Toxic conditions cited in Eastern Health lab review

The lab at Newfoundland and Labrador's largest health authority is plagued by intimidated staff, a toxic working environment and distrust between colleagues, an external review has found.

Eastern Health commissioned the Toronto-based Institute of Quality Management in Healthcare to undertake the review of its lab in December, the same month former laboratory director Dr. Nash Denic complained to executive management of workload problems.

In a cover letter to an Eastern Health vice-president, review author Dr. Gregory Flynn warned that "a toxic environment has developed" at the lab.

"The findings of the review speak to dysfunctional relationships between management and staff; low morale, suspicion and distrust; staff who are hostile and intimidating; and a model of working to a low common denominator," Eastern Health said in a statement Monday.

Eastern Health CEO Vickie Kaminski said the review is concerning, but insisted the authority's lab work has never been safer.

The review was launched before Eastern Health which weathered years of often intense scrutiny over botched breast cancer tests was embroiled in a new scandal, involving errors with tests for the immunosuppressant cyclosporine. Some patients, including a 14-year-old boy who has been in intensive care, received excessive doses of the drug.

Denic was pushed out last week as laboratory director, for failing to have notified chief executive officer Vickie Kaminski in February of problems with testing for cyclosporine. That move prompted two laboratory site chiefs to resign Friday from their administrator roles, and another pathologist to step down from a committee role. Colleagues tell CBC News that Denic is respected in his field, and that they believe he has been held up as a scapegoat.

On Monday, the authority's credibility problems widened, with the resignation of Dr. Jim Hutchinson as a manager responsible for infection prevention and control. Like the pathologists, Hutchinson remains on staff. Hutchinson is not commenting on his decision.

As well, the authority reported that four pathologists are now on short-term sick leave.

Minister blasts MDs as 'childish'

Health Minister Jerome Kennedy, who received a copy of the review last Friday, said the document paints a terrible picture of how the lab works.

On Monday, Kennedy offeredto step in tohelp resolve a simmering dispute with pathologists at the province's largest health authority.

But in an interview with CBC News, Kennedy warned senior medical staff at Eastern Healththat he will only do so if they agree to change the working culture in labs that have had prolonged problems with quality and accuracy.

"There has to be an acceptance that the Cameron recommendations apply to the labs, that there will be a change of culture in terms of the acceptance of accountability, and if we can establish those basic parameters, then I feel that there can be fruitful discussion with the pathologists," said Kennedy, who on Friday had described the behaviour of senior lab staff as "childish."

Kennedy said he wants to help resolve the mushrooming dispute, which appears to be pitting physicians against senior managers.

"I'm open to discussions with the pathologists. I'm willing to meet with them myself, if that will accomplish anything," Kennedy said.

Kennedysaidthere is not a shortage of pathologists working in the province.

"People have stepped aside from leadership roles, but none of them have resigned," he said.

Meanwhile, CBC News has obtained a copy of aletter from the president of the Newfoundland Association of Pathologists that supportsDenic.

"He is widely admired for his diagnostic abilities and his unflagging commitment to patient care. How he managed such a heavy workload for so long is a mystery to us all," said the letter.

"Dr. Denic retains the full support of all pathologists in the province."

Eastern Health admitted last week that Denic had wanted to resign from his position in December.

Colleagues told CBC News that Denic was exhausted and frustrated from a heavy workload, but was persuaded to stay on while the authority worked on finding a replacement and addressing his concerns.