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Prednisolone errors, Clinical Negligence specialist James Bell discusses the dangers of repeat prescribing

By Principal Lawyer, Clinical Negligence

Prescription error cases can be one off events or an established pattern of negligent prescribing. Failures in communication or failures to review medication can lead to serious injuries or even Fatal Accident Claims.
I recently concluded a Clinical Negligence case in which I acted for a young man who was prescribed Prednisolone for approximately 2.5 years by his GP. Prednisolone is used to treat Crohn's disease in it's acute phase (a few weeks at most) but my client was placed on a high dose of this drug for 2.5 years and as a result suffered some unusual side effects, the two most serious of which were a severe depression and Osteoporosis of the Spine. My Client was prescribed Prednisolone on a repeat prescription from July 2005 to June 2008.
In August 2008 my client changed GPs and his new GP was shocked to see that he was on 40mg per day of Prednisolone when there was no acute phase of Crohn’s disease to treat.
It was alleged that the Defendants were negligent in;
• failing to ensure a safe prescribing system within their practice, whereby medications were only issued on repeat prescription without proper review;
• causing or permitting my client to receive repeat prescriptions for Prednisolone otherwise in accordance with the directions given by the hospital consultant;
•  failing to note or act upon the directions given by the hospital consultant in August 2005;
•  failing to review my clients medication on each and every consultation after 1st August 2005 and to adjust the same accordingly;
•  failing to instruct my client to reduce his medication as directed by the hospital consultant and restrict prescriptions of the medication to him accordingly;
• on 27th October 2006 my clients prescription was even doubled.
Letters of claim were sent to the five GP Defendants. Following service of proceedings the Defendants put forward a substantial offer on a joint basis which concluded the case.
Corticosteroids are powerful drugs, mainly used for short term treatment. 2.5 years of this medication caused serious health problems to my client. A quick and simple review of his medication could have prevented this.

Repeat prescribing without regular review by a GP is a highly dangerous practice as this case shows but thankfully most GP’s do not do this.