Lab reformed, cancer inquiry told

The health authority at the centre of Newfoundland and Labrador's breast cancer inquiry has done its best to ensure lab mistakes will not be repeated, a physician says.

Dr. Oscar Howell, Eastern Health's vice-president of medical services, told the Cameron inquiry that while testing will never be error-free, the St. John's pathology lab will not be the problem.

"This is a very important point for me," said Howell, who concluded his testimony at the inquiry Monday. "Somehow we need the cancer patients in this province and their families to get confidence in the work we're doing.

Well before the Cameron inquiry — which is examining how hundreds of breast cancer patients received inaccurate results in their hormone receptor tests — was called, Eastern Health had started overhauling the lab.

Howell told the inquiry that all employees will now have more specialized training. As well, oversight and management have been improved, record-keeping has been strengthened and there are now regular quality checks with organizations based in the United Kingdom, the U.S. and Canada.

Last week, a major piece fell into place, with the provincial government dramatically raising salaries for pathologists, in a bid to solve recruitment and retention problems. Salaries for pathologists jumped overnight from some of the lowest in the country to among the highest.

The inquiry has heard at several points that chronic understaffing in the lab limited its ability to function properly.

Meanwhile, Howell told the inquiry more about the somewhat chaotic sequence of events, as Eastern Health grappled with hormone receptor problems. Howell agreed with inquiry co-counsel Sandra Chaytor that it would have been helpful to have more complete records on patients.

"Most assuredly, if I could have seen that there existed a comprehensive database from which people had great confidence in extracting the data from that, and that there had been a very competent project manager who had nothing else to do and had skills in managing projects like this … but instead, I'm looking at people who are doing this off the corner of their desk," Howell said.

"They're doing it and doing all the other things, and I'm seeing handwritten notes and sticky notes on spreadsheets."

Had trouble understanding issue: official

Meanwhile, Moira Hennessey, the assistant deputy minister for board services at the Department of Health and Community Services, took the stand at the inquiry on Monday.

Hennessey, though, was unable to shed much light on some of the early days of the unfolding cancer testing problems in 2005. Although Hennessey described herself as a note taker, only three handwritten notes from her files were found on hormone receptor testing.

Hennessey told Chaytor that that is partly because of her lack of medical knowledge, which left her unable to comprehend the complexities of immunohistochemical staining and other elements of the pathology lab's work.

"In the early stages of this file, I tell you, I struggled with respect to understanding some of it," she said. "I don't have a clinical background. I mean, the doctors were talking [but] a lot of it I didn't understand."

Hennessey said that she may have thrown out written notes once she had typed briefing notes for the health minister and other officials.