Tuesday, May 6, 2008

Drs. Charles Smith And Rajgopal Menon: Their Colleagues Saw Nothing To Be Concerned About; A Sense Of Deja Vu;

The New Brunswick Inquiry into the flawed work of Dr. Rajgopal Menon has been informed that his colleagues had no idea that there were serious problems with the pathologist's work.

The commission of inquiry into pathology services in New Brunswick was struck after an audit of the laboratory work of Dr. Rajgopal Menon, 73, found a significant number of errors and missed diagnoses, especially in relation to prostate and breast cancers.

(Menon, who will testify at the inquiry later this month, has defended his work, calling the review "unjustified and unfair." He has also filed a civil suit against the regional health authority.)

As reported by the Canadian Press yesterday, in a story headed, "NB inquiry into pathology errors told lack of professionals," this evidence came from Nora Kelly, a former deputy minister of health in New Brunswick.

"Kelly said she had no inkling of serious problems with Menon's work", the story, datelined Moncton, N.B. says.

"She said there were general comments from his colleagues about his slow work habits, his tardiness and missing slides, but no one suggested his work might be sub-standard.

"They didn't like the way he operated, but they never said that he was incompetent," Kelly told commissioner Paul Creaghan, a retired judge."

Slow work...tardiness...missing slides!

Hmmm...Sounded familiar;

Where had I heard that before.

Or, as I had a chance to use my best French in a recent posting, was there not an epic sense of "deja vu?"

As I read these words, I thought back to testimony given to the Goudge Inquiry by Drs. Dirk Huyer, once head of the Suspected Child Abuse and Neglect (SCAN) Unit at the hospital for several years, under cross-examination by Commission Counsel Linda Rothstein;

Try this for size...

MS. LINDA ROTHSTEIN: Dr. Huyer, do you remember what year it was that you last saw Dr. Smith?

DR. DIRK HUYER: I suspect it was 2001.

MS. LINDA ROTHSTEIN: All right. And you would have first met him then 1989?

DR. DIRK HUYER: In January, 1990.

MS. LINDA ROTHSTEIN: 1990. During that period, at any stage, did you develop any concerns about Dr. Smith, as a professional, of course?

DR. DIRK HUYER: There were a number of times where I was notified about issues relating to Dr. Smith.

Primarily, those were issues about timeliness of reports.

And that was a recurrent pattern for me, and timeliness of -- of findings.

So, for example, I've done some talks out West, where police and Children's Aid have been there and made -- and I developed some acquaintances.

And I had been contacted by a RCP -- RCMP officer -- and I can't remember from which province -- who said to me, you know, I sent something to Dr. Smith for an opinion.

It's been a year and a half, and I can't get him.

He won't answer my call.

I -- and I need that material, because court's coming up.

And can you help me, because otherwise I'm going to have to call the
College to -- to get that stuff back.

And so I would go to Charles -- or I went to Charles and I said, Charles, you know, this officer has called me.

What -- what's up?

And then I didn't hear anything more of it following that time, so I made a presumption that he returned the material.

I had heard various things, as I say, about delay and -- and opinions being provided.

And I had heard, although I have no -- no ability to sort through this, that at times his opinion might be different at the time of the autopsy and then his final report."

So what was Dr. Huyer's opinion of his colleague?

DR. DIRK HUYER: Yes. Now, my direct observations of Dr. Smith in the autopsy suite, to me, seemed very thorough, very patient, very methodical in
his approach in doing the autopsies and watching the autopsies.

I never developed a concern about that.

And -- and as -- as you know, I have a very broad experience in watching autopsies with a variety of different pathologists.

So I did not develop any concerns during that time.

Reading his reports, which I had done on a frequent basis, again, concerns didn't jump out to me in -- in the spectrum of other pathology reports that I read.

Obviously, I can't analyse or understand the histopathology, so I couldn't evaluate that in any -- to any -- any degree.

But I -- things were not jumping out to me as being a concern.

His office was pretty cluttered and pretty much on the extreme end of what I would describe as cluttered.

But I'll tell you, I've been in a lot of cluttered offices and that, to me, isn't a definite marker of a problem."

Deja vu?

(At a general level, the comments of Menon's and Smith's colleagues raise crucial questions about hospital culture; Are there pressures on doctors and hospital staff to keep silent about other physicians - even when they have knowledge that the public could be harmed? Is this culture reflected in hospital administrations ad the various self-regulating colleges? Why don't Doctors get more actively involved in cleaning up their professions? Is there a "thin white line?")

Harold Levy...hlevy15@gmail.com;