Corrective Actions taken on Cases Misclassified as Confirmed COVID-19 Infections and Measures to Prevent Further Occurences
Ministry of HealthSpeakers
Summary
This question concerns Miss Cheng Li Hui’s inquiry regarding the misclassification of 41 COVID-19 cases and the corrective measures taken to prevent future occurrences. Minister for Health Gan Kim Yong explained that these errors stemmed from laboratory administrative mistakes or technical diagnostic limitations, resulting in eight cases being reclassified following clinical investigations. Affected individuals were isolated from confirmed patients, and the Ministry of Health rescinded quarantine orders for their contacts once the re-classifications were finalized. Licensed laboratories are required under the Private Hospitals and Medical Clinics Act to implement corrective actions like staff retraining and IT integration to ensure accuracy. To prevent transmission, the Ministry continues to treat borderline results as initially positive while conducting thorough reviews, including repeat testing and epidemiological assessments.
Transcript
12 Miss Cheng Li Hui asked the Minister for Health (a) how did it occur that 41 cases were wrongly classified as confirmed COVID-19 infections; (b) what were the corrective and public health actions that had been taken in the management of these cases including follow-ups with the affected individuals; and (c) how can occurrences of such misclassification be prevented in the future.
Mr Gan Kim Yong: Of the 41 cases that were classified initially as confirmed COVID-19 cases, most were due to administrative errors such as wrongly recorded or duplicated entries by laboratories. Eight were subsequently reclassified as non-cases following laboratory investigations and clinicians’ assessment. Corrective action had been taken early in the management of all these cases to ensure that they were isolated appropriately from other COVID-19 patients. Following the re-classifications, the Ministry of Health (MOH) had also rescinded any active quarantine orders of their close contacts.
All clinical laboratories approved to provide COVID-19 testing are licensed and subject to compliance with the Private Hospitals and Medical Clinics (PHMC) Act. Licensees are required to ensure that they have the relevant resources, competencies and processes to conduct these tests in an accurate, safe and timely manner. Where the administrative errors arise from laboratory processes, the licensees are required to put in place corrective actions, which include additional counterchecks, re-training of staff and IT integration, to ensure that similar errors will not recur.
Testing errors may also arise due to technical limitations inherent in the sensitivity and specificity of diagnostic tests1. Some results may be affected by other infections present in the person. MOH works closely with laboratory and clinical experts to review cases with borderline results and conduct thorough investigations, including repeat testing and review of the relevant clinical history and epidemiology. Such cases may subsequently be re-classified as non-cases. As a precautionary measure, MOH will classify them initially as positive cases and commence public health measures such as contact tracing and placing close contacts under quarantine while investigations are ongoing for such cases. Collectively, these measures will help to reduce the incidents of errors in testing results while allowing public health actions to be taken early to prevent further transmission of infection.