Part of cannabis laws and regulations
From the archives: This article was originally published on August 19, 2017
Scott Wood had been losing weight for weeks, and it was starting to scare him. His skin developed strange blistering rashes, his muscles ached constantly, and his lungs burned. He couldn’t stop coughing, and he was spitting up gobs of thick, clear mucous that looked like Vaseline.
But the worst day came in October when Mr. Wood, 53, a family man and military veteran, collapsed at the grocery store. "I walked about five feet, and I couldn't get a breath," he said. "I was down on my hands and knees in the parking lot."
He ended up in the emergency room that week – the first of seven trips to the ER over a span of six months – but the doctors couldn't figure out what was wrong. It was only later that he began to suspect what was really going on.
Mr. Wood, a former military police officer, had been consuming medical marijuana that, unbeknownst to him, was contaminated with several dangerous pesticides banned by Health Canada.
A doctor had prescribed the marijuana from a federally regulated drug company in September to treat a serious back injury Mr. Wood suffered while serving. At first, it was a godsend, allowing him to stop taking opioid painkillers and get on with his life.
Then, suddenly, in a matter of weeks, "my health went sideways," he said.
He stopped taking the marijuana soon after the mysterious symptoms began. It wasn't for another few months that the company supplying his prescription, Organigram Inc., revealed a problem: nearly all of its products from the previous year were unfit for consumption, and were being recalled due to chemical contamination.
The company, one of about 50 federally licensed medical marijuana producers in Canada, had been caught selling products tainted with two banned pesticides: myclobutanil, a chemical used to kill mildew, and bifenazate, an insecticide prohibited for use on certain types of plants, including cannabis.
The recall has impacted thousands of people, and raised questions about oversight and quality control inside Canada's new federally regulated medical marijuana sector – particularly as the government prepares to legalize the drug for recreational use next year, creating a multibillion-dollar industry. It is one of the most sweeping new policy decisions the federal government has undertaken in years, ending nearly a century of prohibition on cannabis.
In a bid to minimize concerns about the recall, Organigram told its customers there was nothing to be concerned with: the risk of adverse health consequences, it said, was "remote." The company, which grows the product at an indoor facility in Moncton, N.B., said it had no idea how banned pesticides got into its products.
But to Mr. Wood and others who had become seriously ill, something was wrong.
"When I heard that response, I thought, 'Come on – you have almost a year's worth of marijuana, and you don't know?' As a former police officer and investigator, when you give an answer like that, it doesn't sound very credible. Especially when you're in a business that is dealing with people's health," Mr. Wood said.
"Basically, my thoughts were, okay, let's see if that's true or not."
So Mr. Wood gathered his remaining prescriptions, and those of a military colleague whose health had also taken a turn for the worse. Instead of returning them in the recall, he reached out to The Globe and Mail, which arranged for the prescriptions to be tested at a federally licensed laboratory that is among the most experienced facilities in the country at screening for pesticides.
The results of the tests shocked him. Mr. Wood's prescriptions not only contained the two banned pesticides that triggered Organigram's original recall eight months ago, the samples also contained three additional pesticides that are outlawed by Health Canada for safety reasons.
In addition to the myclobutanil and bifenazate that were previously known, Mr. Wood's samples contained significant amounts of imazalil, tebuconazole, and a carbamate pesticide.
Imazalil is used to eradicate root rot, and is not to be inhaled. Tebuconazole attacks fungi outbreaks, but can damage the endocrine system in humans. Carbamate pesticides kill bugs by targeting and disrupting their nervous systems.
The results have called into question the inner workings of Canada's booming marijuana sector since Health Canada began doling out highly coveted production licences four years ago, while reassuring consumers that companies in the lucrative new industry would not be allowed to put profits ahead of safety.
The tests have also ignited a bitter war of words between Mr. Wood and the company, which disputes his findings.
Organigram sent product samples from its own archives to be screened at a lab of its choosing, and said those tests showed no signs of any additional pesticides.
Not satisfied with that response, though, and growing increasingly concerned about the problem of illicit pesticide use inside a supposedly quality-controlled industry, Health Canada conducted an unannounced inspection of Organigram's facility, and gathered archive samples of its own to have screened.
Those tests, completed in August, also did not find the additional pesticides contained in Mr. Wood's samples, raising questions about the discrepancy between the results.
The company believes the new allegations are false. Mr. Wood believes customers aren't being told the truth about what they were exposed to – that the archive samples kept in storage at Organigram have been whitewashed, and don't match up with what people like him actually consumed.
Through social media, Mr. Wood has assembled a database of hundreds of people across Canada who are all reporting the same mysterious health problems: searing abdominal pains, fatigue, blistering rashes, painful aching muscles, lung problems, constant nausea, and – curiously – coughing up a strange clear, thick, mucous.
"You've got all these people, they don't know each other, they all have the same symptoms," Mr. Wood said. And while there has been no determination, "Something's not right. Somebody needs to look into this."
'These are not trace amounts'
When MB Labs, based in Sidney, B.C., received the products from Mr. Wood for testing, the lab examined each sample to ensure they had not been tampered with.
Seven of the eight containers were still factory sealed, while one prescription had been opened and partially consumed – the one Mr. Wood was taking at the time his symptoms forced him to stop.
The lab inspected and photographed the containers using the same procedures it employs when handling evidence for the B.C. Supreme Court. The packaging on the seven unopened containers was intact, MB Labs said, including the foil seal on each bottle. All eight samples were then screened for any signs of foul play, looking for evidence of recently added substances – which would set off alarm bells in the chemical analysis. New contaminants would show up in purer form than the others present.
Nothing irregular was detected in the analysis.
"There was no tampering that we could see," said Wendy Riggs, director of MB Labs. "We are perfectly prepared to testify to that."
Though it was forced to recall a year's worth of production spanning nearly all of 2016, Organigram has denied any knowledge that banned pesticides were in its products. The company said it conducted an internal investigation in February, and was unable to determine where the chemicals came from.
This apparent lack of quality control in the new industry, which was created in 2013, is a problem that has implications far beyond patient safety in the billion-dollar medical marijuana sector. With the federal government preparing landmark legislation to legalize cannabis for recreational use in 2018, Health Canada has said it will rely upon licensed producers such as Organigram to supply the new retail market.
This new business could be worth as much as $10-billion, based on some estimates, and is expected to create a surge in consumption among Canadians when the government moves to sell it openly, much like beer and wine.
The rapid onset of this new industry has encouraged companies to expand quickly. As a result, some offer financial incentives to their staff for producing bigger and higher yielding crops.
Those very bonus structures could – theoretically – encourage employees to break the rules if a crop worth hundreds of thousands of dollars or more is threatened by an infestation of mites or mildew, a common problem when growing the plants indoors in large-scale operations.
"Did we have employees that were incentivized to get a higher yield? Of course," said Dennis Arsenault, the former CEO of Organigram.
"Were there employees that could have been incentivized [to use banned pesticides], either to save their job, either to increase yields, [or] to show competence? Yeah, of course. But have I been able to catch them? No."
Mr. Arsenault stepped aside as CEO after the Organigram recall was announced, following an investigation undertaken by the company, which failed to get to the bottom of the problem. He now sits on the board of directors.
"Where I felt that it was possible was a mid-level manager who, maybe having trouble doing his job, cuts a couple of corners. That to me was what was plausible," he said.
"I think you have to draw the conclusion that someone put it there… We couldn't find the guilty person."
But Organigram isn't the only company with problems. Its recall is one of four known instances of banned-chemical use to hit the industry in the past eight months.
Amid these recalls, it has become easy for companies to tell Health Canada they have no idea how the banned chemicals got into their products. Two of the four recalls – at Organigram, and at rival producer Mettrum – have been dismissed in this fashion, with no determination of how consumers were put at risk.
Health Canada is only now coming to the realization that tougher enforcement is needed.
"Pesticides can be a very powerful ally to food and medicine production, but they have to be used with knowledge and a great deal of care," said Ms. Riggs at MB Labs.
"Because although they may get you out of a pickle and get a crop off the field, they could leave your ultimate client down the line in a great deal of harm. And that is something that has been lost…. There's just too much money riding on these crops."
Despite the fact that such pesticides are strictly banned due to concerns about their impact on human health, and there is no acceptable amount that is allowed under Health Canada regulations, in several of the recalls that have taken place, companies have played down the problem for consumers.
When Organigram announced its recall, the company said the levels detected were only "trace amounts," suggesting there is nothing to be concerned about.
Worried consumers who phoned the company were also informed that such pesticides were sometimes used on food. This explanation omits the fact that many pesticides are designed to be broken down and neutralized by enzymes in the digestive system. Inhaling those same pesticides can be dangerous, and is warned against by the chemical manufacturers.
Organigram said the "trace" levels involved in its recall included myclobutanil concentrations of up to 20 parts per million (ppm), and bifenazate of up to 12 ppm.
While those numbers may sound minuscule, they are not.
Pesticide expert Rodger Voelker, director of Portland-based Oregon Grower's Analytical, a laboratory that helped uncover illegal pesticide use in Oregon and Colorado, where marijuana is legal, said the levels showing up in Canada are far too high.
"These are not trace amounts," Mr. Voelker said of the levels stated by Organigram, and found in Mr. Wood's prescriptions.
What consumers don't know is the term "trace amount" has no real meaning, and companies therefore use it however they want.
"Can you do anything about it? No, because 'trace' is not a legally binding word. So they'll say that as long as they can get away with it."
Among microbiologists, the term "trace amount" usually means a substance that can be detected through chemical analysis, but is too faint to be properly measured. Mr. Voelker, who called the pesticide problem "an emerging public health threat" that governments have not fully considered as they prepare to legalize the drug, argued that trace amounts are usually much smaller than one part per billion, which is equal to 0.001 parts per million. By that measure, the Organigram samples don't come close to being trace levels, he said.
The tests conducted by MB Labs on Mr. Wood's prescriptions turned up myclobutanil levels as high as 13.9 ppm, and bifenazate levels of 23.7 ppm.
The carbamate compound was detected at 26.9 ppm, while imazalil was found at 0.13 ppm, and the tebuconazole at 0.03 ppm.
While those latter two figures may also seem miniscule, Mr. Voelker insisted they are not, particularly since even small amounts of a harmful chemical can have a profoundly negative impact.
"These numbers are egregious," he said. "On an instrument, that's a pretty damn big signal."
His read of the data is that pesticides were applied to the plants in question. "It is extraordinarily unlikely to see numbers like some of these numbers as a result of indirect [accidental] application," Mr. Voelker said.
Ms. Riggs at MB Labs came to the same conclusion. Her analysis of the data is that the pesticide use was intentional – over a sustained period of time – even though Organigram has denied any knowledge of their use.
"The pattern that shows up here is deeply disturbing," Ms. Riggs said.
'We now consider this matter closed'
Though Organigram has already been caught selling products containing two banned pesticides, the company denies further chemicals could have been present.
When informed of Mr. Wood's test results, Organigram CEO Greg Engel immediately suggested the samples could have been manipulated, and that the company wasn't to blame.
As evidence, Mr. Engel said Organigram's own safety packaging – including its tamper-resistant seal – can be easily tampered with.
"I have very real concerns," Mr. Engel told The Globe about the findings. It would be "very easy for an unscrupulous individual to remove our product, replace with tainted product and then place a new tamper-resistant heat seal on the product."
Mr. Engel then said he believed the former customer was intentionally trying to hurt his company.
But there were several problems with the CEO's claim.
Mr. Engel said the customer in question told Organigram in a Jan. 25 e-mail that he would not return his recalled product, and wanted to have it tested. However, the customer was unsure how much was left. To Mr. Engel, this implied the containers had been opened.
Mr. Engel also said the patient had spoken "numerous times" with Organigram's head of customer service, Kathy Cyr, and had made "threats" toward the company.
However, Mr. Wood said he never sent any such e-mail to the company and never spoke with Ms. Cyr, though he requested to speak with her, but was denied by Organigram.
Mr. Wood provided The Globe and Mail with e-mails, recordings of phone calls, and copies of his phone records. His instinct to catalogue every interaction with the company came from his policing days, he said.
The Globe and Mail reviewed this information – including a 53-minute recorded phone call Mr. Wood held with an Organigram senior executive in January to seek more information about the chemicals found in the recall.
When Mr. Engel was asked about that phone call, the CEO said he had no record of it taking place. It was only after Mr. Engel was told that The Globe listened to a recording of the call that Mr. Engel changed his position: yes, in fact that phone call did take place.
Then, when he was informed that there was no record of an e-mail on Jan. 25 – a central piece of the company's argument that the samples could not be trusted – Mr. Engel backtracked, saying the e-mail didn't exist. It was actually a phone call, he said.
Yet, no such call – incoming or outgoing – shows up in Mr. Wood's phone records.
Mr. Wood is upset by the company's reaction.
"People are sick. I want to know what I was exposed to, so that I can seek proper medical treatment," he said. "If they want to investigate me, I welcome their investigation."
While these inconsistencies were being sorted out, Organigram sent product samples from its internal archives for testing. Mr. Engel says the samples came from the same product lots that Mr. Wood would have consumed.
Those tests, conducted at Vancouver's Anandia Labs, confirmed the presence of the two banned pesticides involved in the original recall – myclobutanil and bifenazate – but came back negative for the additional three MB Labs found – imazalil, tebuconazole and carbamate.
"We now consider this matter closed," Mr. Engel said in an e-mail to The Globe, refusing to discuss the matter further.
Dangerous chemicals, difficult to find
Health Canada does not consider the matter of pesticides in the industry closed. The department and the laboratories involved believe there is an explanation for the discrepancies in the test results, and that any potential problems should not be so easily dismissed.
Different labs can find different things, depending on the experience of the technicians, the accuracy of the equipment being used, and whether the samples being tested came from exactly the same plants – or not.
Mr. Engel told The Globe that the facility Organigram chose for its tests, Vancouver's Anandia Labs, uses the highest standards in Canada, implying that Organigram's results were of the highest possible accuracy.
But Jonathan Page, head of Anandia, said that's not necessarily the case.
"Our equipment is standard equipment," Mr. Page said of the lab that began operating last summer. "We are among the most sensitive, but we didn't invent a new machine that gives us an order-of-magnitude higher sensitivity than other labs."
Mr. Page said it's possible his lab tested archived samples that came from different plants in the harvest than the ones that went into the prescriptions of Mr. Wood and others.
"We didn't find those compounds and another lab did, and at fairly high levels," Mr. Page said. "Were there differences between the sample we tested and what was tested elsewhere?"
Mr. Page said he'd be less skeptical had Organigram not already been caught selling product containing banned pesticides – then claimed it was unable to determine the root of the problem.
"Let's face it, they didn't get to the bottom of it," Mr. Page said.
Ms. Riggs at MB Labs says her facility has more than 30 years of experience screening for pesticides, and certain compounds can be hard to isolate.
Her lab began specializing in imazalil more than a decade ago when it began showing up illicitly on greenhouse vegetables.
"Imazalil sulfate is a bugger," Ms. Riggs said. "It was a compound the greenhouse industry for vegetables snuck in to deal with root rot – because it worked. It wasn't legal, but they brought it in anyway. And we knew at the time because of its chemistry that it was a difficult compound to find."
Ms. Riggs said there would be obvious signals if the products had been tampered with.
"A cooked sample usually stands out," Ms. Riggs said. "What happens is you have a chemical profile that indicates that the chemical is in a purer state" than it should be.
"It is extremely difficult for someone to do so, without leaving some kind of a footprint behind."
Health Canada told The Globe and Mail it was not unusual to see differing results between labs, since their approaches can differ.
"Depending on the methodologies used, validation of data, and precision of equipment, it is possible and not unexpected to have different results from different laboratories," the department said in a statement.
A new breed of drug companies
Mr. Engel was named CEO in March, part of an effort by Organigram to turn the page on its pesticide recall problems, which had disrupted operations and hindered the company's stock price, upsetting investors.
In hiring the new CEO, Organigram told investors it landed an industry veteran, which was true.
Prior to joining Organigram, Mr. Engel had previously served as CEO of a rival medical marijuana company, B.C.-based Tilray Inc.
However, during Mr. Engel's time at Tilray, lobbying records show the company held backroom discussions with the B.C. government in an effort to gain permission to use myclobutanil, which is banned in Canada and the United States for use on cannabis, tobacco and other combusted plants due to numerous health concerns, including the discovery that it emits hydrogen cyanide when heated.
According to the B.C. lobbyists registry, Tilray asked the B.C. government for help in getting federal approval for "emergency use" of the pesticide when dealing with mildew infestations, and also for "long term" use. The conversation was never intended to be public.
A Tilray spokesman said the effort was later halted when Health Canada created a list of approved alternative fungicides that should be used instead of the banned pesticide.
The effort would not have had much chance of succeeding, though. The manufacturer, Dow AgroSciences, does not consider myclobutanil safe for use on plants such as cannabis. When inhaled, the compound enters the bloodstream directly through the lungs, without being broken down by the digestive system. No studies have been done to determine whether it is safe to be smoked, and Dow AgroSciences strictly warns against inhalation.
The lobbying documents are an interesting glimpse inside the industry, since the use of pesticides – legal or otherwise – is rarely discussed in the open.
When medical marijuana companies like Organigram meet with investors, they tout themselves not as weed growers or pot heads, but sophisticated pharmaceutical businesses concerned with the health of their clients.
Given the spate of pesticide recalls this year, it's a sales pitch that doesn't always reflect reality.
At an investor conference in Toronto in April, Mr. Engel pitched Organigram to a crowd of several hundred potential shareholders from Bay Street investment firms, telling them about the company's focus on producing high-quality medicine.
From there, the CEO focused on how big the market was going to be once legalization arrived in Canada, and how companies like his stood to profit.
The medical marijuana market was a few billion dollars now, he said. But the industry payday from legalization could be worth much more.
Even better for the industry, Mr. Engel told the audience, is the Canadian government had chosen companies like Organigram to supply this lucrative new market.
"Licensed producers are the preferred source for safe product," he told the audience. He did not mention the pesticide problems Organigram had encountered.
Lab data blacked out
Patients who consumed the tainted marijuana are now searching for answers about their health. Some former Organigram customers, like Wayne Jory, are worried.
Mr. Jory, a 55-year-old homebuilder and father, was never a marijuana smoker. He was prescribed Organigram's products starting in late 2014 after surgery to repair a herniated disc. He disliked the morphine he was given after the operation and found medical marijuana had fewer side effects.
Mr. Jory researched the industry carefully before settling on Organigram, selecting the company because they touted their product as safe, organic, and pesticide-free.
For a while there were no problems. But in May, 2016, Mr. Jory began to notice his lungs burning for days on end, his heart racing inexplicably, and pain shooting through his muscles. He soon began shedding weight – dropping 40 pounds from his 215-pound frame in only a few months. He felt tired all the time, and was dogged by severe, inexplicable bouts of nausea.
"Simple tasks like climbing stairs seemed to drain all my energy. My joints were aching," he said. "I could barely climb a ladder, and when I did, I felt unstable and dizzy."
His doctor was baffled. X-rays on Mr. Jory's lungs came back negative, as did basic blood tests.
"The fatigue was unreal," Mr. Jory said. "In January I went back to my doctor, he ordered more blood tests, and I was told that if I lost any more weight I'd have to get myself to the hospital."
Mr. Jory soon learned about the Organigram recall. Once the problem came to light, his doctor wanted to know exactly how much of the chemicals Mr. Jory had been exposed to, but the company only gave vague numbers for the whole recall, not specifics.
Mr. Jory then filed a request to Health Canada through Access to Information, seeking to know the exact chemical content of each product lot he ingested.
He was surprised to learn in May that he was not entitled to such information.
Mr. Jory was told by the Access to Information and Privacy commissioner for Health Canada that the data he sought was being withheld because it "could result in material financial loss" to a third party.
In his case, that third party was Organigram.
Instead, Mr. Jory received numerous pages of records with the information blacked out, citing privacy laws that, in his case, protected the company – not the consumer.
"They basically just want to bury this," Mr. Jory said. "And I understand why – it's everybody's dirty laundry."
Patients who contact Health Canada complaining of health problems are told to file an Adverse Reaction Report, which is how the government tracks problems with prescription drugs. However, these filings are usually just anecdotal reports that are used for data-keeping purposes.
The Globe has talked to more than a dozen patients who say nothing happens when you file such a report.
Nicolette Lutz of Listowel, Ont., submitted two reports to Health Canada after falling ill from medical marijuana that was later recalled by Organigram.
Her symptoms included abdominal pains, constant burning in her lungs and throat, and a strange buildup of mucous. She couldn't eat, she itched constantly and her skin broke out in painful cyst-like sores across her neck, arms, chest and stomach.
"The worst was the abdominal pain," said Ms. Lutz, 35, who turned to medical marijuana reluctantly to help with chronic insomnia, and assumed it was safe because it was federally regulated.
"There was one night, my husband was sitting beside me on the bed just holding my hand, trying to help me breathe, because I felt like I was going to pass out. It was just so incredibly bad."
Ms. Lutz never heard from Health Canada, and doesn't know if they read the reports she filed. She later e-mailed the department directly to warn them she thought something was seriously wrong with the product, but received a standard response with some links to the government's website.
When she e-mailed Organigram in February to complain about her symptoms, she was offered a refund, but was told she would have to sign a legal release form.
In exchange for a $95 refund, Ms. Lutz would have to agree to "hold harmless Organigram … from any and all liability and damages."
The form included a "confidentiality undertaking" that would prevent her from discussing the matter publicly, and a "non-disparagement" agreement – which stated she could not "criticize, ridicule or make any statement which disparages or is derogatory" toward Organigram or its directors, including posts on social media.
Read the full document here
She didn't sign the form. Eight months after her symptoms emerged, many of the problems persist. Unable to find answers with her local doctor, she is travelling to a clinic in Seattle next week that specializes in toxicology.
She persisted. But Mr. Jory says some people have given up.
"There are others that are too tired to fight," Mr. Jory said. "We're talking about people with cancer. They've got all these other health issues and this was just added on top and they don't have the energy to fight it."
The Globe contacted Health Minister Jane Philpott's office several times this year to ask whether the government plans to look into the health problems some patients are reporting, or at least re-examine the public statement issued by the department that said the risk of adverse health consequences from the recall is "remote," when the evidence suggests that is not the case.
Ms. Philpott's spokesman has said repeatedly the Minister has no comment.
Following the recall, Health Canada attached new conditions to Organigram's operating licence requiring that a licensed laboratory test all of its products.
"Prior to the release and sale of all of our products, we provide the test data to Health Canada for their review," Mr. Engel said this week. "Following their review we are then in a position to release the product for sale."
But Mr. Jory said more should be done, including an investigation into the health problems people have suffered. Things would be different, he said, if the people who are now sick had bought the product off the street, where there are no regulations or supposed oversight. But people like him thought they were buying a government regulated medicine that was safe to consume.
He wonders what will happen if the problems aren't solved by the time the government legalizes marijuana for recreational use next year, when consumption in Canada is expected to rise sharply.
"When this stuff becomes recreational, they're going to be shooting it out the door because they can't keep up to the demand," Mr. Jory said. "It's just asking for problems."
Mr. Wood sympathizes.
"Medically, there's a lot of people looking for answers," he said. "I had a military guy tell me he was using [the recalled product] every day. He's a combat veteran with PTSD. Why should a combat veteran who risks his ass come home, get poisoned, and then the Health Minister says we have no comment?" Mr. Wood said.
New safety measures
Health Canada announced a few months ago that it will now require all of the roughly 50 federally regulated medical marijuana companies to submit to mandatory pesticide testing before products can be sold, to ensure they are clean, and that consumers can trust the industry.
When The Globe informed Health Canada of the test results showing previously unreported pesticides in Mr. Wood's prescription, the department responded swiftly, asking to examine the data.
"As the department responsible for regulating medical cannabis, Health Canada is very interested in the information you have collected," the department said in an e-mail.
"The department takes the information you shared seriously."
A week later, after speaking directly with MB Labs about how the tests were conducted, Health Canada said it was making several more changes to the way the industry and Organigram operates.
"Since learning of the results of tests conducted by MB Labs, Health Canada has taken a number of additional actions."
Health Canada said the lab used by Organigram for its newly mandated safety testing, which is located in New Brunswick, will now be required to screen for a wider array of pesticides – including the same ones that showed up in Mr. Wood's tests.
The lab has added "imazalil and tebuconazole to the testing for more than 70 pesticides that it currently conducts," Health Canada said.
The department said it is now also taking steps to address discrepancies in results from different labs across the country, so more situations don't emerge where one lab is unable to detect pesticides that another could.
"Health Canada is preparing to provide a standard laboratory methodology for pesticide testing in cannabis to licenced producers, which can be used by all third-party laboratories. This should reduce the likelihood of discrepancies between laboratories," the department said.
"We would like to thank you for bringing this information to our attention."
While those are promising steps, Mr. Wood said what those affected need most now is better medical advice – from toxicologists or other specialists who can assist them.
He has since travelled to the United States in search of assistance, and has paid thousands of dollars out of pocket for testing and treatment at the Mayo Clinic. He doesn't want to end up in the ER again.
"I'm 53 years old and I was a fit person. So I want to know what is wrong with me," he said.