PATHOLOGY CRISIS IN CANADA: DR. JAMES MURRAY; PROFESSOR WHO IS SUBJECT OF TERRIBLE ERROR IN DIAGNOSIS SEEKS PROBE OF OTHER PATIENTS TREATED BY HIM;

"Nicholas Bala said the college should undertake an immediate probe of Dr. James Murray’s practice.

The matter is urgent, he said, in light of the emergence of a second Kingston complainant, who contends his cancer was misdiagnosed in 2007 by the same pathologist.

“Ultimately, this is a something the public has a right to know,” Bala said in an interview with the Citizen. “There are potentially other cases out there. And there’s no reason they (the college) should not be going ahead in a timely fashion.”

Murray, a pathologist then working for CML HealthCare Inc. in Toronto, reported as “benign” a skin sample taken from Bala’s shin by a Kingston family doctor in April 2007.

The mistake was discovered only after Bala developed a lump in his groin that was diagnosed in September 2008 as metastatic melanoma, an advanced and potentially fatal form of skin cancer......

Bala’s case is the latest in a series of events that have raised concern about the quality of pathology services in Canada.

Last year, more than 2,700 Quebec women with breast cancer were re-tested to determine whether they could be helped by the drug Herceptin.

That followed a study by the Quebec Pathology Association, which found lab tests for hormone markers — they determine whether the cancer could respond to hormone therapy — were seriously flawed.

In Newfoundland and Labrador, a public inquiry found that more than 380 breast cancer patients received incorrect results for hormone-receptor tests.

The inquiry report said quality controls at the pathology lab in St. John’s were “so deficient as to be practically nonexistent.”

In Ontario, an inquiry headed by Justice Stephen Goudge concluded in 2008 that Dr. Charles Smith’s shoddy work and biased testimony as a forensic pathologist led to a series of wrongful murder prosecutions in the province."

REPORTER ANDRE DUFFY: OTTAWA CITIZEN;
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BACKGROUND: 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, Ontario 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.

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PUBLISHER'S NOTE: I was very saddened to learn that Professor Nicholas Bala - a consultant to the Goudge Inquiry into cases involving Dr. Charles Smith and champion of the rights of children - has fallen victim to a terrible misdiagnosis. To make matters worse, it appears that the College of Physicians and Surgeons of Ontario refused to investigate Prof. Bala's complaint on the basis that the doctor had retired - and the College abandoned other patients of Dr. James Murray who had a legitimate expectation that the governing body of the medical profession in Ontario would ensure that they, too, had not been misdiagnosed. To the College's shame, it had to be forced by a review body - the Health Professions Appeal and Review Board - to reconsider Bala’s complaint and to immediately investigate allegations of a second misdiagnosis by Dr. Murray in 2007. As Ottawa Citizen reporter Andrew Duffy (a crackerjack reporter and former colleague at the Toronto Star) reported, "If the second case is confirmed, the review panel said, the college should quickly undertake a full review of Dr. Murray’s practice." This is the same governing body that blocked the efforts of victims of Dr. Charles Smith to launch complaints against him - until forced to do so by the same Board. This is the same body that kept a secret file - containing damning information about Smith from the Office of the Chief Coroner - away from the eyes of its own investigators. This is the same College that ultimately gave Smith a "caution" on three cases in which independent examiners said they were "extremely disturbed" by deficiencies in his approach. (Since the "caution" was not considered important enough to enter into the College's official registry, his conduct in all three cases was shielded from the public, and he could continue to bask in his self-manufactured reputation as the great Dr. Charles Randal Smith). Last but not least, this is the same College that for whatever reason - in spite of the investigations it was conducting in the three cases - failed to unearth the fact that serious allegations had been made against him by fellow staff members at the Hospital for Sick Children where he worked for many years. I salute Professor Bala for fighting on behalf of all of Dr. Murray's patients and the public to ensure that at immediate review is conducted. The unfortunate lesson I draw from all of this is that some leopards, like the College for Physicians and Surgeons of Ontario, truly won't change their spots.

Harold Levy. Publisher. The Charles Smith Blog.

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"A Queen’s University law professor, whose skin cancer was misdiagnosed three years ago by a Toronto pathologist, wants the retired doctor’s work reviewed by the College of Physicians and Surgeons of Ontario," the story by reporter Andre Duffy published in Ottawa Citizen on July 25, 2010, under the heading, "Queen’s professor calls for review of pathologist’s work: Skin cancer misdiagnosed 3 years ago."

"Nicholas Bala said the college should undertake an immediate probe of Dr. James Murray’s practice," the story continues.

"The matter is urgent, he said, in light of the emergence of a second Kingston complainant, who contends his cancer was misdiagnosed in 2007 by the same pathologist.

“Ultimately, this is a something the public has a right to know,” Bala said in an interview with the Citizen. “There are potentially other cases out there. And there’s no reason they (the college) should not be going ahead in a timely fashion.”

Murray, a pathologist then working for CML HealthCare Inc. in Toronto, reported as “benign” a skin sample taken from Bala’s shin by a Kingston family doctor in April 2007.

The mistake was discovered only after Bala developed a lump in his groin that was diagnosed in September 2008 as metastatic melanoma, an advanced and potentially fatal form of skin cancer.

A Kingston General Hospital pathologist, Dr. Victor Tron, subsequently reviewed Bala’s original 2007 skin sample and found that invasive melanoma had been present on the slide.

It’s important to treat melanoma in its early stages.

Bala underwent three major surgeries, including the partial removal of his liver, and more than a year of chemotherapy to combat the spread of the disease.

He filed a formal complaint with the College of Physicians and Surgeons of Ontario in February, 2009, demanding a broad review of Dr. Murray’s work.

In January, a college committee dismissed the complaint even though two biopsy slides, taken from re-cuts of Bala’s 2007 skin sample, revealed “unequivocal melanoma.”

The committee ruled that since Dr. Murray had retired in 2008, he presented no risk to the public. What’s more, the committee said, his work had been the subject of only two complaints during a 40-year career.

The committee also took into consideration the fact that Dr. Murray had suggested that another biopsy “might be considered” in Bala’s case, and that the original biopsy slide had been lost, frustrating a “truly fair review” of the pathologist’s work.

Bala appealed the decision to the Health Professions Appeal and Review Board, which issued its decision in June.

The review board ordered the college to reconsider Bala’s complaint and to immediately investigate allegations of a second misdiagnosis by Dr. Murray in 2007. If the second case is confirmed, the review panel said, the college should quickly undertake a full review of Dr. Murray’s practice.

Said the review board: “Considering the ramifications of an error to the public... and in light of the tragic and highly public cases of pathology errors in Ontario and Canada, the board would expect the committee and the college to demonstrate an extremely high level of sensitivity to the possibility of any other such situation.”

A spokesperson for the college said the complaint committee is reviewing the appeal board’s direction. “We will reconsider the decision as soon as we can,” said Kathryn Clarke.

Bala said he’s disturbed by the college’s inaction: “This is centrally about them looking at other cases while there are other individuals whose health may well be affected.”

Bala said his life expectancy has been “drastically reduced” by what is now an incurable form of cancer.

“I’m personally hoping for the best, but I have to live with it. I feel well, but I’m very cautious about my situation,” he said. “At best, I will be treated by oncologists the rest of my life.”

Bala’s case is the latest in a series of events that have raised concern about the quality of pathology services in Canada.

Last year, more than 2,700 Quebec women with breast cancer were re-tested to determine whether they could be helped by the drug Herceptin.

That followed a study by the Quebec Pathology Association, which found lab tests for hormone markers — they determine whether the cancer could respond to hormone therapy — were seriously flawed.

In Newfoundland and Labrador, a public inquiry found that more than 380 breast cancer patients received incorrect results for hormone-receptor tests.

The inquiry report said quality controls at the pathology lab in St. John’s were “so deficient as to be practically nonexistent.”

In Ontario, an inquiry headed by Justice Stephen Goudge concluded in 2008 that Dr. Charles Smith’s shoddy work and biased testimony as a forensic pathologist led to a series of wrongful murder prosecutions in the province."

The story can be found at:

http://www.montrealgazette.com/health/Queen+professor+calls+review+pathologist+work/3319933/story.html

PUBLISHER'S NOTE: The Toronto Star, my previous employer for more than twenty incredible years, has put considerable effort into exposing the harm caused by Dr. Charles Smith and his protectors - and into pushing for reform of Ontario's forensic pediatric pathology system. The Star has a "topic" section which focuses on recent stories related to Dr. Charles Smith. It can be accessed at:

http://www.thestar.com/topic/charlessmith

For a breakdown of some of the cases, issues and controversies this Blog is currently following, please turn to:

http://smithforensic.blogspot.com/2010/07/new-feature-cases-issues-and.html

Harold Levy: Publisher; The Charles Smith Blog;