Coroner Andrew Tweddle returned verdicts on deaths of Stanley Weldon, Frank Moss and Harry Gittins (From The Northern Echo)

Coroner Andrew Tweddle returned verdicts on deaths of Stanley Weldon, Frank Moss and Harry Gittins

8:10am Tuesday 16th March 2010 in

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MORPHINE injections given to two men by a former North-East GP were not clinically justified and contributed to their deaths, a coroner has ruled.

Coroner Andrew Tweddle returned verdicts following inquests into the deaths of Stanley Weldon, Frank Moss and Harry Gittins in Bishop Auckland, yesterday.

Former South Durham GP Howard Martin was acquitted of murdering all three men with drugs overdoses, following a trial in 2005.

Mr Tweddle found that cancer patient Harry Gittins would not have died when he did – at his home in Woodham, County Durham, on January 22, 2004 – but for the administration of morphine, diamorphine and chlorpromazine.

He believed Mr Gittins was not close to imminent death at that time and recorded a verdict of misadventure.

An open verdict was recorded in the case of cancer patient Frank Moss, at his home in Eldon, County Durham, on March 14, 2003.

In both cases, he said the administration of drugs “more than minimally or trivially contributed to the death” and he found that injections given by Dr Martin “were not clinically justified”.

Speaking on behalf of both families, Mr Gittins’ daughter, Jillian Coates, said after the inquest: “We have always accepted that there are limits to a coroner’s inquiry and we understand that nothing said today affects the acquittal of Dr Howard Martin on the serious criminal charges he has previously faced.

“That said, the finding that these two men would not have died when they did if they had not received the injection of morphine that Dr Martin administered is a great relief to us and answers one of the questions that has troubled us for years.

“Further, the finding that those injections were not clinically justified is a vindication of concerns we have always felt about the circumstances in which our loved ones died.”

An open verdict was recorded in the case of Stanley Weldon, who had dementia and died in a Newton Aycliffe nursing home on March 18, 2003.

Mr Tweddle said the cause of his death could not be ascertained because of the lack of evidence available after his body was exhumed.

The inquests were resumed after Mr Moss’ daughter, Allison, applied to the High Court for a judicial review.

The Weldon family declined to attend or give evidence at the hearing.

During the inquiry, the doctor, who is now retired and lives in North Wales, was described as an old-fashioned, traditional GP who placed great store on his close relationship with patients.

Mr Tweddle said: “That is to be applauded. However, such old-fashioned and traditional values should not have extended to a course of treatment which was described as ‘risky’ or ‘antiquated’.”

The coroner found that earlier concerns raised about Dr Martin’s practices had been appropriately investigated by health bosses and police.

“I find no causative link between the information known to and investigated by the relevant authorities to the deaths of Mr Weldon, Mr Gittins and Mr Moss,” added Mr Tweddle.

He said it was unfortunate that in 2000 there were a lack of options available within the NHS to deal with GPs about whom concerns had been raised.

System changes have since been made to improve patient safety and GP performance, though the coroner could not determine whether they were adequate.

He will now write to relevant health authorities urging them to review their systems again, in light of evidence given during the inquests.

Mr Tweddle said: “The public should have complete faith in their GPs, because they place their lives in their hands.

“I think it is appropriate for those who have power to influence the way in which GPs work and operate to consider once again what further changes and improvements are necessary, if any, in an endeavour to avoid similar fatalities in future.”