Drugging our kids: RX alliance rewards doctors as drug companies get richer

An Investigative report by the Los Angeles Daily News

The following is from a much larger article well worth reading:

An investigation by this news organization has found that drugmakers, anxious to expand the market for some of their most profitable products, spent more than $14 million from 2010 to 2013 to woo the California doctors who treat this captive and fragile audience of patients at taxpayers’ expense.

Drugmakers distribute their cash to all manner of doctors, but the investigation found that they paid the state’s foster care prescribers on average more than double what they gave to the typical California physician.

The connection raises concerns that Hernandez and many other unsuspecting youth have been caught in the middle of a big-money alliance that could be helping to drive the rampant use of psychiatric medications in the state’s foster care system.

“It sucks that the people marketed it that way, but that’s not that shocking. I’m more mad at the doctors for just going along with it,” said Hernandez, 22, who was prescribed as many as four of the drugs at a time as a foster youth in Southern California.

Overall, drugmakers reported payments to 908 doctors — well over half of those who prescribed psych medications to the state’s foster children, according to this news organization’s analysis of prescribing data and four years of pharmaceutical company payments compiled by the public interest journalism nonprofit ProPublica. And those who prescribed the most typically received the most, the analysis found.

The results provide the most comprehensive look to date at the pharmaceutical industry’s influence on the doctors who treat the 60,000 kids in the country’s largest foster care system — a lucrative target because Medi-Cal pays the bill with little scrutiny.

One Sacramento doctor raked in more than $310,000 in four years to give promotional speeches and an extra $8,500 in meals, records show. Another 224 doctors each got more than $500 in meals, and two of them each received more than $20,000 for travel. The biggest payments went for research, with two Southern California doctors each receiving more than $2 million to conduct drug company-sponsored trials.

Doctors who accept the drug companies’ offerings say they aren’t influenced, and the pharmaceutical industry defends its partnerships as a necessity for developing the lifesaving drugs of tomorrow.

“The kind of medical innovation that we have in this country wouldn’t happen without a robust dialogue between industry and physicians,” said John Murphy, assistant general counsel for the Pharmaceutical Research and Manufacturers of America.

But critics say the drug companies are disguising investments in the name of science to reward doctors who in turn boost the industry’s bottom line.

“These figures suggest these doctors are not looking out primarily for the kids’ interests,” said UCLA social welfare professor David Cohen, who has studied medication use in the foster care system and drug company influence. “They suggest many doctors are looking out for their financial interests, and we should all be wary.”

The findings are especially disturbing because of the growing evidence that psychiatric drugs are being overprescribed to California’s foster children despite their significant side effects, the subject of this news organization’s yearlong investigation “Drugging Our Kids.” The news organization previously reported that almost 1 in every 4 adolescents in California foster care has been prescribed psychotropic medications, often to manage troublesome behavior rather than treat the severe mental illnesses for which they are approved.

While the federal government has cracked down in recent years on how drug companies market powerful antipsychotic drugs to the elderly and children, the industry’s investment in courting doctors appears to still be paying off: California taxpayers spend more on psychotropic drugs than on any other kind of medication prescribed to foster children, according to a decade of Medi-Cal spending data revealed by this news organization in August.

This is only the tip of the iceberg

Regarding the two Shootings in Colorado

Currents reports are suggestive that Matthew Murray was influenced by psychiatric medication, as is too common this day in many public shootings:

At Abeyta's side was Peter Warren, the school's director. Warren said that when Murray came to the school early Sunday asking to stay the night, staff members did not recognize him.After Murray was identified by police, the school realized he had attended its training program in 2002. The Arvada school is a branch of an international missionary program that trains thousands annually.

Warren said school officials refused to assign Murray to a mission because of an unspecified health problem that could make such work unsafe. Warren would not elaborate, and he and Abeyta left without taking questions.

But this is not nearly enough evidence to say it was so, despite the odds in favor of such a conclusion. And to be fair, a person can be on unbalanced mind for reasons not having to do with psychiatric drugs. Uncommon, but it happens.

In court papers, police said Murray had written threatening letters to the school and spent many hours a day on the Internet as a computer student, the Gazette of Colorado Springs reported. [...] It also was unclear why Murray traveled the roughly 75 miles from the missionary school in Arvada to New Life Church, which has a Youth With a Mission branch office. New Life achieved notoriety last year when its founder, Ted Haggard, was accused by a former gay prostitute of trading drugs and sex.

Information is unclear at this time, and we await further reports.

Psychiatrist extradited to face charges in patient's suicide

As reported in The Coloradoan.

Dr. Christian Hageseth III of Fort Collins has been extradited to California to face charges that he illegally prescribed Prozac for a Stanford student who later committed suicide.

Hageseth, a psychiatrist, was to enter a plea Friday in San Mateo County, Calif., to one an count of practicing medicine without a license. However, the judge delayed the hearing until Tuesday so that she could consider defense motions filed earlier this week regarding Hageseth's bond.

Hageseth is expected to enter a not-guilty plea to the charge, San Mateo County Chief Deputy District Attorney Steve Wagstaffe said.

Hageseth was extradited from Nebraska, where in October he was arrested near Sidney during a traffic stop.

Authorities say Hageseth prescribed Prozac for John McKay through the online pharmacy USAnewRX.com. At the time, Hageseth’s restricted medical license did not allow him to give prescriptions.

Two months later, McKay killed himself. He was found with alcohol and the drug in his system.

Hageseth lost his license in Colorado in 1999 due to a relationship that led to his marriage to a former patient, Laurel Burson. However, in 2001, the state Court of Appeals reversed the Colorado State Board of Medical Examiners decision and reinstated Hageseth’s medical license. Still, under the conditions of his reinstated license, he was not allowed to write prescriptions.

Hageseth is being held on $500,000 bond.

Penalties in patient's suicide questioned

From the Denver Post

Five state employees were disciplined after the death of a mentally handicapped man at the Wheat Ridge Regional Center, but an attorney for the family questions whether the right people were punished.

One employee resigned in lieu of termination, two received 5 percent pay decreases for six months, one was counseled on employee expectations and another received a performance memo, according to information provided after an open-records request.

Brian Mattingley, 27, hanged himself at the center in the early morning of Dec. 17, 2005, after a long history of suicide threats and attempts, according to a lawsuit filed in August.

The lawsuit names the center's director, Sharon Jacksi, and an on-call psychologist in training, Joycelyn Lee, but Colorado Department of Human Services spokeswoman Liz McDonough said neither was disciplined.

Lee, who is still working under a licensed psychologist because she doesn't have her license, was a contract employee in 2005 but has since been hired full time, McDonough said.

Attorney Peter Harris, who filed the lawsuit for Mattingley's mother, Terri Wolfe, said Lee and Jacksi should have been disciplined. "If you're in charge, it falls underneath you," he said. "There should have been some sort of discipline. I think it's an institutional problem there."

McDonough disagreed. "It was a horrible tragedy, but based on review we did, we felt we held the appropriate people accountable," she said.

The lawsuit claims that staff failed to properly supervise Mattingley despite his care plan, which required wellness checks every 30 minutes. Lee spoke to Mattingley that evening, but she said he did not threaten suicide, the lawsuit says.

Harris said Lee should have done more than just talk to Mattingley by phone, considering his history.

McDonough said Lee was not disciplined because she was not told that Mattingley threatened suicide the night he died.

The document released by DHS lists the punishments handed out.

Stacey Larrabee, a health care technician at the center, was placed on administrative leave and resigned in lieu of termination in January 2006. She failed to perform bed checks.

Mary Pearson, a licensed psychiatric technician, was docked 5 percent pay for six months for false documentation of medication and failure to do visual checks between shifts. She has since retired, McDonough said.

Carla Juarez, a residential coordinator, also was docked 5 percent pay for six months, removed from the position of residential coordinator in training and made ineligible for promotion for a year for failure to do visual checks.

Joe Martinez, a health care technician, was counseled on employee code of conduct and job expectations because he did a solo check at shift change instead of doing so with another tech. McDonough said he has since left the center.

Carin Hagman, a licensed psychiatric technician II, received a performance memorandum for failing to inform Lee of Mattingley's suicide threats.

Another case illustrating the very bad side effects of anti-depressants.

As seen in this report

Victor Pimental received a five-year prison sentence Thursday and must pay $27,529 in restitution for stabbing his ex-girlfriend at a Grand Avenue bus stop near Safeway in Glenwood Springs.

"My heart goes out to her," he said with a shaky voice. "I don't know what happened that night. I don't know why ..."

Pimental, 54, pleaded guilty to second-degree assault as part of a plea agreement. He also originally faced charges of first-degree attempted murder, first-degree assault and felony menacing charges.

He said he takes full responsibility for his actions, that he's an alcoholic and depressed. He said he's been sober for six months and hopes to make better decisions through rehabilitation.

"He was taking Celexa," Pimental's attorney, public defender Garth McCarty said. "Which does cause some problems, especially when mixed with alcohol."

McCarty said some of the drug's side effects include manic depression, hallucinations and paranoia. He described the attack as a "complete mental or nervous breakdown" for Pimental. He added that head injuries to Pimental's frontal lobe could have affected Pimental's judgment.

Celexa is a brand name for Citalopram, commonly prescribed for depression.

Pimental's brother spoke on his behalf.

"I traveled 800 miles to be here," he said. "He is a great brother. He made some bad choices, and his injuries may explain why he couldn't stay on the right track."

He also mentioned unfortunate circumstances with family that caused great stress and led Pimental to drink. He said he hoped Pimental would be out of jail before their mother died.

"I can't see her going to her grave and not knowing her son's out of prison," he said.

Ninth Judicial District Judge Denise Lynch said Pimental stabbed his ex-girlfriend once in the back and once in the arm. The attack severed a radial nerve and caused permanent injury and a partial loss of movement in the woman's left arm, she added.

Lynch said she doesn't doubt that head injuries may have been a factor and that Pimental had a rough life.

"But I can't ignore the fact that this is a very serious crime," Lynch said.

Pimental will remain in the Garfield County Jail before being sent to a Department of Corrections facility. He's awaiting resolution of two DUI cases and a domestic violence case in the county.

Pimental was arrested on Dec. 11. Police said he contacted the victim on her cell phone as she waited at the bus stop on Grand Avenue near Safeway early in the morning. While she was on the phone, Pimental crossed the street and approached her from behind, pulled a knife and stabbed her. She managed to get away and ran into the store where she called police.

"I wake up every morning and go to bed every night and say a prayer for her," Pimental said before sentencing.

Attacks on menatl health staff rise at Western State Hospital, Psychiatric drugs blamed.

From a much longer article, as reported here Of course, the drug company reps say "not our problem, not our fault"

Violence has been a growing problem at Western State Hospital for years.

If present trends continue, one in four of the Lakewood mental hospital’s more than 1,700 workers can expect to be assaulted by a patient in 2007, according to the state Department of Labor and Industries.

For years, hospital administrators have blamed the violence on familiar causes: not enough staff members, not enough money and increased societal violence that leads to the admission of more-violent patients. But they don’t have the data to back up those assertions.

A News Tribune analysis of drug-prescribing trends at Western since 1999 finds another possible factor: Western is giving more patients psychiatric drugs with side effects that can include extreme agitation and aggression.

The drugs include newer antidepressants and newer anti-psychotics dubbed atypical anti-psychotics.

The newer drugs, which are expensive compared with older, generic alternatives, have been heavily promoted at the hospital by the pharmaceutical companies that make them. Sales representatives for those companies have logged about 1,200 visits to Western since late 2003, when administrators began tracking their activity.

Concerned about their influence on prescribing patterns, the hospital in March banned all drug company representatives from visiting the campus to meet with doctors.

Randy Burkholder, an associate vice president for Pharmaceutical Research and Manufacturers of America, the Washington, D.C.-based drug industry lobby group, acknowledged The News Tribune analysis, saying it’s a “great idea” to discover more about the impact of pharmaceuticals through original investigation.

“There may be something there, there may not be,” he said about the findings. But he cautioned that the analysis doesn’t prove cause and effect. Instead, it just hints at a possible association. Only additional research can make that determination, Burkholder said.

The link between changes in drug use at Western and recent increases in violence “is very plausible,” said Dr. Stefan Kruszewski, a Harvard-trained psychiatrist and an expert on the side effects of anti-psychotic drugs who is on the faculty at Eastern University, outside Philadelphia.

“There is a significant relationship between restlessness and agitation induced by medicine and the propensity for violence,” Kruszewski said.

Western has never studied the idea that changes in drug use could contribute to increased violence, said Dr. Roger Jackson, the hospital’s acting medical director and an employee there since 1993.

Western is not alone in that regard.

“This has not been adequately studied” at any psychiatric hospital, Kruszewski said. “Most studies done on (psychiatric) violence assume violence is secondary to the illness or the surroundings, or because of lack of staff, money or social structures.”

Those assumptions, which have dominated internal and state agency violence studies at Western for more than a decade, do not hold up under analysis.

Since 1999, the staffing ratio of ward workers to patients has improved from 1.18 workers for every patient to 1.34 workers per patient in 2006.

Funding has increased about 50 percent overall – going from $106 million in 1999 to $156 million in 2007 – and has kept pace with medical inflation.

Hospital administrators don’t offer statistical evidence that society has become more violent, leading to a more violent patient population. Meanwhile, violent crime in the areas from which Western draws its patients has dropped significantly, according to U.S. Department of Justice statistics.

What does correspond with the increase in violence is the roughly 35 percent increase since 1999 in the use of drugs that a hospital pharmacy handbook and drug experts say are more likely than similar medications to induce agitation and aggression, The News Tribune analysis indicates.

By the end of 2006, there was roughly one order for these drugs for every patient at Western.

Also with the article is this list

SOME DRUGS WITH AGITATIVE SIDE EFFECTS

Here are some anti-psychotic and antidepressant drugs more likely than others in their class to cause agitating side effects such as restlessness, anxiety and insomnia. Taken as a group, there has been about a 35 percent increase in orders for these drugs at Western State Hospital since 1999. There’s also been a steady increase in assaults on workers over that time. Western averages about 900 patients a day.

Atypical anti-psychotics

Drug Manufacturer Orders on Dec. 6, 2006

Risperdal Janssen 307

Geodon Pfizer 118

Abilify Bristol-Myers Squibb 82

Typical anti-psychotics

Haldol Ortho-McNeil, generic makers 98

Prolixin Bristol-Myers Squibb, generic makers 26

Navane Pfizer, generic makers 6

Antidepressants

Zoloft Pfizer, generic makers 74

EffexorWyeth, generic makers 38

Prozac Eli Lilly, generic makers 37

Wellbutrin GlaxoSmithKline, generic makers 22

Cymbalta Eli Lilly 20

Doctor can be tried for out-of-state prescription in suicide case

from the San Mateo Daily Journal

A Colorado doctor who filled an online Prozac prescription for a 19-year-old Stanford student who later committed suicide can be tried in San Mateo County for practicing medicine without a license, an appellate court ruled.

The decision means psychiatrist Dr. Christian Ellis Hageseth III, 65, can be extradited from his Colorado home back to San Mateo County where he has a $500,000 arrest warrant. The court’s ruling dissolved a stay of Hageseth’s prosecution, paving the way for prosecutors to pick up where they left off last August.

Judge Carl Holm refused to dismiss the case on grounds California has no jurisdiction to try Hageseth under state law but defense attorney Carleton Briggs appealed. Briggs argued prosecuting Hageseth opens the door to trying thousands of out-of-state physicians who participate in so-called telemedicine and beyond.

“The key seems to be if the practitioner knew the patients resided in California but the decision doesn’t seem to limit it just to telemedicine,” Briggs said. “There are potentially thousands of practitioners who can be affected.”

The court held that Hageseth is liable if found to commit a crime “in whole or in part” within the state, according to the opinion by Presiding Justice J. Anthony Kline.

Hageseth should have known state authorities would not take lightly his filling a California prescription without a license, Kline said.

But Briggs said the ruling is creating new law, meaning there was no way for Hageseth to know previously about the responsibility.

Hageseth is charged with one felony count of practicing medicine without a valid California license. A conviction can carry up to three years in prison.

In June 2005, John McKay, a freshman at Stanford University and former student at Menlo-Atherton High School, purchased 90 capsules of generic Prozac via credit card at the online pharmacy site USAnewRX.com which was then shipped from the Mississippi-based Gruich Pharmacy Shoppe.

Online sites like the one used by McKay do not require a physical examination prior to receiving a prescription. Instead, the buyer fills out an online questionnaire which a doctor is supposed to review before signing off on the drugs.

According to previous news reports, McKay requested the drug to treat moderate depression and adult attention deficit disorder. He reportedly wrote on his application that he had taken the drug before and was not suicidal.

Hageseth reportedly signed off on the prescription of flouxetine without a consultation. On Aug. 2, McKay committed suicide by carbon monoxide poisoning, reportedly with alcohol and flouxetine in his system.

The following February, McKay’s parents, David and Sheila, filed a federal lawsuit against Hageseth and the pharmacies, alleging negligence and wrongful death.

Meanwhile, the Medical Board of California launched its own investigation and the San Mateo County District Attorney’s Office filed criminal charges last May.

At the time of McKay’s online purchase, Hageseth had a restricted medical license at the time because of an unrelated relationship with a patient he later married and was not allowed to fill prescriptions. He currently does not have a Colorado medical license because it was suspended after the charge, Briggs said.

The McKay’s federal lawsuit is still pending but it along with the criminal case is being watched by online pharmacy critics who believe it is poorly regulated.

Hageseth shouldn’t have filled a prescription without a good-faith examination, Briggs conceded, but that is not the issue at hand.

“The charge is practicing without a license. What he did was write a prescription and from beginning to end the entirety of the act occurred in Colorado,” Briggs said.

The State Attorney General’s Office filed a brief on behalf of the Medical Board noting it receives a number of complaints about Internet prescriptions filled by out-of-state doctors and has tried limiting the activity, according to the appeals court.

Briggs said he and Hageseth will decide in the next few days first if they’ll fight the decision in court and, if not, if he will wait for extradition or come voluntarily to California.

Briggs is hopeful local authorities will allow Hageseth to remain in Colorado on his own recognizance.

Web Prescription of Anti-Depressants Tests California Medical License Law

As seen at Law.com

[snippet]

Two years ago, Christian Hageseth logged on to the Internet in Colorado and prescribed anti-depressant drugs to a Menlo Park, Calif., teenager with a history of mental illness and alcohol abuse. A few months later, 19-year-old John McKay killed himself in his family home.

Upon learning that Hageseth had treated McKay, and that he didn't have a license in California, state medical investigators urged local prosecutors to charge him with a felony. Last year they did, accusing him of practicing without a California license. The maximum penalty, according to the prosecution, would be three years in state prison and state fines.

And although Hageseth's lawyer and deputy district attorneys in San Mateo County, Calif., disagree on many aspects of the case, this much is clear: The 66-year-old Hageseth would be an easier target for prosecutors had he run his virtual doctor's office inside California state lines.

Now Hageseth -- who had a restricted license in Colorado when he prescribed McKay's medication, according to court documents -- is trying to get the case dismissed, claiming that the state courts lack jurisdiction to try him under California law. Though a San Mateo County judge refused his request, Hageseth's attorney, Santa Rosa, Calif., lawyer Carleton Briggs, has persuaded the 1st District Court of Appeal to consider issuing a writ that would overturn that decision.

Briggs claims that if the 1st District agrees with the government's application of medical licensing laws, thousands of out-of-state doctors could face felony prosecution.

"The decision in this case will shape the future of telemedicine [in California]," Briggs wrote in his petition to the appeal court.

[...]

Susan Penney, a lawyer at the California Medical Association, said she thinks it's uncommon for doctors to prescribe medication without first meeting a patient face to face.

California state law requires medical practitioners to conduct a good-faith exam before prescribing medication, Penney said. The CMA declined to weigh in with an amicus brief on Hageseth's behalf, she said, because Hageseth's position appears to be inconsistent with that requirement.

"We do not believe that we can support [Hageseth's] underlying position ... that it's appropriate to prescribe without a good-faith prior exam," she said.

Full article at the Link - Note: paragraph 20 states "After transmitting his credit card number and some details about his medical history, McKay placed an order for fluoxetine, a generic alternative to Prozac."

What Caused Columbine?

A column from 1999 on the causes of Columbine, by Phyllis Schlafly. Regardless of what you think about her politics, there are several details that came out that are exposed here, and which are worth noting. She doesn't blame it on the liberals, BTW.

Everybody's looking for the causes of the terrible tragedy at Columbine High School in Littleton, Colorado, and for ways to prevent such horrible happenings in the future. Hillary Clinton has volunteered her intuition that "part of growing up is learning how to control one's impulses."

Putting aside the point that most of us don't have impulses to go on a killing rampage, who is going to teach kids to control their impulses? Certainly not the "village" (i.e., the government or government schools), which Mrs. Clinton believes should have prime responsibility for raising children.

For the past 25 years, the prevailing dogma in public school teaching has been Values Clarification (as in the tremendously influential 1972 book of the same name by Sidney Simon). That means teaching students to reject "the old moral and ethical standards" and instead create "their own value system."

Values Clarification teaches that, since there are absolutely no absolutes, students can make their own decisions about behavior instead of looking to God, the Ten Commandments, parents, church, or other authority that teaches that behavior should conform to traditional morality. Indeed, Eric Harris created his "own value system."

Modern public school teaching exalts "tolerance" of other people's behavior as the highest virtue, and "self-esteem" as education's principal objective. We are forbidden to be "judgmental" about the behavior of others when they indulge in their impulses instead of controlling them.

As best described by the late Senator (and former university president) Sam Hayakawa, the public schools adopted "an educational heresy . . . that rejects the idea of education as the acquisition of knowledge and skills . . . and regards the fundamental task in education as therapy." These "therapy" courses opened the floodgates to all sort sorts of psychological courses, one of the weirdest of which was Death and Dying.

In 1987 Colorado Eagle Forum produced a two-hour video in which student Tara Backer spoke at length about the relentless focus on death, dying and suicide in her sophomore classes at Columbine High School in Littleton, Colorado. She and several of her classmates attempted suicide as a result of this depressing teaching, and it took them many months to recover from the experience.

Tara was subsequently interviewed for an ABC 20/20 program in 1988, where she said, "I had thought about [suicide] as a possible option for a lot of years, but I never would have gone through with it, never, because I wasn't brave enough. The things that we learned in the class taught us how to be brave enough to face death."

She added, "We talked about what we wanted to look like in our caskets." ABC's Tom Jarriel concluded the segment by asking if these courses "suggest death as an answer to adolescent problems."

The 20/20 segment showed morbid visuals of student visits to cemeteries, embalming labs, and crematoriums, and told about picking some bones out of the ashes. It was clear that Tom Jarriel and Hugh Downs thought that death ed was bizarre.

An investigative piece in Atlantic Monthly the same year confirmed that death and dying courses are given in "thousands of schools," often sneaked into health, social studies, literature or home-economics courses without parents' knowledge. The magazine described how these courses include requiring students to write their own obituaries, epitaphs, wills, or suicide notes, and to decide how they would prefer to die, have their body disposed of, and who they want for pallbearers.

Unfortunately, parents in Illinois, Michigan and Florida have attributed their sons' suicides to public school courses in death, dying, or suicide.

Death ed is apparently still taught at Columbine. One student told the Associated Press that shooter Eric Harris was asked to write out his will as part of a class assignment.

Littleton, Colorado has been a focus for many years for all the trendy "edufads" such as Outcome Based Education (OBE). In 1993, parents rebelled against this dumbing-down process and, by a two-to-one vote, elected a "back-to-basics" school board.

The teachers union hit back in the following election and retook control of the Littleton schools. The union was supported by People for the American Way, who used the usual negative slurs, accusing those opposed to OBE of being "fundamentalists" and part of the "religious right."

Some politicians are using the Columbine tragedy to push their liberal political agenda, such as gun control. That's obviously not the answer since killers Harris and Klebold violated 18 current federal and state gun control laws that, had they lived, would have kept them locked up for the rest of their lives.

We are paying a terrible price for allowing public school curricula to teach students to create "their own value system" instead of respecting moral laws such as "Thou shalt not kill." It's time to overturn the foolish Supreme Court decision that bars the Ten Commandments from public school classrooms.

Another ex-mental health worker named in tax-fraud scheme

Via the Denver Post

A former health care technician at the state mental hospital is among those indicted in a federal tax-fraud scheme that includes patients at the hospital.

Jenice Melonas, 26, of Colorado Springs, who resigned from her job at the institute in February, is charged in a racketeering enterprise that netted about $25,000 a month.

If convicted, she could face up to 24 years in prison.

Melonas is the second former staffer at the Colorado Mental Health Institute implicated in the March 16 indictment by a Pueblo grand jury.

The indictment alleges that the tax-fraud scheme used the Social Security numbers of patients at the institute to file false federal tax forms.

Those allegedly involved in the fraud falsely claimed some patients at the institute were dependents of other patients and then made claims for payment of the Earned Income Tax Credit.

Richard Gerald Madrid, who retired in December from his job as recreational therapist, is identified in court documents as a member of the criminal enterprise, but he was not indicted.

"I can't tell you anything," Madrid said Wednesday.

Melonas, who was released from the Pueblo County Jail on a $50,000 bond on March 19, could not be reached.

The grand jury also indicted Raul Caraveo, a patient at the institute, who is accused of demanding that half of the tax proceeds go to him, according to the indictment. He is being held at the Pueblo County Jail on $50,000 bail.

The third person indicted was Kenneth Fritz, 45, who in the summer of 2004 escaped from the institute after he was permitted to attend a family reunion in Cleveland. After his escape, his status was changed to "unconditional release" at the urging of his treatment supervisors.

The indictment names six other patients at the institute as participating in the racketeering, but they were not indicted.

Crimes Reported To State Not Forwarded For Prosecution - Psychiatrist Admits To Having Sex With Patients, But Never Charged

As reported on theDenverChannel.com

A psychiatrist who has admitted to having sex with female patients will never be prosecuted for his crime.

7NEWS Investigator John Ferrugia has been looking into previous actions taken by the state medical board but was unable to find the exact number of doctors who have committed similar crimes because the state board records are sealed.

When Dr. Kim Nagel surrendered his medical license in 2004, he admitted to having sex with at least two of his female patients, 7NEWS reported.

Yet since neither the medical board nor the attorney general's office reported Nagel's apparent criminal behavior to the local district attorney, it is now too late for prosecution.

Nagel was investigated by the state medical board after one of his patients, Tina Garcia, filed a complaint in 2003.

Garcia said he had diagnosed her with a sleeping disorder.

"I was incredibly vulnerable because I was ... weakened from a lack of sleep," Garcia said. "I think I would have clutched at any promise to help me break that cycle."

Garcia claims that Nagel manipulated her into depending on him by using intimate facts she had revealed to him during therapy sessions. This dependence led to sex.

"I remember opening the door and he had a vacant stare in his eyes and never spoke to me. He just pulled my flannel nightgown off, [and] had sex with me on the floor. Never said a word," Garcia said.

Eventually, Nagel moved in with Garcia for a short time. Garcia said she believed in him.

"There was no doubt, if I wanted to be healed ... that Dr. Nagel was the answer," she said.

As their affair ended, documents show that Nagel wanted to pay Garcia $300,000 to keep quiet and not report him to the state medical board.

When Garcia did report Nagel to the state medical board, she found out that she was not the only woman involved with the married doctor. He had admitted to having sex with another patient as well, which is a criminal felony in the state of Colorado.

"I was absolutely destroyed," Garcia said.

7NEWS found another sanction against Nagel in 1995.

Yet neither the medical board nor the state attorney general -- who represents all state agencies -- ever referred any of Nagel's charges to the Denver district attorney for prosecution.

"There is no requirement that you inform the victim that there is a possible criminal activity which he or she can report? And there's no requirement that you report it yourself?" Ferrugia asked Colorado's Chief Deputy Attorney General Cynthia Coffman.

Coffman replied, "That's correct."

Despite there being no reporting requirement, Coffman believes that Garcia was informed of her rights in this instance. Coffman believes that her office told Garcia that she could report the crime to the district attorney's office.

"I believe we spoke to the victim, in that particular case who you have spoken to, and told her that she could make a referral and suggested that she speak to the district attorney in Denver," Coffman said.

But Garcia said she thought the attorney general would be the one to file the complaint.

"I presumed based on my conversation with the attorney general's office that formal criminal charges would be placed [and that] he would be listed as a repeat sexual offender," Garcia said.

Coffman explained that it "has not been the policy in the past" for the attorney general's office to directly report any crimes that were reported to them.

In fact, a 2005 audit shows that in the 18-month period prior to December 2004, only two of 260 known criminal offenses were directly referred for investigation by the attorney general or by the Colorado Department of Regulatory Agencies.

When Garcia finally approached the Denver district attorney, Nagel could not be prosecuted because the three-year statute of limitations had run out.

Garcia said, "Because Dr. Nagel was never criminally charged, Dr. Nagel can reapply for a medical license, not just in Colorado, but anywhere in the nation."

When asked if he should get his medical license back, Nagel said he believes that he should.

As a result of Ferrugia's investigation, Coffman said her office and the Department of Regulatory Agencies are now discussing a new policy involving formal notification to potential victims where a crime may have already been committed.

Parents sue University of Colorado over death of son, implicate Psych Medication

As seen in the Colorado Daily News

Ben Stattman was one month shy of graduating from CU-Boulder when he was found dead in his apartment on April 13, 2005.

The 28-year-old molecular biology major bled to death from self-inflicted wounds.

Now his parents are suing Wardenburg Health Center, saying the CU health center misdiagnosed their son's mental illness and prescribed pills that pushed him over the edge.

In October, Ken and Carol Stattman of Colorado Springs filed a malpractice suit against CU in Boulder County District Court, claiming Wardenburg wrongly diagnosed their son with attention deficit hyperactivity disorder and prescribed medication that led to his suicide.

CU will file a formal response to the suit early next week.

The university was “heartbroken when Ben Stattman took his life,” said CU System spokesperson Michele McKinney, but is not responsible for his death.

“The university believes that its health-care providers are not responsible for his tragic suicide and will be asking the court to dismiss the lawsuit in the upcoming weeks,” said McKinney.

Ken Stattman says Wardenburg's alleged misdiagnosis and prescription led to Ben's downward spiral.

“They were treating him for a condition he never had, which in our view caused him to have this breakdownŠ” said Ken Stattman.

The “breakdown” Ken is referring to happened six months before Ben's suicide, when Ben was hospitalized at Boulder Community Hospital for three to four days.

According to Ken, BCH found that Ben had a psychotic disorder.

But after Ben was released from the hospital, Wardenburg continued to treat him for ADHD, not psychosis or depression, according to Ken.

McKinney says Ben wasn't a Wardenburg patient in the year before he killed himself.

“In April 2004, the Wardenburg Health Center discharged Benjamin as a patient,” said McKinney.

Ken says Ben continued to fill a prescription from Wardenburg.

“His medication is more recent than that,” said Ken.

Wardenburg had prescribed Ritalin and Straterra for Ben's ADHD diagnosis. Bottles of the prescription pills were found next to his body.

Toxicology reports showed Ben “did not have anything elevated (in his blood stream) other than what was prescribed,” at the time of his death, said Ken.

The family's attorney Tom Beltz contradicted earlier reports that said the Stattmans are asking for more than $100,000.

“At this point there's not a specified amount that we're requesting,” Beltz said.

Beltz said that some Colorado law provisions place a cap on the amount of claims that can be made against a government entity, and he's investigating whether or not those provisions apply to CU.

A lifelong resident of Colorado Springs, Ben served in the Navy for three years immediately after high school, touring through the Mediterranean, the Baltic and the Caribbean. He moved back to Colorado Springs after his service and lived with his parents while pursuing a general studies associate degree at a local community college.

Ken said he never saw any signs of depression or mental illness in Ben when he lived at home.

After graduating from community college, Ben came to CU-Boulder to complete an undergraduate degree.

“He performed very well at school and worked in the summer,” said Ken. “He didn't appear to be out of the norm in any way.”

Ken declined to say what triggered Ben's first visit to Wardenburg.

Ben lived alone in an apartment on Aurora Avenue, where he was found dead.

He had been scheduled to graduate that May.

Had he lived, he planned on working in a biology research lab while pursuing an advanced degree, said Ken.

Ben's parents continue to live in Colorado Springs. His sister Rachel, who is one-and-1/2 years older, lives in Lakewood, Colo.

Ken said that filing the lawsuit - and re-hashing the past - has been emotionally draining.

“We're not trying to remember this, we're trying to get over it,” he said. “It's very difficult to lose a child.”