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Gabriel Myers, 7, died of suicide. Dennis Maltez, 12, died of serotonin syndrome. Both were on psychotropic medications later found to be excessive or inappropriate for their unique cases. Guardians, advocates and child welfare and foster care attorneys wonder: Could history be repeating itself?
For children in Florida’s juvenile jails, heavy doses of powerful antipsychotic medications seem to be the norm — especially when these “big guns” of psychiatry, which can cause suicidal thoughts and other dangerous side effects, are dispensed by doctors reportedly being speaking and other fees by pharmaceutical companies.
According to a Palm Beach Post investigative report, these drugs “routinely were doled out for reasons that never were approved by federal regulators.” In response to the report, the paper noted that the Florida Department of Juvenile Justice has “ordered a sweeping review of the department’s use of antipsychotic medications.”
“In some cases, the drugs are prescribed by contract doctors who have taken huge speaker fees and other gifts from makers of antipsychotic pills, companies that reap staggering profits selling medications,” the paper reported.
Regarding the level of use, Broward County Public Defender Howard Finkelstein, whose office represents children in juvenile court, told the Post, “This is a very important issue. If kids are being given these drugs without proper diagnosis, and it is being used as a ‘chemical restraint,’ I would characterize it as a crime. A battery – a battery of the brain each and every time it is given.”
The investigations, questions, hearings and discussions lasted more than a year following the apparent suicide in a Florida foster home of Gabriel Myers, a 7-year-old boy on the care of Florida Department of Children and Families — and under the influence of a cocktail of psychotropic medications.
But it wasn’t to be that easy. Florida child welfare administrators, who closed their case in 2010 after finding that none of Gabriel’s caregivers had abused or neglected him.
The agency soon reopened the case, backtracked, and according to reports in the Miami Herald, “verified allegations that Gabriel’s foster parents and their then-19-year-old son, who was baby-sitting that day, were responsible for Gabriel’s death — one of the most controversial in agency history.”
Discussions leading to the new outcome centered on a series of difficult questions that confronted the child welfare agency as it was seeking to redefine itself and promote a greater sense of family among foster children. Read the entire story here.
Florida’s Agency for Health Care Administration suspended the license of the doctor who prescribed a combination of three psychiatric drugs to 12 year old autistic child Dennis Maltez when he died of serotonin syndrome.
The Miami Herald wrote about the case in the article, “Florida suspends Miami psychiatrist in boy’s overdose death.” The paper noted that “red flags were overlooked in the 12-year-old’s prescription drug death, and how a second report blamed the system in the tragic case of 7-year-old Gabriel Myers’ suicide.”
State regulators wrote that Kaplan committed medical malpractice, and that he posed “an immediate, serious danger to the health, safely, or welfare of the public.”
The real question that has yet to be answered by the state of Florida is how many other physicians in the state of Florida who prescribe dangerous combinations of psychotropic medications to disabled persons and foster children which are paid for by the state’s Medicaid program will be allowed to ignore the letters and visits from the AHCA children’s pharmacy management program that red-flag these combinations of medications as potentially dangerous? How many more children like Denis Maltez and Gabriel Myers need to die before the state will do something?
The closely watched story of Denis Maltez, the 12-year-old Autistic boy who the Miami-Dade County Medical Examiner said died of “serotonin syndrome” after being prescribed several psychotropic drugs, took a new turn this week as the prescribing psychiatrist was dropped from Medicaid’s rolls as a medical provider serving the state’s insurance program for disabled and needy children.
More importantly, the Agency for Health Care Administration needs to monitor all physicians who blatantly ignore their “red flag” warning letters, said Howard Talenfeld, attorney for the boy’s mother, Martha Quesada.
“Unfortunately, Florida has no procedure to protect the patients of physicians who write behavioral healthcare prescriptions that exceed thresholds and who ignore the letters from the University of South Florida Medicaid Drug Therapy Program,” Talenfeld told the Miami Herald.
“Nor does the state tell the parents or guardians of mentally disabled persons or foster children that these drugs prescriptions may be dangerous or monitor whether or not the physicians obtained informed consent from them.”
As the Herald reporter wrote, “The death of 12-year-old Denis Maltez raises troubling questions about the state’s safety net for disabled kids. The Miami-Dade Medical Examiner’s Office attributed the death to a life-threatening side effect of over-medication.”
Attorney Howard Talenfeld urged healthcare and disability administrators in a letter to better protect disabled children, “who are powerless to protect themselves from being unnecessarily drugged for the convenience of staff. . . . Without proper oversight and action by your respective state agencies, these individuals will continue to be in harm’s way.”
Among the questions the Herald raised in Denis’ case: (more…)
We at Florida Child Advocate.com congratulate Florida Department of Children and Families Secretary George Sheldon and former Secretary Robert Butterworth for initiating an effort that recognizes that every child, regardless of age or disability, is adoptable. This is a great start, but we have a long way to go.
We’re not alone in recognizing this effort. The Miami Herald reports that Florida leads the nation in finding permanent homes for abused and neglected children.
Washington has recognized the work of what has become a model program, too. Reporter Carol Marbin Miller writes that Florida child-welfare administrators have received nearly $10 million in federal aid for Florida’s adoption program.
“For the second year in a row, the Department of Children & Families has led the nation — by a wide margin — in the number of children successfully adopted from foster care,” Miller writes. “For their efforts, DCF will receive a hefty bonus that can be used to boost next year’s adoption program.” Read More…
“It seems to be a prerequisite for foster children to be on medication.”
These words were spoken by the adoptive father of two 12-year Florida girls. And the reality he spoke of just shouldn’t be the case.
As Florida Gov. Charlie Crist was barnstorming the state discussing Florida’s successes in fostering adoptions, Mirko Ceska was telling the governor about the continued prevalence of psychotropic drugs in the lives of foster kids and others in the state’s care. Read the Miami Herald article here.
Powerful psychotropic should not be used as “chemical restraints” for minor foster children. But such use is widespread instead of behavioral approaches designed to address the real losses in their lives. (more…)
Florida Today writes about the Florida Department of Children and Families study of compliance by physicians and case workers with regard to legal rules related to prescribing mental health drugs to foster care kids. The publication commented that they report was “disturbing and demands action.”
The conclusions — of both the study and Florida Today’s editors — are correct: The practice is too widespread, with too little oversight.
Yet this should be just a starting point. If it were to conduct a similar study, I believe the Florida Agency for Persons with Disabilities ( APD ) would arrive at similar conclusions, namely that group home operators often are administering these medications without the proper power of consent from families or guardians, and physicians aren’t obtaining appropriate histories and conducting appropriate physical or behavioral examinations.
The improper use of psychotropic medications has hit near epidemic proportions in the Florida foster care and group home setting. The public first realized this with the April suicide of Gabriel Myers, 7, and weeks later, with a wrongful death lawsuit filed following the overdose of Denis Martez, 12.
Florida Today’s editorial helps raise public awareness of this important issue. We all should keep awareness high so we can remedy this serious situation. Read the full editorial here.
It wasn’t that long ago when the Florida Department of Children & Families was seen as a hapless bureaucracy. Whether it was their seeking to incarcerate an 8-year-old to ensure he received proper care, or simply losing youngsters supposedly under its care, it didn’t take much for DCF to make a mockery of its role in child welfare.
The good news is that DCF is no longer that troubled agency. Unfortunately, many of those problems that once bedeviled DCF now belong to those local nonprofits and government agencies that are under contract with the state to provide foster care and other child protective services. Thank community-based care for that. (more…)
The April 16 suicide death of 7-year-old Gabriel Myers, a foster child in the custody and care of the Florida Department of Children and Families, shocks the conscience. Gabriel apparently hung himself with the shower hose in the bathroom of his foster home in Margate.
The victim of sexual abuse, as well as other abuse and neglect that resulted in him being removed from his family and placed in foster care, Gabriel had been prescribed a variety of mind-altering psychotropic medications while in foster care to deal with the myriad behavioral problems he was experiencing, no doubt largely the result of the abuse he had suffered. Reports are that he was on three or four different drugs, or combinations thereof, at the time of his death.
What is almost as shocking to the conscience as a 7-year-old wanting to, knowing how to and actually committing suicide, is that a 7-year-old would be on not just one, but multiple psychotropic medications. Most such drugs have never been tested for pediatric use, and have not been FDA-approved for such use. Their prescription and use with kids is generally “off label,” meaning there are no approved instructions or guidelines for such use. (more…)
- Miami Herald – Miami, Florida – December 30, 2011 - Barahona Judge’s Efforts to Ferret Out Leaks Detailed Court records released to The Herald document a judge’s efforts to identify lawyers or child welfare administrators she suspected of leaking secret material to the newspaper.
- Miami Herald – Miami, Florida – December 17, 2011 - South Florida Charter Schools Admit Few Special Needs Children From South Dade to the northern reaches of Broward County, only a handful of students with profound disabilities make it into charter schools, according to a Miami Herald / State Impact Florida analysis of student enrollment data. The trend holds true across the state, where 87 percent of charter schools don’t serve any students with the most intense support needs.
- Associated Press – State College, Pennsylvania – December 16, 2011 - Penn. Deputy Attorney General Cites PSU 'Inaction' A graduate student waited a day after allegedly seeing a child being sexually assaulted on Penn State's campus before telling his supervisor, football coach Joe Paterno. Paterno waited another day before calling the university's athletic director, who looped in a school vice president. "I think it's a sad, sad, sad day, when you think about all of these victims, and you saw the inaction by a number of supposedly important, responsible adults. And there's a lot of inaction in this case," Marc Costanzo, a senior deputy attorney general, said after the preliminary hearing.
- Palm Beach Post – Miami, Florida – December 9, 2011 - Barahona Records: Neighbor Says Jorge Barahona Was 'Super Paranoid' Jorge Barahona was given to paranoia and fears of conspiracies around him that he expressed to a neighbor, according to investigative materials released this week by the Miami-Dade State Attorney’s office, fears that may have led him to murder his adopted daughter and almost kill her brother, Victor.
- The Miami Herald – Miami, Florida – December 9, 2011 - Pleas by Nubia Barahona’s Family Went Unheeded — Until It Was Too Late Relatives of Nubia and Victor Barahona were convinced that the children were being abused by their adoptive father. But they couldn’t get anyone to listen. Nubia Barahona, 10, was found dead in the back of her adoptive father's pickup truck in Broward on Valentines Day.
- Associated Press – State College, Pennsylvania – December 8, 2011 - Ex-Penn State Coach Sandusky Jailed on New Child Sex Abuse Charges Based on 2 New Accusers Former Penn State University assistant coach Jerry Sandusky spent Wednesday night behind bars after new child sex abuse charges were filed against him based on the claims of two new accusers, including one who says he screamed in vain for help while Sandusky attacked him in a basement bedroom.
- Gainesville.com – Plant City, Florida – Mentally Disabled Man Forced to Stand on Ant Hill A 21-year-old worker at a group home was arrested, and the facility where he worked was later shut down after authorities said he forced a mentally disabled man to stand barefoot on fire ant hills as punishment for stealing money. Florida MENTOR's Ike Smith Group Home's license has been suspended. Florida MENTOR continues to operate other facilities throughout the state. The Department of Children and Families and the Agency for Persons with Disabilities are investigating.
- Orlando Sentinel – Orlando, Florida – December 3, 2011 - Orlando Mom Was Foster Parent to Hundreds of Kids Dorothy Pearl Johnson didn't have children of her own. However, as a foster parent for four decades, she mothered about 400 children. Johnson, 87, continued to nurture children until a few months ago, when her failing health forced her to stop. After battling leukemia, she died on Tuesday in the home on Trentonian Court where she had cared for hundreds of children as if they were her own.
- New York Times – New York – November 22, 2011 - Drugs Used for Psychotics Go to Youths in Foster Care Foster children are being prescribed cocktails of powerful antipsychosis drugs just as frequently as some of the most mentally disabled youngsters on Medicaid, a new study suggests.
- USAToday – State College, Pennsylvania – November 16, 2011 - Penn State Case Presses Others to Tighten Abuse Laws Lawmakers and university officials across the USA are moving quickly to tighten up rules on who must report sexual abuse on campus in the wake of the Penn State scandal.
Reuters – State College, Pennsylvania – November 13, 2011 - A Long History in Penn State Child Abuse Case It will not be so easy to wipe out the stain on Penn State's reputation from the alleged abuse and what critics see as a cover-up by university officials who were told that Sandusky was seen raping a young boy in a shower in 2002. The case has drawn comparisons to the child abuse scandals that rocked the Catholic Church, whose top officials are also accused of covering up child abuse over decades.
Forbes – State College, Pennsylvania – November 11, 2011 - Conrad Murray, Penn State and Why the Powerful Enable Evil After Dr. Conrad Murray was found guilty of involuntary manslaughter in the death of Michael Jackson, the blogosphere, rightly, called him an enabler in a long line of celebrity enablers. Allegations that Penn State defensive coordinator Jerry Sandusky raped a pre-teen boy in the college shower seem less shocking than the nauseating cover-up that follows.
