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FATAL ERRORS; 1 Lethal drug injected into Wayne's spine 2 Doctor did not check his medical chart 3 He did not spot drug was wrong colour 4 He took no notice of query by junior doc.


A HOSPITAL doctor's catalogue of errors over chemotherapy injections caused the death of an 18-year-old boy, a court heard yesterday.

Wayne Jowett was making a good recovery from leukaemia when he went for outpatient treatment at the hands of Dr Feda Mulhem.

He was to have the drug Cytosine injected into his spine. But after that procedure, Dr Mulhem told his junior David Morton to give a further spinal injection of the anti-cancer drug Vincristine.

This should only ever be administered through the veins and is lethal if injected any other way. Dr Morton queried the order, but was told to carry on.

Mechanic Wayne fell seriously ill and died nearly a month later in February 2001. Dr Mulhem, 36, denies manslaughter through gross negligence.

The Syrian-trained blood disorder specialist, it was said, failed to check Wayne's chemotherapy chart at the Queen's Medical Centre, Nottingham.

Prosecutor Bruce Houlder QC added: "He failed to check the drug that was to be administered - a fatal error.

"He failed to check the route of administration - also a fatal error.

"Even in the face of a query by the more junior doctor, he then ordered the injection of Vincristine directly into the spine of the patient, thus poisoning the central nervous system - the final fatal error."

Dr Morton, then 26, again questioned Dr Mulhem, who had been made a registrar only two days earlier.

At that point, said the prosecutor, Dr Mulhem looked at Wayne's chart properly.

The QC said: "He took the chemotherapy chart and said 's***'. He was visibly shaken. His reaction said it all.

"There can be no doubt that Dr Mulhem was very distressed...the prosecution say he knew perfectly well what the consequences of what had happened were going to be - almost certain death." The Vincristine should have been given via a vein next day, precisely to avoid that sort of error.

Dr Mulhem later told police he had become confused over the second injection and thought it was the drug Nethotrexate that was being given.

That is a bright yellow liquid and Vincristine is clear, Nottingham crown court heard.

Prosecutor Mr Houlder said: "This explanation, if a genuine one, is the more regrettable." Dr Mulhem had failed in "absolutely basic" responsibilities, added Mr Houlder.

Safety rules at his previous hospital in Leicester should have "warned him that injections into the spine should be given on a separate day to injections into the vein".

Dr Mulhem said in a written statement: "I know it is a lame excuse, but I am a human being."

"I know this mistake may end my medical career, but I am ready to learn from my mistake."

Mr Houlder told the jury that manslaughter was a "quite specific" charge. He said: "It involves proof of actual responsibility for death, and not just simple negligence but gross negligence.

"The prosecution say that this last phrase accurately describes the conduct of Dr Mulhem." It was in a "completely different field" to doctors inadvertently causing a patient's death or injury, despite taking every care". The case goes on.


QUESTION: Dr Morton; ACCUSED: Dr Mulhem went on trial yesterday; DEAD: Wayne
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Publication:The Mirror (London, England)
Date:Jul 1, 2003
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