I think it is worth pointing out that when Sheila requested that her Haloperidol be reduced because she was tired,that Dr Angeloglou thought the reason for her tiredness may be due to the fact she was not taking her procyclidene tablets.Why was this not followed up?According to Dr Angeloglou Sheila was prescribed a months supply of procyclidene tablets on 29th April,so she would have been due a repeat prescription on29th May.There is no mention of a repeat prescription on this date.Did Dr Wilkinson ask Sheila about the procyclidene tablets ? Did she know she was due a repeat prescription? Did she get one on 29th May? If not,why not,and why was this not checked when Dr Angeloglou discussed Sheilas reduced dose of Haloperiol with Dr Wilkinson.Surely Dr Angeloglou had a record of the dates Sheila had been prescribed the procyclidene tablets,and knowing the Haloperidol was a strong tranquillizer ,it should have been important to check if she was taking them.And surely imperitive to keep her supplied with repeat prescriptions.Wasnt it too late for the Doctors to discuss whether or not Sheila was taking the tablets BEFORE they agreed to lower the dose of Haloperidol?If they made checks as to whether Sheila was taking the tablets,a reduction of the Haloperidol may have been avoided.Sheilas was a very serious case,and No mistakes in her medication could be afforded.Dr Ferguson says in CALS book that 100mg would be regarded as a small dose.After seeing the result of JBs trial on tv,Ferguson said he was 'glad that it wasnt Sheila after all'.I wonder why?
Firstly, I wouldn't say "Sheila's was a very serious case". At least, no more serious than anyone else, who'd been admitted to hospital suffering psychosis and prescribed Haloperidol. "Should have" is a frequently used expression when things go wrong. Are they any more right now? In my area, it's recently been announced that there have been 1500 deaths over the last 20 years, all in the mental health area, some in hospitals where they were being 'cared for', and some within three months of them leaving.
It has been alleged that Sheila wasn't taking the prescribed procyclidene. Had Dr Angeloglou suspect that to be the reason for her tiredness, she wouldn't have agreed to requesting a reduction in the Haloperidol dose. Incidentally, the doctor who administered her last dose was, in fact, a locum. I can't remember if this was Dr Angeloglou or Dr Wilkinson, but given that she received consecutive doses, it seems she may have been given her following appointment before leaving the surgery.
You seem very concerned that the requisite 'i's' weren't dotted and 't's' crossed -another "should have"- but how were they going to check on whether or not Sheila was taking her oral meds, regularly. It was precisely for that reason, ie that they couldn't check, that Haloperidol -the imperative medication- was administered intravenously. For the rest, it was Sheila's responsibility. If, as a result of not taking it, she felt overly tired, it was down to her.
I can fully understand that Dr Ferguson was "glad it wasn't Sheila". Not only had he known her quite well, and I imagine she had a attractive and likeable personality, he'd also known her mother. I don't think, from how he couched his words, he ever believed Sheila to have been responsible -I suspect he'd have found difficulty in believing it had it been found to have been her- and he'd have been pleased she'd been exonerated.