Lab Shutdown Causes Backlog in Processing Pap Smear Tests

The state-imposed shutdown of Southern California’s largest Pap smear laboratory has deluged other labs with new business, created delays in processing the tests and left a number of physicians with no place to send slides for diagnosis, authorities said Tuesday.

Central Pathology Services Medical Group in Tarzana was closed by the state Department of Health Services last Friday for allegedly making too many misdiagnoses of Pap smears. The lab, which processed nearly 700,000 smears a year, allegedly had an error rate of 21%.

“This shutdown has put a burden on the system,” said Stanley Ordway, president of Physicians Reference Laboratory in Huntington Beach, which Tuesday was turning away requests from some former Central Pathology clients to handle Pap smears.

“We don’t feel like we could take on that work,” Ordway added. “We can’t overload our technologists here.”

Many labs said they could no longer guarantee the industry standard of issuing test results within 24 hours because of the backlog of smears.

“The turnaround time on Pap smears is not going to be as quick because there is going to be a real logjam,” said Dr. Roberta Nieberg, a professor of pathology at UCLA Medical Center.

Some labs also said patients may have to wait as long as two weeks before their Pap smear can be read.

Meanwhile, state health officials stressed Tuesday that they plan to enforce an order issued Monday against Central Pathology. That order required the lab to contact hundreds of thousands of women whose Pap smears were diagnosed as normal over the last five years and offer to pay for new tests.

Left Up to Firm

Health department spokesman Norm Hartman said the state will leave it up to Central Pathology to determine how to pay the reimbursements.

“The California Department of Health Services is not going to become a clearinghouse for the exchange of funds,” Hartman said.

But Central Pathology said it was unsure how to proceed. “The state has not provided us with any information, and we do not have the answer to that ourselves,” said company spokesman Martin Cooper.

On Monday, Central Diagnostic Laboratory--which is affiliated with Central Pathology--sent a letter to doctors saying it would continue to pick up their Pap smears but have other labs diagnose them. “We will be referring your Pap smears to another quality cytology laboratory,” the letter said. “We assure you that service will not be interrupted.”

Central Diagnostic Lab, which is also based in Tarzana, said it was negotiating with a number of labs to take over its accounts.

“It has become clear that no one laboratory can assume all of that volume of work,” Cooper said. “So what Central Diagnostic is going to have to do is find a number of different laboratories to which it will refer its Pap smear work.”

Cooper said none of the labs Central Diagnostic is talking to are owned by Dr. Allen Levy, who was the founder of Central Pathology. Levy, through a holding company, also owns Central Diagnostic.

During the last several weeks, a number of physicians have stopped using both Central Diagnostic and Central Pathology and have been looking for other labs to do the work.

Some Are Angry

Some obstetricians and gynecologists were angry Tuesday about being left with no place to send slides. “I don’t know how to pick a good lab now,” said Dr. Arthur Wisot, a Torrance physician.

Spokesman Norm Hartman said the Health Services Department is preparing an advisory that will outline steps doctors can take to find reputable laboratories.

Adding to the problem of Central Pathology’s shutdown is a severe shortage of cytotechnologists--the people who sit with a microscope and study slides for signs of medical abnormalities including cervical cancer. The American Society of Clinical Pathologists recently reported that 13.6% of existing cytotechnologist jobs nationwide are vacant.