Some Ignored Tests Showed Evidence of Heart Disease

Officials at New York City's public hospital system recently admitted that some of the heart test results seen only by technicians -- instead of doctors -- at Harlem Hospital Center showed signs of heart problems missed by the technicians.

The acknowledgment came on the heels of the hospital's recent disclosure that the results of 4,000 heart tests had been read by technicians instead of doctors. Initially, hospital officials had claimed that the process was harmless because the technicians were so adept at reading the tests.

A further review of the tests showed that some of the echocardiograms indicated abnormal heart function, though a spokesperson for the hospital claims no one failed to get needed medical treatment.

Many Harlem Hospital patients are black or Hispanic, with a risk for heart disease that is higher than average.

State Health Department officials are investigating Harlem Hospital heart test procedures and talking to doctors there to determine if patients were endangered by the practice of bypassing physicians.

The New York Times asked Dr. John Morley, medical director of health care management system for the state department if the Harlem Hospital procedures were unusual. "Very," Morely said.

He said his investigation will find out why this process was developed; he also said the procedure will be stopped.

In the wake of the revelations about the heart tests, the hospital fired the clinical director of its department of medicine and demoted its medical director.

Echocardiograms are ultrasound images allowing for accurate assessments of the effectiveness of the heart's valves and blood-pumping ability.

In an interview with the Times, cardiologist and past president of the American College of Cardiology, Dr. Douglas Zipes, said the procedure at Harlem Hospital is "unconscionable and unacceptable and malpractice as far as I'm concerned.

"I would bet that there are deaths directly attributable to the failure to read these echocardiograms," he added.

Zipes said that at Indiana University Medical Center, where he works, doctors read the results of echocardiograms within two hours of the procedure.

Harlem Hospital officers said the technicians would read the tests, identifying those that appeared to show signs of abnormality and sending them on to doctors.

Zipes said the process was unacceptable.

Morely said the tests can reveal serious problems, such as severe aorta deficiencies, requiring immediate treatment.

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