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The Quality Assurance CommitteeThe events in the Pediatric Cardiac Surgery program in 1994 were never discussed or reviewed by the HSC's Quality Assurance Committee, which is a committee of the HSC's Board of Directors. Thorfinnson testified that this was because the matter was not brought to the Committee's attention. He indicated that he believed that it should have been brought to the Committee. However, he also stated that he believed the Committee would have allowed the Department Heads to deal with the issue.
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| Current | Home - Table of Contents - Chapter 9 - The Quality Assurance Committee |
| Next | Delays in the autopsy reports |
| Previous | The parents |
| Section 1 | Chapter 1 - Introduction to the Issues |
| Chapter 2 - Pediatric Cardiac Issues | |
| Chapter 3 - The Diagnosis of Pediatric Heart Defects and their Surgical Treatment | |
| Chapter 4 - The Health Sciences Centre | |
| Section 2 | Chapter 5 - Pediatric Cardiac Surgery in Winnipeg 1950-1993 |
| Chapter 6 - The Restart of Pediatric Cardiac Surgery in 1994 January 1, 1994 to May 17, 1994 |
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| Chapter 7 - The Slowdown May 17 to September 1994 |
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| Chapter 8 - Events Leading to the Suspension of the Program September 7, 1994 to December 23, 1994 |
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| Chapter 9 - 1995 - The Aftermath of the Shutdown January to March, 1995 |
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| Section 3 | Chapter 10 - Findings and Recommendations |
| Appendix 1 - Glossary of terms used in this report | |
| Appendix 2 - Parties to the Proceedings and counsel | |
| Appendix 3 - List of witnesses and dates of testimony | |
| Diagrams | |
| Tables | |