Online doctor faces GMC over internet prescribing

A GP who prescribed betablockers for a 16-year-old boy over the internet thwarted attempts by other doctors to keep the youngster off medication, the General Medical Council heard.

Julian Eden, a GP who ran online service e-med, prescribed the drugs to the boy, who had a history of mental illness, without discussing it with his family doctor.

The boy was one of several vulnerable patients who were drawn into drug dependency and abuse by the website which facilitated the prescription of powerful painkillers and sedatives without proper medical scrutiny.

The Fitness to Practice Panel, sitting in central London, heard that within a week of being issued with a repeat prescription for betablockers the boy known as Patient A took an overdose of the drugs.

Dr Gregory Richardson, a consultant in child and adolescent psychology who had been treating the boy, told the panel he had refused to give him medication because he did not believe he was suffering from any particular mental disorder.

He said if he had given in to the boy’s demands and prescribed medication, he would have reinforced the idea that he was ill in the youngster’s mind. Dr Richardson said he had referred the boy’s case to a social worker in order to “de-medicalise” his problem despite the teenager turning up at A&E and threatening to self harm.

The boy had turned to the internet for prescription drugs when doctors refused to give them to him.

“Our feeling was that if he got to 14 or 15 and came to feel he had an illness and received medication that reinforced it, the whole thing would go on into adult life. We have a notion that if we could persuade him he wasn’t ill he might get over it. If we prescribed medication we were saying there is something the matter with him,” Dr Richardson said.

The doctor said the boy would often self diagnose and believed he was suffering from a social anxiety disorder.

“That did not really fit with his ability to go out,” he said.

When Dr Richardson and his medical team refused to prescribe medication the boy became “very antagonistic” and made threats towards hospital staff.

On one occasion he set fire to a shed in the grounds of Limetrees Hospital in York where he was treated as an in-patient and frightened staff by appearing at a window at night.

“Because I would not go along with his view of what he wanted he was very antagonistic probably more to me because I was seen as the person who would not prescribe,” he said.

Dr Richardson said initially he did not believe the boy had been prescribed Propronolol – a betablocker used to control hypertension. But after he took an overdose of six tablets, he became concerned about where he had got his hands on them. He said he reported Dr Eden to the GMC after the boy told him where he had got the tablets from.

“Primarily I was concerned that drugs were being prescribed for this young man without contact with any of the doctors involved in his ongoing care and that drugs were being prescribed which were then used in an overdose.”

Dr Eden, whose clinic is based at the private St John’s and St Elizabeth Hospital in north-west London, admits it was inappropriate to prescribe for the 16-year-old without speaking to his GP but denies it was irresponsible or not in the patient’s best interest.

Another patient who turned to Dr Eden’s website was issued with 51 repeat prescriptions for two sedatives in just over two years. The doctor issued the prescriptions to the man, known as Patient X, between August 2003 and October 2005 despite not actually meeting him until July 2005.

On a number of occasions when Patient X claimed his prescription had been lost in the post, Dr Eden provided him with a replacement without checking whether the “lost” drugs had been dispensed.

The panel has heard that for about a year Dr Eden issued monthly prescriptions for the sedatives dihydrocodeine and diazepam to a mother of three who had a painkiller addiction without contacting her GP or adequately reviewing her condition.

Dr Eden admits putting the patient at risk and that his conduct was inappropriate, irresponsible and not in the best interests of the patient.

He also admits his prescribing of zolpidem and zopiclone to Patient X was excessive, irresponsible and not in his best interests.

Dr Eden also admits it was inappropriate and irresponsible to prescribe slimming drug Reductil to a journalist from The Sun without examining him and after he lied about his weight.

But he denies his prescribing of Viagra to an Independent on Sunday reporter within two minutes of filling out a medical questionnaire was inappropriate, irresponsible and not in his best interests. He also denies his fitness to practise is impaired.

The hearing continues.

Reporting by the Press Association