Sharing an issue I faced, related to Medical. This may help somone in need.
Issue : Medical forms received for me and family both in GCKEY and email.
Both of these forms had different IME numbers, so this means each applicant now had two IMEs or medical forms and confusion was which one to use at Hospital. :
Which forms I used : I did medicals using GcKEY IMEs or forms and another IME issued in our names or passports were having PENDING status at Hospital.
What steps I took to get a solution: Requested hospital to Upload my reports in duplicated IME as well , to which they denied out of no authority.
Made Case Specific enquiry 3 times -- 2 times at Webform IRcC and once to IRCC New Delhi.
How it affected my processing : I got Medical Status Passed at GCKEY after 45 days of waiting and 46th day ECAS also showed Received in status " The fourth line ". So it caused a delayed update but caused no delay in further processing. Still waiting for DM/PPR
Importance of CSE : In this case on a friend's suggestion I made CSE New Delhi, which definitely helped in my case. So I strongly recommend CSE in case of Urgent updates or enquiries.
https://secure.cic.gc.ca/enquiries-renseignements/case-cas-eng.aspx?mission=new%20delhi
Learnings : Always use info provided by CIC in emails , if no option only then opt for GCKEY forms.
I think I answered the query in breif.
Good Luck 8)