Script mistake leads to death
Coroner Christopher Devonport has criticised a Dunedin medical centre and pharmacy for failing to pick up an error on a prescription for the powerful arthritis drug Methotrexate that should have read "3 x weekly", not "3 x daily".
The medical professionals involved – including a GP, a nurse and a pharmacist – missed eight opportunities to correct the lethal mistake that could have saved the life of 72-year-old Kenneth Douglas, Mr Devonport said.
The man took the incorrect dose for a month and died from a gastrointestinal haemorrhage caused by the overdose.
In findings released on Monday, the coroner detailed how Mr Douglas had been taking the drug in a weekly dose for several years to treat his severe rheumatoid arthritis.
GP Anne-Marie Tangney at Dunedin South Medical Centre decided to reduce his dose in May 2012 but mistakenly printed the word "daily" instead of "weekly" on the script.
The pharmacist at Unichem