Windsor patient narrowly avoids surgery

A patient of Dr. Barbara Heartwell — the Windsor, Ont., doctor at the centre of a growing probe at Hôtel-Dieu Grace Hospital on unnecessary mastectomies — narrowly avoided undergoing major surgery for breast cancer she didn't have. 

In 1995, Ginny Hillis found a lump in her breast. Heartwell removed it and a pathology report initially found "no evidence of malignancy." However, a second report by the same pathologist said it was breast cancer.  

Hillis said Heartwell told her the bad news and scheduled her for surgery on the following Monday to explore the lymph nodes on her left side to see if the cancer had spread.    

"I asked for a second opinion, told her that's what I would like, but no, she said it wasn't necessary, that it was very clear that this was malignant," Hillis said in an interview with CBC News.

"I felt like I was on a speeding train. I had to beat the clock. I was going to be operated on in a few days and it was an additional stress that I don't believe I needed."

Dr. Kevin Tracey, interim chief of staff at the hospital, said he was not aware of what Heartwell may have told Hillis about a second opinion but, "if something like that was said, it would be not appropriate."

Clerical error

An investigation at the hospital has revealed a clerical error on the date of the reports. The first report had said there was cancer, and the second showed Hillis did not have cancer, Tracey said.  

"So there's an error in transcription with respect to the report," he said. "That's part of what led to the confusion of Dr. Heartwell, I believe."

Meanwhile, unbeknownst to Heartwell, Hillis sought a second opinion anyway, with the help of her sister, who is a doctor in London.  

The hospital in London said it was not breast cancer at all. After hearing about the London diagnosis, Heartwell encouraged Hillis to seek a third opinion.

"Although apparently I didn't require a second opinion, I was now advised to get a third opinion, so Dr. Heartwell sent me to Toronto to Women's College Hospital, and I was told for the second time that I did not have breast cancer."  

Hillis stressed that she does not question Heartwell's skill as a surgeon.  

"I think the mistake that she made was in telling me I didn't need a second opinion. … I felt I was entitled to a second opinion and we disagreed and I had to take my own steps. That was an additional stress. It was very difficult." 

Hillis never filed a report with any medical authority after what happened, though she admits she probably should have.

"I knew that Dr. Heartwell had to rely on the pathologist and it wasn't her error that I was misdiagnosed and I didn't report the incident at all," Hillis said.

Pathologist suspended

Hôtel-Dieu Grace Hospital suspended pathologist Dr. Olive Williams on Jan. 4, and reported her to the College of Physicians and Surgeons. Williams also provided pathology services to Windsor Regional Hospital and Leamington District Memorial Hospital.

Hôtel-Dieu Grace is leading a review of more than 15,000 cases dating back to August 2003, when Williams was hired to work at the region's laboratory partner, Windsor Essex Pathology Associates.

The suspension of Williams was only made public after it was learned that Heartwell had performed mastectomies on at least two women who did not have cancer.

Heartwell removed a breast from one patient after misreading a pathology report. In the second case, a mastectomy patient learned after her surgery that a pathology report stating she didn't have cancer was available to her surgeon, but Heartwell contends she did not see that report.

Heartwell has voluntarily stopped performing surgeries and her entire mastectomy case history is under review. She has been reported to the College of Physicians and Surgeons.

Officials at Hôtel-Dieu Grace Hospital said they have so far found seven "serious cases of concern" connected to Heartwell but added that the problems may be related to pathology reports.

On Thursday, the Ontario government may consider issuing a directive to hospitals to check their pathology reports in light of the revelations.