Group Assails Mammography Decision

Members of the Orange County Breast Cancer Coalition grilled health officials for 90 minutes Wednesday about the abrupt June closure of the county’s X-ray and mammography inspection office and pledged to protest the action at a rally before Tuesday’s Board of Supervisors meeting.

Two dozen coalition members lashed out during the hastily called meeting at the American Cancer Society, representing organizations including the cancer society and the breast-imaging centers of Hoag Memorial Hospital Presbyterian and St. Joseph’s Medical Center.

They accused county officials of endangering public health by suddenly closing the office, which had responsibility for inspecting about 5,200 X-ray machines and 93 mammography centers throughout the county.

“We see this as a major public health issue,” said Trudy Grossman, who chaired the meeting for the coalition. “Why would you cancel a program that has earned such accolades across the country? Am I satisfied with the answers we’ve been given today? No.”

Health professionals across the county swiftly condemned the June 17 closure, done with no advance notice. County health officials said that even after a four-month search, they couldn’t find a qualified supervisor to manage the office, which also inspects nuclear facilities and the qualifications of radiologic technologists.

Bruce Vancil, regional director for the American Cancer Society, said local inspectors provided a strong assurance that women being referred for breast exams and other X-rays were protected from faulty equipment and unqualified workers. Poor exams can result in cancer going undetected and untreated, he said.

“We had quality and a level of service and open communications with our local program [in the past],” Vancil said. “[Now] we’re very concerned.”

Jack Miller, head of the county’s Environmental Health Division, said the state already inspects the equipment for all counties in California except Los Angeles and San Diego counties, which have their own programs.

“The state has a broader program and can delegate some of these needs,” Miller said. “I have no intention of reinstating [the county program].”

Grossman said the coalition, comprised of about 40 local organizations and businesses, plans to fight Miller’s decision to the Board of Supervisors and the Legislature, if necessary.

“I think the issue is that the department has been mismanaged from the top down, not that they couldn’t find a supervisor,” Grossman said. “This is not just some personnel issue.”

Previous supervisor Robert Gregor, who replaced the unit’s longtime manager who retired, was terminated in January after failing the county’s probation period. Before that, the department had the same supervisor for 23 years.

Breast health professionals and cancer survivors plan to rally Tuesday night before the supervisors’ weekly meeting at the Hall of Administration. The rally is being organized by Trudy Papson, a fired inspector who became a nationally recognized expert in radiologic health during her 11 years with the county.

Supervisor Todd Spitzer said the program’s fate should have been handled by the board instead of administratively.

“This is a public policy decision,” he said. “I would always choose local control, especially when there’s no county costs involved. The board should have heard about this before the decision was made. It looks like we’ve created a problem.”

The state began contracting with Orange County in 1963 to handle local X-ray inspections. Its $500,000 annual budget was covered by a state grant. The program was closed by Miller on June 17; five employees lost their jobs, including Papson and a local monitor for the San Onofre Nuclear Generating Station.

Debbie Pellegrini, assistant branch chief for the Department of Health Services’ radiologic health division, said the state hopes to open a Southern California office soon, which could be in Orange County. Four inspectors will cover seven counties. There are 20 inspectors statewide.

“If a complaint comes in, the state will respond,” Pellegrini said. “All I can tell you is: We’re not going to let mammography [inspections] slide.”

Pat Swan of the Orange County Breast Cancer Partnership, which arranges mammography screenings for 900 women a month, said her experience getting the state to respond has been “very negative.”

“We could have machines out of calibration for hundreds of mammography [screenings] before they’re inspected by the state,” she said. “This is really scary to know we’re going to have to deal with Sacramento. I’m concerned the help we need won’t be there with someone close at hand.”

Local control over the quality of mammography screenings is particularly important in Orange County, which has one of the highest rates of breast cancer in the state, said Sandy Firestone with Hoag’s Breast Cancer Center.

“I’ve been able to encourage women to get mammography [inspections] in good conscience,” she said. “With the state in charge, I won’t be able to do that with as clear a conscience.”