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By Tony Poland, LegalMatters Staff • The class-actions and mass torts team at Gluckstein Lawyers is representing 12 female cervical cancer patients suing Juravinski Cancer Centre (JCC), Hamilton Health Sciences (HHS) over an equipment error which resulted in erroneously targeted cervical cancer radiation treatment.
“It is a sad case,” says senior counsel James Newland, who along with Brian Moher, represents this group of patients. “The hospital investigated the equipment error when it was first discovered, learned that there were 25 patients affected, and then called each patient in for a meeting to disclose the treatment error.
“Cancer touches us all. We all have our own personal experiences with people who have dealt with cancer and how devastating it can be. In this instance, these patients believed they had been treated properly only to learn later about the treatment error,” he tells LegalMattersCanada.ca. “To state the obvious, it has been a very traumatic experience for them to learn of the error and that their treatment may not have been successful.”
Cervical cancer treatment regimen is often threefold
Newland explains that the cervical cancer treatment regimen is often threefold. First, there is external radiation to the pelvic area, combined with chemotherapy, and then followed by further radiation called brachytherapy.
“The brachytherapy is delivered internally, targeting the tumour. Because you can specifically target the radiation at the tumour, higher amounts of radiation are delivered and the treatment has a far better impact. It kills the tumour and doesn’t allow the cancer cells to replicate,” he says. “Brachytherapy is an extremely useful and important adjunct to the other two treatment methods. The three therapies used in combination deliver a very high cure rate.”
However, in this case, Newland says it was later learned the radiation connector tube used in the brachytherapy treatment was about five centimetres too long.
“Rather than targeting the radiation on the tumour, it was delivered elsewhere. This impacted the patients in two ways. First, the tumour is not getting the necessary radiation treatment,” he says. “And because the dose of radiation is very strong, healthy tissue and organs away from the tumour were severely damaged. Some women have been left with severe radiation burns, damaged organs and tissue, and bladder and bowel incontinence.”
Patients forced to find treatment in other locations
The hospital suspended the treatment after learning the incorrect tube was used in 2017 and 2018, Newland says, forcing patients in the catchment area to seek help in other regions.
According to a Hamilton Spectator report, the team responsible for brachytherapy was investigating another equipment issue when they discovered the problem with the guide tube. The hospital then met with the patients who were affected.
“We have apologized to them and their families,” Dr. Ralph Meyer, HHS vice-president of oncology and palliative care and regional vice-president of Cancer Care Ontario, told the Spectator. “We deeply regret that this occurred. Everyone at the JCC is committed to providing treatment that is effective and safe. We will evaluate our processes thoroughly and remedy any gaps in our care.”
Newland says while the case involves an equipment error, it is not a manufacturing error.
“There was nothing wrong with the equipment itself,” he says. “The tubes are interchangeable and it appears the wrong length of tube was used. It was a user error.”
One of the patients involved told the Spectator that she was surprised that the problem could have gone unnoticed.
‘They’re watching everything on the screen’
“Everything was always done with precision and computer and they’re watching everything on the screen. It seems weird to me,” she told the newspaper.
Newland notes the hospital did the right thing by contacting the patients and suspending the treatment while investigating the issue. Unfortunately, there have been recurrences in some of the patients affected, he says. Aside from the physical injury due to mistargeted radiation treatment, and the increased risk of cancer recurrence, Newland says the potential psychological fallout cannot be underestimated.
“When anyone gets a cancer diagnosis it can be overwhelming, even for the most emotionally robust people. It is a heavy load to deal with,” Newland says. “But imagine how it would feel to be told that the treatment you believed had cured your cervical cancer was been subject to an error, and the success of your treatment was now in doubt? It would be quite natural for people to be crushed by this very traumatizing information.”
Newland says it shouldn’t be surprising that many of those patients would lose faith in cancer care and be apprehensive about receiving further treatment.
“These women were dealing with a cancer diagnosis, which is daunting in and of itself,” Newland says. “For most of these patients, this treatment was expected to result in a positive outcome. You have a reasonable shot at returning to health and then you are told, ‘Sorry, there has been an error in treatment that may have significantly affected your care.’”
The actions are pending and the merits of the case have not been proven in court.
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