Cancer testing crisis too much to be handled alone, inquiry told

Eastern Health was overwhelmed soon after the start of its crisis in dealing with flawed cancer tests, a judicial inquiry in St. John's has been told.

Dr. Robert Williams, who retired as vice-president of medical services in 2006, also told the Cameron inquiry that he still carries the burden of what went wrong with flawed hormone receptor tests, in which more than 300 patients received erroneous results that may have affected their treatment.

"I could never forget it. It's with you all the time," Williams, the former top doctor at Eastern Health, told the inquiry Thursday.

"It was a burden on me really. It followed me out, and I continued to think about it."

Williams learned of the first case of a faulty test result in May 2005. By July, as more samples were reviewed, it was clear that something significant was in their midst, even though Eastern Health had only been launched at the beginning of the year.

"This was probably the biggest challenge Eastern Health was going to face, and it would be a national issue," Williams told Justice Margaret Cameron.

Calls for dedicated task force

Williams said that he learned that a dedicated task force would be necessary should anything similar ever happen again. He told the inquiry that he ran out of steam trying to handle his day-to-day duties as well as a widening health crisis.

"This is such a big issue that you almost need to create a task force with the only role is to deal with this issue," said Williams.

"It's that big, in retrospect. So you'd have somebody at a senior level who'd be charged [so that] their only job would be to deal with this."

The inquiry has heard that Eastern Health never did assign one particular person to co-ordinate a response.

Meanwhile, Williams — who represented a voice of reassurance on behalf of Eastern Health during the early months of the crisis — said he felt that the public ought to have been notified quickly about the problem.

Had 'gut feeling' about informing public

Inquiry co-counsel Bern Coffey, though, pressed Williams on his response to a July 2005 memo written by Susan Bonnell, then the authority's director of communications, who advised Williams and George Tilley, Eastern Health's chief executive officer at the time, that she saw no need to go public.

"I'm not sure I strongly expressed anything to her," Williams said.

"I had a gut feeling that maybe we should do something," said Williams, who could not recall whether he passed on his concerns to anyone else.

The public did not learn anything about the problems with hormone receptor testing, which are done to determine whether a breast cancer patient can benefit from the antihormonal therapy Tamoxifen, until October 2005.

"What if any relief did you get from that?" inquiry co-counsel Bern Coffey asked Williams, referring to the news finally breaking.

"Personally, that it was out in the public, and we could address it in the public sense," Williams said.

Preferred contact by phone, not letter

Williams told the inquiry that he favoured contacting patients by telephone rather than through a letter.

"If you phone somebody up and you got a caring person on the other end of the line who has some clinical background and knowledge about this, then that may be better," said Williams, who wanted patients to be given a contact name and number for them to call back.

Contacting patients did not begin until after media reports appeared. As well, the inquiry has been told that Eastern Health had no systemic way of contacting patients, and that even after the inquiry was announced last year, some patients had not been contacted at all.

Meanwhile, Williams also told the inquiry that he was told that there may have been a lack of standard quality control with hormone receptor testing.

"I remember [being told] this area is like an island in a sea," he said.

"This is an area where we didn't have those things in place that had been in place in other parts of the lab."

By the time Williams retired in September 2006, problems with the lab's hormone receptor testing had been resolved.

However, Eastern Health was still mired in a mess of contacting patients and with communicating with the public, which would only intensify in 2007, when exasperated politicians in the Newfoundland and Labrador government ordered the inquiry.