Former head of cardiac surgery in N.S. details allegations of toxic workplace

A former head of the cardiac surgery division for the Nova Scotia Health Authority says he was removed from his post without explanation despite attempts to address a toxic work environment plagued by poor behaviour that included some surgeons allegedly throwing medical instruments.

The allegations are contained in a request by Dr. Edgar Chedrawy for a judicial review, filed in Nova Scotia Supreme Court in May. The Nova Scotia Health Authority and Nova Scotia Attorney General are named as respondents. Chedrawy, who continues to work as a heart surgeon in Halifax, wants to be reinstated as division head along with a review of the decision to remove him.

AllNovaScotia.com first reported on the filing.

According to court documents, Chedrawy was recruited back home to Nova Scotia in 2017 from the University of Illinois, where he was division head of cardiothoracic surgery. He was named division head here in 2018 following an international search.

Doctors allegedly threw medical instruments

The documents say reviews of the cardiac surgery division in 2010 and 2016, before he arrived, recognized "there were serious problems which needed to be remedied within the division and…Chedrawy understood he was recruited in part to help address them."

The 2016 review, according to court documents, observed "incivility and aggression are expected and tolerated: There is some evidence of bullying." Chedrawy's time as division head included investigating and responding to a variety of incidents, which are detailed in the documents.

They allegedly include:

• A doctor throwing an instrument toward a patient's leg when a piece of equipment was not available, cutting the patient. The same doctor allegedly engaged in "profane, sarcastic and inappropriate behaviour" and demonstrated a lack of respect.

• A doctor throwing a sternal retractor at a metal bucket, causing hearing loss for a perfusionist, the surgical team member who keeps the patient's blood circulating during a heart operation. That same doctor allegedly struck a resident and was verbally abusive.

• A doctor alleged to have called a fellow —  a medical specialist in training — by a racist name. Then told them they should go back where they came from and made profane comments about Chedrawy.

• A doctor allegedly refused to try resolving personal dynamics with another cardiac surgeon and asked Chedrawy to remove a disciplinary letter from their personal file, which Chedrawy refused to do.

Not all doctors willing to improve their behaviour

The court documents say Chedrawy was advised by the person who formerly administered the division about what she regarded as "racist and discriminatory behaviour by particular physicians," which Chedrawy reported to the department head.

The documents go on to say that a review of how the cardiac surgery program treated fellows concluded that no further fellows should be assigned to the division until identified problems were resolved.

"[Chedrawy] was concerned that this behaviour was being modelled and treated as acceptable for residents and fellows," the documents say. "He took specific steps to address and resolve these issues, with mixed success. Not all of the physicians were willing to improve their behaviour."

• Nova Scotia Health orders workplace assessment of cardiac surgery unit amid complaints

Chedrawy's request for a judicial review is based on several grounds.

Court documents say he was informed there would be a workplace assessment in 2021. He expressed concerns about the way the review would be conducted and alleged conflicts of interest on the part of the two internal reviewers.

The review went ahead despite his concerns and, according to court documents, Chedrawy was not presented with a copy of the review, its recommendations or given the opportunity to respond.

Told to work with leadership coach

A few months after the review, Chedrawy was told that to keep his position as division head he would have to work with a facilitator to improve collegiality, work with a leadership coach and that three collegiality surveys would be administered.

The letter from Dr. Todd Howlett, executive medical director of the health authority's central zone, and Dr. David Kirkpatrick, head of the department of surgery at the time, advising Chedrawy of these terms notes "there have been a number of positive developments that have occurred under your tenure as division head," yet significant problems remain in the division and escalated under his leadership.

Terminated without notice

Although Chedrawy accepted the terms to keep his job and was working through them, he was informed two months later in a letter from the newly hired head of surgery, Dr. Gail Darling, and vice-president of medicine, Dr. Nicole Boutilier, that he was being terminated as division head effective immediately and would get $97,500 in lieu of six month's notice.

The court documents say Chedrawy had — and continues to have — the support of the majority of the doctors in the cardiac surgery division.

Chedrawy could not be reached for comment.

A spokesperson for Nova Scotia Health said the health authority has no comment on the filing. A spokesperson for the province said this is a human resources issue involving the health authority and directed questions to Nova Scotia Health.

Chedrawy's motion comes amid an external workplace assessment of the cardiac surgery division recently ordered by Nova Scotia Health interim CEO Karen Oldfield.

Oldfield told CBC she ordered the assessment following complaints about the division she first heard in February and through subsequent information gathering.

CBC News reported this week that multiple doctors with international training say they experienced discrimination and other forms of unfair treatment during their time in Halifax as fellows or Dalhousie University medical residents in cardiac surgery.