Coroner calls for review of availability of psoriasis drug after inquest into death of Croydon man Ian Gilbert

A CORONER has found the death of a Croydon man was “entirely preventable” and recommended reviews of prescription advice for the common drug that killed him.

A CORONER has found the death of a Croydon man was “entirely preventable” and recommended reviews of prescription advice for the common drug that killed him.

Ian John Gilbert, 77, died on February 13, 2015, following his admission to hospital on February 4 after taking the drug methotrexate to treat psoriasis.

Coroner Rosemary Carlin handed down her findings yesterday in the inquest of Mr Gilbert’s death at the Coroners Court of Victoria.

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In her findings, Coroner Carlin found Mr Gilbert’s doctor, Dr Stephen Lim, prescribed him with methotrexate and advised him to take two tablets daily.

His regular pharmacist Jennifer Barca dispensed the dosage as advised, despite conveying her “extreme concern” to Dr Lim it would be lethal, and above the recommended dosage of one tablet a week.

During the investigation, Dr Lim agreed he prescribed the incorrect dose of methotrexate and did so without ordering blood tests.

Coroner Carlin said she had “no doubt Dr Lim was seeking to appease Mr Gilbert’s suffering by prescribing methotrexate, but in his eagerness to please he completely failed in his duty of care to Mr Gilbert as a patient”.

She said she felt sympathy for Ms Barca in the conflicting situation, but said “a refusal to dispense would have carried absolutely no risk to Mr Gilbert’s health” and Ms Barca “should not have dispensed it”.

Coroner Carlin made five recommendations — covering the drug and its prescription limits, and to explore further support for pharmacists when they feel conflicted or concerned by prescription advice from doctors.

Speaking outside of court, Mr Gilbert’s daughter Amanda Gilbert said she found Coroner Carlin’s findings “balanced and fair.”
“We are blessed we have been able to get as far as today and we hope there are some positive outcomes that arise from it,” Ms Gilbert said.

“If this whole situation can be prevented for someone else, I think it’s a positive step in the right direction.”

Speaking outside court, the family’s lawyer Paula Pulitano said proceedings for a civil claim in the County Court of Victoria were likely to be launched within a month.