Following an investigation that was unprecedented in scope, the BC Cancer Agency has found 54 examples of unacceptable patient care by the first oncologist hired for a new cancer treatment centre in Prince George.
Four of the cases resulted in potentially preventable deaths, and four others were found to involve "severe, preventable patient harm," a blue-ribbon panel of investigators concluded.
They reviewed the treatment of 540 patients by Dr. Suresh Katakkar, a U.S. physician hired by the BC Cancer Agency in August 2010 for its pending Centre for the North.
In the meantime, Dr. Katakkar practised at the regional cancer unit run by the Northern Health Authority.
Dr. Katakkar resigned last June, shortly after the cancer agency launched its comprehensive review of his patient protocols. He has not made himself available to the media since then. A doctor with the same name is now practising in Tucson, Arizona.
In a statement, the BCCA said it has forwarded its "serious findings" to the B.C. College of Physicians and Surgeons for further review.
Controversy over Dr. Katakkar's patient treatment first arose last year, when he administered an experimental vaccine to Holly Hill, 33-year-old daughter of former MP Jay Hill, who had been diagnosed with terminal cancer.
The vaccine had no peer-reviewed record of success, but had been used once before by Dr. Katakkar, with some success, on a patient in the 1990s.
Both Ms. Hill and her father strongly defended the oncologist's treatment, saying he informed them fully of the chances of it stemming Ms. Hill's cancer. They agreed to have the vaccine provided.
At the time, in an e-mail to his patients, Dr. Katakkar said Ms. Hill seemed to respond to the vaccine, but died in hospital of an infection.
In an interview Friday, Mr. Hill, an MP for 17 years until bowing out in 2010, said he continues to stand by Dr. Katakkar's treatment of his daughter, despite the report.
"Yes, he was doing something a bit unorthodox, but he was doing it with our full support," said Mr. Hill. "He put it on the line to try and save her. He fought for her, after other doctors wrote her off."
He said Dr. Kattakar was honest with his daughter and the family. "He never said he could cure her, but he never gave up on her. What more could you ask of a doctor?"
As to the other cases singled out by the Cancer Agency, Mr. Hill said he would have preferred more details. "I was a little upset by the vagueness of the report. It's a little disconcerting, but I'd like to hear the stories of the families affected."
Dr. Katakkar's practice, which was also backed by several other patients and their families, raised ethical questions about a doctor's duty to dying patients, desperate for treatment, however unproven, that might prolong their life.
Medical ethicists were split on the matter. Some said doctors shouldn't be criticized for doing the best they can for their patients, but others said it is wrong to hold out false hope by using methods that are not approved.
However, the BCCA investigation listed other concerns about Dr. Katakkar, beyond his use of treatments that did not follow BCCA guidelines.
In its review of Dr. Katakkar's practice, the BCCA panel said instances were found of misdiagnosis and failure to refer; use of incorrect protocols causing patient harm; failure to heed warnings regarding patient safety concerns raised by colleagues; and a failure to follow medical standards.
The panel also referred to missing or incomplete patient documentation by Dr. Katakkar, problematic workload management and operating too much of a solo practice.
The BCCA also pointed out that in cases of emergency, when physicians wish to deviate from protocol to give patients a further chance of survival, they may apply to its Compassionate Access Program for permission.
The program is designed to provide a response within two days. Dr. Katakkar did not apply to the program for approval of his unorthodox vaccine.
The BCCA said all instances of concern they uncovered have been communicated to Dr. Katakkar's former patients and/or surviving family members.
Specific details of the cases were not released, because of patient confidentiality, the agency said.
"I want to express our profound regret over the distress caused by this situation," Dr. Max Coppes, president of the BC Cancer Agency, said in a statement. "We have gone to extraordinary lengths to follow up with patients and their families, apologize and ensure they are informed of this situation."
The panel made a series of nine recommendations to lessen the likelihood of similar occurrences and enhance patient safety, all of which have been adopted by the BCCA.