Poor standards, training flagged in St. John's cancer lab reports

Independent reports on a St. John's laboratory point to systemic problems with how tests were done involving hundreds of breast cancer patients.

Eastern Health, the largest health authority in Newfoundland and Labrador, released four reports on Wednesday, less than a week after losing a Newfoundland Supreme Court bid to keep them confidential.

Eastern Health had ordered the reviews after it learned in 2005 that its pathology lab was producing flawed results for hormone receptor tests, which are conducted to determine the course of treatment a cancer patient will receive.

A public inquiry is expected to start soon into why more than 300 patients received flawed results from the lab, and a class-action lawsuit has already been certified.

The four reports point to poor lab standards, a lack of expertise by doctors and technical staff, and little continued training in immuno-histochemistry, a specialized field of pathology.

Dr. Oscar Howell, an Eastern Health vice-president who spoke to reporters on behalf of the authority, acknowledged Wednesday that the problems were systemic.

"I hope by all of this, the people of this province will see that we stepped up to this problem," he said.

"We fully understand our responsibility here."

The flawed tests excluded many patients from being considered for Tamoxifen, an antihormonal drug that has been clinically shown to improve chances of survival.

Eastern Health had wanted to keep the reports out of the public eye when Justice Margaret Cameron, who sits on the Newfoundland Supreme Court of Appeal, begins hearing evidence at a commission of inquiry.

The authority had argued that the reports were peer reviews and part of a quality assurance program, meaning that they would be protected under the Evidence Act and could not be publicly seen.

Lawyers for the commission argued that they could not conduct their work without being able to discuss the reports publicly.

Justice Wayne Dymond ruled last week there was no reason to keep the reports confidential.

Howell said Wednesday that Eastern Health has acted on most of the 54 recommendations to change the way tests are performed, including regular reviews to ensure accuracy.

He said a recent review showed the St. John's lab, which serves hospitals across the province, is now up to the same standards as those in Ontario.

"So, at multiple levels, we are double-checking that the quality of the work coming out of the lab is absolutely top-notch," Howell said.

"That is not something we are doing just for now. That is forever."

No date has been set yet for when Cameron will begin hearing evidence.