Expert advice

Gosport scandal: nurses need to be aware of the liabilities of making medication errors

In light of the untimely deaths at Gosport, nurses should realise they could be struck off or even face criminal charges for administering medicines wrongly

In light of the untimely deaths at Gosport, nurses should realise they could be struck off or even face criminal charges for administering medicines wrongly

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The report from the independent panel set up to investigate patient deaths at Gosport War Memorial Hospital in Hampshire raised serious issues around medicines management.  

The report, published in June, found 456 patients had their lives shortened because of inappropriate prescribing and administration of medication, most notably opioids. 

What happened in Gosport was a tragedy from which lessons need to be learned. The report highlighted systemic problems and many organisations – including the Nursing and Midwifery Council (NMC) – need to be examined to ensure what happened at Gosport cannot happen again.

Serious consequences

Crucial to this is nurses’ and midwives’ understanding of their roles and responsibilities regarding medicines and medication errors.

If medication is administered inappropriately, or an error occurs, it could be due to the prescription or administration of the medicine. 

The prescriber and the person administering the medicine need to be aware of the consequences they could face for being involved. 

There are four potential areas of liability: 

  • Employer 

Employers are entitled to expect the health professionals they hire will act in a competent manner and will follow any guidance issued by the employer. 
Those who don’t could be subject to disciplinary action. This could be suspension from work, limiting the employee's role, a requirement to retrain in certain areas or prove competence in a specific role. The most serious breaches could result in dismissal. 

  • Civil 

A patient who is harmed due to the inappropriate administration of a medication, or a medication error, is eligible to pursue a legal case in the civil courts for damages. The case would be for negligence on the part of the prescriber or administrator who caused the harm. 

If the patient won their case by proving they would not have been harmed if the medication error had not occurred, or if the medication had been administered correctly, they would be paid damages. They would also have to prove that the harm occurred as a result of the actions of the nurse as prescriber or administrator of the medication. 

  • Criminal

If a patient experienced harm due to inappropriate administration of a medication, or a medication error, the police may conduct a criminal investigation to determine if an offence has been committed. This could include causing bodily harm, fraud in the form of falsifying records, or even manslaughter if the patient dies as a consequence. 

If the nurse was found guilty of a criminal offence, the penalty could be a fine, community order or custodial sentence.

  • Regulatory

Nurses and midwives have a responsibility to comply with the NMC code and to make patient safety their primary concern.

Sanctions enforced

The NMC exists to protect patients and the public and it does this by ensuring all nurses and midwives are competent in their roles. If it is alleged that a registrant has acted incompetently, the NMC has the power to investigate through a fitness to practise hearing. If the nurse or midwife is deemed unfit to practise, sanctions could be applied.

Sanctions available to an NMC fitness to practise panel include a requirement for the nurse to retrain in a specific area, an order not to engage in an area of practice unless supervised, a suspension from the register or – the ultimate sanction – being struck off the register. 

It remains to be seen whether the NMC will bring action against any of the nurses identified as part of the Gosport Inquiry. Even if they do not, any nurse identified as administering or prescribing a medicine inappropriately could face other forms of action against them.

Marc Cornock is a qualified nurse, academic lawyer and senior lecturer at the Open University

Further information

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