In December 2016, Northern Ireland pharmacist Martin White was convicted in Antrim Magistrates Court in relation to his dispensing of the incorrect medication to a patient. The medication dispensed to the patient was not the medication named on the patient’s prescription.
Mr White was convicted for breaching Section 64(1) of the Medicines Act 1968, which essentially provides that no person may, to the prejudice of the purchaser, sell any medicinal product which is not of the nature or quality specified in the prescription.
Mr White was sentenced to four months imprisonment, suspended for two years.
In February 2014, Mr White supplied medication to a 67 year old female patient. The medication that had been prescribed for the patient by her doctor was Prednisolone, which is a steroid and had been prescribed for the patients COPD. The medication supplied by Mr White was Propranolol, a beta blocker medication. Tragically, Ms Walsh died as a result of the ingestion of the incorrect medication. Mr White admitted that he supplied the incorrect medication and offered his apologies and condolences to the patient’s family.
In explaining the circumstances in which the error occurred, Mr White said that he selected the incorrect product, Propanolol, which was “side by side with and of similar branding” to the correct product, Prednisolone. Mr White gave evidence that this was his first mistake to make in 24 years of employment as a pharmacist.
Imposing sentence, the Judge had regard to the cumulative effect of Mr. White’s guilty plea, his previous good character, loss of reputation and his permanent financial loss consequent on his decision not to continue to practice as a pharmacist. The Judge said that the negligence “was more than minimal, but there is no evidence of intentional negligence” and accordingly, did not feel an immediate custodial sentence was necessary. During the hearing, an expert gave evidence on behalf of the pharmacist, who stated that Mr White’s actions amounted to poor professional performance, but not professional misconduct.
This particular piece of legislation has been the subject of academic and parliamentary criticism in the UK. It has been suggested that it is unnecessary, in circumstances where pharmacists are independently regulated by a professional regulatory body and can be the subject of fitness to practise processes. A review of the Medicines Act 1968 has been promised in the UK. In 2010 the Crown Prosecution Service published legal guidance for prosecutors on how to handle cases of dispensing errors. This guidance, which is under review, advises that, even in circumstances where the prosecutor is satisfied the evidential test is met and the charge can be proven, the prosecutor should go on to consider whether a prosecution is required in the public interest. The guidance sets out a number of factors to be taken into consideration when determining this, including the culpability of the pharmacist, the seriousness of the dispensing error, the consequences, any follow up actions taken and any previous errors by the pharmacist.
The report on the issue by the Pharmaceutical Journal can be found here.