A former deputy care home manager has been suspended from the profession after attempting to cover up a medication overdose given to a resident.
Paul Kilburn falsified entries in the home’s records to conceal a medicine error by a junior member of staff, a disciplinary panel found.
The Nursing and Midwifery Council (NMC) also ruled he had put the end-of-life patient “at increased risk of harm” by failing to inform his GP about the mistake.
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The disciplinary hearing was told that KIlburn was a registered nurse and deputy manager at Sandringham Care Home in Bishop Auckland, County Durham.
At the time of the incident in November 2019, he was filling in for the home’s manager, who was on holiday.
The panel heard that on one evening, two nurses accidentally gave a patient double their prescribed dose of pain relief medication Alfentanil. One of them then gave the resident another incorrect dose the next day.
One of the nurses realised the error when checking the stock in the controlled drugs cupboard, and told Kilburn.
The panel found that he then altered the records to change the number of vials the patient had received from three to two, and changed another entry showing the number of vials that were left in stock.
A report of the hearing said: “[The nurse] in her evidence was clear that Mr Kilburn accompanied her to the treatment room to review the [controlled drug] book, the medication box of Alfentanil and the Red Card.
“In the presence of Colleague A, he took a red pen and altered the stock check line in the CD book.
“He further altered several columns and did not initial to say that he had done so, in order to indicate that the correct dosage of medication, namely, 1500 micrograms of Alfentanil had been administered to Resident A.”
The panel also found Kilburn an incorrect entry into the Controlled Drug Book to indicate that the additional medication dispensed over the two days had been lost and/or broken.
The report said when the home’s manager returned from holiday, Kilburn did not report the error to her.
But she was informed by a nurse about “discrepancies in the CD book” and spoke to the nurses who admitted that they had given the incorrect dosage of Alfentanil to Resident A.
The report said the manager also discovered Kilburn had failed to inform the resident’s GP and the safeguarding team about the incidents.
The panel heard that Kilburn admitted to his employer that he amended the record and resigned.
The report said, “The panel determined that Resident A was a vulnerable end of life patient.
“In such circumstances, failing to report a medication overdose to any stakeholders placed Resident A at an increased risk of harm.
“The panel further determined that altering the Controlled Drug Book and the Controlled Drug Record was a deliberate act which had been undertaken in order to conceal a medication error and to deceive third parties."
The NMC suspended him from the profession for 12 months, saying, “Given Mr Kilburn’s lengthy career without previous incident, the panel did not find any evidence of a deep-seated attitudinal issue.
“The panel was satisfied that although serious, Mr Kilburn could remediate his misconduct by demonstrating appropriate reflection.”
