Up to 70 percent of patients with head or neck cancer treated at St. Vincent’s hospital in Sydney were given an incorrect dosage of the chemotherapy drug carboplatin for three years. The recommend dose is between 200 and 300 milligrammes but Dr. John Grygiel, one of the hospital’s oncologists, has been administering only 100 milligrammes of the drug since 2012.
“I think that he (Grygiel) felt that the dose he prescribed was genuinely effective and caused less side effects for patients,” says Richard Gallagher, St. Vincent’s director of cancer services. “(But) I still don’t understand where the mechanism or thought came from.”
St. Vincent’s accepted the error in August 2015 and started an internal investigation. The hospital points out that the practice did not have any negative consequences on the patient’s health.
Four patients had relapsed since then. However, this rate is said to be within normal expectations. Still, Gallagher admits that this demonstrates a breakdown in clinical governance.
The patients who experienced the recurrent disease have been informed about the under-dosage this week. The remaining 65 are still being contacted. “We’re working out how to do it. I mean, we’re not going to tell people at the end of an outpatients clinic that there’s been a problem with chemotherapy,” Gallagher adds. “We need to involve social workers, we need to involve people to have a discussion with them.”
Gallagher notes that Grygiel has been disciplined but continues to treat patients at St. Vincent’s under supervision.
The hospital declined to release the internal and independent investigations’ results. Grygiel was approached but he refused to be interviewed.
ABC reported that a failure in clinical governance at the Royal Adelaide Hospital (RAH) haematology unit resulted to 10 cancer patients receiving incorrect chemotherapy doses the patients where only given one dose of Cytarabine instead of two over a six-month period in 2014 and 2015.
“I am advised that Australian Health Practitioner Regulation Agency (AHPRA) is currently assessing this referral and the clinicians’ conduct for investigation and SA Health will make all relevant material available to that investigation,” said Health Minister Jack Snelling.