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Pharmacist flouted suspension after patient's kidney damage

A pharmacist who dispensed “10 times” the prescribed dose of an antineoplastic medicine to a patient later hospitalised with kidney damage has been struck off for practising while suspended.

James Cradock Wootton – registration number 2021533 – also dispensed warfarin without checking the international normalised ratio (INR) level of a patient who later died “as a result of… the anticoagulants he was taking”, the General Pharmaceutical Council’s (GPhC) fitness-to-practise committee noted at a hearing on June 12.

The GPhC highlighted that Mr Wootton, who was not present at the hearing, had “admitted all the allegations against him in their entirety, in a series of emails to the council”.

But it stressed that Mr Wootton had not only caused “very serious harm to individual patients”, but had later “flouted” restrictions by falsifying pharmacy records in an attempt to “cover up” working as a pharmacist while suspended.

A series of dispensing safety breaches

Mr Wootton made a “series of serious breaches of safe dispensing requirements in relation to six different patients” in 2015 while he was working in the pharmacy he owns in Rhymney, Caerphilly in Wales, the regulator noted.

This included twice dispensing warfarin to a patient without a valid prescription, and without checking their INR level. The patient later “died as a result of a gastrointestinal haemorrhage and the anticoagulants he was taking”, the GPhC noted.

Mr Wootton issued another patient a prescription for Hydrea 500mg tablets, with a label instructing them to take – in the words of the GPhC – “nearly 10 times the proper dose”. “After taking the incorrect dose for two weeks, [the patient] was admitted to hospital with acute kidney damage,” the regulator summarised.

The GPhC also noted that at various times, Mr Wootton: dispensed furosemide and quinine sulphate to patients without a valid prescription; instructed a patient to take twice the prescribed daily dose of bisoprolol; and gave another patient a month’s supply of seven different drugs, when they only had a prescription for a seven day-supply of them.

Working while suspended

An investigation by the GPhC led to Mr Wootton being suspended from the register in 2016. However, a further dispensing error brought to light that he had breached this condition on his licence “by working as a responsible pharmacist, without direct workplace supervision, and without having his dispensing checked”, it said.

“He tried to cover up the fact that he had been working in breach of his suspension by twice falsifying pharmacy and dispensing records to suggest another person had been the responsible pharmacist,” the GPhC said.

This led to Mr Wootton being convicted at Cwmbran Magistrates’ Court in February 2017 for having “practised as a pharmacist while not being entered as such in part one or four of the register” on two occasions in July 2016.

Full admissions

The GPhC acknowledged that Mr Wootton – who said he has retired from working as a pharmacist – had “made full admissions in these proceedings, in the same way he pleaded guilty in court”.

However, “that is about all we can say in his favour”, the regulator said.

“Got things very badly wrong”

It concluded that Mr Wootton had “got things very badly wrong in his work” through a series of “repeated and protracted failings” that resulted in “very serious harm” to two patients.

“The registrant dug himself in deeper and deeper by attempting to mislead the council… by evading the controls which the council sought to impose on him, and then by trying to cover up that evasion when he was found out,” it continued.

It also claimed that he was “not wholly of good character”, as he had received a three-month prison sentence in 2009 for “having a knife in a public place” – a conviction which he failed to report to the GPhC.

The regulator stressed that there is “no evidence the registrant has done anything to remediate his obvious shortcomings as a dispensing pharmacist”, and ruled to strike him from the GPhC register.

Read the full determination here.

What do you make of the GPhC's ruling?

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