The Midland Regional Hospital, which is at the centre of major failures in breast cancer diagnoses, was warned 10 months ago of problems with its ageing mammography equipment left it open to litigation.
It emerged today that a letter was sent to hospital management from the radiology department on December 13 thlast year advising that to deliver the highest standard of patient care the department needed an imaging system, which could produce mammograms of the best possible diagnostic quality.
The letter, seen by RTÉ, expressed concern about the age of the mammography machine and advised that a digital system was needed instead of the film system which at times was affected by dirt from the darkroom.
Letter from radiology department at the Midland Regional Hospital to management last December
The letter warned that poor image quality could result in the missed or delayed diagnosis of a tumour, leading to reduced prognosis for a patient, or a false positive test resulting in patients having to undergo unnecessary surgery.
"We are also concerned about the huge potential for litigation in relation to delayed or wrong diagnosis of breast cancer associated with using suboptimal imaging equipment," the letter said.
It emerged last week that at least seven women who had been given the all-clear after tests were subsequently diagnosed with cancer. A review of about 3,000 mammograms taken at the hospital was announced at the end of august.
In a statement this evening the HSE said that: "While acknowledging that radiographers in the X-ray department of the Midland Regional Hospital at Portlaoise highlighted their concerns last December about the quality of images produced by the mammography machine, the HSE is satisfied that the equipment operates within normal Quality Assurance Standards and the clinicians involved continued to use the equipment until the service was discontinued at the end of August.
The statement added that a copy of the latest independent routine inspection report on the machine dated May 18th last indicated that the machine was satisfactory and did not include any identifiable faults.
It has also emerged that that six of the remaining 19 patients who were called back for a review of breast screening will require further assessment, according to the HSE. These patients will be seen at St Vincent's University Hospital later this week.
Fine Gael health spokesman Dr James Reilly said the emergence of the letter raised serious concerns "about the level of dysfunction in the health service".
In a statement, he said that when early warnings were not acted upon it "threatened the safety of patients" and that Minister for Health Mary Harney "must respond in full to the existence of this letter".
"Remember this is the hospital which was designated a centre for breast cancer care for the midlands in 2000 and yet this is the equipment they were dealing with.
"While I support the concept of centres of excellence, what confidence can people have in their delivery in light of this revelation?"
Taoiseach Bertie Ahern was earlier questioned in the D á il about the controversy.
Labour Party leader Eamon Gilmore told the Taoiseach he did not want to hear about "systems failures". "There were serious misdiagnoses in Portlaoise and I want to know what happened in Portlaoise," he said.
He wanted the Taoiseach to tell the House in "plain language" what happened.
"What went wrong, why were the checks not being carried out? Spell it out, what happened in Portlaoise. I think that the women concerned deserve, at least, that courtesy that it is explained what happened there."
Mr Ahern said he wanted to be fair to people and to allow "due process" in the matter.
"As I understand it, the mammograms being read by one consultant were showing different results to another consultant's reading of them. There's a consultant on administrative leave because of that," he said.
Mr Ahern said the matter would be the subject of a report that would be published this month.