GEORGE: DOCTOR MISLED CORONER
A GP who misled a coroner after he issued a suicidal patient drugs without seeing her because she could not afford to pay has been given a formal warning by the GMC.
Penelope Marsh was found dead in a hotel room from a drug overdose after Dr Chembukkavu George gave her a repeat prescription for powerful antidepressants without seeing her.
Mrs Marsh had attended Dr George’s practise in Strood, Kent on 28 May 2005 but gave him a false name, address and date of birth at the consultation.
Dr George prescribed two weeks of the anti-depressants diazepam at 5mg and amitriptyline at 75mg and arranged for a further appointment on 10 June.
But Mrs Marsh returned to the practise on June 7 and was issued with a repeat prescription for the amitriptyline without being seen by Dr George.
Mrs Marsh did not attend her 10 June appointment and was found dead of an overdose in a Kent hotel.
At the subsequent inquest Dr George told Roger Sykes, the Mid Kent and Medway Coroner, he did not have time to carry out checks on new patients.
Mr Sykes later wrote to the GMC voicing his concerns that a suicide risk patient could obtain drugs without being seen.
Alexandra Felix, for the GMC, said the coroner was also worried by Dr George’s remark that he did not see Mrs Marsh face to face on 7 June 2005 because she could not afford to pay.
Dr George told the inquest: ‘The practise is not an NHS practise, it’s self funded so I don’t think I’ve got enough time to go through the information.’
Dr George, who qualified in 1977, also claimed he did not have a phone number to contact the patient on.
He told the inquest: ‘She wasn’t going to pay to see me again so I can’t help her, the surgery is self funding, you don’t get money from the NHS.
‘I thought it was a general case.
‘The practise has been like that for years at this practise.’
After receiving the coroner’s letter in November 2005 the GMC wrote to Dr George in October 2006 and asked him to comment on the allegations.
Dr George wrote back claiming Mrs Marsh told him at the first appointment that she had been given diazepam and amitriptyline before by a psychiatrist in South Africa.
He said when he asked her if she had any intent to self harm she replied ‘absolutely not.’
Dr George later told the GMC that he had signed a repeat prescription form on 7 June after his secretary said she had already given the drugs to Mrs Marsh after she claimed she lost them.
Miss Felix said that account differed from what Dr George told the inquest.
‘You can properly infer that Dr George was not being wholly honest in his accounts,’ added Miss Felix.
But Mr Andrew Hockton, representing Dr George, said the incident was ‘a case of being wise after the event.
‘Mrs Marsh chose to commit suicide, clearly a deliberate decision on the basis of the material before you.’
‘This was a patient who breached this doctor’s trust by lying to him.’
The GMC decided the doctor should be issued with a warning.
Panel chairman Professor Roger Green said the doctor had significantly departed from the GMC’s standards.
‘For example, it considered that the initial examination was inadequate, and that it was inappropriate and irresponsible to have retrospectively authorised the repeat prescription on 7 June 2005, regardless of the previous sequence of events that led this to occur.
‘It did not see that the papers bore out the assertion that you had been dishonest, but it was concerned that the discrepancies between the two accounts were misleading.’
Prof Green issued Dr George with a formal warning that will remain on his record for the next five years: ‘You must prescribe drugs or treatment, including repeat prescriptions, only when you have adequate knowledge of the patient’s health, and are satisfied that the drugs or treatment serve the patients needs.
‘If you are asked to give evidence to any formal inquiry you must be consistent in all your spoken and written statements.’
Dr George, of (3) Harlech Close, Strood, Kent, attended the central London hearing.
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