Never wanted test result problems disclosed, manager tells cancer probe

A senior manager has admitted to Newfoundland and Labrador's breast cancer inquiry that she didn't want anything said publicly about serious problems involving lab tests.

Heather Predham, who manages Eastern Health's risk management program, told the Cameron inquiry that she did not want the authority to release data about hundreds of flawed hormone receptor tests, citing concerns of pending litigation.

Predham described at the Cameron inquiry on Wednesday media briefings held in December 2006, in which Eastern Health did not disclose all that it knew about the flawed tests, which are used to determine whether a breast cancer patient can benefit from potentially lifesaving antihormonal therapy.

Predham told Justice Margaret Cameron that she stepped in when questioning at one briefing became particularly intense, especially over the rate of error of the test.

"They were pressing a lot for this and I just introduced myself, and said I'd like to remind you that we have an action before the court, and we can't tell you everything," Predham said.

That action was a then-pending class action lawsuit against Eastern Health, filed on behalf of patients. Newfoundland Supreme Court certified the lawsuit in 2007, shortly before the Newfoundland and Labrador government ordered a commission of inquiry into what went wrong with the tests, and why Eastern Health officials had withheld or downplayed critical information about the crisis.

Predham told the inquiry that she preferred that the media briefings not be held at all.

"Whenever we had a statement of claim, we didn't talk to the media," Predham testified.

"And the reason for that is because you don't want to say or do anything that could undermine your defence to the action?" commission co-counsel Sandra Chaytor asked.

"That's your way of putting it," Predham replied.

"Mine is just that anything that goes on to the courts goes through the court process and gets released that way."

Questioned over patient contact

Meanwhile, Predham came in for tough questions about patient notification, especially why phone calls were placed to many patients while others were missed.

Ches Crosbie, a St. John's lawyer who filed the class action lawsuit and who represents patients at the Cameron inquiry, asked Predham to explain why Eastern Health did not do more, such as calling patients first and following up with letters.

"We should have done that," Predham said.

"I do believe, in my review — in anticipation — I had commented in some document that we were going to do that. But that was something that was overlooked and missed," Predham said.

"Just lost in the swirl of events?" Crosbie replied.

"Lost in the swirl," Predham said.

Predham was involved in many of the key events under scrutiny at the Cameron inquiry, as she had a responsibility not only for Eastern Health's quality assurance program but also provided guidance on risk management.

Crosbie questioned Predham on how the process of patient notification could be so complicated.

"Some of us remain mystified why it is that a letter could be such a logistical problem?" Crosbie asked.

Predham said the decision came down to the now-retired vice-president of medical services, Bob Williams.

"I could only tell you what I remember, and I can only tell you that Dr. Williams was frustrated with the discussion that was ongoing at that time, And put an end to it by saying 'call them,' " Predham.

Earlier this year, Williams told the inquiry he felt that phone calls would be a more personal form of contact. Williams also apologized for any part that he had played in what went wrong with how Eastern Health responded to hundreds of erroneous test results when the issue was identified in 2005.