Susan Bonnell argued against immediate public disclosure of cancer testing problems in July 2005. (CBC)

A top Eastern Health communications official has testified she knew news of flawed breast cancer tests would eventually leak out in 2005, but nonetheless had no plan on how to deal with it.

Susan Bonnell, who was Eastern Health's director of strategic communications until February, told the Cameron inquiry she assumed during the early months of the cancer testing crisis in 2005 that the media would get wind that something was wrong with the authority's hormone receptor tests.

"I think I probably would say to you that I always knew that it would go public," Bonnell testified Friday, describing Eastern Health's decision to repeat tests used to help determine if a breast cancer patient can benefit from the antihormonal therapy Tamoxifen.

"It's impractical to think that a thousand people would be notified and that it would never, ever reach the media."

While Eastern Health did draft news releases in July 2005, they were never issued. Instead, Eastern Health executives — acting in part on a lengthy memo that Bonnell sent to then-chief executive officer George Tilley — decided not to say anything while the retesting was done.

Bonnell said she knew it was inevitable that the public would learn of the retesting. Even so, Eastern Health had nothing ready — and no plan to guide the authority — when the St. John's newspaper the Independent got wind of the story in late September.

At that time, Bonnell said, the Independent thought that the issue was about mammography, the screening program to determine whether a woman may have breast cancer.

Bonnell said officials in Eastern Health were sharply aware that such a report would be alarming to patients who were not involved in the hormone receptor retesting samples.

"It was totally inaccurate and would impact — in fact, be impactful on tens of thousands of women," she said. "And so I said, 'We've got to talk to this, and we have to tell them what's going on.' "

Bonnell informed an Independent reporter that the retesting involved not mammography, but estrogen receptor and progesterone receptor testing. She also attempted to persuade the Independent to hold off on the story until patients were notified first, but without success.

Saw no point in news release

When the story broke in early October, though, Bonnell did not have a plan of action, and testified she did not see much point in even issuing a news release.

Inquiry co-counsel Bern Coffey asked Bonnell why she cited many reasons against public disclosure, but nothing in favour. (CBC)

"If we were to issue a press release at this point, when the story was already in the news, I'm not sure what the purpose of a press release would be," she said.

Patients were not contacted until after the Independent story appeared, and that process turned out to take many more months than Eastern Health thought.

Bonnell said Eastern Health prepared few communications materials on the cancer testing issue until technical briefings in December 2006, during which officials disclosed some of the results of a massive retesting program, but had decided to withhold key elements, including an error rate of about 42 per cent of retested samples.

Bonnell had already told the inquiry it was a mistake to have withheld information that would become public in May 2007, when the Newfoundland and Labrador government announced the commission of inquiry.

Lack of plan a 'tragic flaw'

Bonnell said weaknesses are easier to see in hindsight.

"One of the tragic flaws in all of this is that, and it's surprising to me because I don't know how it transpired, but for some reason there was never a strategic plan done on this issue," she said.

In 2006, Bonnell appealed to the Toronto offices of public-relations giant Hill & Knowlton for assistance on the hormone receptor issue, although Eastern Health quickly decided to keep its communications work in-house.

Bonnell, who is now assigned as the director of internal communication at Eastern Health, told co-counsel Bern Coffey that she bears some of the accountability for mistakes made through the cancer testing crisis.

"There's responsibility to be shared all around the organization," she said.

Many reasons cited for staying quiet

Coffey asked Bonnell numerous questions about a key July 21, 2005 memo, in which she laid out the case against immediate public disclosure.

Coffey asked Bonnell why she laid out numerous "negative" reasons in the memo against speaking publicly, but nothing in favour of going public.

"Why not?" Coffey asked.

"I don't know, sir," she replied.

In that memo, which Bonnell revised a day later at Tilley's request, Bonnell also argued against a news conference, with Bonnell describing reporters as having a "mob mentality" and who can be "sidetracked."

Bonnell said that that an "an unfortunate term of phrase," and did not accurately describe her views of the media.

However, Bonnell said she was aware of news conferences that had been disastrous for the authority, although she testified that in her eight years working with Eastern Health, and one of its predecessors, the St. John's Health Care Corp., she had organized only two news conferences.

Bonnell said she saw herself as an advocate for journalists within Eastern Health.

Bonnell's key reasons for not going public early included creating undue anxiety among patients, and that it would be "in the best interests of the public" to "maintain the reputation of the lab."