A review of the clinical records of 44 patients who died under the care of former neurologist Michael Watt has found "significant failures in their treatment" and "poor communication with families".
While this review looked at a sample of cases in which people died, potentially thousands more could be affected.
The review arises from a 2018 recall of 2,500 outpatients who were in Dr Watt's care at the Belfast Health Trust.
About one in five patients had to have their diagnoses changed.
This separate review into 44 deaths was conducted by the Royal College of Physicians at the request of the regulator, the Regulation and Quality Improvement Authority (RQIA).
It highlighted concerns over clinical decision-making, prescribing and diagnostics.
It reveals a misdiagnosis rate of 45% among this group of patients, twice that for living patients.
Speaking to BBC News NI, the RQIA's chair, Christine Collins, said the outcome of the review was "shocking and gut-wrenching as so many had experienced unpleasant deaths which they ought not to have done".
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Source: BBC News, 29 November 2022