Former locum handed suspended jail term for dispensing error

A former locum pharmacist has been sentenced to a three-month jail term, suspended for 18 months, following a dispensing error. The judge also ordered the defendant to complete a 12-month supervision requirement with the probation service.

Elizabeth Lee, of Victor Road, Windsor, Berkshire, who was working at a Tesco pharmacy, mistakenly dispensed propranolol instead of prednisolone for 72-year-old Carmel Sheller, who died three days later in hospital.

The court heard on 2 April 2009 that Mrs Lee was working 10-hour shifts without a break when she supplied the wrong drug.

The judge said Mrs Lee bore “no factual or legal responsibility for Mrs Sheller’s death”, which a pathologist had determined was due to Mrs Sheller’s underlying long-term illness.

However, he said: “The public, just as the Sheller family were, are entitled to expect the highest standard of care from those responsible for the dispensing of medication.

“That is why the offence exists as a criminal offence punishable with imprisonment.”

He continued: “Everything that I have read and heard about you, and indeed your family, indicates that you as an individual and as a family are decent people with consideration for others, who in ordinary circumstances would not have come anywhere near a court like this let alone intentionally break the law.

“Also I have been impressed and act upon what I have been told you did back in September 2007 when this matter came to light.

“You have not sought to avoid responsibility, you did not then and you have not now.

“It is worthy of note that you resigned from the Royal Pharmaceutical Society immediately and I am told and accept you will not seek again to work as a pharmacist.”

Gravity of the offence necessitated prison sentence 

The judge said a prison sentence needed to be imposed to “mark the gravity of the offence” but her circumstances had persuaded him to suspend it.

Her barrister Christopher Hudson said Mrs Lee was overworked at the pharmacy where two members of staff were on maternity leave.

The judge was handed a sheaf of glowing references for Mrs Lee.

“Almost without exception those witnesses who worked with her at Tesco speak of her professionalism, her thoroughness, her character,” said Mr Hudson, who added: “She worked long and arduous shifts.

“There was no break because the pharmacy could not function without her presence.”

Mr Hudson said it is still not clear who dispensed the medicine.

“Ultimately it was her responsibility to check and make sure no error was made and although an error was made it was a genuine error under pressure.”

Mrs Lee admitted supplying a medicinal product with a misleading label on the package — a charge brought under the 1968 Medicines Act.

She had been due to face trial on a further charge of supplying a medicinal product that was not of the nature specifically prescribed. But after legal arguments her plea was accepted by prosecutors. The second charge against her will remain on file.

Son of the deceased hoped for manslaughter charge 

Speaking after the sentence Charles Sheller, Mrs Sheller’s son said: “The sentence is not all that we would have hoped for but we understand the judge’s position.

“The pathologist’s report did not go to our favour and the manslaughter charge was dropped. In an ideal world we would have had the manslaughter charge.”

Asked about the manpower problems at the pharmacy, Mr Sheller said Mrs Lee should have spoken to her employers if she was concerned.

“She was the professional in charge. She was the person in the white coat we as the public trust, along with our doctors. You are trusting they have done their job.”

Last updated
The Pharmaceutical Journal, PJ, April 2009;()::DOI:10.1211/PJ.2021.1.81225

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