Health Council of Canada releases annual progress report on health care renewal

Progress Report focuses on innovative practices that are achieving results

TORONTO, June 4, 2012 /CNW/ - Today, the Health Council of Canada releases Progress Report 2012: Health care renewal in Canada, highlighting the progress achieved by governments to date in five key areas: home and community care, health human resources, telehealth, access to care in the North, and comparable health indicators since the 2003 health accord was signed.

The report finds that, overall, provinces and territories have met most of what was expected of them in these five areas. They met their commitments to expand home care coverage, to increase the supply of health care providers, to expand use of telehealth services, to improve access to care in the North and to improve public reporting.

Key findings related to five of the accord commitments include:

Home and community care- Many provinces/territories have moved forward in expanding home and community care services. However, there is variability in access to home care throughout Canada. For example, progress on end-of-life care differs in terms of which services are covered in each jurisdiction.Health human resources- The supply of health care professionals in Canada has increased from 2006 to 2010. The number of physicians grew by 12% to almost 70,000.Telehealth- The use of telehealth has increased significantly by 35% annually over the last five years. In 2010, over 5700 telehealth sites were being used in close to 1,200 communities across the country.Access to care in the North- With additional federal funding in 2004 progress has been demonstrated within each of the three territories. However, all three territories face significant challenges in the recruitment and retention of health care professionals.Comparable health indicators- Each province and territory does its own reporting using their own set of indicators and performance reporting frameworks. There is a need for more comparable pan-Canadian reporting on health system performance.

Although, the report finds that most provincial and territorial governments met their commitments, it also questions whether it was enough to move health care forward. The evidence suggests that since the accords contained vague commitments with few targets, there was more emphasis on putting provinces and territories on similar footing than to push them towards achieving more change and advancements in health care delivery.

"Real progress is made when comprehensive strategies with concrete targets are put in place," said Dr. Jack Kitts, Chair of the Health Council of Canada. "An improved approach to goal-setting and performance measurement in the health system will provide greater impetus to change and achieve higher levels of progress."

The report found that the accords established a series of comparable health indicators for the provinces and territories to report on to the public beginning in 2004. However, comparable reporting only lasted a few years, largely because provinces and territories began to develop reporting frameworks to address their respective planning needs. As a result, the provinces and territories have not consistently reported on progress in the same manner, particularly in a way that is comparable and useful to other governments, the health system and the public. This lack of clear, consistent and comparable information about health system performance makes it challenging for agencies such as the Health Council to provide a national picture to Canadians on progress being made in health systems across Canada.

"What we found this year is that there is more work to be done, especially on comparable indicators. But there is good news. We found a wide array of innovative practices like telehealth services for First Nations in Manitoba or a model of care initiative in Nova Scotia, said John G. Abbott, CEO of the Health Council of Canada. "If practices like these are adopted more widely, they could accelerate progress across Canada."

Progress Report 2012: Health care renewal in Canada describes overall progress in Canada highlighting innovative practices from across Canada demonstrating how this progress has been achieved. The Health Council website provides additional details on the progress being achieved by each of the federal, provincial and territorial governments on these five themes. And, for the first time, the report includes activities from Alberta which recently joined the Health Council this year.

About the Health Council of Canada
Created by the 2003 First Ministers' Accord on Health Care Renewal, the Health Council of Canada is an independent national agency that reports on the progress of health care renewal. The Council provides a system-wide perspective on health care reform in Canada, and disseminates information on innovative practices and innovation across the country. The Councillors are appointed by the participating provincial and territorial governments and the Government of Canada.

To read commentary from guest bloggers, including heath care users and health industry leaders, or to download the full report/appendix visit: www.healthcouncilcanada.ca.

Image with caption: "Progress report 2012: Health care renewal in Canada (CNW Group/Health Council of Canada)". Image available at: http://photos.newswire.ca/images/download/20120604_C5262_PHOTO_EN_14527.jpg

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Manitoba pharmacy probed by Health Canada over gift-basket scheme

Updated: Sun Mar. 18 2012 16:13:35

The Canadian Press

Ottawa — Health Canada called in the Mounties after investigators found a Manitoba pharmacy used a gift-basket scheme to allegedly fleece the federal government's health plan for aboriginals.

The department estimates it overpaid Winnipeg's Pharm Azeem pharmacy by up to $160,389 through the Non-Insured Health Benefits program, a newly released document shows. Health Canada has since reached a settlement with the pharmacy to recover $25,000.

But the former owner of the pharmacy categorically denies any wrongdoing and blames the government for costing him his business -- and his health.

"Because of their actions, I lost my business," Rehan Azeem told The Canadian Press during a lengthy interview.

"We lost everything. I lost everything."

An access-to-information request about a just-reported loss in the Public Accounts of Canada uncovered an audit that described how the drug store would allegedly give away "gift baskets" of dandruff shampoo, condoms and other items along with prescriptions, then bill the government plan for both the prescription and over-the-counter items.

"Improper billing for over-the-counter (OTC) products was found," says the 2006 audit by Health Canada. "A pattern of bundling five (5) over-the-counter products for gift baskets leads the auditors to believe that this action was to inflate billing costs to the Non-Insured Health Benefits program (NIHBP) for financial gain."

The Non-Insured Health Benefits program does cover some over-the-counter medications with a doctor's authorization.

In this case, Health Canada claimed the pharmacy was routinely adding so-called verbal prescriptions to written prescriptions. Doctors can call pharmacies with verbal prescriptions, and the Non-Insured Health Benefits program normally accepts these phoned-in prescriptions.

But the pharmacy's rampant use of verbal prescriptions caught Health Canada's attention.

"The pervasive use of this practice was a concern," the audit says.

"The practice was so institutionalized that a review of the pharmacy's records found that the provider was using a pre-typed sticker with exactly the same five items for almost all clients. ...

"It appears that the pharmacist planned what would be prescribed prior to receiving the verbal orders. This practice became apparent after the pharmacy began 'giving' (and billing) the same five items consistently to (Non-Insured Health Benefits program) clients."

The audit says that at one point, seven out of every 10 people received a gift basket when they filled their prescriptions at the drug store. At first, the pharmacy bundled different items. The audit says it was only later that the gift baskets began to include the same five items: dandruff shampoo, antibacterial soap, anti-fungal cream, ulcer bandages and latex condoms.

Azeem tells a different story. "There was no such thing as gift baskets, first of all," he said. Azeem insisted all prescriptions were properly authorized.

"There's no such thing as five items ... there was not (always) five items," he said.

"Of course there was a verbal prescription, I agree to that, but those prescriptions were authorized by the physicians, so there was nothing wrong. ... They (Health Canada) have not found anything which was not authorized."

He said the pharmacy provided a service to the community.

"Some of the patients had those diseases ... some of the patients had dandruff because of the poor hygiene conditions ... it is a very common scenario there. Most of the people who are in that north end of Winnipeg, they were basically on welfare," he said.

"So by doing so, by providing those over-the-counter prescriptions ... we were actually doing a service to that neighbourhood."

The pharmacy would bill the Non-Insured Health Benefits program for a $5 dispensing fee plus the cost of the medication whenever it filled a prescription, the audit says. But the drug store also billed the plan for the cost of the items bundled in the gift baskets, plus a $25 dispensing fee.

Azeem explained that he was just covering his costs. There was a mark-up on prescription medicine and the Non-Insured Health Benefits program paid the pharmacy between $8 and $10 for its dispensing costs, he said. Throw in the cost of over-the-counter products and staff salaries and expenses start to soar.

"You have to look at the technician. You have to look at my overhead costs, and the pharmacist costs," Azeem said.

"I was not making a big chunk of money."

The drug store's billings to the Non-Insured Health Benefits program rose substantially once it started to use the gift baskets. In 2001, two years before it started bundling items, the pharmacy ranked as the 837th biggest biller in Canada among Non-Insured Health Benefits program pharmacies. By 2005, it had become the 250th biggest biller.

The Non-Insured Health Benefits program paid out $301,434 to the pharmacy in 2005, up from $32,032 in 2001. That is an increase of $269,403, or 841 per cent, over four years.

Azeem maintains he did nothing wrong.

"There was nothing hanky-panky going on."

The audit also found the pharmacy was bundling condoms with prescriptions for children as young as two years old.

"This bundling is a consistent pattern across all age groups and can be characterized as an attempt to inflate billing costs to the (Non-Insured Health Benefits) program for financial gain," the document says.

Azeem blamed a computer-entry error for the condom mix-up.

"It was not intentional," he said. "What was it, $6? We're trying to rob $6 from Health Canada? Come on. This is really insane. No intention was there. It was an entry error. I think probably the technician entered it in wrong. That's it."

Health Canada suspended the pharmacy's billing privileges in February 2006. The auditors wanted their findings passed on to Royal Canadian Mounted Police for "investigation for potential fraudulent billings" to the Non-Insured Health Benefits program.

Health Canada says it asked the RCMP to look into the matter.

"Health Canada initiated a recovery action against the pharmacy and also referred the file to the RCMP in 2006," spokesman Stephane Shank said in an email.

"A settlement for $25,000 was reached and the file was considered closed by Health Canada in January 2011."

The RCMP refused to confirm or deny any investigation, either past or ongoing.

"It is not the RCMP's practice to confirm or deny who or what, may or may not be the subject of an investigation," spokeswoman Cpl. Laurence Trottier said in an email.

"To do so may infringe on the privacy of individuals directly or indirectly, and also, to do so could jeopardize the integrity of any possible ongoing investigation."

The audit says the pharmacy handed over documentation, receipts and records to explain the billings, but most of the paperwork had either already been submitted, or it was deemed unsatisfactory or unacceptable. Azeem disagreed.

"We have provided each and every document," he said. "Prescriptions signed by the physician. Copies of prescriptions."

He said the pharmacy stayed in business for a few months after Health Canada cut off its billing privileges because he felt duty-bound to keep filling prescriptions. But he soon ran out of money and had to close up shop.

The Manitoba Pharmaceutical Association no longer lists the pharmacy in its directory of licensed pharmacies in the province.

Azeem said he tried to sue the federal government over the ordeal, but he dropped the lawsuit when he ran out of money.

"I ended up losing my business. I had to sell my building and everything," Azeem said.

"On top of it, I was on stress (leave) for a whole year, because, you know, it's a big loss. Then besides that, it physically and mentally affected me."

He has since moved to Barrie, Ont., where he works at the military hospital at nearby CFB Borden. Azeem said he is taking online courses through the University of Colorado toward a doctor of pharmacy degree.

"It was a very, very bad impact on my life," he said of what happened at the pharmacy. "I lost my confidence. I lost everything."

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Manitoba pharmacy probed by Health Canada over gift-basket scheme

OTTAWA - Health Canada called in the Mounties after investigators found a Manitoba pharmacy used a gift-basket scheme to allegedly fleece the federal government's health plan for aboriginals.

The department estimates it overpaid Winnipeg's Pharm Azeem pharmacy by up to $160,389 through the Non-Insured Health Benefits program, a newly released document shows. Health Canada has since reached a settlement with the pharmacy to recover $25,000.

But the former owner of the pharmacy categorically denies any wrongdoing and blames the government for costing him his business — and his health.

"Because of their actions, I lost my business," Rehan Azeem told The Canadian Press during a lengthy interview.

"We lost everything. I lost everything."

An access-to-information request about a just-reported loss in the Public Accounts of Canada uncovered an audit that described how the drug store would allegedly give away "gift baskets" of dandruff shampoo, condoms and other items along with prescriptions, then bill the government plan for both the prescription and over-the-counter items.

"Improper billing for over-the-counter (OTC) products was found," says the 2006 audit by Health Canada. "A pattern of bundling five (5) over-the-counter products for gift baskets leads the auditors to believe that this action was to inflate billing costs to the Non-Insured Health Benefits program (NIHBP) for financial gain."

The Non-Insured Health Benefits program does cover some over-the-counter medications with a doctor's authorization.

In this case, Health Canada claimed the pharmacy was routinely adding so-called verbal prescriptions to written prescriptions. Doctors can call pharmacies with verbal prescriptions, and the Non-Insured Health Benefits program normally accepts these phoned-in prescriptions.

But the pharmacy's rampant use of verbal prescriptions caught Health Canada's attention.

"The pervasive use of this practice was a concern," the audit says.

"The practice was so institutionalized that a review of the pharmacy's records found that the provider was using a pre-typed sticker with exactly the same five items for almost all clients. ...

"It appears that the pharmacist planned what would be prescribed prior to receiving the verbal orders. This practice became apparent after the pharmacy began 'giving' (and billing) the same five items consistently to (Non-Insured Health Benefits program) clients."

The audit says that at one point, seven out of every 10 people received a gift basket when they filled their prescriptions at the drug store. At first, the pharmacy bundled different items. The audit says it was only later that the gift baskets began to include the same five items: dandruff shampoo, antibacterial soap, anti-fungal cream, ulcer bandages and latex condoms.

Azeem tells a different story. "There was no such thing as gift baskets, first of all," he said. Azeem insisted all prescriptions were properly authorized.

"There's no such thing as five items ... there was not (always) five items," he said.

"Of course there was a verbal prescription, I agree to that, but those prescriptions were authorized by the physicians, so there was nothing wrong. ... They (Health Canada) have not found anything which was not authorized."

He said the pharmacy provided a service to the community.

"Some of the patients had those diseases ... some of the patients had dandruff because of the poor hygiene conditions ... it is a very common scenario there. Most of the people who are in that north end of Winnipeg, they were basically on welfare," he said.

"So by doing so, by providing those over-the-counter prescriptions ... we were actually doing a service to that neighbourhood."

The pharmacy would bill the Non-Insured Health Benefits program for a $5 dispensing fee plus the cost of the medication whenever it filled a prescription, the audit says. But the drug store also billed the plan for the cost of the items bundled in the gift baskets, plus a $25 dispensing fee.

Azeem explained that he was just covering his costs. There was a mark-up on prescription medicine and the Non-Insured Health Benefits program paid the pharmacy between $8 and $10 for its dispensing costs, he said. Throw in the cost of over-the-counter products and staff salaries and expenses start to soar.

"You have to look at the technician. You have to look at my overhead costs, and the pharmacist costs," Azeem said.

"I was not making a big chunk of money."

The drug store's billings to the Non-Insured Health Benefits program rose substantially once it started to use the gift baskets. In 2001, two years before it started bundling items, the pharmacy ranked as the 837th biggest biller in Canada among Non-Insured Health Benefits program pharmacies. By 2005, it had become the 250th biggest biller.

The Non-Insured Health Benefits program paid out $301,434 to the pharmacy in 2005, up from $32,032 in 2001. That is an increase of $269,403, or 841 per cent, over four years.

Azeem maintains he did nothing wrong.

"There was nothing hanky-panky going on."

The audit also found the pharmacy was bundling condoms with prescriptions for children as young as two years old.

"This bundling is a consistent pattern across all age groups and can be characterized as an attempt to inflate billing costs to the (Non-Insured Health Benefits) program for financial gain," the document says.

Azeem blamed a computer-entry error for the condom mix-up.

"It was not intentional," he said. "What was it, $6? We're trying to rob $6 from Health Canada? Come on. This is really insane. No intention was there. It was an entry error. I think probably the technician entered it in wrong. That's it."

Health Canada suspended the pharmacy's billing privileges in February 2006. The auditors wanted their findings passed on to Royal Canadian Mounted Police for "investigation for potential fraudulent billings" to the Non-Insured Health Benefits program.

Health Canada says it asked the RCMP to look into the matter.

"Health Canada initiated a recovery action against the pharmacy and also referred the file to the RCMP in 2006," spokesman Stephane Shank said in an email.

"A settlement for $25,000 was reached and the file was considered closed by Health Canada in January 2011."

The RCMP refused to confirm or deny any investigation, either past or ongoing.

"It is not the RCMP's practice to confirm or deny who or what, may or may not be the subject of an investigation," spokeswoman Cpl. Laurence Trottier said in an email.

"To do so may infringe on the privacy of individuals directly or indirectly, and also, to do so could jeopardize the integrity of any possible ongoing investigation."

The audit says the pharmacy handed over documentation, receipts and records to explain the billings, but most of the paperwork had either already been submitted, or it was deemed unsatisfactory or unacceptable. Azeem disagreed.

"We have provided each and every document," he said. "Prescriptions signed by the physician. Copies of prescriptions."

He said the pharmacy stayed in business for a few months after Health Canada cut off its billing privileges because he felt duty-bound to keep filling prescriptions. But he soon ran out of money and had to close up shop.

The Manitoba Pharmaceutical Association no longer lists the pharmacy in its directory of licensed pharmacies in the province.

Azeem said he tried to sue the federal government over the ordeal, but he dropped the lawsuit when he ran out of money.

"I ended up losing my business. I had to sell my building and everything," Azeem said.

"On top of it, I was on stress (leave) for a whole year, because, you know, it's a big loss. Then besides that, it physically and mentally affected me."

He has since moved to Barrie, Ont., where he works at the military hospital at nearby CFB Borden. Azeem said he is taking online courses through the University of Colorado toward a doctor of pharmacy degree.

"It was a very, very bad impact on my life," he said of what happened at the pharmacy. "I lost my confidence. I lost everything."

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Health Canada Approves Medical Device License for CARESTREAM DRX-Revolution Mobile X-Ray System

Sun, Mar 4, 2012, 5:58 PM EST - U.S. Markets closed

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Health Canada Approves Medical Device License for CARESTREAM DRX-Revolution Mobile X-Ray System

Thu, Mar 1, 2012, 10:54 AM EST - U.S. Markets close in 5 hrs 6 mins

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Gilenya (Fingolimod): MS Drug Under Health Canada Review in Light of Serious Adverse Events

OTTAWA, ONTARIO--(Marketwire -02/27/12)- Health Canada is informing Canadians of an ongoing safety review of the multiple sclerosis (MS) drug Gilenya (the brand name for fingolimod). The review was initiated following reports of serious adverse events, including 11 deaths reported internationally. No deaths have been reported in Canada.

Gilenya is a prescription drug authorized for the treatment of relapsing-remitting multiple sclerosis to reduce the frequency of attacks (relapses) and delay physical disability. Gilenya is generally recommended when other MS treatments have not been effective or cannot be tolerated. It was authorized in Canada in March 2011.

Currently, it is not clear whether the deaths were caused by Gilenya or whether other factors may have played a role. Four of the 11 reports involved serious heart-related events (three involved heart attacks and one involved a disturbance of the heart rhythm), while the other seven are unexplained. Among these seven is a report involving a patient in the United States who died within 24 hours of taking the first dose.

At the time of authorization, it was known that Gilenya can be associated with certain types of heart rhythm disturbances. The Canadian labelling contains several important warnings with respect to these risks. At this time, when the drug is used as recommended in the authorized Canadian drug label, the benefits of Gilenya are considered to outweigh the risks.

Healthcare professionals are advised to continue to follow the labeling instructions closely, particularly with respect to patient monitoring. Specifically, the label recommends that physicians:

 

--  Obtain an ECG (electrocardiogram) before the first dose if one is not
available in the last 6 months
--  Observe patients for signs and symptoms of bradyarrhythmia (slow heart
rate), including periodic assessment of heart rate, for at least six
hours after the first dose (or if more than two weeks have passed since
the previous dose).
--  Initiate appropriate treatment if clinically important heart-related
symptoms occur. Symptoms include bradyarrhythmia or atrioventricular
block (a problem with the conduction of electricity in the heart).
Continue to manage and monitor patients until symptoms have resolved.
--  Measure blood pressure regularly as Gilenya is known to increase blood
pressure.

Patients taking Gilenya who experience symptoms of heart problems should report them immediately. Symptoms include chest pain, slow or irregular heartbeat, or feeling dizzy. Patients should not stop taking Gilenya without first consulting a healthcare professional. Patients who have any questions or concerns about their Gilenya therapy should speak to their healthcare professional.

Before starting Gilenya, patients should tell their doctor if they are taking other medications such as drugs used to treat abnormal heart rhythms, beta blockers or calcium channel blockers, or if they have a history of heart-related problems such as low heart rate, heart rhythm disorders, congestive heart failure, or fainting.

Health Canada continues to assess all available information, including information from the company (Novartis), and information from other regulators. Health Canada will take appropriate action based on the results of its review. This includes communicating new safety information to health professionals and the public as soon as the review is complete, as appropriate.

Drug labels, also known as "Product Monographs," contain important prescribing and safety information for health professionals and patients, and are available by search of Health Canada's Drug Product Database (http://webprod3.hc-sc.gc.ca/dpd-bdpp/index-eng.jsp).

How to report side effects to health products

To report suspected adverse reaction (side effect) to these or other health products, please contact Health Canada's Canada Vigilance Program toll-free at 1-866-234-2345, or complete a Canada Vigilance Reporting Form (http://www.hc-sc.gc.ca/dhp-mps/medeff/report-declaration/index-eng.php) and send to us using one of these methods:

- Fax: 1-866-678-6789

- Internet: www.healthcanada.gc.ca/medeffect

- Mail (Get a postage-paid label (http://www.hc-sc.gc.ca/dhp-mps/medeff/report-declaration/post_paid-affranchi-eng.php)):

 

Canada Vigilance Program
Marketed Health Products Directorate
Ottawa, ON, Address Locator 0701E
K1A 0K9

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Horizon Health Network to Expand Smoking Cessation Model Throughout Atlantic Canada

FREDERICTON, NEW BRUNSWICK--(Marketwire -01/17/12)- Horizon Health Network's Centre of Excellence for Clinical Smoking Cessation will expand a smoking cessation model of care to a variety of health-care settings in Atlantic Canada over the coming months. Health Canada has provided $607,699 towards the expansion of the "Ottawa Model for Smoking Cessation", which was developed by the University of Ottawa Heart Institute.

Mike Allen, Member of Parliament for Tobique-Mactaquac, on behalf of the Honourable Leona Aglukkaq, Minister of Health, and the Honourable Madeleine Dube, Minister of Health for New Brunswick and senior officials from Horizon Health Network and the Ottawa Heart Institute, announced today the funding support to Horizon Health Network.

This will include cessation training to over 500 health-care professionals in New Brunswick, Prince Edward Island and Nova Scotia and has the potential to reach approximately 10,000 smokers over the next three to five years within Atlantic Canada.

"The Government of Canada is proud to support the Horizon Health Network and the Ministry of Health in New Brunswick, Nova Scotia and Prince Edward Island in their work to reduce smoking rates," said MP Allen. "This tobacco cessation model has been proven to improve smoking cessation rates among hospitalized patients and we're pleased to support its expansion into eleven sites across Atlantic Canada."

Quitting smoking is the most significant preventative measure Canadians can take to improve their health. The smoking cessation model includes a step by step work plan to assist health-care providers to incorporate evidence-based cessation practices into their day to day interactions with clients.

"Smoking is one of the biggest threats to good health," said Health Minister Madeleine Dube. "This program will result in more health care professionals having the skills necessary to help people quit smoking which will improve the overall health of our population here in Atlantic Canada."

In 2009, Horizon Health Network was designated one of three Centres of Excellence for Clinical Smoking Cessation in Canada. It has implemented the model throughout its organization to over 30 sites including hospitals, community health centres and units within the NB Extra Mural Program. Since its implementation, approximately 10,000 New Brunswick smokers have been introduced to the program and smoking cessation rates have increased by an average of 20 per cent.

Providing services for those who are attempting to quit will help increase their chances of success and help us reach our goal of having greater numbers of New Brunswickers live smoke-free," said Wellness, Culture and Sport minister Trevor Holder. "Coupled with support provided by the provincial Smokers' Helpline, more New Brunswickers will benefit from smoking cessation support in 2012."

"We are very pleased to share our expertise and lead the expansion of this important preventive health program across Atlantic Canada," says Donald J. Peters, president and CEO of Horizon Health Network. "Horizon Health Network is pleased to partner with Health Canada and other Atlantic provincial health-care providers to allow smokers increased access to education and support for successful cessation."

Horizon Health Network's partners in implementing this initiative include Health Canada, the University of Ottawa Heart Institute, New Brunswick's Vitalite Health Network, Health Prince Edward Island, and Nova Scotia's South Shore Health Authority.

Horizon Health Network is the largest health-care organization in Atlantic Canada, operating 12 hospitals and more than 100 medical facilities, clinics and offices providing medical services ranging from acute care to community based health services to New Brunswick, northern Nova Scotia and Prince Edward Island. With 1000 physicians, an annual budget exceeding $1 billion and approximately 13,000 employees, Horizon Health Network's strategic vision focuses on research, innovation and education.

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Health Canada news releases are available on the Internet at www.healthcanada.gc.ca/media

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Health Canada: recall of toy wagons, trikes and wheelbarrows over barium concerns

Health Canada has posted a recall notice for some toy wagons, tricycles and wheelbarrows after testing found that the coating on the Ertl-brand products contained barium levels that exceed the allowable amount under Canada's Toy Regulations.

The wagons, trikes and wheelbarrows are licensed by John Deere or Case and sold as toys.

Some forms of barium can be used safely in medical and commercial applications, while other forms of barium can be toxic, causing nausea, vomiting, diarrhea and cramps as well as more severe symptoms.

An independent toxicological review and exposure assessment initiated by TOMY Canada found that no adverse health effects are expected in children resulting from exposure to barium from these toys.

Neither TOMY nor Health Canada has received any reports of incidents or illnesses to Canadians related to the use of these toys.

The following Ertl toys are affected:

— Case 36-inch Stake Wagon: SKU number 14816; UPC number 036881148166

— John Deere Steel Trailer: 15966; 036881159667

— John Deere 28-inch Steel Wagon: 34437A; 036881344377

— John Deere Kids Tuff Trike: 34506A; 036881345060

— John Deere Steel Wheelbarrow: 34636A; 036881346364

— John Deere 36-inch Pink Stake Wagon: 35914; 036881359142

— John Deere Pink Steel Wheelbarrow: 35915; 036881359159

— John Deere Steel Tricycle: 35991; 036881359913

About 1,881 units of the recalled toys, which were made in China, were sold across Canada from September 2010 to January 2012.

Consumers should stop using the affected toys. For more information, visit TOMY Canada's website http://recall.tomycanada.ca/ or call the company at 1-866-725-4407.

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