A RECENT inquest into the death of an elderly patient in Victoria has put a spotlight on a pharmacist's duty to exercise independent judgement when dispensing medication, according to a practice alert from Pharmaceutical Defence Limited (PDL).
On 29 January 2015, at a routine visit with his GP, a 77 year old patient complained of a flare-up of psoriasis, for which the doctor prescribed a daily dose of methotrexate.
The patient's daughters presented the prescription at their usual pharmacy, and the pharmacist on duty immediately recognised that the prescribed daily dose appeared to be incorrect.
She correctly contacted the GP to query the prescription and advised the doctor that methotrexate was usually taken once per week.
The pharmacist expressed 'extreme concern' at the daily dose, describing it as 'potentially lethal'.
The GP nevertheless confirmed the prescription and dose, advising the pharmacist that he had checked the product information on the Monthly Index of Medical Specialties (MIMS).
After some hesitation, the pharmacist dispensed the drug at a daily dose, as prescribed.
The patient took the methotrexate for several days, which ultimately led to his decline, and two weeks later, his death.
"The unfortunate events that transpired in this case emphasise that pharmacists need to exercise independent judgement when dispensing medication," PDL said.
"Pharmacists are independent health care professionals."
In an inquest into the case the state coroner found that the facts "compel an adverse finding against both the GP and the pharmacist... the patient died because a dangerous drug was inappropriately prescribed and then dispensed."
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