Unwittingly rebuked investigator of cancer lab, ex-minister says

A former Newfoundland and Labrador health minister sent a stinging letter to a B.C. pathologist, without knowing that the doctor had investigated myriad problems at a St. John's pathology lab.

Tom Osborne, testifying Tuesday at the judicial inquiry into flawed lab testing involving breast cancer patients, also said he was kept out of the loop on a series of briefing notes that were distributed to others — including Premier Danny Williams — but not to him.

In his first day on the stand, Osborne said he was not told about critical information involving hormone receptor testing, including the background of the author of a letter that brought a ministerial rebuke.

Osborne told Justice Margaret Cameron that he accepted signing a letter presented to him by his staff in April 2006 that criticized Dr. Diponkar Banerjee, then the president of the Canadian Association of Pathologists.

On behalf of that group, Banerjee had written to Osborne's predecessor with a warning about pathology problems in Newfoundland and Labrador, with a particular warning about breast cancer testing.

"You have already experienced a recent example of the effects of not investing in high quality pathology when the errors in breast cancer estrogen receptor status were discovered, affecting hundreds of patients in your service," Banerjee wrote in February 2006 to Osborne's predecessor, John Ottenheimer.

Osborne was presented with a letter to sign by his staff that he acknowledged Tuesday was strong in tone.

However, Osborne testified, he felt at the time that the tone was justified, based on what he was told.

"Your letter suggest that the pathologists employed by Eastern Health are less than qualified, which is a grave disservice to your peers represented by your organization," Osborne's letter said.

Not briefed on pathologist's role: ex-minister

What Osborne was not told when he was given the letter to sign was that Banerjee had direct personal involvement in the hormone receptor issue. Eastern Health recruited Banerjee in 2005 to review its St. John's pathology lab.

"Do you to this day, do you know who Dr. Banerjee is?" inquiry co-counsel Bern Coffey asked Osborne.

"I now know. I've learned that yesterday," Osborne said. "Yesterday I had learned that this, in fact, is the same individual who is the author or one of the authors of the report by external consultants to Eastern Health."

With that knowledge, Osborne said, he would have reacted very differently when presented with the draft letter.

"If I had known that this in fact was the same individual, the letter that was addressed to Dr. Banerjee and signed by me would never have been signed, because this puts a completely different perspective on the letter that he had addressed to Minister Ottenheimer," Osborne said.

Kept out of loop on several occasions

Meanwhile, Osborne told the inquiry about instances in which his own staff and senior managers at Eastern Health were keeping him out of the loop.

After two incidents in which briefing notes left the department without being seen by him, Osborne confronted his deputy minister.

"I had gone to John Abbott and I had gotten very upset, which is generally not my nature, but I did get very upset with him and I said that this is never to happen again," Osborne testified.

Osborne, however, said he later learned of a third incident. In August 2006, a briefing note was prepared especially for Williams on the hormone receptor issue.

Osborne did not learn of it until the next spring, when he was then serving as justice minister.

Equipment, not staffing, blamed

Moreover, officials told Osborne that the root of problems at Eastern Health had to do with the older equipment that had been used.

"They believed it was a systems error," Osborne said.

However, Banerjee's review found that the issue was not replacing the former Dako system with the newer Ventana system, but with how the lab functioned.

Eastern Health tried — and failed — to have Newfoundland Supreme Court keep Banerjee's reports, as well as separate reports prepared by a Toronto lab specialist, kept confidential during the inquiry.

The reports cumulatively pointed to a number of problems, including a "revolving door" in staff and problems with training and maintaining standards.

In previous testimony, Ottenheimer testified that he had not been briefed on the results of the external reviews.

Osborne testified Tuesday that he regretted not having asked to read them.

A subsequent audit found that serious problems at the St. John's lab have been addressed.

The inquiry is examining how the lab produced inaccurate results on hormone receptor tests between 1997 and 2005, affecting the treatment of more than 300 breast cancer patients.