Toronto Public Health says more patients of gynecologist under investigation can now get tested

Toronto Public Health says more patients of a gynecologist linked to potential exposure to blood-borne infections due to improper tool cleaning can now get tested — even if they didn't receive a formal letter from the health agency.

That was frustrating for Amanda Malek, a patient of Dr. Esther Park in 2023 who didn't receive any notification from the city and felt she had a lot of unanswered questions.

When Malek first heard about the public health investigation online, she reached out directly to TPH. "I called multiple times, I told them I got a pap smear, should I be worried, should I be concerned?" Malek said. "They initially told me no."

Toronto Public Health has been sharing more details this week about its investigation into infection risks at Dr. Park's clinic. The agency has also been encouraging more concerned patients to reach out about testing.

"In general, TPH encourages testing because treatments are available," according to a statement sent to CBC Toronto Monday.

Dr. Park's clinic has not provided any comment to CBC News on the investigation. The office's answering machine states the Park is retiring and the clinic is closing in April.

Patients who also got pap tests or any of the listed procedures (endocervical polyp excision, endometrial biopsy or the insertion of an intrauterine device) prior to 2020 can also speak to their health-care provider about testing, per the city's latest investigation update online.

"There was a bit of peace of mind for me before I saw that online because I thought I wasn't impacted," Malek said. "But when I saw the update I thought, 'We've been left in the dark. If we didn't do digging ourselves we never would have known.'"

CBC Toronto has also heard from patients who did receive one of the three procedures listed within the designated time frame but did not receive a letter. Toronto Public Health says it encourages those patients to contact them. 

Public health doc describes cleaning concerns

Dr. Herveen Sachdeva, the city's associate medical officer of health, told The Canadian Press that medical instruments such as speculums were not disassembled before they were cleaned at the clinic.

Sachdeva characterized this as an "important step" to ensure all surfaces are disinfected. She also said there was "significant overdiluting" of the disinfecting solution that the instruments were soaked in.

"As this was the last main step for reprocessing (an autoclave wasn't used to sterilize the instruments), this presents a risk for disease transmission," Sachdeva said in an email.

Those corrective measures recommended to Park include ensuring instruments are disassembled before cleaning, appropriate use of the disinfectant solution, performing quality assurance, and setting up an autoclave — a machine that steams instruments to kill harmful bacteria — to sterilize instruments.

A report posted on Jan. 9 stated Park complied with the corrective measures.

WATCH | This patient filed a complaint years before infection risk:

This patient filed a complaint against Toronto gynecologist years before reports of infection risk

7 days ago

Duration 4:03

Reaction is pouring in after CBC News was first to report on hundreds of patients being exposed to an infection risk at a Toronto gynecologist office. Dozens more patients have been reaching out sharing their negative encounters with the doctor. CBC’s Talia Ricci has more from a patient who filed an official complaint years before reports of an infection risk.

The College of Physicians and Surgeons of Ontario (CPSO) said it's investigating Park in relation to infection control issues in her practice. It would not share specifics or the number of complaints filed about Park, citing confidentiality restrictions.

The CPSO's physicians register states Park's licence is restricted as of December to office-based gynecology.

Trust shaken, patient says 

Since CBC News was first to report on the potential infection risk, dozens of patients have reached out to share concerns about the practice.

Malek says the experience has shaken her trust with the health-care system and empowered her, and others discussing their experiences online, to be more attentive while receiving care and to speak out when something doesn't seem right.

"We want people to be aware of the situation. It doesn't seem like we can put as much in the health-care system or in doctors as we thought," she said.

To date, TPH said there are no infections that are confirmed to be attributed to the clinic's practices. TPH says it doesn't routinely inspect health-care settings unless a complaint is filed.