Hi everyone, Mark Iype in Edmonton today.
When the Alberta government decided to spend $75-million to purchase children’s medication from a Turkish manufacturer last winter after a major shortage of both acetaminophen and ibuprofen in Canada left parents and hospitals in need, eyebrows were definitely raised about the plan.
But an outbreak of respiratory illnesses had left pharmacy shelves bare leaving parents desperate to find relief for their sick kids while hospitals overflowed with the most serious cases. If executed properly, Alberta could swoop in and help solve what was a very real crisis.
Unfortunately, things didn’t work out that way.
According to documents obtained by The Globe and Mail’s Alanna Smith, it appears one of the reasons the Turkish medication was abandoned by hospitals was because the way it needed to be administered to neonatal patients put them at higher risk of a fatal complication known as necrotizing enterocolitis.
The documents show that the imported medication, which is thicker than products typically used by Alberta Health Services, clogged feeding tubes used to deliver the medicine to neonatal patients. The tubes then had to be flushed with water.
The higher volume of liquid and medication then increased the risk of necrotizing enterocolitis, which inflames the intestines of infants. AHS ordered staff to stop using the product in neonatal intensive-care units in May, approximately two months before it was pulled from all uses at Alberta hospitals.
“Neonatal patients with very low body weight have fragile and incompletely developed intestines, which cannot accommodate large boluses of fluid administration for medications,” said Isaac Van Dyne, an executive associate with AHS, to Nicole Williams, the Health Minister’s chief of staff, in an Oct. 23 e-mail in response to questions asked during a weekly call that included Health Minister Adriana LaGrange.
“The volume/osmolality issues from the Atabay acetaminophen was determined to possibly increase the risk of Necrotizing Enterocolitis (a potentially fatal injury to the intestines) in these tiny patients.”
AHS spokesperson Kerry Williamson says no patients developed the potentially fatal condition or were injured, although there were also reports of children “gagging and refusing to take the medication.”
The Alberta government declined to comment on the report.
Alberta Premier Danielle Smith announced in December, 2022, that the province had procured five million bottles of children’s acetaminophen and ibuprofen. But as The Globe previously reported, of the 1.5 million bottles actually shipped, just 13,700 were ever distributed to hospitals or pharmacies and the province is unlikely to ever receive the outstanding 3.5 million units, despite paying tens of millions upfront.
The Premier has repeatedly defended the deal, saying the province will be prepared should there ever be another shortage in children’s fever-reducing medications.
Alberta’s stock of Atabay ibuprofen will expire in November, 2025, and acetaminophen in January, 2026.
The provincial government has said it is working with the Turkish manufacturer to “explore options” to fulfill the remainder of the contract. In the same e-mail from Van Dyne to Williams, he said AHS is hoping to fulfill the remainder of the contract – equivalent to $49.4-million – through the purchase of intravenous, or IV, acetaminophen.
“Our understanding is that Atabay is in the process of requesting approval from Health Canada but the process could take 6-12 months so we have not received any of the substitute product yet,” Van Dyne said.
Health Canada said in a statement to The Globe that it has not received any proposals for importing IV acetaminophen and that there is no shortage of that product.
This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief Mark Iype. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.
Wendy Cox