Clinical director of Wexford General Hospital Dr Colm Quigley has told a Medical Council inquiry that this is the first time he has been the subject of a fitness to practise hearing.
Dr Quigley, who is a former president of the Medical Council, is facing allegations of poor professional performance in relation to the treatment of Patient X, who was referred to him in July 2009.
The male patient died in April 2011 from inoperable lung cancer.
Dr Quigley told the inquiry that no cancer was missed in Patient X in 2009.
He said this was clear after having now read all of the medical reports, including tests conducted at St Vincent's Hospital in Dublin in 2011 where Patient X was later treated.
Dr Quigley, a consultant physician, said a paper administrative system operated at his private clinic at Ely Hospital in Ferrybank, Wexford, and it seemed to have been reasonably robust.
He said the patients were seen and tests were performed in a timely fashion.
Dr Quigley also said his medical secretary worked with him for 14 years and was superb. He said he had never experienced a flaw whereby tests were not ordered.
Dr Quigley said that when Patient X was referred to him by his GP in July 2009, the GP had already organised a chest X-ray and the result was normal.
Otherwise, the patient had ankle pain, a club foot and low sodium levels.
He said Patient X was a smoker, but there was no evidence of lung cancer.
Dr Quigley said that most of the important information from a patient examination was given in a dictated letter and not the handwritten notes.
He told the inquiry he may have mistakenly believed a test request form went to Wexford General Hospital.
Dr Quigley has said there is no allegation that his conduct contributed to the patient's death.
He said he "should have done better" in the case of Patient X, but it was not poor professional performance.
He said he was not alerted to the fact that tests were not done after the August 2009 consultation.
Dr Quigley said that when Patient X was referred to him again and was seen in December 2010, he focused on different health problems.
He said the fact that the earlier tests were not done should have been picked up.
Dr Quigley told the inquiry there may have been a problem with the dictaphone resulting in letters not going out.
Earlier, Dr Quigley's medical secretary gave evidence on the second day of the inquiry.
She said she does not know what happened to the X-ray request form for Patient X at Wexford hospital.
The secretary said she did not detach the form from the patient's file as there was no reason to do so.
The X-ray was not performed in 2009.
Prof Garry Courtney, the clinical director at St Luke's Hospital in Kilkenny, told the inquiry that Patient X was a complex case and he attended three hospitals.
Giving expert evidence for Dr Quigley, he said tests were planned and not done and it was a “huge mistake”.
Prof Courtney said a paper-based system is only as strong as paper and cannot properly track tests.
He said paper clips and staples can become detached and it will never be known what went wrong in this case.
