"THE PROVINCE ON MONDAY NAMED THREE TOP DOCTORS TO LEAD A FAR-RANGING INVESTIGATION INTO THE TREATMENT OF PATIENTS AND QUALITY OF CARE AT THREE WINDSOR-AREA HOSPITALS GRAPPLING WITH A CRISIS SPARKED BY QUESTIONABLE PATHOLOGY REPORTS. THE PROBE WILL ALSO EXAMINE MISTAKEN SURGERIES AT ONE HOSPITAL AFTER TWO WOMEN HAD MASTECTOMIES WHEN THEY DIDN'T HAVE CANCER. A PATHOLOGY REVIEW AT WINDSOR'S HÔTEL-DIEU GRACE HOSPITAL ALREADY HAS LED TO THE SUSPENSION OF ONE PATHOLOGIST."
REPORTER TANYA TALAGA: THE TORONTO STAR;
-------------------------------------------------------------------------------
PUBLISHER'S NOTE: Dr. Barry McLellan is the ideal person to coordination this crucial investigation. He is utterly fearless. As Chief Coroner of Ontario he personally supervised the investigation that led to the discovery of the crucial forensic evidence in Dr. Charles Smith's office at the Hospital for Sick Children in Toronto - "missing" for years - that led to the exoneration of William Mullins-Johnson. He then instituted an inquiry of forty-five of Smith's cases that revealed that sparked the Goudge Inquiry. Dr. McLellan pursued the evidence no matter where it might lead on the forensic side of pathology in Ontario - as he can be expected to do on its hospital counter-part. McLellan's appointment is an excellent start on the road to regaining public confidence in the pathology practiced in Windsor. (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, that there was a crisis in Canadian pathology.)
-------------------------------------------------------------------------------
"The life of pathologists at many Ontario hospitals involves a crushing workload and tight deadlines, says one doctor working on the front lines in the GTA," the Toronto Star story by reporter Tanya Talaga published earlier today begins, under the heading "As hospital probe widens, are pathologists overworked?"
"The province on Monday named three top doctors to lead a far-ranging investigation into the treatment of patients and quality of care at three Windsor-area hospitals grappling with a crisis sparked by questionable pathology reports," the story continues.
"The probe will also examine mistaken surgeries at one hospital after two women had mastectomies when they didn't have cancer.
A pathology review at Windsor's Hôtel-Dieu Grace Hospital already has led to the suspension of one pathologist.
But health advocates and pathologists say a patchwork of protocols and widely varying workloads create a climate where mistakes are more likely to happen.
One pathologist at a suburban GTA hospital said pathologists sometimes review 30 to 35 cases in one day. Those cases can vary in terms of workload and how many slides are examined.
"One case can be 30 slides, or one can be three slides. A mastectomy is a lot of slides and different from gastro biopsies," the pathologist said. "Still, you are expected to have a fast turnaround time. You have to finish your cases. The physicians need their reports."
Some larger hospitals, such as well-equipped teaching hospitals, limit the amount of work that can be done in a day, or how many slides can be examined, but that is often not possible in smaller settings or in hospitals with fewer specialists, the pathologist added.
The Ontario Hospital Association is calling for a province-wide examination into the quality of pathology services and for the establishment of regulatory standards.
President Tom Closson has said a shortage of pathologists – there are 411 in Ontario – and inconsistent hospital protocols mean patient care could suffer.
Pathologists are medical doctors, also known as lab physicians, who take on five extra years of specialist training and earn roughly $340,000 annually.
They review laboratory results and help make important diagnoses such as whether tissue is cancerous.
A pathologist's workload varies significantly depending on where the doctor works, said Dr. Dina El Demellawy, a lab physician who also teaches at the Northern Ontario School of Medicine.
"Throughout the province there is no consensus on pathology work-load," she said.
The pathologists who bear the brunt are those in small community hospitals, she added.
Ontario's Liberal government has quadrupled the training spots for pathologists since coming into office.
El Demellawy said that while increasing the training spots is helpful, there have to be jobs available.
"Many new graduates in pathology, they can't find jobs," she said. "You can train people but that doesn't mean they are in the system."
Health Minister Deb Matthews said Monday the government's "highest priority" right now is to reassure Windsor patients about their pathology results.
The review in Windsor will look back over the past two years and examine 3,000 pathology results.
The investigation is expected to be finished in June.
Dr. Barry McLellan, the president of Sunnybrook Health Sciences Centre and Ontario's former chief coroner, will lead and co-ordinate the investigation.
McLellan, in his role as chief coroner, began a sweeping review five years ago of 45 child autopsies conducted by discredited pathologist Dr. Charles Smith.
"I've asked Dr. McLellan to do whatever we have to do to speed up the review of the tests," Matthews said.
"I understand he's going to have each case reviewed twice."
Also on the investigation panel are Dr. Robin McLeod of Cancer Care Ontario, who will focus on surgical errors, and Dr. John Srigley, also from the cancer agency, who will look at pathology results.
The three hospitals under review are the Hôtel-Dieu, Windsor Regional Hospital and Leamington District Memorial Hospital.
The Liberals announced the review in Windsor will look back over the past two years and at 3,000 pathology test results – not 15,000 dating back to 2003, as previously planned.
The probe will also look into two mistaken mastectomies at Hôtel-Dieu.
Dr. Barbara Heartwell, who performed both surgeries, has voluntarily stopped performing surgeries until the probes are complete.
Matthews has asked the doctors to report on circumstances surrounding the mistaken surgeries, errors in pathology reports and other issues related to patient care.
Hôtel-Dieu suspended the privileges of pathologist Dr. Olive Williams on Jan. 4.
Overall, seven cases of concern have come to light since hospital officials began a pathology review last November.
The review preceded the revelations about the mistaken mastectomies.
Matthews said she'll wait for McLellan's report before deciding if a broader review is needed."The story can be found at:
http://www.healthzone.ca/health/newsfeatures/healthcaresystem/article/773669--overworked-pathologists-beg-for-help?bn=1
Harold Levy...hlevy15@gmail.com;
