Bright graduate died after GP practice dosage error

West Sussex Assistant Coroner Ms Henderson has concluded an Inquest into the tragic death of a 30-year-old man who had been receiving medication for severe back pain at a village medical practice. It points to shortcomings in the treatment given by the practice in Loxwood.

This week’s hearing and an adjourned hearing at Crawley in January learned that Leeds University graduate Hamish Hardie died in August 2019 at the family home in Wisborough Green from an accidental overdose of prescribed painkillers, for which the dosage label was unclear.

Hamish required pain relief for severe back pain caused by two prolapsed lumbar vertebral discs, for which he was waiting for private surgery, and was dealt with at Loxwood by a qualified doctor who was in his final year of GP training under the supervision of a senior GP.

Dosage not specified

The doctor prescribed two opiate painkillers, Dihydrocodeine and Oramorph, as well as the relaxant Diazepam. The prescription for the Oramorph on the label tragically said it should be taken as directed, which was unclear. Sadly, this was also not identified by the dispensing practitioner within the pharmacy at the practice.

Hamish’s mother Mary-Anne took responsibility for administering the medication, but the uncertainty about the Oramorph label and reliance on Hamish for dosage details meant that more frequent and higher doses were given.

Sadly, Hamish died two days later and a post-mortem confirmed that the primary cause was a prescription drugs overdose, which the Coroner concluded was accidental. The trainee and supervising GPs did not recall seeing an alert on the medical records and the computer system meant that with an Oramorph prescription its labelling default standard was ‘use as directed’.

“We still feel that Hamish was badly let down that day and that his life was unnecessarily cut short by medical failings,” Mary-Anne Hardie reflects. “It was May 2019 when Hamish developed back pain from a suspected slipped disc. That was confirmed on an A&E visit in June, when he was given Diazepam and put on the list for a possible operation. We are disappointed that the GPs did not see the alert on the computer and that if the labelling and prescription advice had been clear, or the pharmacy had spotted the inconsistency, then we feel that Hamish would still be here as he was looking forward to job interviews and a new chapter in his life.” 

A ‘perfect storm’

Specialist solicitor Tim Deeming of Tees Law adds: “The Coroner described this as a perfect storm and it is tragic that the GPs did not know that the labelling system defaulted, and that the pharmacy did not then spot this.

“While we are glad to know that the Loxwood Medical Practice has made significant changes to procedures following Hamish’s death we all hope that the NHS and GPs will take steps when providing such prescriptions to provide clear guidance on use, as well as checking computer systems to ensure that other families do not have such devastating outcomes.” 

Mother seeks inquest answers over 2016 Corrie McKeague disappearance

The anguished mother of a serviceman who went missing after a night out four years ago hopes that an inquest, which was announced yesterday (5 November) and ordered by the Chief Coroner despite no body being found, will provide answers about what happened to her son.

A painstaking search for 23-year-old Corrie McKeague grabbed national headlines in September 2016 when he failed to return to his base at RAF Honington, Suffolk, after an evening in Bury St Edmunds ten miles away.

CCTV footage last pictured Corrie in a bin area behind some shops in Bury, which led investigators to search a landfill site near Cambridge on two occasions in an unsuccessful quest to establish whether he had been carried off on a waste lorry.

Solicitors instructed

Other investigations and multiple appeals for information about Corrie’s disappearance were inconclusive, but his mother Nicola Urquhart has remained determined to find out what happened and has instructed solicitors to help her press for answers.

“Corrie’s mother wishes to ensure that all the right questions are asked and answered as fully as possible at the inquest scheduled to be undertaken at Ipswich Coroner’s Court early next year,” explains inquest specialist Tees Law.

 “The inquest will be an ideal opportunity to bring together the various strands of investigation. Tees Law will support the family throughout what will be an emotional, but we hope fruitful, process for them. 

“We shall be doing our utmost to assist the investigation in exploring every aspect of this tragic mystery so that all relevant circumstances are put before the Coroner to enable important conclusions to be drawn.” 

If you would like to contact us about a news story, please visit our Media Enquiries page for contact details.

What is pension drawdown and how does it work?

Pension (or income) drawdown is one of the ways you can use your pension pot to provide a regular income when you reach retirement. Drawdown is a flexible way of accessing your pension, while allowing your pension fund to keep growing. Here, we explain exactly how drawdown works and whether it’s right for you.

Pension drawdown is available to those aged 55 or over (increasing to age 57 in 2028) and enables you to take an income from your pension pot while leaving your remaining pension savings invested.

You can choose to move your pension into drawdown in one go or a little at a time. You may be able to do this with your current provider or by transferring your pension to a drawdown provider elsewhere. If you decide to transfer, it’s important to first check you won’t lose any valuable benefits or be charged high exit fees.

Under rules introduced in April 2015, you can take up to 25% of your pension pot you use for drawdown as tax-free cash – you can take this in one go or each time you move part of your pension into drawdown. Further withdrawals can then be made as and when you choose, whether you do this in one go, take regular monthly payments, or withdraw lump sum payments as and when you need them.

Drawdown allowances and tax rules

The first 25% you take of your pension pot will be tax-free, while the remaining 75% will be subject to Income Tax. How much you pay will depend on your total income for the year and your tax rate. For 2020/21 this means:

  • if you have no other income, no tax will be due on the first £12,500
  • on income between £12,501 and £50,000 you’ll pay tax at 20%
  • on income between £50,0001 and £150,000 you’ll pay tax at 40%
  • on income over £150,000, you will pay tax at 45%.

What are the benefits of drawdown?

One of the biggest advantages to drawdown is the flexibility it offers. Not only does it enable you to take money from your pension savings whenever you need it, there’s no limit on the number of withdrawals you can make, and you can take out different sums each year.

At the same time, the remainder of your pension pot can stay invested which means if your investments perform well, your income could grow throughout retirement. Drawdown gives you the option of being able to choose your own investments, use ready-made portfolios or let an adviser choose on your behalf.

What are the downsides?

It’s important to understand that it’s your responsibility to ensure your retirement income lasts the duration of your retirement and to understand that the more you withdraw from your pension pot, the quicker it will be depleted. If you make withdrawals too frequently, your retirement income could run out earlier than expected.

Consider, too, that large withdrawals can push you into a higher tax band and, as soon as you withdraw more than your 25% tax-free lump sum, the Money Purchase Annual Allowance (MPAA) applies which limits the amount that be contributed to your pension to £4,000 per year.

Additionally, there’s no guarantee that your investments will continue to grow which means you could get back less than you invest.

Buying an annuity is still appropriate for many people in retirement as it allows you to use your pension savings to buy a guaranteed income that lasts the rest of your life. If you prefer, you can use part of your pension savings to buy an annuity and leave the remainder in drawdown.

How to manage drawdown funds during retirement

If you’re considering drawdown, it’s important to plan carefully, taking into account how long you need your pension to last – remember that your retirement could last 30 years or more. As part of this, you’ll need to consider what to do with any cash you withdraw over the short, medium and long-term:

Short-term: when still in employment, it’s advisable to keep three to six months’ worth of income in a current account or savings account that will give you instant access for covering emergency costs. Upon retirement, this should increase to one to three years’ worth of expenditure.

Medium-term: cash that’s not required in the immediate future could be tied up in a fixed term savings account as these tend to pay higher interest rates than you’ll get with an easy access account. In return, you must leave your funds untouched for the term of the account, which could be anywhere between six months and five years. As a general rule, the longer the term of the account, the higher the rate of interest. You could choose to lock some cash away in a shorter-term account, and another chunk in a longer-term one.

Long-term: investing can be a good option for any cash you won’t need to use for longer than five years. Investing in the stock market tends to give better returns than cash savings over the long-term but remember that your investments can fall in value as well as rise, so you should ensure you understand the risks involved first.

Key questions to consider

Before deciding whether pension drawdown is right for you, it’s worth asking yourself the following questions to ensure you fully understand your options:

  • How much of my pension do I want to move into drawdown?
  • Will I be charged an exit fee if I transfer my pension?
  • Am I comfortable managing my retirement income or would a guaranteed income be more suitable?
  • How regularly should I make withdrawals?
  • Am I comfortable with the investment risk and do I have other income to fall back on?

How we can help

Should you need help answering these questions, our expert pension advisers are on hand to discuss all your pension and retirement options. We take a holistic approach tailored to you, the individual, and will always make alternative suggestions if appropriate.

Our advisers will talk to you in jargon free language to help you understand your choices and our advice and recommendations will be focused on helping you to get the best possible result.

The value of investments can go down as well as up and you may not get back the full amount you invested. The past is not a guide to future performance and past performance may not necessarily be repeated.

 

This material is intended to be for information purposes only and is not intended as an offer or solicitation for the purchase or sale of any financial instrument. It is not intended to provide and should not be relied on for accounting, legal or tax advice, or investment recommendations. Past performance is not a reliable indicator of future returns and all investments involve risks including the risk of possible loss of capital. Some information quoted was obtained from external sources we consider to be reliable.

Tees is a trading name of Tees Financial Limited which is authorised and regulated by the Financial Conduct Authority. Registered number 211314.

Tees Financial Limited is registered in England and Wales. Registered number 4342506.

Tees is awarded Customer Service Excellence standard

Tees Law, an award-winning, Top 200 law firm with offices throughout Hertfordshire, Essex and Cambridgeshire, is delighted to have been successfully awarded the Customer Service Excellence standard.

The accreditation requires organisations to undergo a rigorous assessment process involving interviews with clients and employees conducted by a qualified assessor, on-site visits and an in-depth examination of those areas of the business deemed to be a high priority for customers – namely delivery, timeliness, information, professionalism and staff attitude. The accreditation lasts for three years, with holders subject to annual re-assessment.

Mike Harris, Customer Service Manager at Tees, said: “Client experience is at the heart of everything we do, which is why we are so delighted to have achieved this prestigious accreditation. We always tell our clients to ‘expect more’ from us, and the Customer Service Excellence award not only demonstrates that we are attaining those high standards set, but also gives our clients reassurance that we are continually striving to put them first, at every touchpoint on their journey with us.”

Tees has consistently received excellent client feedback in the annual rankings of specialist directories such as the Legal 500 and the Chambers and Partners guide to the legal profession. In this year’s Legal 500 results, many of the comments received from clients praised the firm’s client-centred approach: “I was delighted with the service that was received from the team at Tees”, “Our experiences of all aspects have been excellent”, and “Tees is highly professional, responsive and client-friendly.”

Group Managing Director, Ashton Hunt, said he was “bursting with pride” when he announced the firm’s achievement. He explained: “This award comes as a result of a thorough and detailed assessment of the whole firm’s approach to delivering a first-class service to our clients, and every single member of our team should take enormous pride in receiving it. It’s a recognition of all the hard work that everybody is doing and proof that putting client experience at the heart of our strategy is woven into our very fabric.”

Looking to the future, Ashton says the firm remains positive about the year ahead: “Our aim going forward is to continue to improve the experience we seek to deliver for every Tees client. We have learned a great deal from how we have been able to continue to deliver for our clients during the pandemic, and our experiences are helping to drive further improvements to be implemented across the business. Our core strategy remains: to continue to invest in the best technology to support our outstanding people, who are focused on delivering an exceptional experience for our clients.”