Breast Cancer Screening Fiasco Continues in Newfoundland

by John McKiggan

Newfoundland’s Eastern Health Board is trying to gag it’s employees by getting them to sign confidentiality agreements.

George Tilley the former CEO of Newfoundland’s largest health board didn’t tell his counterparts at the province’s other health boards about breast-cancer testing errors until two months after he discovered them.

His excuse? He was waiting the lab to call him back!

Negligent Cancer Screening Put Patients at Risk: Miramichi Hospital

by John McKiggan

More on the cancer screening fiasco unfolding in New Brunswick. The Miramichi Hospital claims in a lawsuit filed by the disgraced pathologist that is the subject of potential criminal charges that there were issues about the doctors work as far back as 1998.

Dr. Rajgopal Menon was suspended by New Brunswick’s College of Physicians and Surgeons following a complaint from the Miramichi Regional Hospital Authority about Menon’s “deficient practice” involving “erroneous interpretations of surgical specimens.”

Menon sued the Hospital over the allegations. In a defence filed by the Hospital Authority officials claims that Menon’s:
“lack of professional standards have resulted in patients being placed at risk as well as other physicians, and in particular surgeons, who must rely on (him) for accurate and timely pathological diagnosis.”
The Hospital’s allegations are a double edged sword. If the facts in the defence are correct, it may mean that cancer patients who have been “placed at risk” (not able to receive timely treatment) due to Menon’s “lack of professional standards” may have a potential medical malpractice claim against the Hospital Authority for failing to take proper steps to ensure patient safety when it became aware of the risks due to Menon’s “lack of professional standards”.

Negligent Cancer Screening in New Brunswick May Lead to Criminal Charges and Medical Malpractice Claims

by John McKiggan

A New Brunswick doctor faces potential criminal charges and possible liability for medical malpractice as a result of an investigation into negligent cancer screening.

Pathologist Dr. Rajgopal S. Menon was suspended by New Brunswick’s College of Physicians and Surgeons last year after a complaint from the regional health authority that he put patients at risk by missing instances of cancer following evidence of negligence in breast and prostate cancer biopsies performed by Menon in 2004 and 2005.

The latest review is going to include 15,000 cancer screening tests performed by the doctor stretching all the way back to 1995.

Majority of Infant Deaths Due to Medical Error Preventable

by John McKiggan

Medical errors (Iatrogenic events) among newborns are common and often preventable according to a recent article in the journal Lancet.

In the report To Err is Human, medical errors were estimated to have caused 44,000 deaths in the U.S. every year. A similar Canadian study estimated medical errors kills 24,000 Canadians each year.

However, available reports have focused mainly on adults and (older) pediatric patients, not newborn babies, who are a high-risk group.

More Than 25% of Elderly Patients Suffer Prescription Errors

by John McKiggan

Prescription errors are a major problem for elderly patients, according to a new study published in the journal Medical Care, the official journal of the American Public Health Association.

The authors of the study found that 26.2% of elderly patients who participated in the study received inappropriate or suboptimal drugs as treatment. However, patients who received care from geriatric specialists had significantly lower rates of prescription error.

The authors of the study suggest that seniors make sure that they have a very good primary care physician (family doctor) and that they consider seeing a geriatrician for complex healthcare management needs or multiple chronic disease management.

Quality of Cancer Treatment Depends on Doctor’s “Characteristics”

by John McKiggan

The medical treatement that cancer patients receive depends on the personal characteristics on the doctor treating the patient, according to a new study published in the Journal of the National Cancer Institute.

According to the study:
…adjuvant radiotherapy following breast conservation surgery (BCS) is considered to be an indicator of quality of care for the majority of women with breast cancer, but many women do not receive adjuvant radiotherapy.
The study confirmed the results of previous research that indicated a patient’s personal characteristics (age, race, marital status etc.) determined the level of care received.

However, the study also found that the doctors characteristics also played a role in whether patients received the expeceted level of care. The study found that patients were more likely to receive adjuvant radiotherapy if they had a surgeon who was female, had a medical degree (as opposed to an osteopathicdegree), or was trained in the United States.

Psychiatric Medical Malpractice Claim Dismissed

by John McKiggan

A psychiatrist who misjudged a patient’s risk of suicide was found not to have been negligent when the patient subsequently committed suicide.

In Buyze v. Malla the deceased, Mr. Buyze had been treated several times by various doctors for depression and suicidal thoughts. He was seen in the emergency department by the on-call psychiatrist, the Defendant Dr. Malla who diagnosed him with:
…major depression with anxiety and a history of suicidal ideation…
Buyze was admitted to the psychiatric ward of the Hospital. He subsequently left the Hospital ward and was later found to have comitted suicide by over dosing. After Mr. Buyze’s body was found, the Defendant Malla added the words “no attempts/no plans.” to his diagnosis of Mr. Buyze.

The trial judge ruled that:
…history has proved that Dr. Malla erred in his assessment of Mr. Buyze’s risk of suicide. I am not persuaded, however, that Dr. Malla breached the standard of care expected of a reasonably prudent psychiatrist.
The court stressed that an error of judgement is not necessarily negligence and that the court must be careful not to judge an individual’s conduct on the basis of consequence alone.

Medical Malpractice Claim Over Birth Injuries Dismissed

by John McKiggan

An obstetrician’s failure to obtain informed consent was not the legal cause of an infant’s brain damage, according to a decision from Ontario.

The Ontario Court of Appeal just released a ruling upholding a trial decision dismissing a claim of obstetric malpractice.

In Cruz v. Robins the trial judge held that the use of forceps during the infant plaintiff’s delivery caused the baby’s brachial plexis injury and brain damage. The judge found that the parents, Mr. and Mrs. Cruz should have been consulted and should have been informed of the option of a caesarean section and its risks. Further, he found that they should have been advised of the risks involved in proceeding with a mid-forceps delivery. Nevertheless, the trial judge concluded that had the appellants been advised and given the choice, the same result would have occurred.

No National Standards for Disclosure of Medical Errors

by John McKiggan

In Canada there are no national standards or policies regarding the disclosure of medical errors (“adverse events”) to patients. Provinces and health care organizations have been left to decide for themselves what obligations health care providers have to disclose medical errors to patients.

In 2005 The Canadian Patient Safety Institute (CPSI ) formed a committee to create national guidelines for the disclosure of “Adverse Events”.

In 2007 CPSI released their draft national guidelines for consultation with various national and provincial health care organizations.

Only 2% of Canadian Medical Malpractice Victims Receive Compensation!

by John McKiggan

Nearly a quarter of Canadian adults (5.2 million people) report that they, or a member of their family, have experienced a preventable adverse event (lawyer speak for medical malpractice) according to a report released by the Canadian Institute for Health Information.

In Canada, most doctors are defended by a single organization, the Canadian Medical Protection Association (the C.M.P.A.). According to their most recent annual report, the C.M.P.A. has TWO POINT NINE (2.9) BILLION DOLLARS in reserves (money in the bank). The C.M.P.A. uses this money to hire the best experts and lawyers money can buy. Canadian victims of medical malpractice have an almost insurmountable challenge in the face of such overwhelming financial odds.

Some Frightening Statistics:
• The C.M.P.A.’s annual reports brag about its success rate in defending claims brought against doctors. Between 2002 and 2006 over 5000 lawsuits were filed against doctors in Canada. More than 3800 of those claims were dismissed or abandoned because the victim or his or her family, either quit, ran out of money or died before trial.