"McLellan, a former chief coroner, started a review five years ago of 45 child autopsies conducted by discredited Ontario pathologist Dr. Charles Smith, who was once considered a leading forensic expert.
That review revealed that mistakes had been made in 20 cases, which cast doubt on several criminal convictions and sparked a public inquiry into Smith's work that recommended greater oversight for pathologists."
REPORTER MARIA BABBAGE; THE CANADIAN PRESS;
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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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"TORONTO - Provincial investigators probing unnecessary surgeries in southern Ontario said Wednesday they had "significant concerns" with the work of a pathologist involved in a mistaken mastectomy case," the Canadian Press story by reporter Maria Babbage published earlier today begins, under the heading, "Ontario investigators find 'significant concerns' with work of pathologist."
"After reviewing more than 6,000 cases stretching back to 2003, investigators say they had concerns about certain diagnoses by Dr. Olive Williams and the quality of some of her reports," the story continues.
"Medical experts had moderate or major disagreements with the original diagnosis in 221 of Williams' cases, 45 of which warranted "further investigation, treatment or patient follow-up," the report said.
Eight of the 45 patients needed further follow-up, with some needing additional investigation and or treatment, it added.
Medical experts also reviewed 19 additional cases of concern that were not part of the larger pathology review, which included some cases from other pathologists. Reviewers had concerns with four of Williams' cases in that group, as well as two other cases by other pathologists.
However, the report concluded that Williams' error rate was within an acceptable range as quoted in medical literature.
Williams is no longer practising in Ontario, but if she decides to resume her practice, the College of Physicians and Surgeons should consider assessing her competency, the report said.
The province's medical regulatory body is already investigating Heartwell and Williams. Hotel-Dieu Grace Hospital in Windsor — where the two unnecessary mastectomies were performed — suspended Williams' privileges in January.
Dr. Barry McLellan, who led the four-month probe, said he couldn't say whether cataracts contributed to potential errors by Williams, as alleged in an internal report by health officials.
"We certainly did not find any evidence to support any physical or medical condition contributing to any increase in rate because we didn't see that increase in rate over time," he said in Windsor.
The 74-page report cleared Dr. Barbara Heartwell, the surgeon involved in the two mistaken mastectomies.
Although there were some concerns that Heartwell may not be staying up-to-date with medical advances and was slow to adopt new surgical techniques, she "generally performed safe surgery and provided safe care," the report said.
It recommended that Hotel-Dieu lift its restrictions on her practice.
McLellan said his team was also concerned with "unproductive relationships" between doctors, senior management and the board of directors that existed at Hotel-Dieu for more than a decade.
"It is difficult to advance a quality agenda... unless you have good working relationships in the hospital," he said.
However, patients should share his confidence that facilities will resolve the issues as a result of the investigation, he said.
"There's little doubt that the lessons learned here in Windsor are valuable ones," McLellan said.
"They're lessons that hospitals across the province can look to and learn from. Ultimately, they will strengthen the quality of health care in Ontario."
Malcolm Maxwell, CEO of the Grand River Hospital in Kitchener, was appointed Wednesday as facilitator to oversee the implementation of the report's recommendations.
The report urged the hospitals to streamline, centralize and standardize their pathology work, adding doctors needed to continue training to keep up-to-date with modern practices and reporting methods.
The investigation began in March after two women came forward saying their breasts had been removed under the mistaken belief they had cancer.
Laurie Johnston of Leamington, Ont., had a mastectomy last November from Heartwell, who admitted she misread the results of a needle biopsy that found Johnston did not have cancer.
Janice Laporte, whose breast was removed by Heartwell in September 2001, was told a week after her surgery that she didn't have cancer.
Health Minister Deb Matthews called for the probe amid revelations that more incidents of unnecessary surgeries and incorrect pathology reports might be uncovered in Windsor. The investigation included Windsor Regional Hospital and Leamington District Memorial Hospital.
"I know this process has been difficult for some patients and their families and I hope that Dr. McLellan's report will provide them with the answers they have been looking for," Matthews said in a statement Wednesday.
"Today, the investigators have said that Windsor and Essex County residents can have confidence in the quality of care their hospitals are providing. I share that confidence."
McLellan, a former chief coroner, started a review five years ago of 45 child autopsies conducted by discredited Ontario pathologist Dr. Charles Smith, who was once considered a leading forensic expert.
That review revealed that mistakes had been made in 20 cases, which cast doubt on several criminal convictions and sparked a public inquiry into Smith's work that recommended greater oversight for pathologists.
In Newfoundland and Labrador, hundreds of patients whose breast cancer tests were botched received a $17.5-million settlement in a class-action lawsuit. Mistakes were detected on hormone receptor tests, which play an important role in determining the most appropriate course of treatment for breast cancer patients.
The province included the two other hospitals in its investigation because Williams has reports connected to all three facilities."
The story can be found at:
http://www.kbsradio.ca/news/14/1182408
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;