N.B. pathologist under review objected to quality assurance process: doctor

The doctor whose complaint sparked a review of pathology services at a New Brunswick hospital said Thursday that he tried to improve the speed and accuracy of diagnoses but faced objections from now-suspended pathologist Dr. Rajgopal Menon.

Dr. Carl Hudson, the former vice-president of medical services at the Miramichi Regional Hospital, told the inquiry into Menon's work that he tried several times to implement an effective quality-assurance program at the hospital amid concerns about delayed and incomplete test results.

He said Menon objected to the idea of a random re-testing process, saying it would be ineffective, time-consuming and add to an already heavy workload for pathologists.

When asked if there was someone in the hospital who could have ordered a quality-assurance program be put into place, Hudson answered, "One would think."

Hudson testified he first noticed a problem with Menon's work in 2003, when he found the pathologist was taking a long time to finish reports. He said he spoke to Menon several times about the delays, but they continued to occur.

Hudson said Menon did not prioritize cases, which meant that some cancer tests were left for months.

He also spoke of a case in 1998, when Menon failed to detect a severe form of cancer in a woman's breast tissue sample. Hudson said another pathologist was concerned about the findings, checked the slides and found the error.

Hudson said Menon did not seem concerned about the mistake and procrastinated in dealing with it.

Hudson notified regulatory authorities of concerns about Menon's work in January 2007, after an independent audit of 227 cases of breast and prostate biopsies from 2004 to 2005 found that 18 per cent of the cases had incomplete results and three per cent had been misdiagnosed.

Menon has blamed a heavy workload and doctors' poor handwriting for the errors. Hudson said he knew Menon had a lot of work but communicated to him that workload was a problem.

Hudson was expected to continue his testimony Friday.

Earlier this week, patients affected by the botched tests shared stories of anxiety over their test results in camera.

Patients testified that they had lost confidence in the health-care system and questioned whether their treatments and invasive surgeries were truly necessary. Some also testified that delays had altered the course of their treatment.

During the first phase of the inquiry, in Moncton in May, Menon apologized to the patients, but said he was not aware of any errors in his work and takes "practically zero" responsibility for any incomplete or misdiagnosed results.

The inquiry will run until June 24 in Miramichi, then return to Moncton for four final weeks of hearings in September.

The inquiry will not assign any criminal responsibility for the misdiagnoses.

Justice Paul Creaghan is expected to make recommendations to the government by Jan. 1.