Cancer smear scandal spreads

By FRANCESCA MOLD and FIONA BARBER

New medical misadventure claims by prostate and skin cancer sufferers whose slides were read by former Gisborne pathologist Dr Michael Bottrill are under investigation by ACC.

The revelation comes two days before a commission of inquiry into Dr Bottrill's reading of cervical smears between 1991 and 1996 is due to begin in Gisborne.

Alliance health spokeswoman Phillida Bunkle said the claims backed up her belief that the inquiry should be widened to include other cancer cases relating to Dr Bottrill's slide reading.

In response to questions from the Weekend Herald, ACC yesterday confirmed that 36 claims had been received by its medical misadventure unit.

Of these, two were for melanoma samples, one for breast and one for prostate. The breast claim had been declined. The other three were still under investigation.

Of the 32 cervical cancer claims, 10 had been accepted, two declined and 20 were being considered.

Ms Bunkle wrote to the Health Funding Authority last week detailing two non-cervical cases related to slides read by Dr Bottrill.

The first involved a 22-year-old man who died after a cancerous growth developed on his wrist. The second involved a 52-year-old woman who had radical surgery after a cancer was detected on her shoulder.

Ms Bunkle did not know whether those cases were before ACC, but said she would raise them at the Gisborne hearing.

"I still think there is a strong case to have the inquiry widened to include these cancers. There is no evidence the mistakes made by Dr Bottrill are limited to cervical smears."

However, Health Funding Authority spokeswoman Tracy Mellor said yesterday that the authority was aware of the ACC cases when it decided not to widen the inquiry beyond cervical screening.

A counsel acting for the inquiry, Royden Hindle, said lawyers or people giving evidence could raise issues about other cancers but the inquiry would focus solely on cervical screening.

"... The inquiry has enough on its plate with cervical smears."

Before deciding to restrict the inquiry to cervical screening, the authority commissioned a re-examination of cervical cancer and breast sample slides originally read by Dr Bottrill.

A Sydney laboratory found the former pathologist had identified only 101 of 857 it found to contain "high-grade abnormalities" or cases where "high-grade abnormality cannot be excluded." Dr Bottrill reported the rest of the slides to be low grade (180), outside normal limits (8) and normal (562).

A Christchurch pathologist re-read 380 breast slides and found that fewer than 20 results differed from Dr Bottrill's findings.

In the case of the non-cervical claims made to ACC, two kinds of specimens could be in question - slices of tissue (histology) and cells spread over a microscope slide (cytology). Prostate and breast samples can either come from fine needle aspirations (cells) or biopsies (tissue). Melanoma samples usually involve biopsies.

ACC said that to decide whether medical misadventure had occurred, it had to find that a personal injury had been caused as a direct consequence of an "adverse event."

It said that in all the Gisborne cases an adverse event had been established, because the misreading of the cervical smears had been proven. However, to establish personal injury, it had to be shown that earlier diagnosis and treatment could have "favourably altered the outcome."

Wellington lawyer Bruce Corkill yesterday confirmed that he was representing a woman with a complaint about the reading of a breast sample by Dr Bottrill.

Mr Corkill, who is appearing at the Gisborne inquiry, was not sure if his client was the same as the one before ACC. He also has another client with a non-cervical cancer case related to Dr Bottrill.