Disagreed with experts on cancer disclosure: former minister

A former Newfoundland and Labrador health minister testified Monday that he disagreed with experts who decided to keep botched cancer tests under wraps in 2005.

However, John Ottenheimer told the Cameron inquiry on flawed hormone receptor tests that he accepted the reasons that medical experts and senior managers gave him on not immediately disclosing what turned out to be a major public health issue. 

Ottenheimer said he first learned of errors at the St. John's pathology lab on July 19, 2005, and received a full briefing two days later.

Ottenheimer said he felt the public should be told right away about what he described as a "critical public health issue," although he told Justice Margaret Cameron that senior officials at the Eastern Health regional authority disagreed.

"I felt on the issue of notice to the public that we should go public immediately," Ottenheimer testified.

"However, when surrounded by people of significant experience and expertise — again, the oncologists, the surgeons, the senior administrative personnel — and if there is a point of view contrary to my thinking, as a non-medical person, I accepted that," he said.

"I accepted that point of view."

Public safety protected: Ottenheimer

Ottenheimer said that he felt assured in 2005 by Eastern Health's decisions, because he felt that two areas that were of personal importance — public safety and minimizing risk to patients — were being addressed.

'I felt on the issue of notice to the public that we should go public immediately.' — John Ottenheimer

For instance, he cited Eastern Health's decision to suspend hormone receptor testing at the lab — which provides services for patients across Newfoundland and Labrador — while retesting began at Toronto's Mount Sinai Hospital.

Ottenheimer said Eastern Health managers told him that physicians warned against starting a panic among their patients and overwhelming clinics with anxious calls.

"They were concerned about the stress and duress that was being experienced by their patients and that any notification to their patients prior to retesting would only add to that stress and duress," he said.

Meanwhile, Ottenheimer said the office of Premier Danny Williams was told in July 2005 about serious problems with a St. John's pathology lab.

Ottenheimer said his communications director informed the premier's office "on or about the same time" he found out about flawed breast cancer tests.

The inquiry is examining how more than 300 breast cancer patients were given wrong results on hormone receptor tests, meaning that many were wrongfully excluded from drug therapies like Tamoxifen.

The Cameron inquiry, which began hearing evidence two weeks ago, has been told that Eastern Health managers were aware of serious problems at its pathology lab for several months before action was taken.

Ottenheimer is being asked about what he knew regarding unfolding problems involving hormone receptor tests, which are used to help determine the best course of treatment for breast cancer patients.

The inquiry has already been presented with a series of exhibits — but, so far, more questions than answers — about what was known in 2005 when issues with the lab became known to managers.

Situation critical, but not 'explosive,' former minister says

In a handwritten note made during a conversation with Ottenheimer on July 19, 2005, former Eastern Health chief executive officer George Tilley wrote down the words "explosive" and "the sooner the better."

But Ottenheimer said Monday he had no recollection of using the word "explosive."

"I am under oath," Ottenheimer said. "I do not recall ever using the word explosive, or hearing it."

However, Ottenheimer said he recognized that the issue was serious from the outset, although he added, the numbers of questionable samples "were not overly large" at that point.

He described what he heard on July 19 as a "critical public health issue," and that he requested, and got, a formal briefing on July 21.  

Ottenheimer testified that he felt the general public, and not just affected patients, should be informed about problems with the lab.

"If in fact we had a problem over, what was it, seven or eight years with our main lab in this province, I felt that was a public issue," he said.

Ottenheimer told the inquiry that information presented to him in July was comparatively sketchy compared with what later became evident.

"I got the sense … that I don't know if they knew. This was early on," Ottenheimer said. "They needed to assess and in some cases retest."

Ottenheimer said he expected the issue to be made public in the subsequent weeks.

However, the first the public learned of the matter was in a news report in the Independent, a weekly St. John's newspaper, in early October — more than two months after he was briefed.

Ottenheimer told the inquiry he was glad the issue finally surfaced in the public eye.

"I was firm in my belief that it should be done right away. And, to put it simply, on Oct. 2, when it did go public, I was relieved. I felt a sense of relief," he said.

"It was out there — it's now public information."

Out of the loop: authority chair

Eastern Health chair Joan Dawe, who testified for three days last week, was told the next day about problems at the lab. Although Tilley's e-mail did not convey those words, he wrote that Ottenheimer was pressuring him to take the issue public.

Dawe told Cameron that she felt she was out of the loop about the severity of problems at the lab, and that she would have liked to have known then what she later learned — sometimes, she said, from media reports.

Eastern Health communications staff drafted a news release in July 2005, but it was never issued, and nothing was said publicly until October 2005.

Ottenheimer had not previously commented on why he did not alert the public or, as Dawe testified last week, the Eastern Health board.

"You're going have to ask Mr. Ottenheimer that," Dawe told the inquiry.

The inquiry this week will be focusing on what and how much politicians knew about problems with the lab.

Last year, when the full extent of problems with flawed testing became clear, Williams said, "It wasn't a deliberate attempt to hold back — certainly not by this government."

The premier's office said Williams was vacationing out of the province on Monday, and would not be available for comment.

Tom Osborne, who replaced Ottenheimer in the health portfolio, and current minister Ross Wiseman are also expected to testify this week.