Halifax Medical Malpractice Lawyer Blog

I get several calls a week from patients, of family members of patients, who are concerned about the care that they, or their family member, have received from their doctor or hospital.

In most cases, a careful investigation of the facts reveals that there are no grounds for a medical malpractice claim (in other words, the doctor or hospital wasn’t negligent) or that there may have been negligence in the patient’s care, but the cost of filing a lawsuit would be more than the potential recovery.

Explaining these facts to my clients is one of the more frustrating aspects of being a medical malpractice lawyer. I hate telling patients that I believe there was negligence in the care they received but that I don't think they should pursue a compensation claim.

My colleague Ches Crosbie has posted about this problem at the Newfoundland Injury Law Blog. Ches is one of Newfoundland and Labrador’s finest medical malpractice lawyers. He points out that the decision to accept or reject a client who has a medical malpractice claim is always difficult.

College of Physicians and Surgeons

However, if you are not satisfied with the care that you or your family has received, you can file a complaint with the College of Physicians and Surgeons. Each province has a College of Physicians and Surgeons that is made up of a panel of doctors and lay persons (non doctors) who are responsible for hearing complaints about doctor’s conduct and administering discipline.

Discipline can range from something as simple as giving the doctor a warning to as serious as suspending the doctor’s license or taking away the doctor’s license to practice medicine in that province.

File a Complaint About the Doctor!

I encourage patients and family members who are concerned about a doctor’s conduct to contact the College of Physicians and Surgeons to express their concerns. Often the patients don’t follow through with the complaint. I think this is a real mistake.

There are certain doctors who I regularly receive calls about. However, if the patients don’t file a complaint with the College of Physicians and Surgeons, there is no way for the College to know about any potential concerns about the doctor’s conduct.

When a patient finally files a complaint the College may not take the complaint seriously because it is the first complaint received about a particular doctor. The Board members' reasoning may be something like: “Well, we have only received one complaint about his/ her conduct. Lets give the doctor a warning to make sure it doesn’t happen again”.

On the other hand, if the College has received a half dozen or more complaints about the same doctor they will be far more likely to take the complaint seriously and more likely to administer more severe discipline to the doctor.

Ches gives some good advice about what type of information should be contained in a complaint to the College of Physicians and Surgeons. I would recommend anyone considering filing a complaint to take a look at his post.

Continue reading "You Can File a Complaint About Your Doctor!" »

Dr. Rajgopal Menon, a pathologist responsible for potentially hundreds of faulty cancer test results should have been fired years ago according to Justice Paul Creaghan

5000 + Test Results Wrong or Incomplete!

Justice Creaghan is heading up an inquiry formed after an independent audit found that more than 5000 of Menon’s pathology tests for breast cancer and prostate cancer were incomplete or misdiagnosed. Let me repeat that: Menon's test results were wrong in more than FIVE THOUSAND cases. More than 25% of all the test results he performed over 12 years contained errors!

As a result, cancer patients had their diagnosis delayed or, in some cases, patients were told they had cancer when they did not.

Menon Refuses Responsibility

Menon has consitantly refused to take responsibility for his actions. Take a look at some of my previous posts: Disgraced Pathologist Menon “Sorry” but Blames Everyone in Sight and Disgraced Pathologist Menon's Work had 'Big Problems': New Brunswick.

The National Post has reported that Menon questioned Justice Creaghan at the press conference announcing the inquiry results. Menon asked why Justice Creaghan did not make any recommendations regarding the quality of the hospital administration during the time that he was employed with the hospital district.

Menon was quoted as saying: “This is very important because there is a lot of interaction between the administrators and pathologist, especially at the Chief’s level”.

Health Authority Knew About Problems

Creaghan acknowledged that there were problems at the Miramichi Regional Health Authority. That’s putting it kindly. I have posted about previous evidence from the inquiry which made it clear that staff at the Health Authority were well aware of the problems with Menon’s work.

For example: Health Authority Knew about Pathologists Problems: Miramichi and Deputy Minister Received Complaints about Disgraced Pathologist: New Brunswick and Negligent Cancer Screening put Patients at Risk: Miramichi Hospital and finally Negligent Cancer Screening in New Brunswick may Lead to Criminal Charges and Medical Malpractice Claims.

It seems to be clear from the evidence presented at the inquiry that Menon’s work did not meet the standard of care required of a competent pathologist.

Delays in Diagnosis may have Fatal Consequences

If Menon’s faulty work resulted in a delay in diagnosing cancer patients, it’s possible that patients may have died due to his incompetence. Since early identification and treatment provide the best chances of survival, it is foreseeable that the problems with the Miramichi Health Authority may have lasting and fatal effects for many patients.

Lawyers are considering a proposed class action against the Health Authority for systemic negligence. If you or a family member has been diagnosed with cancer as a result of testing performed at the Miramichi Regional Health Authority you should contact a lawyer to see whether you have a potential medical malpractice claim.

Continue reading "Pathologist Menon Should Have Been Fired Years Ago: N.B. Inquiry" »

How often does medical malpractice happen in Canada?

The short answer is that the law suits that are filed in court are just the tip of the iceberg when it comes to medical malpractice claims in Canada.

Medical malpractice claims in Canada tend to get a lot of attention in the media. Everyone is concerned about the quality of health care that they receive, and claims that raise concerns about problems with medical care naturally get reported in the newspapers or on television.

Most Malpractice Victims Don't File Law Suits

But the fact is that most victims of medical malpractice never file a law suit.

More Than Half of Medical Mistakes "Preventable"

A famous research study conducted by Harvard Medical School determined that more than half of all injuries caused by medical management (in other words, not caused by the patient’s initial injury or disease) were preventable, and another quarter of those incidents were caused by negligence.

24,000 Canadians Die Every Year

In May 2004 the Canadian Medical Association published: "The Canadian Adverse Events Study: the incidence of adverse events in hospital patients in Canada". The report confirmed findings of similar studies in the United States, Australia, the United Kingdom, Denmark and New Zealand.

The Canadian study concluded:

• As many as 24,000 patients die each year due to “adverse events” (code words for a bad result).

• 87,500 patients admitted annually to Canadian acute care hospitals experience an adverse event.

• 1 in 13 adult patients admitted to a Canadian hospital encounter an adverse event.

• 1 in 19 adults will potentially be given the wrong medication or wrong medication dosage.

• 37% of adverse events are “highly” preventable.

• 24% of preventable adverse events are related to medication error.

A report by the Canadian Institute for Health Information (CIHI) indicated that nearly one quarter of Canadian adults (5.2 million people) reported that they, or a member of their family, had experienced a “preventable adverse event” (medical error).

Only a Few Law Suits Filed Each Year

According to the annual report of the Canadian Medical Protective Association (the CMPA), the group that defends most lawsuits filed against doctors in Canada, about a 1000 legal actions are commenced against doctors in Canada each year.

But the Canadian Medical Association says that 24,000 people die each year due to medical errors and more than 87,000 patients in Canada experience an adverse event.

Why Don't More Canadians File Medical Malpractice Claims?

So why aren't their more medical malpractice law suits in Canada?

Part of it certainly has to do with the difference in attitude between Canadians and Americans when it comes to litigation. We just aren't as likely to file a lawsuit as Americans are.

It certainly isn't because the CMPA is settling the claims of victims before they file their lawsuits. Their annual report shows they settle less than 500 claims per year.

Is it because they can't find a lawyer willing to take on a complicated and expense medical malpractice claim? Perhaps. Medical malpractice claims are complicated, time consuming, risky and very expensive. There are few lawyers willing to devote the time and money it takes to prosecute medical malpractice claims.

I believe that a bigger problem is that most patients don't know they have been the victim of negligence!

There are no national standards regarding the disclosure of medical errors to patients.

Related posts:

Majority of Infant Deaths Due to Medical Error Preventable

Medical Malpractice Kills More Than 24,000 Canadians Each Year

Overworked Nurses Causing Medication Errors

Continue reading "How Often Does Medical Malpractice Happen in Canada?" »

Altering medical records does not happen as often as it appears to happen on television or in the movies. However, it happens enough that experienced medical malpractice lawyers develop a sense of when further investigation into the legitimacy of a medical record or chart is warranted.

One of my favourite movies of all times is The Verdict with Paul Newman. I love the scene where he finally realizes that he can prove that the defendant doctor altered the medical files of the woman who was left in a coma because of the doctor’s negligence.

Lessons Learned From Past Cases:

Over the past 18 years, I have learned some lessons about when to suspect that a medical file may have been altered.

Notes on one report, not on another:

In one case I was involved in the specialist’s report that was received by my client’s family physician did not have (exculpatory) handwritten notes that appeared in the report in the specialist’s file.

Lesson:
Look for all copies of the record and compare them.

Different Versions of reports:

In one case the surgeon dictated three different versions of the operative report. The family doctor received the first version days after my client’s surgery. After my client’s condition deteriorated, he dictated a second version (which was found in the Hospital chart). After my client became comatose and was transferred to another hospital for corrective surgery he dictated a third version of the report which was in his office copy of my client’s chart.

Lesson:
Get the records, and get them fast.

Were they working?

In a claim involving allegations of nursing negligence, the nursing notes contained statements that the patient’s condition had been communicated to the attending physician. However the date of the entry was for a day that the nurse in question wasn’t working!

Lesson:
Compare staffing sheets/time cards with the medical chart to detect entries/notes by staff members that were not present/on duty that day.

Medication Errors:

Medication errors are a common mistake among nurses who are overworked or inexperienced.

In a claim involving a fatal overdose, the nursing notes indicated that the deceased had received the proper dosage of medication. However, the medication administration records, which were not supplied by the hospital when the chart was originally requested, showed that the medication had been administered to the patient twice.

Lesson:
Compare the medication administration records with the nursing notes and physicians orders.

Destroying Records:

In an anesthesia negligence claim the anesthesiologist tore up the original anesthesia record and prepared a new record with different data. One of the nurses involved in the operation retrieved the original record and scotch taped it together.

Lesson:
Interview everyone, including retired employees.

White out = Suspicious Records

In a birth injury claim two of the babies APGAR scores had been whited out and changed from a 0 to a 2 (normal).

Change the Numbers - Change the Result:

In a fatality claim the deceased’s blood pressure reading had been changed from 170/90 to 120/80 by using a different colour pen to alter the numbers 7 and 9. The change couldn’t been seen on the photocopy of the patient’s chart, but was reasonably obvious on examination of the original chart.

Lesson:
Whenever I have a reasonable suspicion that the medical files have been altered, I make an appointment to attend at the Hospital or the doctor’s office to view the original chart.

What to Look For:

Some “red flags” that I look for, based on past experience, that may indicate the possibility of altered medical records are:

• Crowding or squeezing entries above a signature, or between lines;
• Erasures, crossed out entries or white-out corrections;
• Changes in slant of handwriting;
• Using different pens or computer typeface to write one entry;
• Notes on different dates in the same colour ink from same pen;
• Notes in different colour ink (different pen) in the same chart note;
• A typed entry following handwritten entries, or vice versa;
• Missing original records that have replaced by photocopies;
• Entries that are self-serving;
• Half sheets instead of the standard size page (page cut in half);
• Additional notes on the original document, not on copies received by client;
• An unusually late date of dictation of a consult report;
• Any handwritten entry made by someone who erred significantly in treatment.

Continue reading "Altered Medical Files: "I think my records have been tampered with!"" »

Moira Hennessey, an assistant deputy minister in Newfoundland and Labrador's health department has told the Cameron Inquiry that she was ordered not to question confusing figures about cancer test results according reports from the CBC.

“Forgot” to tell Bosses about Problems

She also testified that she “forgot” to pass on information on problems with cancer screening results to her bosses.

Ordered to Alter Records

Hennessey told Justice Margaret Cameron she altered a ministerial briefing note on the orders of her boss, the deputy minister of Health John Abbott.

Abbott had ordered Hennessy to change briefing notes to indicate that recommendations to fix the pathology lab had been implemented when in fact they had not.

"The note came back I can still see it, actually. The note came back to me with the words crossed, like slashed, through it," she said.

Error in Judgement

Hennessey denied any attempt to cover up problems in the department. When asked about why she had not told the Minister of Health the correct information, Hennessey responded:

"Regrettably, that was an error in judgment on my part,"

Didn’t Disclose Hundreds of False Test Results

Hennessey did not tell her boss that test results showed that more than 300 breast cancer patients had been given incorrect testing results.

It is hard to believe that bureaucrats could put the lives of hundreds of people at risk, simply because they didn't want to face the political fall out. Well...perhaps it isn't so hard to believe.

Continue reading "Officials told to Turn a Blind Eye to Cancer Test Results: N.L." »

Dr. Rajgopal Menon, the dismissed pathologist at the centre of a public inquiry into botched cancer screening tests and autopsies in New Brunswick, apologized to his former patients yesterday for any errors he may have made.

Menon "Apologizes"

“I wish to sincerely apologize to any patient if I have made an error in reading their pathology slides. I was not aware of any errors in my work."

More Problems Than Previously Reported

The expert hired to review Menon’s work, Dr. Rosemary Henderson testified yesterday that she found 14 incorrectly diagnosed cancer tests done by Menon in just a two year period. More than the 6 or 7 errors that had previously been reported.

Menon Casts Blame on Others

But today Menon changed his tune. He blamed his bosses whom he said “were out to get him” according to CBC reports.

Notes "Planted"

Menon claimed that signed notes of a 1998 meeting where Menon was told to clean up his act or face dismissal were fake.

"The meeting never happened," Menon insisted. "I think the notes were planted."

Menon "Blackmailed"

He claimed that New Brunswick’s College of Physicians and Surgeons tried to blackmail him into resigning.

"Maybe, in hindsight, it would have been better," Menon said when asked what he thought of the offer. "But that is like blackmail for me. . . . That is not professional medicine."

Hospital Was The Problem

Menon said the problem was not with him but the Hospital where he worked:

"As far as I was concerned, it was the administration," he said.

Doctor "Out To Get Him"

When questioned about a letter from another doctor expressing concerns about Menon’s competency, Menon told the inquiry:

"He wanted my job and I didn't want to give it," Menon said. "That was the only problem."

Everyone to Blame But Himself

You have to wonder what colour the sky is in the fantasy world that Menon lives in. It appears that the only people Menon didn’t blame for his incompetence are the cancer victims who were not able to receive treatment because he botched their test results telling them they were cancer free!

How many people have died or have not received proper medical treatment because of Menon? He obviously has not read my previous post Doctors: Say "I'm Sorry" and don't get sued!

What do you think? Is Menon incompetent or an innocent victim of an incredible smear campaign?

Continue reading "Disgraced Pathologist Menon “Sorry” but Blames Everyone in Sight" »