FIRST, DO NO HARM
Watch the entire
documentary online  (runs
appox 41:30)
MORE:
The Story
The Interviews
Resources
THE STORY
In March, 2004 the Ontario
College of Physicians and Surgeons of Ontario announced
that it was revoking the license of Dr. Errol Wai-Ping,
a gynecologist accused of mistreating, misdiagnosing
and castrating dozens of women who were his patients.
| DEFINITION OF AN ADVERSE
EVENT |
| An adverse event is an unintended injury or complication
that results in disability at the time of discharge,
death or prolonged hospital stay and that is caused
by health care management rather than by the patient's
underlying disease process. |
This announcement signaled the end of one of Canada's
most serious and longest running cases of medical error.
It came on the heels of the Canadian
Adverse Events Study which
revealed one in thirteen Canadians is harmed by
the medical care that is supposed to help them.
The fifth estate's documentary First,
Do No Harm examines the story of Dr. Wai-Ping,
the cases of some of his patients, and investigates
the official process that allowed Dr. Wai-Ping to continue
practicing almost a decade
after complaints had first been made about his competence
as a surgeon.
"Clearly this
wasn't
a good doc having a bad day. This was a pattern
of conduct that frightened me because knowing
what I know, the little I know about infection,
I wonder what could possibly happen to somebody
else that didn't
know."
- Nicole Harder |
One of those patients is Nicole Harder of Cobourg,
Ontario. In 1995, when Nicole was 31, she complained
to both the Ajax-Pickering hospital and the College
of Physicians and Surgeons of Ontario about Dr. Wai-Ping,
claiming that he performed an unnecessary hysterectomy
and causing a potentially life-threatening infection.
For seven years, Nicole Harder fought the Ontario
College of Physicians and Surgeons and the hospital
where he worked to reveal what, if any, measures were
being taken to investigate her complaint or discipline
Dr. Wai-Ping.
She learned that the College referred
her complaint to a confidential committee called Quality
Assurance. Although the proceedings of this committee
are kept secret, Harder obtained documents that showed
the QA committee determined there were "significant" breaches
in Dr. Wai-Ping's standard of care. For that,
he was ordered to take a remedial communications course.
Eventually Harder settled a malpractice suit against
Dr. Wai-Ping.
In the past serious complaints about a doctor's
clinical care usually went to a disciplinary board,
which has the power to take a doctor's license
away. In most provinces disciplinary hearings are open
to the public.
| FIRST,
DO NO HARM |
It
is a widely held misconception that "First,
Do No Harm" comes
from the Hippocratic Oath. Although the oath expresses
a similar sentiment it does not contain those words.
In fact, Hippocrates came closest to issuing this directive in his treatise Epidemics,
in an axiom that reads, "As to diseases, make a habit of two things -- to
help, or at least, to do no harm."
|
The fifth estate's investigation
reveals that across Canada there is a new trend to
retrain doctors, not blame them. In Ontario it's called
Quality Assurance. The disturbing thing is, everything
that happens in Quality Assurance is secret.
The College
received at least 12 complaints about Dr. Wai-Ping
between 1994 and 2001. In all of that time he had a
spotless record so far as any patients could find out
and there were no restrictions on his surgery.
Dr. Wai-Ping continued to perform surgery until a
Toronto Star investigation made the matter public in
2001. Weeks later, the College finally referred the
case to the Disciplinary Committee and Dr. Wai-Ping
was forced to resign.
More than 300 of Dr. Wai-Ping's patients are
now launching a class action lawsuit against the doctor,
the College of Physicians and Surgeons and Rouge Valley
Ajax-Pickering Hospital.
Read
the College of Physicians and Surgeons of Ontario discipline
hearing on Dr. Wai-Ping 
(note:
this is a .pdf file)
^TOP
THE
INTERVIEWS
"The hospital administration
didn't do their job. And when the College was
notified about the questionable skill from other
patients before me, they didn't do their job
either." |
Lyn
Logan
Logan complained to the province's medical
regulator about Dr. Wai-Ping. The surgery Dr. Wai-Ping
performed on her required five more surgeries to fix
and she spent years in recovery.
The College
told Logan that her complaint against the doctor would
be sent to the Disciplinary Committee. Instead it went
to Quality Assurance.
Like Nicole Harder, Lyn Logan eventually
received an out-of-court settlement in a malpractice
suit.
"He was a godsend.
We thought he was, he was the miracle worker
because without him, we would never have conceived." |
Robin Heaton
Robin Heaton was one of Dr. Wai-Ping's
first patients in Ajax-Pickering.
She saw him for fertility treatments. He delivered
her two children. But cycles of drugs caused painful
cysts which Dr. Wai-Ping removed surgically. Eventually
he also removed Heaton's uterus.
Heaton says he told
her she would die without the hysterectomy. But an
investigation by the College of Physicians and Surgeons
later determined that her hysterectomy was unnecessary
and her fertility treatments mismanaged.
"I even thought of
standing out in front of his office and warning
women as they went in." |
Sue Coulter
Sue Coulter complained to
the hospital and the College of Physicians and Surgeons
about Dr. Wai-Ping's care. When Wai-Ping removed
her uterus, he punctured her bladder. A simple
surgery turned into 6 weeks of painful recovery.
What
shocked her is how few people at the hospital seemed
surprised.
"Very few, if any doctors
are disciplined as a result of poor surgical
technique." |
Paul Harte
Paul Harte is the malpractice
lawyer representing the women who say they were harmed
by Dr. Wai-Ping.
He says this case opened a rare
window on our medical system and how it fails to
protect patients from doctors who make mistakes.
"On behalf of the
hospital, I'm so, so sorry that you had to go
through that experience." |
Mary Gavel, Director of Risk Managment,
Rouge Valley Health System
Mary Gavel says the hospital did have Dr. Wai-Ping's
practice reviewed by an expert in the year 2000. Gavel
says the expert's recommendations about Dr. Wai-Ping
were only about improving his communications skills.
The fifth estate has learned that the review was far
from comprehensive. The reviewer only looked at cases
the hospital identified and was never asked to compare
Dr.Wai-Ping's performance to others in his department.
The fifth estate discovered that data from the hospital's
own records showed Dr. Wai-Ping's surgical complication
rates were much worse than any of the other surgeons
he worked with.
^TOP
RESOURCES
A listing of
medical regulatory agencies in Canada, the U.S. and
the United Kingdom.
Canada
College of Physicians and Surgeons of Alberta
College of Physicians and Surgeons of B.C.
College of Physicians and Surgeons of Manitoba
College of Physicians and Surgeons of New Brunswick
Newfoundland
and Labrador Health Boards Association
College of Physicians and Surgeons of Nova Scotia
College of Physicians and Surgeons of Ontario
College of Physicians and Surgeons of P.E.I.
Collège
de Médecins du Québec
College
of Physicians and Surgeons of Saskatchewan
Patient
Safety Institute - set up by the Canadian government
in 2003, this group will work to improve the quality
of health care across the country
U.S.
Federation
of State Medical Boards
United Kingdom
General
Medical Council
Studies About Adverse
Events:
The
Canadian Adverse Events Study - the Canadian study
referred to in the fifth estate story
To
Err is Human: Building a Safer Health system -
a report on the U.S. system
(note: this is a .pdf
file)
Patient
Safety and Healthcare Error in the Canadian Healthcare
System: A Systematic Review and Analysis of Leading
Practices in Canada with Reference to Key Initiatives
Elsewhere - a Canadian report
(note: this is
a .pdf file)
|
