Nfld. & Labrador

Eastern Health spending millions to send lab tests out of province

Newfoundland and Labrador's largest health authority is still spending millions to send lab work out of the country — including estrogen/progesterone receptor tests that were the focus of a judicial inquiry in 2007 — CBC News has learned.

ER/PR tests that were focus of the Cameron Inquiry still going to U.S.

Eastern Health says its been sending some laboratory work to the U.S. since early 2014. 0:34

Newfoundland and Labrador's largest health authority is still spending millions to send medical tests out of the country — including estrogen/progesterone receptor tests that were the focus of a judicial inquiry in 2007 — CBC News has learned.

"ER/PR and HER2 tests are performed at Vitro Molecular Laboratories, located in Miami, Florida. Eastern Health has been using this laboratory since early 2014," says a statement from the health authority.

"We recognize that it is not ideal to send these tests out of the country due to the impact of the current American exchange rate."

Eastern Health says its been sending some laboratory work to the U.S. since early 2014. (CBC)

A CBC News access to information request found that from Jan. 1, 2015 to Dec. 31, 2015, Eastern Health spent $2.5-million dollars on laboratory work and tests done outside of the province.

Almost two-thirds of that — $1.6-million — was spent in the U.S.

Nearly $350,000 was due to the U.S./Canadian dollar exchange rate.

Eastern Health says many medical tests, not just breast cancer tests are sent to labs in the United States.

"The $1.6 million spent for referral testing in the US is encompassing of all laboratory testing – not just breast cancer testing - and would include tests such as genetic testing, specialized pathology testing and biochemistry testing which are referred to accredited labs throughout the US, as needed," says Eastern Health.  

We recognize that it is not ideal to send these tests out of the country due to the current American exchange rate.- Eastern Health

Problems with inaccurate ER/PR tests caused a scandal in 2005 and triggered a judicial inquiry.

The tests help determine if a patient diagnosed with breast cancer might benefit from a powerful, but potentially toxic therapy, such as Tamoxifen

Justice Margaret Cameron's 2009 report flagged a series of laboratory mistakes and managerial oversight problems.

Eastern Health plans to do all its own breast cancer laboratory work at its own facilities by the end of 2016. (CBC)

Eastern Health sent its ER/PR tests out of the province for several years until it said quality issues were resolved in 2011.

Even though the health authority said it can now do those tests at its own laboratory, it can't do two other tests also used to determine treatment for breast cancer.

"While Eastern Health has the ability to perform ER/PR tests, the implementation of [other tests] which helps determine if a cancer is positive or negative, will not occur until later this year."

 Eastern Health says doctors want all three tests, including ER/PR tests, done at the same laboratory.

"It is the preference of clinicians to have these three tests performed on all breast specimens at the same laboratory and therefore Eastern Health continues to use Vitro Molecular Laboratories [in Miami]," says Eastern Health's statement.

Justice Margaret Cameron, who heard testimony between March and October 2008, found that every level of the health-care system failed patients. (CBC)

Eastern Health said it chose the U.S. lab because of its accuracy, as well as its ability to provide results within several days compared to several weeks with Canadian labs.

The health authority expects to be doing all three breast cancer tests internally by the end of 2016.