FREDERICTON - A confidential report that triggered the suspension of a senior New Brunswick pathologist says health problems could have affected the quality and reliability of his work.

A 2007 peer review of Dr. Rajgopal Menon, released Thursday by the New Brunswick Court of Queen's Bench, states that Menon, 73, had vision difficulties, a significant tremor in his hands and cognitive issues that may have contributed to missed and mistaken diagnoses in his laboratory work.

As well, the review discovered that Menon had removed over 500 Pap smear slides from the Miramichi, N.B., laboratory where he was employed, possibly in connection with his efforts to invent a medical scanner he was developing and marketing overseas.

"The suspicion exists that these slides were used for personal entrepreneurial purposes," the review states, adding that Menon eventually returned most of the missing material.

New Brunswick is currently reviewing about 24,000 of Menon's cases after an audit earlier this year showed a significant number of errors in his work, especially in cancer tests.

The re-examination involves cases Menon handled between 1995 and February 2007, mostly in Miramichi.

Government officials say it's possible the missed and mistaken diagnoses have caused deaths.

A public inquiry is now underway into pathology services in Miramichi and the RCMP has been asked to investigate.

It is the latest case of questionable laboratory work in Atlantic Canada to shake public confidence in Canada's health-care system.

A public inquiry is also underway in Newfoundland and Labrador, where people have heard heart-wrenching stories about suffering caused by flawed medical tests, mostly for breast cancer.

Menon has said little publicly about the controversy surrounding his work.

However, he disputed the peer review in court documents, insisting he was "not interviewed, invited to participate, or given an opportunity to make any presentation with respect to the findings in the report."

He said the findings are "unjustified and unfair."

Justice William Grant of Court of Queen's Bench ordered a publication ban on the review last year at the request of Menon, who had been suspended by the New Brunswick College of Physicians and Surgeons.

The college subsequently asked the court to lift the ban so it could turn over the review to the Miramichi Health Authority. Lawyers for the New Brunswick Telegraph-Journal newspaper and the CBC also argued for the report's release.

The court agreed to lift the publication ban last month, but it gave Menon 30 days to appeal. No appeal was filed.

The review, conducted by Dr. Rosemary Henderson of the Queen Elizabeth Hospital in Charlottetown and Dr. Bruce Wright of the South Shore Regional Hospital in Bridgewater, N.S., is damning to Menon professionally.

It concluded that the pathologist "failed to meet the current standards of surgical pathology" because of inaccuracies and incompleteness in his work and serious delays in performing his duties.

The review noted that Menon's hands shook so much he was unable to trim and submit tissue samples properly.

As well, his failing vision - he had cataract surgery in 2006 - meant he had to get closer and closer to specimens he was examining but still could not see everything clearly.

The review also found that Menon had difficulty responding to verbal and written information and with interpreting slides. It suggested his age may be a factor.

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