Questions raised about how pathologist's file handled

The director of medical services at the New Brunswick hospital at the centre of an inquiry into allegedly misdiagnosed biopsies told a public inquiry on Thursday that despite concerns about a former pathologist no one wanted to file a formal complaint.

Jeff Carter, the former risk management co-ordinator at Miramichi Regional Hospital, who previously testified before a public inquiry into the faulty cancer biopsies in the pathology lab at the hospital was cross-examined by the lawyers of now-suspended pathologist Rajgopal Menon.

Carter was questioned on Thursday regarding how Menon's file was handled by the hospital.

New Brunswick Health Minister Mike Murphy called the inquiry after an independent audit of 227 cases of breast and prostate cancer biopsies from 2004 to 2005 found 18 per cent had incomplete results and three per cent had been misdiagnosed.

More than 23,700 cases from the northeastern New Brunswick hospital involving patients treated between 1995 to 2007 are being reviewed by an Ottawa lab. The audit will also include about 100 cases carried out for Regional Health Authority 4 in Edmundston, N.B., in 2002.

Menon, now 73, worked as a pathologist at the health authority in northeastern New Brunswick from 1995 until February 2007, when he was suspended following complaints about incomplete diagnoses and delayed lab results.

Concerns about absenteeism

During previous testimony, Carter said he had concerns about Menon's absenteeism and noted he had received complaints about the pathologist from a family physician and a coroner.

Carter told the inquiry on Thursday that he hadn't filed a formal complaint about Menon's attendance record until after he was suspended as chief pathologist.

He said there had been "hallway chat" about Menon's attendance among the hospital staff but no one wanted to file a formal complaint.

But Carter said he did pass complaints about Menon's medical files to the former vice-president of medical services, Dr. Carl Hudson.

Hudson was concerned that he was "nit-picking the man to death," Carter testified.

Carter said Hudson also asked him if he had been singling Menon out, "which I replied vehemently 'no.' "

"I showed him [Hudson] the health records file and the chart discrepancies," Carter said. "My job is to improve where there's opportunity."

Final phase of inquiry

The inquiry has entered its final phase — 18 days of hearings at the University of Moncton.

In addition to cross-examination of previous witnesses, there will be about 20 expert witnesses, including representatives of the Canadian Association of Pathologists, the New Brunswick Medical Society and medical experts from universities in the United States.

In the initial two phases, the inquiry heard testimony from health officials, affected patients and Menon.

Witnesses in the final phase will give opinions on whether New Brunswick's pathology laboratories need an overhaul.

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

Justice Paul Creaghan is expected to make recommendations to the government by Jan. 1 on how to prevent any further misdiagnoses.