As seen in the Boston Globe. It is unclear if the doctor was aware of the father's potential problems as seen in yesterday's report from the Patriot Ledger. As reported by WHDH-TV, the state Department of Social Services investigated concerns about the amount of medication being given to the 4-year-old girl, but did not seek an independent review of her treatment until after her death.
Dr. Kayoko Kifuji, the psychiatrist who treated Rebecca Riley in the months before the Hull girl died from an overdose of prescription drugs, agreed yesterday to immediately stop treating patients while the state investigates her role in the case.
The Board of Registration in Medicine accepted Kifuji's voluntary agreement to cease the practice of medicine at its meeting yesterday, a day after Riley's parents pleaded not guilty to murder charges for allegedly giving her excessive amounts of the drug Kifuji prescribed for the 4-year-old.
The agreement does not detail any specific allegations against Kifuji, who works at Tufts-New England Medical Center. But the board said in a statement that such agreements "are one tool available to the Board to ensure the safety of the public during the pendency of an investigation."
Nancy Achin Audesse, the board's executive director, said after the meeting: "Clearly this case and the attention it has garnered is very frightening to patients and to the public, and it raises a lot of questions. A voluntary agreement gives us time to gather information and decide what we need to do next."
Tufts-NEMC issued a statement yesterday saying that Kifuji is on a paid leave of absence, but that hospital executives could not comment further on the case, because of concern about medical confidentiality of the child.
The agreement is considered a disciplinary action that will appear on Kifuji's record as a physician. But she states in the document that "nothing contained in this agreement shall be construed as an admission or acknowledgment by me as to wrongdoing."
The doctor's lawyer said yesterday that she did nothing wrong. "Dr. Kifuji's diagnosis of Rebecca, her prescribing of medication, and the care provided was 100 percent appropriate under the circumstances," said attorney J.W. Carney Jr. "Dr. Kifuji agreed to a voluntary suspension from practice so that she can have the opportunity to present all of the facts to the board staff in a calm and professional setting, rather than the frenzy of an emergency hearing."
When asked whether he expected the Plymouth district attorney to pursue criminal charges against his client, Carney said that Kifuji "provided first-class medical care to her patient and did absolutely nothing wrong medically, never mind anything that was in violation of the law."
Kifuji began treating Riley in August 2004 and diagnosed her with attention deficit hyperactivity disorder and bipolar disorder. She prescribed medications, including clonidine, a blood pressure drug for adults that is also sometimes given to children to reduce aggressiveness and help them sleep. Prosecutors allege that Riley's parents, Michael and Carolyn Riley, intentionally killed their daughter in December by giving her an overdose of clonidine.
In a State Police affidavit filed Feb. 5 in Hingham court, investigators said they interviewed Kifuji twice about the care she provided to Rebecca Riley. She told police she saw the girl in her office sometimes every two weeks and other times every two months.
Carolyn Riley had told investigators that the doctor had said the parents could give Rebecca an extra half-tablet of clonidine at night if she couldn't sleep. But Kifuji emphatically denied that, according to the affidavit. "No! Never!" she is reported as saying.
Kifuji told police that Carolyn Riley called her in the early fall, saying she had lost an entire bottle of clonidine, so she reauthorized the medication. Rebecca's mother called her 10 days later, the affidavit quoted Kifuji as saying, stating that water had gotten into the new bottle and ruined the pills. At that point, Kifuji said, she authorized an additional 10-day supply and required all future prescriptions to be filled every 10 days to prevent more accidents.
Yesterday Carney defended his client's handling of the situation. "It appeared to Dr. Kifuji that she had no reason to disbelieve the mother's account of losing or wetting the medication," he said.
In a second interview with investigators, the doctor said that Carolyn Riley told her in October 2005 that she had gradually increased her daughter's nighttime dose of clonidine to 2 1/2 tablets from two tablets, according to the affidavit. Kifuji told investigators that she was shocked by the statement and explained to Carolyn Riley that an increased dose of the potent drug could kill Rebecca. She said she told her that if she went outside prescribed doses again, she would report her to the Department of Social Services.
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