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- A Stuijt
- Retired South African medical journalist, ex-Sunday Times of Johannesburg.
SA radiologist Dr L. Darius Tsatsi suspended in Saskatchewan
10:13 | 
Posted by
A Stuijt |
May 27 2009 -- SASKATCHEWAN, CANADA. Dr L. Darius Tsatsi, 52, pictured, a University of Cape Town-trained radiologist who worked for the SA government for several years and was a professor of radiology at the Medical University of South Africa -- is in trouble in Canada. Questions have been raised about his ability to ‘correctly read scans’. More than 70,000 scans he has analysed since 2004 now are being reviewed… see
Joe Kirwan, CEO of the Sunshine Health Region in Saskathewan, Canada, said ´as soon as we heard about potential misinterpretations identified in this review we took action… all exams being questioned will be reviewed. Patients will be made of aware of their exams and their family physicians will be notified.´
The issue of medical errors was placed under intense focus in this Canadian province following the disturbing news that Saskatchewan's Health Ministry also ordered a review of more than 70,000 diagnostic images -- X-rays, mammograms, CT scans and untrasounds -- that had been interpreted by the South African-born radiologist whose skills were being questioned at Yorkton hospital ever since 2006. Dr. L. Darius Tsatsi's hospital privileges were suspended this month by the Sunrise Health Region pending investigations and a competency hearing by the College of Physicians and Surgeons. Tsatsi has worked for Sunrise since 2004, writes the Leader Post newspaper in Saskatchewan. http://www.leaderpost.com/Health/When+lives+stake+there+room+error/1619319/story.html
Toll free number for patients
A special toll-free number, 1 877 854 4424 has been set up for worried patients in the region. More than 70,000 of Dr Tsatsi’s scans are now being reviewed for accuracy. Sharon Tropin, their director of communications, can be phoned by the news media at 306 786 0144.
The Yorkton based Sunrise Health Region announced that it suspended Dr Tsatsi on May 14 after ´serious problems were found in cases he had been involved in. ´Dr Tsatsi reportedly welcomed the review, and has agreed to stop practicing medicine while it was underway.`
One patient who publicly expressed concern was Joanna Sigurdson from Canora in east/central Saskatchewan, who told CBC News that she had contacted the toll/free information line to learn more about two mammograms performed on her in September 2008.
- Tsatsi had examined her test results and determined that there ´had been nothing to be concerned about´. However she said she now was ón ´pins and needles´ while waiting for the results of the review of her scan.
The College of Physicians and Surgeons of Saskathewan said in a statement that it had first reviewed 103 scans that Tsatsi had done last year after problems arose from 2006. Their interpretation of these scans differed from his on too many occasions, the health alert was then raised, and he was suspended.
Diagnostic errors
`The amount of times where diagnostic errors could have "disastrous" consequences for patients was "worryingly" high´, said the college. `There were at least five cases where patients were at risk´, it was reported from Canada. A committee was also appointed to hold a hearing to establish whether Tsatsi's skills are satisfactory.
According to the college, ´shortcomings in Tsatsi's skills had first been detected during a routine check of his work in 2006.
- `There was concern over his ability to spot abnormalities on scans. The college's council suspected that Tsatsi perhaps did not have "sufficient skills and knowledge" to do his work, and wanted to subject him then already to a "competency hearing".
Refresher course
- Tsatsi undertook via his lawyer to do refresher courses and managed to avoid the hearing, it is alleged.
- He completed a refresher course at the McMaster University, but the college was still not satisfied and 103 scans were re-evaluated.
When did he graduate?
- It would appear that Tsatsi moved to Canada in 2004. He qualified as a radiologist at the University of Cape Town in 1976 according to most news reports, but according to his own Facebook page, he graduated in 1982.
He was born on 29 March 1957, again according to his brief Facebook profile -- so he could not possibly have graduated in 1976 because he would only have been ten years old at the time.
Beeld newspaper has also established that in May 2004, he was still the head of radiology at Dr George Mukhari Hospital in Ga-Rankuwa when the hospital had opened a R11-million angiography unit. He was also a professor at Medunsa.
- Tsatsi was also on the editorial committee of the South African Radiology Journal and worked at a private hospital in Mafikeng.
Bertha Scheepers of the Health Professions Council for South Africa told Beeld newspaper on May 27 2009 that ´they ‘had no records of any complaints against Tsatsi.´ And the local health authority in Canada also said the qualifications and testimonials with which Tsatsi had arrived in the country were "impeccable".
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LESSONS TO BE LEARNED --
Anne Kyle, The Leader-Post reports Friday, May 22, 2009 -
The registrar with the College of Physicians and Surgeons of Saskatchewan says there are lessons to be learned from what happened in the Sunrise Health Region because it could happen elsewhere.
Dr. Dennis Kendel was referring to a college audit that revealed significant clinical differences of opinion in 103 random diagnostic cases interpreted by Yorkton radiologist Dr. L. Darius Tsatsi between May 28 and Nov. 14, 2008.
- "Some people might naively believe this could never happen in Regina or Saskatoon. But I think they are dead wrong. It could happen there, although it is less likely to happen,'' Kendel said.
- Radiologists working in Regina and Saskatoon have easier access to colleagues who can provide second opinions on complex diagnostic images that are difficult to diagnose, he said.
While radiologists working in isolation in small regional hospitals or rural settings often don't have access to, or the ability to consult, a colleague who can provide that second set of eyes, he said.
- "What we really want to do is create a system where, if possible, errors can be detected and intercepted before they harm people,'' he said.
While acknowledging medical errors are made every day, Kendel said Dr Tsatsi “needs to accept that if he hasn't maintained his capacity to perform at a level that is safe then he is responsible for that and he will bear the consequences of that under the college's regulatory process. He will be appearing before a college competency hearing later this year.”
The audit also resulted in the health region suspending Tsatsi's hospital privileges pending further investigation and a competency hearing by the college relating to his skills in interpreting diagnostic images. The audit results also prompted the Ministry of Health to order a review of more than 70,000 diagnostic images examined and interpreted by Tsatsi during the five years he worked in Saskatchewan.
"In the review process that has been undertaken, job No. 1 is to get those films re-read as quickly as possible and to get that information into the hands of the doctors that are actually caring for those patients at the moment so that information can be brought to bear in their ongoing care,'' Kendel said. "But during that process I also am pressing very hard to make sure that even as we go about this review we try and extract whatever lessons we can about what failed in the system and what can we strengthen in the system to make things safer.'' The picture on the left comes from his own Facebook blog.
- - -
TIMELINE OF EVENTS
Summer of 2004 --
- Dr. L. Darius Tsatsi works as locum in the Prince Albert Parkland Health Region.
Fall 2004 --
- Tsatsi begins work as locum in Sunrise Health Region.
April 2005 --
- Tsatsi employed as full-time radiologist at Sunrise.
Dec. 22, 2005 --
- Prince Albert doctor raises concerns about Tsatsi's work during his locum in Prince Albert. This expression of concern prompted college's advisory committee on medical imaging to accelerate its scheduling of Tsatsi for review through its diagnostic imaging quality assurance program.
January 2006 --
- College of Physicians and Surgeons of Saskatchewan's diagnostic imaging quality assurance committee expresses concerns over Tsatsi's practice following review of facility in Yorkton
March 2006 --
- The college appoints a competency committee to review Tsatsi's diagnostic skills and knowledge.
October 2006 --
- The competency committee submits its report to the college council and Tsatsi. The report identifies some deficiencies in Tsatsi's diagnostic knowledge and skills involving CT scans. Committee did not identify concerns about his actual reading of images because the margin of error in terms of a clinical difference of opinion in the cases reviewed were generally within the range of what would be regarded as acceptable.
Winter 2006 --
- Tsatsi's lawyer requests that he be permitted to voluntarily undergo remedial education rather than proceeding directly to a competency hearing.
January to December 2007 --
- Tsatsi takes a number of courses in the United States to upgrade his skills.
January 2008 --
- Tsatsi takes a three-month full-time secondment with the radiology department at McMaster University.
Spring 2008 --
- College asks for feedback from McMaster faculty regarding Tsatsi remedial education.
June 2008 --
- His performance assessment at McMaster combined with information that he “failed the Royal College of Physicians and Surgeons of Canada exams” and his previous competency evaluation is presented at the college's council meeting. Council directs a further investigation.
September 2008 --
- College council appoints a second competency review committee, which does a random audit of 103 diagnostic imaging cases that were examined and interpreted by Tsatsi between May 28 and Nov. 14, 2008. Significant clinical differences were identified and a recommendation made to college for a historical retrospective review of all of his work.
May 13, 2009 --
- College council advises health region of its concerns relating to potential patient safety issues.
May 14, 2009 --
- Health Region officials meet with Tsatsi and suspend his hospital privileges. A copy of the report is faxed to the Ministry of Health. Tsatsi also voluntarily agrees not to practise in Saskatchewan until this matter is resolved.
May 15, 2009 --
- College notified Ministry of Health. Health Minister Don McMorris apprised of the situation.
- Regulatory, regional and provincial health officials spend weekend putting together an action plan to re-evaluate 70,000 diagnostic images and contact patients.
May 19, 2009 --
- Health region and the college hold a news conference to advise the public of the situation.
- Prince Albert Parkland also issues a public advisory. see
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sources
- Dr Tsatsi’s Facebook page: http://www.facebook.com/pages/Radiological-Society-of-North-America-RSNA/16433949891?v=info&ref=mf#/profile.php?sid=008fdb5e50813f76845625d1d05745bc&id=1835644108&hiq=tsatsi&ref=search
- http://www.sunrisehealthregion.sk.ca/
- http://www2.canada.com/reginaleaderpost/news/story.html?id=78087bf2-b2ec-41bc-9d0b-2173850ed7c3&p=2
- http://www.sunrisehealthregion.sk.ca/images/Articles/24_Sunrise_diagnostics_052009.pdf
- http://supportforhealth.com/pdf/hf_sep07report.pdf
- http://news.sympatico.msn.cbc.ca/Local/SK/ContentPosting?newsitemid=sask-tests-review-patient-123&feedname=CBC_LOCALNEWS&show=False&number=0&showbyline=True&subtitle=&detect=&abc=abc&date=True
- http://www.news24.com/News24/South_Africa/News/0,,2-7-1442_2522687,00.html
- http://www.thestarphoenix.com/Yorkton+radiologist+Darius+Tsatsi+welcomes+investigation+into+diagnostic+imaging+interpretations/1616840/story.html
- http://www.info.gov.za/speeches/2004/04052409451001.htm Speech at opening of George Mukhtari Hospital new angiography suite, dr Tsatsi, Head, Diagnostic Radiology and Imaging, attending, May 2004.
- South African Journal of Radiology- Editorial Policies
report by College of Physicians and Surgeons of Saskatchewan:
- Quoted: ‘A peer review of Dr. Tsatsi performance through the College's Diagnostic Imaging Quality Assurance program identified performance deficiencies that were sufficiently worrisome to cause the ACMI to refer the matter to the College Council. The Council concluded that it had reasonable grounds to believe that Dr. Tsatsi may lack skill and knowledge and it appointed a Competency Committee to investigate. The Competency Committee submitted a report to the Council which noted some deficiencies in DR. Tsatsi's knowledge and skills. Through his legal counsel, Dr. Tsatsi made a request that he might be permitted to voluntarily undergo remedial education rather than proceeding directly to a Competency Hearing. His request was accommodated. Dr. Tsatsi completed a remedial education program at McMaster University. The feedback provided to the College in Saskatchewan by the McMaster Faculty involve in his remedial education program did not satisfy the Council that Dr. Tsatsi deficiencies in knowledge and skills had been satisfactorily remediated. The Council appointed a Competency Committee to conduct a second competency investigation. In the course of that investigation the Competency Committee reviewed a randomly selected series of 103 D.I. studies which Dr. Tsatsi had interpreted after completing the remedial education program at McMaster. The report of this Competency Committee identified a high incidence of disagreement with Dr. Tsatsi's interpretation of D. I Studies and a worrisome proportion of those disagreements involve clinical situations in which a diagnostic error could have devastating adverse consequences for patients. The Executive Committee of the College Council has appointed a Competency Hearing Committee and a hearing to formally determine Dr. Tsatsi's competence is pending. Because the disputed interpretations of several cases reviewed by the Competency Committee have profound implications for the patients in question, the College of Physicians and Surgeons alerted the Sunrise Health Region and the Ministry of Health to these findings so the Sunrise Health Region and/or the Ministry of Health might have an opportunity for timely intervention that can mitigate risk of patient harm’.http://www.quadrant.net/cpss/tsatsi.html
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Ballito businessman Christo Viljoen robbed after Loftus rugby game, Pretoria
Just a taste of what it will be like for 350,000 foreign football fans at the FIFA WC2010 in South Africa?
May 27 2009 Pretoria-born businessman Christo Viljoen, 57, who had fled from the city’s crime to Ballito at the KwaZulu-Natal coast two years ago, travelled back to his beloved home town to cheer on the Blue Bulls in the Super14 semifinal rugby tournament at the Loftus Versfeld stadium.
The Afrikaner had left Pretoria two years ago after two cars were hijacked within just one year, deciding to move to the coast 'to get away from the crime'.
- But this week, he was happy to be back in town to watch rugby with his family, who live near the Loftus Versfeld rugby grounds.
On Saturday after the game, just as he was walking back to his girlfriend's home near the stadium, he was attacked -- right across from the Afrikaans High Boys School, just past the Dutch Reformed Church.
The man who stood in front of him demanded his cellphone. "I told him very courteously in the English language exactly what he could do. I'm six foot, he was shorter, stockier',” said Viljoen.
"He grabbed me and hit me right in the face with a brick he picked up from the pavement. The next moment, I didn't know where I was any more.”
When he woke up, it was two hours later, and a school guard was standing over him. Next, the metropolice stopped by, but left again after he gave them his girl friend's telephone number, asking them to phone her. Shortly thereafter, his family showed up and ordered an ambulance, which took him to the nearest hospital for treatment. His attacker took his bank cards, ID-book and cellphone.
"This is so unnecessary. This is my country. Can't I walk in the streets anywhere any more? This is not what a person wants.'
- But he's not deterred: he's going back to Loftus to watch the rugby on Saturday.
- http://jv.news24.com/Beeld/Suid-Afrika/0,,3-975_2523085,00.html