E. coli cheese outbreak in B.C., Alberta leaves 1 dead, 10 ill

One person has died and 10 have become ill in B.C. and Alberta after eating E. coli tainted products from Gort's Gouda Cheese Farm of Salmon Arm, B.C.

A statement from Health Canada said there were four cases of illness in B.C. and seven in Alberta.

"One of the cases in British Columbia has died, and the cause of death is currently under investigation," said the Health Canada statement.

One person is still recovering in hospital and several cases remain under investigation, said B.C. Centre for Disease Control epidemiologist Dr. Eleni Galanis.

The illnesses began in July, with the majority of infected people displaying symptoms in late August to early September. 

Gort's Gouda has been linked to an outbreak of E. coli in B.C. and Alberta. (Gort's Gouda Farm Cheese)

Recalled cheese

All sizes of the raw milk cheeses listed below are affected by the recall:

• Medium Gouda Cheese Quaso de Prato.
• Aged Quaso de Prato.
• X Aged Quaso de Prato.
• Cumin Quaso de Prato.
• Greek Blend: Onion, Paprika, Parsley, Pepper, Thyme, Oregano Quaso de Prato.
• Gouda Cheese with Jalapeno Peppers Quaso de Prato.
• Smoked Gouda Cheese Quaso de Prato.
• Gouda Cheese with Red Peppers, Ginger, Onions & Garlic Quaso de Prato.
• Peppercorn, Ginger, Paprika, Onion & Garlic Quaso de Prato.
• Parsley, Celery, Onion, Garlic, Dill & Chives Quaso de Prato.
• Maasdammer.
• Beaufort.
• Parmesan.
• Mazouda.

​An alert from the Canadian Food Inspection Agency states the affected products have lot codes 122 to 138 and were sold at the manufacturer's outlet, at retail stores in Alberta and B.C, and through internet sales from May 27 to Sept. 14, 2013, inclusive.

Some product packages may not bear a lot code or indicate that the cheese was made with raw milk, and CFIA advises consumers who are unsure if they have purchased the affected product to contact their retailer.

Farm owner and operator Kathy Wikkerink said she was devastated by the news.

"We feel like we … we have hurt these people and it's totally unintentionally ... we were totally unaware of this bacteria being in any of our products," she said.

"We only have raw milk cheese sales ... people come here for raw milk cheese," adding the farm will only make pasteurized cheese for the time being. 

"Our shelves are bare and we just are trying to hold it together and stay alive," she said.

It is illegal to sell unpasteurized milk, but cheese made from unpasteurized milk is legal for sale in Canada.

E. coli facts

Officials advise that if you have eaten this cheese and feel well, there is no need to do anything further.

But if you have eaten this cheese within the last 10 days and have severe diarrhea or feel very sick, see your health-care provider.

• E. coli is a germ, or bacterium, that infects the digestive tract of animals.
• There are many types of E. coli, and most of them are harmless. But some can cause severe illness, even death.
• E. coli O157:H7 can cause stomach cramps and mild to severe diarrhea that can be bloody.
• Symptoms start two to 10 days after exposure to the bacteria, and usually last between five to 10 days.
• For more information on E. coli and its health risks, visit the BCCDC website.

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Playground equipment involved in rising number of injuries

More than 28,000 children are injured every year on playgrounds across Canada, and the rate of hospitalizations has gone up by eight per cent between 2007 and 2012, CBC News has learned.

Even though playgrounds continue to be upgraded and made safer, experts point to a lack of consistent standards —together with problems maintaining playground surfaces properly — with the continuing rate of injury.

In all jurisdictions in Canada, play structures only need to adhere to the Canadian Safety Association Standards in the year they were built, and no upgrades are mandatory. Some experts think that has to change.

"If equipment does not meet the standard then children should not be allowed on that equipment," said Debbie Friedman, director of trauma at the Montreal Children's Hospital.  

"Because I think we are only setting them up to potentially have a serious injury," she said.

Debbie Friedman of the Montreal Children's Hospital tells CBC News that although there are risks for kids using playgrounds, 'physical activity, being outdoors, is extremely important for a child's motor development, psychological development.' (CBC News)

Pamela Fuselli, of Parachute, a national injury prevention organization, echoed the concern about the lack of mandatory CSA standards and she called for more regulations to prevent injuries.

"There isn't a national body that regulates playgrounds, so while there are CSA standards for playgrounds, they're voluntary," she told CBC News. "Some municipalities have adopted them, or written them into their bylaws and guidelines that structures need to meet these standards,"

"There isn't a body that oversees if that is put into place or not," she said.

Studies show that playground surfaces and equipment that meet the standards and are properly maintained lead to fewer injuries.

According to the Canadian Paediatric Society, "Playgrounds modified to meet the current CSA standard can reduce associated injuries by as much as 49 per cent."

Playgrounds can be made safer

Research also shows that playgrounds can be made safer and that the playground surface is usually the most important factor.

CBC News tested a Winnipeg playground with Keith Thomas, a risk management expert with the Manitoba Association of School Boards.

Thomas operates a tool called the Triax 2000 that measures the impact of a playground fall on a steel ball meant to simulate the weight of a child's head.

The tool is on a tripod that holds a steel ball filled with sensors at the height of a play structure's highest point. When released it measures the force of the fall.

He told CBC News that playgrounds frequently fail the test, which is considered a score 1,000 and over, because of inadequate surfacing.

"What happens in many cases is people only have the bare necessity when it comes to sand or pea gravel," Thomas said. "We're trying to educate them to have 10 inches — frequently there is less than 10 inches."

Maintenance of the surface is another problem that Thomas pointed out. 

As children pound the playground, a cement-like surface results that will not protect them from fractures and other serious injuries.

"That's why maintenance is such a big issue," said Thomas. "If we have good protective surfacing and we can reduce those numbers of falls … it will reduce the overall injuries that children suffer on playgrounds."

The playground CBC News tested came in at 981, but Thomas pointed out that without proper maintenance, that playground surface may fail in the future.

"It looks like concrete but it's actually a hard surface that needs to be broken up," he said. "It definitely points to the need for proper maintenance."

Pamela Fuselli, of the injury prevention group Parachute, recommends avoiding playgrounds with hard surfaces, including dirt and grass. She says playgrounds with soft, deep surfaces reduce the risk of injury. (CBC News)

Fuselli said that the playground surface should be deep and soft, and that could go a long way in preventing injuries.

"Fractures are the most common injury that we see from playgrounds and those are due to falls," she said. "And falls cause not just fractures to arms and legs but the more serious ones like head injuries."

She also emphasized maintenance and said that regular upkeep should be a part of any playground management.

Serious hospitalization rates due to playground injuries across Canada also vary by region.

By province, Saskatchewan has had by far the highest injury rate by population, more than double the rate for both Ontario and Quebec.

Manitoba's rate almost doubled from 2007, at 48 serious hospitalizations, to 77 incidents in 2011.

The data also shows a steady increase in playground-related hospitalizations starting in 2006.

According to numbers provided to CBC News by the Canadian Institute for Health Information, there had been a gradual decrease in all injury-related hospitalizations — including those due to playground injuries — since 1994.

Gone up steadily since 2006

The number of playground hospitalizations, however, has gone up steadily since 2006.

Again, experts cannot say why there has been an increase, but they point to numerous factors including parental supervision, an increase in the number of playgrounds and the prevalence of multi-age structures.

Friedman told CBC News that there has been an increase in play structures geared for different ages being built in the same area, and this can cause big problems.

"The sections for older kids are a lot more enticing to the younger kids, and if they are on it then they clearly need a different level of supervision."

Friedman also believes that parents play a major role in keeping their kids safe.

"Supervision in this type of activity means eyes on the child, being in arm's length and not being halfway across the yard on your cellphone having coffee with a friend," Friedman points out.

Fuselli agreed, but said that risk of serious playground injuries needs to be measured against the benefits of physical exercise.

 "Where are the kids playing if there isn't a playground?" Fuselli asked. "Are they in the street, are they doing more unsafe behaviours or activities?"

"We'd all agree that physical activity, being outdoors, is extremely important for a child's motor development, psychological development. They're developing their social skills, and I think we want to encourage activity," she added.

Friedman advocates for a ban on play structures that are not approved.

 "I think if it doesn't meet the standard then it shouldn't be used. I think we know enough in this day and age that is a straightforward principle," she said. "We are concerned because certainly you don't need to have a hundred of the same injuries to get the idea that there's a problem."

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Mental health care needed by 1 in 6 Canadians

About one in six Canadians said they needed mental health care last year, Statistics Canada reports.

The findings are included in the agency's 2012 Canadian Community Health Survey on mental health that was released Wednesday. The survey results were based on a national sample of more than 25,000 people 15 or older in the 10 provinces.

The need for mental health care was mainly for counselling, the survey suggests. Other mental health care needs were for medication and information.

"An estimated 600,000 had a perceived unmet mental health care need, and more than 1,000,000 had a partially met need," the report's authors said, extrapolating from the sample.

About 17 per cent of the population 15 or older reported having had an mental health care need in the past 12 months, the agency found. Of these:

• 67 per cent said their needs were met.
• 21 per cent said their needs were partially met.
• 12 per cent said their needs were unmet.

"The presence of a mental disorder, higher distress, and chronic physical conditions were positively associated with perceiving a mental health care need, many of which were unmet or only partially met," the report's authors concluded. "As well, higher levels of distress predicted a greater likelihood that needs would be unmet or partially met."

Dr. Ian Dawe, physician-in-chief at Ontario Shores Centre for Mental Health Services in Whitby, Ont., said the report misses a large swath of other illnesses such as schizophrenia and panic disorders.

Dawe said that patients often say it's relatively easy to get prescription medications, but needs for counselling go unmet. He said barriers include cost for those without insurance and the fact that counselling may occur outside of a doctor's office.

Most perceived barriers to receiving mental health care were related to personal circumstances, although almost one in five who reported barriers said they were related to features of the health-care system, such as language barriers.

At least one in five Canadians will experience a mental health condition or illness in his or her lifetime. The other four in five will have a family member, friend or colleague who will be directly affected.

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Suicide rate climbs after global economic downturn

Roberto La Rosa, right, filled out a temporary job application in November 2008. There was a clear rise in suicide after the 2008 global economic crisis, researchers say. (Alan Diaz/Associated Press)

Suicide rates in Europe and North America increased after the 2008 global economic crisis, especially among men and in countries with greater increases in unemployment, a new study suggests.

Researchers from Hong Kong and the UK used data from 54 countries to look at changes in suicide rates after 2008, when turmoil in the banking sector led to downturns in stock markets, bankruptcies, and job losses.

"We found a clear rise in suicide after the 2008 global economic crisis, there were about 4,900 excess suicides in the year 2009 alone compared with those expected based on previous trends (2000-07)," David Gunnell of the University of Bristol and his co-authors concluded in Wednesday's issue of the British Medical Journal.

The largest increase in Europe was seen in 15-24 year old men and in 45-64 year old men in the U.S. In Canada, the researchers estimated there were 294 excess suicides among men. There was no change in suicide in European females and a small increase was seen in American females.

The researchers say that their findings likely underestimate the true global impact of the economic crisis on suicide since data were unavailable for countries such as China and India.

Because younger men were most at risk, the researchers suggested that countries with limited resources could target their labour market support at this group. But in many countries, government austerity measures are contributing to further job losses, they said.

"Urgent action is needed to prevent the economic crisis leading to further increases in suicides."

The mortality database sources included the World Health Organization and the U.S. Centers for Disease Control and Prevention.

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Alzheimer's drugs may harm people with mild memory issues

Andrea Tricco says Alzheimer's medications may cause gastrointestinal harm among people with mild cognitive issues. (David MacIntosh/CBC)

Drugs to treat Alzheimer's disease don't help patients with mild cognitive impairment and are linked to greater risk of harm, a Canadian review concludes.

People with mild cognitive impairment show symptoms of memory problems that are not severe enough to be considered dementia or to interfere with day-to-day functioning. Each year, three to 17 per cent of people with mild cognitive impairment deteriorate to dementia, research suggests.

It was hoped that "cognitive enhancers" used to treat dementia might delay progression to dementia.

Dr. Sharon Straus of the department of geriatric medicine at the University of Toronto and her team reviewed clinical trials and reports on the effects of four cognitive enhancers.

"Cognitive enhancers did not improve cognition or function among patients with mild cognitive impairment and were associated with a greater risk of gastrointestinal harms," the reviewers concluded in Monday's issue of the Canadian Medical Association Journal.

"Our findings do not support the use of cognitive enhancers for mild cognitive impairment."

The medications act on different neurotransmitters in the brain, such as acetylcholine. The drugs are:

• Donepezil (Aricept).
• Rivastigmine (Exelon).
• Galantamine (Reminyl).
• Memantine (Ebixa).

Straus says patients and their families are increasingly requesting the medications, and she suspects that some of the off-label prescriptions are for mild cognitive impairment, a use that Health Canada hasn't officially approved.

The trials were done between 1999 and 2007 in North America, Europe, New Zealand, Australia, South America, Israel and Turkey. All the studies compared cognitive enhancers with placebos. The average age of the patients ranged from 66 to 73.

The meta-analysis showed patients taking the medications experienced more nausea, diarrhea, vomiting and headaches than those taking placebos. One study found a higher incidence of bradycardia, or slow heart rate, among patients taking galantamine.

In 2004, there were 900,000 prescriptions filled for the medications, said study co-author Andrea Tricco at St. Michael's Hospital in Toronto.

"It does lead us to believe that … perhaps, people are taking these medications that shouldn't be," Tricco said.

The authors suggested longer-term trials to ensure accuracy of results beyond 84 weeks of followup.

The Canadian Consensus Conferences on the Diagnosis and Treatment of Dementia have also not been recommending acetylcholinesterase inhibitors for mild cognitive impairment, said Dr. Paul Verhoeff, a psychiatrist in the Behavioural Neurology Memory Disorders Clinic at Baycrest Health Sciences in Toronto, who was not involved in the research.

For people with mild cognitive impairment, Verhoeff suggested strategies to compensate for memory loss, such as:

• Associating names with a name you already know.
• Remembering images of scenes.
• Keeping an appointment book in the same place at all times or using reminders on digital devices.

"The difficulty, it's almost an oxymoron, is that people have memory problems, and you have to teach them new strategies to compensate for these memory problems," Verhoeff said.

Baycrest has a program, which is going national, to help patients retain the strategies and to educate loved ones, since their support is also extremely important, Verhoeff said.

He stressed the importance of paying attention to the common risk factors among heart disease, stroke and Alzheimer's, such as high blood pressure and cholesterol levels, diabetes and excess weight.

The review was funded by the Drug Safety and Effectiveness Network at the Canadian Institutes of Health Research.
 

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Antibiotic resistant bugs kill thousands yearly in U.S.

Dr. Thomas R. Frieden, director of the U.S. Centers for Disease Control and Prevention, says the agency is seeing an increase in resistance rates for many microbes. (Erik S. Lesser/Associated Press)

 For the first time, the U.S. government is estimating how many people die from drug-resistant bacteria each year — more than 23,000, or about as many as those killed annually by flu.

The figure was released Monday by the Centers for Disease Control and Prevention to spotlight the growing threat of germs that are hard to treat because they've become resistant to drugs.

Finally estimating the problem sends "a very powerful message," said Dr. Helen Boucher, a Tufts University expert and spokeswoman for the Infectious Diseases Society of America. "We're facing a catastrophe."

Antibiotics like penicillin and streptomycin first became widely available in the 1940s, and today dozens are used to kill or suppress the bacteria behind illnesses ranging from strep throat to the plague. The drugs are considered one of the greatest advances in the history of medicine, and have saved countless lives.

But as decades passed, some antibiotics stopped working against the bugs they previously vanquished. Experts say their overuse and misuse have helped make them less effective.

In a new report, the CDC tallied the toll of the 17 most worrisome drug-resistant bacteria. The result: Each year, more than 2 million people develop serious infections and at least 23,000 die.

Of those, the staph infection MRSA, or methicillin-resistant Staphylococcus aureus, kills about 11,000, and a new superbug kills about 600. That bacteria withstand treatment with antibiotics called carbapenems — considered one of the last lines of defence against hard-to-treat bugs.

Germs like those have prompted health officials to warn that if the situation gets much worse, it could make doctors reluctant to do surgery or treat cancer patients if antibiotics won't protect their patients from getting infections.

"If we're not careful, the medicine chest will be empty" when doctors need infection-fighting drugs, said CDC Director Dr. Tom Frieden.

It's not clear that the problem is uniformly growing worse for all bugs. Some research suggests, for example, that MRSA rates may have plateaued.

But CDC officials and others are using the report to press doctors and hospitals to do more to prevent the spread of infections and to more wisely prescribe antibiotics. Experts say as many as half of all antibiotics are not used correctly or are prescribed for the wrong thing — for example, they don't work against flu or colds.

The CDC report warned that misuse creates other problems, too. One is the rise of a nasty strain of intestinal bug called Clostridium difficile, or C-diff. It flourishes in the gut when other bacteria are killed off by antibiotics, and is linked to 14,000 deaths annually.

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Medical emergencies in U.S. can cost Canadians thousands

A quick trip to the U.S., even for a day of shopping or to catch a ball game, can be a costly one in the event of  a medical emergency. 

Few people consider purchasing additional health or travel insurance for a quick jaunt to our neighbour's.

According to travel agents and insurance brokers, little has changed since a 2011 RBC survey of people aged 18-34 found 44 per cent "rarely or never" purchased health insurance for travel to the U.S.

"They just feel very sure nothing is going to take place," said 82-year-old Mae Youngman, president of Mae's Travel. "To take the chance isn't worth it. I know that myself."

She's living proof a little extra money up front can save a person from a lot of financial hardship down the road.

She has suffered an aneurysm in Fort Lauderdale, Fla., had her appendix removed in Sarasota, Fla., and broke her elbow in Mexico. In all three cases, she received out-of-country medical treatment, including a seven-hour operation and three-week hospital stay.

She said without additional insurance, she could not have paid for the treatment.

Mae Youngman has suffered an aneursym, had her appendix removed and broke her elbow outside of Canada but was covered through insurance each time. (CBC News)

Youngman estimates about half the people she books vacations for opt for travel insurance.

"I don't know how they do it on their own, how they pay for it," Youngman said.

Mike Outram is a Windsor, Ont., man who couldn't. The gymnastics coach suffered a fall in a Michigan gym and is now a paraplegic.

When the injury happened, his medical care in the U.S. cost him $168,000 when all was said and done.

"And I really didn't have anything done," he said. 

He never had insurance.

"Where's the $168,000 going to come from to pay this bill?" he still asks. "It never really crossed my mind. Being on a border town you don't really think about it. You don't think, even going to a baseball game or getting on a bus, 'how am I going to get in an accident?' You can slip. You can be in a hospital in an instant."

OHIP coverage minimal

The Ontario Health Insurance Plan (OHIP) does pay for some out-of-province medical treatment, including some in the U.S. 

OHIP pays up to $400 CAN per day in U.S. hospital costs, depending on level of care. The plan also reimburses outpatient visits at $50 CAN per day. And it reimburses physicians costs at the rate they would be paid in Ontario. If a U.S. physician charges more than a Ontario doctor for the same procedure, the Ontario patient pays the difference.

OHIP spokesperson Julie Ingo said the province spends $14 million a year reimbursing Ontarians who suffer medical emergencies out of province.

"Ontario fees are much lower than in the U.S.," she warned. "What OHIP is reimbursing under the travelers program is a limited amount and not the whole cost."

Most of OHIP's coverage is for emergencies only.

Denise Luxford, a travel insurance specialist in Windsor, Ont., said a simple slip and fall down the stairs or broken  arm can result in a $5,000 US bill.

Luxford said that in some cases, American doctors conduct tests, such as MRIs, that Canadian counterparts would not call for.

"My own kids don't think about it," she said of travel insurance. "I have to remind them when they go. They're so used to OHIP covering us here. I don't think they understand the rules.

"Everybody has heard horror stories."

$350,000 bill

Sue and Glenn Bacarro have one. They were heading home to Windsor, Ont., from Detroit Metro Airport when Glenn lost control of their SUV in a snowstorm and the couple were struck by a transport truck.

Sue suffered a bruised tailbone and crawled out the back of the SUV.

Glenn, though, had a collapsed lung, fractured spine, broken nose, broken pelvis, 12 broken ribs and an aorta dissection. He also lacerated his kidney, liver and spleen.

He spent two weeks in two U.S. hospitals before he returned home.

Mike Outram fell in Michigan and is a paraplegic. His medical bills in the U.S. cost him $168,000 US and he had no insurance. (CBC News)

The Bacarros had auto insurance, OHIP and an insurance plan through the University of Windsor, where Sue was going to school.

"I thought possibly, yeah, [it could be expensive] but I was thinking of Glenn and his well-being. I kept saying, 'do the treatment and we'll figure it out,'" Sue said.

The bill was $70, 000 U.S. when she realized auto insurance didn't cover the medical costs. The bill ended up being $325,000 before Glenn came home.

"What a price to put on a life, right?" Glenn said.

Sue said she could barely keep up with the mounting bills.

"There are so many things coming at you; treatments, reports, invoices, insurance. It's very busy," Sue said.

Eventually, every dime was paid for by OHIP and insurance. It took six years to close the case. Meanwhile, bills were coming and collection agencies were calling, almost immediately.

'The effect on your family can be devastating.'- William Goldstein, personal injury lawyer

Glenn said the system is not easy to navigate.

"It's hard to understand what you're dealing with or what you're agreeing to. It's all business and technical terms. It's a whole other world," he said. "We honestly don't know what happened. We don't know who paid for what."

They couple now has out-of-country medical insurance that covers up to $5 million.

"You don't think about it but if anything happens and you end up in a hospital, you're looking at hundreds of thousands of dollars in payments," Glenn said. "How are you going to cover that?"

Will Goldstein, a person injury lawyer, said even a Canadian's auto policy should be bolstered before heading to the States.

"One of the things you have to worry about in the state of Michigan is a lot of folks driving around without insurance. You shouldn't assume the people who bang into you have proper insurance. You better make sure your insurance is high enough to cover the situation where you're hit by an uninsured or unidentified car," he said. "The effect on you and your family could be devastating."

Do you buy additional insurance when you travel outside Ontario?

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10 West Nile cases confirmed in Alberta

Health officials say 10 cases of West Nile virus have now been confirmed in southern Alberta this summer.

Five of the cases were reported from mid- to late-August, with the most recent one involving a man in his 40s.

West Nile can lead to neurological disease and is spread by mosquitoes.

Health officials say about 20 per cent of cases are non-neurological, and only about 1 in 150 is neurological.

Symptoms of non-neurological syndrome include fever, chills, nausea, vomiting, fatigue, skin rash, swollen glands and headache.

Severe neurological syndrome is rare, but can lead to death.

Alberta Health Services say nine out of the 10 confirmed cases are non-neurological. Most individuals who are exposed show no symptoms.

Health officials are reminding all Albertans, particularly seniors, to take precautions when enjoying the outdoors:

• Wear long-sleeved light-coloured shirts, pants and socks.
• Make sure door and window screens fit tightly and have no holes that may allow mosquitoes indoors.
• Reduce standing water sites around your home (bird baths, toys, flower pot saucers, swimming pool covers, etc.).
• Apply an approved mosquito repellent with DEET to exposed skin and clothing.
• Avoid going out at dawn and at dusk, when mosquitoes are most active.
• Ensure rain barrels are covered at all times.

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Confidential medical records faxed to Sask. school

Medical records are being mistakenly sent to a school on the Clearwater Dene First Nation.

The first patient record came through the school's fax machine in March, and dozens more followed. Officials at the school estimate they have now received close to 60 private medical files by mistake.

All are addressed to patients of Dr. Vaughan Nicholls. The general practitioner had treated patients at the La Loche Health Centre for 25 years.

Since March, dozens of confidential medical records have been accidentally faxed to Clearwater Dene First Nation School. (Clearwater Dene First Nation School website)

"Honestly, I don't want to look at the faxes," said Clearwater River School Principal Mark Klein.

He said those with cover pages appear to be coming from a variety of specialists and medical offices in Saskatoon.

Klein initially contacted the hospital to complain, and followed up with the health region. After several more months and dozens of faxes, Klein took his concerns to Saskatchewan's Information and Privacy Commissioner.

"I've been here 17 years and we've had this fax number for all 17 of those years and probably longer than that," said Klein. "It's not like we've changed our number or the health district has changed their number."

His school's fax number ends in the same four digits as the Keewatin Yatthé Health Region's main telephone line in Buffalo Narrows.

Specialists in Saskatoon say doctors provide them with fax numbers on the referral sheets that follow a patient to the specialists' offices. They also buy directories from Saskatchewan's College of Physicians and Surgeons, which are published twice a year.

Wrong number listed in medical directory

The college said the wrong fax number for Dr. Nicholls was listed in the directory it published in January, 2013. Officials there learned about the mistake in mid-February.

"We're not quite sure why or how the mistake happened, but it did, and it was in the book," said Dr. David Poulin, the deputy registrar for the college. He said four separate notices were sent to doctors and laboratories, asking them to manually correct the error. A new directory with the correct information was published in July.

"We assumed it had gone down to a trickle, if not zero, because we hadn't heard from anybody else on this since March," said Poulin.

Still, patient records continue to arrive at the school on the Clearwater Dene First Nation nearly every week.

Sask. privacy commissioner said the school is not alone

Three years ago, Saskatchewan Privacy Commissioner Gary Dickson wrote a 36-page report on the problems associated with faxing personal health information in Saskatchewan. Even so, his office is investigating 20 similar complaints over the past year, which are related to medical records being faxed to the wrong destinations.

Saskatchewan Privacy Commissioner Gary Dickson says his office is investigating some 20 cases of confidential records being faxed to the wrong places. (CBC)

"This isn't cutting edge technology," said Dickson. "If we're still having these kinds of problems that relate to misdirected faxes, it doesn't augur well for electronic health records, when we're going to have a whole lot more information about patients in electronic form."

He said his office can issue reports, and provide guidelines. However, it has no power to enforce the law.

"Trustees aren't doing what the law requires of them," said Dickson. "There need to be significant consequences. And in Saskatchewan nobody has ever been charged under the Health Information Protection Act, although we have had plenty of breaches, and some of them are really serious and really egregious."

Doctor said he was unaware of the issue

When CBC contacted Dr. Nicholls, he said no one ever told him patient records were going astray.

"This is the first I've heard of it," said Nicholls. "I didn't even know it was happening."

Nicholls recently moved to Stony Rapids, but said doctors in La Loche still rely on paper files to track patients. There is no electronic record-keeping at the health centre in the Dene community, which serves 3,500 residents.

"There are six doctors up there and they're all receiving information from other doctors," said Nicholls, who said he's concerned about missing information.

Each time a medical record arrives at the school, staff there now fax the documents to the health region in Buffalo Narrows, and mail the erroneous fax to Saskatchewan's Privacy Commissioner in Regina.

Officials trying to find origins of misdials

Last week, the College of Physicians and Surgeons said it would contact the Keewatin Yatthé Health Region's information and privacy officer, so it could track down the offices and laboratories using the wrong fax number, and ask them to correct it.

The college said the problem extends beyond this case.

"The issue with fax numbers occurs not infrequently," said Dr. Poulin. "There are mistakes that are made from time to time. It happens when somebody's faxing and they type in the wrong number."

He said some medical offices may have programmed the wrong number into their fax machines.

"When somebody programs in a new fax number, we'd like them to send a test fax," said Poulin. "Faxes are still used a lot in the medical system and we have a lot of concerns about that."

Health region CEO calling for electronic records

Richard Petit, the CEO of the Keewatin Yatthé Health Region, said officials have spoken with about a dozen specialists' offices and medical laboratories, to warn them not to use the school's fax number. Some have mistakenly sent several faxes to the school.

Clearwater Dene First Nation is close to La Loche, about 600 kilometres northwest of Saskatoon. (Google Maps)

Petit said patients in La Loche should contact the health centre there, if they're concerned their records have gone astray. He said starting next week, the region will investigate each mistaken fax, to make sure that patient safety was not at risk. In the meantime, he's also pushing the province to adopt electronic health records.

"In this day and age this should not be happening," Petit said.

Klein says he and school secretaries are frustrated.

"The health district in a way is lucky because it's coming to a professional institution and we're dealing with all of the paperwork in the proper way," said Klein. "Faxes could be going to random houses or anyone with a fax machine and that's a little bit scary."

Klein noted six faxes arrived at the school during the summer months, while staff and students were on holiday.

"We're not here in the summer, and information that doctors needed to meet with those patients was sitting on our fax machine," said Klein. "That information could have sat there for three or four weeks on our fax machine without anybody noticing."

"I don't think anybody wants their medical information being randomly sent to fax numbers in the province."

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Personnelle Cold and Flu product recalled

A recall for Vita Health over-the-counter cold and flu medications because of labelling errors has expanded again.

Health Canada said Friday that Vita Health's voluntary recall now includes Personnelle Cold and Flu-in-One Extra Strength Convenience Pack. The product is missing a "reference to important information," the regulator said.

Since December 2011, Vita Health has been voluntarily recalling various Rexall, Compliments, Safeway, Life brand and other over-the-counter cold medications because of labelling errors.

Some of the pain and cold relief packages are labelled as having child-proof caps when they don't.

Others are missing allergy warnings or alerts about not taking the pills if you have certain medical conditions.

"Vita Health is reviewing its product labels and putting actions in place to address the labelling issues," Health Canada said.

The regulator said it has no information suggesting the quality of the products on the list is affected.

The list includes over-the-counter anti-inflammatory, cold and flu, allergy and sinus, and acetaminophen medications.

"The product recalls initiated by Vita Health between December 2011 and today and aggregated on the 'Healthy Canadians' website are solely and directly due to package labelling errors, where in most instances certain wording on the label was inadvertently omitted," Stephanie Haverstick, a spokeswoman for the company, said in a statement.

"None of these product recalls are due to concerns with the safety or efficacy of the actual products themselves or with the ingredients or formulas. There have been no adverse events or consumer illnesses reported."

A complete list can be found on the department's recall website at www.healthycanadians.gc.ca. 

Consumers are asked to return the product to the place of purchase or call Vita Health at 1-800-665-8820, Monday to Friday 9 a.m. to 5:30 p.m. ET for instructions.

Haverstick said the company's self-initiated review of all labels is expected to be completed by the end of the month.

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