Health authority had concerns about pathologist, inquiry told

There were concerns about how long it took a former pathologist at the Miramichi Regional Hospital to perform tests, a public inquiry heard on Thursday.

Jeff Carter, director of medical services at the northeastern New Brunswick hospital, testified he heard concerns about former pathologist Rajgopal Menon beginning in 2002.

A public commission is examining how breast and prostate cancer tests were misdiagnosed at the Miramichi Regional Health Authority.

Carter said while he was the regional risk management co-ordinator at the hospital in 2002 he heard complaints about Menon's slow turn around times completing tests in the pathology lab.

Carter said once he started to delve into Menon's work he found there were concerns on record about the pathologist that dated back to 1998.

In 2003, a medical transcriptionist also complained one of Menon's reports was incomplete, Carter testified. Over time, Carter said he heard there were hundreds of reports from Menon that were missing information.

Carter said he was told Menon transcribed his own reports, which was unusual compared to other doctors at the hospital.

Menon's work was then tracked to see how long it would take him to complete testing compared to the health authority's other pathologist, Carter said.

The tracking showed Menon averaged 11.4 days to complete the testing. The other pathologist took an average of 3.6 days, Carter said.

Carter also testified that in 2005 he had been contacted by a family physician who complained that it was taking too long to get biopsy results back. The patient in question had been sent for the tests 64 days before the phone call, Carter said.

23,700 patient cases reviewed

Menon, 73, worked as a pathologist at the Miramichi Regional Health Authority from 1995 until February 2007, when he was suspended following complaints about incomplete diagnoses and delayed lab results.

A peer review of Menon's work, released publicly in March, indicated the pathologist had serious medical problems that could have affected the accuracy of his work, including cataracts and tremors in his hands.

Health Minister Mike Murphy called the public inquiry after an independent audit of 227 cases of breast and prostate cancer biopsies from 2004-05 found 18 per cent had incomplete results and three per cent had been misdiagnosed.

Currently more than 23,700 patient cases from the eastern New Brunswick hospital from 1995 to 2007 are being reviewed by a lab in Ottawa. The audit of the biopsies will also include about 100 carried out at the Regional Health Authority 4 in Edmundston in 2002, when Menon also worked there.

The commission will be hearing testimony for four weeks at the University of Moncton before going to Miramichi, where any of the 227 patients affected by the initial review can testify in June. The commission will then return for a final four weeks of hearings in Moncton in September.

The inquiry will not assign civil or criminal responsibility to any person or organization.

By Jan. 1, 2009, former judge Paul Creaghan is to make recommendations to the government on how to prevent an excessive level of misdiagnoses from happening again.