Workload, poor handwriting were problems in pathology lab: Menon

The dismissed pathologist at the centre of a New Brunswick inquiry into misdiagnosed medical tests spent Thursday refuting the complaints of other doctors with whom he worked.

Rajgopal 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.

Menon testified Thursday that illegible handwriting from doctors and a heavy workload made his job in the pathology lab at the Miramichi hospital extremely difficult at times.

Much of Thursday morning's testimony focused on a letter sent by Larry Lacey, who worked with Menon for about a year beginning in April 1996.

In the letter, sent to Menon on Feb. 5, 1997, Lacey wrote, "You have mishandled several cases….You express irritation and criticism for the way in which I responded to these problems."

Lacey's letter states "…the pathology department has a reputation in this province for bad turnaround times and a significant number of disturbing errors."

The reputation had created negative expectations for the pathology lab, said Lacey's note.

Menon told the inquiry that he listened to the points that Lacey had made in his note but that he felt the other doctor was after his job as chief of pathology.

"He wanted my job and I didn't want to give it," Menon said. "That was the only problem."

Thousands of cases being reviewed

Menon said he still did not establish a quality assurance program in the lab and shortly after the note was sent, Lacey quit.

Nearly 24,000 cases from 1995 to 2007 are being reviewed by a lab in Ottawa after an audit found serious errors and omissions in an independent audit of Menon's work.

Health Minister Mike Murphy called a formal inquiry into the pathology work at the Miramichi hospital 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.

On Wednesday, Menon apologized to patients, but said he was not aware of any errors in his work. He later told CBC News that he took "practically zero" responsibility for any incomplete or misdiagnosed results, and that he had become a scapegoat for the hospital administrators.

If there were errors, the problems rooted out of the volume of work that went through the lab, Menon said.

Hearings go through the summer

Menon told the inquiry on Thursday he often went into the lab early to avoid having to deal with hospital administrators and questions.

He also had trouble finding time to call family doctors if there were holes in information sent to the lab about a patient. The workload in the lab became further complicated when Menon no longer had access to a secretary in the late-1990s and had to adapt to using a new computerized system to collect information about patient cases, he said.

Justice Paul Creaghan is chairing the inquiry, which will not assign any criminal responsibility for the misdiagnoses.

Creaghan is expected to make recommendations to the government, on how to prevent an excessive level of misdiagnoses from happening again, by Jan. 1.

Menon is expected to continue testifying at the inquiry, which is being held at the University of Moncton, until into Friday.

The inquiry will then move to Miramichi in June, where any of the patients affected by the initial review of 227 cases can testify. It will return to Moncton for a final four weeks of hearings in September.