This will have to be entirely anecdotal. I'm not aware.... I apologize again for coming back to data, but we don't have any really solid data on the full spectrum of drug shortages.
In my own practice, I work out of St. Michael's Hospital in Toronto. I've had more than a handful of situations where the medication I've prescribed was unavailable at the pharmacy that issued the previous prescription. We asked them to look around at other pharmacies. They couldn't find the medication. These were cardiac medicines and I was asked to think of a substitute. Often the substitute medications are not as effective.
We're not talking about generic versus non-generic. We're just talking about medication type A versus medication type B. It is happening. I'm not sure within the cardiac realm that it's been a situation where the medication was completely unavailable in any place. We've had relative shortages inside hospitals. We've had information from our hospital pharmacy that we need to be very careful on the use of certain in-hospital medications, particularly some pain-killing medications used in anaesthesia, medications used in acute cardiac care, but I don't have any information to tell you that this has resulted directly in patient harm. It's just something that we need to be very careful about in terms of future planning.