CHARLOTTE, NC (Fred Clasen-Kelly/The Charlotte Observer) - Mecklenburg County's interim health director acknowledged Wednesday that her agency may have failed to properly track nearly 100 women who needed additional care following abnormal Pap smears.
Alma "Gibbie" Harris told reporters that an internal review found 95 cases in which there is no record that patients underwent a colposcopy despite Pap smears that showed risks for cervical cancer.
That means patients who received Pap smears at public health clinics on Billingsley Road in southeast Charlotte and Beatties Ford in west Charlotte might not have been informed they needed an exam meant to stop the spread of cancer.
Harris said officials have recently sent letters and made phone calls to the women. They are also trying to schedule colposcopy exams for them, Harris said.
"We wanted to make absolutely sure" patients received any needed care, she said.
The comments come after the county acknowledged in February that the two health clinics did not notify at least 185 women about abnormal Pap smears from April of 2016 to December.
The news also follows reports from two consulting firms and the county's internal audit office that detail problems in the agency. Criticism included workers failing to put accurate information in patients' files, patients enduring unacceptably long waits for appointments and other lapses in care.
The reports recommended sweeping changes to management, suggesting that top leaders and supervisors failed to hold employees accountable. County officials said Wednesday that it may take as much as $4.6 million to fix the problems.
Fallout from the lapses led to the resignations of Health Director Marcus Plescia and four other employees. Harris took over as the interim leader in June.
County leaders have previously assured the public they have contacted the 185 women and set up treatment for those who needed it.
But Wednesday's news suggested that patient notification problems may run deeper than previously known.
After Pap smears that produced abnormal results, a nurse was supposed to contact patients. Policy called for the nurse to send patients as many as three letters.
The process is meant to help the clinics track whether patients received the follow-up care they need.
"Many of the staff did not use the (computerized) system in place," Commissioner George Dunlap said. "There is no way to determine if they did what they were supposed to do."
On Wednesday, the county's internal audit office presented preliminary findings from a three-year review of Pap smear notifications.
Auditors found the Health Department failures to tell patients about abnormal tests stretch back prior to last year.
Harris said the review also found that agency workers did not document if 95 women had undergone a colposcopy. There is no way to tell from records if the women had been notified about their Pap smear results or had sought treatment from a private provider, Harris said.
The mistakes contradict public statements from Plescia and other officials who for months defended the agency and assured the public that problems were limited to one nurse and her supervisors.