N.L. Health Board Missed Dozens of Patients in Cancer Review: Health Minister

By Tara Brautigam, THE CANADIAN PRESS

ST. JOHN’S, N.L. – Newfoundland’s largest health board, already under fire over hundreds of botched radiology exams, missed dozens of patients in a review of widespread problems with breast cancer testing because of shoddy record-keeping, the province’s health minister said Friday.

The Eastern Health authority announced last December that it had arranged for Mount Sinai hospital in Toronto to redo the hormone receptor tests of 939 breast cancer patients from 1997 to 2005 after oncologists detected inconsistent results in breast tumour samples.

It wasn’t until May that it was revealed through documents filed with the province’s Supreme Court that 317 of those patients were denied critically important treatment for their breast cancer because of a faulty testing method.

At a news conference Friday, Health Minister Ross Wiseman said a departmental review has found those figures to be wrong, and that the actual number of breast cancer patients whose tests were redone is closer to 1,000.

“It’s totally unacceptable,” Wiseman said, attributing the omissions to poor database management within Eastern Health.

“It’s disturbing to know that we would have such incomplete information … when we’re managing such sensitive information and such sensitive data.”

Wiseman said he wasn’t yet able to determine how many more patients, if any, missed out on potentially life-saving therapy.

“This is a process that’s evolving,” he said, adding that a more definitive number of patients whose tests were redone would be available within weeks.

“It would be premature to start speculating on what might or might not happen.”

In the last three months, the results for 15 patients were sent to Mount Sinai for retesting. Treatment for 13 of those patients will not change, but Wiseman said he is still waiting for the results of the other two patients.

Eastern Health is currently the subject of a judicial inquiry and a class-action lawsuit launched by more than 100 patients because of the breast cancer test errors.

Louise Jones, Eastern Health’s interim CEO, wasn’t available for comment Friday but in a brief statement said the organization would address any problems with its database at the inquiry.

“Right now our primary focus is on ensuring that any individuals who need to be notified as a result of the database will be notified,” Jones said.

“We recognize that effective database management is a key issue for this organization.”

At least 36 patients in Newfoundland and Labrador who received wrong hormone receptor test results have died, though it remains unknown how many died as a result of their cancer.

The tests are considered crucial in determining the course of treatment for a breast cancer patient because, if patients are found to be estrogen-and/or progesterone-positive, they may respond to hormone therapy such as Tamoxifen.

If not, they may be given other treatment, such as chemotherapy.

Medical experts acknowledge there is a degree of uncertainty in assessing hormone receptor test results, but Eastern Health officials have said they’re unable to explain how so many tests under their purview were wrong.

Eastern Health has also faced questions over the quality of its health care and its willingness to release information to the public after it suspended one of its radiologists in May.

The health agency announced Wednesday that Dr. Fred Kasirye missed glaring abnormalities such as tumours, broken bones and cases of pneumonia on 708 exams.

Liberal health critic Yvonne Jones said Friday the public’s faith in its health-care system has been rattled.

“Our health-care system was facing enough turmoil when problems were identified with questionable radiology readings and (hormone receptor) testing,” Jones said in a statement.

“There is now a broader crisis developing as people are left with shaken confidence.”

Wiseman stressed that the province’s health-care system is still reliable.

“We witnessed two examples of where we’ve had system failures,” Wiseman said.

“It has really, I think, brought into question how our health system functions … but I would encourage people and ask people to reflect on the good quality work that is being done.”

The judicial inquiry is expected to resume hearings in the new year.