Thursday, April 30, 2009

Nosocomial: Hospital-acquired

Major contributors to nosocomial infections include the emergence of antibiotic-resistant bacteria, poor hygiene practices by healthcare providers, incompetent staffing, substandard practices and apathy on the part of healthcare providers. Nosocomial, derived from Latin, means "hospital-acquired". The term is used to shield hospitals from the "embarrassment" of germ-related deaths and injuries, injuries leading to death exacerbated by hospital cutbacks and carelessness by doctors and nurses.

To a distinctly greater extent or degree, nosocomial infections often can be identified by clinical criteria alone, such as through ongoing concurrent medical record review.

Tuesday, April 28, 2009

Medical horrors in Canada !

Slate -> The Fray -> Fighting Words


CTV.ca | Three in 10 Cdns. report medical errors


Canada's health care myth

Are you aware that not diagnosing a condition is one of the most common forms of medical negligence? The Institute of Medicine explains: medical mistakes are responsible for close to one hundred thousand fatalities every year.


Doctors seek gag orders to stop patients' online reviews ...


Dr. Hall of Shame

Corruption in Ontario's HEALTHCARE System..!

Secret





In Memory Of
Arlene H. Berry
1958-2000



A Penetrating Analysis
of Corruption
In
Ontario's
HEALTHCARE System..!


The truth about Corruption in the Ministry of Community Safety and Correctional Services via the Office of the Chief Coroner for Ontario: This Ministry's mandate is a commitment to "ensuring that Ontario's communities are supported and protected by law enforcement and public safety systems that are safe, secure, effective, efficient and accountable". This of course is bullshit. In fact, nothing could be further from the truth.

Ontario has a long and sad history of socially unacceptable medical corruption and criminal coverup under shield of the College of Physicians and Surgeons of Ontario that has sought to institutionalize rip-offs with OHIP, and to keep sick people sick and their families oblivious to it, and to shield bad doctors from medical procedure mistake(s) and criminal accountability.

Make No Mistake: Medical Errors Can Be Deadly Serious.


Neither the government, the medical profession, nor the press desire to lift the manhole cover on this Sewer of corruption, needless suffering, and unnecessary deaths. Perhaps it’s time they had their moral codes thoroughly overhauled.
Shame: A Major Reason Why Most Medical Doctors Don't Change Their Views
WHY AREN’T MEDICAL AND SURGICAL PROCEDURES STUDIED?

When medical science abandons safe medical practices for highly dangerous ones we have a serious situation that we need to look at under a microscope.

A definitive review and close reading of medical peer-review journals, and government health statistics shows that Canadian and American medicine frequently causes more harm than good. Perhaps the words "health care" give us the illusion that medicine is about health. Allopathic medicine is not a purveyor of healthcare but of disease-care.

IATROGENIC DEATH

Iatrogenic means "caused by medical treatment". The term iatro comes from the Greek word "iatros", for medical or medicinal.

Iatrogenic death occurs when people die due to errors or negligence caused by doctors and pharmacists. Thousands of patients in our hospitals or under doctors care die annually and scores of others suffer serious injury because of medical "mistakes" and "doctor-caused" injury and illness is clearly the leading cause of death in Canada. All Canadians should be outraged at this monstrous wasting of human life.

It is estimated that one in every 200 patients in our hospitals has an iatrogenic death annually, even homicide can go undetected because autopsies are not being performed and there are no safeguards in place. The truth is that many diseases, including cancer can be traced to "iatrogenic" causes. In fact, more patients die from the treatments they receive than from the malaise doctors so dubiously seek to cure, with iatrogenic deaths attributed to "natural, non-specific or undetermined" causes.

Since fewer than 10 percent of medical mistakes are reported to hospital authorities, or any other authorities for that matter, the patients, or their families are never told that the injuries were caused by the doctors. That means greater than 90 percent of iatrogenic deaths go undiscovered, hence no disciplinary action is ever taken on any of the doctors involved in these incidents. It is also a measure of honesty and integrity in the medical profession, a profession that has its roots in occult formulas, medieval magic, and quackery of all kinds.

The 1960's saw physicians in Canada go on strike and the mortality rate dropped.
Beware of the backstage workings of Ontario’s medical establishment, and in particular, the College of Physicians and Surgeons of Ontario and its conflicting interest relationship with the Office of the province’s Chief Coroner.

That the purpose of a coroner’s investigation is to determine cause of death, or that the prime function of the coroner’s office is to prevent deaths is grossly misrepresented. Alarmingly, the Coroner’s Act precludes coroners from finding fault or assigning blame, a perversion incorporated into the Act to "shield" bad doctors from medical wrongdoing.

The truth is that the coroner’s office is used as a dumping ground for cases embarrassing either to the government or the medical profession, as in the case of Arlene H. Berry, who died suddenly, and unexpectedly at the age of 41. She was the victim of a horrific chain of medical negligence that is nothing short of criminal. No autopsy was performed. A family request for a formal inquest was also denied.

That it is still possible to bury things in the coroner’s office is both shocking and appalling. My experience with the coroner is that this office is "totally corrupt", and involved in "massive coverups" of it’s own, primarily involving iatrogenic (doctor-caused) deaths. One might ask how many iatrogenic deaths are uncovered as a direct result of a coroner’s investigation? How many reported by the office of the Chief Coroner in his annual report? The answer is NONE.




According to a CMAJ-JAMC report on medical ethics "The profession has accepted that dishonesty is necessary because of the dire consequences of being truthful."

Among disgraceful physicians attached to the public purse include more than 400 appointed local "cash-for-life" (up to age 70) coroners throughout the province who report to the regional coroner who ultimately reports to the chief coroner of Ontario.

Although a coroner’s responsibility is to the public, his allegiance is first to the government and medical profession, corruption notwithstanding.
"The coroner’s office has been regarded for too many years as a "convenient rug under which embarrassing cases could be swept, safely hidden from public scrutiny."
- Dr. Morton Shulman - Taken from his books entitled: Can't Somebody Shut Him Up? - Shulman, Morton Dr. & Kastner, Susan and Coroner.

The coroner’s office works under a "cloak of secrecy". They tell the police, the press, and the public only what they want them to know. Downplaying by omission is common since the basic selection/omission process necessarily omits what they don’t want the public to know, with coverups and criticisms suppressed.
The coroner perceives his findings to be unalterable. One might argue that such findings are not credible because no matter what the facts, he would still conclude no findings of medical wrongdoing, evidence of altered and falsified medical records notwithstanding.

The purpose of an inquest is not only to determine the cause of death, but look for ways to prevent similar deaths in future. To hold an inquest means hearing evidence from all of the witnesses who have information about a death. The decision not to hold an inquest is up to the coroner, but dirty politics dictate the course of that direction, with determination of holding an inquest at the whim of the coroner, and those who pull his string, akin to censorship, and "concealment".

The coroner regards an inquest "unnecessary" whenever there is a likelihood that the public will become enraged because they are afraid of the anger and embarrassment that will result - consider a few iatrogenic causes: Iatrogenic death by Water Intoxication, or Dehydration, Acute Pulmonary Oxygen Toxicity, Oxygen Depravation, SIRS and SEPSIS due to clinical insult, Drug Induced Cardiomyopathy with contraindicated medications, Withholding Life Support and scores of medical secret methods employed by doctors and nurses to kill their patients to coverup their negligence, or outright stupidity.

"In one case, an effort was made by an official of the Attorney General’s department to hand pick an inquest jury, by-passing the normal selection system. One proposed juror was connected with the company involved in the death under investigation."
- Dr. Morton Shulman




If common sense prevails, medical opinion must be logically sustainable, but most often it is not, and so is seen to be flawed. If medical opinion were to be accepted without scrutiny, health professionals could legislate themselves right out of liability for negligence. For this reason multiple medico-legal opinions are sometimes necessary. To compound the problem, one cannot find a doctor who will testify against another doctor, and the coroner’s office is no exception. They all belong to the same fraternity of freebooters that focuses on use of deception, dishonesty and outright lies to protect "it’s own".

Coroners rely explicitly on the opinion of others, because they have none of their own. The bald truth is that specialists in a given field are "not always expert in that field". What they don’t understand is what they are too lazy or incompetent to find out, Dr. McLellan.

As a death investigator, the coroner, with his immature posture of infallibility does not have first hand knowledge of the topic on which he professes to affirm, yet he concurs with opinions of others that lie outside the field of his own expertise, with his own opinion, if he had one, being of secondary value.
Bias is the single most serious problem when dealing with expert opinion and doctors are the worst offenders. There is no such thing as an unbiased expert, and scientific misconduct goes far beyond discriminating against ethnic groups to include targeting the "have-nots" of society. Lawyers often regard certain doctors as "hired guns", who take cash for comment.

The coroner, in his biased efforts to prejudice the results of his investigation does not give his "hand-picked" expert all of the facts. All communication is limited, slanted, or biased to include or exclude relevant information. But omission can also be used as a deliberate way of concealing. By withholding vital information, such as iatrogenic radiation injury to the nervous system, for example, he tells the expert only what he wants him to know. The expert knows this, and so analyses and returns his opinion according to data input.
With a simple "meeting of the minds", the expert proceeds to tailor or lard the report to justify the opinion that is in his opinion, being sought, often using parallel links in the given theory to obfuscate the truth.

While pretending to educate the coroner in the technical matters at hand, the objective of the biased expert is to make it appear as though the coroner understands the technical issues, while also giving as little information as possible.

Once there is a perception of understanding the expert infers from the opinion expressed that the coroner is the one making an independent decision and that his opinion will be correct rather than just agreeing with him. Of course this is just theatre which allows professional bias to skew the results.
"The opinions expressed herein by the author do not necessarily take into account all the facts and circumstances surrounding the death."

"The final conclusions of the Coroner’s investigation may differ significantly from the opinion expressed herein".

Further findings suggest that expert opinion, in the absence of consensus "evidence-based medicine", and published literature, is totally worthless.
A medical expert renders his opinion in his own "self-serving" interest, given his own values, and how much credence should be given to such opinion may well be subject to debate. It is in the analysis of "self-interest" that values most clearly play their role. For example, the coroner’s expert invariably has insinuated himself into a case or “conspiracy” for money, some with "revolving door" payoffs.

The coroner in his “dubious” dealings with other doctors would invariably have wheedled himself, predictably, upon the favours of one or more of his self-aggrandize and flatter colleaugues, i.e., classmate or golfing buddy, or other conflicting interest minion he knows personally due to being involved with one doctor or hospital or another, such as from Sunnybrook Hospital, for example, Dr. McLellan.
One might ask whether it is possible, in his field of expertise for legitimate differences of opinion to occur between qualified experts. Since the answer is invariably “yes”, the opinion expressed is not necessarily the correct one, is it? The expert therefore is not a wholly dependable source of information.
Any medical professional who, in rendering his opinion as to cause of death, volunteers his unsolicited belief as to another doctor’s conduct or standard of care, finding in favour of his fellow colleague invites being labeled retrospectively with the most nefarious motive.

In this regard, one might well ask what is the frequency with which such expert sells his opinion for monetary gain, including the side for which he predominantly finds, and whether he consistently finds in favour of his fellow colleagues. One might also ask what is his relationship to the coroner.

As can be seen, the coroner’s expert is, if not a charlatan, at least not what he is purported to be. In fact, he is nothing more than a paid shill and thus unworthy of belief. Indeed there is no need for him to show up at the coroner’s office - he would simply have mailed his opinion together with his time and charges.
Coroners are keen to play a role in decision-making but generally lacking when it comes to problem solving where expediency is a "means-end". Being closed minded may predispose.

The coroner sometimes uses the police to assist with an investigation, but the police rely on the coroners to interpret what they have uncovered. The coroner has no expertise in forensic science and the police have none in medicine. They tell each other only what they want each other to know. The coroner has the final say and will say what he is told to say by the hierarchy. Coroners neither investigate a complaint thoroughly, impartially, or accurately, unless considerable legal and public pressure is brought to bear. And in the absence of an autopsy or fact-finding post mortem, a coroner’s report can be a mixture of half-truths and bald falsehoods.

Much about what we have come to learn about disease, including statistical information, was discovered and confirmed through autopsies. But as it now stands, doctors seek to confirm their findings through human experimentation, i.e., by trial and error, using unsuspecting patients as their test subjects.
Autopsy findings help measure the overall quality of care in a hospital and community. But autopsies are seldom performed, except in medico-legal cases or where they are specifically requested, and in fact doctors try to discourage them, usually because they themselves have something to hide.

Coroners don’t do post-mortems, they know almost nothing about pathology. They are performed by a pathologist, who reports his findings to the “attending” physician. Talk about a "conflict of interest" should the attending physician or medical negligence be at fault.

Coroners are a partisan group of professional disinformation artists with a vested interest concealed behind a neutral, bland, inoffensive name who tend to operate in self-congratulatory and complementary packs or teams whose prime function is to prevent rational and complete examination of evidence which would hang them or any of their self-aggrandize and flatter colleagues. They are white coats in black hats acting as provincial government officials, licenced to practice ignorance, mayhem and unpardonable blunder with immunity from liability for wrongdoing.

Coroners, as with other physicians, are incredibly polished, and they are all charmers, but they are basically narrow, shallow people who don’t give a damn about iatrogenic death, or the pain and suffering that doctors have caused. Further findings suggest that coroners, like many other doctors, suffer from metacognitive skill deficit disorder, a syndrome that spans a broad continuum of metacognitive incompetence or lack of capacity to distinguish accuracy from error. Not only do these doctors reach erroneous conclusions and make bad choices, but their incompetence robs them of the metacognitive ability to realize it. Faulty reasoning may predispose.

With iatrogenic death falsely ascribed to illness, chalked up to natural, non-specific or undetermined causes, skewed by indiscreet investigative case histories, medical omission and bold-faced lies (to include falsified information on death certificates) undoubtedly surfeit and permeate the coroner’s files with disgust to excess.

Ontario’s coroners have adopted as their motto "We Speak For The Dead To Protect The Living", a quotation from Thomas D’Arcy McGee, a journalist and poet as well as a politician. In my opinion, if the dead could speak there would be dire consequences for the living, and many Canadian doctors would be facing “prison terms”.

That the "Office of the Chief Coroner for Ontario serves the living through high quality death investigations and inquests to ensure that no death will be overlooked, concealed or ignored", is an insult to one's intelligence - an absolute afront to one's dignity. The truth is that the Coroner's office only supervises inquiries into deaths of persons "other than those under medical attention" at time of death. In short, Ontario's doctors can thus get away with murder, and they do indeed. The philosophy "don’t cause any trouble for the government and especially not for the medical profession" is the philosophy of the Ontario government.

Mike Harris gutted the health care system in Ontario and used those monies to grease the political cogwheel, to feather his own nest and squandered the rest to the detriment of health care throughout the province, precipitating a rash of doctor-caused illness and untold deaths in hospitalized patients.

If the truth be known, the elite in Ontario are effectively immune to law. The law is a tool (as is the office of the Chief Coroner) to serve the ends of the powerful, where selective enforcement is the norm.

Bad policies based on misguided notions and a patronizing, pseudo-moralizing Harris government paternalism have produced disastrous consequences for health care in Ontario. Corrupt politicians and cabinet ministers cynically exploit the resulting suffering to maintain their positions of power, reinforcing their misguided policies. Police on the street end up bearing the brunt of selective enforcement due to political intervention, and political ass kissing while innocent lives are being destroyed and hideous crimes are being committed by bad doctors and nurses , in the name of "medicine".

The modern physician has already become one of man’s most potent killers and cripplers, and iatrogenic (doctor-caused) disease is in effect epidemic.
In failing to exercise simple prudence to protect the public from medical atrocities, the Ontario government itself is criminally negligent.
The reason police investigations into medical negligence and mishaps involving criminal negligence cases are not especially effective, is that their investigators are either uninformed, ignorant, or completely outclassed by a group of professional disinformation artists (liars), trained to subvert justice. It is the disinformation artists and those who pull their strings who have a vested motive for concealing the truth. Further findings suggest that the outcome of any meaningful investigation into doctor-caused death is "dictated" by the extent of political intervention, and cover-ups go straight to the top, the Attorney General of Ontario, et al.

Although the medical disciplinary machinery exists, it does not function due to dysfunctions in the self-regulatory system overrun by unchecked abuse.
Self-regulation is a failure. Despite record numbers of complaints against bad doctors to official bodies and severe criticism from the press, the government has never taken serious action against the College. Why?

The annals of medico-legal literature on civil malpractice and litigation are comprehensive, each bearing another gothic medical horror story.
In May of 2001, "The Toronto Star began undertaking a serious investigation into the College and exposed that 99% of all complaints are either dismissed or handled in secrecy."

"My experience with this system is that this agency is totally corrupt, and involved in massive coverups... The investigators who handle the complaints for the College of Physicians and Surgeons are either uninformed, ignorant or criminal in their investigations." Thunder Bay On-line

The Toronto Star - recent multiple front page headline series, How System Helps Shield Bad Doctors (May 5-7, 2001 and follow-ups) revealed heart-wrenching butchery, incompetence and coverups.”




What we need is a sustained, non-partisan political consensus to clean out the medical establishment’s dirty secrets, give all victims of medical malpractice redress, punish medical negligence, dispense with self-regulation, police the doctors, turn coronership over to the electorate, and start fresh without the baggage of secret, unacknowledged medical atrocities.

HOW RELIABLE IS MEDICAL OPINION?


"A pier review against an incompetent or corrupt physician is composed primarily of equally incompetent or corrupt pier review pannels. The medical complaints system in Ontario is cloaked in secrecy." - Malcolm Everett











Get The Facts

Truths, Half-truths & Lies.


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Dangerous Doctors: How to Find Them Before They Kill You
Doctors' Strike: Death Rates Fall
Doctors can carry dangerous bugs from patient to patient ...
Iatrogenic Death Fred Foldvary
White Wall of Silence...
Book Details - Wall of Silence
Disposing of patients to protect doctors
Breaking Down the Wall of Silence by Alice Miller and Simon Worrall
Killer Doctors
The Politics of DEATH
DOCTORS' ETHICS? EXAMPLES OF THE LACK THEREOF
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canada health scientists - DRUG Safety Whistleblowers In Canada
Medico-legal Conspiracies & Medical Fraud - exposed
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MDs , ALLOPATHIC MEDICINE , IATROGENIC DISEASE , MALPRACTICE AND ...
CQ - Canadian Quackery Watch -


THE POISONED NEEDLE by Eleanor McBean
If doctors don't understand ethics, it's time to start teaching them...
Addendum - Re: The Arlene Berry Death Coverup
Rx for Injustice!

Coroner orders review of Toronto pathologist. It seems clear, Ontario's Chief Coroner should be reviewed!





Only in Canada!!!

Secret





Dr. Allon Reddoch, Former President of the Canadian Medical Association


The case of Dr. Allon Reddoch M.D. provides a most interesting look into the inner workings of the Canadian Medical Association.

In 1998, Dr. Reddoch, then president of the Canadian Medical Association, was found guilty of professional misconduct by his peers.

Indeed, a review concluded Dr. Reddoch "failed in all respects to take the normal actions that one would expect of a physician to diagnose and treat a patient with a serious illness."

His ridiculous punishment:

  • Dr. Reddoch was fined $5,000;
  • Dr. Reddoch was forced to take a clinical-competency course;
  • Dr. Reddoch was to suffer a published reprimand.

Following his being found guilt of professional misconduct, Dr. Reddoch remained president of the Canadian Medical Association.

He appealed the verdict of his peers and lost his appeal in August 1999. It is only then, one year after he was found guilty of incompetence/negligence, that Dr. Reddoch resigned from the presidency of the Canadian Medical Association.

But he has continued to practice. In fact, there was no interruption to his medical practice. And his $5,000 fine represents at most three weeks' worth of income.

Imagine the ethics of the Canadian Medical Association. The members, all physicians, knew that their president, Dr. Reddoch, had been found guilty of professional misconduct, [read gross negligence(?)] and did not find that the integrity of the Canadian Medical Association was compromised by the president's misconduct.

Is that the level of ethics that Canadian doctors are capable of?

By all accounts, it is...!

Our conclusion: Canadian physicians and surgeons do not mind being represented by people they find incompetent or negligent.


The following are reprints of National Post articles covering this disgusting display of medical standards. The National Post is Canada's best newspapers.



March 2, 2001

Leading MD negligent in Yukon girl's death: judge
Former CMA President: Nurse cited as well, but bulk of blame assigned to doctor

Michael Hale
Canadian Press


WHITEHORSE - A local doctor who is a former president of the Canadian Medical Association and a nurse at Whitehorse General Hospital have been found negligent in the death of a teenage girl.

Allon Reddoch was cited in Yukon Supreme Court for not providing an acceptable standard of care to 16-year-old Mary-Ann Grennan, who died of botulism on her birthday, April 26, 1996.

Kelly White, the nurse who last treated Mary-Ann, was found to have failed to report important developments in the girl's condition to a doctor.

Mr. Justice Howard Irving said the greater fault lay with Dr. Reddoch and apportioned two-thirds of the blame to the doctor.

"The patient's condition had been deteriorating and suggestive of a possible primary neurological disorder as a cause for her complaints, none of which was recognized by [Reddoch]," Judge Irving said.
"Dr. Reddoch seemed to be so sure Ms. Grennan's symptoms were psychogenic he failed to consider any differential diagnosis."

Though botulism could not have been expected to be diagnosed, proper attention to the increasing signs of a neurological disorder, whatever it was, could have saved the girl, Judge Irving said.

"I found it puzzling indeed that Dr. Reddoch took such a narrow view of Ms. Grennan's symptoms that he failed to recognize the deterioration in her condition."

Mary-Ann made three visits to the hospital's emergency ward before being admitted on Sept. 9, 1995. Hospital notes indicate she was admitted with gastroenteritis.

Botulism, a form of food poisoning, went undiagnosed during Mary-Ann's hospital stay, when she suffered from respiratory arrest and then fell into a coma before dying eight months later.

However, the final diagnosis before Mary-Ann's respiratory arrest was globus hystericus or inflammation of the throat due to anxiety. Dr. Reddoch then diagnosed an iron deficiency due to dehydration.

He said after the verdict that attention from the court case was becoming too heavy a burden for him and his family.

"I don't think I've done anything wrong," he said.

Dr. Reddoch said he expects an appeal will be filed, although no decision has yet been made. "At this stage, I'm not giving up."

Ms. White, the nurse of duty when Mary-Ann suffered respiratory arrest, is out of the territory and unavailable for comment.

Ron Browne, chief executive officer of Whitehorse General Hospital, said the court decision did not shake the hospital's faith in Ms. White's abilities.

"She is an excellent nurse, and in our view, she tried very hard to figure out for herself what was happening," Mr. Browne said. "Unfortunately, time ran out."

Judge Irving also awarded $143,850 to the Grennan estate, based on calculations of the girl's expected income after living expenses.

Edward Grennan, Mary-Ann's father, said in an interview the award was never an issue.
The decision bodes well for medical care in the territory, he said.

"The one thing about this, I'm hoping and praying, it will wake some people up," he said. "The next time, a child who complains will be believed."



Page URL: http://www.nationalpost.com/search/story.html?f=/stories/20000909/394588.html

September 9, 2000
Doctors negligent in diagnosis, court told
Girl's death examined

Adam Killick
National Post

WHITEHORSE - A doctor from White Rock, B.C., yesterday testified that doctors, including Allon Reddoch, the former president of the Canadian Medical Association, failed to take proper steps to diagnose and treat Mary-Ann Grennan, a 16-year-old girl suffering from botulism in 1995.

In a report filed as evidence in Dr. Reddoch's malpractice suit, Paul Assad, a general practitioner and specialist in emergency medicine, said doctors failed to do a neurological examination on the girl that might have revealed she was suffering from double vision or other eye problems, which when considered with some of her other symptoms, might have made a diagnosis of botulism more likely.

Dr. Reddoch and the Whitehorse General Hospital are being sued for malpractice by the girl's father, Ed Grennan, for the potential lost income of the girl, had she not died from brain damage suffered under respiratory arrest caused by the disease. Both defendants are denying negligence.

Dr. Assad also alleged Dr. Reddoch failed to do a differential diagnosis on the girl, and determined without completing a full physical examination that she was suffering from globus hystericus, an anxiety disorder that causes the sensation of having a lump in the throat. He also criticized Dr. Reddoch for prescribing Ativan, a tranquillizer that depresses the respiratory system.

In cross-examination, however, Chris Hinkson, Dr. Reddoch's lawyer, noted there is no evidence on the charts that Ms. Grennan ever complained about her vision to doctors or nurses, and that under treatment, some aspects of her condition were improving.

Dr. Assad also seemed unfamiliar with the facilities available at Whitehorse General Hospital, a small centre without resident specialists that services the town's 25,000 residents. At one point he said Dr. Reddoch should have consulted with an internist about Ms. Grennan's condition, insisting such a specialist worked at the hospital, when in fact none has ever worked there, according to hospital doctors watching in the gallery.

Mr. Hinkson assailed Dr. Assad's credibility, noting he had not worked with a hospital in-patient for 19 years. He also suggested Dr. Assad, rather than acting as an independent expert, was trying to help the plaintiff.

Dr. Assad also conceded doctors do not do differential diagnoses in many cases, and doctors are taught to look for common diseases over rare ones. There had never been a reported case of botulism in the Yukon before Ms. Grennan's, court heard yesterday. There are usually fewer than 10 cases in Canada per year.


Page URL: http://www.nationalpost.com/search/story.html?f=/stories/20000908/393763.html

September 8, 2000
Test that might have saved girl's life ignored, court hears
Malpractice trial of former president of Canadian Medical Association

Adam Killick
National Post

WHITEHORSE - Evidence entered yesterday at the malpractice trial of Dr. Allon Reddoch, the former president of the Canadian Medical Association, shows that nurses treating a 16-year-old girl with botulism were confused about her diagnosis and how to treat her.

That confusion appears to have led them to ignore a critical test result on Mary-Ann Grennan's lungs that might have saved her life.

Less than an hour after the low-oxygen saturation reading, botulism paralyzed Ms. Grennan's lungs, stopping her breathing long enough to cause irreparable brain damage.

Although the botulism was cured, she slipped into a coma from which she never recovered.

Her father, Ed Grennan, is suing Dr. Reddoch and the nurses at the hospital for the potential lost income of his daughter, an amount estimated as high as $200,000, claiming their negligence caused her death.

Dr. Reddoch and the Whitehorse General Hospital, the nurses' employer, are denying responsibility for Ms. Grennan's death.

Ms. Grennan went to hospital three times after eating home-smoked pike. Her condition deteriorated from an upset stomach to an inability to swallow, hold her head or move her arms and legs.

Although he did not do a full physical examination or conduct any tests, Dr. Reddoch, her family doctor, ultimately diagnosed the girl with globus hystericus, or anxiety disorder, believing she was upset about the death of her great-grandmother.

Partial transcripts of interviews with nurses show how Ms. Grennan's diagnosis changed over a matter of hours from gastroenteritis to tonsillitis to globus hystericus as different doctors looked after her. She was also diagnosed with anemia at one point.

"I was just confused. I couldn't figure out what was, you know, what am I supposed to be looking at?" Coleen MacDonald, a nurse who was on a shift the night before Ms. Grennan suffered respiratory arrest, said in the case's examination for discovery.

"Is it fair to say every time you brought a doctor in, you got a different diagnosis?" Ms. MacDonald was asked by Robert Gibbens, Mr. Grennan's lawyer. "I don't want to go quite that far, but that would be getting close," she replied.

At the end of Ms. MacDonald's shift, about 15 hours before Ms. Grennan suffered respiratory arrest, Dr. Reddoch diagnosed the teenager with globus hystericus. Ms. Grennan was given Ativan, a respiratory depressant used to treat anxiety, but Alan Macklon, a nurse on duty after Dr. Reddoch's diagnosis, said he did not see her behave in an "overtly anxious" way.

"She did not seem emotionally distraught," Mr. Macklon said.

A third nurse, Kelly White, explained she thought Ms. Grennan's eventual inability to stand up or walk was dramatized because of Dr. Reddoch's diagnosis that her illness was emotional. Following instructions on the girl's chart, she gave her another dose of Ativan.

Less than three hours later, Ms. White took a reading of Ms. Grennan's oxygen saturation, and, although it was as low as 84% -- clearly a signal of respiratory problems -- she did not tell a doctor about the finding, and left the girl alone.

Thirty-seven minutes later, she was found unresponsive in her bed.

Dr. Reddoch testified earlier this week that, had he been summoned after the reading, he could have given her supplemental oxygen and prevented her respiratory arrest.

Patsy Vance, the girl's mother, yesterday described how she watched her daughter deteriorate.

At one point, with difficulty breathing, Ms. Grennan begged her mother not to leave.

"She was scared something was going to happen to her," Ms. Vance related, sobbing. "She asked me, 'Mom, what's wrong with me?' and I couldn't answer her."


Page URL: http://www.nationalpost.com/search/story.html?f=/stories/20000907/392292.html

September 7, 2000
Dead girl's earning potential in dispute
MD may have to pay teen's father more than $200,000

Adam Killick
National Post

WHITEHORSE - If Dr. Allon Reddoch, the former president of the Canadian Medical Association, loses his malpractice suit in the botulism death of a 17-year-old girl, he could be required to pay more than $200,000 in damages to her father, according to a forecast by Cara Brown, a Calgary forensic economist.

Ms. Brown's settlement figure is the higher of two being presented to the court. The estimated settlement range was determined by the potential value of Mary-Ann Grennan's estate today had she lived a full life.

Ms. Brown's report was entered as evidence on behalf of Ed Grennan, Mary-Ann's father. The figure is based on statistical information for female Yukon residents with Ms. Grennan's education.

Ms. Grennan died after Dr. Reddoch failed to diagnose botulism, and instead believed she was suffering from anxiety disorder. After the disease paralyzed her ability to breathe, she slipped into a coma from which she never regained consciousness.

Mr. Grennan is suing Dr. Reddoch and the Whitehorse General Hospital for the potential income of his daughter had she lived, claiming their negligence caused Ms. Grennan's death. Both Dr. Reddoch and the hospital, which represents seven nurses identified in the suit, are denying negligence.

If Howard Irving, the deputy Yukon Supreme Court judge hearing the case, sides with Mr. Grennan, he will have to decide how much Ms. Grennan's estate would be worth. Competing economic forecasts by both the plaintiff and the defence range from $180,000 to around $300,000. From those amounts, the judge will have to deduct a percentage that Ms. Grennan would have spent on day-to-day expenses. The plaintiff and defendant's estimates of that deduction range from 35% to 100% of her income, meaning that even if the defendants are found negligent in her death, they may not have to pay any settlement.

If she had died more recently, Mr. Grennan would be unable to make any claim at all, thanks to changes last year in the Yukon Survival of Actions Act. The right of the estate of a dead person to seek the potential income of the dead person was then wiped off the books, bringing the territory in line with most jurisdictions in Canada, which have banned potential income claims where the deceased has no dependents.

Although Dr. Reddoch challenged Mr. Grennan's right to claim the earnings, a judge ruled earlier this year that the law in effect when Ms. Grennan died would be in use for the trial. If Mr. Grennan had lost that challenge, "we wouldn't likely be here today," Robert Gibbens, his lawyer, said yesterday.

Under the new law, Mr. Grennan, ironically, would only be in a position to sue for damages if his daughter had survived, Mr. Gibbens said.

Mr. Grennan spent part of yesterday on the witness stand, answering questions from Chris Hinkson, Dr. Reddoch's lawyer, about his daughter's apparent promiscuity and poor performance at school, which Mr. Hinkson suggested were harbingers for her future career prospects. Although Mr. Grennan testified she was intending to return to school the week after she contracted botulism, she had been expelled the year before for truancy and had failed most of her core subjects since Grade 8.

Mr. Gibbens acknowledged it will not be easy for Judge Irving to place a price tag on the value of Ms. Grennan's potential career earnings. "It's an almost impossible task," he said.



Page URL: http://www.nationalpost.com/search/story.html?f=/stories/20000906/390789.html

September 6, 2000
Doctor testifies he was not told of girl's worsening condition
Botulism death: Father suing former head of Canadian Medical Association

Adam Killick
National Post

WHITEHORSE - Dr. Allon Reddoch, the former president of the Canadian Medical Association, told a courtroom yesterday that he might have saved the life of a girl with botulism had nurses told him critical information about her condition.

In September, 1995, Mary-Ann Grennan stopped breathing after botulism paralyzed muscles controlling her lungs. Although she was revived, the 17-year-old had suffered brain damage and fell into a coma from which she never awoke.

Less than hour before she stopped breathing, a nurse found that her lungs were operating at between 84% and 90% of capacity, usually considered a warning of respiratory failure. Patients can be placed on supplemental oxygen or be connected to breathing apparatus while the problem is addressed. "There were things that could have been done," Dr. Reddoch said.

Neither Dr. Reddoch, who lived a two-minute drive from the hospital, nor an attending physician was notified of the finding. Dr. Reddoch was summoned after she stopped breathing.

Dr. Reddoch and the Whitehorse General Hospital, which is responsible for the nurses, are being sued by the Ed Grennan, the girl's father, who claims their negligence is responsible for Ms. Grennan's death. He is seeking damages and recovery of the girl's potential income had she lived. Dr. Reddoch and the hospital deny any negligence.

Yesterday, Mr. Grennan described how his daughter, after eating home-smoked pike, deteriorated over several days from having an upset stomach to an inability to swallow, hold her head up, walk or see properly. He broke down several times while relating the story.

In 1998, Dr. Reddoch was found guilty of professional misconduct after the Yukon Medical Council concluded he had not followed acceptable medical standards in treating the girl. Although she had been diagnosed with food poisoning and had been to hospital three times, Dr. Reddoch, her family physician, attributed her symptoms to an emotional disorder called globus hystericus, believing she was upset over the recent death of a reat-grandmother. He arrived at the diagnosis without conducting a full physical examination, the council, which regulates the 45 physicians in the Yukon, concluded. Dr. Reddoch has appealed the council's decision twice.

His lawyer, Chris Hinkson, said yesterday that Dr. Reddoch's professional reprimand was "irrelevant" to the case, noting it did not address whether Dr. Reddoch could be faulted for not correctly diagnosing botulism, a rare form of food poisoning of which there are usually fewer than 10 cases in Canada each year.


But Robert Gibbens, who is representing Mr. Grennan, said in his opening remarks that Dr. Reddoch, in concluding the girl's illness was psychological, "failed to follow a trail of inquiry" that would have lead to the correct diagnosis, noting that he prescribed Atavan, a drug used to treat anxiety, which is a respiratory depressant.



Page URL: http://www.nationalpost.com/search/story.html?f=/stories/20000905/389637.html

September 5, 2000

Malpractice suit against former head of doctors' group begins

Adam Killick
National Post

WHITEHORSE - Dr. Allon Reddoch, a former president of the Canadian Medical Association, begins a malpractice suit today over the death of a 17-year-old girl four years ago.

Mary-Anne Grennan died in April, 1996, eight months after slipping into a botulism-induced coma. The girl had made three trips to the hospital in which she was misdiagnosed -- and nurses believed she was "whining" and "dramatizing" her illness.

Ed Grennan, Mary-Anne's father, is suing Dr. Reddoch, the girl's family doctor, as well as three other physicians, seven nurses and the Whitehorse General Hospital, alleging their negligence caused his daughter's death.

All, including Dr. Reddoch, are denying negligence in the case.

Dr. Reddoch, who has already been found guilty of professional misconduct, continues to practise in the Yukon capital.

He appealed the finding, but lost in August,1999, after which he resigned as CMA president. He has launched another appeal.

The malpractice suit is being heard by a judge from Alberta because all the justices on the Yukon Supreme Court were forced to declare a conflict of interest since they knew one of the parties involved.

Although he has not specified an amount, Mr. Grennan is suing for damages and the lost potential income of his daughter. Dr. Reddoch tried unsuccessfully to have the suit dismissed, but a judge ruled earlier this year that since-amended Yukon legislation allows for the claim. Dr. Reddoch has appealed that decision as well.

Botulism is an extremely rare --and deadly -- form of food poisoning.

Ms. Grennan fell ill Sept. 8, 1995, after eating a large amount of home-pickled pike. On her first trip to the Whitehorse General Hospital with stomach pains, she was diagnosed with gastroenteritis and sent home. Mr. Grennan returned to the hospital with his daughter when her condition did not improve. She was again diagnosed with gastroenteritis, given medication and sent home. Her condition, however, worsened, and she was admitted to hospital.

Dr. Reddoch saw her the following afternoon, writing in her case notes that she was upset about the death of her great-grandmother.
Later that evening, Ms. Grennan was too weak to lift a cup to her mouth.

Nurses on duty believed she was play acting. According to nurses' notes from the case, she was "dramatizing" her illness and "whining."

The following morning, Dr. Reddoch saw her again. He did not do a full physical exam, but he diagnosed her with "globus hystericus," or anxiety disorder. Nurses' notes noted she continued "to act as a rag doll."

That night, she stopped breathing, and, after being resuscitated, lapsed into a coma. She died on April 28, 1996.

In September of that year, Mr. Grennan filed a complaint with the Yukon Medical Council against Dr. Reddoch, and, a year later, he launched the malpractice suit.

Dr. Reddoch was found guilty of professional misconduct in the case, after a review concluded he "failed in all respects to take the normal actions that one would expect of a physician to diagnose and treat a patient with a serious illness." He was fined $5,000, forced to take a clinical-competency course and was to suffer a published reprimand.

However, his lawyer, Chris Hinkson, will argue that the professional reprimand is not relevant in deciding the central issue in the malpractice suit: that his client's treatment of the girl caused her to die.

Mr. Hinkson said he plans to call several experts on botulism to testify to the difficulty in diagnosing and treating the disease, and of the likelihood Ms. Grennan's life could have been saved in any case.

Dr. Reddoch and Mr. Grennan declined interview requests. "It's a tragic case for everyone," Mr. Hinkson said.




Yukon: Bid to dismiss botulism case

June 20, 2000
National Post

WHITEHORSE - Lawyers for Whitehorse General Hospital and several doctors and nurses have asked a judge to dismiss a lawsuit filed by the family of a teenaged girl who died of botulism. Defence affidavits filed this month claim Mary-Ann Grennan got proper medical care. Dr. Allon Reddoch, former head of the Canadian Medical Association, and three colleagues are named in the suit filed by the girl's family. It also names seven nurses and the hospital where she died after falling into a coma.


SEXpatients.com

SOURCE

TheStar.com/doctors

Secrets




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How system helps shield bad doctors

Secrets



May. 5, 2001. 07:48 AM

How system helps shield bad doctors
College admits flaws in process

ROBERT CRIBB, RITA DALY AND LAURIE MONSEBRAATEN
STAFF REPORTERS

Medical Secrets


You've just been diagnosed with cancer. You're scheduled for surgery in a few weeks by a doctor you hardly know.

In Ontario - and across Canada - provincial laws governing doctors say you can't find out if your surgeon has been hauled before the physicians' watchdog for complaints of malpractice, even for the exact operation you're facing. You aren't told if the surgeon is under investigation now, or has a spotless record.

The medical complaints system is cloaked in secrecy.

Since discipline procedures at the College of Physicians and Surgeons of Ontario can take three years, some dangerous doctors continue practising without patients knowing there may be a risk.

In the last six years, the college investigated 13,000 complaints about doctors. Of those, 99 per cent were either dismissed outright or handled internally and in secret.

We can learn nothing about them. The college, which says it is bound by privacy provisions in the Regulated Health Professions Act, will not reveal the names of the doctors involved, how many had complaints against them, the nature of the complaints or how they were handled.

The only window into a doctor's competence, integrity and past professional conduct is a public disciplinary hearing conducted by the college.

A Toronto Star investigation shows that since 1994, when new legislation governing doctors came into effect, only 141 complaints have reached this stage.



Of 13,000 complaints lodged against doctors, 99 per cent were either dismissed or handled in secret by the College of Physicians and Surgeons of Ontario


Data on those cases, compiled by The Star using the college's public records, reveal a disciplinary system that typically hands out lenient penalties, rarely revokes licences, can take years to render decisions and puts doctors on higher legal footing than complainants.

The Star's data show that 111 doctors have been found guilty of offences ranging from fraud, drugging and sexually assaulting patients and missed diagnoses, some causing death. Of those, 34 received the college's maximum penalty - licence revocation.

The majority of sanctions handed out were suspensions averaging less than three months or reprimands, usually with some conditions, such as cash fines, additional training or letters of apology.

Ontario's college took an average of three years to reach those decisions - tied with Manitoba as the slowest medical disciplinary system in Canada.

The overwhelming majority of Ontario's 20,480 practising doctors - skilled professionals dedicated to meeting the highest standards of care - has never been the subject of a college disciplinary hearing. They may face a minor complaint or two over the years but for the most part their records are clean.

But some physicians who have done great harm are allowed to continue practising.

Dr. Kenneth Bradley, a former Milton chief surgeon, was twice was found guilty of medical negligence involving patients who died. Still, Bradley kept his licence and later moved to Virginia, where he was implicated in another four deaths.

Dr. Stanley Dobrowolski, a London, Ont., psychiatrist, was disciplined three times for sexually related offences. He is still treating patients.

Dr. Anthony Laws, who practises in Oakville, falsified documents to cover up his role in the death of a 14-year-old patient under his care.

People who feel they have been harmed by a physician can seek damages through the courts. But the self-governing College of Physicians and Surgeons of Ontario is the only authority that can suspend or revoke a doctor's licence.

The Ontario Medical Association, which speaks for the province's doctors, believes the college is doing an ``exemplary job'' of protecting the public and guiding the profession.

Dr. Alex Schumacher, the OMA's immediate past president, says the low discipline rate is a reflection of the province's high licensing standards compared to other jurisdictions.

But the college itself acknowledges the system should be more open and must resolve patient complaints more quickly.



`We have to act before the public loses confidence.'

- Dr. Rocco Gerace
President of the College of
Physicians and Surgeons of Ontario


``We have to act before the public loses confidence,'' says college president Dr. Rocco Gerace.

And that means getting tougher on dangerous doctors, say some college members.

``Clearly there has been less than effective identification of those (doctors) who have serious problems that need addressing,'' says Dr. David Walker, dean of health sciences at Queen's University and co-chair of the college's complaints committee.

Last year in Ontario, 21 doctors had their licences revoked or suspended.

During the same period, Michigan, with a similar number of physicians, suspended or revoked the licences of 102 doctors. In Massachusetts, another comparable jurisdiction, it was 45.

In Ontario and elsewhere, most doctors can keep practising while they are being investigated. But in a growing number of states, information about doctors under investigation is posted on Web sites for anyone to see.

Gerace doesn't think the American focus on discipline gets to the heart of the matter.

``Their measure of success is their percentage of discipline referrals. I would suggest to you that a discipline referral is a failure.

``We have to balance the will of the public for revenge - an eye for an eye and a tooth for a tooth - versus what's best for the public interest, which is having doctors deliver better care. Do we need to have a few examples out there? Just beat someone up?''

Gerace says that while U.S. jurisdictions rely solely on discipline, Ontario has developed unique programs to assess and retrain doctors whose skills are lacking.

The philosophy reflects the college's belief that most doctors who have made clinical mistakes are anxious to improve and will become better doctors through education rather than punishment.

But according to a recent government report about the discipline process, there is no system in place to ensure this approach is actually working.

The government-commissioned report expressed concerns that the quality assurance program ``may not be the appropriate response'' for patient complaints about doctors.

And since the process is handled entirely behind closed doors, there's no way patients or the public can judge whether their complaint was handled adequately.

That secrecy is only lifted when complaints trigger disciplinary hearings.

In the past six years, the majority of those hearings - 77 out of 141 - concerned sexual misconduct, followed by cases involving patient deaths (19), and psychological harm inflicted by doctors (10).

Other offences that went to disciplinary hearings included fraud, physical injuries and faulty record keeping.

The focus on sex-related cases reflects the college's zero-tolerance policy, adopted in 1994 following a provincial government task force that estimated 10 per cent of Ontario doctors had sexually abused a patient at some time.

The Star data show that 25 of the 61 doctors found guilty of sex-related complaints had their licences revoked, 24 received suspensions averaging 3* months, 10 received reprimands and two quit their practices.

Zero tolerance covers anything from inappropriate touching to consensual intercourse to rape. The Ontario Medical Association is currently challenging this policy before the courts as a Charter of Rights and Freedoms issue.

The Star data shows that in at least four cases, physicians allowed to continue practising went on to repeat the same offence.

Dobrowolski, the psychiatrist from London, Ont., is a prime example.

He has appeared before the college three times since 1994 on complaints ranging from hugging, kissing, fondling and sexual intercourse with patients.

At his second appearance, in 1996, the panel concluded Dobrowolski demonstrated ``an extremely worrisome pattern of behaviour.''

Dobrowolski received a short suspension and two reprimands but never lost his licence. He continues to treat patients in London.

``It (the disciplinary system) is such an unpleasant process from the point of view of a physician that even just talking about it brings back bad memories,'' he said, when contacted by The Star. ``You try and put it behind you and get on with life.''

Many doctors see the college as an adversary that often dishes out unwarranted punishment.

Of the 19 cases of death under physician care that reached the disciplinary committee since 1994, no fault was found in five.

In the other 14 deaths since 1994, the college did lay blame on substandard care. Three of the 14 doctors had their licences revoked, while the rest were handed reprimands or given short licence suspensions.

On Aug. 20, 1993, Tom and Patricia Bain buried their only son, 14-year-old Jonathan. At the time, the Mississauga couple were told his death was caused by a viral infection.

The family contends that tests later revealed prescribed drugs caused the teenager's death. They complained to the college that Oakville physician Anthony Laws covered it up.

Throughout the process, Laws continued to practise with a clean record.

College documents show Laws first prescribed the drug Cylert, which has been linked to liver problems, to treat Jonathan's Attention Deficit Disorder (ADD) in 1992.

In July, 1993, the boy was admitted to hospital with severe liver problems. He died after undergoing two liver transplants.

Following the teen's death, tissue tests revealed Cylert was the cause of Jonathan's liver failure, according to the family.

The Bains complained to the college that Laws ``never told us of the risk in advance, he never monitored our son when he was on the drug, he never ordered blood tests despite the risks.''

The Bains are upset that Laws prescribed Ritalin, another ADD drug, along with Cylert.

``He was experimenting with our son,'' Tom Bain told The Star.

But at the hearing, medical competence wasn't the focus. The panel was more concerned about Laws' conduct after Jonathan's death, ruling that he falsified letters to the Bains' family doctor and entries in Jonathan's chart and failed to warn them about the risks of liver failure.

``Our complaint was never dealt with because our complaint was never for forgery, falsification or perjury,'' Bain says. ``It was for the medical aspect.''

In June, 1999, Laws was found guilty of professional misconduct and handed a six-month suspension, reduced to three for meeting conditions such as seeking psychiatric treatment and upgrading his skills.



`He should have been revoked.'

- Tom Bain
referring to the family's complaint
about Dr. Anthony Laws
`(Laws) felt the disciplinary decision was fair and he didn't have any complaint about the process.'
- Tom Curry
Laws' lawyer


``He should have been revoked,'' says Bain. ``The system failed us.''

Tom Curry, the Toronto lawyer representing Laws, said his client ``felt the disciplinary decision was fair and he didn't have any complaint about the process.''

Like all complainants, the Bains had no official standing before the college, acting merely as witnesses in the case.

College lawyers, much like crown attorneys, act on behalf of the system, not the individual. Complainants cannot call witnesses or ask questions.

If complainants want their own legal advice, they must pay for it themselves.

On the other side of the room, money is no object for doctors. The Canadian Medical Protective Association (CMPA), which represents more than 90 per cent of doctors in Ontario, picks up the tab for top legal representation.

Doctors, in turn, are reimbursed with public money for most of the insurance premiums they pay. This year, it is expected the province will pay just under $70 million out of total malpractice premiums of about $100 million.

``I've walked out of college hearings thinking physicians are protected far more than they deserve,'' says Toronto lawyer Barry Swadron, who has represented several clients in complaints against physicians.

``Doctors stick together. If a fight is involved, the odds against the victim are astronomical.''

College president Gerace dismisses the claims of a power imbalance between doctors and complainants, saying the system is designed to protect the public interest.

``The analogy is the criminal system. If someone gets drunk and kills my child, I want to be a party to that but I'm not. The prosecutor is there to protect the public interest,'' he says.

``We're there to ensure that either a physician is found to be okay or is found to be wanting and that the correct steps are taken.''

FILE COPY


Investigative reporter Robert Cribb can be reached at: rcribb@thestar.ca

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