Chapter 6: The General Medical Council
Findings of fact: Jean Stevens (Patient L)
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The findings of fact for Jean Stevens who had been admitted to Daedalus Ward on 20 May 1999 were as follows (GMC100948, pp205–6, 239–41):
20 May 1999: Dr Barton prescribed 10 mg oramorphine in 5 ml, 2.5–5 ml
- FtP found proved that there was insufficient clinical justification for such prescriptions.
- Dr Barton admitted that the prescribing created a situation where drugs could be administered which were excessive to the patient’s needs.
- FtP found proved that the prescribing was inappropriate.
- FtP found proved that the prescribing was potentially hazardous.
- FtP found proved that the prescribing was not in the best interests of Jean Stevens.
20 May 1999: Dr Barton prescribed diamorphine with a dose range of 20–200 mg daily subcutaneously
- FtP found proved that there was insufficient clinical justification for such prescriptions.
- Dr Barton admitted that the dose range was too wide.
- Dr Barton admitted that the prescribing created a situation where drugs could be administered which were excessive to the patient’s needs.
- FtP found proved that the prescribing was inappropriate.
- Dr Barton admitted the prescribing was potentially hazardous.
- FtP found proved the prescribing was not in the best interests of Jean Stevens.
20 May 1999: Dr Barton prescribed midazolam with a dose range of 20–80 mg subcutaneously
- FtP found proved that there was insufficient clinical justification for such prescriptions.
- Dr Barton admitted that the dose range was too wide.
- Dr Barton admitted the prescribing created a situation where drugs could be administered which were excessive to the patient’s needs.
- FtP found proved that the prescribing was inappropriate.
- FtP found proved that the prescribing was potentially hazardous.
- FtP found proved that the prescribing was not in the best interests of Jean Stevens.
21 May 1999: a further prescription was written by Dr Barton for 10 mg oramorphine in 5 ml, 4 times a day, 20 mg at night
21 and 22 May 1999: doses of oramorphine, diamorphine and midazolam were subsequently administered to the patient
- FtP found proved that there was insufficient clinical justification for such prescriptions.
- Dr Barton admitted that it created a situation where drugs could be administered which were excessive to the patient’s needs.
- FtP found proved that the prescribing was inappropriate.
- FtP found proved that the prescribing was potentially hazardous.
- FtP found proved that the prescribing was not in the best interests of Jean Stevens.
In relation to advice:
- Dr Barton admitted that she did not obtain the advice of a colleague when Jean Stevens’ condition deteriorated.