In last November’s issue of The Interim, we looked at the general state of Canadian medicine, which we noted is distinguished by characteristics including the fact that it kills more than 100,000 pre-born Canadians a year through abortion and perhaps as many as 24,000 born ones a year through medical errors, takes up huge chunks of government budgets and is marred by fraud to the tune of up to $10 billion.
In all fairness, it must be pointed out that at least one commentary exists contradicting the assertion that 24,000 people die every year from medical errors in Canada. “Improving Patient Safety: Moving Beyond the Hype of Medical Errors,” written by Alan J. Forster, Kaveh G. Shojania and Carl van Walraven, was published in the Canadian Medical Association Journal on Oct. 11, 2005. It suggested that the identification of medical errors is “a subjective process” that leads to “wide variations in the reported prevalence of adverse events.”
The commentary also noted that most errors only cause temporary symptoms and that there is no assessment of the degree to which an error contributes to a patient’s eventual death. Only six per cent of patients who were victimized by a medical error would have been expected to live an additional three months had the errors not occurred, it said.
Regardless of this, however, a survey of anecdotal events shows that in absolute terms, there are still massive problems with our medical system. Where we looked at the situation in general in November, let us now look at some specifics up to April 2004.
• In November 1999, a class-action lawsuit was authorized against Montreal’s St. Charles Borromee Hospital for allegedly failing to provide even the most basic services for its severely disabled long-term patients. This included neglecting to wash and feed them properly between 1993 and 1997.
• In July 2002, Alfred Potter, a mentally ill man, died in the emergency room of Hamilton’s St. Joseph’s Hospital after a series of errors by emergency department nurses and a family doctor.
• In October 2002, 11-year-old Claire Lewis died in a Hamilton hospital from what were openly described as “a string of errors and bad decisions” in her care. Her father, a nurse within the Hamilton healthcare system, had to spend months fighting the hospital to accept its responsibility in the death, before it coughed up an unprecedented letter of apology.
• In September 2003, a $4.6 million lawsuit was filed against Hamilton fertility doctor Salim Daya for unethically conducting an unofficial clinical trial on a patient, which included a sham operation.
• In October 2003, doctors were reported to be continuing to prescribe the anti-depressants Paxil and Effexor to teenagers despite warnings of dangerous side effects, including increased risks of suicidal thoughts.
• Also in October 2003, a joint conference of the Canadian Bioethics Society and the American Society for Bioethics and Humanities heard that hospitals in the Western world allow interns and residents to practise resuscitation techniques on newly deceased patients without consent.
• The same month, the boss of a probe into the Canadian SARS outbreak said a massive overhaul of the public health system was needed to address weaknesses including a lack of basic public health tools.
• In November 2003, Zambian-born Regina Dr. John Schneeberger, who was convicted of drugging and sexually assaulting two of his patients, was released from prison to calls for deportation from a federal MP.
• Also in November 2003, an advisory was issued after Captain William Jackman Hospital in Labrador City may have used unsterile instruments in its gynecology clinic over a one-and-a-half-year period.
• The same month, the Kansas City Star newspaper unearthed documents that revealed Red Cross officials in Canada and the U.S. in the early 1980s were more concerned with legal requirements than with halting the spread of hepatitis C in blood supplies. It wasn’t until 1990 that testing for the disease was begun in Canada.
• The same month, Whitby, Ont. obstetrician-gynecologist Dr. Errol Wai-Ping appeared before a disciplinary committee of the College of Physicians and Surgeons of Ontario on charges that included botched hysterectomies, deliveries and gynecological procedures, life-threatening infections after surgery, unnecessary hysterectomies and failure to diagnose cancer.
• In January 2004, the Quebec College of Physicians launched an investigation into the case of Montreal pediatric surgeon Maria Di Lorenzo, who was infected with the AIDS virus, but continued operating on children for 13 years without medical administrators being aware of her condition.
• The same month, the Ontario Ministry of Health admitted that medical instruments manufactured for single use – including forceps, scissors and speculums – were being reused by Ontario hospitals. By then, nine hospitals were forced to alert former patients that they might have been exposed to instruments that weren’t properly sterilized.
• In February 2004, the Quebec Court of Appeal upheld the dismissal of paramedics Sebastien Valade and Martin Gariepy, who refused to treat a dying man because they were on a break when they were called on to help.
• In March 2004, federal Auditor-General Sheila Fraser said Health Canada’s medical device protocols so lacked credibility, they are routinely ignored by hospital and lab workers. That put Canadians using pregnancy tests, pacemakers, MRIs and some forms of birth control at risk.
• In April 2004, Hamilton surgeon Dr. Daniel Bowser, whose patient died because he failed to properly communicate instructions for the man’s care, was ordered to pay almost $1.3 million as a result of a lawsuit.
• The same month, about 175 hip surgery patients over a six-year period were recalled by Montreal General Hospital because a surgical instrument used in operations performed on them may not have been properly sterilized.Part 3 in this series will follow in an upcoming issue of The Interim.