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Nottingham City NHS PCT: illegal drug dispensation by pharmacist responsible for miscarriage?

Abstract:
Mr Steven Walker, pharmacist from St Albans, Bullwell, Nottingham City, dispensed drugs to pregnant patients which might have been the cause for miscarriage. In a documented case a pregnant patient visited the office of pharmacist Mr S Walker in order to obtain medication against her migraine. Mr Walker dispensed aspirin. Later on the patient suffered a miscarriage. In a second pregnancy the same patient was given codeine by Mr S Walker as medication against her painful migraine with aura. After the intake of codeine the patient saw her GP because of a toxic rush on her body. Codeine can cause such a rush. Nottingham City NHS PCTwas informed on this case, however refused to start an investigation on pharmacist Mr S Walker.

The case:
An independent commission under the leadership of PRT-MALTA surfaced a documentation on a pregnant patient from Nottingham City NHS PCT who suffered from chronic migraine with aura during her first pregnancy. The patient was using aspirin as medication against her migraine which she received from pharmacist Mr S Walker as over-the-counter-medication (OTC). Later on the patient had a documented miscarriage. During her second pregnancy the patient again suffered from migraine with aura. As could be retrieved from the documentation the patient received codeine as medication against her migraine from pharmacist Mr S Walker. Because of a rush on her body – which started after the intake of codeine - the patient showed up at her GPs office and reported on the entire case. Together with the Medicines Information Services (Liverpool) a locum-GP found a safe medication for treatment of migraine during pregnancy. The authorities of Nottingham City NHS PCT, and the head of the drug prescribing team, Dr Trevor A Mills, were informed on this case. No investigation was started on the dispensing habits of pharmacist Mr S Walker. The pregnant patient was not informed on the toxic medication dispensed by the pharmacist. Then the pharmacist Mr S Walker filed a complaint against the locum-GP with Nottingham City PCT because of the irresponsible discontinuation of aspirin and codeine which Mr S Walker dispensed to the pregnant patient. Eventually the GMC suspended the licence-to-practice of the locum-GP on grounds of medical incompetence and in order to protect the public from medical incompetence. The locum-GP must not have informed specialised sites outside the core medical circle of Nottingham City PCT regarding the misconduct of pharmacist Mr S Walker. In contrast to both the NHS and GMC all statements are documented by effects of evidence.

Comments:
In general, aspirin is the drug of choice to start with for treatment of migraine – according to the clinical guidelines (www.eguidelines.co.uk) – if it is not contraindicated, i.e. forbidden by the law. In case of pregnancy, aspirin is forbidden by law. Aspirin can cause bleeding, miscarriage and heart-lung-failure of the unborn child. Further, codeine is forbidden for treatment of migraine, as ruled by the clinical guidelines on treatment of migraine, and by the British National Formula (www.bnf.org). Further, in rare cases during pregnancy, codeine is known to cause a toxic skin rush – as the pregnant patient presented with her GP. Toxic skin rush is a well known side effect of codeine, in particular during pregnancy, as reported by scientific medical literature. Pharmacist Mr Steven Walker must have known the restrictions on dispensing on drugs. Before this incident happened the Nottingham City PCT ruled on the Board Meeting of August 28, 2007 (B/139/07) that the pharmacists should get more involved in the development of independent prescribing, investigation and review on medication of patients in order to save money for the NHS. In general this can be regarded as a wise idea. However pharmacists should also have the professional competence if they are treating patients with over-the-counter-medications such as aspirin. A pharmacist dispensing aspirin or codeine to a pregnant patient cannot be regarded as a professional part of the NHS. More, dispension of aspirin and codeine during pregnancy can cause bodily injuries. The mother already suffered from a miscarrige which could have been the cause of Mr S Walker`s drug dispension. With a high degree of probality we can conclude that the skin rush of the patient can be regarded as the result of the intake of codeine. The dispensing of both medications was illegal under both the British Medical Act and British Criminal Act. Mistakes on prescribing or dispensing of medications can happen. However mistakes must be explained to the patient and corrected. The worst what can happen is to cover-up the mistakes of medical propfessionals and telling lies on the patient, as done in this case reported. The Crown prosecutor from outside of Nottingham City PCT would be the right site for initiating an investigation in this case, because of the documented bodily injury of the pregnant patient. However the Crown prosecutor would be blind without the professional support from the medical system, i.e. NHS and GMC. Both organisations already demonstrated by covering-up that they are not interested in an investigation of the case.
In another case the locum-GP who reported on this case also warned the NHS and GMC on galvano-spa-bath (http://en.wikipedia.org/wiki/Spa_bath) which can be regarded as a hazard for the British public. Such equipment is used by health professionals in order to improve the health of patients. The use of such an equipment can introduce heavy metals into the body of the patient. His scientific evaluation was published in a peer reviewed journal (Zierer O., J Altern Complement Med. 2008 May;14(4):349-50. Galvano-spa-bath and health risks due to incorporation of chromium, nickel, and platinum released from electrodes) which can be retrieved from http://www.ncbi.nlm.nih.gov/sites/entrez. Not surprising, both NHS and GMC did not show any interest in the protection of the people.
Because neither GMC nor Nottingham City NHS PCT are willing to protect patients from pharmaceutical misconduct the papers should warn the public on the harmful dispensing habits of pharmacist Mr S Walker from Bulwell, Nottingham City. Further, procedures of the GMC in covering malpractice and fraud within the NHS should be notified to the public

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*Nottingham City NHS* PCT: illegal drug dispensation by pharmacist responsible for miscarriage? Abstract: Mr Steven Walker, pharmacist from St Albans, Bullwell, Nottingham City, dispensed drugs to pregnant patients which might have been the cause for miscarriage. In a documented case a pregnant patient visited the office of pharmacist Mr S Walker in order to obtain medication against her migraine. Mr Walker dispensed aspirin. Later on the patient suffered a miscarriage. In a second pregnancy the same patient was given codeine by Mr S Walker as medication against her painful migraine with aura. After the intake of codeine the patient saw her GP because of a toxic rush on her body. Codeine can cause such a rush. Nottingham City NHS PCTwas informed on this case, however refused to start an investigation on pharmacist Mr S Walker. The case: An independent commission under the leadership of PRT-MALTA surfaced a documentation on a pregnant patient from Nottingham City NHS PCT who suffered from chronic migraine with aura during her first pregnancy. The patient was using aspirin as medication against her migraine which she received from pharmacist Mr S Walker as over-the-counter-medication (OTC). Later on the patient had a documented miscarriage. During her second pregnancy the patient again suffered from migraine with aura. As could be retrieved from the documentation the patient received codeine as medication against her migraine from pharmacist Mr S Walker. Because of a rush on her body – which started after the intake of codeine - the patient showed up at her GPs office and reported on the entire case. Together with the Medicines Information Services (Liverpool) a locum-GP found a safe medication for treatment of migraine during pregnancy. The authorities of Nottingham City NHS PCT, and the head of the drug prescribing team, Dr Trevor A Mills, were informed on this case. No investigation was started on the dispensing habits of pharmacist Mr S Walker. The pregnant patient was not informed on the toxic medication dispensed by the pharmacist. Then the pharmacist Mr S Walker filed a complaint against the locum-GP with Nottingham City PCT because of the irresponsible discontinuation of aspirin and codeine which Mr S Walker dispensed to the pregnant patient. Eventually the GMC suspended the licence-to-practice of the locum-GP on grounds of medical incompetence and in order to protect the public from medical incompetence. The locum-GP must not have informed specialised sites outside the core medical circle of Nottingham City PCT regarding the misconduct of pharmacist Mr S Walker. In contrast to both the NHS and GMC all statements are documented by effects of evidence. Comments:** In general, aspirin is the drug of choice to start with for treatment of migraine – according to the clinical guidelines (www.eguidelines.co.uk) – if it is not contraindicated, i.e. forbidden by the law. In case of pregnancy, aspirin is forbidden by law. Aspirin can cause bleeding, miscarriage and heart-lung-failure of the unborn child. Further, codeine is forbidden for treatment of migraine, as ruled by the clinical guidelines on treatment of migraine, and by the British National Formula (www.bnf.org). Further, in rare cases during pregnancy, codeine is known to cause a toxic skin rush – as the pregnant patient presented with her GP. Toxic skin rush is a well known side effect of codeine, in particular during pregnancy, as reported by scientific medical literature. Pharmacist Mr Steven Walker must have known the restrictions on dispensing on drugs. Before this incident happened the Nottingham City PCT ruled on the Board Meeting of August 28, 2007 (B/139/07) that the pharmacists should get more involved in the development of independent prescribing, investigation and review on medication of patients in order to save money for the NHS. In general this can be regarded as a wise idea. However pharmacists should also have the professional competence if they are treating patients with over-the-counter-medications such as aspirin. A pharmacist dispensing aspirin or codeine to a pregnant patient cannot be regarded as a professional part of the NHS. More, dispension of aspirin and codeine during pregnancy can cause bodily injuries. The mother already suffered from a miscarrige which could have been the cause of Mr S Walker`s drug dispension. With a high degree of probality we can conclude that the skin rush of the patient can be regarded as the result of the intake of codeine. The dispensing of both medications was illegal under both the British Medical Act and British Criminal Act. Mistakes on prescribing or dispensing of medications can happen. However mistakes must be explained to the patient and corrected. The worst what can happen is to cover-up the mistakes of medical propfessionals and telling lies on the patient, as done in this case reported. The Crown prosecutor from outside of Nottingham City PCT would be the right site for initiating an investigation in this case, because of the documented bodily injury of the pregnant patient. However the Crown prosecutor would be blind without the professional support from the medical system, i.e. NHS and GMC. Both organisations already demonstrated by covering-up that they are not interested in an investigation of the case. In another case the locum-GP who reported on this case also warned the NHS and GMC on galvano-spa-bath (http://en.wikipedia.org/wiki/Spa_bath) which can be regarded as a hazard for the British public. Such equipment is used by health professionals in order to improve the health of patients. The use of such an equipment can introduce heavy metals into the body of the patient. His scientific evaluation was published in a peer reviewed journal (Zierer O., J Altern Complement Med. 2008 May;14(4):349-50. Galvano-spa-bath and health risks due to incorporation of chromium, nickel, and platinum released from electrodes) which can be retrieved from http://www.ncbi.nlm.nih.gov/sites/entrez. Not surprising, both NHS and GMC did not show any interest in the protection of the people. Because neither GMC nor Nottingham City NHS PCT are willing to protect patients from pharmaceutical misconduct the papers should warn the public on the harmful dispensing habits of pharmacist Mr S Walker from Bulwell, Nottingham City. Further, procedures of the GMC in covering malpractice and fraud within the NHS should be notified to the public

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