Hospital Patients 'Left To Die Without Fluids' (Heroin RX / Brompton's Cocktail)

[Tchort]

Portsmouth.co.uk

6/19/2009

By Clare Semke
Elderly patients were left to die without fluids because medical staff did not want them to recover, a panel heard.
Philip Beed told a General Medical Council hearing it was 'usual procedure' for patients receiving end-of-life care at Gosport War Memorial Hospital not to be rehydrated.

Speaking at a hearing into the fitness to practise of Gosport GP Jane Barton – formerly clinical assistant there – he admitted administering high doses of powerful painkillers and sedatives to patients on now defunct Daedalus ward.

Mr Beed, a former senior ward manager at the hospital, gave evidence to a five-strong panel examining Dr Barton's conduct relating to 12 elderly patient deaths there between 1996 and 1999.

He told the hearing at Regent's Place, Euston Road, London: 'In 1998 the usual procedure for patients receiving palliative care wasn't to rehydrate them (when using a syringe driver.]

'There was evidence that it wasn't of benefit to them.'

When asked by General Medical Council counsel Tom Kark if it would lead to the deterioration of a patient, he replied: 'It could do if it was a patient we weren't wanting to make a recovery, yes.'

Mr Beed admitted administering high doses of powerful painkiller diamorphine – a form of heroin – to Gladys Richards on Daedalus ward after the 91-year-old was re-admitted on August 17 1998.

The cocktail Mrs Richards – who was initially admitted six days earlier following a hip operation – was given also included anti-psychotics and a sedative.

Mr Beed said the drugs were 'pre-prescribed' by Dr Jane Barton.
He started Mrs Richards on the daily cocktail including 40mg diamorphine three days before her death.

However, the panel heard the normal conversion rate for a patient being switched from oral morphine to a syringe driver – an automatic pump for administering drugs – as in Mrs Richards' case meant she should have had a maximum 10mg. Mrs Richards died on August 21, 1998.

Dr Barton admits her prescriptions were 'potentially hazardous', and that she failed to keep adequate notes.

Dr Barton agreed her actions relating to notekeeping were 'inappropriate' and not in Mrs Richards' 'best interests'.

She denies serious professional misconduct.

The panel is examining Dr Jane Barton's conduct in relation to the deaths of Geoffrey Packman – known as Mick – Ruby Lake, 84, Robert Wilson, 74, Elsie Devine, 88, Leslie Pittock, 82, Elsie Lavender, 88, Arthur Cunningham, 79 – known as Brian, Enid Spurgeon, 92, Alice Wilkie, Jean Stevens, 73, Eva Page and Gladys Richards, 91.

http://www.portsmouth.co.uk/newshome/Hospital-patients-were-39left-to.5385406.jp

 

[Tchort]

Mr Beed admitted administering high doses of powerful painkiller diamorphine – a form of heroin – to Gladys Richards on Daedalus ward after the 91-year-old was re-admitted on August 17 1998.

The cocktail Mrs Richards – who was initially admitted six days earlier following a hip operation – was given also included anti-psychotics and a sedative.

Brompton cocktail is an elixir meant for use as a pain suppressant, and dosed for prophylaxis. Made from morphine or diacetylmorphine (heroin), cocaine, highly-pure ethyl alcohol (some recipes specify gin), and sometimes chlorpromazine (Thorazine), it was given to terminally-ill individuals (especially cancer patients) to relieve pain and promote sociability near death. The chlorpromazine suppresses nausea from whatever source, and tincture of cannabis was once used for this purpose.

The Brompton cocktail is named after the Royal Brompton Hospital in London, England, where it was invented in the late 1920s for patients with tuberculosis. While its use is rare in the 21st century, it is not unheard of. It was far more common in the late 19th and early 20th centuries. The original idea for an oral mixture of morphine and cocaine helping patients in agony with advanced disease is credited to surgeon Dr Herbert Snow in 1896.

While each of the ingredients combat pain and other problems that occur with it in those who may be nauseous from effects of chemotherapy, radiation, and/or high and escalating doses of morphine (which can also cause somnolence or sleepiness, hence the stimulant), it is also generally acknowledged that the whole is greater than the sum of its parts with the various active ingredients all potentiating the morphine or other opioid in their own ways. The synergy between opioid analgesics and centrally-acting stimulants is well-known and widely used: for example, the caffeine content of many codeine-based pain relievers, and prescription of dextroamphetamine or methylphenidate to patients on high doses of opioids both to combat the somnolence from the painkillers and to boost their pain-killing ability.

Some specifications for variants of Brompton Mixture call for methadone, hydromorphone, or other strong opioids in the place of morphine, diphenhydramine in place of the chlorpromazine, and/or methamphetamine, amphetamine, dextroamphetamine, co-phenylcaine, methylphenidate or other stimulants in the place of cocaine. The original recipe for Brompton Mixture also calls for chloroform, cherry syrup to help mask the bitter taste of some of the components, and distilled water in some quantity as a dilutant for the chloroform and/or to add volume to allow for more precise titration of doses.


http://en.wikipedia.org/wiki/Brompton_cocktail

Sounds like a rendition of Brompton's Cocktail was given to this woman. It just isn't being picked up on by the media.

 

[a thing]

powerful painkiller diamorphine – a form of heroin – to Gladys Richards

Diamorphine is a form of heroin? Just like poppy pods contain a chemical often found in LSD? What will they think of next?

 

[Tchort]

Diamorphine is a form of heroin? Just like poppy pods contain a chemical often found in LSD? What will they think of next?

Actually I appreciate this definition. I personally believe "Heroin" is simply a brand name for anything sold as a strong opioid meant for injection/insufflation/chasing. While Diamorphine is the 'original' Heroin, and is found in most Heroin, this is not entirely the case (the Fentanyls, Meperidines, Desomorphine, Morphine, etc are also sold as Heroin).



However the article pushing LSA from Morning Glory* as an ingredient found in LSD is certainly over the top.

 

[Huaca]

Government or medical personnel should not make life or decisions about whether to kill a patient or try to save him. Socialized medicine tends to endorse euthanasia/murder of those they deem not worth saving.

The patient should have complete sovereignty over his own body. Treatment or lack of treatment should never be done without the patient's informed consent.

 

[static_mind]

I disagree. If someone is on the edge of death and is dieing painfully then I think a euthanasia shot is for the best. There was a case here in Aus where a woman sufficated when she was stuffed in the boot of a car while playing sex games. In hospital it was found her brain was destoryed. Euthanasia is a crime here so the doctors had to remove her feeding tube and she starved to death.

If an animal is suffereing in its death its considered humane to put it out of its misary. Apperently its humane to let a human suffer till they die on their own.

 

[stimutant]

but: how can you, not being inside that person, decide its better for her to die than to live?

 

[Dragynfyr]

brompton cocktail huh.... interesting

 

[The Straight Dope]

Some specifications for variants of Brompton Mixture call for methadone, hydromorphone, or other strong opioids in the place of morphine, diphenhydramine in place of the chlorpromazine, and/or methamphetamine, amphetamine, dextroamphetamine, co-phenylcaine, methylphenidate or other stimulants in the place of cocaine.

What the hell is co-phenylcaine?

 

[Tchort]

What the hell is co-phenylcaine?

I originally thought the same thing. It appears to be a combination of Phenylephrine & Lidocaine. Both are mild CNS stimulants, but I doubt this combination of them would be strong enough to do what the stimulant in a Brompton's Cocktail is supposed to do.

Co-Phenylcaine Forte nasal spray

Ingredients

LIDOCAINE HYDROCHLORIDE [SKIN] 5%
PHENYLEPHRINE [NOSE] 0.5%

http://admin.safescript.com/drugcgic.cgi/DRUG?1040990337+0

 

[JahRed24x]

own version of a brompton cocktail for December 2012, just incase the ancient mayans are right about the world ending. LOL My friends think its stoopid but, hey, if an asteroid or some other world ending disaster happens ill at least have a "hot shot" to go out peacefully into the land of nod forever...