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.