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Doctors reviewing the backlog of thousands of echocardiograms performed at New York City’s Harlem Hospital found there are substantially more of the unread tests than previously thought and they span a period years longer, said an article yesterday by The New York Times.

An echocardiogram is a test that uses sound waves to create a picture of the heart. The test shows the size and shape of the patient’s heart, as well as the organ’s function. When viewing this test, a doctor looks for health conditions such as physical damage or abnormalities, impaired function, infection, possible blood clots inside the heart, fluid buildup in the pericardium (the sac around the heart), and problems with the aorta.

A routine record review last month by Columbia University, who provides doctors to the New York City Health and Hospitals Corporation (HHC) through an affiliate program, found the backlog of patient’s heart tests and notified the company on May 20. They determined that although the patient’s heart tests had been viewed by a technician, they had never been reviewed by a cardiologist.

On May 25, a joint press release by NYC Health and Hospitals Corporation and Columbia University Medical School announced that the backlog contained about 4,000 echocardiograms performed between 2007 and 2010.

Physicians at Harlem Hospital were apparently aware of the backlog and had requested more staff from hospital administrators. The backlog of tests perpetuated because physicians at the hospital used a policy allowing technicians to review and prioritize the tests, alerting physicians to those the technician deemed abnormal first, the rest falling by the wayside.

"While the process the doctors followed may have alerted cardiologists to those echocardiograms that were most likely to be abnormal, the failure to read echocardiograms in a timely manner is inexcusable and may have placed patients at risk," said HHC President Alan D. Aviles. "As our team of cardiologists continues to review every pending echocardiogram, we will take immediate action to locate any patient that may be in need of follow-up care."

The investigation has now revealed that the test backlog extends as far back as 2005 and numbers 1,000 more than previously thought, totaling about 5,000. Doctors are also re-reviewing an additional 2,000 tests that doctors read and made notes in the medical records but never signed them, as required by medical protocol.

200 of the patients whose echocardiograms went unread have since died and investigators are trying to determine if these deaths were avoidable had the tests been properly handled.

According to The New York Times, the investigation has, “found six patients who might have been deprived of necessary medical treatment because the results of their heart tests were not read by doctors.”

Ana Marengo, a spokesperson for the city’s Health and Hospitals Corporation, told the newspaper that the hospital has attempted contact with all six patient, resulting in three patients who have seen a cardiologist, two patients with appointments to do so, and one who has been unreachable.

The New York City Health and Hospitals Corporation (HHC) is only notifying those patients whose test review shows an immediate need for medical attention. The rest of the 5,000 patients will only learn their test was in question when the hospital corporation sends out a letter of reassurance after the review is completed.

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