Bad advice: Food safety and biological nonsense from leading Toronto hospital

In 2008, Listeria in Maple Leaf cold-cuts killed 23 Canadians and sickened another 55.

amy.pregnant.listeriaAn outbreak of listeria in cheese in Quebec in fall 2008 led to 38 hospitalizations, of which 13 were pregnant and gave birth prematurely. Two adults died and there were 13 perinatal deaths.

A Sept. 2008 report showed that of the 78 residents of the Canadian province of British Columbia who contracted listeriosis in the past six years, 10 per cent were pregnant women whose infections put them at high risk of miscarriage or stillbirth.

The majority — nearly 60 per cent — of pregnant women diagnosed with listeriosis either miscarry or have stillbirths.

In the April 2010 edition of the journal, Canadian Family Physician, the Motherisk team at the Toronto Hospital for Sick Children published a piece that said, without any references, that “pregnant women need not avoid soft-ripened cheeses or deli meats, so long as they are consumed in moderation and obtained from reputable stores.”


christine_rupert.jpg.size.xxlarge.letterboxFive years later, the hospital has finally decided to take action.

But not because of bogus advice.

The Hospital for Sick Children has permanently discontinued hair drug and alcohol tests at its embattled Motherisk Drug Testing Laboratory after an internal review “further explored and validated” previous, and as yet undisclosed, “questions and concerns.”

The decision, announced earlier this year, comes amid a Toronto Star investigation and mounting pressure from critics to shutter the lab, whose hair drug and alcohol tests have been used in criminal and child protection cases across the country, typically as evidence of parental substance abuse.

In March, Sick Kids temporarily suspended all non-research operations at Motherisk, after Lang’s review and the hospital’s review revealed new information, pending the results of Lang’s review, which are expected by June 30.

Yesterday, parents who had lost custody of their children or were convicted of crimes as a result of the lab’s results, received some vindication.

Now if they could get their kids back.

ITALY-G8-G5-AGRICULTURE-FARMAccording to a Star editorial, a powerful report made public last week by retired judge Susan Lang found the testing program at the Motherisk lab was “inadequate and unreliable.” As a result, the Ontario government is launching an immediate review of all child custody and criminal cases that may have been adversely affected by false results from the lab.

The probe is both overdue and very welcome. In the last 10 years hair samples from more than 16,000 people were requested by child protection agencies and the review found six criminal cases that led to convictions where hair tests from the lab were used. No one knows how many parents may have lost custody of their children or how many may have been convicted of a crime based on faulty lab results.

Still, it didn’t have to take so long to resolve — or indeed occur in the first place.

First, Sick Kids could itself have reviewed procedures at the lab when questions were first raised about the accuracy of Motherisk hair strand testing during an October 2014 court case, which overturned evidence from the lab based on expert testimony that its results were unreliable.

Instead, in the face of an investigative series of articles by the Star’s Rachel Mendleson, the hospital went on the defence.

Then, when it did conduct a “review” it got it wrong. In November of last year, CEO Dr. Michael Apkon and pediatrician-in-chief Dr. Denis Daneman announced that an internal probe of Motherisk’s processes “has reaffirmed that the public can have full confidence in the reliability of Motherisk’s hair testing.”

Thankfully, the public and those who lost custody of their kids or were convicted of a crime based on the lab’s “unreliable” results did not have to depend on these two men’s judgment of the program for justice.

Two days later the Ontario government announced Lang’s independent investigation, which found that the lab’s “flawed hair-testing evidence had serious implications for the fairness of child protection and criminal cases.”

There’s more the hospital could have done to prevent this disaster. As Lang found, the hospital could have headed it off in the first place if it had applied lessons around forensic training and oversight from a 2008 inquiry into the actions of the hospital’s former disgraced pathologist, Dr. Charles Smith.

Smith, who served as head pediatric forensic pathologist at the hospital, made errors in hundreds of autopsies before 2001 that resulted in false convictions of several people for killing small children.

In the end, it isn’t just leadership at the Motherisk lab that is on “trial.” It is the people who run one of the country’s most prestigious hospitals.

Prestigious is an adjective thrown around so people don’t ask questions.

If it’s so prestigious, how did they get the Listeria advice so wrong?


Investigative journalists still required for food safety – even if newspapers disappear

Toronto city councillor Brian Ashton said yesterday,

"I was stunned that the Toronto Star was able to – for the second time – expose a problem that the Board of Health seemed to be unaware of," referring to the newspaper’s "Dirty Dining" series in 2000, which prompted public health to release restaurant inspection records. "The Toronto Star is becoming more like a board of health than the Board of Health."

Food safety stories are increasingly the fodder of investigative journalists, regardless of media. We all eat, so we’re all interested to a point, although not everyone wants to go politico with every bite – sometimes it’s enough to not barf.

The recent Toronto Star series on the filth of soft-serve ice cream machines is an example of media setting the public health agenda.

Toronto Public Health is cracking down on more than 100 ice cream vendors after a Star investigation revealed hazardous levels of bacteria in soft-serve cones across the city.

Consumers can do the same thing – with pictures and video that can readily be captured by most cell phones. Send it to your local health unit.

Otherwise, D-listers like Tori Spelling (above, right, exactly as shown) set the agenda.

Canadian food safety bureaucrats still aren’t that into you

If Canadian cattle or chickens get sick, the public is told all about it.

If Canadian people get sick, not so much.

That’s what I wrote in Dec. 2006 in a piece called, Sorry, bureaucrats just aren’t that into you.

I’ve said the same thing for the past month as the listeria in Canadian cold-cuts outbreak became public. The latest figures show at least 18 dead and 60 confirmed or suspected ill.

The several-week delay in telling Canadians about listeria in Maple Leaf cold-cuts, coupled with the self-congratulatory and exceedingly false statements about the superiority of Canadian disease surveillance is just another episode in the arrogant and dysfunctional father-knows-best approach to providing health advice practiced by various Canadian authorities.

Dr. Phil would say the relationship between officials at the Canadian Food Inspection Agency (CFIA) and the Canadian public is like a couple headed for divorce: they don’t speak unless forced to, and when asked, it’s denial, deceit and deception.

Rob Cribb of the Toronto Star reports today that a major review of Canada’s food recall system three years ago identified serious problems that experts say continue to threaten public safety.

“Spotty inspections across the country, delays in warning the public about tainted food and a lack of follow-up to prevent repeat outbreaks are documented in the government report, obtained through access to information legislation.

The 2005 Canadian Food Inspection Agency (CFIA) review predicts concerns that have emerged from the current Maple Leaf listeria outbreak that has claimed 18 lives.

"There is no clear policy on when a recall requires public warning," the report states.

Timely public disclosure of food risks re-emerged as an issue last month when it took three weeks for officials to warn the public of tainted Maple Leaf meat. …

In the aftermath of the outbreak, public health officials and politicians were quick to reassure Canadians that the country has one of the best food safety systems in the world. But behind the scenes, the review documents a history of serious internal concerns: "Most findings in this report have previously been identified by the various parties involved in food recalls."

The CFIA audit paints a picture of a sometimes-chaotic system where turf wars can impact the public’s need to know about food warnings. …

Doug Powell, a Canadian food safety expert working at Kansas State University, said any warnings officials received from the review appear to have been ignored. "It’s contentment with mediocrity. The bureaucrats don’t seem to care very much. They all talk a good game, but they never think it will happen to them, so they just go on."

I can imagine Dr. Phil asking in his Texas drawl "How’s that working out for ya’ll?"

The most frustrating part is that CFIA is staffed with individuals who are excellent public advocates and spokespeople. On issues relating to mad cow disease or avian influenza, CFIA goes out of its way to communicate with Canadians, perhaps fearing that any crisis of confidence will reduce sales and impact Canadian farms.???

Yet when it comes to the 11 to 13 million foodborne illnesses in Canada each and every year, CFIA has adopted a policy of don’t ask, don’t tell. ???Maybe Dr. Phil can get the public and CFIA into a relationship based on open communication, trust, and respect, but I doubt it. Time to move on.