State board bans psychiatrist from prescribing meds to children

From a Report in the Grand Forks Herald

Dr. Thomas Peterson, a Grand Forks psychiatrist who is CEO and medical director of the Richard P. Stadter Center, cannot prescribe psychotropic medications to children after the North Dakota State Board of Medical Examiners found he overprescribed doses to two children younger than 12.

“Peterson was found to have prescribed excessive amounts of atypical antipsychotic medications to two children under his care,” according to Duane Houdek, executive secretary for the state board. The stipulation to Peterson’s license was made during the board’s regular meeting Friday in Bismarck.

These atypical antipsychotic medications include Risperdal, Zyprexa, Geodon and Seroquel.

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The board found, and Peterson agreed, that he’d prescribed to one child “such an excessive amount of atypical antipsychotic medications (that) are beyond the acceptable standards of prescriptive practice for a child in this age group.” For the other child, the board found he prescribed a “particular combination of medications” that was “injudicious and an excessive use of atypical antipsychotics.”

Specific information, such as who filed the complaints, is not publicly available. Both complaints are from incidents that occurred in 2006, but Houdek declined to say when the complaints were filed with the board. “We act on them as soon as we get them,” he said.

On Tuesday, Houdek provided the Herald with a copy of an amended complaint filed Jan. 25 detailing specific medications and dosages each child was prescribed. The complaint asked for Peterson’s license to be revoked, but the parties reached an agreement Feb. 19 to place the restriction on Peterson’s license until he can show he attended the class on how to dose children.

Houdek said the board “didn’t have information of immediate harm” to the two children, identified in the complaint only as Patient A and Patient B.

Details, According to the complaint:

Patient A — whose birth date is redacted from the complaint, but who officials say is younger than 12 — was admitted to the Stadter Center under Peterson’s care and diagnosed with ADHD and bipolar disorder. The child had “suicidal threats, physical aggression toward his mom and trouble sleeping at night,” and medication sheets indicated the child’s diagnosis as nonspecific depression.

“During (Patient A’s) hospitalization, he continued to struggle with aggression and other behavior issues, but at no time was there any documentation of psychotic symptoms, hallucinations, delusions, paranoia or any other symptoms suggestive of manic spells.”

But the child was prescribed antipsychotics, including Seroquel, Risperdal and Zyprexa.

Patient A continued to take the medications during hospitalization and when discharged from the center.

Patient B, whose age also was redacted from the complaint, was admitted to the Stadter Center under Peterson’s care after “exhibit(ing) agitation, aggression and behavior issues at home and in the school setting.”

This child was diagnosed with “bipolar disorder, mixed, severe, pervasive developmental disorder and borderline intellectual functioning.”

The child already was taking two atypical antipsychotic medications and two mood stabilizers when admitted to the center for care. The child’s mother “called and complained to (Peterson) about (Patient B) being on too many medications, and on one occasion, even requested a transfer to a different facility.”

The child was discharged “on a high dose of Depakote” which equaled “1,375 milligrams, higher than commonly used for a 5 year old (sic)” and two separate prescriptions of Geodon (an antipsychotic medication). Peterson “in effect, sent (Patient B) home with two atypical antipsychotic medications, which is injudicious and an excessive use” of them, according to the complaint.

Peterson and the board agreed that his authority to prescribe these medications to children would be suspended at the end of February, according to the complaint. The board didn’t act on the agreement until Friday.

Peterson “looks forward to appearing before the board at a special telephone hearing on his petition to satisfy the board that he has complied with the agreement,” according to Schreiner.

The board hadn’t received a copy of the petition for review Tuesday afternoon, so it was hard to say when a special hearing would be scheduled, Houdek said.

Disciplined before

Peterson has been disciplined by the board before, Houdek said.

He received a “letter of censure” from the board after the 1997 flood “because he had put out an ad that implied the offices of other psychiatrists were closed,” Houdek said.

Once a review is complete, and if the board reinstates Peterson’s license with no restrictions, Peterson’s license will remain on probation for three years.

Peterson has been licensed to practice in North Dakota since 1991, according to Houdek.