Khoo Teck Puat Hospital (KTPH) has apologised and will be giving compensation to breast cancer patients as a result of lapses at the healthcare institution that caused misdiagnoses over eight years.

Five employees, comprising KTPH’s management and staff, have been identified for not adequately performing their duties and responsibilities, which led to the serious lapses.

The penalties meted out against them include getting fired, fined, and receiving a stern warning.

Appropriate counselling, retraining and re-education are currently being conducted.

The National Healthcare Group (NHG) announced these actions in a statement on May 3, 2021, after investigations have been completed.

The NHG had set up the independent review committee to carry out a thorough evaluation of the misdiagnoses.

Eventual outcome

A Board of Inquiry (BOI) was set up after the review committee’s investigations.

The committee had sought to examine the roles, responsibilities and actions of specific staff involved before meting out disciplinary action.

A disciplinary committee was convened by the NHG Board in March after the BOI's deliberations.

Compensation will be looked into

The NHG statement also said "the appropriate compensation for each individual patient" will be looked into, now that the hospital has reached out to all affected patients.

But this process will “take some time” to complete, the statement added.

KTPH will also provide psychological counselling to these patients, where needed.

No mention was made as to the quantum of compensation for patients.

What hospital revealed previously

The hospital previously revealed in December 2020 that about 180 of KTPH's breast cancer patients may have been incorrectly diagnosed over the past eight years.

The patients were misdiagnosed with a type of malfunctioning gene, likely resulting in half of them having received unnecessary treatment.

What investigations revealed

It has since been found that the inaccurate human epidermal growth factor receptor 2 (HER2) positive rates were caused by a suboptimal HER2 staining protocol at the KPTH department handling these laboratory tests. 

In other words, the problem was caused by human error that led to over-staining of slides.

This resulted in a higher-than-usual HER2 positive rate, caused by the interpretation of the slides.

HER2 is a gene determining how a healthy cell grows.

Human error to blame

The deviation of HER2 positive rates from international benchmarks was noted earlier on during the laboratory’s regular monitoring, but detection of the error was delayed.

The deviation was instead attributed to differences in patient population, and staff failed to perform quality control checks properly, including monitoring and properly analysing the HER2 positive trend closely over time.

An internal review was only done in 2020 when the clinicians reviewing breast cancer cases noticed the higher than usual positive rate and sought to understand the deviation.

NHG said the investigations by the review committee revealed inadequacies in the quality control at KTPH’s HER2 immunohistochemistry section. 

Top photo via Google Maps