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article imageSurgeon who de-breasted woman in Ontario reinstated

By KJ Mullins     Mar 11, 2010 in Health
Windsor - A surgeon at Hotel Dieu Grace Hospital in Windsor, Ontario mistakenly removed a woman's breast last fall. This week the hospital decided the surgeon's future at their facility.
The Board of Directors of Hotel Dieu Grace Hospital heard the case of Dr. Barbara Heartwell on March, 10, 2010 to decide if the doctor would retain her privileges at the hospital. The information that follows comes from the hearing's press released obtained by Digital Journal.
The Board along with the Chief of Staff for the Medical Advisory Committee, Dr. Gordon Vail and Dr. Alan Forse, Chief of Surgery, Medical Director of Trauma and Surgical Services and Regional Head of Oncological Services for Cancer Care Ontario were present during the hearing.
Mr. Patrick Hawkins for the Medical Advisory Committee of Hotel Dieu Grace Hospital and Ms. Johanna Braden, for the Board of Directors of Hotel Dieu Grace Hospital made appearances during the hearing. Appearing in behalf of Dr. Heartwell were Ms. Andrea Plumb, Ms. Carolyn Brandow and Ms. Avril Farlam.
Dr. Barbara Heartwell, General Surgeon was also a witness during the hearing.
The public was not allowed into the hearing in accordance with the Statutory Powers Procedure Act and Board Policy No. 028 regarding Open and In-Camera Sessions of the Board.
The Board's motive for the closed door nature of the hearing was so that evidence could be fairly presented without revealing confidential personal health information of patients. The Board has decided that the evidence will be sealed. The Board has determined that it can issues its Decision and Reasons for Decision without revealing patient information and for that reason Reasons have been made available to the public.
The Medical Advisory Committee (MAC) is allowed to appoint physicians to their staff for a period of not more than one year. Each year every physician must submit a new application to be appointed to the medical staff of the hospital. When a problem arises during that one year period the MAC does not address how hospitals respond.
When the conduct, performance or competence of a member exposed or is reasonably likely to expose patient(s) to harm or injury immediate action is to take place. The former Interim Chief of Staff took this step concerning Dr. Heartwell on February 26, 2010.
During a Special Meeting of the MAC on March 2, 2010 it was concluded that the mid-term suspension of Dr Heartwell's privileges was not needed because the doctor was not an immediate threat to patient safety. At that time it was recommended to the Board that Dr.Heartwell be reinstated with the condition that her elective cancer cases by reviewed by another general surgeon prior to any oncology surgery for a period of three months to be reviewed by the MAC on a monthly basis.
The MAC presented three of Dr. Heartwell's cases at the Special Meeting. In the first case the pathology reports had inconsistencies and irregularities. In the second case it was determined that the surgery would have been performed on the patient's breast irrespective of the pathology reports shown to the committee. In case three Dr. Heartwell fully admitted she had read the pathology report incorrectly. The MAC believed that Heartwell could change her practice in order to avoid this error in the future.
During the hearing Dr. Vail gave evidence of a written caution issued to Heartwell by the Complaints Committee of the College of Physicians and Surgeons of Ontario (CPSO) dated February 26, 2010.
This caution dealt with an incident that had occurred in 2004. The matter was resolved in October 2005 by issuing a written caution to Dr. Heartwell. This evidence did not affect Dr. Vail's opinion of the MAC recommendation from March 2, 2010.
During the hearing it was said that Dr. Heartwell appropriately disclosed the mistake to her patient and apologized giving full disclosure.
Dr. Forse testified that he concurred with the MAC recommendation that patient safety would be assured and that it was in the best interest of both the hospital and the community to reinstate Dr.Heartwell with conditions.
An internal review of Dr. Heartwell's 692 mastectomy cases have been reviewed for the period 2000-2010. At this time 5 of the cases are waiting for necessary documentation from other institutions in order to finish the review. In addition all other surgeries by Dr.Heartwell are currently being reviewed. As of this week 4,249 cases have been reviewed with 129 left to be fully reviewed. There has been no concerns identified to date from those reviews.
Dr. Forse and all other surgeons in the Department of General Surgery have agreed to oversee Dr. Heartwell in a commitment to ensure this type of mistake does not happen again.
The decision of the hearing was that Dr. Heartwell has been reinstated effective immediately as per the MAC recommendation. Dr. Heartwell is to have a second opinion prior to her elective cancer surgeries for a period of three months. The MAC will review the case on a monthly basis.
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