Paul Pidgeon was found dead at his Surrey home in March 2022, after overdosing from medication he bought in bulk from Booker Wholesale in Wimbledon
A South London mechanic was able to use his business trade card to buy painkiller medication in bulk from a major high street wholesaler, sidestepping normal retail restrictions and triggering a review of safety procedures across the chain following his death.
The revelation came during an inquest into the death of Paul Pidgeon, leading a coroner to warn that similar cases could put other lives at risk if safeguards are not tightened.
Mr Pidgeon’s business, Southfields Garage in Southfields, Wandsworth did not permit him to buy or supply medication to the public. Despite this, the inquest revealed that staff at Booker Wimbledon did not carry out any checks on his business account status when he visited to make bulk purchases of painkiller medication on two separate occasions.
Mr Pidgeon was found dead at his home in East Clandon, near Guildford, in March 2022, surrounded by empty packs of painkillers. The inquest heard that he had deliberately taken an overdose the day before, although his intentions remain unclear with regards to ending his life.
His cause of death was recorded as toxicity from the medicinal overdose, with contributing conditions of coronary artery disease and fatty liver which made him susceptible to toxicity.
In her report, Surrey’s Assistant Coroner Anna Crawford concluded that Booker Wholesale’s Wimbledon branch had failed to check whether Mr Pidgeon’s garage business was authorised to purchase medicines. Miss Crawford said this lapse exposed a “dangerous” gap in the wholesaler’s procedures and could allow other non-medical businesses to make similar purchases.
The coroner also expressed concern that such unchecked sales could lead to future deaths across the company’s branches. As a result, operator Booker Group Limited was asked to explain how it would prevent this from happening again.
In its response, Booker acknowledged that weaknesses in its older systems allowed the sale to Mr Pidgeon but insisted those issues have now been resolved. It assured the coroner that its new procedures meet all regulatory standards and will prevent a repeat of the tragedy.
Mr Pidgeon had been a Booker customer for more than 20 years, joining long before stricter membership checks were introduced. The company told the coroner it could no longer access his original account documents and suggested there may have been a misunderstanding about his business type, though this was only speculation.
The company offered its condolences to Mr Pidgeon’s family and said it has since introduced stronger systems to ensure medicines are only sold to those entitled to supply them. It also hired an external consultant to help improve its practices in this area. The wholesaler now requires customers to prove their authorisation before being allowed to purchase medicines. Each verified account must also undergo a full review every two years to confirm continued eligibility.
Booker also introduced an automated till block in September this year, which prevents unqualified customers from completing purchases. Staff are unable to override this system, ensuring that only approved retailers, care homes and schools can buy medicines.
All medicines are kept in secure, locked rooms that can only be accessed with the help of trained staff. Booker said this measure was already in place in Wimbledon but is now enforced across all its branches since Mr Pidgeon’s death.
The company added that staff must complete annual compliance training and pass a competency test before being allowed to handle medicine sales. Regular audits are carried out by a ‘responsible person’ to ensure that every branch adheres to national guidelines.
Despite this, Booker said it had not been made aware of the inquest until it received the coroner’s report in August this year. This was because it had not been invited to make representations at the inquest as an ‘interested person’.
Booker says it remains committed to improving safety and upholding strict compliance across its network. The coroner has shared her findings with the national medicines regulator and Mr Pidgeon’s family.
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