Doctor's manslaughter trial halted owing to defendant's health

The trial of a doctor in England accused of manslaughter over the death of a teenage patient with cancer was halted last week after the judge was told that the defendant, Dr Feda Mulhem, was not fit to continue. The jury was discharged in the second week of the trial at Nottingham Crown Court, but a retrial is still possible. Dr Mulhem, aged 35, was charged with unlawfully killing Wayne Jowett, aged 18, who was recovering from leukaemia when the cytotoxic drug vincristine, which is meant to be injected intravenously, was instead injected into his lower spine (BMJ 2002;325:616). Specialist registrar Dr Mulhem, of Leicester, allegedly ordered a junior doctor to deliver the injection. The incident happened on 4 January 2001 at the Queen's Medical Centre in Nottingham, only three days into Dr Mulhem's first specialist registrar post. Before the trial was halted, Bruce Houlder QC, prosecuting, said that Dr Mulhem had ordered the injection into the spine of the patient, even after a query from the senior house officer who was doing the injection, who had been on the ward for only five weeks. Within 15 minutes both doctors realised their mistake, but attempts to save the teenager's life were unsuccessful. In a statement to police, Dr Mulhem, who qualified in Syria and came to Britain in 1998, said he had mistaken the drug for methotrexate, a drug which is properly injected into the spine. The case was the 14th such error involving vincristine since 1985; 11 of these had been fatal (BMJ 2001;322:1013). Four doctors have previously been prosecuted for manslaughter over the same error but ultimately cleared. In 1991 two junior doctors at Peterborough General Hospital were convicted of manslaughter, but the conviction was overturned on appeal. The Queen's Medical Centre admitted liability for the error and paid an undisclosed amount in compensation to Mr Jowett's parents. Dr Mulhem was retrained as a specialist registrar at Nottingham City Hospital. After the incident Professor Gordon McVie, director general of the Cancer Research Campaign, said: "This drug should never be given by anyone other than a consultant." An inquest, which resulted in a verdict of accidental death, was told that neither doctor had any formal training in administering the drug. * A GP made a preliminary appearance at Chester crown court this week charged with unlawfully killing a patient with a morphine injection. Dr Narendra Sinha, 67, of Liverpool, is accused of manslaughter over the death of Maureen Lyth, who was in her sixties, in September 2001 while he worked as a locum GP in Ellesmere Port, Cheshire.