STORY: "Former head of Motherisk program under investigation by medical regulator," by reporter Rachel Mendleson, published by The Toronto Star on March 1, 2017.
SUB-HEADING: "Dr. Gideon Koren retired from SickKids in June 2015 after the hospital shuttered the Motherisk lab and reassigned oversight of the Motherisk program."
PHOTO CAPTION: "Dr. Gideon Koren, former director of the Motherisk program at the Hospital for Sick Children, is being investigated by the College of Physicians and Surgeons of Ontario. "
GIST: Dr. Gideon Koren, the founder and former director of the Hospital for Sick Children’s embattled Motherisk program, is under investigation by the province’s medical regulator. The College of Physicians and Surgeons of Ontario (CPSO) has confirmed it is investigating Koren — a rare move by the college, which is mandated to keep confidential its investigations unless there is a “compelling public interest” to disclose the information. College spokesperson Kathryn Clarke said she could not provide details about the nature of the probe or when it was launched. A SickKids spokesperson said the hospital sent the CPSO a summary of findings from its internal investigation into Motherisk in 2015. The SickKids probe was launched after a Star investigation exposed questions about the reliability of Motherisk’s hair drug and alcohol tests. The probe uncovered serious problems at the lab and its affiliated call centre, prompting a public apology by hospital CEO Michael Apkon, who had initially defended the reliability of Motherisk’s tests. Koren retired from SickKids in June 2015 after the hospital shuttered the Motherisk lab and reassigned oversight of the Motherisk program. He could not be reached for comment and his lawyer did not respond to calls from the Star for this story. He is listed as a member of the big data team at Maccabitech, the business development arm of the Maccabi Group, an Israeli health-care company. His profile on the Maccabitech website describes him as a “clinical pharmacologist/ toxicologist with long experience on the effects and adverse effects of medications and chemicals in human. (sic)” “At the University of Toronto he established and oversaw a large research program on the safety and risks of drugs in pregnancy and children,” the profile states. There is no mention of SickKids or Motherisk, which he founded at the hospital in 1985 and grew into a leading resource for pregnant and lactating women and their doctors about the effects of medications, alcohol and drugs of abuse. Maccabitech did not immediately respond to a request for comment. Koren has held a medical licence in Ontario since 1982 and is also licensed to practise in Israel, where he was educated, according to his CPSO profile. A source confirmed that he is living and working in the Tel Aviv area. Spokespersons for the departments of medicine and pharmacy at University of Toronto, where Koren has previously taught, said on Tuesday that he no longer holds appointments with those faculties......... The CPSO reprimanded and fined Koren $2,500 in 2003 for writing anonymous “poison pen letters” to Dr. Nancy Olivieri and other colleagues at SickKids during a tense battle with Olivieri — behaviour the disciplinary panel described as “childish, vindictive and dishonest.” Koren denied writing the letters until they were tied to him through DNA testing. In December 2015, a provincially established independent review concluded that Motherisk’s hair tests were “unreliable” and “inadequate” for use in the thousands of child protection proceedings across Canada and handful of criminal cases in which they were submitted as evidence between 2005 and 2015. Child welfare agencies relied heavily on Motherisk’s hair tests as proof of parental substance abuse. Although child protection cases were the “bread and butter” of the lab’s work, no one in the lab, including Koren, had forensic training, and operations “fell woefully short of internationally recognized forensic standards,” wrote Justice Susan Lang, who conducted the review.
Lang identified significant concerns with the reliability of the hair tests for the entire 2005-2015 period she was assigned to review. But the tests Motherisk conducted before 2010 were particularly problematic. During this period, the lab did not have the capability to confirm results with so-called gold-standard testing, and relied on a preliminary screening test, despite the fact that “the requirement to carry out a confirmation test on any preliminary positive results . . . was highlighted in both the literature and in all internationally recognized hair-testing standards well before 2005,” Lang concluded. There was also a written caution included in the screening test that Motherisk used stating that it “provides only a preliminary analytical test result. A more specific alternate chemical method must be used in order to obtain a confirmed analytical result.” Yet Motherisk “very rarely” sent samples to its reference laboratory for such confirmation and failed to inform children’s aid societies and other customers that the results were only preliminary, Lang found. From 2005 to 2010, Koren signed each of the result reports before they were released, but neither he nor anyone else at Motherisk checked the work of the technician who performed virtually all of the tests, Lang concluded. (Although her review was limited to the 2005-2015 period, Lang reported that Motherisk started performing hair tests for use in child protection proceedings in the 1990s.) Koren has never spoken publicly about the Motherisk controversy. The SickKids’ investigation revealed that Motherisk had misled the hospital for several years about its proficiency testing process. It also exposed a privacy breach at the Motherisk call centre resulted in staff using records in at least 70 cases to contact people for their consent to use their data without the approval of the hospital’s Research Ethics Board. Following questions from the Star in 2015 about Koren’s ties to the Quebec-based drug company Duchesnay, the maker of Diclectin, a popular morning sickness drug that Motherisk endorsed, the hospital implemented new conflict-of-interest policies and added a disclosure on the Motherisk website. An ongoing probe of thousands of individual child protection cases in Ontario that relied on Motherisk testing has so far identified 24 cases in which the hair tests played a key role in the decision to remove children from their families. Koren and SickKids are named as co-defendants in several lawsuits seeking damages on behalf of parents who claim they lost custody of their children due to Motherisk’s flawed hair tests. In his online profile at Maccabitech in Israel, Koren is described as “the author of more than 1,600 scientific papers.” The Lang review identified six articles he co-authored that incorrectly stated that results obtained using the screening test had been confirmed with a gold-standard method “when that was not so.”"
The entire story can be found at:
See related Toronto Star editorial at the link below: " Investigation into founder of Motherisk program is long overdue: Editorial: Finally, the Ontario College of Physicians and Surgeons is investigating Dr. Gideon Koren."..."For two and a half years a Star investigation has revealed scandalous shortcomings that shattered families and ruined reputations in the now-defunct Motherisk hair-testing program at Toronto’s Hospital for Sick Children. The stories led to provincial and internal reviews of the program that tested hair strands for traces of drug or alcohol abuse. Now the Star’s Rachel Mendleson has confirmed the Ontario College of Physicians and Surgeons is investigating the founder and former director of the discredited program, Dr. Gideon Koren. The college won’t provide details of the probe or when it was launched, but it is long overdue. Too many questions have been left outstanding about how the Motherisk program could have been run for a full 10 years with so many alarming shortcomings that affected so many child protection and criminal cases. In fact, Koren and SickKids are named as co-defendants in several lawsuits seeking damages on behalf of parents who claim they lost custody of their children due to Motherisk’s flawed hair tests. The lawsuits come as no surprise. The provincial review concluded that Motherisk’s hair tests were “unreliable” and “inadequate for use in the thousands of child protection proceedings across Canada and handful of criminal cases in which they were submitted as evidence between 2005 and 2015.” And SickKids’ own investigation revealed that Motherisk had misled the hospital for years about how it carried out its tests. Meanwhile, an ongoing probe of thousands of child protection cases in Ontario that relied on Motherisk testing for traces of drug or alcohol abuse has so far identified 24 cases in which the hair tests played a key role in the decision to remove children from their families. Among the questions raised in the provincial review by Justice Susan Lang that the college would do well to consider when investigating Koren:
- Why no one in the lab he created and oversaw had forensic training, even though child protection cases were the “bread and butter” of the lab’s work.
- Why the lab did not have the capability to confirm results from 2005 to 2010 with the so-called gold-standard of testing.
- Why the lab failed to inform children’s aid societies and other customers that the results were only preliminary.
It’s time there were answers from Motherisk’s founder and director. The college’s job now is to get them, and make them public.
For a glimpse into the legal morass some innocent parents were put through inside Ontario's child welfare system when trying to get children lost because of Motherisk's shameful practices, see the link below: Superior Court Justice Grant Campbell determined that the parents received incompetent counsel from lawyers Brigitte Gratl and Jane McKenzie. Gratl represented the mother in the case and the father retained McKenzie. Both were retained through Legal Aid. The case, which was heard in Kitchener, Ont., concerned a since-debunked Motherisk drug test that the mother took, which resulted in her child — identified as K. — being removed from her custody in 2012. The case languished through the system for years, and it became what Campbell described as a perfect storm of “errors, incompetence, institutional oversights and mistakes,” which left the child in a “legal limbo,” where neither parent had contact with her. In his 101-paragraph decision, Campbell said the parents and K. “have been consumed and trampled by the Frankenstein process we have created and allowed to become unmanageable.” He painted a dark picture of the country’s child welfare system, where judges and courts are scrambling to keep up and the few private counsel that will take these kinds of legal aid cases are completely overwhelmed. He said the system’s process is underfunded and overworked and has been exacerbated by last year’s R. v. Jordan decision in the Supreme Court of Canada. “The child welfare system in Ontario is broken,” Campbell wrote. “The patchwork of child welfare legislation spread across Canada is not working.” Campbell apologized to the parents “on behalf of the very system that perpetrated this upon you.” Lawyers say Campbell’s decision is unusual, as rather than simply making a ruling on narrow legal issues, the judge took the opportunity to comment on the system at large. “He revealed the underbelly and the weaknesses of the family court system,” says Steven Benmor, a Toronto family lawyer, who was not involved in the case. Benmor says Campbell’s criticisms of the child welfare system are accurate when it comes to Ontario, as the system is broken when it fails even one family. “When these people fall through the cracks, it reveals a weakness in the overall system,” he says. Campbell found that both Gratl and McKenzie had “dropped the ball” in their handling of the case and that they both failed to register their clients’ objections to delays and procedural unfairness. “The transcripts appear to show that both parent’s counsel had no plan/nor any or much preparation to do anything positive for their clients, other than cross examine (at length) whatever evidence the Agency brought forward,” Campbell wrote. “The overall picture appears that both counsel effectively conceded the result of the procedural delays and the status quo that had been established.” The parents filed a long list of complaints against the two lawyers, which included that they had ignored instructions, been unprepared, shown an unwillingness to consult or explain and had even showed disdain for their clients. Campbell found that McKenzie had failed to zealously represent her client’s interests throughout the trial and ignored the father’s indigenous heritage. Campbell also found that Gratl took no steps to get a competing drug test to challenge the Motherisk one. Nor did she bring a motion before the court concerning the mother’s indigenous heritage, which would have affected the child’s placement. Campbell found that three and a half years had elapsed from the time K. was taken from her mother and when the trial judge issued her decision, which he said was “not only entirely unacceptable, it is reprehensible.” The judge also found that the trial process was “unfair, unjust and skewed against the parents.” “The integrity of the administration of justice was compromised by this trial and brought into disrepute,” Campbell said. While Campbell found that the trial judge’s decision was unreliable, he declined to set aside the decision and issue a new trial, as he determined that would further harm the stability of the child, who was set to be adopted by a foster parent. He did, however, order that the parents be given contact to the child.
PUBLISHER'S NOTE: I am monitoring this case/issue. Keep your eye on the Charles Smith Blog for reports on developments. The Toronto Star, my previous employer for more than twenty incredible years, has put considerable effort into exposing the harm caused by Dr. Charles Smith and his protectors - and into pushing for reform of Ontario's forensic pediatric pathology system. The Star has a "topic" section which focuses on recent stories related to Dr. Charles Smith. It can be found at: http://www.thestar.com/topic/