Dr. Beverley Carter said she quit doing a review of flawed breast cancer tests when she received no help from superiors. (CBC)

A physician who wrote at times scathing notes about how Eastern Health handled faulty breast cancer tests has told a judicial inquiry she received little help from superiors in trying to investigate the issue in 2005.

Dr. Beverley Carter also told the Cameron inquiry that she objected strongly when she learned in a summer 2005 meeting that Eastern Health wanted to tell the public that old equipment was at the root of flawed hormone receptor tests, even though it was not true.

Carter, a pathologist specializing in breast cancer, told Justice Margaret Cameron that she had already been working on quality assurance work in the lab before Eastern Health learned its hormone receptor tests had problems.

But when Carter wanted to launch a retrospective study of the tests in the summer of 2005, she received no help from the top.

She appealed directly to George Tilley, the chief executive officer of Eastern Health, who was unmoved by her plea.

"You asked for Mr. Tilley's support, and did he say yes, or no or really not answer the question?" asked inquiry co-counsel Bern Coffey.

"Well, he didn't say yes," Carter testified about what she described as "a very stressful meeting."

Carter is a key witness at the inquiry, which has been hearing evidence since March of how hundreds of breast cancer patients received inaccurate lab test results, which may have meant wrong treatment.

The inquiry had already been presented with documentation of how Carter called for a sweeping response to the flawed cancer tests.

She wanted not only a full review of previous test results, but a program to notify patients immediately of errors in the tests, which are used to guide treatment.

The inquiry had already been told, though, that Carter's memo did not travel far up the Eastern Health executive ranks.

Told to work within system, MD says

Carter told the inquiry that Tilley — who resigned last year, amid a controversy over not only the cancer tests but a separate issue involving botched radiology tests — told her to work within the system, even though she was given no meaningful resources, or relief from her existing work burden.

Carter testified that former Eastern Health CEO George Tilley told her to work within the Eastern Health management system. (CBC)

"What he said was this is the way that the management structure is, so you have to work within that structure," Carter said. "So, if I was saying that [the] management structure was not co-operative with me, you know, the answer was, well you have to learn … how to work this out," she testified.

Carter said she discussed the problem with colleagues and decided that her plan for a full retrospective study could not succeed without appropriate resources.

"[I] thought, 'Well, I wasn't getting the support that I needed from the administration in the lab or of the hospital to do this retrospective review ,and that I would resign from that aspect of it and continue to offer my services as a consultant on it, if they wanted my opinion," Carter said.

Eastern Health did not follow much of Carter's advice. Patients learned of the cancer testing issue first in media reports, and there turned out to be myriad problems with patient notification. As recently as this year, a few patients had not been notified at all.

As well, a breast cancer patient database was not launched until after the inquiry was announced last year.

Draft release pointed to equipment change

Carter also told the inquiry of how she reacted when Eastern Health's communications and risk management personnel presented a draft news release, blaming old equipment for the cancer testing problems, at a meeting she attended with senior Eastern Health staff.

"I'm not sure if it was for the government or the press or who it was for," Carter told the inquiry.

The draft release, which was never sent, said Eastern Health "had a problem with the estrogen receptor testing and it was due to the Dako system, and now they had a Ventana system which was much more sensitive and therefore, you know, they knew what the cause of the problem was," said Carter, referring to the machinery used in different phases of the hormone receptor testing program.

"I objected to that statement being released to anybody or even it being true," she testified.

"You, based upon a review you had conducted to that point, knew that that was not accurate," Coffey said.

"Just I know that's not accurate at all," said Carter, who said a "very long and very heated debate" ensued.

The issue of blame relating to equipment failure is a key issue for the inquiry, which has been told that Eastern Health often led others — especially politicians — to believe that machines, not human error, were at the root of the problems.

As early as this year, Premier Danny Williams has cited the change of the equipment as solving the cancer tests.

As well, Eastern Health chair Joan Dawe testified she was led to believe until this winter that equipment was the key reason for the cancer testing problems.

However, external reviews that Eastern Health commissioned in 2005 — and then went to Newfoundland Supreme Court to keep secret — showed clearly that equipment was not responsible. Instead, the reviewers pointed to numberous problems, from poor training, to low standards and high turnover of staff.

In another memo, which has been cited on several occasions at the inquiry before she took the stand Monday afternoon, Carter had referred to those reviews as "fairly damning."

Carter resumes her testimony on Tuesday.