Risk unacceptable—doctor

Press, 8 September 1982, Page 6

Risk unacceptable—doctor

PA Auckland ’.The medical superintendent of Porirua Psychiatric Hospital told the Oakley inquiry yesterday that he believed Oakley staff took an unacceptable risk in treating Michael Watene with con-, tinual high dosages of a sometimes dangerous drug. The superintendent. Dr John Hall, said it was a reasonable assumption that the combination of the drug haloperidol with electroconvulsive therapy (E.C.T.) caused the death of Mr Watene on February 22. Dr Hall, who is representing the Royal Australian and New Zealand College of Psychiatrists, was the twenty-third witness to testify at the inquiry. .

He said that haloperidol was an effective and commonly used tranquilliser for acutely excited or disturbed patients. “The fact that haloperidol has some dangers of its own does not appear to have been given sufficient regard (in the Watene case).” Over the last year at least, he said, published reports had indicated that dosages above 100 milligrams a day were potentially dangerous. ' A conversation between Mr Watene and a witness suggested an improvement in the patient's behaviour the day before he died, Dr Hall said. Asked whether an improvement made continued high dosages of the drug an

unacceptable risk, Dr Hall replied: “Yes, I would have to say it was." Either the medication or the E.C.T, and its accompanying anaesthetic would have been acceptable on its own, he said, In view of Mr Watene’s apparent improvement on Sunday, February 21, he told the committee, it would have been prudent for the E.C.T. scheduled for the next morning to have been at least postponed until discussions, could be held with the doctor in charge of the patient. To Mr David Morris, counsel for the Auckland Hospital Board, Dr Hall said that he had no major criticisms of Watene’s treatment at Oakley from the time of admis-

sion on February 15 until the week-end of February 20-21. Dr Hall said that' on the week-end the dosages of haloperidol were higher than he would have prescribed. He did not agree that nursing notes about Mr Watene on February 21 indicated that he had not responded sufficiently to the drug for the dosages to be reduced. To Mr David Lee, counsel for Oakley doctors, Dr Hall agreed that the high dosages of haloperidol suggested Mr Watene must have been a very disturbed patient with a high resistance to the drug. He also agreed that direct contact between doctor and patient was the most important component in a treatment decision.