TORONTO - An Ontario pathologist under scrutiny at a public inquiry seemed to lack even "basic training" in forensic pathology -- a discipline in which he toiled for years, an international panel of experts concluded in a scathing review of Dr. Charles Smith's controversial autopsies.

Gaps in elementary knowledge led Dr. Smith to make a litany of errors, the experts are quoted as saying in minutes of a 2006 meeting.

He too readily diagnosed suffocation as a cause of death, failed to properly identify injuries and mistook changes that happened after death as injuries, the experts said at the meeting. Dr. Smith's diagnosis of head trauma based on brain weight was "untenable and outside the mainstream of forensic pathology," they added.

The group also dismissed testimony in court of Ontario's head of pediatric forensic pathology as frequently unbalanced, misleading and "emotive."

"The panel indicated that Dr. Smith did not appear to have basic training in forensic pathology," said the minutes of a December, 2006, meeting involving three of the international experts.

"The panel indicated that Dr. Smith's testimony had a tendency to become unbalanced. This, combined with a lack of knowledge in forensic pathology, sometimes resulted in unreasonable testimony."

Relatively few details of his errors have been revealed publicly before now. The minutes were introduced at the inquiry.

In another, 2007 memo, however, Dr. Michael Pollanen, Ontario's chief forensic pathologist, suggests it would be unfair and misleading to single out Dr. Smith for public criticism, when others involved in the death investigations likely made mistakes, too.

In fact, a later review by the chief coroner's office found serious problems with the role of the coroners -- the officials who oversee such investigations --in several of his cases.

The inquiry was prompted by the expert panel's findings about 45 post-mortems done by Dr. Smith in deaths where there were suspicions of criminal behaviour. The panel found significant mistakes in 20 of the cases.

Some parents and others charged with homicide offences have since been cleared.

The panel consisted of three pathologists from Great Britain, one from Finland and one from Alberta.

They met to discuss their findings and reach a consensus at two "reconciliation" meetings late last year in Toronto, each involving three of the specialists.

The minutes of the sessions were raised at the inquiry.

The experts were particularly blunt about Dr. Smith's work in the case of three-year-old Tyrell. The pathologist said the boy's serious brain injury was caused by a blunt-force impact to his head.

"All agreed that the opinion given by Dr. Smith as to the mechanism of injury, by any reasonable standard, is grossly erroneous," the experts are quoted as saying.

Tyrell's caregiver was charged with murder, but the charges were later withdrawn.

In the case of baby Taylor, who died in 1996 at three months, the panel said the autopsy findings were misinterpreted by Dr. Smith and the cause of death should have been listed as "unascertained."

He had said the cause was head injury, and the parents were charged with second-degree murder, though a judge later threw out the case.

His conclusions in other, individual cases, the experts said, were "largely unreliable," unbalanced or "not supported by any evidence."

In a later memo on the review, Dr. Pollanen noted that a decision was made in 1991 to appoint a pediatric pathologist -- Dr. Smith -- and not a forensic pathologist to be the first head of the pediatric forensic pathology unit, based at Toronto's Hospital for Sick Children.

Forensic pathologists are specifically versed in identifying or ruling out evidence of crime.

"In retrospect, his lack of expertise in forensic pathology was destined to become problematic," the official said.

Although Dr. Pollanen helped set up the outside review of Dr. Smith, he said in the memo it was probably too narrowly focused and likely misleading.

"It would seem to be inequitable to publicly disclose shortcomings of Dr. Smith without recognition that he worked in the coroner system of death investigation that has not been subjected to the same level of scrutiny," he wrote.

"It seems that one individual has been publicly recognized as requiring review. I am not sure that view is now sustainable."

Dr. Barry McLellan, the province's chief coroner until recently, assigned two of his staff to review the work of coroners in the Smith cases. They ended up reporting significant concerns about the coroners' actions in 15 cases.

In other testimony, Dr. McLellan revealed that a previously announced review of 13 autopsies done by Dr. Smith where child abuse was suspected between 1981 and 1991 had looked at two cases so far.