Doubts over non-investigation into the suicide of surreal musical/comedy act The Amazing Mr Smith

Joe Stead, an old codger, has some facts

In December last year, in three blogs, I mentioned the death of musical/comedy act The Amazing Mr Smith who died after jumping off a cliff near Bridport in Dorset.

The inquest into his death was last month.

Yesterday, I received the below from Joe Stead, who was Derek Smith’s friend and sometime manager. Joe has been talking to Derek’s daughter Rosie and to others who knew Derek. He says: “This is my own interpretation of events as I see them.”

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The Amazing Mr Smith, in a 2013 Vimeo mini-documentary

The inquest into the death of my good pal Derek ‘The Amazing Mr Smith’ took place on Wednesday 19th February in Dorchester. The coroner, Mr Nicholls, said: “One of the matters which the inquest needs to address is whether Mr Smith deliberately took his own life. For that conclusion to be recorded, the evidence has to be such that the coroner is satisfied beyond reasonable doubt. Having looked at the evidence in this case, I am going to return an open verdict because I am not satisfied on the evidence I have before me that Mr Smith intended to take his own life.”  And with that the proceedings were closed.

It is important we get the facts straight.

I had known Derek since 1970. I was his best man when he got married and I made numerous trips from Yorkshire to Dorset after his wife Viva died in April 2009. I guess I drove down every couple of months. He was great fun to be with and we had a lot of laughs together.

On the Monday before Derek died, his doctor prescribed Paroxetine/Seroxat, a drug that can, on occasions, cause suicidal tendencies. It is a treatment for depression which Derek never had. Paroxetine is also prescribed for anxiety.

For at least a couple of months before he died, Derek was suffering severe toothache that general medicines could not prevent. Anyone who has suffered severe toothache for just 24 hours will know just how depressing that can be. But Derek was NOT depressed. Lack of sleep and pain made him anxious – NOT depressed.

According to a specialist at Dorchester Hospital there was, in fact, nothing clinically wrong with his teeth although Derek believed that his jawbone had become infected. The maxofacial specialist he saw explained that this was not the case and told him that he had problems with the muscles in his jaw and it was this that was causing the severe pain in his jaw. Initially, this made Derek a lot happier.

I visited Derek in November exactly three weeks before his death.  He was in great spirits and very much in love with his girlfriend Annette. There was no indication at that time that he might jump off a cliff, but he did complain each morning that he had slept badly because of his teeth.

He visited the doctors again (Thursday afternoon, December 5th) and Annette accompanied him. He pleaded with the doctor (a different doctor to the one who had prescribed Paroxetine) to give him something to “knock me out for 24 hours” (Derek’s words). The doctor was, however, alarmed at Derek’s state of mind and immediately told him to stop taking Paroxetine/Seroxat because he believed it had made Derek suicidal.

Derek followed the second doctor’s instructions, but there can be little doubt that the medicine would have remained within his body for a good few days after he stopped taking it. That very morning he had told Annette he had been twice to West Bay with the intention of taking his own life but was relieved because he could not go through with it. This was the reason they had made another visit to see the doctor.

Derek certainly felt anxious. He was still in pain. His doctor had not satisfied his needs for pain relief, nor had he obliged in giving him the 24 hours sleep he so desperately needed. Having seen the doctor, Derek now understood his irrational thoughts and behaviour of the previous night. Apparently he was in reasonably good spirits and Derek promised he would tell Annette if he felt suicidal again.

But within 24/36hours he fell to his death from the cliffs at West Bay Bridport.

Waking that Sunday morning Annette, finding herself alone, drove immediately to West Bay fearing the worst.

When Annette, who was with Derek during his last days, was summoned to give evidence about events leading up to his death, the only thing that the coroner was interested in was: “How long did it take you to drive to West Bay?”

Why was only one question asked and why such a stupid question that did not even pertain to his actual death?

The doctor who had prescribed Paroxetine/Seroxat only five days before Derek’s death was not called. Indeed no doctors were called. Evidence about his medication and visits had been submitted, but the coroner chose not to include this information in the medical evidence he mentioned at the inquest.  When Annette, at the end of the inquest, asked the coroner why the doctor who prescribed Paroxetine/Seroxat was not called he refused to answer on the grounds that the inquest was now closed.

To sum up then…

No-one from the medical profession was present at the inquest.

No mention was made of the fact that Derek had been to his GP’s surgery twice in the last week of his life due to a long-standing problem with pain in his jaw, which was preventing him from sleeping and causing anxiety.

As mentioned above, he went first on Monday 2nd December to get help for the pain, lack of sleep and consequent anxiety and was prescribed Paroxetine.

He went back three days later and saw another doctor after becoming suicidal immediately after taking Paroxetine.

Nothing was said at the inquest about the second doctor telling him to stop taking Paroxetine because it was making him suicidal or about the fact that he was then prescribed Mirtazapine.

Instead, the coroner presented irrelevant information from almost a year ago, describing how Derek had attended a mental health course offered by the NHS – even though his scores on measures of mental health were zero, which indicated he had absolutely NO mental health problems at the time.

Why was this insignificant detail from almost a year before mentioned, yet recent and important information about the visits to his doctor and his medication omitted?

We have to wonder why the coroner chose not to mention that the second doctor had stopped the Paroxetine because it had made Derek suicidal.

Curiously the local paper The Dorset Echo, which reported the inquest, seems to display a similar timidity when it comes to reporting anything which might possibly upset GlaxoSmithKline (the manufacturers of Paroxetine) and implicate Paroxetine.

The Dorset Echo‘s original online headline for its report on the inquest was:

QUESTIONS OVER ’SUICIDE DRUG’ LINK TO MUSICIAN’S DEATH

yet two days later this was quietly changed to:

QUESTIONS OVER PRESCRIPTION DRUG LINK TO MUSICIAN’S DEATH

The original wording in the article was also changed from describing Paroxetine as “a drug with links to suicide” to the more cautious description of it as “a drug with alleged links to suicidal thoughts”.

I understand Paroxetine is no longer prescribed to young people because of proven links to suicide in this age group and long-standing campaigns exist to stop Paroxetine from being prescribed to all ages because of links with suicide.

It is odd that some changes to the online report of Derek’s inquest appear to have been easily achieved, possibly in order to appease GlaxoSmithKline and avoid lawsuits, but, when Annette and Derek’s family requested corrections to the numerous factual errors in the article, no changes were forthcoming.

Consequently the report which appears online still contains inaccurate, misleading and distorted information about the evidence given at Derek’s inquest. For example, it says “An inquest heard that the 65 year old had a history of depression”.  

Four pieces of evidence were presented and not one of them described Derek as being a depressed man with a history of depression. In fact, two of the pieces of evidence described Derek as being happy and one piece of evidence showed that he scored zero on clinical measures which indicated that he had no depression.

The question I ask myself is the same question Annette asked the coroner: Why was the doctor who prescribed a drug that has side effects that can cause suicidal tendencies not called?

Frankly the whole thing has a nasty smell of a cover-up by the coroner to protect the doctor or perhaps because of the controversy surrounding Paroxetine/Seroxat.

So we who were his friends are still left wondering:

(a) Why Derek was prescribed a drug that encouraged suicide?

and

(b) Why the doctors involved were not called to give evidence?

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That was what Joe Stead sent me yesterday. If you look up the Wikipedia entry on GlaxoSmithKline it currently includes this:

Paroxetine is an SSRI anti-depressant released by GSK in 1992 and sold as Paxil, Seroxat, Aropax, Brisdelle, Pexeva and Sereupin. The company’s promotion of the drug for children was one of the grounds for the 2012 fraud case in the United States.

For 10 years the drug was marketed as “not habit forming,” which numerous experts and at least one court found to be incorrect. Approximately 5,000 US citizens have sued GSK after using paroxetine; lawsuits have also been filed in the UK. The lawsuits allege that the drug has serious side effects, which GSK downplayed in patient information.

In 2001 the World Health Organization ranked paroxetine as the most difficult antidepressant to withdraw from. In 2002 the FDA published a new product warning about the drug, and the International Federation of Pharmaceutical Manufacturers Associations said GSK had misled the public about paroxetine and had breached two of the Federation’s codes of practice. In early 2004 GSK agreed to settle charges of consumer fraud for $2.5 million; the drug had $2.7 billion in yearly sales at that time.

The legal discovery process also uncovered evidence of deliberate, systematic suppression of unfavorable Paxil research results. One of GSK’s internal documents said, “It would be commercially unacceptable to include a statement that efficacy [in children] had not been demonstrated, as this would undermine the profile of paroxetine.”

In June 2004 FDA published a violation letter to GSK in response to a “false or misleading” television commercial for Paxil CR, writing: “This ad is concerning from a public health perspective because it broadens the use of Paxil CR [beyond the conditions it was approved for] while also minimizing the serious risks associated with the drug.”

GSK said that the commercial had been reviewed by the FDA, and that it would not run again.

In March 2008 the Medicines and Healthcare Products Regulatory Agency concluded that GSK should have warned of the possible ill effects of taking paroxetine a lot sooner. GSK could not be prosecuted under the old legislation. As of 2008 GSK’s prescribing information acknowledges that “serious discontinuation symptoms” may occur. Court documents released in October 2008 indicated that GSK “and/or researchers may have suppressed or obscured suicide risk data during clinical trials” of paroxetine.

The suppression of the unfavorable research findings and the legal discovery process that uncovered it is the subject of Side Effects (2008), a book by Alison Bass.