Dismissed U.K. whistleblower fires back

September 15, 2006

The bitter feud between a trauma radiologist and senior management at a top London teaching hospital shows no signs of easing.

The bitter feud between a trauma radiologist and senior management at a top London teaching hospital shows no signs of easing.

Dr. Otto Chan was fired from his job as a consultant radiologist at Barts and the London NHS Trust in June. Chan claims he was dismissed because he threatened to go public with allegations that the hospital was not reading all x-rays. The hospital said he was fired for gross misconduct. An appeal is pending.

The trouble started in 2002, according to Chan. One day he noticed that boxes of unread x-ray films that had accumulated over two years and had been strewn in the hospital corridors were missing. Each packet contained from one to eight images. He later found the boxes hidden in a locked room in anticipation of a government inspection.

"None of the CT scans, angiograms, or x-rays was read for two years," Chan said.

He reported the incident to the hospital, which then asked him to oversee the problem. He agreed to read all the films, which took him seven months at a cost of about $18,000, he said. By 2004, a second backlog of another 15,000 packets of film had accumulated. This time, the hospital refused his request to report all the films.

"These patients had fractures and cancers. Many patients had operations canceled because the hospital couldn't find the results of their x-rays," he said.

Chan threatened to go public with the problem. But shortly thereafter, in January 2005, the hospital suspended the radiologist on charges that included racism, bullying, and harassment. Chan said he was targeted because he was a whistleblower.

He challenged the suspension, and the hospital appointed an internal investigation. In April 2006, after 15 months of review and at a cost of nearly $3 million, the panel found no truth to any of the charges, Chan said.

"The panel said I was deficient with managers. Well, you can imagine that I was fiercely deficient with managers. When they tried to tell me not to report films, I told them where to go," he said.

Two months later Chan was fired.

Although the panel's findings are confidential, Chan said it had recommended reinstating him. In a written statement released by the hospital, however, medical director Dr. Charles Gutteridge said the panel concluded that there were grounds for dismissal.

"The decision to dismiss him was only taken after a 19-month investigation, which included a formal hearing by an independent panel comprising a senior barrister, a representative from the doctor's medical royal college, and an independent member," said Gutteridge's statement.

Because the investigation is continuing, the hospital would not grant requests to speak with several individuals, including a radiologist who Chan said was responsible for hiding the films, a human resources official who Chan said fabricated the charges against him, hospital CEO Paul White, and Gutteridge.

In an e-mail, Ray Dunne, senior press officer for the hospital, disputed British press accounts of the saga. He wrote that Chan was dismissed because of his behavior toward clinical colleagues and it had nothing to do with any concerns he may have had about x-rays.

Dunne also wrote that the x-rays didn't go unchecked, that clinicians had examined and acted on the x-rays but that the radiologist shortage caused delays in obtaining formal radiology reports. It's a well-known problem across all U.K. hospitals, he noted.

Dunne did not dispute the general outline of events given by Chan or the figures that Chan provided.

In his statement, Gutteridge said that the reporting delays affected only low-risk x-rays - films previously examined and acted upon by clinicians, including radiologists, but awaiting formal reports.

"We reviewed our procedures in 2004 and found that in some cases formal reports were not needed. We have since revised our reporting practices and increased the number of staff available to report on x-rays. All relevant x-rays are now reported on within appropriate timeframes," he said.

In a July 10 article, the Daily Mirror reported that at least 375 nurses, 152 doctors, and 35 other clinical staff are suspended at a cost of hundreds of million dollars a year. Many healthcare workers say the NHS Trust uses this tactic to get whistleblowers to keep quiet, according to the article.

In a Sept. 1 article, the Mirror detailed a list of problems at the hospital caused by what physicians say is management's focus on numbers rather than patients. Problems reported include potential spinal injuries not investigated because not enough radiologists were on duty and one interventional radiologist on duty where there would normally be five.

The paper reported that Chan criticized hospital management for allowing all but six radiologists to leave on vacation in August. He said their interest in saving money rather than lives could prove fatal in the event of a terrorist attack. The London NHS Trust was the hospital that treated most of the victims of the subway bombings in July 2005 and is also likely to be the location for imaging services at the 2012 Olympics.

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