‘Horrifying’ — doctor blows whistle on CT scanner disaster at major state hospital

“A computed tomography (CT) scan is a medical imaging technique used to obtain detailed internal images of the body. For three weeks, Dr George Mukhari Academic Hospital in Ga-Ramkuwa had no functioning CT scanners.” (Photo: iStock)

By Takudzwa Pongweni

28 Jan 2024

Patients are suffering and even dying, says medical insider. Vital CT scans at Ga-Rankuwa can’t be done because machines have broken down and management has failed to renew maintenance contracts.

One of the biggest public hospitals in South Africa has been operating with just one back-up CT scanner – leading to patients having their treatment delayed, receiving inadequate care and even dying, says a whistle-blower doctor.

For nearly three weeks, Dr George Mukhari Academic Hospital in Ga-Rankuwa, north of Pretoria, had no functioning CT scanners at all.

Computed tomography, known as a CT scan, is a diagnostic imaging procedure that uses X-rays and computer technology to produce images of the inside of the body.

A doctor at the hospital, who asked not to be named out of fear of victimisation, told Daily Maverick the problems with the scanners began in 2023.

He described the situation as “horrifying and gross mismanagement”.

They are fully aware of this problem. They are fully aware that this is causing deaths and suffering.

“I know of at least one patient who, owing to this, has passed away. Owing to the nature of the problem, I can only assume that a significantly larger number of patients have passed away,” he said.

A significant number of patients have had treatment delayed, have suffered unnecessarily or received inadequate care, he said.

“Instead of lying in casualty for one day, they lie there for four to six days with illnesses that cause them significant suffering and no one can intervene because they can’t get the information from the CT scanner that we should have,” he said.

Failure to renew warranties

The doctor explained that two of the CT scanners are fairly old – between eight and 10 years – and that a new scanner was installed in 2023. However, the new one has low specifications.

“It can’t handle significant patient load. It’s more just to supplement what we can do on the other two scanners,” he said.

Those two had stopped working in 2023, the first in June or July and the second in about November. The new low-specification scanner stopped working early this month – leaving the hospital with no CT scanners.

“The way that it works with our suppliers is that, once the machine is bought, they give you a five- or eight-year warranty. Once that warranty expires, you need to pay for an additional warranty,” he said.

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According to the doctor, these warranties were not renewed by hospital management.

Typically, when a hospital cannot manage emergency patients, it is placed on divert – meaning that patients are sent to other hospitals nearby, said the doctor.

“Our management team has been very reluctant and has denied putting our hospital on divert,” he said. “They are fully aware of this problem. They are fully aware that this is causing deaths and suffering.”

The doctor explained that the CT scanners were supplied by two manufacturers, one of them Philips. The contract for the Philips scanner was set to expire in June 2023.

“Towards the end of 2022, our head of department issued a purchase order to… management knowing that we’re going to have to renew these contracts,” he said. According to the doctor, the paperwork lay stagnant until April 2023.

This is a problem that everyone has been aware of for longer than a year and a half.

“A meeting was then held with our supply chain [management], who at that point said: ‘Why have we not issued these documents earlier?’ But those documents were issued and they were just sitting on someone’s desk,” he said.

He explained that suppliers renew maintenance and warranty contracts for three to five years as an industry standard.

“Our hospital at that point felt that the cost was not something they could budget for, so they asked us to go back to Philips to negotiate,” he said.

Philips offered a six-month contract in the middle of 2023.

“They then sat on that six-month renewal contract again at supply chain and management until about November/December,” he said.

Although doctors had tried to make do, patients were being harmed, with some falling through the cracks or having to be rescanned and subjected to more radiation than they needed to be.

A meeting was held at the beginning of this year, when it was revealed that the hospital could not afford a six-month contract. It would need to renegotiate with Philips for a three-month contract, as the 2024 budget for the hospital only takes effect in April.

“The fact of the matter is, this is a problem that everyone has been aware of for longer than a year and a half. We have been constantly going to them with this problem, and they keep throwing in a new excuse or new forms or new stipulations.”

A computed tomography (CT) scan is used to obtain detailed internal images of the body. For nearly three weeks, Dr George Mukhari Academic Hospital in Ga-Ramkuwa had no functioning CT scanners, according to a whistle-blower. (Photo: iStock)

Other hospital technology affected

The hospital’s picture archiving and communication system also relies on Philips.

“That allows, when we do a scan, whether it’s a CT scan, MRI, X-ray – those images go onto the local network, allowing the radiologists to report on those studies, and the clinicians can view the images on their computers in whichever department they are, as well as the reports,” the doctor said.

According to the doctor, the system has had limited functionality for almost two years. “It is a running joke in our department that it pretty much stops working for like a week every month, and you revert to writing stuff by hand, and the clinicians can’t see the images,” he said.

“We’ve been instructed by management to make do.”

The doctor added that Philips had been providing good service, compromising and going out of its way to help the hospital.

“At some point, if you aren’t being paid for a couple of years, you need to draw a line somewhere,” he said.

Siemens is set to implement a new system at the hospital.

“That system is going to be implemented towards the end of January, beginning of February this year, but there have also been constant delays with that,” he said.

Patients bearing the brunt

The hospital has lost studies and CT scans of patients for a year and a half. They had been stored on the archiving system on two hard drives. One of the drives failed and could not be repaired, while the other was stolen.

“With a patient on chemotherapy, what usually happens is that they’ll have a scan before they start treatment, then follow-up scans after that to see if they are responding to treatment,” the doctor said.

“But because we can’t access these old studies, there’s nothing for us to compare.”

Although doctors had tried to make do, patients were being harmed, with some falling through the cracks or having to be rescanned and subjected to more radiation than they needed to be, said the doctor.

The situation was now “horrifying and people are actively dying”.

The doctor said a head of department and another doctor had been engaging with the hospital management, to no avail.

“I know for a fact that they’ve been banging on that door for months,” he said.

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On 16 January, one of the scanners had started working again, but the machine was overloaded and could break down again.

“It is the back-up machine, so we can only do a fraction of the cases we need to do… but at least we can do most of our emergencies now,” he said.

“Management is still delaying the fixing of our other two scanners.”

Daily Maverick asked the Health Department for comment on 17 January and again on 22 January, but there was no response by the time of publication. DM

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R29.

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Failure to renew warranties

Other hospital technology affected

Patients bearing the brunt