Documents reveal the use of acetaminophen brought to Alberta from Turkey increases the risk of a life-threatening injury to newborn babies. In December 2022, Premier Danielle Smith announced Alberta had secured five million bottles of children’s acetaminophen and ibuprofen from Istanbul-brd Atabay Pharmaceuticals. Smith’s deal with the Turkish pharmaceutical was previously criticized for being expensive and ineffective, but documents show the imported drugs produced adverse effects in babies, including “gagging and refusing to take the medication.”Provincial government documents obtained by the Globe and Mail through an access to information request detail some of the issues that arose from the deal procured last year. The publication received 28 pages of emails between officials at Alberta Health and Alberta Health Services (AHS) that show the Alberta government had brought in the Turkish supply of medicine due to a surge in pediatric respiratory illnesses. The imported medication is thicker in viscosity than its local counterparts, and it clogged feeding tubes, which then had to be flushed with water. AHS officials said the extra liquid in the tubes increased the risk of a medical issue called necrotizing enterocolitis, which inflames the intestines of infants,” the Globe and Mail reported. AHS spokesperson Kerry Williamson said the product was halted in all Alberta neonatal intensive care units in May as hospitals transitioned back to standard products. Williamson told the Globe and Mail in a statement that no patients developed necrotizing enterocolitis, were injured, or fell ill after taking the medication. AHD executive Isaac Van Dyne said the decision followed questions surrounding the developing issue in a weekly call where Health Minister Adriana LaGrange was present. “Neonatal patients with very low body weight have fragile and incompletely developed intestines, which cannot accommodate large boluses of fluid administration for medications,” Van Dyne said to Health Minister’s chief of staff Nicole Williams in an email October 23. ”The volume/osmolality issues from the Atabay acetaminophen was determined to possibly increase the risk of Necrotizing Enterocolitis (a potentially fatal injury to the intestines) in these tiny patients.”Van Dyne said nurses found clogs in gastric and nasal-gastric tubes, which are used when the child can’t swallow medication and the extra water in the tubes was “not ideal.”In addition to thickness, the products are more bitter and less concentrated than the same drug from North America. There were 10 cases reported in April and May of 2023. The babies would experience swelling, gagging and difficulty swallowing. Van Dyne revealed another problem with the way the drug was being administered to children. What he described as “look-alike mix-ups” between the acetaminophen and ibuprofen bottles from Turkey because they look similar, “created a risk for medication errors” of children being given the wrong medicine. The Government of Alberta hopes to continue in the contract with the Turkish company, which costs taxpayers about $49.4-million, but switching to intravenous acetaminophen. It will have to be approved by Health Canada first. “Our understanding is that Atabay is in the process of requesting approval from Health Canada but the process could take 6 to 12 months so we have not received any of the substitute product yet,” Van Dyne said.