Dr. Barry Gallagher says pathologists had been told their comments to an external reviewer would be confidential. (CBC)

Pathologists who reported dire problems at Newfoundland and Labrador's largest health authority say that Eastern Health is now using their own complaints against them.

An external review of Eastern Health's labs found distrust between staff and senior management, and what an external reviewer described as a "toxic" and dysfunctional work culture.

Eastern Health, which has been trying to shore up public confidence in its work amid revelations of new testing errors involving the immunosuppressant drug cyclosporine, released the report on Monday, even though it had been commissioned long before the new testing errors came to light.

Among other things, the report said some staff at the pathology lab are intimidating, and that there are constant conflicts.

Last Friday, Health Minister Jerome Kennedy admonished the pathologists for what he called "childish" behaviour.

Dr. Barry Gallagher, president of the Newfoundland and Labrador Association of Pathologists, said pathologists at Eastern Health were astonished that the report was made public.

Eastern Health CEO Vickie Kaminski says she wants to restore public confidence in the authority. (CBC)

"They feel betrayed by Eastern Health, that this has happened," Gallagher told CBC News.

"They were told it was going to be a confidential report."

Gallagher said the association's members took part in the report, prepared by the Toronto-based Institute of Quality Management in Healthcare, because they were assured they could speak candidly. Gallagher said pathologists welcomed the opportunity to help improve the working environment.

"We could understand if there were matters of serious patient care in there," Gallagher said.

"But when it's an issue of what pathologists think of each other, and that sort of thing — things that can go on in every office and every institution where people are unhappy with each other — that release can be counterproductive."

The report was released just days after Eastern Health forced out Dr. Nash Denic as laboratory chief, for not having informed chief executive officer Vickie Kaminski promptly enough for errors involving cyclosporine.

That action led three pathologists to resign from supervisory roles within the authority.

'Other options'

As well, Dr. Jim Hutchinson — an internationally recognized expert in infection control — resigned from a supervisory role on Monday, citing a lack of support for Eastern Health's senior management team. Hutchinson, though, is not commenting on his decision.

Kaminski told reporters Monday that she hopes problems within the lab can be settled soon, but also said pathologists do not have to stay at their present jobs.

"We can only hope they get past it, and if they can't, then they have to decide what they want to do," she said. "They have other options."

Speaking with CBC News on Tuesday, Kaminski said she released the report because the authority expected that sooner or later, it would have been released under access to information legislation.

Eastern Health has been under intense public scrutiny for almost three years. The Newfoundland and Labrador government called a judicial inquiry into breast cancer testing errors in 2007, amid revelations that the authority had known its error rate was several times higher than it had indicated publicly.

Justice Margaret Cameron's subsequent inquiry found numerous problems at the authority, from poor training and inadequate equipment to serious problems with managerial oversight.

The newly released external review points to ongoing problems for pathologists. Kaminski said that she had not been aware that some pathologists, even though they earn high salaries, type their own notes because there is insufficient support staff.