"HÔTEL-DIEU GRACE HOSPITAL SURGEON DR. BARBARA HEARTWELL HAS VOLUNTARILY STOPPED PERFORMING SURGERIES AFTER IT EMERGED SHE MISTAKENLY PERFORMED MASTECTOMIES ON TWO WOMEN WHO DID NOT HAVE BREAST CANCER. HÔTEL-DIEU HAD EARLIER SUSPENDED THE PRIVILEGES OF PATHOLOGIST DR. OLIVE WILLIAMS ON JAN. 4. OVERALL, "SEVEN SERIOUS CASES OF CONCERN" AT HÔTEL-DIEU HAVE COME TO LIGHT SINCE HOSPITAL OFFICIALS BEGAN A PATHOLOGY REVIEW LAST NOVEMBER. FIVE OF THOSE CASES INVOLVE HEARTWELL'S PATIENTS, INCLUDING THE TWO MISTAKEN MASTECTOMIES, HOSPITAL OFFICIALS SAY. HEARTWELL TOLD HÔTEL-DIEU SOME CASES OF CONCERN COULD INVOLVE "ISSUES WITH INCORRECT PATHOLOGY REPORTS," ACCORDING TO A HOSPITAL STATEMENT WEDNESDAY."
REPORTER TANYA TALAGA; TORONTO STAR;
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PUBLISHER'S NOTE: During the past two years, this Blog has reported on a crisis in Canadian pathology indicated by serious breakdowns in hospitals in Newfoundland, New Brunswick, Quebec, Saskatchewan and elsewhere in the country. The purpose, beyond seeking review and reform, is to show that the wide-ranging problems with pathology in Canada were not limited to the criminal sector - and that serious errors, sometimes lethal, were being made in reading test results on living patients. In short, to demonstrate that there was a crisis in Canadian pathology.
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"The Ontario government has launched a probe into botched medical procedures at a Windsor hospital and a review of 15,000 pathology tests dating back to 2003 after mistaken mastectomies on at least two women," reporter Tanya Talaga's story, published earlier today under the heading Mistaken mastectomies spark probe of hospita," begins.
"The actions of two doctors are also being investigated by the College of Physicians and Surgeons of Ontario, the provincial medical watchdog," the story continues.
"The government is considering sending a directive to all Ontario hospitals to check their pathology reports in the wake of the Windsor revelations.
Hôtel-Dieu Grace Hospital surgeon Dr. Barbara Heartwell has voluntarily stopped performing surgeries after it emerged she mistakenly performed mastectomies on two women who did not have breast cancer.
Hôtel-Dieu had earlier suspended the privileges of pathologist Dr. Olive Williams on Jan. 4.
Overall, "seven serious cases of concern" at Hôtel-Dieu have come to light since hospital officials began a pathology review last November. Five of those cases involve Heartwell's patients, including the two mistaken mastectomies, hospital officials say.
Heartwell told Hôtel-Dieu some cases of concern could involve "issues with incorrect pathology reports," according to a hospital statement Wednesday.
The pathology review started before the hospital learned from a media outlet on Feb. 5 of the first mistaken mastectomy, said Kim Spirou, vice-president of communications at Hôtel-Dieu.
"There are two parallel processes in place. One did precede the other. The pathology situation – that predated the Heartwell case. There was already a review at Hôtel-Dieu relating to a different adverse medical event which led to the broader review."
Neither Heartwell nor Williams has been disciplined by the college in the past, according to spokeswoman Kathryn Clarke.
Health Minister Deb Matthews announced Thursday the province is stepping in and will conduct its own external review of the Windsor matter along with the local health authority – the Erie-St. Clair Local Health Integration Network.
"Clearly there was a problem here that had an impact on the lives of people," said Matthews.
"The hospital already announced that it would review what happened. We think it is important, they think it is important, that we have people outside the hospital to take a look."
Matthews said the probe could expand.
"This is an external review of the situation in Windsor. If it appears we need to go broader, we will."
Windsor Essex Pathology Associates, the laboratory that provides pathology services to Hôtel-Dieu, also provides service to the Windsor Regional and Leamington District Memorial hospitals.
Windsor Regional said it has reviewed 171 slides reviewed by a pathologist over a period of six weeks and found no problems. The hospital would not identify the pathologist, whom it says worked primarily with Hôtel-Dieu.
Williams refused to comment.
Matthews said she believes Hôtel-Dieu responded appropriately to the mistaken mastectomies. "We need to take it seriously and continue to improve our system," she said.
In an effort to cut down on medical mistakes, Ontario is implementing surgical checklists for all hospitals in April. The province will publicly report results in July.
"Ontario is leading the way when it comes to surgical checklists," she said.
"It will be in all hospitals, for all operations, by April. It is proven to reduce deaths, to reduce complications. It improves patient safety. It is the right thing to do."
Hôtel-Dieu last week acknowledged Heartwell mistakenly removed patient Laurie Johnston's breast last fall, and said Heartwell has admitted she misread the results of a needle biopsy that found the woman did not have cancer. Public interest in the story intensified when another woman, Janice Laporte, came forward to say she had a breast removed by Heartwell in 2001 in error.
The hospital revealed Wednesday that a previous, unrelated probe of pathology results had uncovered problems in seven cases.
Malpractice lawyer Paul Harte said this situation could have been avoided if the surgical checklist had been used.
"I find it appalling in this day and age a major hospital like that didn't have a checklist like this," said Harte, who successfully acted for 225 women in a class-action suit against Dr. Errol Wai-Ping.
In one of the most highly publicized cases in Ontario, Wai-Ping, a Whitby obstetrician-gynecologist, lost his licence in 2004 after amassing a multitude of patient complaints and lawsuits against him dating back to 1992.
"It is ridiculous when you think about it. Look at a high-risk industry like aviation. It would be unacceptable for a pilot to not follow a checklist. It is a simple, easy way to prevent injury," Harte said.
Hôtel-Dieu has been the subject of controversy in the past with the death of a nurse, Lori Dupont. For nine months prior to her stabbing death on Nov. 12, 2005, Dupont was harassed by her former lover, Marc Daniel, an anesthesiologist at the hospital.
She complained about his behaviour and the Ontario Nurses Association said the hospital did not do enough to protect the 36-year-old nurse.
The Dupont family lawyer, Greg Monforton, said it was troubling to hear the recent revelations about Hôtel-Dieu.
"This is hugely disquieting, to say the least," he said."
The story can be found at:
http://www.healthzone.ca/health/yourhealth/women%27shealth/article/771860--mistaken-mastectomies-spark-probe-of-hospital
Harold Levy...hlevy15@gmail.com;
