Generic Paxil Suicide Lawsuit


Citizens Commission on Human Rights Award Recipient (Twice)
Humanist, humorist

Monday, April 23, 2018

Prescribing Death



People who suffer from allergies, medical disorders, and disease usually know best what medications and/or food they can and cannot tolerate.  For example, I suffer from a type of inflammatory arthritis called gout. There are many foods and drinks that my body cannot tolerate. I realize, as do medical specialists, that foods high in purines, such as shellfish, will likely increase the risk that I will suffer a painful gout attack. Therefore, I avoid or reduce my consumption of specific foods and beverages in order to stay healthy.

I'm of sound mind, but if I wasn't, I'd have to rely on my loved ones to ensure foods high in purines are eliminated from my diet. Good health and medical care is often a family affair for all of us, whether we suffer from gout or medication allergies. Most doctors would agree that concerned family members play a vital role in patient care, particularly when the patient is a minor or might need assistance in decision making.


Thomas "Oliver" McGowan (18)

The Poisoning of Oliver McGowan

Eighteen-year-old Thomas Oliver McGowan, known as Oliver, died on November 11, 2016. He lived with cerebral palsy, epilepsy and autism, which began after contracting meningitis twice during childhood. On Saturday, October 22, Oliver was suffering from simple partial seizures and taken by ambulance to Southmead Hospital in Bristol, UK.

Upon arrival, Oliver was intubated, a process of inserting an endotracheal tube through the mouth and into the airway. This was apparently done to place Oliver on a ventilator to assist with his breathing. Oliver was sedated with Lorazepam, a drug indicated to treat seizure disorders. He was then taken for a CT scan which did not show any changes to his brain.

As doctors at Southmead Hospital eased the Lorazepam, Oliver's seizures returned. Instead of reinstating the Lorazepam, the doctors made a decision that ultimately killed Oliver. They prescribed him the antipsychotic, Olanzapine, a drug indicated to treat schizophrenia and bipolar disorder. It is better known in the US by its brand name Zyprexa. Oliver developed Neuroleptic Malignant Syndrome (NMS), an adverse effect of the drug, his temperature rose to 43C and his brain swelled to the point that it was coming out of the base of his skull.


Dr. Monica Mohan

Dr. Monica Mohan's Arrogant Destruction

The consultant neuropsychologist who made the decision to administer Olanzapine is Dr. Monica Mohan. It appears she made a calculation of risks and benefits but ignored more than 500 citations assessing the impact of antipsychotic drugs on challenging behavior. Of these 500 citations, only 3 were methodologically sound randomized controlled trials, and even these were unable to show whether antipsychotic drugs were beneficial in controlling challenging behavior. (1)

Neuropsychology and publications aside, doctors and staff at Southmead Hospital were repeatedly told by both Oliver and his parents, Paula and Tom,  not to give him antipsychotic medications because he was allergic to them.

Oliver's avoidable prescription-drug death and last week's inquest has been covered by the British media. The week-long inquiry showed how doctors, after learning of Oliver's adverse drug reaction to the drug that was administered, performed a CT scan on his brain which showed Oliver’s brain had swelled to the point doctors said there was no “meaningful recovery”.

During the inquiry, consultant neuropsychologist, Dr. Mohan, told the inquest she would do it again because she believed it was in “his (Oliver's ) best interest”.

I kept an eye on the proceedings and, like the majority of the public, I was gobsmacked at last Friday's verdict delivered by Assistant Coroner Dr. Peter Harrowing.

Harrowing, a former Director of Pharmacy Services to the University Hospitals Bristol NHS Foundation Trust, concluded Olanzapine had been properly prescribed and that NMS could not be predicted as it was a “very rare adverse effect”. Further, Harrowing said he agreed with Dr. Mohan. He said the doctors were right to prescribe the drug that precipitated Oliver’s death. Dr. Harrowing also ruled against a Prevention of Future Death.

I reached out to the McGowan family who told me, "The coroner argued that it wasn’t an allergy but a sensitivity or intolerance. Of note, Oliver had previously suffered oculogyric crisis (a dystonic reaction to certain drugs) in Bristol Children’s Hospital with his seizures increasing from one per fortnight to 30 a day.  Sean Collins, safeguarding lead at Southmead Hospital, had consulted with ICU staff about using a non-pharmaceutical approach for when sedation was refused but was not consulted by Mohan."

Smoke-and-mirrors

I'm never shocked anymore by Inquest verdicts. I've long been a fan of the website AntiDepAware, moreover its author Brian. AntiDepAware includes links to reports of inquests held in England and Wales since 2003. It's a great window into the world of coroners and how they don't really work for nor represent the dead. Coroners are often just doctors protecting doctors and the majority repeatedly fail to protect the living by being honest about what happened to the dead. Oliver's case is, tragically, no exception to the medical industry's business-as-usual model. Loved ones who question the medical industry in order to help protect others from suffering avoidable harms are often shocked to see the medical industry's chief concern is to protect their colleagues and business systems.

It's difficult enough to lose a beautiful child who had his whole life ahead of him. But to then endure more smoke-and-mirrors deception from a pharmacist-cum-assistant coroner is beyond the pale. Further, Oliver's parents had to pay for the ordeal following Oliver's death whereas Southmead Hospital was supported throughout the inquest by public funding. (Yes, folks, this is where your hard-earned tax money goes.)

When I think about the avoidable death of the talented and handsome young man named Oliver McGowan, I can't help but also think about thousands of other "Olivers" and "Olivias" out there whose prescribed deaths aren't covered by the news. While they remain faceless to the public, they are not faceless to family and friends.

Nothing will bring Oliver back to life. The inquest that could have reduced future avoidable deaths by improving crisis communication and medical safety instead seem to have increased the likelihood that doctors will practice medicine however they choose, parents be damned.

Arrogance among doctors is a deadly flaw. A 2002 journal article by Allan S. Berger (2) states, "...the most critical variable in the development of arrogance is a physician's knowledge and thereby his or her power over the patient. This can delude some physicians into imagining that they are all-powerful." He continues, "...we should not exaggerate our own importance. We are but an instrument of healing and not its source."

I couldn't agree more.

Bob Fiddaman

(1) Are antipsychotic drugs the right treatment for challenging behaviour in learning disability?: The place of a randomised trial

(2) Arrogance among physicians ~ Berger AS




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