MONCTON, N.B. - Officials with New Brunswick's Health Department have told an inquiry there were small signs of possible trouble at a Miramichi medical laboratory, but nothing that triggered alarms about incomplete tests and misdiagnoses.
Lise Daigle, director of hospital services, testified Tuesday that the Health Department is removed from the day-to-day operations of the province's hospitals and their laboratories.
She said much of the quality control in the province's hospitals rests with national bodies, such as the Canadian Council on Health Services Accreditation and the Canadian Standards Agency.
Daigle said only once, when reading a report, did she get an inkling there might be trouble at the laboratory in Miramichi, where the work of veteran pathologist Dr. Rajgopal Menon is now under a microscope.
"Not all the dimensions were there," she said of quality assurance at the Miramichi laboratory.
"It was fragmented," said commission lawyer Marc-Antoine Chiasson.
"Yes, that was the impression I was getting," Daigle replied.
An Ottawa laboratory is reviewing almost 24,000 cases handled by Menon from 1995 to 2007 after an audit showed significant numbers of incomplete biopsies and missed disagnoses, especially in relation to prostate and breast cancers.
Daigle also said that although she worked closely with laboratory consultants for years, no issues were brought to her attention about the Miramichi lab and Menon's work.
"You never had any problems raised with respect to the operations of that laboratory?" asked commission chair Paul Creaghan.
"That's accurate," answered Daigle.
Former deputy health minister Nora Kelly earlier told the inquiry that while she had heard complaints about Menon's work habits, such as tardiness and missing slides, "no one ever said that he was incompetent."
Menon, 73, worked as a pathologist at the Miramichi Regional Health Authority from 1995 until 2007, when he was suspended by the New Brunswick College of Physicians and Surgeons following complaints about incomplete diagnoses and delayed lab results.
A peer review of Menon's work, released publicly in March, indicated the elderly pathologist had health problems, such as cataracts and hand tremors, that may have affected the quality of his work.
Menon, slightly built and bespectacled, attended the hearing Tuesday. He said nothing and would not be interviewed by news reporters, but is expected to give his testimony later in the month.
He has defended his work, calling the review "unjustified and unfair." He has also filed a civil suit against the regional health authority.
Daigle said that while New Brunswick does not have its own agency to accredit medical laboratories, as is the case in several other provinces, she said the Canadian Standards Agency has developed new standards for labs that are now part of the accreditation process.
She said all New Brunswick hospitals are accredited, which guarantees a measure of quality and reliability.
The inquiry will continue in Moncton until early June. There then will be hearings in Miramichi in the summer, to be followed by more hearings in Moncton in September and October.
Creaghan is not expected to report to the New Brunswick government until early next year.
