Some Doctors and Hospital Quit Lab Blamed for Errors

At least one hospital and some physicians said Thursday that they have stopped sending Pap smears to Central Pathology Services Medical Group after the disclosure that the state is investigating the Tarzana laboratory for allegedly making too many misdiagnoses of Pap smears slides.

But other practitioners said they will continue to use the laboratory.

Newhall Community Hospital said Thursday that it has stopped submitting Pap smears to Central Pathology. A hospital spokesman would not say how many slides usually are sent to the lab. The lab said it had received smears from the Newhall hospital as late as Wednesday.

Some other local hospitals declined to disclose where they send Pap smear slides, and many do their tests in-house.

Some Doctors Switch

But, a number of doctors’ offices contacted Thursday said they had quit sending Pap smears to Central Pathology. Robin Smith, office manager for gynecologist Dr. Sid Kamrava in Tarzana, said: “We’ve had a few phone calls from patients. He (Dr. Kamrava) has switched for everybody’s good. He is not going to switch back.”

Some practitioners, however, said Thursday that they are pleased with Central Pathology’s performance. “We haven’t had any problems,” said Cindy Osife, office nurse for Dr. Peter Forbes in Sherman Oaks. “We will continue to use them.”

Federal and state health officials said Thursday that they had received telephone calls from physicians and their patients worried about Pap smear tests done at Central Pathology. “To tell you the truth this would frighten me if I were a woman,” said Peter Summers, acting chief of standards and certification for the U.S. Department of Health and Human Services. “I can certainly understand people’s concerns.”

Central Pathology spokesman Martin Cooper said the laboratory estimated that it has received about 80 calls from doctors and patients since Wednesday morning.

Cooper said the number of slides being sent to Central Pathology has fallen by about 10% from the lab’s daily average volume of 2,600 Pap smears. “It looks like there is a slight drop off,” Cooper said.

But Cooper said the company was unaware of doctors who have dropped the lab from their vendor lists. “Unless they call us and tell us that, we would have no way of knowing that,” he said.

No doctors have called to formally cancel, Cooper said. But the lab and its customers usually do not enter into business contracts, so doctors’ offices as well as hospitals can terminate their relationship with Central Pathology simply by sending their Pap test slides somewhere else.

On Wednesday, The Times reported that the California Department of Health Services had sent a team of 20 inspectors to Central Pathology to follow up on allegations made by the federal government that the laboratory misdiagnoses Pap smears as much as 12% of the time, including some that contain evidence of life-threatening disease.

The federal Department of Health and Human Services found in a January inspection that the lab had failed to detect a range of diseases from herpes to cervical cancer in a random sampling of 1,258 Pap smears, according to an internal government report.

Summers has called services at the lab “an immediate threat to patient health and safety,” according to a letter the government sent to Central Pathology.

Central Pathology has disagreed with most of the federal government’s findings.

Last month, the federal government dropped Central Pathology from the approved vendor lists for both Medicare and Medi-Cal because, among other things, the lab’s error rate of as much as 12% failed to meet federal quality-control standards.

Health Plan of America in Orange, a health maintenance organization that provides medical service to more than 48,000 people in Southern California, also has stopped using Central Pathology. The HMO ordered its patients’ Pap smears be sent to another pathology lab after it got a letter about the federal government’s decertification of Central Pathology for Medicare and Medi-Cal patients.

Several labs that process Pap smears said this week that they have seen an increase in business because they are processing tests formerly done at Central Pathology. One laboratory manager, Mark Rubin of Metro Medical Labs in Long Beach, said his firm has seen its weekly quotient of new clients double.

Meanwhile, Central Pathology owner Dr. Allen Levy sent a letter to employees Wednesday asking them not to talk to the media. “Now is the time for all of us to pull together,” he wrote. “So remember, your reply to the outside world is ‘no comment.’ ”