Natural Resources committee  Thank you, Mr. Chair and committee members, for the opportunity to appear before you today. As you know, I'm Karen Gulenchyn. I'm a specialist in nuclear medicine and internal medicine, and I've worked in this field since 1979. I'm currently the medical chief of the Department of Nuclear Medicine at Hamilton Health Sciences and at St.

Natural Resources committee  Thank you. Let me start, first of all, with the fact that there were major differences across the country. Our information led us to understand that British Columbia was handling and managing this issue the best of all of the provinces in the country. That was largely because there were a fair number of institutions in British Columbia that were contracted with a supply coming from an alternative supplier who was not dependent upon molybdenum that came from Chalk River.

Natural Resources committee  First of all, I think it's fair to say that there was no formal channel of communication in place when all of this began. I first learned that there was an issue on November 30, which was a Friday, sitting in my office, when my charge technologist came in and said, “We're not going to have any isotope to do the lymphocentigraphy on Monday.”

Natural Resources committee  You mean the communication protocol currently in place? I'll ask the people at the Ministry of Health, or perhaps you can. It's a Ministry of Health document with NRCan.

Natural Resources committee  And they are also experienced in the use of those procedures.

Natural Resources committee  Actually, there was a broader variety of people involved. There was a representative of the cardiology community, a representative of the oncology community, and the head of the Edmonton Radiopharmaceutical Centre, who provided really excellent technical advice as to how these products were distributed and what changes could be made to their distribution to improve the situation.

Natural Resources committee  Yes.

Natural Resources committee  Certainly that exact information was provided to us as part of the ad hoc working group, in terms of the fact that they could ramp up, but we would be looking at about a 10% to 15% increase and it would not fill the entire capacity, and also it would not be available to Canadians until the end of December.

Natural Resources committee  Medical radiopharmaceuticals are in fact drugs that are assessed by Health Canada. So any supplier would have to submit a file that would identify both the safety and efficacy of the product that they were putting on to the market. Once approved by Health Canada, physicians in the country have the assurance of Health Canada that the product is both safe and efficacious and can be used.

Natural Resources committee  There were alternative generators that have been approved by Health Canada. The difficulty was that the company was not able to supply the entire market.

Natural Resources committee  —or a company.

Natural Resources committee  I believe there are two major generator manufacturers. One of them is Bristol-Myers Squibb and the other one is Covidien. My understanding was that there were insufficient numbers of generators coming into the country in order to supply the market. That certainly was what we were experiencing.

Natural Resources committee  More global information was coming to us through the Health Canada ad hoc committee, in terms of what they were able to supply. On the ground, had our central radiopharmacy been able to access more generators, then they certainly would have done so and would have been able to supply us with more product.

Natural Resources committee  This is the piece that was published by the CMAJ just this week? Is that correct?

Natural Resources committee  I was provided with it this morning by the CMA and I have reviewed it. I think what is important to understand is that given adequate notice, given the time to ramp up supply and bring the material into the country, then yes, they could have presumably done so. But in the situation we were in, in December, they could not have possibly met the needs of the country.