Thread by @ZiadFazel

When I finally got my hands on $80m Danielle Smith/MHCare Medical boondoggle children's acetaminophen, I weighed & measured it.

Thanks to glass bottle: 291 grams

250,000 bottles = 73 tons!

Smith's decision to airlift that to Alberta in Jan 2023 is case study in bad ethics.

🧵

@TheBreakdownAB @LukaszukAB @JMeddings @PfParks The whole boondoggle is enough to kick out a gov and bring in Auditor General.

But Smith's decision to manufacture AND airlift these 250,000 bottles – without a child safety cap (!) – shows the worst of it in one incident.

Shameless Smith made an expensive PR stunt about it.

GoA admitted that the package design they + MHCare submitted for Health Canada approval did not have child resistant cap required by law since at least 2006.

But Smith decided to:
• manufacture 250,000 deficient bottles anyway
• AIRLIFT them here

alberta.ca/release.cfm?xI…

On 18 Jan 2023, GoA even published this Flickr Album of 50 photos, including Health Min Jason Copping, Deputy Premier Nathan Neudorf, and the CEO of Edmonton International Airport, Myron Keehn.

Who's not there? Sam Mraiche or anyone from MHCare Medical.

flickr.com/photos/alberta…

Let's focus on the airlift.

The plane is a Boeing 747-400BCF, where BCF stands for "Boeing Converted Freighter" from passenger plane.

250K bottles alone, without pallets and packaging, is about 73 tons.

The maximum payload of this plane is 108 tons.

nationalairlines.com/our-fleet/

But when Smith & Copping made their splashy announcement on 6 Dec 2022, they said Alberta would get 5m bottles in 10 shipments of 500K bottles each.

500K bottles would weigh 146 tons, which is over the maximum payload of even National's largest plane.

alberta.ca/release.cfm?xI…

My bachelor's degree is in Industrial Systems Engineering, and I have a background in new product development, manufacturing, and procurement.

When I see politicians throw around numbers like 5 million bottles, or even 250K bottles, I know they're making stupid promises.

500K bottles is too much for a single airlift, so Smith & Copping decided instead to get 250K bottles, charter an entire 747, and pretend they were solving an AHS crisis by airlifting 73 tons of pharmaceutical in glass bottles to Edmonton.

But it's for the children, right?

Children are starving to death around the world, running out of even Ready-to-use-Therapeutic-Food (RUTF).

RUTF packages are 100 grams each. So Alberta's chartered 747 could have carried 73 tons, or 730,000 packages of food to help those kids survive.

unicef.org/press-releases…

Instead of starving children, Smith instead threw our money around to TAKE 250K bottles of acetaminophen FROM the developing world, and hoard the inventory at AHS, which already had adequate stock.

Mauro Chies said so, as clearly as an AHS CEO can tell a "You're fired" Premier.

How can I prove AHS did not need the meds?

See @alanna_smithh Oct 2023 report. AHS only distributed 9000 bottles internally, before ordering staff in July 2023 not to use it.

If AHS were in crisis needing this airlift, they'd be using 9000 bottles/WEEK.

theglobeandmail.com/canada/alberta…

Thanks @LukaszukAB for the subtle correction.

I was incorrectly writing "tons".

But I am actually using "tonnes" which is 1,000 kg.

The airplane payload is in "metric tons" which is American for "tonnes".

Sorry, that skewed my spelling, not my math.

While I am – and hopefully some of you are – double-checking my math:

The $80m boondoggle package is 14 cm high, 6 cm wide, and 6 cm deep. That's 504 cubic centimetres, for 0.000504 m^3 in SI units.

250,000 would take about ~126 m^3 in volume.

Time for Unit Load Device (ULD)

ULD pallets are standardized carriers for air freight, which work with the cargo handing equipment so you don't drive forklifts in an airplane, and allow you to secure the load.

You can see the 3 Amigos standing on those cargo handling rails and bearings in the photos.

Now, I don't know which ULD pallet Atabay used for the air freight, but let's guess something like about 7.5 m~2 of usable area, loaded to ~1.5 m high.

So maybe 11.25 m^3 of volume per pallet?

So 126 m~3 of meds would take 11 to 12 pallets?

nationalairlines.com/our-fleet/

@LukaszukAB Why am I trying to estimate these dimensions?

To price airlift from Istanbul to Edmonton:
• 73 tonnes on 12 pallets x 6.1 tonnes each
• each pallet 3 m x 2.5m x 1.5 m high
• about 9000 km as crow flies
• just over 16 hours non-stop flying?

Anyone in this industry know?

For reference, bookmark @alanna_smithh excellent report.

AHS admitted they spent $4m on shipping. But Copping had repeatedly said the $70m for 5m bottles = $14/bottle was a LANDED cost.

ie including shipping.

So the $4m was just for that one airlift?

theglobeandmail.com/canada/alberta…

Yes, you read that right:

$70m was paid UP FRONT to "Atabay". But I think this is the pattern of GoA deception, hiding the involvement of MHCare Medical.

I believe the $70m was paid to MHCare Medical. I'm guessing Atabay is choked about how little of that $70m they got.

I've heard from someone with federal procurement experience, who can't believe Alberta paid $70m UP FRONT, saying it should be paid based on progress of goods of acceptable quality, etc received.

Yup. This whole $70m contract stinks.

Tonight, I focus just on that one airlift.

While I singled out Alanna Smith for her work, there are several investigative reporters doing excellent work on this boondoggle. I hear their questions at press conferences, and find their work when I back up my threads.

Please feel free to secretly tip your favourite.

I remember trying to figure out how Smith and Copping had already spent $15.8m by 31 March 2023.

It is hard to figure this out when a government is actively lying to you. @pancholi_rakhi did a great job in limited time to drill into budget estimates.

@pancholi_rakhi Let's try this again.

$3.5m for 250K bottles no child-resistant caps
$3.5m for 250K bottles for retail
$4m airlift faster than $14 standard shipping
$4.8m secure disposal/other?
-----
$15.8m

Was there a 250K risk buy without Health Canada at $3.5m, plus secure disposal $1.3m?

Enough on airlift for now.

Let's get into why Smith decided to get 250K bottles manufactured WITHOUT child-resistant caps at all.

From the outset, Smith claimed all 5m bottles were intended for retail, in pharmacies, with full Health Canada approval.

alberta.ca/release.cfm?xI…

"Alberta’s government and Alberta Health Services are working with Health Canada on COMPLETING the drug establishment licensing approval process."

[emphasis mine]

So why even manufacture children's acetaminophen without a child safety cap?

Blaming Health Canada is false.

I remember Smith testily giving false information to a reporter:
• Alberta always intended for the first batch to go to AHS
• Alberta was not rejected or blocked by Health Canada for a product design that failed to include the child-resistant cap

pressreader.com/canada/calgary…

Notice GoA's deception saying "the manufacturer" instead of the importer, MHCare Medical?

Atabay is only a Foreign Building (FB) Site in MHCare Medical's application for a Drug Establishment License.

Health Canada regulates that Canadian Importer.

drug-inspections.canada.ca/gmp/inspection…

It is GoA + MHCare Medical's shared incompetence that delayed the manufacture of bottles with child-resistant caps, not Health Canada.

They submitted a complete design for approval AFTER 30 Dec 2022.

Health Canada approved that on 26 Jan 2023.

canada.ca/en/health-cana…

So instead of waiting until January for Health Canada to approve their resubmission of a complete design for approval.

Smith decided to intentionally manufacture deficient bottles without child-safety caps:
• unusable outside hospitals in Alberta
• risk of harm to kids

Instead of using lawyers as they are supposed to be used, to make products safer and more valuable WITH regulatory approval, Smith used them to find loopholes to manufacture WITHOUT APPROVAL.

She does that a lot, IMO.

MHCare Medical didn't care- they got $70m up front.

Of course I thought of you two as I did this section.
@sameo416 @dparkinson45

Smith blames "Ottawa" a lot for her failures too.

Smith dishonestly pretends Health Canada did not advise GoA that child-resistant caps were needed until AFTER GoA/MHCare Medical had submitted their application to import their design without caps.

alberta.ca/release.cfm?xI…

First, as I reminded Minister Copping directly on 2 Feb 2023, child resistant caps are required by law since at least 2006.

MHCare Medical got paid $70m for this. Alberta Health was "helping".

Not Health Canada's job to design your product for you.

Second, Health Canada even prepared a guideline in Sep 2016 specifically for acetaminophen "to assist in preparing drug submissions when seeking an approval to sell a pharmaceutical drug product in Canada."

How negligent to ignore something this clear?!

canada.ca/en/health-cana…

@TheBreakdownAB @JMeddings @LukaszukAB Third, Smith & Copping said in 6 Dec 2022 announcement they were already working closely w Health Canada + Alberta Pharmacists to meet Canadian requirements.

And again, MHCare Medical was paid $70m to do what they laughably still claim on their website.

mhcaremedical.com

@TheBreakdownAB @JMeddings @LukaszukAB For those that think Smith wasn't involved enough in the details (so may have been duped by Copping) that is not what she demonstrated - and explicitly said - in this testy, dishonest exchange 10 Jan 2023.

Ironically, this presser was "to be more open".

youtube.com/live/fCOg4iTFK…

@TheBreakdownAB @JMeddings @LukaszukAB In that presser, Smith repeatedly denied, in the face of all evidence, that Health Canada had rejected GoA's plan to distribute the meds to pharmacies without child-resistant caps.

Madeline Smith (and others) already had statements from Health Canada.

pressreader.com/canada/calgary…

@TheBreakdownAB @JMeddings @LukaszukAB Let's go back to 22 Dec 2022, when Copping's answers revealed stupid, wasteful and unsafe decisions GoA was making in December:
• after GoA's initial overpromising announcement
• before Health Canada approved only in-hospital use on 30 Dec 2022

youtube.com/live/DeYlqLqMc…

@TheBreakdownAB @JMeddings @LukaszukAB To @alanna_smithh, Copping said GoA was investigating bringing into Alberta the first 500K shipment "pending Health Canada approval".

ie. knowingly manufacturing + airlifting unsafe acetaminophen without child-resistant caps, while pressuring Health Canada to back down.

@TheBreakdownAB @JMeddings @LukaszukAB @alanna_smithh When @Jantafrench pressed Copping on specifics about obstacles to regulatory approval, Copping did not mention child-resistant caps.

Massive deception.

Only labelling, and the Drug Establishment Licensing for foreign building Atabay and their secret importer MHCare Medical.

Looking back over the evidence, it appears Smith authorized:
• manufacture of 500K bottles without child resistant caps or Health Canada Approval
• airlift of 250K bottles
• safe disposal of 250K bottles in Turkey

Maybe @pancholi_rakhi @shoffmanAB can ask Smith in #ableg?

@pancholi_rakhi @shoffmanAB By her own 6 Dec 2022 PR, Smith also approved AIRLIFT FOR ALL 10 shipments of 500K bottles each!

500K is than one 747, so the shipments dropped to 250K each.

Huge waste of taxpayer dollars when $14/bottle to MHCare was landed cost (by ship likely).

alberta.ca/release.cfm?xI…

Ominous suggestion 👇it was likely MHCare Medical who got paid for the airlifts too. They tout that expertise, and AB Health loves to sole-source from them.

Maybe @pancholi_rakhi @shoffmanAB can ask Smith or LaGrange about this too?

March 2023 shipment with first 250K bottles for retail was likely airlifted too.

Maybe MHCare Medical is contractually guaranteed that. Maybe Smith just wanted good PR ASAP.

Those were manufactured Feb 2023, and arrived in time for this 20 March 2023.

globalnews.ca/news/9565704/a…

In Nov/Dec 2022, Smith used GoA lawyers to find a loophole to the legal safety requirement for child-resistant caps on children's acetaminophen.

Just like in Nov/Dec 2022, Smith used GoA lawyers to find loopholes to gut the Conflict of Interest Act.

edmontonjournal.com/news/politics/…

Smith pretends the main reason for Food & Drugs Act is hospital use, and that retail use is some secret higher level where requirement for child-resistant caps is hidden.

False. The focus of the Act is unsafe Sales & Advertising of Drugs.

canlii.org/en/ca/laws/sta…

Here's the loophole I think Smith used:

"no person shall sell.."

Therefore Smith dumped it internally on AHS hospitals, protecting the importer MHCare Medical, and Health Canada imposed a Risk Management Plan.

@Lorian_H @UbakaOgbogu @NdbYyc1305

canlii.org/en/ca/laws/reg…

@Lorian_H @UbakaOgbogu @NdbYyc1305 @TheBreakdownAB @LukaszukAB @Mark_Ungrin @PfParks @gilmcgowan Dumping it "internally" on AHS Hospitals = forcing pharmacists & nurses to manage the risk of wrong concentration, no child-resistant cap, and crap labelling without Health Canada approval.

But "internally" means risk of harm to our children.

pressreader.com/canada/calgary…

@Lorian_H @UbakaOgbogu @NdbYyc1305 @TheBreakdownAB @LukaszukAB @Mark_Ungrin @PfParks @gilmcgowan @GosiaGasperoPhD Even though only 9000 bottles from that unethical shipment of 250K were distributed within hospitals, that 3.6% still managed to put infants at risk.

Thankfully, because this purchase was completely unnecessary, more bottles had not been distributed.

edmonton.ctvnews.ca/imported-pain-…

@Lorian_H @UbakaOgbogu @NdbYyc1305 @TheBreakdownAB @LukaszukAB @Mark_Ungrin @PfParks @gilmcgowan @GosiaGasperoPhD The "clarification" from AHS:
• tries to minimize "adverse event" by "adverse reaction" examples first
• "Technically..."
• "Instances where product packaging and labeling can be misapprehended can also qualify as an adverse event." ie Dosing Error

albertahealthservices.ca/news/Page17971…

I would LOVE to get one of the original products dumped on AHS. Safely dispose of all liquid inside first - I just need empty bottle, package, and any insert or dosing device.

Be happy to review it.

Would also love to see the Risk Management Plan Health Canada imposed on AHS.

@threadreaderapp please unroll all the tweets in this thread hopefully going back to 29 October, and continuing through tonight.

I think I'm done.

Think about this from Atabay perspective:
• Alberta government + their shady importer demand 500K bottles NOW
• Neither of them know Canada's regulatory requirements
• Rich Canadians deprive developing world during global shortage Dec 2022
• then force dump of 250K bottles

How vested is Smith in this $80m boondoggle?
• Snit when @Jantafrench asks legitimate questions at presser purportedly to prevent kids hospital overload
• What about PREVENTION? We're getting OTC meds
• Where's CMOH advice? He's not part of this deal

And for those wondering where Copping ended up after losing Calgary Varsity in May 2023?
• Not in Law Society directory
• He's a Special Advisor at Blue Rock Law, like Steve Allan
• "Boutique" founded in 2023; Doug Schweitzer one of the co-founders

bluerocklaw.com/about

Unspent balance of $70m contract paid up front is $49.4m, ~ 3.5m of 5m bottles.

Alberta Health keeps hiding middleman MHCare Medical, by saying it is with 🇹🇷manufacturer.

I checked Drug Product Database tonight: no pending applications.

Refund time.

theglobeandmail.com/canada/alberta…