Medical technologists preparing sections of biopsy samples at the Pathology and Laboratory Medicine at the Toronto General Hospital.The Globe and Mail
Four years ago, the head of Canada's pathologists association said the country's medical-testing laboratories were unravelling at the seams. "Perhaps we just didn't yell loud enough," Jagdish Butany said then, explaining that the problems had been festering for years.
It's worth yelling about now. Laboratories all over Canada, in provinces rich and poor, have committed far too many life-altering mistakes. Like a game of Whac-a-Mole, each time the people of one province discover to their horror a long-standing pattern of laboratory errors, and that province resolves to figure out why, another horror story pops up in another province.
Enough. The provinces should urgently convene an expert panel to ensure that every province and territory constructs its medical care on a solid foundation of pathology and diagnostic imaging. They should develop a system of quality controls that are proven and consistent, to the extent possible, throughout Canada. And they should be able to count on the backing of the premiers and health ministers. Any province that wishes not to accept and apply the standard of care would be accountable to its residents for an explanation.
If it is a matter of money, it should be obvious by now that cost savings in pathology are illusory. Medical care built on haphazard test data is a waste of money, effort and expertise, not to mention dangerous. But the latest province to reveal pathology problems is Alberta, where lack of money is surely not an excuse for the pattern of errors at three hospitals (one in Calgary, one in Edmonton and one in Drumheller) uncovered since November. Alberta's discoveries follow on problems identified with four radiologists in British Columbia last winter.
And that followed on problems with diagnostic imaging and pathology in Manitoba and Ontario, which followed on New Brunswick and Newfoundland and Labrador. At least 386 people had their breast-cancer tests botched in Newfoundland and Labrador between 1997 and 2005; the government settled a class-action lawsuit for $17.5-million. A judge who handled New Brunswick's review said, "The Department of Health had no idea whether the pathology laboratories in the province were operating at acceptable levels of quality." The problems in that province went on for more than a decade. If that isn't worth yelling about, what is?
And it's worth yelling about the individual cases, even if it cannot be conclusively shown that the errors led to deaths. In Powell River, B.C., John Moser went in for a scan in August, 2010, and no cancer was detected. That December, he was admitted to hospital; last January, he died. "He literally collapsed before he was finally diagnosed with cancer," his daughter, Janet Baird, said.
In all the noise about federal-provincial funding agreements for health, the crisis in pathology has not been given the national attention it deserves. Fixing pathology before the next discovery of botched tests should be a priority for the entire country.