Undoubtedly, there are first-rate health practitioners and facilities available in Ontario. But access to exceptional doctors and hospitals does not guarantee that you’ll receive exceptional health care. Harmful medical errors, or “adverse events,” occur in an estimated 7.5% of hospital admissions across the country.[1]
When health care goes wrong, what literally adds insult to injury is the secrecy surrounding these mistakes. Consider the numerous instances where medical errors leading to disability or even fatality were not adequately disclosed. “Oral cautions” given by the College of Physicians and Surgeons of Ontario (CPSO) to doctors, warning them to deal with serious issues such as errors in prescribing medication, did not appear on the Public Register until 2015. Hepatitis C outbreaks at three Toronto colonoscopy clinics between 2011 and 2013 were initially kept out of the public eye.[2]
As well, the Quality of Care Information Protection Act (QCIPA), which was meant to encourage medical professionals to share information about critical incidents and health care quality improvement,[3] has been used by some hospitals to bury medical errors.[4]
Secrecy surrounding medical errors has been pervasive and has on occasion resulted in concealment of alleged negligent misconduct.[5] The Ontario Superior Court of Justice recognized that cover-ups occur when Justice Lederman applied the doctrine of fraudulent misrepresentation to toll the limitation period in Giroux Estate v. Trillium Health Centre [2004] O.J. No. 557, affirmed by the Court of Appeal. Justice Lederman commented at paragraph 40 that “The course of Dr. Harvey’s conduct, beginning with lies, and leading ultimately to the falsification of evidence, was done for the purpose of hiding his alleged negligence and also for the purpose of creating doubt in the plaintiffs’ minds about the wisdom of bringing a claim.”
Resistance to the secrecy surrounding medical errors has recently emerged, notably within those institutions that themselves rely on “privacy.” The Ontario Hospital Association has stated it wants hospitals to know about all complaints against doctors and nurses,[6] Ontario Health Minister Eric Hoskins pushed for better disclosure regarding public health inspections and outbreaks,[7] and the backlash to the QCIPA’s effects was palpable.[8]
Steps have been taken in some areas to reduce the secrecy. The CPSO launched a transparency project that culminated in the broadening of the scope of publicly available information on doctors, including the addition of oral cautions to the Public Register.[9] There was a review of the QCIPA that led to proposals for change[10] that were debated in the legislature on March 3, 2016.
What remains to be seen is if these piecemeal policy shifts will lead to cultural ones. Regulatory reform will only go so far. That was the problem with the QCIPA in the first place; the explicit intention was to enable discussion that would improve care and avoid repetition of mistakes, not leave families wondering why their child died. We may be nominally travelling towards transparency, but as we well know, implementation and interpretation are everything. Are we moving towards a brave new world of disclosure, or will we learn, yet again, that old habits die hard?
For additional information on Medical Errors, read these blogs:
- A Patient's Right to Know About Medical Errors and the Lack of Transparency
- The Frightening Reality of Medical Errors
- Causes of Medical Errors in Canada
Bogoroch & Associates LLP has extensive experience in medical malpractice litigation. Bogoroch & Associates LLP strongly believes that victims of medical malpractice are entitled to access to justice. Please contact Richard Bogoroch (rbogoroch@bogoroch.com) or Heidi Brown (hbrown@bogoroch.com) for further information on how we can assist you or your family member.
[1] G. Ross Baker et al, The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada, CMAJ May 25, 2004 vol. 170 no. 11 doi: 10.1503/cmaj.1040498
[2] Theresa Boyle, Hepatitis C outbreaks at three Toronto colonoscopy clinics kept secret, Toronto Star website, Sept. 27, 2014
[3] Ontario Ministry of Health and Long-Term Care, Quality of Care Information Protection Act, 2004
[4] Olivia Carville, Hospitals still use flawed secrecy law to review medical errors, Toronto Star website, May 29, 2015
[5] Tom Blackwell, Inside Canada’s secret world of medical error: ‘There is a lot of lying, there’s a lot of cover-up’, National Post website, Jan. 16, 2015
[6] Theresa Boyle, Hospitals want to know about all complaints against MDs, nurses, Toronto Star website, July 29, 2014
[7] Theresa Boyle, Ontario health minister orders data on clinics made public, Toronto Star website, Oct. 5, 2014
[8] CTVNews.ca staff, Family seeks answers in woman’s death after she visited dental clinic, CTV News website, Nov. 21, 2014
[9] College of Physicians and Surgeons of Ontario, Transparency of Physician-Specific Information
[10] Olivia Carville, New health legislation will improve transparency, Toronto Star website, Sept 19, 2015