Horizon defends staff handling of cancer patient's tests

The Horizon Health Authority's chief of surgery says he is confident his staff did everything they could to identify the tumour growing on Deby Nash's kidney.

Nash raised concerns last week about how long it took for atumour on her kidneyto be diagnosed.

Dr. John Dornan said people can feel quite well until they have five to 10 per cent of their renal function remaining.

Dornan said health officials often do blood tests to identify potential problems even if a patient is feeling good.

"Sometimes there are changes to the blood tests that suggest to us, that there's a problem. And it is flagged, and subsequent tests are undertaken and repeated to see if there's a trend there," Dornan said.

"If there's a trend, if the day after, or the month after, it was continuing to deteriorate, then you'd expect a call and you'd expect further investigation and that is generally how we handle things."

Nash said the team was doing that faithfully over the past 10 years that she has been their patient. But she said someone "dropped the ball" last fall.

Unknown to her, her monthly blood tests showed her creatinine levels, (a waste chemical a healthy kidney disposes of), began increasing in November and continued increasing until she was finally notified in late February.

"The spike in that particular level happened over a four-month period. So if there was a trend, that they were starting to notice, not one, not two, but three and then four months, I was never advised within any of that four-month period that a trend had been noticed and they were investigating it," she said.

"At no time."

'It's a lesson learned'

Nash acknowledges that lots of things can cause levels to fluctuate and in the decade that the Saint John Regional Hospital has been monitoring her blood, changes in her levels have prompted calls within 24 hours to her to have her re-tested.

Nash said as soon as she learned there was an anomaly, she asked why she hasn't been told of it by the health professionals.

"It is a lesson learned. I will ask for all of my results forever. That is the lesson I have learned from this at a great personal cost," she said.

It turned out Nash has a 5.5-centimetre cancerous tumour on her one, transplanted kidney.

She will have kidney surgery in Halifax on Tuesday. Nash said she believes if it had been caught earlier, the kidney would have had a better chance of being saved.

Right now, she faces a good possibility of losing the kidney all together and being back on dialysis.

No reason to change protocols

Dornan says he sees no reason to change the hospital's protocols in regards to kidney patients.

But he does say, if Nash ends up returning for dialysis after her surgery, that she will once again trust the team.

"I trust our team, and their approach to all cases, including this case and I'd be glad to discuss it with this patient because I have reviewed it," he said.

"And I hope in times to come, she develops a good working relationship with our team and other centres, whether it be in Halifax or Fredericton and I hope she gets this confidence back."

Nash said the health professionals in the health authority will have to prove to her that she should have confidence in the system.

"Trust is earned. And we have a long way to go," she said.