The federal Centers for Medicare and Medicaid Services has asked the state health department to investigate charges by a former pathologist at Magee-Womens Hospital that the hospital falsified "hundreds of thousands" of Pap smear reports and destroyed medical records.

The pathologist, Dr. Susan A. Silver, filed suit this week against Magee, the University of Pittsburgh, UPMC Medical Center and University of Pittsburgh Physicians Inc., alleging that she was removed from the staff after she complained that her unauthorized autosignature was affixed to Pap smear reports she had not reviewed. In addition, a class action suit has been filed on behalf of two Allegheny County women who want Magee to notify women who had Pap smears processed through Magee laboratories between 1995 and 2001.

Health department spokes-man Richard McGarvey confirmed yesterday that the Centers for Medicare and Medicaid Services, formerly the Health Care Financing Administration, had asked for the review.

"We're aware of the lawsuits and we're looking into what action needs be taken, if any," he said.

McGarvey said the investigation could involve a review of medical records, an on-site inspection, and interviews with staff and patients "when appropriate." The process can last from two to three days "up to a number of weeks, depending on how many people we have to talk to and how much documentation we need to look at."

If problems are found, the hospital will be told to develop a plan for correcting them.

Told of the investigation yesterday, UPMC spokeswoman Jane Duffield said, "Any certifying authority is always welcome to come in. In fact, Magee-Womens Hospital proactively called [the Joint Commission on Accreditation of Healthcare Organizations] and the Department of Health and informed them of the lawsuits and the media coverage."

Duffield reiterated that, "We believe all the allegations are unfounded, and that we will prevail in court."

In her suit, Silver said she notified hospital officials of the "unlawful and unsafe practices" involving the signatures and suggested corrective steps. When those steps were not taken, she and colleague Dr. Kenneth S. McCarty Jr. told the College of American Pathologists.

After hospital officials learned that the college would look into the matter, Silver said she was temporarily suspended, transferred to a full-time research position and later told she could not return to Magee. She also said medical records were destroyed or altered.

Silver is a board-certified pathologist with certifications in anatomic pathology and cytopathology, which is the study of diseased cells. She joined the UPMC staff in 1998 and later became a full-time pathologist at Magee. She has been unemployed since July 1, and says the hospital has destroyed her reputation and career.

Pap smears involve removing cells from a woman's cervix, then examining them microscopically for abnormalities that could indicate cancer. The cells are removed during a pelvic examination, then spread on glass slides for review.

In her suit, Silver says the hospital wanted to increase profits and market share by making it appear that physicians were reviewing the results in addition to cytotechnologists. In one instance, Silver was contacted by a gynecologist about two Pap smear reports bearing her signature, even though she had never reviewed the slides.

Although she complained and was assured that using the unauthorized electronic signature was an unintentional mistake, Silver says the practice continued. She also alleges that patients were never notified. Her suit seeks relief under Pennsylvania's Whistleblower Law and the Medical Care Availability and Reduction of Error (Mcare) Act of 2002.

Last month, two bills were introduced in the Pennsylvania House amending the Mcare Act to provide greater protection for medical workers who blow the whistle on poor or dangerous care. The bills were prompted by a series of Post-Gazette stories published in October about physicians who faced reprisals from their hospitals after reporting substandard care.