Tony Kinney thought the metal device implanted in his hip by a surgeon in 2006 would relieve his pain. But instead, he says, it left him living in anguish and unable to work.

“I can’t do anything. I’ve lost everything I own, house and possessions,” he says.

Metal-on-metal hip devices, like the kind Kinney received, have been the subject of concern — and even lawsuits — for more than 15 years. The devices have been known to cause pain, potential metal poisoning and the need for additional surgeries in some patients. The devices are no longer used at all for total hip replacements in Canada because of those complications.

But they continue to be used — though in shrinking numbers — for hip resurfacing: a bone-preserving alternative that reshapes the ball, called the femoral head, at the top of the thighbone and caps it with a prosthesis. The surgery is considered most suitable for younger men who want to maintain movement and athletic ability.

In 2012, Health Canada issued a notice to surgeons about the risks of metal-on-metal hip implants, especially for women, saying they were known to cause “pain, implant loosening and significant soft tissue reactions thought to be the result of increased levels of metal (cobalt and chromium) ions in the surrounding joint tissue.”

Even so, since then there have been at least 5,215 hip resurfacings reported in Canada, according to data provided to the Investigative Journalism Bureau by the Canadian Institute for Health Information (CIHI).

CIHI’s data does not indicate the implant material, but all hip resurfacing devices licensed in the country were metal-on-metal until last month, Health Canada spokesperson Karine LeBlanc said in an email. In late July, a ceramic hip resurfacing system was approved.

At least 492 Canadians had hip resurfacing surgery in the 2012-13 fiscal year — the same year the notice was sent out. Fifty-three of them were women, despite being identified by Health Canada as a group with increased risk for metal hip implants.

The number of resurfacings overall didn’t dip below 400 until 2019.

So far, in 2025-26, at least 280 Canadians have had the surgery. (The data excludes Quebec, which requires special authorization to release such information to CIHI.)

“I can make an argument that every hip resurfacing that’s metal-on-metal is failed from day one,” said Dr. Stephen Tower, an orthopedic surgeon based in Alaska, who was implanted with a metal device himself during hip replacement surgery.

The devices expose nearly anyone implanted “to toxic levels of cobalt in blood and urine,” he said, adding elevated levels are associated with neurologic and cardiovascular issues.

Why hasn’t Health Canada acted? “It is not within Health Canada’s mandate to oversee patient management or the delivery of clinical care,” said LeBlanc.

Debate over hip resurfacing

Kinney’s arthritis and hip pain hindered him from being able to work long shifts as an aircraft engineer in Nova Scotia. He was told resurfacing was the solution.

Today, 20 years after his surgery, he is part of a national class action lawsuit, yet to be certified, alleging the implants he and others received are “inherently defective.”

The suit targets Wright Medical Technology, an American company that sold its orthopedics parts business to MicroPort Scientific Corporation in 2014. MicroPort, founded in Shanghai, China, is also named in another class action suit proceeding at the same time with similar allegations.

The law firms representing MicroPort and Wright, respectively, declined to comment on the lawsuits. Both have filed a notice of intent to defend their actions in Ontario.

There is debate within the North American medical community about the role of metal-on-metal hip resurfacings.

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Some orthopedic surgeons interviewed by the IJB called them a vestige of the past.

Dr. Amit Atrey, an orthopedic surgeon based in Toronto and spokesperson for Arthritis Society Canada, said there’s been a shift away from metal-on-metal resurfacings because of the risks and because total “hip replacements now work so well.”

Others disagreed, saying metal resurfacings can be the best option for carefully selected patients. They allow for a higher range of motion than a total replacement and have lower dislocation rates.

Metal-on-metal is not “inherently bad,” said Dr. Prem Ramkumar, an orthopedic surgeon based in California. “It’s fine if used for the right indication, with the appropriate metallurgy, and positioned correctly during surgery.”

Dr. John Antoniou, a Montreal orthopedic surgeon who does resurfacing surgeries, agreed. “Registry data indicates that metal-on-metal resurfacing should be done on men with good bone stock who are very active,” he said.

There are only a few surgeons in Canada who do such surgeries because of the steep learning curve and volume required to maintain one’s skill, he said.

A 2025 study , published in the AME Surgical Journal, looked at online joint registry data between 2010 to 2024. Its authors concluded that resurfacing is a “safe and effective alternative to (replacement) for appropriately selected patients when performed by experienced surgeons at specialised centres.” It also called increased levels of metal ions “a significant problem.”

Metal particles released into the circulatory system when metal components rub together can eat away at tissue and cause damage in the area. According to Health Canada, it can cause pain in the groin, hip or leg, swelling at or near the hip joint, a limp and limited range of motion.

‘Missed out on life’

A year after his resurfacing, Kinney had surgery to remove the metal implant and replace it with a non-metal device. But the pain continued.

In 2016, Kinney sold his home, unable to survive on long-term disability benefits. He left Nova Scotia — rent was too high — and moved to New Brunswick, farther from his grown children. His time is spent managing pain.

“Missed out on life, pretty much,” he said.

He isn’t alone.

Doug Smerek, a Calgary karate instructor, was implanted with two metal-on-metal devices, one in each hip, in 2017 and 2022 respectively.

Both of Smerek’s surgeries came after the Health Canada warning, which he says his doctors never flagged.

He’s been “living a nightmare,” he told the IJB. The implants have caused him pain, cramping in his calves, and difficulty lifting the front part of his foot. He says he has anxiety attacks at night.

One of the metal devices implanted in Smerek, made by MicroPort, was also recalled in 2016 — a year before it was put into his body. The recall was issued due to an increasing trend of follow-up surgeries since 2009 and a “specific hazard/harm for suspected tissue reaction to metal debris,” according to the Health Canada recall notice.

The recall applied to the parts if used for hip replacement, not if used for resurfacing. But Smerek says he is still concerned.

“Health Canada recognizes that these experiences can be difficult for patients and families,” LeBlanc told the IJB. “Patients who have concerns about their devices should contact their healthcare provider.”

It’s up to the provinces and territories to deliver services, including the procurement and use of devices in their public health systems, said LeBlanc.

Health Canada can take regulatory action when warranted, “based on emerging evidence such as new scientific literature, reports of medical device problems, and information shared by international regulators,” she said.

The federal department supposedly keeps track of hip resurfacing devices as part of its “standard ongoing post-market monitoring.” But since the 2012 warning, there have been no updates or additional notices.

Health Canada initiated a review of metal-containing hip implants in 2019. But resources had to be reallocated due to the COVID pandemic and the assessment was postponed indefinitely, said LeBlanc.

Not every province or territory is mandated to report to CIHI, which manages the national medical device registry. The IJB reached out to provincial health authorities across Canada with questions about the current use of metal-on-metal hips devices. The responses reveal a patchwork of policies.

In British Columbia, Fraser Health and Vancouver Coastal Health said their facilities do not use metal-on-metal for resurfacings. Acute Care Alberta said the same.

Metal-on-metal is only used for hip resurfacings in “very rare circumstances,” Nova Scotia Health told the IJB.

Santé Quebec said implant use varies depending on the institution and surgeon. Saskatchewan Health Authority said the decision on the type of implant used “is made by the physicians in consultation with their patient” and “is not at the direction” of the agency.

Ontario Health did not respond to the IJB’s request for comment.

Lawsuits launched

Several previous class action lawsuits in Canada were launched against metal hip device manufacturers starting around 2010, resulting in recalls and settlements from major companies such as Johnson and Johnson, Stryker and Zimmer.

In September, a certification hearing will be held for the class action that includes Kinney and Smerek as plaintiffs. Certification means a judge must decide if the case can proceed as a class action.

“There’s no place for these products in the marketplace at all,” said Joel Rochon, a partner at Rochon Genoa, the law firm handling the class action suit.

“Health Canada and the regulators need to step up and do their part to ensure that these allegedly defective devices are no longer available.”

***

Tower, the Alaskan surgeon, had a metal-on-metal hip replacement in 2006. He says he suffered a slew of symptoms including tinnitus, mild deafness, spatial disorientation and sleep apnea. The symptoms, he said, stemmed from cobalt toxicity, also referred to as metallosis, a kind of metal poisoning.

The symptoms disappeared when the implant was removed, he says.

“If Canadian patients can still get a hip resurfacing through the public system, those responsible for quality assurance at Medicare and those at the FDA following adverse medical device events are either wilfully blind or asleep at the switch,” he told the IJB.

Patients can become quite sick, said Tower. “They’re very frustrated because nobody knows what to do with them, and a lot of times they’re dismissed.”

Smerek agrees. After being ignored by Canadian doctors, he said, he found a surgeon in the U.S. who specializes in revisions. He has undergone revision surgery for one of his hips but is awaiting a second surgery to remove the last metal device still in his body.

“I’m deteriorating slowly,” he said. “I can’t wait.”

The Investigative Journalism Bureau (IJB) at the University of Toronto’s Dalla Lana School of Public Health is a collaborative investigative newsroom supported by Postmedia that partners with academics, researchers and journalists while training the next generation of investigative reporters.

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Canadian provincial politicians are vastly overpaid compared to their U.S. counterparts, but their electors have little to show for it, according to a new report released by the Canadian Taxpayers Federation (CTF).

The Subnational Politician Pay Report looks at average salaries for provincial and state politicians across Canada and the United States.

It found that Canada’s provincial politicians are paid significantly more than their American counterparts; almost twice as much in fact. The average wage for a provincial politician last year was $115,378, while state legislators made just $58,241 on average. (All figures are in Canadian dollars.) Only 18 per cent of American representatives make over $100,000, while 70 per cent of Canada’s provincial politicians do so.

The list of salaries is topped by New York, California, and Pennsylvania, all among the top five U.S. states in terms of population. California’s roughly 40 million inhabitants is almost on par with all of Canada.

Next in the list were the provinces of Ontario and Quebec, combined home to about 60 per cent of Canadians. They were followed by Illinois, Alberta, Alaska and British Columbia.

Next up in tenth place was Massachusetts, followed by Nova Scotia, Manitoba and Saskatchewan. The provinces of Newfoundland and Labrador, New Brunswick and Prince Edward Island were not far behind, in 17th, 18th and 22nd place, respectively.

“Politicians often argue they should give themselves bigger salaries to attract talented people to run for political office,” the report notes. “If it’s true, jurisdictions with high-paid politicians should perform better. In reality, there is little correlation between jurisdictions that pay politicians handsomely and better outcomes for taxpayers.”

For instance, Texas, with a state representative salary of just $10,331, came sixth last on the list.

“Despite this, Texas is wealthier on a per-person basis than any Canadian province, with a GDP per capita of $88,517,” the report found. North Dakota was also low on the list of salaries, paying just $10,193, while also outperforming every Canadian province in GDP per capita.

“Of the 19 American states with a higher GDP per capita than all Canadian provinces, 13 of those states pay their representatives less than any Canadian province,” the report said. “New Mexico, the only subnational jurisdiction across Canada and the United States that doesn’t pay its representatives, is wealthier than eight of 10 Canadian provinces.”

While politicians’ salaries seemed to have little correlation with their constituents’ wealth, there was a link between higher pay and higher taxes. A list of the combined top marginal tax rates was topped by eight Canadian provinces, all with rates of more than 50 per cent. California came next, with Alberta and Saskatchewan not far behind in 11th and 14th place, respectively.

“States with low salaries for politicians take disproportionately less money from taxpayers,” the report found. “Among the 10 American states with a top marginal tax rate lower than 40 per cent, only one state (Alaska) pays their politicians more than $50,000 a year. The average politician salary among these states is $30,892.”

The CTF had particularly harsh words for Albertaand B.C. , given their combination of low population, high MLA salaries and low GDP per capita.

“Alberta MLAs are getting paid more than most politicians, but taxpayers aren’t getting top-notch results,” said Kris Sims, CTF’s Alberta Director. “Giving bigger paycheques to politicians doesn’t lead to better outcomes for taxpayers.”

She added: ““In Colorado, which is almost the same size as Alberta, state politicians are paid about $66,000 and people in that state are richer than they are here.” Indeed, Colorado salaries placed it at roughly the middle of the pack, but its GDP per capita put it in 10th place. Alberta was the top Canadian province in that list, at 20th.

Alberta MLAs got paid $123,838, in 2025, the third highest among Canada’s provincial politicians and the seventh highest salary of subnational politicians across Canada and the United States.

Meanwhile, B.C. placed ninth for MLA salaries, 15th last in GDP per capita, and fourth highest in top marginal tax rate. Yet the credit rating agency S&P Global this year downgraded the province to “A” from “A+” and noted: “B.C.’s budgetary performance will be the weakest of peers, both domestic and international.”

“MLAs in Victoria are some of the highest paid while charging some of the highest taxes in North America,” said Carson Binda, CTF’s B.C. Director. “We’re paying premium prices for bargain-bin results from the government benches.”

He noted that B.C. MLAs also gave themselves a pay raise this year, bringing their base salaries to $122,000.

“The last thing MLAs should be doing is lining their pockets with more taxpayer cash,” Binda said. “British Columbians are facing big costs from the province and deserve politicians focused on lowering their bills, not padding their own paycheques.”

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A refugee who pleaded guilty to trafficking large amounts of methamphetamine and fentanyl and committing sexual assault has convinced an Alberta judge to give him more time to appeal his convictions by arguing he was misled into believing he would not get deported for serious criminality.

Mahir Yahya Sharif, who has served three years for his drug and sex crimes, is facing deportation to Somalia after the Department of Immigration declared him a danger to Canada.

Alberta Court of Appeal Justice Kevin Feth has granted Sharif more time, ruling that to deny him the chance to appeal “means he will suffer the ‘unduly punitive effect’ of removal from Canada based on guilty pleas that would not have been entered had he been properly informed, and deportation to a dangerous country he does not know and that does not want him.”

Sharif was a permanent resident at the time of his convictions in 2022, having been admitted into Canada through the refugee settlement program in 2019 at the age of 19.

“He and his family were declared Convention refugees by the United Nations in 2013 based on race-based attacks in Somalia, where his parents were born,” Feth noted in a July 27 decision out of Calgary. At the time, Sharif and his family were living in a refugee camp in Egypt.

Sharif was born in Saudi Arabia in 1999, after his parents fled there from Somalia. His first language is Arabic. He does not speak Somali.

He has a history of schizophrenia, aggravated by substance use that apparently started after coming to Canada, the judge said in his decision.

“Immigration proceedings leading to deportation were initiated against the applicant in 2024 because of his convictions, and he has since been found inadmissible to remain in Canada on grounds of serious criminality.”

After Sharif breached his parole conditions, he was “returned to custody in late 2024 and ultimately placed in the Regional Psychiatric Centre in Saskatchewan,” said Feth’s decision.

“In early 2025, he was visited by an immigration officer twice and provided with voluminous immigration documents, all in English, but ‘did not understand what the immigration proceedings were.’ He was told to respond by April 2025,” Feth said.

In May 2025, a delegate of Immigration Minister Lena Diab determined Sharif was inadmissible in Canada. “Mr. Sharif’s criminal activities were both serious and dangerous to the public, in addition to the lack of evidence of rehabilitation and the difficulty following rules, I have reasonable ground to believe that Mr. Sharif represents a present and future danger to the Canadian public, whose presence in Canada poses an unacceptable risk,” said the delegate in a report.

The delegate “found a ‘less than reasonable chance’ that the applicant would be at risk if returned to Somalia, and that any humanitarian and compassionate considerations for his continued residency in Canada were outweighed by the danger he posed to the public.”

Sharif lost his residency and was transferred to Ontario into the custody of Canada Border Services to await deportation on June 30, 2025. He was told that Somalia had informed Canadian officials that he would not be accepted into the country, so he was to be deported to Nairobi, Kenya, where he would be left to make his own way to Somalia, Feth said.

This past May, the Federal Court dismissed Sharif’s application for a judicial review of the ministerial delegate’s report that led to his removal order.

“At the same time, the applicant filed a complaint with the United Nations Human Rights Committee which requested that Canada suspend his removal pending consideration of the complaint.”

When Diab refused, Sharif applied for a judicial review of her decision, but a judge dismissed his application.

Last month, the Ontario Court of Appeal dismissed Sharif’s appeal of that decision.

Meanwhile Sharif applied to the Alberta Court of Appeal asking for more time to appeal his convictions.

“The primary argument is that at time of his guilty pleas, the applicant did not understand the collateral consequences of those pleas, including that his convictions and sentence would make him inadmissible in Canada and lead to his deportation with no ability to appeal,” said Feth.

Sharif said his lawyer had told him that if he didn’t plead guilty and tried to defend himself, he would spend more time behind bars.

“My lawyer also told me that I likely would not be deported after pleading guilty because the charges were not serious.”

“When I pled guilty to the charges, I did not know that a conviction for sexual assault or a sentence of more than six months would make me inadmissible in Canada and subject to deportation. I also did not know that if I was ordered removed by immigration officials, I would not be able to appeal that decision because I was a permanent resident and not a citizen.”

Sharif argued he wouldn’t have pleaded guilty if he knew that could lead to deportation. “At the time I pled guilty, I was terrified of being sent to Somalia. I believed I would be imprisoned in Somalia because I am unable to speak Somali and have no connections in that country. I believed I would be killed in Somalia due to my clan. I still believe this is the case.”

Feth heard that Sharif’s convictions involved serious offences, including trafficking large amounts of methamphetamine and fentanyl to undercover police officers.

“The sexual assault involved digital penetration of the complainant’s vagina for a period of 10 minutes, while both the applicant and the complainant were patients in a psychiatric care facility,” Feth said in his ruling.

Sharif also pleaded guilty at the same time to taxi fraud, theft under $5,000 and mischief.

The Immigration Department delegate who determined he posed a danger didn’t address “the seriousness of Mr. Sharif’s mental health condition and how those with mental health issues are treated in Somalia,” Feth said.

The delegate also didn’t explore “whether Somalia would allow his re-entry as (Canada Border Services Agency) internal notes indicate that Somalia does not allow for the return of anyone with a diagnosed mental health issue.”

Diab’s delegate failed to touch on “Somalia’s corresponding refusal to issue him travel documents … the CBSA’s decision not to accompany him to Somalia, contrary to CBSA policy, and … evidence about Al-Shabaab posing a significant and growing security risk in Mogadishu contrary to the author’s conclusion that the group has not had a presence in Mogadishu in over a decade and poses minimal risk.”

The delegate also didn’t consider that Sharif failed to respond to the Danger Opinion because he “was involuntarily held in a mental health institution, had no legal counsel, and did not speak English well enough to respond.”

Even though it dismissed his appeal, “the Ontario Court of Appeal remained concerned about the applicant’s deportation,” said Feth, who noted Sharif plans to apply for leave to appeal the outcome of that case to the Supreme Court of Canada.

“The decision to remove Mr. Sharif given his mental health condition and concomitant needs is harsh,” Feth said.

“There is no dispute that Mr. Sharif was an involuntary patient in a mental hospital at the time he committed the index (sexual assault) offence. No evidence was proffered as to the circumstances surrounding his decision to plead guilty. Moreover, he is seriously ill and will require significant long-term care.”

Somalia has refused to issue him travel documents, Feth said.

“The CBSA will not accompany him to Somalia, contrary to CBSA policy, and there is some evidence that the Al-Shabaab militia has considered that people deported from Western countries may be spies and sometimes execute them based on this suspicion. His removal may well result in serious risks to his safety,” said the judge.

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