Private MRI clinic told B.C.

man he was fine

before his serious stroke
Case raises serious questions about delays, conflicts and mistakes in publicprivate health care
By Kathy Tomlinson, CBC News Posted: May 18, 2015 2:00 AM PT Last Updated: May 19, 2015 11:43 AM
PT

Play Media

MRI clinic told man he was fine before his stroke 2:32
Stroke victim Peter Peczek believes mistakes and delays in the "failing" health-care system wrecked his life.
"I felt I was just pushed over. Next your 15 minutes is up," said Peczek. "I just needed somebody to take
me seriously."
The B.C. man said he couldn't get in to see a neurologist or get an MRI at a hospital. Then, a private MRI
clinic failed to detect his life-threatening condition.

Following his stroke, Peczek spent several months learning how to walk again. (Peczek family)
Soon afterward, he had a serious stroke that put him in the intensive care unit.
"They basically gave me three days to live. I wasn't breathing on my own," said Peczek, who can no longer
drive or support his family since getting out of hospital last year.
"I cannot walk my balance is very poor I am alive by the grace of God."
Doctors familiar with his case told Go Public that if his MRI had been read accurately, or if he'd been
assessed by a neurologist, his stroke might have been averted with medication.

Opportunity missed
"An opportunity for stroke prevention was missed, and a stroke that might have been prevented turned out
to be quite bad," said Ontario neurologist Bryan Young, who reviewed the case.
"I feel very badly about what happened to him," said Pezcek's family doctor Roger Crittenden.
"The lesson to be learned is to look at the facts around a case, look at the history and examine all the pieces
of the puzzle."

Neurologist Dr. Bryan Young reviewed the case and told Go Public that if the MRI had been read
accurately, the stroke might have been prevented. (CBC)
Peczek's suffering has also raised broader concerns over mixing public and private-for-pay health care
including possible conflicts of interest and errors by physicians who spread themselves too thin.
"If they work for both systems, then they are simply overworked and overwhelmed maybe," said Peczek,
50.
The radiologist who read Peczek's MRI for the private clinic also works in a public hospital.

"Moonlighting can be dangerous, especially with something as detail oriented as reviewing scans," said Dr.
Ryan Meili, a general practitioner and public health-care advocate.

Numerous 'frustrating' doctor visits

Before his stroke, Peczek suffered escalating dizzy spells. He said some were so severe he vomited.

Peczek said the emergency room physician told him he couldn't have an MRI done right away in the
public hospital. (CBC)
He went to his doctor and the emergency room at Kelowna General numerous times. He said he was told
he might just have migraines or an inner ear problem.
"Everybody was just shrugging their shoulders it was very frustrating," said Peczek.
He was on a wait list to see a neurologist when he went to the ER one last time. He said the attending
doctor told him he couldn't refer him for an MRI in the hospital, as only the neurologist could do that.

Dr. Casey McMillan, a radiologist, concluded there were 'no significant findings' on Peczek's MRI from
Image One, a private clinic. (South Okanagan Similkameen Medical Foundation)
He referred Peczek for a scan at the private local MRI clinic instead.
"Which I find quite comical," said Peczek. "Canada and the free health-care system and the doctor
that is providing that free health care tells me to go to the private MRI."
Peczek paid $1,300 at Image One in Kelowna. Radiologist Casey McMillan interpreted the scan on behalf of
the clinic and concluded there were "no significant findings."
Peczek's stroke the following month was caused by a dissection in a neck artery, which doctors later said
was evident in the earlier MRI.

Mistake 'clearly made'

"A mistake was clearly made I definitely don't want that to happen to somebody else," said Peczek.
The owner of Image One MRI sent a statement saying the clinic is accredited and "strives to achieve the
highest level of professional excellence."

"It would not be appropriate for Image One MRI to comment on any matters involving identifiable individuals
who may have received services," said owner Mike Large.
The radiologist involved didn't reply to numerous messages asking for comment.
To add insult to injury, Peczek said, after his stroke the neurologist's office called to say he finally had an
appointment.

Public health-care advocate Dr. Ryan Meili said moonlighting in the private system can leave doctors
stretched too thin and increase the risk of mistakes. (CBC)
"I said, 'You're a little bit too late I had my stroke already.'"
Dr. Young said a specialist should have been brought in much earlier. "Ordering the scan by itself, without
neurological input, is not good enough," he said.
National figures show patients wait as long as 80 days for MRIs in the public system.
However, in this case, B.C.'s health minister suggests contrary to what happened that the ER
physician could have sent Peczek for an MRI in the hospital immediately.

Public MRI available: minister

"If someone needs an emergency MRI and the ER physician feels that is necessary, there are no waits,"
said Terry Lake. "It is not the case that a neurologist has to refer to an MRI."
Go Public discovered that several doctors who work in or manage public hospital systems also own or work
for private MRI clinics in B.C.
"You add an element of conflict of interest," said Meili. "You can wait or go around the corner, pay me a
bit of money straight up and we'll see you right away."

Health Minister Terry Lake said that emergency room physicians can order an MRI immediately if they
deem it necessary. (CBC)
He worries patients like Peczek are sent for private testing as a quick fix, when they really need more
attentive care.
"We over-order a lot of tests and we do that out of medical, legal reflex. Sometimes because we are too
busy."
Peczek consulted a lawyer about suing. He was told it would be too difficult to prove with certainty his stroke
wouldn't have happened regardless.

"People like me and my family, we have to suffer nobody cares," he said.