Friday, December 12, 2008


The first Canadian Press story on the report into disgraced pathologist Dr. Rajgopal Menon leads with the fact that the authorities who hired Menon failed to properly check out his level of competency.

This is another eerie parallel with the Charles Smith travesty in Ontario.

MIRAMICHI, N.B. — "A public inquiry into the work done by the former chief pathologist at a hospital in northern New Brunswick says his hiring was done in a rush and without proper background checks on his level of competency," the December 11, 2008 story under the heading, "Inquiry finds background checks weren't done in hiring of pathologist Menon," begins.

"Justice Paul Creaghan also said in his final report released Wednesday that Dr. Rajgopal Menon should have lost his licence in 2005, two years before he was suspended from working by the College of Physicians and Surgeons of New Brunswick," the story continues.

"Overall, we found that his service was unsatisfactory in terms of both attention to his duties and to the level of his performance," Creaghan wrote in his three-volume report.

The retired judge also pinpointed a litany of systemic problems within New Brunswick's health care system and found that the Health Department had no idea whether pathology labs in the province were operating at acceptable levels of quality.

He also found there has been no program of quality control in the pathology lab at the Miramichi Regional Hospital since 1994.

"The commission found no meaningful peer review of Dr. Menon's work while he was employed at the hospital," Creaghan said in the report.

Menon worked at the Miramichi hospital from 1995 until early 2007, when his licence was suspended following complaints about incomplete diagnoses and delayed lab results. It has since been reinstated but Menon must complete remedial training before he can return to the laboratory.

The inquiry was called shortly after his licence was suspended after the Health Department launched a review of almost 24,000 cases dating back 13 years from Menon's lab.

An audit of Menon's work earlier this year found 18 per cent of 227 breast and prostate cancer reports were incomplete and three per cent were incorrect.

Among his 52 recommendations, Creaghan said the College of Physicians and Surgeons needs greater resources to deal with discipline matters.

He said the process of suspending Menon's licence took too long as a result of legal avenues available to the doctor and the cautious approach taken by the college in reacting to potential legal repercussions.

Menon, who is now in his 70s, said his work was not as flawed as the inquiry was told and he questioned the way the hospital was managed.

"My rate of errors are much less than what you've seen in the report," he told reporters after the report was released.

"There was no reference to the management's role in creating the problems."

Asked if he thought he had been made a scapegoat for problems at the lab, he replied: "That would be self-serving, but I did not intentionally do all those things."

The report makes no findings of criminal or civil negligence, and none of the findings is binding on the provincial government.

Health Minister Mike Murphy said he wants time to study all the recommendations, but will announce his plans prior to the spring budget.

"There is a quality control program in place to the extent of auditing within that lab ... but there is not a quality assurance program in place on a provincewide scale," Murphy said.

"We have to make sure that nothing like that can go off the rails again as it did for a number of years."

The report states that Menon's hiring in 1994 coincided with the amalgamation of two community hospitals into a new regional facility and management demands were pressing.

"The sense of urgency resulted in a situation where there was pressure on the CEO of the day to hire whomever he could get and Dr. Menon was the only candidate who appeared to be available," the report says. "The check on Dr. Menon's current level of competency was not thorough or even adequate."

The report also said the hiring policy used to in Menon's case was "confused" as the credentials committee recommended he be hired on a probational basis for one year. Instead, Menon was hired without any conditions in an oral agreement.

Creaghan also recommended that the Health Department maintain pathology lab services in all regional hospitals in the province, and that it negotiate a deal with the Capital District Health Authority in Halifax to provide consultative laboratory services to pathology labs in New Brunswick.

"If we don't have those systems in place, this problem's going to happen again. There's no question in my mind. ... I don't know when, but it's going to happen again."

A 2007 peer review, released publicly last March, concluded Menon wasn't fit to work. It stated Menon had medical problems that could have affected the accuracy of his work, including tremors in his hands and cataracts.

A lab in Ottawa is still reviewing the 24,000 cases from Menon's lab in Miramichi. About 100 cases from Menon's brief stint at Edmundston Regional Hospital in 2002 are also under review.

During his testimony in May, Menon apologized for any mistakes that might have been made on his behalf.

"I wish to sincerely apologize to any patient if I made an error in reading their pathology slide," he testified. "I was not aware of any errors in my work."

Menon has filed a civil suit against the regional health authority.

Halifax lawyer Raymond Wagner has filed an application for certification of a class-action lawsuit against Miramichi's Regional Hospital Authority on behalf of patients whose test results were reviewed by Menon.

New Brunswick is not the only province that has called an inquiry into problems in its medical labs.

A public inquiry into hundreds of botched breast cancer tests in Newfoundland and Labrador concluded its public hearings on Oct. 31.

The inquiry, which has yet to release its final report, was asked to determine how an estimated 400 patients under the Eastern Health authority's care were given inaccurate results on their breast cancer tests.