Four Montreal hospitals are coming to the aid of the Lakeshore General as it carries out its recall of 684 patients who must have their colonoscopies redone following the discovery that a general surgeon had botched the exams for the last three years.
But the four hospitals — the Montreal General, Royal Victoria, St. Mary’s and the Jewish General — are already grappling with lengthy waits of their own for the diagnostic procedure.
The recall at the Lakeshore highlights the fragility of the public system of colonoscopies to screen for colorectal cancer, experts warn. It also raises questions about the capacity of the system should the Quebec government move ahead with plans to make colonoscopy screening a province-wide program similar to mammography.
For the next six Saturdays, two gastroenterologists as well as other staff at the McGill University Health Centre — which oversees the Royal Vic and the Montreal General — will be working overtime to complete up to 150 colonoscopies.
“Obviously, our resources are maxed-out completely, but we are happy to be helping out our sister institution,” said Ian Popple, a spokesperson for the MUHC. “Our mission is to deal with complex, tertiary-care cases, but we realize that these poor patients need to be seen as soon as possible.”
Similar agreements have been worked out with the Jewish General and St. Mary’s.
“This won’t affect wait times at all,” said Sandrine Charpentier, a public-relations official with the Lakeshore. “The other hospitals have agreed to increase their volume of colonoscopies for the recall.
“People are calling our hospital first and we are arranging appointments for them at the other hospitals,” she added.
Before the recall, some “low-risk” patients at the Lakeshore were waiting as long as two years for a colonoscopy, said Geraldine Matthews, nursing coordinator of specialized units at the Pointe-Claire hospital.
By comparison, some patients at the Jewish General have been given colonoscopy appointments four years from now.
In February, former health minister Yves Bolduc ordered the Royal Vic to overturn its decision to bar new patients from colonoscopies after The Gazette reported on a memo about the ban.
In May, the chief of gastroenterology at the MUHC told The Gazette that his health network might not be able to meet national medical guidelines in providing average-risk patients with a colonoscopy in a timely fashion because of a lack of resources as well as surging demand. At present, the average wait time for a colonoscopy at the MUHC is under a year for average-risk patients, which is considered medically acceptable.
The Lakeshore announced the recall on Sept. 12, with a top gastroenterologist suggesting that at least a dozen patients had probably been given falsely negative results — that is, they were told they had the all-clear when, in fact, they did have colon cancer.
One of those patients, a 70-year-old Pierrefonds man, is the lead plaintiff in a class-action lawsuit that is being prepared against the Lakeshore. The man is now undergoing chemotherapy at the Jewish General after an operation to remove cancerous tissue from his colon in June.
The recall covers colonoscopies that were performed by Dr. Gilles Bourdon from 2009 to 2012. In June, Bourdon reached an agreement with the Quebec College of Physicians to no longer perform colonoscopies or surgery in hospital pending an investigation into his conduct.
The Lakeshore discovered the incomplete scoping during a routine quality-control review in April, and waited five months to disclose the problem to the public. Lakeshore officials have defended that wait as necessary in order to carry out an investigation into Bourdon’s colonoscopies, inform the College of Physicians and put in place the resources to deal with the recall.
Lakeshore officials have declined to give figures on the cost of the recall, but it could easily run into the hundreds of thousands of dollars once overtime expenses are included. The health department has decided to cover the costs.
Barry D. Stein, president of the Colorectal Cancer Association of Canada, said his organization continues to receive calls from people who face lengthy waits for a colonoscopy.
He urged the government to allocate more resources for colonoscopies, noting that Ontario invested an additional $10 million “to build up capacity in the hospitals” before making colonoscopies a province-wide program.
Doctors say that colonoscopies have been clinically demonstrated to prevent colorectal cancer — the second leading cause of cancer death in Canada after malignancies of the lung — since pre-cancerous polyps can be snared upon detection.