Who is responsible for the unexpectedly diluted chemotherapy cocktail that more than a 1,000 cancer patients received since February 2012? And will we ever know when aspects of the story are being treated as safely guarded secrets?
The issue has been making headlines this week with fingers pointing in all directions.
At least two of the hospitals involved have now taken back the preparation of the drug cocktail – both Durham Region’s Lakeridge Health and the Windsor Regional Hospital have said they are able to prepare it themselves.
London Health Sciences also says they have the capacity to prepare the drugs internally, but LHSC Vice-President Tony LaRocca told the London Free Press that they contract out the work because it is “more practical and efficient.”
Did he really say that with a straight face, especially after knowing the questions London patients and their families must now have?
All of the hospitals involved do group purchasing through Medbuy, which is owned by its member hospitals in three provinces. That group purchasing includes pharmaceuticals.
On Medbuy’s website, it claims that “members are highly engaged and have worked to develop specific criteria for the safe handling and administration of chemotherapy drugs as well as packaging and labelling requirements.”
The question is, were these requirements part of the Medbuy contract with Marchese Hospital Solutions? Marchese is the source of the diluted chemotherapy drug cocktails.
Like many public health care contracts with the private sector, the details remain a secret.
Marchese is saying they are not to blame, telling the Toronto Star that the drugs were administered in a way that was “not consistent with the contract” — the same contract the public conveniently cannot see.
Yet media reports suggest the issue was one of mislabelling and miscommunication. If so, did Marchese need to have it in writing that the contents on the label had to match the contents of the mix?
The hospitals are all pointing fingers at Marchese for the failure, as are two Southern Ontario law firms that have been retained to engage in a class action suit against the company.
Yet nobody can say for certain whether these patients were affected by the lower doses. Lakeridge Health maintains their relationship with Marchese was too short to have any impact – at most their 34 affected patients would have only had two doses of the cocktail.
In London, where 665 patients received the cocktail since March 2012, or in Windsor where 290 patients were impacted since February 2012, families are openly wondering if the lower doses played any role in the outcome of the treatment.
The Health Minister, as usual, has said she has ordered an investigation by the College of Pharmacists and will “take whatever steps we need to make sure it never happens again.” Given all the recent failures around private provision of public health care, she may want to permanently record this response on her voicemail.
The NDP meanwhile are calling for a ministerial investigation with a full public report.
If there is one undisputed hero in all this, it is the Peterborough Pharmacy Tech who spotted the difference when Peterborough started using the Marchese-prepared cocktail this March. As a result, only one Peterborough patient was administered the low dose. Incidentally, the Peterborough Pharmacy Techs are represented by OPSEU.
The diluted drugs are sharing headline space with a new Senate Committee report that is calling for Health Canada to step up drug oversight.
The Senate Committee particularly noted problems with secrecy regarding what Health Canada learns about whether the drugs are harmful, fatal, or fail to work.
And if that isn’t enough, the Toronto Star has been reporting this week on a strange case of a baby pronounced dead at Humber River Regional Hospital. The baby started wiggling a short time later while its body was covered under a sheet. The hospital’s report – you got it – is secret, protected under the Quality of Care Information Protection Act.
As much as politicians like to talk about accountability, it might be a little difficult when private for-profit and not-for-profit health care providers are so protected by secrecy laws. It also does not bode well for the public as we face increased privatization of public health care services.