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St Vincent’s doctor providing incorrect chemo doses

Dozens of cancer patients treated by St Vincent’s Hospital doctor, Dr. John Grygiel, have died from a variety of causes after receiving off-protocol doses of the chemotherapy drug carboplatin.

The senior oncologist was stood down in February after an investigation revealed that Dr Grygiel had given incorrect doses of chemotherapy to 78 neck and head cancer patients between 2012 and 2015.

Doses too low and not based on the individual

Of those treated with the low dose, 30 have since died, 23 as a result of cancer. It would be expected that failure to adhere to protocols is likely to result in higher rates of local recurrence and higher overall mortality.

At the time Dr Grygiel was only prescribing patients with 100mg of the drug, regardless of weight, age and kidney functionality. This dose is not in line with the National Comprehensive Cancer Network (NCCN) or eviQ’s guidelines. The eviQ guidelines include 26 head and neck chemotherapy protocols, with 7 of the protocols containing carboplatin. Neither eviQ nor NCCN guidelines use flat dosing.

NSW Ministry of Health Inquiry into the prescribing of chemotherapy at St Vincent’s Hospital by Dr Grygiel has highlighted the magnitude of the systematic off-protocol prescribing and has recommended that the hospital apologise to patients and their families as well as offer intensive follow-up at another oncology unit.

Chemotherapy is normally used with a number of other drugs, including radiation to treat cancer in patients. Head and neck cancer patients can be administered chemotherapy either orally or intravenously. The type of treatment directed to a patient is based on the stage of the disease, whether the patient had received previous chemotherapy or radiation treatments and if the cancer has spread to other parts of the body.

Chemotherapy is given to a patient in 2- 8 week cycles to give the patient’s body rest to restore cells in between. The number of cycles, length of cycles and the number of individual treatments that occur within a cycle depend on the type of cancer and stage of the disease.

This type of cancer treatment attacks cancer cells and it can also impact normal cells, which can cause side effects. Some patients experience no side effects, while others experience one or all of the following;

  • nausea and vomiting
  • diarrhoea or constipation (often due to anti-nausea medication)
  • fatigue
  • mouth sores or ulcers
  • increased risk of infection
  • increased risk of bruising
  • hair loss
  • muscle weakness
  • skin sensitivity to sunlight
  • dry or tired eyes
  • loss of appetite

If you are unsure whether you or a family member is receiving the right dose of chemotherapy you can contact the Cancer Council on 13 11 20 for reliable information.

If you, or a family member, were treated by Dr Grygiel at St Vincent’s Hospital, contact us here -

Written by Shine Lawyers. Last modified: April 26, 2016.

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