Saturday, March 13, 2010

WINDSOR HOSPITAL CRISIS: HOSPITAL RELEASES WRITTEN REPORT EXPLAINING ITS DECISION TO ALLOW HEARTWELL TO CONTINUE OPERATING; THE WINDSOR STAR;



"AT WEDNESDAY’S HEARING, WHICH WAS NOT OPEN TO THE PUBLIC, THE BOARD HEARD ABOUT THREE OF HEARTWELL’S CANCER CASES WHICH RAISED CONCERNS. THE PATIENTS’ NAMES AND OTHER DETAILS WERE NOT REVEALED IN THE BOARD’S WRITTEN DECISION AND SUMMARY OF EVIDENCE. HEARTWELL ADMITTED SHE MISREAD A PATHOLOGY REPORT IN ONE OF THE CASES BECAUSE OF “A CONFLUENCE OF FACTORS,” INCLUDING A “POORLY FORMATTED” REPORT AND A POSITIVE ULTRASOUND TEST. DR. RANDAL GOSNER, WHOSE REVIEW OF THE CASE WAS ENTERED INTO EVIDENCE, WROTE: “ALTHOUGH I CAN’T DEFEND THE MISTAKE, I CAN CERTAINLY UNDERSTAND HOW IT COULD HAPPEN TO A GENERAL SURGEON.”......DR. ALAN FORSE, CHIEF OF SURGERY AT HOTEL-DIEU, TESTIFIED THAT HEARTWELL’S CLINICAL DECISIONS IN THE OTHER TWO CASES “WERE NOT UNREASONABLE.” HE SAID REINSTATING HEARTWELL’S PRIVILEGES IS IN “THE BEST INTERESTS OF THE HOSPITAL AND COMMUNITY.”"

REPORTER SONJA PUZIC: THE WINDSOR STAR;

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PUBLISHER'S NOTE: During the past two years, this Blog has reported on a crisis in Canadian pathology indicated by serious breakdowns in hospitals in Newfoundland, New Brunswick, Quebec, Saskatchewan and elsewhere in the country. The purpose, beyond seeking review and reform, is to show that the wide-ranging problems with pathology in Canada were not limited to the criminal sector - and that serious errors, sometimes lethal, were being made in reading test results on living patients. In short, to demonstrate that there was a crisis in Canadian pathology.

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"WINDSOR, Ont. -- Hotel-Dieu Grace Hospital's board of directors restored Dr. Barbara Heartwell's surgical privileges Thursday, concluding that the surgeon is not a threat to patient safety,"
the March 12, 2010 Windsor Star story by reporter Sonja Puzic begins, under the heading "Windsor Dr. Barbara Heartwell's surgical privileges at Hotel-Dieu Grace Hospital reinstated."

"Heartwell, whose privileges were suspended after it was revealed she performed two unnecessary mastectomies, can immediately return to the operating room, with the condition that another general surgeon reviews her elective oncology cases before each surgery," the story continues.

"Heartwell’s work will be reviewed for three months, with monthly updates to Hotel-Dieu’s medical advisory committee.

In its written decision, the hospital board found “that the conduct and competence of Dr. Heartwell will not expose patients to harm or injury, nor is it reasonably likely to expose patients to harm or injury.”

A panel of seven hospital board members reached that conclusion after hearing evidence Wednesday night from the medical advisory committee and Heartwell’s lawyers.

Three weeks ago, Hotel-Dieu said the experienced surgeon had misread a pathology report and performed an unnecessary mastectomy last fall on Laurie Johnston of Leamington, who never had breast cancer. Days later, Sarnia woman Janice Laporte came forward with her story of having a cancer-free breast removed by Heartwell in 2001.

On Feb. 23, Heartwell voluntarily stopped performing surgeries at Hotel-Dieu while the hospital reviewed her past cases. But she changed her mind three days later, prompting then-interim chief of staff Dr. Kevin Tracey to suspend her privileges.

The MAC found that Heartwell’s suspension was not necessary because “less restrictive measures” could be taken. It recommended to the board that her hospital privileges be reinstated and that another surgeon review her cancer cases for three months.

At Wednesday’s hearing, which was not open to the public, the board heard about three of Heartwell’s cancer cases which raised concerns. The patients’ names and other details were not revealed in the board’s written decision and summary of evidence.

Heartwell admitted she misread a pathology report in one of the cases because of “a confluence of factors,” including a “poorly formatted” report and a positive ultrasound test.

Dr. Randal Gosner, whose review of the case was entered into evidence, wrote: “Although I can’t defend the mistake, I can certainly understand how it could happen to a general surgeon.”

Gosner noted that Heartwell had “appropriately” disclosed the mistake to the patient and apologized.

Dr. Alan Forse, chief of surgery at Hotel-Dieu, testified that Heartwell’s clinical decisions in the other two cases “were not unreasonable.” He said reinstating Heartwell’s privileges is in “the best interests of the hospital and community.”

The board also heard that the hospital has so far reviewed 692 mastectomies and another 4,249 surgeries done by Heartwell. More than a 130 of them still need to be fully examined, but no concerns have been flagged.

Heartwell is allowed back in the OR as early as Friday, but Hotel-Dieu officials didn’t know Thursday when her next surgery will be."

The story can be found at:

http://www.windsorstar.com/health
/Windsor+Barbara+Heartwell+surgical+privileges+Hotel+Dieu+Grace+Hospital+reinstated/2671925/story.html


Harold Levy...hlevy15@gmail.com;