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Legal obligation to write clearly

Doctors are legally obliged to write clearly, as emphasized in the UK Court of Appeal ruling in the following case. A doctor had written a prescription for Amoxil tablets (amoxicillin). The pharmacist misread this and dispensed Daonil (glibenclamide) instead. The patient was not a diabetic and suffered permanent brain damage as a result of taking the drug.

The court indicated that a doctor owed a duty of care to a patient to write a prescription clearly and with sufficient legibility to allow for possible mistakes by a busy pharmacist. The court concluded that the word Amoxil on the prescription could have been read as Daonil. It found that the doctor had been in breach of his duty to write clearly and had been negligent. The court concluded that the doctor's negligence had contributed to the negligence of the pharmacist, although the greater proportion of the responsibility (75%) lay with the pharmacist.

On appeal the doctor argued that the word on the prescription standing on its own could reasonably have been read incorrectly but that various other aspects of the prescription should have alerted the pharmacist. The strength prescribed was appropriate for Amoxil but not for Daonil; the prescription was for Amoxil to be taken three times a day while Daonil was usually taken once a day; the prescription was for only seven days' treatment, which was unlikely for Daonil; and finally, all prescriptions of drugs for diabetes were free under the National Health Service but the patient did not claim free treatment for the drug. All of these factors should have raised doubts in the mind of the pharmacist and as a result he should have contacted the doctor. Therefore, the chain of causation from the doctor's bad handwriting to the eventual injury was broken.

This argument was rejected in the Court of Appeal. The implications of this ruling are that doctors are under a legal duty of care to write clearly, that is with sufficient legibility to allow for mistakes by others. When illegible handwriting results in a breach of that duty, causing personal injury, then the courts will be prepared to punish the careless by awarding sufficient damages. Liability does not end when the prescription leaves the doctor's consulting room. It may also be a cause of the negligence of others.

Source: J R Coll Gen Pract, 1989: 347-8