Hospitals urge Ontario-wide pathology review

The association representing Ontario's public hospitals wants the province to extend an investigation into the pathology procedures at a Windsor hospital to the rest of Ontario's hospitals.

Ontario's Ministry of Health announced last Thursday it was launching a review at Windsor's Htel-Dieu Grace Hospital in light of revelations that a surgeon there performed unnecessary mastectomies on at least two women. The cases were linked to incorrect or misread pathology reports.

Htel-Dieu Grace is also leading a review of more than 15,000 patients' tests dating back to August 2003, when Dr. Olive Williams, the local pathologist involved in the cases, was hired to work at the region's laboratory partner, Windsor Essex Pathology Associates.

Tom Closson, head of the Ontario Hospital Association (OHA), told CBC News the ministry's investigation should be provincewide because the peer review system for pathologists is "inadequate."

"We need to make sure we have an adequate peer review system of pathologists looking at each other's work to make sure that individual pathologists are coming up with reliable results, in terms of whether a person has cancer or doesn't have cancer, on a consistent basis throughout the province," Closson said.

An inexact science

Closson said pathology is "not totally exact science." Pathologists examine tissue samples and body fluids in order to diagnose diseases or rule them out.

But doctors aren't infallible and can misinterpret samples. They sometimes miss cancers or believe it's there when it's not.

Closson said he's seen a "high number" of these mistaken assessments across the country in recent years.

In 2005, health officials in Newfoundland and Labrador revealed there had been serious errors in breast cancer tests conducted on women in St. John's. The day before an official inquiry was to begin, the province confirmed over 100 women had died after they received inaccurate test results and failed to get proper treatment.

In May 2008, Grey Bruce Health Services in Owen Sound, Ont., had to review 40,000 patients' tests because of mistakes made by a veteran hospital pathologist.

Around the same time, a Winnipeg hospital launched an investigation into Dr. Robert Stark, one of its senior pathologists. The review found he had made errors in more than 40 pathology cases.

Hospitals in British Columbia and New Brunswick have also recently undertaken pathology reviews.

Closson said it makes sense for the Ministry of Health to take a broader look at pathology procedures. He said the aim of developing a provincewide system is not to put pathologists under unfair scrutiny, but to improve patient care.

"This isn't a search and destroy mission," he said. "This is a peer review process that ensures we have consistent quality of interpretation through the province."

The Ministry of Health has not said whether it would extend the Windsor probe to include other hospitals. Closson said Deb Matthews, the province's minister of health, suggested she would consider it after the investigation into Htel-Dieu Grace is completed.