PATHOLOGY CRISIS IN CANADA: NEWFOUNDLAND; DAMNING EXTERNAL REPORT RELEASED. LACK OF EXPERTESE CITED IN PROVINCE'S LARGEST MEDICAL LAB;

"The review by Ontario’s University Health Network identifies numerous problems:

* Dysfunctional relationships among various members of the medical staff.
* Lack of expertise in complex areas of testing.
* Inappropriate relationships and responsibilities between managers and medical staff.
* Low morale, suspicion and distrust within the group.

The UHN's report recommends that all the pathology and cytology laboratories should be consolidated at a single site at Health Sciences Centre in St. John’s;"

CBC NEWS;

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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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"An external review of Newfoundland and Labrador’s largest medical laboratories has found dysfunctional relationships among staff and a lack of expertise in complex areas of medical testing," the CBC storypublished earlier today under the heading, "N.L. medical labs lack expertise: report," begins.

"The head of the province’s largest medical authority announced the results of the review Thursday," the story continues.

""We have a lot of work to do,” said Eastern Health CEO Vickie Kaminski. "This won't be a report that gets put on our shelves."

The review by Ontario’s University Health Network identifies numerous problems:

* Dysfunctional relationships among various members of the medical staff.
* Lack of expertise in complex areas of testing.
* Inappropriate relationships and responsibilities between managers and medical staff.
* Low morale, suspicion and distrust within the group.

The UHN's report recommends that all the pathology and cytology laboratories should be consolidated at a single site at Health Sciences Centre in St. John’s

It also said the province needs to recruit expertise in areas of complex medical testing.

It said the province needs more and better medical and scientific staff in the areas of biochemistry, hematology/hemopathology, transfusion medicine, microbiology, molecular diagnostics, cytogenetics and histocompatability testing in immunology.

Thursday, Kaminski said the health authority aims for 100 per cent accuracy, but it's not always possible.

"Realistically, we know that we're going to have problems in our testing in certain areas just because it's human nature, just because equipment will fail, just because there are a whole bunch of reasons that are known to us but outside our control," she said.

A University Health Network official involved in the review said medical laboratory problems are plaguing other parts of the country too.

"It's a question, I believe, of the complexity of laboratory medicine and the complexity of molecular testing. The demands on such are growing exponentially," said the UHN's Brad Davis.

Eastern Health ordered the external review in February after discovering a problem at its biochemistry lab at the Health Sciences Centre related to testing of the immunosuppressive drug cyclosporine.

In January, medical staff with the health authority began questioning the results of tests measuring blood levels of the drug.

Cyclosporine is commonly used after a transplant to prevent rejection of a new organ. It's also used to treat skin disorders and autoimmune diseases like lupus.

An external re-evaluation of some of cyclosporine test results found Eastern Health's laboratory was underestimating blood levels of the drug in some of its patients.

The cyclosporine problem came almost a year after Justice Margret Cameron completed a judicial inquiry into problems with laboratory tests that were given to breast cancer patients in Newfoundland and Labrador.

The provincial government ordered the inquiry into hormone receptor testing after it was revealed that hundreds of breast cancer patients between 1997 and 2005 received inaccurate laboratory test results.

A hormone receptor test is used to determine what kind of treatment a cancer patient should receive. An inaccurate test might result in a patient being denied an antihormonal treatment, such as tamoxifen, that may have helped them.

Cameron concluded that Newfoundland and Labrador's largest health authority failed hundreds of breast cancer patients with shoddy laboratory work and "practically non-existent" quality controls.

Cameron determined that Eastern Health not only made hundreds of mistakes with hormone receptor tests over an eight-year period but also wasn't aware of them because it had almost no quality-control measures in place to govern the pathology lab's work.

"There was a failure of both accountability and oversight at all levels," Cameron determined in a report released March 3, 2009, in St. John's."

The story can be found at:

http://www.cbc.ca/canada/newfoundland-labrador/story/2010/07/29/nl-lab-review-729.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; hlevy15@gmail.com;