growth factor receptor 2 (HER2) staining protocol at the KTPH department handling such laboratory tests had resulted in inaccurate HER2 positive rates.
HER2 is a gene that determines how a healthy cell grows.
The suboptimal staining protocol, said NHG in a statement on Monday (3 May), was caused by human error.
The overstaining of slides had impacted how the slides were interpreted, which in turn led to the inaccurate HER2 positive rate that was higher than usual.
Further, KTPH had failed to carry out stringent checks at the time the protocol was established. Such checks include monitoring and properly analysing the HER2 positive trend closely over time.
The error was only detected when clinicians reviewing breast cancer cases had spotted the abnormal positive rate, which prompted an internal review into the matter.
The patients were diagnosed over a period of eight years with a type of malfunctioning gene. Half of them had reportedly received unnecessary treatment as a result, according to the hospital in Dec last year.
Five individuals, including management and staff, were found to have fallen short of their duties and responsibilities in ensuring that the protocol was abided by, which had led to the lapses, said NHG.
Sanctions against them included terminating their employment at KTPH, financial penalties and a stern warning.
While NHG said that “appropriate counselling, retraining and re-education are currently being conducted”, it did not name the staff members who were implicated. NHG also did not disclose how many were let go or financially penalised.
KTPH medical board chairman, associate professor Pek Wee Yang said that the hospital “will look into the appropriate compensation for each individual patient”.
However, the amount of compensation was not mentioned.
Assoc Prof Pek added that KTPH will also provide psychological counselling where required for the affected patients.
Earlier this year, at least 200 breast cancer patients at KTPH were reportedly wrongly diagnosed with a more aggressive form of the disease than the one they actually had.
Some of the patients were consequently given unnecessary treatments that had likely cost each of them tens of thousands of dollars.
Following that, Senior Minister of State for Health, Koh Poh Koon said in Parliament on 4 Jan that the amount charged for the unnecessary treatments will be refunded to the affected patients.
“The portion of the bills which arose from the unnecessary treatment will be fully refunded,” said Dr Koh, adding that the refunds will likely total millions of dollars.
Tanjong Pagar GRC Member of Parliament (MP) Joan Pereira — one of the MPs who had posed questions in Parliament to Dr Koh regarding the KTPH lapse — asked Dr Koh in Jan if the affected patients will be compensated for psychological effects caused by the unnecessary treatment.
Dr Koh indicated that no compensation will be offered for psychological distress resulting from the lapse.
He said that “the portion of the bills which arose from the unnecessary treatment will be refunded” and that KTPH was “ready to provide clinical and financial support for the affected patients including ongoing and follow on treatments”.
Dr Koh also told Parliament that patient reclassification is “not necessarily a bad thing”, as “the preferred state” for cancer is over-treatment as opposed to under-treatment.
He added that not having HER 2 positive cancer would mean that patients have a better prognosis.
On 11 Dec last year, KTPH revealed that about 180 patients had been wrongly diagnosed with HER 2 positive breast cancer, a less common form of breast cancer and normally affects 15-20 per cent of such patients.
It added that it was also reviewing tests conducted since 2012.
In Mar this year, Professor Chua Hong Choon, former chief executive officer of the Institute of Mental Health replaced Mrs Chew Kwee Tiang as the KTPH CEO.
No statement, however, appeared to have been made by either the hospital or NHG on the matter.
Prof Chua’s replacement of Mrs Chew raised questions on whether she was given the boot due to the misdiagnosis fiasco in Dec last year.
TOC had reached out to KTPH on 5 Mar about the change in CEO but did not receive any response from the hospital regarding the issue.
Also read: KTPH misdiagnosis scandal – What happens if there are side effects further down the line?