Cancer test data errors should have been caught: official
Newfoundland and Labrador government officials should have realized that Eastern Health was not publicly disclosing everything it knew about breast cancer testing mistakes, an inquiry has been told.
Robert Thompson, a senior civil servant in the government, said Health Department officials ought to have noticed that the data supplied in an August 2006 briefing note, which was sent to Premier Danny Williams, was significantly at odds with what Eastern Health would publicly release at a media briefing four months later.
The August 2006 memo showed that more than 300 breast cancer patients had received inaccurate results from hormone receptor testing, which is done to determine whether a patient can benefit from the potent antihormonal drug Tamoxifen.
Thompson, who was the clerk of executive council — and thus the province's chief civil servant — at that time, was also sent a copy, but it arrived when he was on vacation.
"The likelihood is that it was on my desk awaiting my coming back," Thompson, who now chairs a task force on adverse health effects and advises cabinet on health policy, told Justice Margaret Cameron.
But when he returned from vacation, Thompson said, he focused instead on catching up with pressing business. He cannot recall reading the memo until May 2007, when cabinet was briefed on the scope of problems at the Eastern Health lab.
"I remember pulling out this note and looking at it and being surprised by the structure of the note, with so much data in it and it being an odd-looking note," said Thompson, describing the tables of data that were included in the memo.
He said he remembers thinking, "Where did this [come from?] — I don't remember reading this."
Eastern Health told reporters in December 2006 that errors with hormone receptor testing had an error rate as low as 10 per cent. However, the note — like an affidavit Eastern Health filed in 2007, in response to a class action lawsuit — showed that more than 40 per cent of hormone receptor tests were inaccurate.
'There was a disclosure gap'
Thompson said officials in the Health Department should have noticed significant differences between what Eastern Health said publicly and what it had provided to government.
"It's at that point [that] the department's examining of that information should've alerted them," Thompson said.
"That should've been the point of first defence, that there was a disclosure gap at that point."
Last month, former health minister Tom Osborne testified that he did not see the August 2006 briefing note at all until he had left the department, and was serving as justice minister during the May 2007 briefing. Osborne said he was angered after he had been given those facts, and said that he might have been able to compel Eastern Health to provide full disclosure months before it was forced to do so.
As well, Osborne also said that Eastern Health officials had provided him and key officials with yet another set of figures in November 2006, as the authority prepared to make a public announcement on its retesting program.
However, Osborne did not pay attention to media reports on the December 2006 briefing, and said he did not know for some time that Eastern Health had withheld data.
The inquiry has also heard from John Abbott, who served as deputy minister of health at the time, that he always thought that it was Eastern Health's responsibility, and not that of government, to solve problems with hormone receptor testing.
Abbott finished his inquiry testimony with a recommendation to create an independent agency that could alert patients immediately of adverse health effects.