PUBLISHER'S NOTE: I have included with this post a previous post April 30, 2017_ in which I opined that Gideon Koren wasn't the only prestigious staff member who the Hospital for Sick Children failed to curb before serious harm was done, and asked "How about Charles Smith?"..
"There is much in common between Gideon Koren and Charles Smith," I pointed out. "Both brought fame, prestige and money, to the world-famous hospital; Both were treated with silk gloves in spite of the disturbing allegations against them which called for a strong measure of protection of the public. Both were permitted by SickKids to carry on their work - Koren, in spite of the Discipline Panel's statement that there were grounds for dismissal, Smith in spite of the fact that his colleagues at the hospital believed that children of trusting parents were at risk. Both Koren and Smith have left legacies of destroyed lives and families; Some of the Smith cases have yet to be sorted out in the Ontario Court of Appeal, and the aftermath of Motherisk, as innocent parents ae forced to fight in the courts to get their children back, could go on for years." Read the entire editorial at the link below:
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PASSAGE ONE OF THE DAY: An independent review sparked by
a Star investigation into Motherisk
concluded in 2015 that the lab’s drug and alcohol hair tests, used in
thousands of child protection cases and several criminal cases, were
“inadequate and unreliable.” The Star’s investigation revealed that
prior to 2010, Motherisk’s testing process was using a methodology that
experts described as falling short of the “gold-standard test.” “In
the circumstances, I have concluded that the laboratory’s flawed
hair-testing evidence had serious implications for the fairness of child
protection and criminal cases,”
said independent reviewer Susan Lang, a retired Court of Appeal judge, in 2015."
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PASSAGE TWO OF THE DAY: "This was not
Koren’s first time in the college’s crosshairs.
He was suspended for five months, two of which without pay, for
professional misconduct in 2003 for writing so-called anonymous “poison
pen letters” to Dr. Nancy Olivieri and her supporters at Sick Kids,
calling them “a bunch of pigs” among other things. The pair had
worked on a drug study for generic drug maker Apotex, but ended up
disagreeing on the drug’s effectiveness, with Olivieri wanting to go
public with her concerns about potentially harmful side-effects. Apotex
terminated her clinical trials, but she published her findings anyway in
the New England Journal of Medicine. “It defies belief that an
individual of Dr. Koren’s professed character and integrity could author
such vicious diatribes against his colleagues as he did in the ‘poison
pen letters,’” reads the 2003 decision. “His actions were childish,
vindictive and dishonest.”
A separate Star investigation published last year also
identified what appear to be problems in more than 400 of Koren’s
papers. That prompted Sick Kids to announce in December a review of his
vast body of published work. The Star’s investigation found these
papers had been inadequately peer-reviewed, fail to declare, or perhaps
even obscure, conflicts of interest and, in a handful of cases, contain
lies about the methodology used to test hair for drugs."
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STORY: "Former head of Sick Kids’ Motherisk lab gives up medical licence amid investigation," by Legal Affairs Reporter Jacques Gallant, published by The Toronto Star on February 22, 2019.
PHOTO CAPTION: "Dr. Gideon Koren, founder and former director of Motherisk."
GIST: "Dr. Gideon Koren has agreed to never practise medicine again in Ontario in the face of
an investigation by the province’s medical regulator into whether he
committed “professional misconduct or was incompetent” while he was in
charge of the
Hospital for Sick Children’s Motherisk laboratory. The
promise to relinquish his licence is laid out in what is known as an
“undertaking,” posted on Koren’s profile on the College of Physicians
and Surgeons of Ontario’s website. In the document, signed by Koren this
month in Tel Aviv, he also promises not to reapply for a license in
this province. An independent review sparked by
a Star investigation into Motherisk
concluded in 2015 that the lab’s drug and alcohol hair tests, used in
thousands of child protection cases and several criminal cases, were
“inadequate and unreliable.” The Star’s investigation revealed that
prior to 2010, Motherisk’s testing process was using a methodology that
experts described as falling short of the “gold-standard test.” “In
the circumstances, I have concluded that the laboratory’s flawed
hair-testing evidence had serious implications for the fairness of child
protection and criminal cases,”
said independent reviewer Susan Lang, a retired Court of Appeal judge, in 2015. In March 2017, the college first confirmed to the Star
it was investigating Koren, who was in charge of the now-shuttered Motherisk lab until retiring in 2015. Koren
has had an active license to practise medicine in Ontario since 1982.
In recent years, he has been living and working in Israel. Koren
and his Toronto-based lawyer did not return requests for comment
Thursday. The undertaking means that the college’s investigation into
Koren will cease. Had the probe continued, one potential outcome could
have seen the college referring allegations of professional misconduct
to its discipline committee to hold a public hearing. It’s
unclear when the regulator first began its investigation into Koren.
Sick Kids previously told the Star that it forwarded results of
its internal investigation into Motherisk to the college in 2015. That
internal probe found the laboratory was at times operating without
appropriate oversight or proper quality assurance checks and had misled
the hospital over its testing process — which was relied upon in many
child protection cases across the country. “We deeply regret that
the practices in the Motherisk drug testing laboratory didn’t meet the
high standard of excellence that we have here at Sick Kids, and we
extend our sincere apologies to children, families and organizations who
feel that they may have been impacted in some negative way,” former
Sick Kids CEO, Dr. Michael Apkon, told the Star in an interview in 2015. This was not
Koren’s first time in the college’s crosshairs.
He was suspended for five months, two of which without pay, for
professional misconduct in 2003 for writing so-called anonymous “poison
pen letters” to Dr. Nancy Olivieri and her supporters at Sick Kids,
calling them “a bunch of pigs” among other things. The pair had
worked on a drug study for generic drug maker Apotex, but ended up
disagreeing on the drug’s effectiveness, with Olivieri wanting to go
public with her concerns about potentially harmful side-effects. Apotex
terminated her clinical trials, but she published her findings anyway in
the New England Journal of Medicine. “It defies belief that an
individual of Dr. Koren’s professed character and integrity could author
such vicious diatribes against his colleagues as he did in the ‘poison
pen letters,’” reads the 2003 decision. “His actions were childish,
vindictive and dishonest.”
A separate Star investigation published last year also
identified what appear to be problems in more than 400 of Koren’s
papers. That prompted Sick Kids to announce in December a review of his
vast body of published work. The Star’s investigation found these
papers had been inadequately peer-reviewed, fail to declare, or perhaps
even obscure, conflicts of interest and, in a handful of cases, contain
lies about the methodology used to test hair for drugs." (Files by Rachel Mendleson and Michele Henry.)
EDITORIAL FROM PREVIOUS POST: (April 30, 2017); Rachel Mendleson reports in her Toronto Star story, (April
29, 2017) headed, "Years before Motherisk scandal, SickKids stood by
doctor who wrote
‘poison pen letters,' that, after finding the allegations against Dr.
Gideon Koren proven," a discipline panel, composed of the former
presidents of SickKids and the University of
Toronto, ruled, "Your
actions constitute gross misconduct and provide sufficient grounds for
dismissal.” Although the panel upbraided Koren for "repeatedly lying”
and showing a
“reckless dereliction of duty,” Mendleson notes: "But,
citing his research achievements and the many young doctors he
supervised, who they said would be “disproportionately disadvantaged” if
Koren were fired, they instead docked him two months’ pay, fined him
$35,000 and continued his suspension until June 1, 2000. Koren remained
head of the Motherisk Program he founded in 1985. Charles Smith, the
notorious namesake of this Blog, also faced a barrage of serious
allegations before his voluntary, departure from the Hospital in July,
2005. However, before he quietly slunk out into the night - without
announcement or ceremony. the once celebrated pathologist had been the
subject of a battery of complaints made by physicians at the hospital
who were concerned about his diagnostic accuracy. In response to
evidence called about the hospital's response to these complaints,
Justice Stephen Goudge, concluded in the report of his independent
Inquiry into many of Smith's cases:
"As well as timeliness, the
hospital had concerns about Dr. Smith's diagnostic accuracy, Clinicians
rely on pathologist's diagnoses to make critical decisions of
treatment. Diagnostic discrepancies in surgical pathology can have
profound effects on patient care. As pathologist-in-chief, Dr. Becker
dealt with diagnistic concerns about Dr. Smith's pathology reports on
several occasions. Arround 1997, there was deonstrable convern at
Sickkids about Dr. Smith's clinical skills in the reading and
interpretation of microscopic slides. ........"On March 21, 1997, Dr.
Paul Thorner, the associate head of pathology at SickKids, wrote a memo
to Dr. Becker regarding diagnostic discrepancies in four of Dr. Smith's
surgical pathology cases. The identification of four misdiagnoses within
a short time frame was concerning. The first involved an error in what
should have been a straightforward diagnosis. In the second case, the
proper diagnosis was one that was easy to confuse with the diagnosis
made by Dr. Smith. The third case involved diagnosis of an unusual
lesion that might be difficult to recognize. These three cases did not
affect patient care. The fourth did. In the fourth case, Dr. Smith
misdiagnosed two frozen sections of tissue. Dr. Smith reported that
the two frozen sections were reactive, or non-malignant. Based on Dr.
Smith's diagnosis, the patient was removed from the operating roo to
recover. Subsequently the tissue samples were blocked and the permanent
slides were prepared. Dr. Smith correctly read the permanent section as
malignant. The child had to return to the operating room for placement
of a chemotherapy line. At a minimum, the child required a second
surgical procedure. More seriously, the peoper treatment may have been
delayed unnecessarily. In April 1997, Dr. Becker prepared a letter
addressed to Dr. Smith about "a disproportion in the number of
complaints about diagnostic inconsistencies from pediatricians and
surgeons" regarding Dr. Smith's surgical pathology work. The letter
indicated that Dr. Becker was curtailing Dr. Smith's responsibilities
in surgical pathology until Dr. Smith completed continuing medical
education courses to improve his surgical pathology skills. The letter
was unsigned and appears not to have been sent. Dr. Smith testified that
no one ever advised him of significant concerns regarding his surgical
pathology work or informed him that, as a result, he should cease
performing surgical cases. Dr. Becker's letter also stated that, as Dr.
Smith woud not be conducting surgical pathology on a regular rotation,
his "salary from the Division of Patholgy will be reduced by $20,000 for
1997." However, Dr. Smith's salary was not reduced in this matter.
Whether the letter was sent or not, it clearly reflects Dr. Becker's
concerns with Dr. Smith's diagnostic skills.".........Also, in 1997, a
SickKids oncologist complained about two surgical pathology cases in
which Dr. Smith had made errors.........These cases were a small
minority of all the surgical pathology work that Dr. Smith conducted
during the course of his career. However, at times, his colleagues were
clearly frustrated with his diagnostic mistakes. This frustration was
evidenced by an email written by Dr. Thorner to Dr. Becker in May, 1997
in which he referred to two complaints regarding Dr. Smith as "another
nail for the coffin." However it must be said that the complaints
regarding diagnostic issues did not rise to the level where the
pathologist-in-chief formally restricted Dr. Smith's privileges."
There is much in common between Gideon Koren and Charles Smith: Both
brought fame, prestige and money, to the world-famous hospital; Both
were treated with silk gloves in spite of the disturbing allegations
against them which called for a strong measure of protection of the
public. Both were permitted by SickKids to carry on their work -
Koren, in spite of the Discipline Panels statement that there were
grounds for dismissal, Smith in spite of the fact that his colleagues at
the hospital believed that children of trusting parents were at risk.
Both have left legacies of destroyed lives and families: some of the
Smith cases have yet to be sorted out in the Ontario Court of Appeal,
and the aftermath of Motherisk, as innocent parents fight to get their
children back, could go on for years."
Harold Levy: Publisher: The Charles Smith Blog.
http://smithforensic.blogspot.com/2017/04/hospital-for-sick-children-dr-gideon.html
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PUBLISHER'S
NOTE: I am monitoring this case/issue. Keep your eye on the Charles
Smith Blog for reports on developments. 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 found at: http://www.thestar.com/topic/charlessmith. Information on "The Charles Smith Blog Award"- and its nomination process - can be found at: http://smithforensic.blogspot.com/2011/05/charles-smith-blog-award-nominations.html Please send any comments or information on other cases and issues of interest to the readers of this blog to: hlevy15@gmail.com. Harold Levy: Publisher; The Charles Smith Blog;
