Problems facing pathologists common: national doctors college; Problems are also being investigated in Newfoundland and Labrador, New Brunswick

| May 6, 2008

No hospital is immune to the deficiencies that have contributed to problems with medical testing in several provinces that have affected thousands of patients, the Royal College of Physicians and Surgeons of Canada said Thursday.

If something isn’t done quickly to address the chronic underfunding and staff shortages in hospital laboratories, patients could lose faith in the system, said Dr. Andrew Padmos, the college’s chief executive.

"I – in conversations with people involved in pathology and laboratory medicine – understand that there’s no part of Canada, no institution in Canada which could claim to be invulnerable in terms of concerns of this nature, of the quality," he said.

"To some degree, every institution – whether it’s an academic health centre with 20 or 30 pathologists on staff or a smaller regional hospital with a handful of pathology resources – every one of them is experiencing shortages, work-life pressures due to increasing workloads, increasing complexity and reduced availability of the technologies that would help them get the work done."

Reports of erroneous medical tests in Ontario, New Brunswick and Newfoundland have led patients and the public to wonder about the state of diagnostic medicine in Canada, he said.

The latest investigation prompted a Grey Bruce Health Services to contact patients after the hospital said it found errors in the work of one of its three pathologists – mistakes a review says may have resulted in missed cancer diagnoses or altered the care patients received.

GBHS said Thursday it will expand its probe of Dr. Barry Sawka’s work after it said an initial review of 600 tests found a high rate of error.

Sawka, who voluntarily withdrew from practice in February after a routine test identified an error in one of his findings, is estimated to have overseen about 40,000 cases over 14 years at the hospital. Attempts to contact him Thursday were unsuccessful.

"People are just stunned at the fact that this has happened," said Pat Campbell, the hospital’s president and CEO.

"This is a fairly small community, so many of our staff, lots of our community are not only going to be in the position of a caregiver as part of Grey Bruce Health Services, but they’re also potentially a patient that’s caught up in this."

A public inquiry is currently underway in Newfoundland to determine how nearly 400 patients received inaccurate results on their breast-cancer tests between 1997 and 2005.

And in New Brunswick, some 24,000 pathology tests are being reviewed and a judicial inquiry has been called after an audit said there were incomplete or misdiagnosed results in the work of pathologist Dr. Rajgopal Menon.

Menon, who called the review "unjustified and unfair," has filed a civil suit against the regional health authority.

Diagnostic imaging tests of about 4,500 patients are also being reviewed in Prince Edward Island after questions were raised about the work of a single pathologist.

Pathologists are experts in the use of laboratory tests to diagnose and treat disease. For example, the diagnosis of cancer on a breast biopsy or in a blood smear is performed by a pathologist.

To become a pathologist, about 12 years of post-secondary education is needed. After completing an medical school, a physician usually studies for at least five years and must pass a rigorous certification examination from the Royal College of Physicians and Surgeons of Canada.

Critical decisions, such as the proper and cost-effective use of blood transfusion products, choice of antibiotics and test panels, are made regularly by pathologists. They also perform forensic examinations and are major practitioners of medical informatics – the science of providing health information quickly, accurately and keyed to patient care needs.

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