Friday, December 29, 2006

Another man sues psychiatrist over sexual molestation

As seen here

A second 19-year-old man is suing Cincinnati child psychiatrist Dr. Leo D'Souza, accusing the doctor of sexually molesting him.

The lawsuit was filed Thursday in Hamilton County Common Pleas Court by a man who says D'Souza sexually molested him during an office visit earlier this month.

Another 19-year-old man filed a similar lawsuit Dec. 11 in Hamilton County Common Pleas Court, alleging that D'Souza sexually molested him during a doctor's visit when he was a minor. That case is pending.

D'Souza and his employer, Cincinnati Counseling Service, are named in the suit that seeks damages in excess of $25,000.

The lawsuits are not the first allegation of abuse against the doctor.

A third 19-year-old man who says he was sexually molested by D'Souza in 2003 settled out of court with him for $7,500 in 2005, according to Hamilton County Probate Court records.

"Since the filing of the initial complaint and the coverage it received in the media, we have received a number of calls from other potential victims," said attorney Mike Allen, who represents both men, but did not represent the man who settled out of court. "We are in the process of interviewing them and referring them to the appropriate law-enforcement agencies.

"The number of people who have come forward leads one to be concerned about how extensive the abuse may be."

D'Souza, who was working Thursday in the center's Colerain Township office, did not return a call for comment. No attorney is listed in court records.

Cincinnati Counseling Service owner Robert Ford was not in Thursday. A message left for him was not returned.

D'Souza has not been criminally charged. Complaints about doctors to the Ohio Medical Board are not public until substantiated. The parents of the 19-year-old man who filed the Dec. 11 lawsuit have filed a complaint with the medical board about D'Souza, Allen said.

In the lawsuit filed Thursday, the man says D'Souza fondled him during an office visit this month. After listening to the man's heart with a stethoscope and pushing on his abdomen, D'Souza told the man to drop his pants and underwear and then fondled him under the guise of an exam, according to the lawsuit.

The suit makes a claim of sexual battery against D'Souza and a claim of negligence against Cincinnati Counseling Service Inc., the doctor's employer.

In the Dec. 11 lawsuit, the man said the abuse started in 1999 or 2000 and ended in December 2005.

D'Souza was treating the man at the counseling center's Westwood office for bipolar disorder, depression and other related conditions.

In the lawsuit, the man said he was 12 or 13 when D'Souza began to include a "physical examination" during office visits. During those exams, which occurred at least six times, D'Souza fondled the man, the lawsuit says.

The suit makes a claim for child abuse and medical malpractice against D'Souza. The man is also suing Cincinnati Counseling Service for negligence.

The abuse in the 2003 case is alleged in a letter filed in Hamilton County Probate Court to D'Souza from the victim's attorney dated Jan. 4, 2005.

D'Souza is accused of sexually molesting a 16-year-old boy during an initial consultation for treatment of a bipolar disorder.

D'Souza coerced the teenager to see him alone, despite initial requests that his mother be present, according to the letter. Once alone, D'Souza ordered the boy to undress and then fondled the boy's genitals, according to the letter.

A complaint was made to the Ohio Medical Board, according to the letter.

The letter offered to drop the claim in exchange for $15,000. It gave D'Souza 10 days to respond, or a lawsuit would be filed in Hamilton County Common Pleas Court.

The case was settled for $7,500 on Oct. 19, 2005, according to probate court records.

Thursday, December 28, 2006

Medical board puts psychiatrist on probation

The Medical Board of California on Wednesday revoked the license of a Yuba City psychiatrist but stayed the revocation and imposed five years of probation, including extensive retraining.

In a settlement with the board, Thomas Jerome Lancaster admitted overprescribing medications for a patient who became addicted. According to the board's accusation against him, he prescribed 19 different drugs for the woman over five years.

Retired Sutter County Judge Timothy Evans, who was serving as a visiting judge in Yuba County in 2003, reported Lancaster to the board after awarding custody of the woman's 4-year-old child to her ex-husband.

Lancaster has a Pearsall Way address, according to the settlement document. He has an unlisted phone number and could not be reached for comment. His attorney, Robert J. Sullivan of Sacramento, did not return a phone call.

The board ordered Lancaster not to practice “solo” and to work only under the supervision of a qualified doctor. He cannot treat patients outside of his places of employment, which were listed as Enloe Medical Center in Chico, Butte County Mental Health and two agencies that work with developmentally disabled patients. He must inform all his employers of the settlement.

Lancaster must enroll in a clinical training program and take three different courses, including one in prescribing practices.

Sacramento attorney Ron Haven, who represented the patient in a lawsuit against Lancaster, said last year that his client won a “very significant settlement.”

Wednesday, December 27, 2006

Psychiatrist Accused In Drugs-For-Sex Case Sued

he Baltimore County psychiatrist who was suspended in February amid allegations that he traded pain pills for sex is facing more legal trouble.
As seen in the report from WBAL in Baltimore

A lawsuit filed in Circuit Court alleges Dr. Nelson Hendler raped a female patient while she was under sedation. The woman is identified in the lawsuit as Jane Doe II. She is seeking $50,000 in damages.

Hendler's lawyer said he was unaware of the lawsuit.

Hendler was the founder of the Mensana Clinic in Stevenson. He is scheduled to go on trial in February on seven charges of possessing a controlled dangerous substance with the intent to distribute.

His license was suspended after the Maryland Board of Physicians accused him of sexual improprieties with three patients and handing out painkillers without proper prescriptions

Tuesday, December 26, 2006

Mother's anger at medicine overdose by teacher

Of course, many school systems feel fine with diagnosing conditions in the first place. As seen here

An angry mother has told how her son was given an overdose of medicine by a teacher at his school.

Marcus Malone was admitted to Darlington Memorial Hospital struggling to breathe and with high blood pressure after the mistake by a teacher.

The nine-year-old boy had been given his medication at lunchtime.

Staff at Gurney Pease Primary School, in Darlington, immediately realised the dose was too big and took him to hospital.

The local education authority has admitted a mistake was made, but the National Union of Teachers believes their members should not be shouldered with the responsibility of administering medicines to children in the first place.

Marcus has to take two methylphenidate (Ritalin) tablets every day for his attention deficit hyperactivity disorder.
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He takes a 10mg tablet every morning at home and is given a second 5mg tablet at lunchtime at school.

Last Monday, a support teacher incorrectly gave him a 20mg tablet - four times his normal dose.

His mother, Caroline, received a call from the school at about 1.20pm to say he had taken the overdose.

Marcus was taken to hospital and admitted to the day unit because he was struggling to breathe and had high blood pressure. He was allowed home at 5.30pm.

He returned to school the next day.

Mrs Malone said: "They just had to wait for the medication to get out of his system."

But she was angry her son had been given an incorrect dose.

She said: "They shouldn't have done it. I have had no apology from the school. They have overdosed my son and I cannot get any help.

"I was just so angry. The mistake could have killed him. When you take your child to school you want him to be safe - he is in the school's hands."

Marcus has taken the medication for a year, during which time there have been no other problems.

Mrs Malone suggested a registered nurse should administer the dose rather than one of the teachers.

She also said since the incident, two teachers have been present when he takes the medication.

A Darlington Borough Council spokesman said: "This was a genuine mistake, which was immediately realised.

"The school contacted the pupil's mother and his GP, who advised that he should be taken to hospital to be checked over.

"A member of staff took him to hospital, where they were met by his mother. The school is extremely sorry about the incident."

Elaine Kay, northern regional secretary for the NUT, said medication should be given by properly trained staff, who are aware of the associated risks.

She said: "We would always advise teachers that they do not administer medication. It is not part of their role and responsibility.

"It should be given by properly qualified staff who know how to give it properly."

Saturday, December 23, 2006

Psychologist Penalized for Prison Sex

A followup to an earlier report, as seen in the Sacramento Bee

The state Board of Psychology on Thursday temporarily suspended the license of Marilyn A. Windham, an ex-prison psychologist who recently pleaded guilty to a felony charge of having sex with an inmate.

A judge in the state's Office of Administrative Hearings found "good cause" to bar the Lincoln woman's practice, stating that allowing her to continue "will endanger the public health, safety and welfare, and serious injury would result to the public," according to a statement from state officials Friday.

Windham, 56, resigned last year from the California Department of Corrections and Rehabilitation after a guard caught her in a sexual position with an inmate in California State Prison, Sacramento, in Folsom.

Earlier this month, Windham pleaded guilty to the sex charge and is scheduled to be sentenced Feb. 2. Prosecutors said she could face up to 90 days in jail.

Another hearing on the status of her psychology license is scheduled for Jan. 10.

Friday, December 22, 2006

Couple Guilty of Abuse For Caging Foster Kids

As seen earlier, they had done this on the advice of a psychologist. Here's the story as seen on ABC

A couple accused of caging some of their 11 adopted special-needs children were convicted of some felony and misdemeanor charges today.

The jury began its deliberations Tuesday. Sharen and Michael Gravelle were charged with eight counts each of felony child endangering, misdemeanor child abuse and misdemeanor child endangering. The endangering charges accused the couple of putting the children at a substantial risk of mental health impairment.

Defense attorneys described the couple as working under difficult circumstances to provide a loving family environment. "They loved their children," said Richard Drucker, an attorney for Michael Gravelle.

But Huron County Prosecutor Russell Leffler argued that having difficult children "doesn't mean you put children in cages or boxes."

"They were cruel to children," Leffler said. "The Gravelles aren't good parents. They never have been."

The children, who had problems such as fetal alcohol syndrome and a disorder that involves eating items that are not food, ranged in age from 1 to 14 when authorities removed them in September 2005 from the Gravelle home in rural Wakeman, about 60 miles west of Cleveland. The youngsters were placed in foster care last fall, and the couple lost custody in March.

The case began when a county social worker visited the home after a complaint and likened the red and blue cages to kennels. In the trial, that social worker testified that the cages reminded her of slave quarters.

Ken Myers, an attorney for Sharen Gravelle, said wire and wooden enclosures were used because of intolerable behavior by the children. The behavior improved after the enclosures were used, Myers said.

"They were urinating and defecating all over the house," he said.

Sharen Gravelle shook her head as the prosecutor spoke. Michael Gravelle leaned back holding his chin in his hand.

The Gravelles, who lost custody of the children in March, face one to five years in prison and a maximum fine of $10,000 for each felony count.

Court Allows Eli Lilly To Bury Zyprexa Documents

As seen here. Part of a much larger well documented article detailing the sordid history of Eli Lilly in this matter.

Alaskan attorney, Jim Gottstein, says that after being served with a mandatory injunction, he has returned the internal Eli Lilly documents that he obtained in litigation and provided to the New York Times to the court.

Information from the documents related to Lilly's antipsychotic drug, Zypexa, was highlighted two days in a row in front-page articles in the Times

The documents reveal the illegal marketing schemes used by Lilly to make Zyprexa its best-seller, which the company has managed to keep hidden for years by entering into out of court settlements in civil lawsuits which included confidentiality clauses and by getting judges to place the documents under protective orders to shield them from public view.

For instance, the documents under seal here are from a case where Lilly entered into an out-of-court settlement in June 2005, and agreed to pay $690 million to cover claims by about 8000 Zyprexa victims. But in order to get paid, the plaintiffs were required to sign a confidentiality clause and basically keep their mouths shut about Zyprexa from then on.

Thursday, December 21, 2006

Study: Teens Use Medicines to Get High

As seen in the San Fransisco Chronicle

Teens increasingly are getting high with legal drugs like painkillers and mood stimulants, and they're turning to cough syrup as well, says a government survey released Thursday.

The annual study by the National Institute on Drug Abuse, conducted by the University of Michigan, showed mixed results in the nation's longtime campaign against teen drug abuse.

It found that while fewer teens overall drank alcohol or used illegal drugs in the last year, a small but growing number were popping prescription painkillers like OxyContin and Vicodin and stimulants like Ritalin.

As many as one in every 14 high school seniors said they used cold medicine "fairly recently" to get high, the study found.

It was the first year that the government tracked the frequency of teens who reported getting high from over-the-counter medicine for coughs and colds.

"It's bad that kids are buying cough syrup and using it this way — it's not good for them," said John P. Walters, director of the White House Office of National Drug Control Policy.

The study found about one in 10 high school seniors have abused the painkiller Vicodin and Walters said kids may be pilfering the pills from their parents' medicine cabinets.

"That is one thing you can do — take the pills that are no longer being used and throw them away, get rid of them," he said in an interview.

Walters credited public service advertising with a steady decrease in overall teen drug use over the past five years and said the agency would shift some of its 2007 advertising budget toward combatting prescription drug abuse.

He challenged the recommendations of an August government audit that said the anti-drug advertising campaign wasn't working and suggested Congress consider reducing its funding. The report by the Government Accountability Office found some children were actually more likely to use marijuana after seeing the ads.

"We're pushing back," Walters told reporters Thursday as he outlined the study results. "What this shows is we're pushing back successfully."

The rise in prescription drug abuse was a troubling conclusion in a study that Walters described as good news overall because of the drop in teen use of alcohol, cigarettes, marijuana and other illicit substances.

An estimated 840,000 fewer teens reported using illegal drugs now compared to five years ago, he said.

The annual study, in its 32nd year, surveyed 50,000 students in the 8th, 10th and 12th grades at more than 400 schools nationwide. It found, that over the last year:

_Illegal drug use at all three grade levels dropped, if only slightly. An estimated 36.5 percent of high school seniors reported using illicit drugs at some point in the year.

_Marijuana remained the single most abused drug among teens, although its use also dropped slightly within all three grades. Nearly 12 percent of 8th graders reported using it, compared to 25 percent of 10th graders and 31 percent of high school seniors.

_One-third of 8th graders said they had consumed alcoholic beverages, compared to more than a half of 10th graders and two-thirds of seniors surveyed. That also was a small decrease among the three grade levels. But the number of 10th and 12th graders who reported getting drunk increased slightly.

Comparatively, the number of teens who got high from medicines and households items instead of illegal drugs was small. They included:

_Nearly 10 percent of high school seniors admitted to using excessive dosages of Vicodin, a slight increase over the last year.

_Nine percent of 8th graders sniffed glue, spray paints, cleaning fluids or other inhalants, down slightly.

_3.6 percent of 10th graders got high off Ritalin, up two-tenths of 1 percent. Ritalin is used normally to combat effects of attention deficit disorder.

That teens are turning to cough syrup to get high is particularly alarming, experts said, because the medicine is cheap and easy to get. Moreover, few people — teens and their parents alike — recognize the dangers of overdosing on the otherwise safe and legal drugs.

"There is this mistaken belief that intentionally abusing prescription and over-the-counter drugs is somehow safer than abusing street drugs," said Steve Pasierb, president and chief executive of the New York-based Partnership for Drug Free America. "What parents don't realize is that this is about your kids taking six pills with a beer."

The National Institute on Drug Abuse:

White House Office of National Drug Control Policy:

Partnership for Drug Free America:

Lawsuit says Texas was duped on drug

From the Star Telegram

A pharmaceutical company duped the state of Texas into spending millions of dollars on expensive psychiatric drugs and made improper payments to at least one state official, according to a lawsuit filed by a whistle-blower and joined by the Texas attorney general's office.

At the heart of the suit is a controversial state program that instructs doctors at state-funded healthcare facilities on which medicines to prescribe for a variety of mental illnesses.

The Star-Telegram reported last year that more than $3 million had been donated to the program by drug companies and an organization created by a drug-company founder. Dr. Steven Shon, who managed the program, had taken more than 80 trips throughout the country and abroad to promote it, with his expenses often underwritten by drug companies.

The lawsuit targets Johnson & Johnson and related companies, including Janssen Pharmaceutical, which makes the antipsychotic drug Risperdal. The suit was filed in 2004 in Travis County by Allen Jones, a former employee in the Pennsylvania Office of Inspector General who investigated drug-company ties to his state's officials. In the process, he learned of allegations related to Texas.

The lawsuit was sealed while the attorney general's office looked into the case, until late Friday. It seeks damages that would amount to millions of dollars.

Brand-name expenses

While the suit does not name the "state mental health program decision-maker" who it alleges received payments and other benefits, a spokeswoman for the Texas Health and Human Services Commission confirmed that the lawsuit refers to Shon.

Shon, who left the Department of State Health Services this fall during the investigation, said he has not received money from drug companies in connection with his work for the state. Money went to pay for his travel expenses or to reimburse taxpayers for his time away from the office, he said.

"These assertions are really ridiculous," he said.

However, Shon said he received a few thousand dollars from Janssen for consulting work unrelated to his state job several years ago. He said he got approval from the department's legal staff, but commission spokeswoman Stephanie Goodman said the agency was unaware of any such payments and would not have approved them.

The lawsuit alleges that Johnson & Johnson and its subsidiaries misled state officials about the benefits of Risperdal, including promoting it for treating children when it had not been federally approved for such use. The company's influence led the state to buy the expensive brand-name drug instead of cheaper generic alternatives, according to the suit. The result, it alleges, was that the state paid too much in claims for Medicaid, which covers medical costs for low-income people.

Spokesmen for Janssen and the attorney general's office declined to comment Tuesday.

Drug-company donations

A major portion of the lawsuit focuses on the Texas Medication Algorithm Project, which Shon coordinated. That program offers a series of treatment plans, or algorithms, for various mental illnesses, including which drugs to use. In many cases the plans recommend the newest drugs, which are the most expensive and not available in generic form. The plan allows doctors to deviate from the recommendations if they have sound reasons, state officials say.

Supporters of the algorithms say that in many cases, the newer drugs are more effective than their older counterparts and can have fewer debilitating side effects. But many have come under increasing scrutiny from federal regulators, including warnings that they can increase the risk of suicidal behavior or can lead to illnesses such as diabetes.

Such drugs are huge business for pharmaceutical companies. In a recent three-year period, more than $190 million was paid in Texas for outpatient Medicaid claims for Risperdal alone, according to the state Health and Human Services Commission. During the same period -- fiscal years 2003 to 2005 -- almost $700 million was spent on all antipsychotic medications combined. That does not include care for people in state institutions.

Drug companies, including Janssen, gave the state more than $1 million to help promote the plan. And the Robert Wood Johnson Foundation -- established by the founder of Janssen parent company Johnson & Johnson -- gave $2 million. A company spokesman has said the foundation is independent of the company.

The exact amount of money donated by the companies remains unclear. Shon has acknowledged that his agency did not always seek required approval from the department's governing board before accepting donations.

Forced out

Shon left his job with the state in October. Goodman would not say why Shon left but confirmed that department officials had been notified of the attorney general's investigation before his departure. In a memo provided to the Star-Telegram by the commission, the department's acting commissioner informed Shon that he was being terminated from his position "effective immediately." No reason was given.

But Shon said he was given the option of resigning or being terminated, and he chose to leave. He was told "the direction I was going in was not the direction the department was going in." He added that he believes the pressure of the investigation played a role.

Shon said that as coordinator of the project he did not make decisions about which drugs should be recommended. Those were made by a panel of experts, he said.

He was not the only state official to make trips to promote the algorithms in various states and countries, including Italy, Japan and South Korea. Versions of the Texas program have been adopted in more than a dozen states.

Goodman said the department still supports the algorithm program. A number of experts have reviewed the recommendations and believe they are valid, she said.

Mental Health Groups Implicated In Texas Health Department Money Scandal

As seen in the Star Telegram

Officials changed documents, pressured witnesses and delayed an inquiry into whether the state health department inappropriately used lobbyists to push legislation last year, a state investigative report shows.

The report by the inspector general's office of the Texas Health and Human Services Commission said the delay gave potential targets of the investigation time to obscure the paper trail so investigators could not determine whether the Department of State Health Services did anything wrong, the Austin American-Statesman reported.

But the report concluded that three mental health advocacy groups improperly used state grant money to lobby for a bill that the health department favored. The bill, which failed, would have privatized state mental health services.

State law bars a state agency from directly contracting with a registered lobbyist.

All three groups -- Texas Mental Health Consumers, the National Alliance on Mental Illness of Texas and the Mental Health Association in Texas -- deny the allegations. The alliance and the association employ lobbyists, but their leaders said they weren't paid with state money.

Health department spokeswoman Carrie Williams said officials do not agree with all aspects of the report but are working on making the recommended changes.

"The report is something we take seriously," she said.

The matter began last year when Gov. Rick Perry's office received a complaint from an unidentified person alleging that several advocacy groups had used state grant funds to lobby for privatization. The complaint also suggested that a top health official implied that the groups would lose their state money if they failed to lobby as directed.

The governor's office ordered the inspector general to investigate but later agreed to let the Health and Human Services Commission, which oversees the health department, conduct an internal audit first.

Perry spokesman Ted Royer said the audit and the investigation had to be conducted separately because both involved examining the same documents and talking to the same people. The inspector general's office began investigating immediately after the audit was finished. But the six-month delay hindered the inquiry, according to the report.

The investigators said they found three versions of one document, a quarterly progress report from Texas Mental Health Consumers to the department about a state grant.

Mike Halligan, the advocacy group's executive director, said he changed the word lobby to educate in the progress report after state officials "freaked out" when they saw it during the internal audit. He said the word lobby was a poor word choice and did not reflect his group's actions.

Williams said the department is still trying to understand why different versions were found.

Wednesday, December 20, 2006

Lilly Denies Promoting Zyprexa for Off-Label Uses, uses 'Casablanca Defence'

This strikes me a being along the lines of a Casablanca Defense, named for Inspector Ranault in the film “Casablanca,” who in one scene is 'shocked, simply shocked' that gambling was going on, all as he pocketed his share of the take. As seen in this report

In front-page news articles on successive days, the New York Times accused Lilly of a campaign to promote the off-label use of Zyprexa (olanzapine), its anti-psychotic medication, while systematically downplaying the drug's side effects. Lilly denied the allegations.

"At Lilly, we do not engage in off-label promotion, as alleged in the Times article," said Steven Paul, M.D., the company's executive vice-president for science and technology.

The newspaper, citing marketing documents obtained from a lawyer representing mentally ill patients, said the company had encouraged primary care physicians to prescribe Zyprexa for patients who did not have schizophrenia or bipolar disorder, the two conditions for which it is approved.

The newspaper also said the company had engaged in a decade-long effort to downplay the risk of weight gain and hyperglycemia associated with the drug, side effects that some critics suggest could lead to increased rates of type 2 diabetes.

Dr. Paul said the company had acted properly: "We believe that it is absolutely appropriate to discuss Zyprexa and its indicated uses with primary care physicians in the interest of meeting a critical medical need," he said in a statement posted on the company's Web site.

The statement added that Lilly "deplores the illegal release of select confidential documents."

The FDA, which is charged with enforcing the rule against marketing for off-label uses, did not respond to requests for comment on the newspaper's allegations.

The newspaper said the marketing documents outline a multi-year campaign -- dubbed "Viva Zyprexa" -- in which sales reps were to discuss representative case profiles with primary care physicians. But the case profiles included patients who would not ordinarily have been diagnosed with either schizophrenia or bipolar disease, the Times said.

Dr. Paul defended the company's appeal to primary care physicians. "About half of medical care for serious mental illness takes place in a primary care physician's office," he said, because many people either have no access to a psychiatrist or do not seek psychiatric care.

"Our experience in mental health has taught us that primary care physicians are asking for education on severe mental illnesses, since they see many of these patients in their offices," Dr. Stevens added.

The company said the documents given to the Times were a small fraction of 11 million documents that were originally part of a lawsuit in which patients taking Zyprexa claimed they developed diabetes as a result of taking the drug. Lilly agreed last year to pay $700 million to settle about 8,000 of the claims, but more are before the courts.

The documents "do not represent an accurate view of company strategy or conduct," the company said.

Zyprexa, which accounted for more than $4 billion in sales last year, is one of the most popular of the atypical antipsychotics, largely because it is seen to have fewer adverse effects than other medications, allowing patients to remain longer on the drug.

But two recent, large-scale comparative trials have suggested that older medications may do nearly as well and -- because they are less expensive -- may be more cost-effective.

Also, the class has been under attack because of its purported links to diabetes. The company acknowledges that some patients taking Zyprexa may experience weight gain, but has consistently held that there is no evidence showing it leads to type 2 diabetes.

Lilly is insisting on "a very high standard of evidence," according to Jeffery Lieberman, M.D., of Columbia, who led the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. It found that Zyprexa was the most effective of the newer anti-psychotic agents, although some of the older drugs were almost as good.

But, he said, the clinical community is all but convinced of the diabetes link. "From the standpoint of clinical experience and scientific evidence, there certainly seems to be an association with some of the anti-psychotic drugs and weight gain and metabolic effects, including the element of hyperglycemia," he said.

"This is something that I think is generally believed in the clinical community," he said. He noted that the FDA had required the company to add a warning about hyperglycemia to the drug's label.

Tuesday, December 19, 2006

Doctor wantonly doled prescriptions, police say

From The Morning Call Online

A Monroe County doctor and psychologist was charged Monday with improperly prescribing and distributing powerful and potentially addictive drugs.

Harold Pascal, 71, of 5007 Poole Road, Smithfield Township, repeatedly prescribed drugs such as Adderall, a stimulant, and Xanax, an anti-anxiety drug, without reviewing a patient's medical history or providing treatment, according to the state attorney general's office.

'We allege that these appointments were strictly for the purpose of providing a prescription,'' said Nils Frederiksen, deputy press secretary for Attorney General Tom Corbett.

Corbett said that Pascal is charged with four counts of prescribing or delivering controlled substances outside the scope of accepted medical treatment principles, a felony punishable by up to 15 years in prison and a $250,000 fine.

Pascal is also charged with three counts of Medicaid fraud, a third-degree felony punishable by up to seven years in prison and a $15,000 fine.

The charges followed a 15-month investigation during which agents from the attorney general's Bureau of Narcotics Investigation say they received 27 prescriptions from Pascal. The agents presented evidence to a statewide grand jury, which recommended the charges.

District Judge Michael Muth of East Stroudsburg released Pascal on $25,000 unsecured bail. A preliminary hearing is scheduled for next Tuesday.

In addition, the attorney general's office is taking steps to seize Pascal's East Stroudsburg office, a checking account and a safe deposit box. Pascal also has an office in Lehighton, but spends most of his time in East Stroudsburg, Frederiksen said.

Pascal could not be reached for comment.

The investigation was prompted by reports from a confidential informant who complained of family members being overmedicated. Pascal had been chosen for one of the family members by a school district, the grand jury said. Frederiksen said he didn't know which one.

According to the grand jury:

Pascal asked the undercover agents what they wanted, then wrote prescriptions for the drugs.

The agents said they openly discussed his prescription writing habits with him. They said the doctor was aware the drugs he was prescribing were addictive, and that he knew of reports that patients were selling them on the street.

Patients who gathered in Pascal's waiting room often spoke openly about their addictions and advised the agents to compile a list of drugs they wanted from the doctor.

Though his office was open only a few hours each week, he would frequently see up to 60 patients a day. He met them in a room that had no medical furniture or examination equipment.

FDA Panel Recommends Warning For Adult Antidepressant Suicide Risk

As seen in Medical News Today

An FDA advisory panel on Wednesday voted 6-2 in favor of updating black box warnings on antidepressants to state that there is an increased suicide risk for young adults up to age 25, the New York Times reports (Carey, New York Times, 12/13). According to FDA's review, for every 1,000 young adults ages 18 to 24 who are given the drugs, about four will act on suicidal thoughts who otherwise would not have done so. The review found that the drugs did not increase the risk of suicide in adults ages 25 to 65 and that they significantly lowered the risk of suicide in people older than 65. Antidepressants since 2004 have carried a black box warning about an increased risk of suicidal thoughts and actions in children and adolescents (New York Times, 12/13). FDA proposed adding new warnings about suicide risk in young adults, which the advisory panel has now endorsed. The advisory panel "also encouraged the FDA to add language to the black box about the importance of treating depression in hopes that the addition of new warnings won't cause doctors to limit the antidepressant prescriptions," the Journal reports (Wall Street Journal, 12/14).

FDA Comments
Thomas Laughren, director of FDA's division of psychiatry products, said, "We don't know" why antidepressants appear to have different effects on different age groups (Graham, Baltimore Sun, 12/14). Laughren said FDA is leaning toward expanding the black box warning to include young adults, and agency officials said they will try to write language that would encourage health care providers to prescribe the drugs carefully, not abandon them, the Washington Post reports. Robert Temple, director of FDA's Office of Medical Policy, said that regulators are in a difficult position because they are obligated to warn physicians about monitoring patients for suicidal tendencies but also are concerned that the warning might lead doctors to stop prescribing the drugs (Vedantam, Washington Post, 12/14).

Davis Shern, president of Mental Health America, said that the current black box warning for children and adolescents has resulted in a 20% drop in antidepressant prescriptions for those age groups. At the same time, Shern noted the suicide rate for children and adolescents has increased, according to some estimates. He said, "A black box warning will scare people away from treatment and end up causing greater harm than it does good" (Baltimore Sun, 12/14). Christopher Kratochvil, a psychiatrist and spokesperson for the American Academy of Child and Adolescent Psychiatry; John Mann, a psychiatrist and spokesperson for the American Foundation for Suicide Prevention; and Donna Barnes, president of the National Organization for People of Color Against Suicide, all said that new suicide warnings might harm depression patients by making them afraid of treatment. However, British psychiatrist David Healy and Harvard University lecturer and psychiatrist Joseph Glenmullen said that FDA's review downplayed the risk of suicide from antidepressants and suggested that several suicides in industry-sponsored studies were never disclosed, the Post reports (Washington Post, 12/14).

Broadcast Coverage
Several broadcast programs reported on the FDA panel's consideration of the issue:

  • ABCNews' "World News Tonight": The segment includes comments from U.S. residents who testified for and against increased labeling for antidepressants (McKenzie, "World News Tonight," ABCNews, 12/13).

    Related ABCNews video is available online.

  • CBS' "Evening News": The segment includes comments from Sherri Walton, second vice president of the Mental Health Association of Arizona, and U.S. residents who testified for and against increased labeling for antidepressants (Attkisson, "Evening News," CBS, 12/13).

    Video of the segment is available online.

  • NBC's "Nightly News": The segment includes comments from U.S. residents who testified for and against increased labeling for antidepressants (Snyderman, "Nightly News," NBC, 12/13).

    Video of the segment is available online.

  • NPR's "All Things Considered": The segment includes comments from Joanne Silberner, health correspondent for NPR, and U.S. residents who testified for and against increased labeling for antidepressants (Norris, "All Things Considered," NPR, 12/13).

    Audio of the segment is available online.

  • NPR's "Day to Day": The segment includes comments from Silberner (Chadwick, "Day to Day," NPR, 12/13).

    Audio of the segment is available online.

Sunday, December 17, 2006

Former Prison Psychologist Acknowledges Prison Sex with Inmate

From the Fresno Bee

A former prison psychologist this week acknowledged having sex with an inmate she was hired to help at California State Prison, Sacramento.

Marilyn A. Windham, 56, pleaded guilty Tuesday to a felony charge of having sex with a male inmate at the Folsom prison in June 2005. A bodybuilder and aspiring crime novelist, Windham is scheduled to be sentenced Feb. 2. She faces 90 days in county jail.

Court documents show a prison guard discovered the psychologist partially nude and "in a compromising position" with an inmate in the B Facility Clinic.

The inmate told investigators that he went to the room to get supplies "and that it 'just happened,'" according to court documents. He said the act was consensual and had not occurred before.

Windham resigned about a month after the incident. She sent the inmate a card saying, "I want you to know how much I enjoyed knowing you. You made me laugh."

The psychologist had initially faced three felony counts, said Steve Secrest, a supervising deputy district attorney in Sacramento County.

Windham has a public MySpace page and described herself as an "existential psychologist," according to The Sacramento Bee.

"Dr. Windham believes in the significance of the relationship between client and doctor," she wrote on the Internet space.
The MySpace page in question has since been made private

Psychologist Defends Caging of Special Needs Children

More on the sad case of the Gravelle children

A psychologist testifying for Michael and Sharen Gravelle said on Thursday that the enclosed beds were appropriate for their adopted special-needs children.

"It can restrain their behavior," Sandra McPherson testified. "It would be the least restrictive alternative."

However, she said on cross-examination that the enclosed beds might have harmed the children if they were used for discipline.

"They could have been counterproductive to the development of the kids," she said.

The Gravelles are on trial in Huron County Common Pleas Court, each charged with 16 counts of felony child endangering and eight misdemeanor child endangering charges. Prosecutors accuse the couple of keeping some of their 11 special-needs children in enclosed beds, which they have characterized as cages.

The couple said they enclosed some of the beds to protect the youngsters from their own destructive behavior. They have denied mistreating the children.

The Cleveland Heights psychologist criticized investigators and social workers who questioned the children after they were removed from the Gravelle home in September 2005. The children's answers may have been tainted because the same questions were asked numerous times, McPherson said.

McPherson also said the agencies that placed the children in the home were to blame for the children's problems.

"The outcome may have been different if they were placed in smaller families," she said.

The Gravelles' private social worker, Elaine Thompson, was not called to testify because she awaits trial in February in connection with the case. She faces 32 charges of complicity to commit child endangering and failure to report abuse.

Thompson's attorney, Marilu Laubenthal, spent about three hours reading a transcript of testimony given by Thompson during a custody hearing in December.

Thompson said the Gravelles explained that the enclosed beds were meant to provide a safe nighttime environment for the children.

The children's behavior improved with use of the cages, Thompson said.

"It took about two years," she said.

Common Pleas Judge Earl McGimpsey told jurors testimony will finish early today, and deliberations will begin on Tuesday.

Saturday, December 16, 2006

Famous Psychiatrist No Longer Endorses Hysterectomies for Teenagers

Commentary, as seen in Mother Jones

Louann Brizendine, psychiatrist and author of the much-hyped The Female Brain, admits in the most recent issue of the New York Times Magazine that she's not a fan of placebo-controlled studies.
Deborah Solomon: Although your book draws heavily on other scientists’ research, you don’t do any clinical research yourself. Isn’t that a drawback?

Dr. Brizendine: I don’t like doing clinical research because of placebos. In a “double-blind placebo-controlled study,” as they are called, neither the doctor nor the patient knows what the patient is taking. I don’t want to give patients a placebo. It’s cruel.
Hmmm. Sounds like someone does not accept standard scientific methods. And the journal Nature has discredited her book. I wonder if we should really take her seriously.

Oh, guess not. Turns out, Brizendine is not a fan of fact-checking either. She culled the statistic that women use 20,000 words a day, while men use about 7,000 — the bedrock of her thesis — from self-help guru Allan Pease, author of such classics as Why Men Don't Have a Clue and Women Always Need More Shoes, Why Men Lie and Women Cry, and Why Men Can Only Do One Thing at a Time and Women Never Stop Talking.

But Brizendine is a fan of Zoloft, so much so that you wonder if she got paid for product placement. A quick scan turns up at least seven mentions of the brand name, as a cure for cases such as Shana, who presented symptoms of depression as early as age 10. But consider these symptoms: Shana "started sleeping till noon on weekends," "waited till the last minute to finish big projects, and she liked to stay up watching television." Her female hormones soon surged to such heights that she talked back to her mother, saying, "I am going to the beach tomorrow and there's nothing you can do about it," and "You don't know what you're talking about." (Read more insults/symptoms on page 44). Her mother slapped her, but came to her senses and sought help from a psychiatrist, the one and only Louann Brizendine.

Dr. Brizendine writes:
Fifty years ago, one successful treatment for PMDD was removing the ovaries surgically. At the time, this was the only way to remove the hormone fluctuation. Instead of removing Shana's ovaries [emphasis mine], I gave her a hormone to take every day — the continuous birth control pill — to keep her estrogen and progesterone at moderately high but constant levels and prevent her ovaries from sending out the big fluctuations of hormones that were upsetting her brain. With her estrogen and progesterone at constant levels, her brain was kept calmer and her serotonin levels stabilized. For some girls I add a medication such as Zoloft — a so-called SSRI (selective serotonin reuptake inhibitor) — which can further stabilize and improve the brain's serotonin level, in other words, improve one's mood and sense of well-being. The following month her teacher called me to report that Shana was back to her good old self again — cheerful and getting good grades.
How creepy. Shana better be happy. Or else the doctor would take out her uterus.

-- April Rabkin

Scraping by on $150,000 a year

From a report on CNN Money, in which psychiatrist Amy Schuett of Omaha, Nebraska has trouble scraping by on a measely $150,000 per year.

If she thought it would really fix her family's finances, Amy Schuett would make it her New Year's resolution to squeeze every bit of extra spending from the family budget.

But she's already slashed so many little luxuries - the gourmet coffee, the restaurant lunches, the weekly dates with husband Brian - that she's fresh out of ideas.

Cable TV? Unplugged. Pool membership? Down the drain.

They've even considered giving up their unlisted phone number. At a cost of $3 a month, this move wouldn't save much - even over, say, 150 years - but it shows how desperate the couple feel about easing their financial strain. "We're struggling week to week to get by," says Brian, 42. "Any money that comes in gets chewed up right away."

Digesting that fact becomes harder when you consider that the Schuetts earn a comfortable living, with Amy, 39, pulling in $150,000 a year as a hospital psychiatrist. True, their income did take a big hit last summer when Brian got laid off from his job as a sales rep for a pharmaceutical firm (he'd been making a base salary of $82,000 a year, plus commissions as high as $24,000).

And they do have four daughters to raise, ages four to nine. But still.

The Schuetts don't have any child-care bills (Brian is now a stay-at-home dad). They don't have credit-card debt. They don't splurge on fancy vacations. And they live in a nice but definitely not luxurious home on a three-acre plot in Elkhorn, Neb., just west of Omaha, where the cost of living is, well, livable.

Yet, says Amy, "We live from one paycheck to the next, we're struggling to save and we never seem to have enough money to do anything fun."
And yet we see this:
Last year, for instance, Brian's parents gave the Schuetts a horse named Red for their kids to ride. They think it will cost a few hundred dollars a month to feed and care for the animal, and they're willing to give up ballet lessons and gymnastics classes for the girls to pay for it.
I'm sure that most folks would love to be able to afford a horse for the girls. As seen here, 95% of American households make less than 150,000 a year.

Thursday, December 14, 2006

Antidepressants to get new suicide warnings

As seen here

Antidepressants can increase the risk of suicidal behaviors in people up to age 24, federal public health officials warned Wednesday as they decided to expand a drug warning label that now applies only to children and adolescents.

Users of all ages should be closely monitored, the Food and Drug Administration said after a contentious hearing on an issue that has bitterly divided psychiatrists, mental health advocates and the family members of people who have committed suicide.

After a huge federal analysis of hundreds of clinical trials, an expert federal panel recommended that agency officials tell doctors and the public of the risk but also find a way to note that the risk declines with age and that leaving depression untreated is also risky.

While the studies on the relationship between the drugs and suicide appear contradictory, the experts said one possibility is that the drugs may pose a risk early in treatment but have a protective effect in the long term.

The action taken Wednesday is unlikely to quell the debate.

"I've been out here 21 times and I'm not going to stop," said Kim Witczak, 40, of Minneapolis. She became a crusader for the warning on antidepressants in 2003 after her husband, Woody, hanged himself in their garage shortly after he began taking the antidepressant Zoloft for insomnia. She was one of dozens of people who crammed the hearing in Silver Spring, Md., and said the expanded warning does not go far enough.

"How does a drug know the difference between someone who is 25 and 35 years old?" she asked.


The FDA based its decision on a review of 372 studies on 100,000 patients and 11 antidepressants, including Lexapro, Zoloft, Prozac and Paxil.[...]

Antidepressants and Antipsychotic Medications For Infants

In a horror story, psychiatrists have admitted prescribing antidepressants and antipsychotic medications to infants under the age of one. As seen in this report

According to Dr. Yolande Lucire, a forensic psychicatrist based in New South Wales, Australia, doctors are giving children younger than 1 year of age prescriptions for atypical antipsychotics -- a class of narcotics used to treat schizophrenia, bipolar mania, psychotic agitation and other similar conditions.

In an email to Alliance for Human Research Protection President Vera Hassner Sharav, Lucire, published on the AHRP web site, Lucire says that she is taking kids under her care off of atypical antipsychotic medications.

"Not one met the criteria for schizophrenia when these drugs were started," Lucire says in the email. She added that the patients "often got psychosis on antidepressants given for anxiety, or substance induced disorders."

While Australia is the second largest consumer of psychotropic drugs, according to Sharav, it still takes a back seat to the United States. Sharav reports that the alliance obtained the New Jersey Medicaid record of psychotropic drugs prescribed to more than 39,000 children aged 0 to 18. They found that most of the drugs were prescribed for off label use, i.e. a condition for which the drug was not originally designed. Also, the reports indicated that the antidepressant Effexor and antispsychotics such as Risperdal are being prescribed to children younger than 1; antipsychotics like Seroquel are being prescribed to 2-year-olds; and .05 milligram to 20 milligram doses of the antipsychotic Risperdal are being prescribed to 3-year-olds.

"Is this what 'leave no child behind' is all about?" said Sharav on the AHRP web site.

Predictably, the children on these drugs (and some who have stopped taking them) are displaying horrifying side effects. Lucire reports patients who are "punch drunk with dementia," occasionally psychotic and showing signs of akathisia, or an inability to sit still. Additionally, Lucire noted she had observed hyperactivity, aggression or hostility, and cognitive impairment, along with tardive dyskinesia, a neurological disorder brought on by long-term use of, or high-dose exposure to, drugs that block dopamine receptors. Repetitive, involuntary and purposeless movements characterize the condition.

If these side effects were not disturbing enough, a Duke University study suggested that the drug class might be connected to pancreatitis. Worse, some patients -- adults and children -- are reporting cases of type 1 and type 2 diabetes, as well as hyperglycemia in connection with use of atypical antipsychotics, with some cases ending in death. The condition seemed to affect mostly young, male patients.

The link between diabetes and the atypical antipsychotics is thought to stem from the weight gain reported by some users of the drugs. Some patients have said they gained as much as 65 pounds, and subsequently developed diabetes or glucose abnormalities. This has caught the attention of the FDA, which is waiting on a Veterans Administration analysis before deciding whether to put a warning label on the drugs, according to a spokesperson. Some atypical antipsychotics already carry such labels in Japan and Europe.

Psychiatrist charged with endangerment

From the Fayette County Review

A Memphis psychiatrist was arrested by Fayette County sheriff’s deputies Friday and charged with reckless endangerment and illegal possession of a firearm.

Dr. Mark Luttrell, 47, of 415 W. Key Road in the Fisherville community was released on an appearance bond Saturday morning. He was scheduled to be arraigned Monday in Fayette County General Sessions Court.

Ray Garcia, public information officer for the sheriff’s office, said that on Dec. 5, deputies received a call that there was a vehicle partially in the roadway in the 200 block of Key Road. They found the vehicle unlocked with the keys in it, along with two loaded weapons—a .45-caliber pistol and a .22-caliber revolver—and some armor-piercing rifle ammunition.

When the deputies determined that the vehicle was registered to Luttrell, Garcia said they attempted to make contact with him at the Key Road address listed on the registration. The vehicle was towed to Hannah’s.

Friday morning, he said, Luttrell came to the sheriff’s office, where he was arrested on the charges. That afternoon, deputies went to his residence with a search warrant issued by General Sessions Judge Mike Whitaker.

Garcia said the case is still under investigation.

Wednesday, December 13, 2006

NY State cites Psychiatric center. Clinic is fined, forced to stop taking new patients

The psychiatric center in upstate Brewster where accused murderer Evan Marshall of Glen Cove was once treated has been fined $80,000 and ordered not to accept new patients after regulators discovered several violations.

The state Office of Mental Health placed Supervised Lifestyles Residential, or SLS, under a temporary "cease-and-desist" order after visits at the center Nov. 6 and 7.

"Although the final report of this review has not yet been finalized ..., the results of the visit indicated serious regulatory violations," according to a Nov. 17 letter addressed to Alfred Bergman, co-chairman and chief executive, and Joseph Santoro, co-chairman and chief operating officer.

Violations include the lack of criminal background checks for staff, use of manual restraints and required jail-like jumpsuits in a community service program that humiliated some patients, according to the Office of Mental Health letter.

Spokesman Gerald McKelvey said yesterday the center has requested an agency hearing to contest the allegations. He also said most of the violations stemmed from insufficient record-keeping and some had been voluntarily addressed before the visits.

Marshall, 31, was a patient at SLS for at least four months, and police said he had been granted a leave to visit his mother in Glen Cove when he beheaded and dismembered Denice Fox, 57. McKelvey couldn't comment on Marshall, citing privacy concerns.

SLS, a private center founded in 1987 that provides a dorm-like setting for 140 patients a year, has never had its license suspended, state regulators said.

The order stopping admissions remains "until an acceptable plan of corrective action has been reviewed and accepted," said Jill Daniels, a spokeswoman for the Office of Mental Health.

Such a plan has been sent to the agency, said McKelvey, who added, "We will appeal this matter."

The violations prompted some mental-health professionals to remind care-seekers to thoroughly research facilities like SLS before signing up.

"In some cases, people are receiving poor treatment," said Carol Smaldino, a Port Washington therapist, who has a patient who once lived at SLS for about four months.

Smaldino's patient of six years said the reported violations only skim the surface of problems at SLS. The client, who spoke on condition of anonymity, said some patients were unnecessarily strong-armed and some were given so-called "med holidays," which meant they were taken off their medication.

McKelvey said psychiatrists routinely stop medication for some patients when the treatment has been deemed ineffective or when prescriptions are based on the wrong diagnosis.

Lance, a 31-year-old resident of upstate Mahopac with a personality disorder who spoke on the condition that only his first name be used, said SLS turned his life around and he wrote a letter recently to the Office of Mental Health praising the center after receiving treatment there from 2001-03.

"I never witnessed anyone being abused," he said. "I witnessed a girl take a kitchen knife and plunge it into her arm repeatedly. Obviously, there's restraint needed there."

What the state said

Some of the violations outlined by the state at Supervised Lifestyles Residential, a rehabilitation center in upstate Brewster. SLS spokesman Gerald McKelvey said the allegations are being contested.

State officials questioned the number of times SLS used manual restraints, pointing to at least 25 instances in the past 10 months. SLS initially reported to state regulators in September that restraints were used three times in 12 months, officials said.

SLS had not performed criminal background checks on staff hired since April 2005, state officials said. SLS said in October the center, which has 60 to 70 employees, performed the necessary background checks. No criminal records turned up for the six employees checked so far, SLS said.

State officials said a program at the center required some patients to perform community service while wearing jumpsuits, humiliating them. SLS said use of the jumpsuits ended in August.

Experts testify that 'cages' hurt children's mental health

An update on the case where the parents of young children caged them to keep them under control. The parents previously said that this was done on the advice of a psychiatrist. The behavioral problems of the formerly caged kids is debated. As seen here:

The future for the Gravelle children was in question during the trial of their parents Mike and Sharon.

Today, three psychologists testified that the children, who had to sleep in enclosed beds, did so at a significant risk to their future mental health.

The Gravelle's are accused of keeping their 11 adopted children in so-called cages.

Investigators say they were used for sleeping and discipline.

The Gravelle's maintain that the enclosed beds were necessary to keep the children from harming themselves. The couple said the children set fires, urinated down registers and ate non-food items.

Testimony from the expert witnesses is important to the prosecution. For a conviction on the felony charges, prosecutors must prove the Gravelle's caused substantial harm to the children.

Through questioning, the defense attempted to discredit the experts, indicating their opinions are based on assumptions and not exact science.

The prosecution is expected to rest its case Wednesday morning and then the defense starts.

CCMH files suit, says psychiatrist trashed apartment

As seen in the News Record of Gillette, Wyoming.

A former Campbell County Memorial Hospital psychiatrist who is charged with identity theft is now facing a lawsuit from his former employer because he allegedly damaged the furnished apartment he subleased from the hospital.

The hospital sued Lyndon Keith Steinhaus, 47, Thursday in Campbell County District Court to try and get him to pay for $15,000 in damages they say he caused to the apartment. They are also asking for punitive damages, attorneys fees and court costs.

“(Steinhaus) has caused significant damage to the premises, including knife cuts in the furniture, stains on the furniture and the carpet, holes in the wall, knocking a door off its hinges and other significant damages to the premises,” the court documents allege.

Investigators contacted Steinhaus Nov. 30 to investigate reports that he used his ex-wife's identity to withdraw money from her account and to buy his girlfriend a tennis bracelet.

When investigators arrived, they found that his apartment was “a disaster,” according to charging documents that noted food strewn on the walls, floor and ceiling.

Darcy Jo Bogenrief, a lawyer who's Steinhaus' 41-year-old girlfriend, told investigators that he'd been drunk the past couple days and that he'd been out of control. Bogenrief, like Steinhaus, is facing felony charges of identity theft and conspiracy to commit identity theft.

Donald Percifield, who owns the apartment and leases it to the hospital, said the apartment was “just trashed” when he saw it. Garbage, beer cans and cigarette butts were all over the floors. Just about every wall had a hole in it. And something that looked like spaghetti sauce appeared to have been slopped on the walls.

“I've rented to supposedly lower-class people, and I've never had damage like this,” Percifield said. “It was unreal.”

Tom Lubnau, the hospital's attorney, said he could not comment on the case because of ethical prohibitions against talking about a case in progress.

Jeremy Michaels, Steinhaus' attorney, had not yet received notice of the case at press time and did not want to comment until he'd had a chance to review the accusations.

Tuesday, December 12, 2006

LawSuit: Child Psychiatrist Abused Patient, Damages Sought

As seen in the Cincinatti Enquirer

A Cincinnati child psychiatrist is accused in a lawsuit of sexually molesting one of his patients.

A 19-year-old man, who was not identified in the lawsuit that was filed Monday in Hamilton County Common Pleas Court, is suing Dr. Leo D’Souza for child abuse and medical malpractice. The man is also suing D’Souza’s employer, Cincinnati Counseling Service, for negligence.

Neither D’Souza nor the counseling center returned a call for comment.

The man alleges in his suit the abuse started between 1999 or 2000 and ended in December of 2005. D’Souza was treating the man at the counseling center’s Westwood office for bipolar disorder, depression and other related conditions.

D’Souza has not been criminally charged.

The man’s parents recently filed a report with the Ohio Medical Board, according to the man’s attorney, Mike Allen. Those complaints are not public until they have been substantiated.

“This was a serious breach of medical ethics with obvious devastating effects for our client,” Allen said. “This kind of abuse you almost never recover from.”

The plaintiff is seeking at least $25,000 in damages.

In the lawsuit, the man said he was 12 or 13 when D’Souza began to include a “physical examination” during office visits. During those exams, which happened at least six times, D’Souza fondled the man, the lawsuit alleges.

“As a direct and proximate result of Dr. D’Souza’s negligence, the symptoms of John Doe’s underlying mental disorders were exacerbated,” according to the lawsuit.

The lawsuit names Cincinnati Counseling Service, which has four offices, alleging the company either knew or should have known about the abuse.

Monday, December 11, 2006

Therapist labelled sexual predator

Another case where therapist = the rapist. As seen in this report

A therapist who developed sexual relationships with female clients - in one case, conducting an affair while also treating the woman's husband - has been labelled a "sexual predator", but health authorities are powerless to stop him practising.

Geoffrey Mogridge was yesterday named by the Deputy Health and Disability Commissioner, who said she was concerned about risk to the public if he continued to practice.

"I view Mr Mogridge's behaviour as that of a sexual predator, not a 'sick puppy' as he has euphemistically stated," said Deputy Commissioner Tania Thomas.

Mr Mogridge last night told the Herald he was still working as a natural therapies practitioner on the North Shore, but no longer offered counselling services or massage.

He denied being a risk to the public and said the relationships investigated by the commissioner carried on for 10 months and were consensual.

Mr Mogridge said he would never again have sex with clients. "These are learning curves. You don't see there's anything wrong at the time."

Ms Thomas said Mr Mogridge was an unregistered health care provider and the commissioner's powers were limited. She chose to publicly name him, "in light of my concerns about protection of the public".

Mr Mogridge would be referred to the Director of Proceedings to consider whether he should go before the Human Rights Review Tribunal.

The tribunal can award compensation, issue restraining orders and various other directions, such as requiring a health care provider to undergo remedial training.

The commissioner investigated three complaints against Mr Mogridge, including two from a husband and wife who went to him in 2003.

Mr Mogridge started a sexual relationship with the woman, a victim of rape, and later told her husband, whom he also treated, of the affair.

"We were both just enjoying each other's company and doing some work at the same time," Mr Mogridge last night said of the affair. "I made it very clear about separation and the boundaries between the two."

Mr Mogridge became involved with another client, a woman who had suffered sexual abuse, around the same time. He claimed the woman became upset because she found out about the other relationship.

The commissioner said Mr Mogridge used his position for his own gratification and exploited the women.

North Shore police yesterday said a complaint of indecent assault laid against Mr Mogridge was withdrawn about a month ago because the complainant did not want to give evidence.

Mental Inmates Humiliated

As seen in The Australian

Psychiatric patients have been stripped naked, physically abused and injected with sedatives against their will, a damning report into Western Australia's mental health facilities hasfound.

It also reveals that some patients received carpet burns to their faces and other injuries, including severe bruising, while others who had been committed to care were charged $24 a day for the privilege.

The Council of Official Visitors' annual report on the treatment of mental health patients finds there were a number of cases of basic human rights violations and criticises the state Government for a lack of action in recent years.

"The issue about people being secluded naked is very distressing, particularly because we recorded the problem in last year's report and brought it to the Government's attention, and despite all of that there areanother three cases this year," report author Judyth Watson told The Australian.

In 2005-06, the council - an independent body set up to monitor the treatment of patients - had several complaints from patients at the Mills Street Centre, in suburban Bentley, that nurses had removed their clothes while they were kept in isolation.

"One woman complained that on several occasions of seclusion she had her clothing removed and on two of them she was not provided with any coverings," the report says.

Another patient was secluded 13 times and left naked during two of those times.

"It was humiliating and embarrassing for her - her anxiety was heightened when her clothes were removed by a male nurse and when she was monitored naked by close circuit television," the report says.

Opposition health spokeswoman Helen Morton said the council exposed the practice at Perth's main psychiatric facility, Graylands at Mount Claremont, last year.

"One year later, the practice continues at Bentley, sometimes against patients who are seen as difficult," Ms Morton said.

West Australian chief psychiatrist Rowan Davidson said clothing had been removed from some patients because staff thought it was necessary for the patients' protection.

However, he said that practice had since been changed.

State Australian Medical Association spokesman Paul Skerritt said that while seclusion was sometimes necessary and effective, he did not agree with stripping patients naked.

"I can't possibly see how that could be legitimate treatment," Professor Skerritt said.

The council also received complaints from patients that excessive force was used as they were transferred to seclusion.

The report says: "They say they sustained injuries including carpet burns to the face and swollen/bruised parts of limbs. These injuries were seen by Official Visitors."

Dr Watson acknowledged the difficult line nurses had to walk in assessing the risk of patients harming themselves or others.

She said another issue the Government had yet to resolve, despite years of discussion, was a daily fee charged to some long-term involuntary patients at Graylands.

"These are terribly vulnerable patients who have no choice about whether they can leave," she said.

The 41 patients are being charged $23.65 a day for board and lodging.

Health Minister Jim McGinty said every mental health patient was entitled to be treated with respect and dignity. "We are currently drafting a new Mental Health Act to positively enshrine the rights of the mentally ill in the laws of Western Australia. We expect to introduce a bill in state parliament in the first half of next year," he said.

Saturday, December 09, 2006

Investigation in alcohol-for-Ritalin School Incident

As seen in the Albany Democrat Herald

An incident involving a teacher’s aide who allegedly made an alcohol-for-Ritalin trade with a high school student has not yet resulted in charges.

Eric Hsu of the Linn County District Attorney’s Office said the incident has been sent back to the Linn County Sheriff’s Office for further investigation.

“That has gone backwards instead of forwards,” Hsu said. “It looks like it will be longer now than we anticipated.”

The incident allegedly took place Sept. 14 on the campus of Sand Ridge Charter School.

According to the sheriff’s office, a 17-year-old junior came home intoxicated that day and told his mother a teacher’s aide had given him a fifth of Jack Daniels whiskey in exchange for 10 tablets of Ritalin.

The mother contacted Sand Ridge officials, who turned the information over to deputies.

Kelli Dixon, 35, of Sweet Home was arrested Sept. 15 on charges of furnishing alcohol to a minor, a misdemeanor. Sgt. Jim Yon said the sheriff’s office wanted the district attorney’s office to drop that charge in favor of a charge of delivery of a controlled substance, a felony.

“I think they’ve dropped everything at this point,” he said.

He said the sheriff’s office initially charged the student involved with delivery of a controlled substance and delivery of a controlled substance within 1,000 feet of a school, but the district attorney’s office dropped both charges.

Yon said the sheriff’s office still believes initial information about the incident is correct. However, he said, investigators do want to conduct further interviews, which may add to or change charges in the case.

“We need to try to track one more person down,” he said.

Both Dixon and the family of the boy declined to comment on the incident.

Friday, December 08, 2006

NIH Psychiatric Researcher Accused in Conflict of Interest Case; of Improperly Taking Money From Drugmaker

From the Baltimore Sun

: As seen in this report, the corrupt shrink has plead guilty.

A senior government scientist working in Alzheimer's disease research was charged by federal prosecutors yesterday with accepting $285,000 in consulting fees and travel expenses from the world's largest drug manufacturer without proper approval from his bosses.

The criminal case emerged as a rare example of a top leader in the sciences being accused of breaking the law over a breach of professional ethics.

Leaders at the National Institutes of Health and their overseers in Congress have described the private financial arrangements between drug companies and publicly employed scientists as the worst scandal in the history of the agency.

Pearson "Trey" Sunderland III, chief of the geriatric psychiatry branch of the National Institute of Mental Health, which is part of the NIH, was charged yesterday with conflict of interest. He is accused of accepting payments from Pfizer Inc. without authorization from his superiors and ethics watchdogs. The misdemeanor charge was filed by criminal information instead of by indictment, which usually signals that a guilty plea is expected.

If convicted in U.S. District Court in Baltimore, the 55-year- old scientist from Chevy Chase could be sentenced to up to one year in prison and fined up to $100,000. He is scheduled to make his first court appearance Friday.

His attorney, Robert F. Muse, declined to comment yesterday.

Arthur Caplan, chairman of the medical ethics department at the University of Pennsylvania, called the case "unbelievable. It's just staggering news that will have an enormous ripple effect."

In October, former Food and Drug Administration Commissioner Lester M. Crawford pleaded guilty to two misdemeanor charges, admitting that he lied about owning stock and options in companies regulated by the agency.

This fall, the Los Angeles Times reported that an internal agency review had found that Dr. Thomas J. Walsh, who has helped lead major clinical trials involving cancer patients at NIH, improperly received fees totaling $100,970 from pharmaceutical and biotechnology companies without prior disclosure. Walsh, who has not been charged by federal authorities, remains an agency employee.

NIH officials confirmed yesterday that more than 40 scientists at the agency are thought to have engaged in outside, fee-based relationships with private companies. Almost none of them were charged with crimes. Instead, officials said, the scientists were disciplined internally or retired from the agency.

A spokesman for Rep. Edward Whitfield, a Kentucky Republican who is chairman of the Committee on Energy and Commerce Subcommittee on Oversight and Investigations, declined to comment on the charge against Sunderland.

Rep. John D. Dingell, a Michigan Democrat who is expected to take over as chairman of the powerful energy committee in January, said the case raises questions about the management of the National Institutes of Health.

"Sunderland remained on the payroll for years after NIH was given information from this Committee about this conflict and while the Surgeon General sat on an NIH recommendation that he be removed," Dingell, the ranking Democrat on the committee, said in a statement. "Will a criminal conviction for conflict of interest be enough to get someone fired from NIH?"

Other committee officials said the criminal charge helped explain why Sunderland declined to testify before its investigative subcommittee this year.

"It looks like there was a reason that Dr. Sunderland took the Fifth when he came to testify before our committee, and that was because he'd done something wrong," Larry Neal, a spokesman for the energy committee, said in a statement.

Sunderland remains an employee of the National Institute of Mental Health, spokesman Don Ralbovsky said yesterday.

His continued employment baffled some members of Congress.

"Hopefully, this announcement will also clear the way for Dr. Sunderland's termination from the Commissioned Corps," Neal said in his statement. "That as of a few months ago he continued to collect his salary and travel to Hawaii and other locales on taxpayer-funded trips is a total betrayal of the public trust."

Rep. Bart Stupak of Michigan, the ranking Democrat on the Subcommittee on Oversight and Investigations, said that if Sunderland is not disciplined "even after criminal charges have been brought, we can only conclude that no one is being held accountable, the system is broke and the public trust has been violated."

In a congressional report released in July, Sunderland was accused of accepting more than $500,000 from Pfizer without obtaining required advance approval.

Federal prosecutors declined yesterday to explain the disparity between that accusation and the more limited scope of the federal charge, saying they would not comment beyond the allegations contained in court papers. A message left for a Pfizer spokeswoman was not returned yesterday.

Speaking more broadly about the ethical restrictions on government scientists, Caplan said the recent scandal has put researchers in a difficult position.

"There is a mixed message here, which is: Stay away from the private sector but please work with the private sector," the ethicist said. "A lot of the rules that have been put in after the scandals are too restrictive. ... Saying your secretary's husband can't own stock in a pharmaceutical company doesn't make any sense to a lot of people."

With degrees from Harvard and George Washington universities, Sunderland has been a leader in his field. He has written more than 250 articles, book chapters and reviews, and he co-wrote the book Aging and Mental Health.

As branch chief since 1997, Sunderland supervised his agency's geriatric research, including the creation and management of collaborations with outside partners.

According to court papers filed by prosecutors, Sunderland was required under agency rules to disclose all income earned from outside activities and travel expenses exceeding $260 that were reimbursed by outside sources.

In addition, before engaging in outside employment, Sunderland was required to file a form disclosing the name of the outside organization, the nature of the employment and any anticipated compensation.

In late 1997, Pfizer representatives approached Sunderland about his agency's joining a scientific collaboration, according to court papers. It was to involve researchers at Pfizer and the British company Oxford Glycosciences Limited who were searching for new Alzheimer biomarkers, physical traits in the blood or cerebral spinal fluid indicating the presence and progress of the disease.

Prosecutors allege that Sunderland joined the collaboration without full disclosure. From 1998 to 2003, the branch chief and his staff members, acting in their official capacities, provided Pfizer with advice, expert opinions, statistical analyses and data interpretation.

According to the criminal information filed against Sunderland, Sunderland signed an agreement in June 1998 to serve as a private consultant for Pfizer.

During his five years as a consultant, Pfizer paid Sunderland $125,000 in retainer fees, $35,000 to attend company meetings and additional money for related travel expenses.

According to the criminal information, Sunderland did not disclose to his supervisors at the National Institute of Mental Health the nature of his work and compensation from Pfizer.

SSRI experts head to Washington to testify before FDA panel

The ever insightful Evelyn Pringle has written this column, as seen here and here

On December 13, the FDA’s Psychopharmacologic Drugs Advisory Committee will hold a public hearing to review the suicidality data from the adult selective serotonin reuptake inhibitor (SSRI) studies.

And, for what seems like the umpteenth time, SSRI experts from all over the US, and as far away as the UK, will travel to Washington to once again testify at yet another hearing on the suicide risks associated with these drugs.

The committee is expected to vote on whether the risk of SSRI-induced suicidality in adults should be included in a black box warning on all SSRI labels, including Paxil, Prozac, Zoloft, Lexapro, and Celexa.

The FDA should begin the hearing by announcing that suicide rates for adults have not declined at all in the US, even with the massive widespread use of SSRIs. According to a federal study by researchers from Harvard Medical School and elsewhere, in the June 2005, Journal of the American Medical Association, despite a dramatic increase in treatment with antidepressants in 2001-2003, when compared to 1990-1992, the rates of suicidal ideation, gestures and attempts among adults have remained basically unchanged.

There is probably no legal expert in the US more qualified to testify about SSRIs than Baum Hedlund attorney Karen Barth-Menzies, and she will be at the hearing with bells on. Over the past 10 years, she has represented thousands of clients against SSRI makers.

By now, the FDA knows that Ms. Menzies makes no secret of the fact that she is outraged about the overprescribing of these powerful and dangerous drugs to all age groups for nothing more than everyday problems.

This will be Ms. Menzies' fourth time up to bat. She has already testified three times at government hearings. She first spoke at an FDA Psychopharmacologic Drugs and Pediatric Advisory Committee hearing in February 2004, about the increased risk of suicide in children and adolescents taking SSRIs.

At that particular hearing, the famous SSRI litigator concluded her testimony by telling the panel: "Put me out of business for the right reasons. Warn about these drugs."

Many of Baum Hedlund's clients who have suffered tragedies caused by SSRIs will be also be attending the hearing and some will be speaking. However, a number of clients who wanted to testify were not selected by the FDA's new "lottery" system, and will not be permitted to speak. But Ms. Menzies says she plans to speak on their behalf.

She has firsthand knowledge of how the drug companies hid the evidence about the suicide risks. The documents that have been unearthed in litigation reveal that the risk was known in the mid-1980s before the first SSRI, Prozac, was approved for use in the US.

Because of Baum Hedlund's work in the Prozac litigation, Ms. Menzies has the ability to provide the committee with the historical background on SSRIs, including internal company documents that show how and why the SSRI suicide risk with adults was obfuscated 15 years ago during the first FDA advisory committee hearings on the suicide issue.

She will explain exactly how the clinical trial data were manipulated by SSRI makers to skew the statistical analyses of suicidality. "Civil lawsuits," she says, "have uncovered internal company documents to which not even the FDA has access."

And she maintains that the drugmakers have purposely failed to conduct studies on the risk of suicidality because they already knew such trials would produce negative results.

In August 2004, Ms. Menzies testified before the California State Senate and called for better patient informed consent about the risks associated with SSRIs.

Next, she testified at the September 2004 FDA Advisory Committee's follow-up hearings and discussed the lack of efficacy in SSRI treatment of children, as documented in pediatric clinical trials that had surfaced during litigation.

In between the February and September 2004 hearings, Ms. Menzies met with members of Congress to discuss SSRI related suicidality and the FDA's failure to alert the public about the dangers of SSRIs, and provided documentary evidence to show that the risks posed were real.

She also provided information to investigators in two separate congressional investigations that resulted in two hearings in 2004, at which drug company executives and FDA officials were interrogated and chastised by members of Congress.

In addition to Ms. Menzies, one of the world's most highly regarded SSRI experts, Dr. David Healy, a professor at North Wales Department of Psychological Medicine, at Cardiff University, will be flying in from the UK to testify at the hearing. He, too, will give a repeat performance.

Dr. Healy has authored 12 books, including Let Them Eat Prozac, The Antidepressant Era, and The Creation of Psychopharmacology, and is known to be outspoken when he believes it is necessary. During his testimony at this hearing, Dr. Healy says he plans to draw attention to the manipulation of the clinical trial data on SSRIs.

For over a decade, he has been trying to raise awareness about the link between SSRIs and suicide. Back in August 1991, Dr. Healy authored the paper, "Antidepressant Induced Suicidal Ideation," in which he said that the cases of two patients "suggest that the emergence of suicidal ideation on antidepressants cannot always be attributed to a lifting of psychomotor retardation but rather that the ideas may in some instances be produced by antidepressants."

Three years later in 1994, he authored the paper, "The Fluoxetine and Suicide Controversy," and stated, "In the opinion of this author, the volume of case reports and other studies is sufficient to demonstrate that antidepressants and antipsychotics may induce suicidal ideation in certain individuals under certain conditions."

After the February 2004 advisory committee hearings, Dr. Healy analyzed the data from the pediatric SSRI trials on suicidality and hostility, including those kept hidden for years, and sent his analysis to the FDA on February 19, 2004.

To distinguish the difference between suicide possibly caused by SSRIs verses suicide caused by an underlying illness of depression, Dr Healy broke down the studies into a group of children being treated for depression and a group of anxious children who were being treated for obsessive compulsive disorder or social phobia.

From a pool of 931 depressed patients taking SSRIs versus 811 depressed patients taking placebo, Dr. Healy determined that there were 52 suicidal acts by patients on SSRI versus 18 in the placebo group.

In a pool of 638 anxious patients taking SSRIs versus 562 anxious patients taking a placebo, there were 10 suicidal acts in the SSRI group versus 1 in the placebo group.

When these data sets were combined, in the 1,569 patients on SSRIs there were 62 episodes of suicidality versus only 19 episodes in 1,373 patients on a placebo.

This analysis clearly shows that SSRIs can cause some children who were not depressed to begin with to become suicidal.

Dr. Healy believes the FDA should do more about the industry's practice of paying medical professionals to publish fraudulent research papers ghostwritten by PR firms. "While it is not FDA's brief to regulate the academic literature," he states, "the possibilities of a close to fraudulent representation of data and of extensive ghostwriting does set up an argument that these apparently scientific articles are in fact infomercials rather than the real thing."

"If these articles are essentially advertisements," Dr. Healy says, "it is much less clear that FDA can throw their hands up and plead an inability to do anything about the production of such materials."

Former Federal fraud investigator, Allen Jones, will also be testifying at the hearing and he, too, has testified before about the over-promotion and marketing of psychiatric drugs.

"The pervasive manipulation of clinical trials, the non-reporting of negative trials and the cover-up of debilitating and deadly side effects," Mr. Jones says, "makes it impossible to prescribe, or take, these drugs with any level of meaningful informed consent."

"Doctors and patients alike," he states, "have been betrayed by the governmental entities and officials who are supposed to protect them."

During an investigation in Pennsylvania, Mr. Jones learned all about Big Pharma's methods promoting the sale of psychiatric drugs by corrupting public officials and says, "conflicts of interest permeate the testing, approval and marketing of drugs in America."

"Academic researchers with industry ties," he explains, "put favorable spin on dubious clinical trial results and then the embellished results are presented to FDA Advisory Boards peopled with Pharma consultants, grantees and advisors."

"These results," he reports, "are further embellished in medical journals by still more academics on drug company payrolls."

From there, he says, this body of misleading research becomes institutionalized by "expert panels" in treatment guidelines generated by additional academics and researchers with financial ties to the industry.

As a fraud investigator, he discovered a hidden account in Pennsylvania where drug companies were funneling money to the state employees who were in charge of deciding which psychiatric drugs could be included in the treatment guidelines for the official list of drugs covered by public health plans like Medicaid and prescribed to people in all state institutions and programs.

According to Mr. Jones, the employees "were given unrestricted educational grants that were deposited into an off-the-books account, unregistered, unmonitored, literally operated out of a drawer."

Mr. Jones also found that the drugmakers were paying these same state employees honorariums of up to $2,000 to speak at industry events and giving them perks such as lavish meals and trips.

After the SSRIs and atypical antipsychotics were successfully added to the state formulary list, Mr. Jones reports, Pennsylvania spent a combined total of $139 million in 2003, for those two classes of drugs alone.

Last month, the former Pennsylvania chief pharmacist, identified as being on the take by Mr. Jones during his investigation, was indicted on felony and misdemeanor conflicts of interest charges involving accepting money from drug companies while a state employee with great influence over the drugs that would added to the state formularies to be prescribed to patients in Pennsylvania.

"I predict we will be seeing many more prosecutions of this type," Mr. Jones says, "as the extent of drug company corruption of government officials becomes known."

Another prominent SSRI expert making a return visit to testify once again is Dr. Joe Glenmullen, a psychiatrist and clinical instructor in psychiatry at Harvard Medical School, and the author of the book, "Prozac Backlash," which describes his experiences of watching patients become suicidal while taking SSRIs.

He has testified previously about a specific side effect of SSRIs called akathisia, which he and many other experts say can make some patients so agitated that they feel death would be a welcome relief.

"This side effect is so well established," Dr. Glenmullen told a previous panel, "that it is clearly described with SSRIs in the Diagnostic and Statistical Manual (DSM), the American Psychiatric Association's official diagnostic manual."

"If you look at the transcript of the FDA hearing on this very side effect 10 years ago," he stated, "you will see the FDA saying repeatedly we don't know what to do, we need more research."

"It is a tragedy," he added, "to be here 10 years later and hear the FDA saying the same thing."

"The industry's response to this side effect," he continued, "has been to blame the underlying psychiatric conditions of patients, to dismiss legitimate medical case reports as anecdotes, and to scare the media away from the subject, claiming that it would frighten patients away from treatment."

"Well, I prescribe SSRIs and I warn patients," he told the panel, "and they are not frightened away from treatment."

In conclusion, Dr. Glenmullen clearly stated that the suicidality in SSRI patients was not caused by an underlying psychiatric condition; that it was caused by akathisia.

"Let's stop blaming the victims," he said, "and deal with this very real side effect."