Junior doctor is struck off after prescribing errors and “disgraceful” conductBMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h1663 (Published 26 March 2015) Cite this as: BMJ 2015;350:h1663
A junior doctor who made two “potentially dangerous” prescribing errors within days and then committed a string of petty crimes while excluded from work has been struck off the UK medical register.
Prashen Pillay was a foundation year 1 trainee doing a rotation in geriatric medicine in Sussex when he wrote 250 milligrams instead of 250 micrograms on a digoxin prescription—effectively multiplying the dose by 1000. A nurse, realising that such a dose was impossible, administered 2.5 milligrams, still 10 times the intended dose. The 76 year old patient, Joan Dixon, died of a heart attack within hours.
Pillay had made a similar error two weeks previously, transcribing “4 units” of fast acting insulin as “40 units,” although the 82 year old patient escaped with a mild hypoglycaemic episode. The errors occurred in October 2010, two months after Pillay began his hospital job.
After Joan Dixon’s death he was excluded from Western Sussex Hospitals NHS Foundation Trust, and the General Medical Council imposed conditions on his work. The trust’s exclusion was periodically extended until his contract expired in August 2011. At Joan Dixon’s inquest in 2012 Pillay promised to “make it my life’s work to ensure this can’t happen again.” After the inquest the GMC suspended him from practice on an interim basis.
By that time Pillay had already embarked on a petty crime spree, notching up convictions for threatening behaviour, making off without payment, and obtaining services dishonestly. He also received two fixed penalty notices—one for abusing bar staff and refusing to pay a bar bill and taxi fare, and the other after he was caught urinating on the floor in a Morrisons supermarket.
In March and April 2014 he posed as a working doctor on three occasions. First he turned up at St George’s Hospital in Tooting, south London, and falsely told anaesthetic staff that he was undertaking an official clinical observership at the hospital. He told one doctor that his GMC issues had been resolved and that he was due to take up a post in Durham. The next day he attended an operation, changed into scrubs, maintained a patient’s airway, and cannulated the patient. He also attempted to assist with the patient’s transfer but was prevented from doing so.
A month later he stopped to offer assistance to police and paramedics attending a collapsed pedestrian in Shepherd’s Bush, west London. He told a police community support officer that he was an anaesthetist and told paramedics that he worked in accident and emergency in Derby. He attempted to cannulate the patient and argued that intubation was needed. When the paramedic questioned his credentials Pillay asked, “Who’s the one with the medical degree?” and denigrated the paramedic’s job.
A week after that incident he turned up at Durham University School of Medicine claiming that he had secured a post at Darlington Hospital. He went to a life cycle lecture and addressed the students, claiming that he was a clinical skills expert. He disrupted the lecture, feigning retching sounds and behaving rudely to the lecturer.
The Medical Practitioners Tribunal Service panel found Pillay guilty of misconduct for the dosing errors and of dishonesty for his convictions and false statements, describing his conduct as “quite simply disgraceful.” Pillay, who qualified at Newcastle University, admitted most of the charges and applied for voluntary erasure when his case came before the panel. After his application was refused he dismissed his counsel and did not attend the hearing.
Part of the hearing and the panel’s determination remain confidential—a step usually taken when an element of the case concerns the doctor’s health.
Cite this as: BMJ 2015;350:h1663