GP suspended for enrolling patients in drug trials without consent
Owen Dyer, London
A Hertfordshire GP who included his patients in drug trials without their
knowledge was last week suspended by the GeneralMedical
Council.
Dr Robert Macindoe Adams, 58, admitted enrolling 12 patients in seven drug
trials for pharmaceutical companies including AstraZenecaand
SmithKline Beecham without providing an opportunity for informed
consent.
The trials involved drugs for depression and hypertension. In two cases Dr
Adams was found to have overstated the patients'symptoms to meet the
strict criteria for antidepressant trials.He was also found to have
changed patients' treatment and prescribedplacebo to conform to
studyprotocols.
Dr Adams, who is reportedly in poor health, did not attend the hearing but
was legally represented. His counsel, Charles Foster,said his client
was his own harshest critic and had "excoriatedhimself" over his
actions. Most of the charges wereuncontested.
Ten of the patients entered into the drug trials were found to have been
given insufficient information to provide informedconsent. In
particular, Dr Adams neglected to give them patientinformation
leaflets relating to the studies. He failed to mentiona trial at all
to twopatients.
One of these patients, referred to by the GMC's professional conduct
committee as Mrs K, became suspicious when Dr Adams changedher
treatment after enrolling her in a trial of the calcium channel
blockerlercanidipine.
Mrs K expressed her concerns about her change of treatment in a letter, in
which she also complained about frequent bloodtests. Mr Edward
Henry, counsel for the GMC, said she "thoughtthere could be no
reason for giving blood repeatedly with herarm turning black and
blue." At one point she asked Dr Adams:"Are you selling my blood?"
Taking of samples that are not necessaryto the patient's wellbeing
could be construed as assault, saidMrHenry.
Although Dr Adams wrote in reply to Mrs K's letter, he failed to mention that
she was being prescribed lercanidipine as partof a clinical trial.
He accepted the GMC's charge that this letterwas
misleading.
Professor Peter Richards, chairman of the panel hearing the case, said:
"Patients were exposed to risks of treatment and toperiods of
placebo treatment without their knowledge. Patientsmust be able to
have confidence that any treatment is both necessaryand in their
best interests. Pharmaceutical companies must beable to rely on
doctors' strict compliance with drug protocols.Trust is a
cornerstone of good medical practice. This trust wasabused."
Mr Foster told the committee that his client was no longer practising and had
no plans to resume clinical work. Unless heappeals against the
decision, Dr Adams will be suspended for 12months. His case will be
reviewed before the end of that suspensionperiod.
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