An extra 28 patients have been identified in NSW as being prescribed the wrong dose of chemotherapy; on top of the 130 head and neck cancer patients already identified at Sydney’s St Vincent’s Hospital.
But the final report from NSW Health, which looked at the Sydney-based doctor’s work at Orange and Bathurst hospitals; found “the effect of this practice on individual patient outcomes cannot be determined”.
The investigation, led by chief cancer officer Professor David Currow, was only able to examine around 300 patient records from January 2006 to February this year.
Health Minister Jillian Skinner defended the scope of the investigation on Tuesday saying; records had been difficult to obtain because Dr.Grygiel was working as a private practitioner.
“He wasn’t on the (NSW Health) staff and his prescriptions went to local pharmacies,” Ms Skinner told reporters.
The investigation will continue if the department gets access to the Pharmaceutical Benefits Scheme records from the Commonwealth government. It’s “quite possible” the patient toll could rise by one-third once those records are made available, Prof Currow said.
“We expect that number will rise but that it will rise modestly from here,” he said during a joint press conference with the minister.
The report has urged the department to consider; “mechanisms to capture systemically the prescribing of oral chemotherapy” across the state.
It’s also recommended evaluating every person registered with the NSW Cancer registry who has had; an “off-protocol dose of 100mg carboplatin or reduce dose of capecitabine”, and reviewing FIFO clinical service arrangements in local health districts.
The government will implement all 16 recommendations in full, Ms Skinner said.
An extra $1.5 million has also been allocated to “ensure” rural cancer services in western NSW. New software is being rolled out across public hospitals. It will ensure chemotherapy is given to patients in the right doses and can be monitored electronically.
WERE PATIENTS IMPACTED?
Dr Grygiel has faced scrutiny over his actions after allegations he gave lower doses of chemotherapy to his cancer patients; despite not having any published protocol to show this worked.
Of the 130 patients under his care at St Vincent’s, 37 have since died but it’s unclear whether his treatment was to blame.
Nine of the 37 reportedly died from non-cancer or unspecified causes, while 42 are now cancer-free.
According to The Daily Telegraph, Dr Grygiel has since launched an unfair dismissal case after being sacked from St Vincent’s.
Chief cancer officer Professor David Currow’s investigation found Dr Grygiel prescribed “off protocol” low doses of Carboplatin between 2006 and 2015.
There have been calls for embattled Health Minister Jillian Skinner to set up a Special Commission of Inquiry into the scandal.
“Minister Skinner has consistently sought to avoid responsibility or cover up the seriousness of this scandal,” NSW Greens health spokesman Jeremy Buckingham told AAP.
Dr Grygiel moved to St Vincent’s Hospital in 1992. Continued his outreach work in the state’s central west until March 2013.
He was sacked by St Vincent’s last month following Prof Currow’s first report. The report said it wasn’t feasible to conclude whether the deaths or current survival rates of affected patients could be linked to the dosage mistreatment.
Ms Skinner said the government has taken a number of steps to reassure cancer patients their treatment is sound. This includes a review of all public cancer patients who have received treatment over the past five years.
NSW secretary of health Elizabeth Koff has been considering the report since it was submitted to the health department on Friday, Ms Skinner said in a statement.
Sources and references