Doctor admits drug blunder killing

Wayne Jowett died a month after the mistake

A doctor has admitted the manslaughter of a teenage cancer patient who died after a hospital drug blunder.

Wayne Jowett, 18, died after a toxic cancer drug was wrongly injected into his spine rather than a vein.

Dr Feda Mulhem, of Stanley Road, Leicester, pleaded guilty to the unlawful killing at Nottingham Crown Court on Monday.

Dr Mulhem had ordered a junior doctor to administer the drug into the spine - neither had been formally trained in giving chemotherapy.

An independent report later criticised staff and procedures at Nottingham's Queen's Medical Centre, and highlighted design faults in syringes and drug packaging.

Spinal treatment

The teenager was undergoing treatment for a form of leukaemia early in 2001 when the mistake happened - and was actually in remission from the disease.

The drug he was given to complete his treatment, vincristine, is safe if injected into a vein, but highly toxic if given "intrathecally" - into the spine.

Mulhem failed to note what was written on the patient's haematology chart and failed to see which drug should have been administered.

He also failed to check the route of administration and the syringe, which would have stated that the drug was vincristine and would have told him that the drug should have been injected into a vein.

The error only came to light when another junior doctor queried what had happened.

Bruce Houlder QC, prosecuting, told an earlier hearing: "What he did was to fail in a number of respects, which were absolutely basic in his responsibilities as a doctor.

"These failures led directly to the death of Wayne Jowett."

Although desperate attempts to reverse the treatment's effects were made once the mistake was realised, it was too late.

Wayne gradually became paralysed and died almost a month later when his breathing machine was turned off.

The two doctors were immediately suspended as Queen's Medical Centre set up an inquiry into the death.

The mistake happened because of a mix-up between two chemotherapy drugs which should never have been given to the patient at the same time.

The other drug, cytosine, was supposed to be given as a spinal injection.

Catalogue of errors

Exactly the same mistake has been made in UK hospitals on 13 occasions over the last 15 years, with mostly fatal consequences.

The Department of Health set up a committee - chaired by Chief Medical Officer Professor Liam Donaldson - to come up with ways of reducing the number of medical mistakes within the NHS.

Its report in June 2000 urged the government to examine ways of completely wiping out deaths and disability caused by "wrongly administered spinal injections" by the year 2001.

Work is being undertaken to reduce the risk of such events by designing vincristine phials so that they cannot physically be fitted to spinal injection kits.

Mulhem is due to be sentenced on Tuesday.