Events | 2009.09.11
Overdose GP found 'grossly negligent'
Cumbrian GP operated \'far below\' expected medical standards, General Medical Council rules
A doctor who killed a grandmother with a diamorphine overdose and gave another patient a potentially lethal injection within the space of an hour operated at "far below" the medical standard expected, a disciplinary panel ruled today.
In an intermediary decision, the General Medical Council found that the fitness to practise of Dr Michael Stevenson, 57, who worked for an out-of-hours GP service, was "impaired" by his conviction for manslaughter and his "misconduct" in dealing with the second patient.
Stevenson was spared jail when he admitted causing the death of Marjorie Wright, a 58-year-old grandmother, at her home in Workington, Cumbria, in January 2005.
The family GP, from Millom, accidentally gave Mrs Wright a 30mg dose of diamorphine instead of 5mg, failed to monitor her reaction to the drug and left to attend another house call. She was found dead when police broke into her home shortly afterwards.
On his next visit for the CueDoc out-hours GP service, Stevenson administered an identical overdose to a 59-year-old builder, who suffered an immediate respiratory arrest. The patient survived after paramedics were called and gave him an emergency antidote.
The GMC panel\'s chairman, Professor Ken Hobbs, said: "In respect of both Mrs Wright and Mr E, the panel finds Dr Stevenson\'s conduct to have fallen far below the standard expected of a competent registered medical practitioner."
Stevenson initially faced allegations in relation to four patients he treated with painkilling drugs while working for CueDoc. His 15-month jail term, suspended for two years, over the death of Mrs Wright was considered by the panel after they determined the facts of the other cases.
The GMC disciplinary hearing will now consider further evidence and submissions to decide whether Stevenson should be struck off the medical register or be subjected to any professional sanctions. He has previously vowed never to practise again.
In 2007, Preston crown court was told Stevenson, the senior partner at the Seascale Practice, was forced to take a sabbatical by colleagues over concerns about his workaholic nature.
He had suffered from depression since childhood and tried to bury his mental illness through overwork. Later that year lawyers for the GMC told a high court hearing, which extended his interim suspension from practice, that inquiries had been launched into up to 14 further possible excessive dose cases involving Stevenson.
The court heard Cumbria police investigated those allegations but no criminal charges would be brought. Stevenson was called to the home of Mrs Wright on 30 January 2005 after she complained of a migraine.
The fitness to practise panel said Stevenson had at least two opportunities to check the dose he was about to administer to her – both the box and vial of diamorphine were clearly marked 30mg.
Hobbs said: "In the interests of patient safety, it should be standard practice for a general practitioner to check the dosage given on any occasion, but it is even more imperative to do so when administering a potentially dangerous substance such as diamorphine.
"Furthermore, the panel is gravely concerned that after administering the injection, Dr Stevenson must have left Mrs Wright on her own without having stayed to observe her for long enough to monitor adequately her reaction to the medication.
"In this respect, the panel considers that Dr Stevenson was irresponsible in his aftercare of Mrs Wright."
Christina Lambert QC, representing the doctor, said he was working "exceptionally hard" at the time and was "horrified by the events in relation to Mrs Wright, went to the police of his own accord and entered a guilty plea to the charge of manslaughter".
She said that in the context of events he was an "otherwise caring and compassionate medical practitioner".
Giving evidence, Stevenson admitted he was irresponsible in mistakenly giving 30mg of diamorphine hydrochloride to Mr E, rather than the intended 5mg.
The builder called CueDoc when he suffered a slipped disc and could not get off the toilet because of severe back pain. Hobbs said the panel considered Stevenson\'s treatment of Mr E was "grossly negligent".
"It is extremely concerned that despite having at least two opportunities to check the dose he was about to administer, and despite such caution being expected of a competent general practitioner, he proceeded recklessly to administer to Mr E a potentially fatal dose," he said.
For more information, please visit
http://www.guardian.co.uk/society/2009/sep/11/gp-overdosed-patients
