PUBLISHER'S NOTE: The article published by The Canadian Journal of Pathology referred to in this post is called, "Dick van Velzen and the Burnside Warehouse organ scandal in Nova Scotia Canada," and authored by James A. Wright Jr. and William Hibbitts in the May 2023, Volume 15 issue. A note by the publication's Erica Schollenberg reads: "In this issue of the Canadian Journal of Pathology you will find a fascinating account of the fortunately brief Canadian practice of Dick van Velzen, whose practice at Alder Hey Children's Hospital in the UK was publicly and extensively documented and criticized. It may surprise some readers that the typical Canadian pathology resident probably doesn't immediately recognize the names Dick van Velzen or Alder Hey. Some likely aren't even familiar with Canadian pathology's own more recent "scandals," including: The Goudge Inquiry into the practice of Dr. Charles Smith; the report into pathology failures in Miramichi, New Brunswick; the Cameron Inquiry on hormone receptor testing in Newfoundland; and the independent review into the Motherisk hair toxicology laboratory. I encourage all Canadian pathologists to read these reports."
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ABSTRACT: Wiley's online library: "Dick van Velzen practiced as a pediatric pathologist at Alder Hey Children's Hospital in Liverpool, England from September 1988 until December 1995; he then relocated to the IWK-Grace Health Centre, a children's and maternity hospital in Halifax, Nova Scotia, Canada, where he practiced until he was fired for cause in January 1998. About a year and a half later, his practice in Liverpool came under increasing scrutiny, with the initial focus on the massive collection of post-mortem pediatric organs he had accumulated for planned future research on sudden infant death syndrome. Soon, a Parliamentary Inquiry began investigating the full scope of his Liverpool practice. During the Inquiry, another organ-hoarding scandal erupted; van Velzen, when leaving Halifax after his dismissal, had put his family's personal belongings into a storage facility at Burnside Industrial Park and then did not pay bills. As his belongings were being prepared for auction, formalin-fixed organs were found, and a Canada-wide arrest warrant for disrespect for human remains was issued by the Halifax Police. While the Alder Hey scandal resulted in a 535-page-long Parliamentary Report and the Human Tissue Act, van Velzen was never charged criminally in the UK. The largely unknown story of his second organ scandal in Halifax, is related here. Although he had obtained the body parts with the consent of the parents of the child to which they had belonged, his failure to properly identify and store them traumatized parents already impacted by his organ-hoarding in the UK, traumatized additional parents in Halifax, and resulted in significant waste of public resources in investigating the case. He pled guilty to “indignity to a human body” in Canada and was fined and placed on 12 months' probation."
https://onlinelibrary.wiley.com/doi/abs/10.1002/ca.24115--------------------------------------------------------------------------
PASSAGE ONE OF THE DAY: "That polarizing moment, it later turned out, would save the hospital from the riptide of a macabre scandal that exploded less than two years later on the other side of the Atlantic. It was revealed that the organs, including hearts and brains, from more than 850 infants were being stored in the cellars of a building used by the Alder Hey hospital in Liverpool, England, stripped from the bodies of dead children and stockpiled without their parents' consent. At the centre of the scandal was pediatric pathologist Dick van Velzen, who had worked at Alder Hey between 1988 and 1995, before decamping for Canada and the IWK hospital. It was a horror show for the parents of dead children at Alder Hey, a headline mill for the media, was named one of Time magazine's Top 10 scandals of the year, and suddenly meant the IWK faced many questions."
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PASSAGE TWO OF THE DAY: "Following the Alder Hey scandal, and after losing his medical licences in Canada and the U.K., van Velzen co-founded a Dutch company that manufactures a preservative solution for cut flowers and fruit. Reached by CBC News at his home last week, he declined to do an interview. It's not clear, then, what he would think of the fact that a copy of the 535-page report from the Alder Hey inquiry (including 191 pages dedicated to "The van Velzen years") sits on the shelf of one of his old offices at the IWK. It's there alongside other inquiry reports. There is the Ontario inquiry that examined the work of Dr. Charles Smith, whose autopsy mistakes led to wrongful convictions. There is Cameron report into erroneous breast cancer screening results in Newfoundland, and the Creaghan inquiry into faulty cancer diagnoses in Miramichi, N.B.
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STORY: "25 years later, the story of a Halifax hospital and a U.K. organ-hoarding scandal," by CBC Nova Scotia Journalist Journalist Richard Cuthbertson, published by The Canadian Broadcasting Corporation, on December 20, 2023.
SUB-HEADING: "Former colleagues of Dr. Dick van Velzen offer new details of his time at the IWK.
PHOTO CAPTION: "Dr. Dick van Velzen worked for two years at the IWK Grace hospital, now known as the IWK Health Centre, in Halifax."
PHOTO CAPTION: "Van Velzen's former IWK colleagues are speaking publicly about the two years he spent at the hospital."
GIST: "On Jan. 18, 1998, Kent Dooley sat across from a brilliant pediatric pathologist with a devoted following at Halifax's IWK Grace children's and maternity hospital and told him he was fired.
The move by Dooley, the head of pathology and laboratory services, was bewildering to many outside the division.
"'I sure hope you have a good reason for this,'" Dooley recalls the hospital's head of obstetrics telling him later that day.
"'Yeah, I do,'" he replied. "'And I can't tell you what it is.'"
That polarizing moment, it later turned out, would save the hospital from the riptide of a macabre scandal that exploded less than two years later on the other side of the Atlantic.
It was revealed that the organs, including hearts and brains, from more than 850 infants were being stored in the cellars of a building used by the Alder Hey hospital in Liverpool, England, stripped from the bodies of dead children and stockpiled without their parents' consent.
At the centre of the scandal was pediatric pathologist Dick van Velzen, who had worked at Alder Hey between 1988 and 1995, before decamping for Canada and the IWK hospital.
It was a horror show for the parents of dead children at Alder Hey, a headline mill for the media, was named one of Time magazine's Top 10 scandals of the year, and suddenly meant the IWK faced many questions.
More than 25 years later, van Velzen's former IWK colleagues are speaking publicly about his two-year tenure at the hospital, describing in detail what led to his hiring, their creeping concerns about his work and ethics, and their decision to finally seek his dismissal.
They want the particulars of what happened put on the record, and co-authored a piece earlier this year in the Canadian Journal of Pathology. They also hope there are useful lessons to be drawn, not just about what went wrong, but also about what went right at the IWK. How instead of becoming another Alder Hey, the hospital faded into a scandal footnote.
A good first year
Pediatric and perinatal pathologists broadly perform two kinds of work. One is autopsies on dead children to determine cause of death or whether an earlier diagnosis was correct. In the case of miscarriage, an autopsy can reveal crucial genetic information to parents.
The second aspect of their work is to examine tissue, such as from a tumour, removed from a living patient during surgery to help diagnose and treat diseases such as cancer.
The work is crucial. It's also exacting and detailed-obsessed, which is wh
Dr. Bob Fraser, left, a pediatric pathologist at the IWK Health Centre is shown with medical laboratory technologist Erin Gillis on Dec. 6. (Richard Cuthbertson/CBC)
In the mid-1990s, the IWK, like many hospitals, was faced with a pediatric pathologist shortage and was desperately trying to recruit an experienced specialist to join three junior doctors.
In 1995, van Velzen reached out to one of the hospital's pathologists, Dr. Lothar Resch. Another pathologist who worked at the IWK, Dr. James Wright, said van Velzen gave a lecture as part of his interview and his level of knowledge was "outstanding."
His references, including from Alder Hey, were good, and included a glowing one from a world-renowned pediatric pathologist.
When asked why he wanted to leave one of the largest children's hospitals in Europe, Dooley said van Velzen replied it was due to dysfunction and corruption in the country's health service.
During van Velzen's early days at the IWK, Wright and others were willing to shrug off the more difficult parts of his personality, such as his arrogance. At one point, van Velzen boasted about a T-shirt his friends at Alder Hey had given him that said "Dick van Velzen" on the front, followed by "Before van Velzen dicks you" on the back.
His first year at the IWK went well, and he was made head of anatomical pathology, dividing his time between clinical work and various research endeavours.
Mistakes mount
The second year was different. It was lab technologists that first raised concerns, often confiding in Resch, the most senior of the remaining pathologists. Mistakes that were once rare became more common.
In the early 1990s, a new IWK policy mandated that 10 per cent of a pathologist's reports would be reviewed by a colleague. As errors mounted, van Velzen's colleagues increased their vigilance.
It was awkward confronting their boss about sloppy autopsy reports or significant diagnostic errors. In one case, van Velzen described the inside of a heart that he'd never dissected and was still sitting fully intact in a jar.
One of the issues, Wright suspected, was that van Velzen would often dictate results using a template, long after performing an autopsy, and was likely confusing cases.
Van Velzen was at times contrite. At others, he blamed technologist staff or stood by his reports, citing additional but undocumented work he had done, according to Dr. Bob Fraser, a pathologist who worked with him.
What bothered Fraser was that even when the mistakes were clear, there was no urgency from van Velzen to fix them.
"If you are told that there is a mistake, there's nothing more important in your life on that particular day than getting that mistake corrected," said Fraser, 63, who still works at the IWK. "First of all, you admit it, and then you correct it, and then you let everybody know what the correction is. And it just didn't seem to happen with Dr. van Velzen."
Research concerns
Dooley was also growing concerned about research being conducted by van Velzen, who had ingratiated himself with many of the medical staff outside pathology, adding their names — sometimes 10 at a time — to dozens of the scientific abstracts he submitted to conferences.
Abstracts are meant to describe preliminary research. They are not peer-reviewed, Dooley said. The worry was that van Velzen was not producing full peer-reviewed papers.
Instead, Dooley said it was becoming evident that van Velzen was submitting abstracts before he did the research. One, for instance, was based on hundreds of microscope slides that had never been reviewed.
In late 1997, Resch gathered Fraser and Wright in this office and asked them a thorny question: Would they trust van Velzen to diagnose one of their loved ones if they were not given the chance to confirm it themselves?
Put in such concrete terms, it was a thunderbolt. Both answered no.
They moved the problem up the chain at the IWK, submitting documented examples of issues with van Velzen's work, and he was fired.
Aftermath of the firing
But van Velzen did not go quietly. He filed a wrongful dismissal suit that was later abandoned, and a parallel investigation by the IWK's medical staff discipline committee quickly drew in a dozen of the city's top lawyers.
But he remained a full professor at Dalhousie University, which meant not only could he continue his research at the IWK, he could roam at will through the pathology unit.
He could still voice his side of the story, claiming that he was the victim of jealous colleagues, while the three pathologists behind his firing were told by hospital officials to remain silent.
Van Velzen and his wife, Dr. Lynne Ball, a hematologist who also worked at the hospital, left Canada for Trinidad in May 1998, and then moved to The Hague in the Netherlands.
In the fall of 1999, the Alder Hey scandal began to kindle. An inquiry report later found that during his time at that hospital, van Velzen had ordered organs be retained from all autopsies for his research into sudden-infant death syndrome. The hoard of organs grew, but hardly any were used.
Parents who had lost their children had no idea.
The report also found that van Velzen diverted clinical technicians to help with research, while claiming he was understaffed. In the meantime, autopsy reports weren't being done or the results were fabricated.
At the time, van Velzen maintained that he had done nothing wrong. He blamed Alder Hey, saying he worked in a "rundown" department and the hospital ran out of money, which meant work related to autopsies couldn't be completed. He claimed he never took organs from a body without parents' consent.
"That people forgot to tell the parents what a post-mortem actually is, is terrible, but it is not my fault," he told the BBC in 2001.
For Dooley, it was galling to learn through the inquiry that one of the Liverpool administrators who had written a letter of reference for van Velzen had in fact been trying to get rid of him.
But his former IWK colleagues weren't surprised by what was revealed at Alder Hey. The van Velzen they had come to know was dishonest, willing to fabricate results and cut corners, propelled by "uncontrolled ambition," a pathologist with little insight into his own weaknesses who refused to consult with others.
They note that while van Velzen was allowed to work alone in Liverpool, with staff under his control, he never did so at the IWK.
The IWK's autopsy consent forms were more explicit, but by this time van Velzen's research interest had also shifted and there was no longer a reason to hoard hundreds of organs. There was no evidence that organs were taken and stored at the IWK without parents' consent.
Tissue and organs from an eight-year-old child were later found at van Velzen's storage container in the Burnside industrial park in Dartmouth, N.S., but it was determined they had been sent to him by parents outside Nova Scotia.
Van Velzen later pleaded guilty to offering indignity to human remains and was handed a conditional discharge. He never faced charges in the U.K.
For Fraser, a key takeaway is the IWK's policy of pathologists reviewing each other's work. At points in his IWK career, he said, he was just one of two pathologists at the hospital. They were stretched beyond thin, the floor of his office would be stacked with cases, but they never abandoned that quality assurance measure.
It's what helped lead to van Velzen's downfall.
Following the Alder Hey scandal, and after losing his medical licences in Canada and the U.K., van Velzen co-founded a Dutch company that manufactures a preservative solution for cut flowers and fruit. Reached by CBC News at his home last week, he declined to do an interview.
It's not clear, then, what he would think of the fact that a copy of the 535-page report from the Alder Hey inquiry (including 191 pages dedicated to "The van Velzen years") sits on the shelf of one of his old offices at the IWK.
It's there alongside other inquiry reports. There is the Ontario inquiry that examined the work of Dr. Charles Smith, whose autopsy mistakes led to wrongful convictions. There is Cameron report into erroneous breast cancer screening results in Newfoundland, and the Creaghan inquiry into faulty cancer diagnoses in Miramichi, N.B.
"I have them all, and I keep trying to convince residents to read them," said Dr. Erica Schollenberg, the office's current occupant.
Schollenberg, who began working at the IWK in 2015 and is now head of anatomical pathology at the hospital, admits that since medical school she has been fascinated by the "true crime of medicine."
The van Velzen case, she said, is different from other kinds of pathology scandals triggered by incompetence or hospital dysfunction. He was dishonest, and the lesson to young doctors isn't, "Don't be a liar."
She said the very question three IWK pathologists asked themselves more than 25 years ago — Would you let this doctor treat one of your loved-ones? — has become a common one for licensing colleges to ask.
"It's a very telling question and it's very hard for people to answer that question dishonestly," she said."
The entire story can be read at:
https://www.cbc.ca/news/canada/nova-scotia/iwk-hospital-halifax-uk-organ-hoarding-scandal-1.7062671
| PUBLISHER'S NOTE: I am monitoring this case/issue/resource. 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; |
SEE BREAKDOWN OF SOME OF THE ON-GOING INTERNATIONAL CASES (OUTSIDE OF THE CONTINENTAL USA) THAT I AM FOLLOWING ON THIS BLOG, AT THE LINK BELOW: HL
https://www.blogger.com/blog/post/edit/120008354894645705/47049136857587929
FINAL WORD: (Applicable to all of our wrongful conviction cases): "Whenever there is a wrongful conviction, it exposes errors in our criminal legal system, and we hope that this case — and lessons from it — can prevent future injustices.
Lawyer Radha Natarajan;
Executive Director: New England Innocence Project;
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FINAL, FINAL WORD: "Since its inception, the Innocence Project has pushed the criminal legal system to confront and correct the laws and policies that cause and contribute to wrongful convictions. They never shied away from the hard cases — the ones involving eyewitness identifications, confessions, and bite marks. Instead, in the course of presenting scientific evidence of innocence, they've exposed the unreliability of evidence that was, for centuries, deemed untouchable." So true!
Christina Swarns: Executive Director: The Innocence Project;
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YET ANOTHER FINAL WORD:
David Hammond, one of Broadwater's attorneys who sought his exoneration, told the Syracuse Post-Standard, "Sprinkle some junk science onto a faulty identification, and it's the perfect recipe for a wrongful conviction.
