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[This edited version of the report has been prepared by Dr Robert N Moles]

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24 August 2007 Rob Tripp Whig Standard “Pathologists working overtime”

He said that Ottawa staffing woes force Kingston doctors to perform more autopsies. Problems with forensic pathology services in Ottawa have put pressure on Kingston's two forensic pathologists. In the past eight months, the Kingston doctors have conducted roughly a dozen extra autopsies in criminally suspicious or homicide cases. "There are some potential problems, there's no question about this," said Dr David Dexter, director of the regional forensic pathology unit at Kingston General Hospital and one of the two pathologists who inherited extra work. Dr Iain Young, head of pathology at Queen's University, is the other doctor who conducts forensic autopsies.

These are cases in which bodies and tissues are examined as part of an investigation that may have legal implications. The cases, which sometimes lead to murder trials or other court proceedings, can be very complex. "When you're dealing with a case that is already recognized as a suspicious death or a homicide, those cases do take a lot of time, there's no question about that and you have to be very meticulous," Dexter said. The forensic pathology unit in Kingston is one of five across Ontario that examine bodies under the provincial coroner's system.

The unit based at the Ottawa Hospital has stopped doing forensic work. "There have been a series of staffing issues in the Ottawa unit and we felt that the most appropriate thing to do was to move temporarily, and I emphasize temporarily, the autopsies for criminally suspicious or homicide cases to two other units," said Dr Andrew McCallum, regional supervising coroner for eastern Ontario. Cases also have been moved to Toronto.

An Ottawa pathologist has been criticized recently over the handling of a murder case in which a bar manager was wrongly accused of killing his wife. The pathologist concluded the victim was strangled. Two other pathologists concluded she drowned after falling into a swimming pool. Charges against the man were dropped. "There's no single case or single pathologist that this is related to," McCallum said. "It's a situation with the unit as a whole and it has to do with a variety of things that I can't get into."

McCallum said ongoing recruitment of new pathologists in Ottawa should resolve the issue within the next 12 months. In the meantime, Kingston doctors will continue to examine Ottawa murder victims. It has not caused a workload problem, said Young, Kingston 's other forensic pathologist. "It's not that we aren't working close to full capacity, but it's just that when you have these fairly small workload demands, that we can adjust and manage it because we view ourselves as part of a network of these five centres," said Young.

If the Ottawa cases being handled in Kingston lead to trials, the Kingston doctors will have to make trips to Ottawa to confer with lawyers and present evidence at hearings and trials. Those commitments could bring future workload pressures. "It is something that we're aware of and we recognize that we're going to have to manage this carefully and it's something that we're going to monitor as we go on," Young said.

Dexter said the Kingston unit has conducted between 310 and 320 autopsies each year in the past four or five years. Roughly 200 of them are medical-legal autopsies. "That's everything from somebody dropping dead of a heart attack to a car accident," he said. Cases that are not criminally suspicious can be conducted by other pathologists without forensic expertise. But the unit is typically conducting about 20 forensic autopsies yearly that have legal implications, including homicides and cases that lead to inquests, such as deaths in prisons. Ottawa's problems come at a time when public confidence in forensic pathology in the province has been undermined. A provincial commission of inquiry will begin hearings this fall into two decades of work by Dr Charles Smith. An investigation by the Office of the Chief Coroner found that Smith, once considered a leading expert in forensic pediatric pathology, made errors in 20 out of 45 cases that were reviewed. At least a dozen or more people may have been wrongly convicted of crimes they did not commit because of Smith's errors.

McCallum said the decision to move forensic autopsies out of Ottawa demonstrates that the coroner's system has checks and balances in place to ensure changes are made when needed. "We need to ensure that the criminal justice system has the benefit of the most appropriate evidence and that's what we're doing by this temporary change," McCallum said.

Source: 24 August 2007 Rob Tripp Whig Standard “Pathologists working overtime”

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