Oncologist is found guilty of misconduct after 27 year old patient dies in trial

BMJ 2012; 345 doi: (Published 20 September 2012) Cite this as: BMJ 2012;345:e6352
  1. Clare Dyer
  1. 1BMJ

A consultant described as “the father of urological oncology” in the UK has been found guilty of misconduct over his role as principal investigator in a clinical trial at University College London Hospital, in which a 27 year old patient died.

But Stephen Harland, the hospital, and research bodies had all learnt lessons that would make trials for cancer patients safer, and the consultant’s fitness to practise was not impaired, the Medical Practitioners Tribunal Service (MPTS) panel held.

Gary Foster, a graphic designer who had been told he had a 60% chance of survival, was taking part in a multicentre trial called TE23 funded by the Medical Research Council into the use of five drugs in combination, including bleomycin, for treating testicular cancer.

Seven times he was given twice the dose of drugs he should have received, and he died when his lungs failed in October 2007, four months after joining the trial. A second patient was affected by the same error but survived.

The coroner concluded that Gary Foster had died as a result of an accidental adverse healthcare event, caused by a prescribing error to which the set-up of an electronic prescribing system had contributed. An internal inquiry by University College London Hospitals NHS Foundation Trust found that the chemotherapy regimen had been incorrectly set up on the hospital’s electronic prescribing system.

Foster’s parents filed a complaint against Harland with the General Medical Council (GMC), which sent the case for hearing by the MPTS.

The MPTS found Harland guilty of misconduct by not adequately implementing the trial protocol or the prescribing protocol, not adequately training team members for their role, not adequately supervising the trial, and not safely administering it. He was also found to have given misleading evidence to the coroner about the number of radiographs Foster had undergone, although the GMC accepted that the evidence, though mistaken, was given in good faith.

One colleague described Harland to the panel as “the father of urological oncology in this country.” The panel concluded that he had been proactive in remedying his conduct and had developed “a great deal of insight” into what went wrong, and both he and the trust had learned lessons.

MPTS panel chairman Douglas Gentleman said that the panel had determined “that the public interest is best served by allowing a highly skilled doctor who makes a valuable contribution to medicine to continue to practise.”

In an unusual endnote addressed to Gary Foster’s parents, he said, “The panel wishes to add the following. Its heart goes out to you, the parents of patient A, for the loss of your son. It pays tribute to you for the courage you exhibited in making the complaint against Dr Harland and for the dignified way in which you have conducted yourselves throughout these proceedings. In the panel’s view, the complaint was rightly made and the GMC was correct to act upon it.”

He said Harland had “clearly demonstrated that significant lessons have been learned by himself, the hospital trust, and the research bodies,” and that the panel believed “that the procedures now in place are likely to mean that the care of patients in cancer trials will have been made much safer.”


Cite this as: BMJ 2012;345:e6352

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