When a Mistake is not Misconduct

Christopher Geering recently won a High Court appeal against the Nursing and Midwifery Council. A panel of the Conduct and Competence Committee had found Ms Masih impaired, and imposed Conditions of Practice on her registration, as a result of a single instance of drug maladministration. All the other allegations had fallen away. She had given a patient her weekly injection of methotrexate, a drug prescribed for her arthritis, but had failed to document having done so. Consequently a colleague then administered a second dose during the course of the same shift. The patient was monitored and found to have suffered no harm. The amount administered remained within therapeutic parameters. In its decision the panel noted the importance of accurate documentation and the potential harm which may arise from such medication mistakes. On appeal, however, the High Court accepted Christopher’s argument that a single such mistake – in the circumstances of an extraordinarily chaotic ward – did not in itself cross the threshold of misconduct even where a patient is exposed to potential harm. The degree of culpability was too low. A finding of no impairment was substituted and costs awarded against the Nursing and Midwifery Council.