Monday, December 13, 2010

PATHOLOGY CRISIS IN CANADA; ONTARIO TO TAKE CONTROL OF WINDSOR HOSPITAL INVOLVED IN MISTAKEN MASTECTOMIES, THE CANADIAN PRESS REPORTS;

"The report, released in August, came after two women came forward saying their breasts had been removed at Hotel-Dieu under the mistaken belief they had cancer.

Laurie Johnston of Leamington, Ont., had a mastectomy in November 2009 from Dr. Barbara 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.

The 74-page report appeared to clear Heartwell, who "generally performed safe surgery and provided safe care," although there were some concerns that she may not be staying up to date with medical advances and was slow to adopt new surgical techniques."

REPORTER MARIA BABBAGE; THE CANADIAN PRESS;

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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 Ontario, 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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"TORONTO - The province is taking control of a troubled Windsor hospital that became the centre of a controversy over surgical and pathology errors," the Canadian Press story by reporter Maria Babbage published on December 13, 2010 under the heading, "Province to take control of Windsor hospital involved in mistaken mastectomies," begins.

"A full-time supervisor will be brought in to oversee Hotel-Dieu Grace Hospital once cabinet approves the request, Health Minister Deb Matthews said Monday," the story continues.

"The provincial supervisor will ensure that the recommendations of a recent report into pathology errors at three Windsor-area hospitals are implemented, she said.

"We need to get Hotel-Dieu Grace back on track. We need to do it as quickly as possible," Matthews said in a conference call.

"We do not have concerns around patient safety, but we do have concerns about the workplace environment."

The report, released in August, came after two women came forward saying their breasts had been removed at Hotel-Dieu under the mistaken belief they had cancer.

Laurie Johnston of Leamington, Ont., had a mastectomy in November 2009 from Dr. Barbara 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.

The 74-page report appeared to clear Heartwell, who "generally performed safe surgery and provided safe care," although there were some concerns that she may not be staying up to date with medical advances and was slow to adopt new surgical techniques.

But the four-month probe uncovered "significant concerns" with the work of pathologist Dr. Olive Williams after reviewing more than 6,000 reports stretching back to 2003.

It also found that "unproductive relationships'' between doctors, senior management and the board of directors existed at Hotel-Dieu for more than a decade.

The report urged the hospital to foster better relationships, but concerns were raised by provincial facilitator Malcolm Maxwell about the "timely implementation" of that recommendation, the government said.

Hospitals are usually placed under provincial supervision when they can't balance their books, but Matthews said Hotel-Dieu was a "special case."

"It's a bit unusual for a supervisor to go in for a reason related to the culture of a workplace," she said.

"More often, it has more to do with financial concerns. So this is a bit of an unusual situation."

She said the hospital has been "extremely co-operative," but remained tightlipped on why she found it necessary put the hospital under provincial control.

Just two weeks ago, Matthews said she would follow through on the board's request for a full-time adviser, saying there was no need to appoint a supervisor, who has far more power.

But advisers have no authority under provincial law, Matthews said Monday. At first, she said Maxwell advised the government to appoint a supervisor, but later clarified her remarks, saying he didn't specifically recommend a supervisor.

Maxwell said the hospital developed plans to implement changes, but needed full-time help to follow through.

"What was missing was clarity of responsibilities, who advised and who made decisions on various points and well-defined processes that would leave everyone with an interest in a decision, confident that they'd been heard and confident that the decision was made the right way," he said in an interview.

As for the hospital, both the board of directors and executives "fully support" the appointment of a full-time supervisor, said spokesman Steve Erwin.

"Clearly, the hospital needs to do better in terms of relationships between leadership, the board, medical staff, and we hope that a supervisor in this hospital will help drive the hospital towards that goal," he said.

Hotel-Dieu, which has 413 physicians and 1,785 staff, has a troubled history going back years.

In 2005, nurse Lori Dupont was stabbed to death by her former boyfriend, Marc Daniel, while on duty at Hotel-Dieu. Daniel, an anesthesiologist who also worked at the hospital, injected himself with a fatal dose of anesthetic and died days later.

The case prompted the governing Liberals to bring in legislation last year that required employers to take reasonable precautions to protect employees from domestic violence that may occur at work.

Last March, Windsor police said they were investigating allegations of "inappropriate comments" made by an off-duty emergency room doctor at Hotel-Dieu to a nurse and clerk.

The hospital is also dealing with a multimillion-dollar wrongful dismissal lawsuit filed by former spokeswoman Kim Spirou, who alleges CEO Warren Chant pressured her to cover up wrongdoing at Hotel-Dieu.

Chant has called the allegations "scandalous and meritless."

Matthews said the lawsuit had nothing to do with her decision to appoint a supervisor, but Progressive Conservative health critic Christine Elliott said she has her doubts.

"I think there's a lot more to this than meets the eye here," she said.

"It must be a very toxic situation there if the facilitator hasn't been able to deal with it.""


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The story can be found at:

http://www.winnipegfreepress.com/life/health/province-to-take-control-of-windsor-hospital-involved-in-mistaken-mastectomies-111788754.html

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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://www.blogger.com/post-edit.g?blogID=120008354894645705&postID=8369513443994476774

Harold Levy: Publisher; The Charles Smith Blog; hlevy15@gmail.com;