The former head of Newfoundland and Labrador's largest health authority testified Wednesday that he had been unaware for four years about a critical memo that flagged serious problems at a St. John's pathology lab.

Former Eastern Health CEO George Tilley was pressed on why he did not ask questions about a 2003 memo that raised serious concerns about the state of the St. John's pathology lab.
(CBC)

In his second day of testimony at a judicial inquiry examining flawed breast cancer testing, former Eastern Health chief executive officer George Tilley said he did not know until 2007 about a scathing review that pathologist Gershon Ejeckam wrote in June 2003 about the lab.

That report — which Premier Danny Williams presented in the house of assembly in late May 2007 — laid out a litany of problems at the lab, including "grossly inadequate" staffing and persistent problems with immunostains.

Inquiry co-counsel Bern Coffey asked Tilley why he had not seen the memo before, and also why he didn't even ask why the memo had not been brought to his attention.

"Well, you have professionals on staff, you have physicians on staff, you don't micromanage a process," Tilley testified.

"You have to rely upon the people that are leading these areas, and if they had spoken to the effect that that issue, from their perspective, was dealt with appropriately, then I accepted that."

Ejeckam's memo also included a strongly worded caution that problems at the lab could expose the health system to litigation.

Not looking to blame anyone: Tilley

Despite that red flag, Tilley did not question those under him why it hadn't been brought to his attention.

"It's not my style to look for blame," he testified. "I am a strong advocate for making improvements in a system."

'It's not my style to look for blame. I am a strong advocate for making improvements in a system.'—George Tilley

The Ejeckam memo led to a five-week halt in some testing and an overhaul in the pathology lab, which appeared to satisfy Ejeckam, who retired in 2006.

Tilley did not seem too concerned that government officials not only saw the Ejeckam memo before he did, but had publicly touted its significance. Williams discussed it in the house of assembly, days after the government announced it would organize a judicial inquiry into what went wrong at the lab.

Health Minister Ross Wiseman testified last week that Dr. Oscar Howell, a senior official at Eastern Health, had faxed the memo to John Abbott, then the deputy minister of health. Wiseman said he gave it to Williams.

The memo is important, as it contributes much to the understanding of problems at the lab. In May 2005, Eastern Health was alerted that the lab may have serious problems with hormone receptor testing, a particular type of immunostaining that it started doing in-house in 1997.

By July 2005, a full-fledged investigation was underway that would involve temporarily halting hormone receptor testing and sending lab samples for retesting at Mount Sinai Hospital in Toronto.

While that work was launched, though, Eastern Health and government officials were at odds over how to — or even if they should — tell patients and the public.

Minister called him on issue, Tilley says

Tilley gave testimony on Wednesday that contradicted what the inquiry heard two weeks ago from John Ottenheimer, who was the health minister at the time.

Ottenheimer testified that Tilley contacted him on July 19, 2005, and — although he was not sure of it — they met over lunch.

Not so, Tilley testified. Rather, he said Ottenheimer contacted him that day.

"Very rarely would I call a minister," Tilley said. "It would be the minister calling me first or … the minister calling and me calling him back."

Tilley's testimony, therefore, suggests that Ottenheimer already knew about the issue before they discussed it.

Tilley also commented on how the word "explosive" came to be written in his notebook. On March 31, Ottenheimer testified, "I am under oath. I do not recall ever using the word explosive, or hearing it."

Tilley said the word, though, was Ottenheimer's, although he added, "I said to him, you know, I don't disagree with that. This is a significant issue."