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London Doctor debarred After Patient Dies from Detoxification

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    ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP) Contact: Vera Hassner Sharav Tel: 212-595-8974 veracare@rcn.com FYI The British Medical Journal reports about a
    Message 1 of 1 , Nov 1, 2001
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      Contact: Vera Hassner Sharav
      Tel: 212-595-8974 veracare@...

      The British Medical Journal reports about a case involving death due to an
      experimental detoxification treatment "put financial incentives above
      patient interests and compromised patient safety." The anesthesiologist was
      debarred from the British medical register.

      BMJ 2001;323:955 ( 27 October )

      Doctor struck off after patient dies from detoxification treatment
      Owen Dyer, London

      An anaesthetist in England was struck off the medical register by the
      General Medical Council last week after a heroin addict died while under his
      care undergoing a controversial treatment in which the doctor had an
      undisclosed financial interest.

      Dr Gary Gerson was found guilty of serious professional misconduct in his
      treatment of Brendan Woolhead, aged 34, a long time heroin addict who
      underwent a course of ultra-rapid opiate detoxification at the London
      Welbeck Hospital.

      The controversial technique involves a cocktail of drugs, including the
      opiate antagonist naltrexone, and a general anaesthetic to keep the patient
      unconscious during the first hours of withdrawal. Fifteen different drugs
      were believed to have been administered to Mr Woolhead before he had a
      seizure and heart failure.

      A toxicologist who examined the body also found evidence that he had taken
      more opiates after beginning the treatment.

      In addition to his role at the London Welbeck Hospital, Dr Gerson was a
      director of Medetox, a company which sought to commercialise the ultrarapid
      opiate detoxification treatment. The GMC's professional conduct committee
      found that the company used "intensive marketing techniques" to attract
      opiate addicts and made false claims that the treatment had been proved to
      be pain free and safe.

      The committee found that Mr Woolhead was not given sufficient information to
      make an informed choice about his treatment and that Dr Gerson did not
      disclose his own financial interest in Medetox. The contractual agreement
      that Mr Woolhead signed "put financial incentives above patient interests
      and compromised patient safety."

      Mr Woolhead was booked for treatment before being assessed. The committee
      found that when Dr Gerson did see him, he failed to elicit information about
      his medical history, notably the fact that he had developed brain damage in
      the IRA bombing of a bus in London in 1996.

      Mr Woolhead, who had been seriously injured in the blast, was an Irishman
      who had been wrongly accused by several newspapers of being implicated in
      the explosion. He had won more than £200000 ($300000) in libel damages as a
      result, some of which he put towards the £4700 treatment, for which payment
      was demanded in advance.

      After establishing that the treatment would begin the following morning, Dr
      Gerson let Mr Woolhead return to his hotel, despite the probability that he
      would take opiates in the intervening period. When he returned in the
      morning, he was given a blood test, but treatment began before the test
      results were available.

      Thirty hours after the start of the treatment, Mr Woolhead had a cardiac
      arrest. Proper resuscitation equipment was lacking, the committee found, and
      Dr Gerson failed to exert all possible efforts to save his life. The
      anaesthetist, who was not present or represented, was culpable of a
      "wholesale breach" of good practice principles and was struck off the
      medical register.

      In the early 1980s Dr Gerson was unsuccessfully sued in a leading
      medicolegal case on informed consent, Chatterton v Gerson. In the first
      attempt to import the US doctrine of informed consent into English law, he
      was sued for battery for failing to warn a patient that a pain relieving
      injection could lead to numbness in her leg and impaired mobility. The court
      held that because the patient had been told the nature of the operation, she
      had given a real consent.
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