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Doctor from Nottingham City NHS PCT involved in addicting patients with narcotic drugs

Abstract:
Dr Trevor A Mills from Nottingham City NHS PCT is involved with supplying / prescribing codeine which has resulted in their subsequent addiction. From medical documentation of patients Dr T Mills treated, it could be retrieved that the doctor was prescribing the highest dosage of co-codamol for the relieve of pain over many years.  Co-codamol consists of codeine and paracetamol. Codeine in combination with paracetamol can cause liver damage and addiction to narcotic-drugs. Therefore co-codamol should be given to, in particular, older patients only for a short period of time, but not for many years, as Dr T Mills did. The misconduct was reported to both the GMC and Nottingham City NHS PCT for investigation. The administration refused to start an investigation on Dr T Mills.

The case:
An independent commission under the leadership of PRT-MALTA (advised by pharmacologist Dr Zierer, MD, PhD, MSc) surfaced a documentation on an older patient from Nottingham City NHS PCT who suffered from fibromyalgia and depression for more than 6 years. Fibromyalgia is a disease accompanied by pain of muscles. Pain of muscles can also be caused by chronic depression. The patient received a daily dosage of 240 mg codeine and 4000 mg paracetamol for treatment of pain over more than 5 years. This is the maximum dosage of co-codamol 30-500 which is recommended as being safe by the British National Formula (www.bnf.org) – however only for a short period of time, i.e. a few weeks. The GP responsible for this prescribing record is Dr Trevor A Mills (GMC-No 2714743) from the drug prescribing team of Nottingham City NHS PCT. A locum-GP stopped the year long prescription habit of codeine to said patient due to lack of medical results and the active problem of addiction. The locum-GP documented on file of the patient:” review of the past medication;  diagnosis of fibromyalgia / depression; explained to the patient the potential of addiction of co-codamol 30-500 over many years; patient should start with venlafaxine 37.5 mg daily, for 16 days; after this patient should see the GP for further evaluation”. When the locum-GP commenced on the treatment of venlafaxine 37.5 mg daily Dr T Mills raised concerns on the prescribing competence of said locum-GP. Venlafaxine was regarded by Dr T Mills as “toxic” medication which must not be substituted in favour of the maximum daily dosage of codeine. Dr T Mills discontinued venlafaxine and started on the 6th year of codeine-administration by documenting on file:” STOP venlafaxine. Patient will get benefit from cloimipramine and regular co-codamol (240 mg codeine – 4000mg paracetamol- daily). See patient in 12 month again”. Both the GMC and NHS started an investigation against the locum-GP who discontinued the addicting codeine medication. Eventually they suspended his licence-to-practice on grounds of medical incompetence and prescribing toxic medication (venlafaxine) to patients. In contrast to both the NHS and GMC all statements are documented by effects of evidence.

Comments:
Codeine in a daily dosage of 240 mg can addict patients, requesting a higher dosage of codeine and further stronger opiates resulting in drug addiction. This can be observed specially in the older age group – as stated by the British National Formula (BNF). Best examples of drug addiction can be seen in Styal Prison, Manchester, a prison for femal drug addicts. Needless to say that drug addiction is causing severe economic stress to the British society. Certainly, not all drug addicts in British prison were addicted by their GP. However, GPs have special responsibility regarding prescribing drugs with a well known potential on addiction such as codeine. Dr Trevor A Mills (GMC-No 2714743) from the drug prescribing team of Nottingham City NHS PCT, responsible for the codeine-prescriptions, was confronted with his prescribing habits. Dr T Mills documented in writing that codeine would be regarded as a safe pain-killer-medication, regardless the restrictions stipulated by the BNF. Further to addiction, a patient runs the serious risk of hepatotoxicity associated with large doses of paracetamol, such as prescribed by Dr T Mills. All parties involved, i.e. Dr T Mills, NHS and the GMC know on the potential hazards caused by this careless prescribing habits. They actively documented on the file of the patient, that the patient would benefit from a daily dosage of 240 mg and 4000 mg of paracetamol for a further period of 1 year – after having prescribed that maximum dosage already for 5 years without any positive medical effect. Further 12 month of codeine administration with the maximum dose – and then see your GP again (!!). This written statement of Dr T Mills, approved by the NHS and GMC, is clearly a violation of both the “Medical Act 2004” and “General Medical Rules (Fitness to Practice) Rules 2004”. Both, induction of hepatotoxicity (liver damage) and addiction to narcotic drugs could be regarded as personal injury in the sence of Worker`s Compensation Acts or further as a bodily injury (Model Penal Code §210.0) under the British Criminal Act of 2008, if done scienterly. Because all parties were informed in writing by the locum-GP on the potential hazard of maximum dosage of co-codamol it can be assumed that Dr T Mills, NHS and GMC acted scienterly, i.e. knowing on their medical misconduct or at least accepting the known personal injuries of the patient. Further, the parties accused of medical malpractice are medical professionals with a licence-to-practice who must have known the hazards. In general, patients are not able to understand what their GP is doing, they are helplessly trusting into the medical system. Therefor they cannot and would not start an investigation, even if there are concerns of misconduct. Crown prosecutors are also not capable of understanding what doctors are doing. Thus they also would not start an investigation on members of the medical system.

To make the entire case more surprising: the licence-to-practice of the locum-GP who documented and reported on the entire case was suspended by the GMC because of medical incompetence. This can be seen as an indication that all offical parties involved in this case of drug addiction and personal injury are acting scienterly. They are obviously trying to cover-up the entire case by suspending the licence-to-practice of that person who reported on the case hoping to neutralise a witness on medical malpractice. In oder to prevent such cover-up the public must be informed on members within the medical system, obviously following their private rules and jeopardizing the health of our respected patients

 
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