Newfoundland inquiry told health board discouraged from revealing problems with breast cancer tests

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ST. JOHN'S, N.L. - Newfoundland's largest health board was discouraged from telling patients about problems with breast cancer tests to minimize the threat of litigation, despite a plea from the province's health minister months earlier to warn the public of the emerging debacle, a public inquiry heard yesterday.

A series of notes, e-mails and meeting minutes were entered as evidence that provide a glimpse into how the Eastern Health authority learned of the errors, what it did to inform the public and its failed attempts at damage control.

In an e-mail dated Oct. 18, 2005, St. John's lawyer Daniel Boone advised the board against sending patients a letter informing them that their breast cancer tests were being reviewed at Mount Sinai Hospital in Toronto.

"There is a possibility that we could be sued in a class action by those people who receive this proposed correspondence whose test results do not change. Otherwise these people would not have a cause of action, so sending the letter actually exposes us to a liability which does not now exist," Boone wrote to Heather Predham, Eastern Health's risk management consultant.

"I do not see how the letter advances the health care of the affected patients and it increases our exposure to claims for damages. I would recommend against sending it."

Instead, Eastern Health phoned patients to tell them their breast cancer tissue samples were being retested "to allow for dialogue and to ensure understanding," according to minutes of a board meeting a week later.

But that account contrasts with testimony from patients and relatives of deceased patients who have told the inquiry that Eastern Health wasn't keeping them in the loop about the test results.

The inquiry is focusing on Eastern Health's handling of hormone receptor tests, which are a valuable tool that doctors use in determining the course of treatment for breast cancer patients.