Investigation Reveals Irregularities in Cancer Genetic Specialist’s Patient Records

An internal review into the practices of Emeritus Professor Allan Spigelman, a senior cancer genetic specialist at St Vincent’s Hospital Sydney, has exposed significant irregularities in nearly one-third of the medical records reviewed. The investigation, which covered over 1,600 patient records from April 2022 to June 2023, found that while approximately 1,100 records contained no errors, there were alarming discrepancies affecting about 540 patients. Notably, one patient experienced an 'adverse clinical health outcome' after receiving faulty advice related to their cancer risk, and roughly 20 others faced potential risks tied to incorrect information. Emeritus Professor Spigelman, who has a notable background as director of cancer services and clinical director of The Kinghorn Cancer Centre, operated the genetics cancer service as the sole specialist for several years prior to his contract not being renewed in June 2023. The investigation came to light in September 2023, driven by the discovery of irregularities in three patient records, which led to a sweeping review by independent cancer genetics experts. This review found Spigelman’s practices diverged from established national guidelines, particularly in regard to the necessary partnership with genetic counselors, integral for best practices in patient care. Critically, hospital staff criticized St Vincent's oversight during Spigelman’s tenure, claiming that tensions existed between him and the hospital leadership. As a result of this review, which intends to broaden its scope to include records dating back to 2020, St Vincent’s has begun reaching out to the affected patients. The response from St Vincent’s leadership emphasizes their commitment to transparency and corrective measures to mitigate future risks. Comparisons have been drawn to past scandals involving the hospital, underscoring the importance of accountability in healthcare. This incident could raise questions regarding the governance structures within healthcare institutions and the supervision of specialists. In parallel, the NSW Health Care Complaints Commission (HCCC) has been notified of the situation, although currently, no conditions restrict Spigelman’s practice elsewhere in the health system. This case aptly illustrates the volatile intersection between medical expertise and patient safety, reinforcing the critical need for rigorous checks and a multidisciplinary approach in healthcare delivery.