Craig Woudsma is the reluctant hero of the so-called “chemo drug scandal.” He is the OPSEU pharmacy assistant at the Peterborough Regional Health Centre who stopped to question the differences between oncology medication prepared by the hospital’s old contract supplier and the new – Marchese Hospital Solutions.
He was the first to do so. 1200 cancer patients received less than their prescribed dose due to an error that has four Ontario hospitals, their purchasing agent, and Marchese all pointing fingers at each other.
Yesterday Woudsma may have not felt the hero, appearing before the Ontario’s legislature’s social policy committee heavily coached by senior hospital officials and their contract lawyer, who sat directly behind him and his senior colleague Judy Turner.
As it turns out, maybe it was the hospital officials themselves who should have been back on the hot seat.
Why would Peterborough Regional Health Centre want to contract out the preparation of oncology drugs 200 kilometers away in Hamilton when it had the resources to do so on site?
Woudsma and Turner couldn’t answer any questions pertaining to the decision to contract out their work. They weren’t privy to discussions on this decision and were unaware if anybody at the pharmacy was.
Yet before 2011 PRHC prepared its own oncology drugs. When they started contracting out via Medbuy to Baxter, it meant no loss in staff or hours. It was part of the routine of the pharmacy. And then it wasn’t. When the job was repatriated after the dosage problem was discovered, PRHC still had the staff and resources to do the compounding in hospital. Woudsma said they were confident doing it. It didn’t affect workflow. There were no problems.
Turner had suggested to the committee that she didn’t object to the contracting out if it meant the hospital saved money and the process was safer.
Yet there never had been any safety issues when the PRHC’s pharmacy prepared the drugs in-house. That’s what pharmacies do. After the contracting out, well that’s another story. As it turns out, Marchese wasn’t even subject to federal or provincial oversight, something Ontario is rushing to correct.
The question is, how could this contracting out have saved any money when it didn’t mean any changes in staffing or hours back at the hospital? How could it be cheaper for Marchese to hire its own pharmacy assistants, prepare the mix, label and ship what is mostly saline solution across the center of the province? How could this be less costly than PRHC simply acquiring the raw medication to do its own compounding?
This is a fair question to ask at a hospital that not too long ago had to reduce 160 full-time equivalent jobs to pull out of a persistent long-term deficit problem.
Even more disturbing, after Woudsma and Turner brought forward their concerns, they were told by a consulting pharmacist to go ahead and use the mix anyway.
It was only later that Peterborough would quarantine its Marchese supply.
What is emerging at the testimony is that there appears to be a communications break down between the expectations of the hospitals and Marchese. Marchese contends if the full chemo cocktail is administered, the difference in the amount of saline solution would not be material. But the problem is the hospitals were not using the entire bag.
Woudsma himself said that the Baxter bag he compared with the new Marchese content was not empty, but not sufficient to administer to a patient.
Woudsma said he was the first one to use the Marchese stock at PRHC. He was surprised to see that the new product required refrigeration, unlike the bags prepared by Baxter. Whereas the labelling of the content by Baxter was clear, the Marchese labelling left him with questions about the consistency between the bag’s content and what was on his electronic worksheet.
Under oath Woudsma and Turner admitted their opening statements were prepared in conjunction with the senior hospital officials and its lawyer. Woudsma further stated that the hospital had given them some preparation for their appearance before the committee. The statement was more of a “collaborative” process, he said.
Woudsma doesn’t think himself a hero. “It’s just part of our job.” He says he didn’t respond to initial requests for interviews because he didn’t want to add to the spectacle.
We find it very unlikely that a hospital this tightly wrapped about its decision-making would have ever permitted it anyway.