Child molestation case against child psychologist Kenneth McPherson is moving out of limbo

From the Augusta Chronicle (See the link for a photo)

Psychologist Kenneth McPherson, 58, was named in two indictments that accuse him of committing acts of child molestation in 2005, 2008, 2010 and 2011. McPherson has pleaded not guilty in Richmond County Superior Court.

Since 2011, the criminal cases have been placed on trial calendars but later postponed. In January, Assistant District Attorney Rex Myers and attorney Kirk Gilliard presented an order to Chief Judge J. Carlisle Overstreet to put McPherson’s cases on the dead docket because the prosecutor could not find several necessary witnesses.

Although the order was signed and dated Jan. 12, it wasn’t filed with the clerk’s office until Wednesday, when a motion requesting the cases be removed from the dead docket was also filed. According to the motion filed by Assistant District Attorney Natalie Paine, the witnesses have been located and interviewed.

Although McPherson wasn’t indicted until 2011, parents of some of his patients warned authorities that something was wrong in 2005. The mothers of two boys reported inappropriate sexual behavior that the children said they learned at McPherson’s office. But one of the boys was unable to communicate with a forensic child interviewer, and the second child’s statement was not thought to be strong enough to file charges.

In early 2011, however, more specific allegations were brought forward and sheriff investigators obtained search warrants for McPherson’s Central Avenue office. Investigators reported finding sexually explicit materials and a photograph of a child dressed only in underwear that had been taken in the office.

McPherson was indicted June 7, 2011, on seven counts of child molestation and one count of sexual exploitation of a minor. Overstreet, who is assigned to preside over the case, granted McPherson’s release on a $200,000 bond Aug. 16, 2011.

McPherson was licensed in 1990 in Georgia to practice psychology. His license expired Dec. 31, 2012, according to the Secretary of State’s office.

Couple sue psychiatrist, claiming he tried to seduce the wife.

I thought I had reported on this case earlier, but it appears not. There are a number of similar cases which we have previously reported in Georgia. As reported in the Atlanta Journal Constitution over the weekend. Main allegations given below, with more info at the link

An Alpharetta couple who sought out a psychiatrist to help their 4-year-old son contend they were emotionally victimized by their therapist's efforts to break up their marriage and seduce the wife.

Beverly Wilhelm contends in a lawsuit filed late last month in Fulton County State Court that Dr. Jonathan Lauter's improper advances drove her to depression. Her husband, Madison Wilhelm, alleges Lauter preyed upon his insecurities in therapy sessions.

The couple's lawyer, William G. Quinn of Decatur, said the case represents a horrific violation of trust even though Lauter and Beverly Wilhelm never had sex.

"In this case, my client came to me feeling decimated emotionally and betrayed," Quinn said. "Psychiatric literature confirms that when a patient feels they have been exploited by a trusted professional therapist that the psychological consequences are very similar to incest or child molestation."

Lauter, who moved to New York in 2006, was practicing in Roswell at the time. He acknowledged the Wilhelms were his patients and that Beverly Wilhelm confessed her love for him during a therapy session but said he did nothing wrong.

[...]

The lawsuit doesn't contend that Lauter consummated the relationship, just that he took advantage of a confused patient by pushing her toward romance, even pursuing her from afar after he moved.

The suit claims the Wilhelms went to Lauter in August 2005 thinking their son had issues adapting to a new sibling. The therapist saw them for about six months before deciding he no longer needed to treat the boy. By early 2006, Lauter began couples counseling for the Wilhelms and eventually individual sessions for both.

By April 2006, Beverly Wilhelm confessed to Lauter she had fallen in love with him, the suit says.

"Beverly, you have to know that I feel the same way about you. Nothing exists in a vacuum," the suit contends Lauter told her. The suit alleges Wilhelm wanted to break off therapy, but Lauter convinced her to continue the relationship.

Lauter "had targeted her and had embarked upon a plan to sexually seduce and exploit her in order to meet the defendant's own personal sexual and emotional needs," the suit states.

The suit contends that in June 2006 he told Wilhelm, "I would love to make love to you. I have always been attracted to you. I saw doors opening when you told me how you felt."

Lauter moved to New York in August 2006 but continued to call her in Alpharetta, including an invitation to rendezvous in New York; the contacts continued through July 2007, when Lauter told Wilhelm he no longer matched her feelings, the suit says.

"Rather than strengthen her marriage, and increasing her self-esteem, the defendant caused the plaintiff to feel unworthy, depressed, isolated and at times suicidal," according to the suit.

It further claims Lauter was counseling her husband, in part, because of stress from a prior marriage that ended after unfaithfulness. Rather than helping him, Lauter was trying to undermine the couple's marriage, the suit maintains.

Mental Health Screwup: Girl Must Repeat High School

Another fine example of how the mental health industry keeps screwing things up, this time in the realm of public education. Seems like a typical bureaucratic attitude of typical attitude of "Not Our Fault, Not Our Problem".

From this report from WGCL-TV, CBS 46, Atlanta Georgia.

A Gwinnett County teenager will have to spend another four years in high school while other teens her age go to college, her family said Tuesday.

Daphne and Brian Adams said that several years ago, Gwinnett County schools improperly placed their daughter in classes for the mentally impaired, instead of addressing her language disability.

The school district has told the family that the girl must start over to get a diploma. Her family said their daughter, who is 18, is embarrassed to be in classes with students who are 13 and 14.

“The track that she's on, she's set up to fail,” said Daphne Adams.

Special education attorney Chris Vance said Tuesday that the school system should have realized their mistake. Tests have shown that the girl has an average IQ score of 91.

Her parents said they have spent their retirement savings to help their daughter catch up. They said they want Gwinnett County to reimburse them and pay for private schooling until their daughter graduates.

“She wants a real diploma. She doesn't want a piece of paper,” Adams said.

Tuesday, the school district issued this statement: "There are legal constraints on what a school system can say about individual students. That said, we can assure you that processes and procedures are in place to address students' educational needs and placement."

Parents file suit: Agency cleared psychiatric hospital despite autistic boy's deep cuts, dehydration.

An extensive article detailing neglect in a psychiatric hosptial, as reported by the Atlanta Journal Constitution. A truly horrifying case.

The ambulance crew found Vince Allen on the hospital floor, curled into a fetal position, languishing in a soiled diaper. The 15-year-old, an ambulance technician later wrote, was covered with open wounds from "severe body mutilation."

When the technician asked what happened during Allen's 12-day stay at the state psychiatric hospital in Atlanta, a nurse said, "Well ...," and shrugged.

At Hughes Spalding Children's Hospital, where the ambulance crew took Allen for treatment, a physician described Allen as "emaciated." He was dehydrated. His kidneys had failed. Bruises and cuts covered his head, his chest, his abdomen, his legs, his neck, his buttocks. Several wounds, doctors wrote, were "superinfected" —- so badly, they had to be drained surgically.

Deep, black-crusted wounds and inflamed scratches ran across his body, photographs taken at Hughes Spalding shortly after Allen's admission in January 2006 show. Even his teeth were caked with blood.

The agency that operates the state's seven psychiatric hospitals twice documented Allen's precipitous decline. Yet, in separate investigations, it cleared employees at Georgia Regional Hospital/Atlanta of wrongdoing.

"Unsubstantiated," the agency concluded about allegations of neglect and abuse. "Lack of sufficient evidence."

The injuries to Allen, who is autistic, required 36 days of treatment at Hughes Spalding. Last week his parents sued the agency, the state Department of Human Resources, claiming the boy was "neglected and mistreated to the point of death" at Georgia Regional.

What happened to Allen at Georgia Regional reflects a pattern of poor medical care at the state hospitals. An investigation by The Atlanta Journal-Constitution found that at least 115 patients died under suspicious circumstances and that authorities substantiated almost 200 cases of patient abuse from 2002 through 2006. As many as 21 more questionable deaths occurred in 2007, the newspaper recently reported.

A state-funded study recently questioned the quality of care in the chronically overcrowded and understaffed facilities and recommended more hiring, better pay and closer attention to medical treatment.

What happened after Allen left Georgia Regional illustrates another persistent failing in the state hospitals: deficient investigations into alleged maltreatment or abuse. The Journal-Constitution's review of hundreds of cases found that officials rarely call in police or other outside agencies and often dismiss complaints before compiling all pertinent information.

In Allen's case, the investigator relied only on Georgia Regional's employees and files. The investigator did not examine records from Hughes Spalding or interview doctors there. Her report makes no mention of the photos of Allen's injuries.

A DHR spokeswoman, Dena Smith, declined to comment, citing the pending lawsuit and privacy regulations.

The lawsuit, Allen's medical file and other documents depict grim conditions in the state hospital.

Allen, who is virtually mute, was bathed just twice at Georgia Regional. He never brushed his teeth. His arms and head unrestrained, he scratched and gouged and bit himself over and over. Open sores went untended. When a child protective caseworker visited, Allen was lying half-naked on the floor.

He looked, the caseworker wrote later, as if he had been "whipped."

There is much more at the link

Case against psychiatrist unfolds - Shrink accused of molesting patients at Gwinnett clinic

As seen in the report, more than one doctor has had disciplinary problems at this fine facility. From the Atlanta Journal Constitution

Dr. Mohammad Qureshi seemed typical of the psychiatrists at Georgia's state mental hospitals.

He was young, with just a few years' experience. He trained at a foreign medical college. And he was willing to work for the relatively low pay the state offers to those who treat the extremely difficult patients who occupy its psychiatric facilities.

But for five months this year while working at Northwest Georgia Regional Hospital in Rome, Qureshi was under suspicion for sexually molesting patients on his second job 90 miles away.

Still, he continued seeing patients at the state hospital until police arrested him in late September. At least 12 women have told authorities that Qureshi fondled them during psychiatric examinations at a Gwinnett County clinic.

The psychiatrist's arrest prompted an investigation at Northwest Georgia Regional. But no patients there made allegations against him.

"There is no evidence of any misconduct by Dr. Qureshi," said Kenya Bello, a spokeswoman for the Department of Human Resources, which runs the state hospitals.

Qureshi, 45, of Lawrenceville has pleaded not guilty. He is free on bond, awaiting trial on sexual assault charges, facing the possibility of years in prison. DHR fired Qureshi from Northwest Georgia Regional, and the state medical board could suspend or revoke his license.

The case is playing out as officials face questions about the quality of medical care in the seven state psychiatric hospitals.

The U.S. Justice Department is investigating whether poor care in the facilities violates the civil rights of patients. Meanwhile, a panel appointed by Gov. Sonny Perdue is examining the role of the hospitals' staff physicians in creating and sustaining dangerous conditions, among other issues surrounding mental health care in Georgia.

The inquiries followed articles in The Atlanta Journal-Constitution reporting that at least 115 patients died under suspicious circumstances from 2002 through 2006, many after questionable medical treatment.

Qureshi's lawyer, Andrew Margolis, did not respond to requests for an interview. He proclaimed his client's innocence at a hearing last month.

Qureshi, a native of Pakistan, is a U.S. citizen, according to his state personnel records. He graduated from Sindh Medical College at the University of Karachi in 1986 and trained at the University of Connecticut from 1999 to 2003. Files on his medical licenses in New York and Georgia do not show where he practiced during the 13-year interval.

Qureshi came to Georgia in 2006 after working for 19 months at a state mental hospital in Ogdensburg, N.Y., on the Canadian border.

At the St. Lawrence Psychiatric Center, hospital administrators received no complaints about Qureshi's behavior, said Dr. Hari Sanghi, the clinical director.

"Nothing," Sanghi said. "We don't have any adverse record on him. He was doing his job properly. We did not see any problems."

Qureshi left the New York hospital, Sanghi said, to be near his parents after they moved to Georgia.

He went to work at Northwest Georgia Regional in November 2006. His annual salary was $108,000 for a 32-hour work week — a significant cut from the $145,000 a year he earned in New York.

About the same time, Qureshi took a second job with the Gwinnett-Rockdale-Newton Community Service Board, which operates several mental health clinics in three counties outside Atlanta.

In April, according to recent court testimony, two female patients at the community service board's Lawrenceville clinic complained that Qureshi had touched them inappropriately. The board's director warned Qureshi but kept him on the staff, a police detective testified.

Qureshi's personnel file does not reflect whether anyone at the community service board notified state officials about the allegations. In fact, the file makes no mention of Qureshi's second job in Rome.

By September, complaints about Qureshi had escalated.

A 43-year-old woman alleged that during a psychiatric session, Qureshi had instructed her to disrobe and then fondled her. Over the next few weeks, 11 more women came forward to Gwinnett authorities with similar allegations.

Northwest Georgia Regional suspended Qureshi shortly after his arrest on Sept. 28. He remained on the state payroll until Oct. 22, three days after a Gwinnett County magistrate judge bound the case over to Superior Court for trial.

State personnel officers thoroughly checked Qureshi's background and credentials before hiring him, said Bello, the DHR spokeswoman. Sanghi, who was Qureshi's supervisor in New York, said he gave him a positive recommendation when Georgia officials called for a reference.

Past ethical lapses do not necessarily disqualify physicians from working in Georgia's state hospitals.

At least five doctors now employed in the facilities were hired despite having been disciplined for drug abuse. Another had temporarily lost his license because of alcohol use. Yet another had been punished for sexual misconduct with two of his patients at a private psychiatric hospital.

Feds investigating NW Georgia Regional Hospital

From the Rome News Tribune

Northwest Georgia Regional Hospital is under investigation by the Department of Justice, officials at the facility have confirmed.

Superintendent of the state run mental health hospital Karl Schwartzkoph confirmed Thursday morning that the federal investigators were at the facility.

Schwartzkoph said the investigation was a result of recent statewide news reports.

Recent reports have focused on alleged deficiencies in Georgia’s mental health treatment centers.

Also, in October a psychiatrist employed at the facility —Dr. Mohammad Uzair Qureshi, 45 — was arrested on charges of sexual battery and sexual assault by a practitioner of psychotherapy against a patient. Around a dozen patients have claimed Qureshi fondled them during sessions.

“They are there to look at the hospital system to determine if any areas need to be improved,” said Department of Human Resources Spokeswoman Kenya Bello. “They feel like there are areas to look into at this point, they haven’t decided if there are any problems.”

Bello said these investigations are not unique to the Rome facility

More come forward to accuse psychiatrist

From this report in USA Today

A dozen women have come forward claiming a Lawrenceville psychiatrist fondled them during patient consultations, a Lawrenceville police detective said Friday.

"I'm dealing with an influx of women," Detective Brad Daugherty testified in a probable-cause hearing Friday for Dr. Mohammad Uzair Qureshi.

Qureshi, 45, faces charges of sexual battery and sexual assault by a practitioner of psychotherapy against a patient, a felony punishable by up to five years in prison and a $5,000 fine.

A Gwinnett County magistrate judge Friday granted Qureshi a $75,000 bond provided he surrenders his passport, agrees to have no unsupervised contact with patients and consents to being monitored by a GPS device.

Qureshi was first arrested earlier this month after a female patient at the Gwinnett-Rockdale-Newton Community Services Board in Lawrenceville complained he touched her inappropriately during an appointment. He spent one night in jail before being released on $33,200 bail.

Since then, police have interviewed 11 more women with similar accusations, Daugherty said.

Qureshi was jailed again last week based on some of their statements.

Even though a judge granted him bond, Qureshi will not be able to practice psychiatry while the case is pending, according to his lawyer Andrew B. Margolis. His employer, Northwest Georgia Regional Hospital has suspended Qureshi until the case is settled, Margolis said.

Qureshi wore a green prison jumpsuit in court, his demeanor unassuming, and he appeared almost bookish in wire-framed glasses.

The detective testified that Qureshi used his position of authority as a doctor to manipulate some female patients into removing their shirts and bras.

He asked them if they were feeling anxious, Daugherty said, which was a segue into touching their arm for a pulse or having them lift their shirt and bra so he could check their heart rate with a stethoscope.

"They went along with it even though they were questioning why he needed to touch their breasts. Especially when their heart is not in either one of them," Daugherty said.

Daugherty said the director of the community services board warned Qureshi in April about touching two other patients inappropriately.

After his initial arrest, Qureshi was fired from the community services board, according to its lawyer.

The lead defense attorney said Qureshi is innocent and the case will not stand up in court.

"To call this investigation flimsy would be a kindness at best," Margolis said.

Psychiatrist faces more sexual assualt charges as 8 women come forward

From the Atlanta Journal Constitution

A Lawrenceville psychiatrist was back in jail Wednesday with no bond allowed after more women came forward to say he inappropriately touched them, police said Wednesday.

Six more women have given statements to police similar to the first alleged victim, said Capt. Greg Vaughn, a spokesman for the Lawrenceville Police Department. The first woman who complained to police told them that Dr. Mohammad Qureshi asked her to disrobe during a psychiatric session and touched her breasts, he said.

"That's the thing," Vaughn said. None of the women "knows exactly what happened (with the first woman) so when they come forward and tell us (similar details), it's like, 'Wow, same thing.'"

Police charged Qureshi Tuesday afternoon with six counts of felony sexual assault and six counts of misdemeanor sexual battery. Those charges are in addition to one count of sexual assault and one count of sexual battery Qureshi faces as a result of the first woman who contacted police.

In addition to the seven women who have come forward, Vaughn said, there are perhaps two more who have called police but have not given statements.

Qureshi, 45, worked at the Gwinnett-Rockdale-Newton Community Services Board, which assists people suffering from mental illness, retardation or drug addiction. He was dismissed by the board after the first woman complained about him to police.

Qureshi said a few days ago that the allegations were "totally false."

Vaughn declined to give details of how Qureshi convinced the women to disrobe, in order to keep allegations valid if more women come forward.

But, "I could see how he could it," he said. "The red flag should have come up, but you trust your doctor and (if) he talks well enough to do it, I could somewhat see [how it could have happened]."

Two new women allege fondling by Psychiatrist

From the Atlanta Journal Constitution

Two more women have told police that a Lawrenceville psychiatrist charged with sexually fondling patients touched them inappropriately, police said Tuesday.

The women contacted police after hearing about the case Monday. They bring to five the number of complaints filed against Dr. Mohammed Uzair Qureshi, according to Capt. Greg Vaughn, spokesman for the Lawrenceville Police Department.

No additional charges have been filed against Qureshi, 45, of Lawrenceville, since he was charged Friday with sexual assault by a practitioner of psychotherapy against a patient. In that incident, a 43-year-old woman told police that Qureshi asked her to disrobe during a psychiatric session and touched her breasts.

Police are investigating the latest accusations, Vaughn said.

Qureshi was released Saturday from the Gwinnett County jail on $33,200 bond.

When contacted by the AJC on Monday, he said "these are totally false allegations.

Qureshi had been working at the Gwinnett-Rockdale-Newton Community Services Board. He was fired after the criminal charges were filed, according to David Will, the attorney for the community services board.

Psychiatrist Accused of Molesting Woman

From WXIA-TV 11 in Atlanta

A woman who sought medical help for "anxiety issues" was given an appointment with a psychiatrist who, she reported to police last week, sexually assaulted her during his consultation with her.

Now police are saying that the psychiatrist may have also molested additional patients, under the guise of performing physical exams.

Lawrenceville police arrested the psychiatrist, Dr. Mohammad Uzair Qureshi, on Friday, charging him with one count of sexual assault and one count of sexual battery.

Since then, "we've had two more victims come forward that were victimized by Dr. Qureshi," popularly known as "Dr. Q," said Lawrenceville Police Captain Greg Vaughn.

According to the police incident report, the 43 year old woman had gone to Gwinnett Rockdale Newton Community Service Board, or "GRN," on Gwinnett Drive near Scenic Highway in Lawrenceville, last Thursday, "to consult with a physician about anxiety issues."

The doctor who saw her was Dr. Qureshi who, she complained, "conducted what she felt was an unnecessary breast exam" during her first and only appointment with him.

The report says "Dr. Qureshi unexpectedly grabbed her left wrist for what she assumed was done to check her pulse. She then stated that Dr. Qureshi asked her to pull up her shirt" and "reveal her breast from her bra. At which point, Dr. Qureshi began touching both of her breast [sic]."

The woman immediately complained, and GRN called police.

"There's no reason in the world," Capt. Vaughn said Monday, "that a psychiatrist would need to take a female top off to do some type of examination."

Dr. Qureshi was released over the weekend on a bond of $33,200 as police intensified their investigation of him.

Capt. Vaughn said detectives are checking out the complaints of the two women who came forward following Dr. Qureshi's arrest, and that the doctor may face additional charges.

The address that Dr. Qureshi gave police when he was arrested is an apartment complex off of Lawrenceville Highway, just west of Lawrenceville. An employee of the complex said Dr. Qureshi has moved out. 11Alive News was unable to reach Dr. Qureshi by telephone for comment.

GRN released a statement Monday that Dr. Qureshi "was not an employee of GRN, but was an independent contractor supplied to GRN by a private company that provides psychiatric services" to GRN.

The statement goes on to say that the medical director of that company talked with Dr. Qureshi about the complaint and then fired him.

A check of the state medical board website shows that there have been no medical board investigations of Dr. Qureshi in Georgia and no disciplinary actions taken against him in Georgia.

But Lawrenceville police are asking women who believe "Dr. Q." had inappropriate physical contact with them during an appointment, but have remained silent about it, to call Lawrenceville police.

"This man is a doctor," said Capt. Vaughn. "And we all trust our doctors. And we all listen to them. So Dr. Qureshi was, obviously, he could convince these ladies that they needed some other type of exam" and they may not have realized, at first, Vaughn said, that the physical exam was not part of a psychiatrist's normal procedure.

Psychologists Shot Down Nine Times in 2007

Seen in this report

The National Psychologist reported in its Sept/Oct 2007 issue that prescription privileges bills to give psychologists prescription privileges in nine different U.S. states failed in each and every case. Most never left committee, reflecting the leadership’s unease of granting prescription rights to non-medical professionals.

The bills failed in Hawaii, California, Georgia, Illinois, Mississippi, Missouri, Montana, Tennessee and Oregon. It came closest to passing in Hawaii, but was vetoed by the governor when it reached her desk.

What’s at stake here?

Two powerful professional organizations — the American Psychological Association and the American Medical Association — butting heads over whether it is safe to allow psychologists, with additional medical training, to prescribe psychiatric medications.

Psychologists receive little or no formal training in medicine in their graduate studies today (as most physicians who are not psychiatrists receive little or no formal training in psychological theory and practices). If psychologists gained greater prescribing authority, they could rely less on medical doctors, such as psychiatrists, to prescribe common psychiatric medications.

Psychologists argue that there is a demand for such services in rural and areas throughout the country that currently do not have coverage by psychiatrists.

Doctors argue such privileges are already available to professionals who want them by undergoing medical school or similar training.

Psychologists believe they don’t need such intensive training because psychiatric medications are largely limited to affecting the mood, and don’t interact as much with other body systems.

As anyone who has looked into the side effects of psycho-active drugs knows, this last point is a woefully naive take on the situation. I can only imagine what additional horror stories await us if this were to go through.

Second wrestler’s death tied to prescribed drugs

Seen in this report

The circumstances of the deaths of wrestler Chris Benoit and his family have stirred much attention locally and nationally in past weeks. So has the funneling of prescription medication to Benoit by Carrollton physician Dr. Phil Astin.

Added to the local list was the February 2006 death of another wrestler, Tyrone resident Michael Durham.

Though ruled accidental, Durham had been turned away from a local pharmacy for trying to have too many prescriptions filled, including some written by Astin. Levels of a muscle relaxer found in Durham’s blood had the potential to be toxic.

Durham’s death occurred Feb. 15, 2006. Tyrone police responded to a call at the Senoia Road residence of a friend, fellow wrestler Eric Zinck, according to Tyrone police reports.

Officers found Durham lying in a hallway of the mobile home near the front door. A subsequent check for signs of life by Fayette EMS found none.

Durham lived in Peachtree City but had been staying at his friend’s home because he was going through a divorce, according to reports.

Also found at the scene was a prescription for 120 tablets of 350 milligrams of carisprodol, a substitute for the muscle relaxer Soma, that was filled one day before his death, according to reports filed by Det. Dean Johnson.

The pill bottle was empty, reports said. The drug had been prescribed by Astin, Tyrone Police Public Information Officer Brandon Perkins said Monday.

Another prescription drug belonging to Durham was found at the residence. The drug, 120 tablets of 2 milligrams of alprazolam, a generic form of the anti-anxiety drug Xanax, had been prescribed on Jan. 3.

Officers found one pill in the bottle, reports said. That drug had been prescribed by another physician.

Commenting Monday, Perkins said Tyrone police contacted the local Eckerd pharmacy two days after Durham’s death and was told that Durham had been getting a lot of prescriptions filled and had subsequently been turned away.

Concerned, Det. Johnson turned the prescription information over to a state regulatory agency dealing with those matters but did not receive a follow-up call, Perkins said.

Ruled accidental, Durham’s death was due to coronary artery atherosclerosis, blockage of the blood vessels to the heart, and to morbid obesity, according to autopsy reports issued by Assistant Medical Examiner Keith Lehman. The autopsy also revealed severe enlargement and scarring of the heart.

Toxicology tests revealed the presence of the muscle relaxer Soma “at levels higher than expected for therapeutic dosing and in a range with potential to have been toxic,” the report said. “Examination of Mr. Durham’s medications revealed many more carisoprodol (Soma) pills missing that would have been expected if he had taken the medication as instructed.”

Toxicology reports also noted hydrocodone in Durham’s blood at a level consistent with a therapeutic level, even though he was not known to have been prescribed hydrocodone. “The hydrocodone would have contributed to the toxicity of the carisoprodol and (its breakdown product) meprobamate. The combined effects of these drugs would have likely resulted in toxicity and probably contributed to the death, although the drug toxicity would not be expected to have been fatal by itself in the absence of heart disease,” the report concluded.

Mental Hospital Deaths: State of Georgia often ends probes without all the evidence, Key questions left unasked

As seen in this report

Despite intensifying scrutiny, Georgia's state mental hospitals continue to absolve themselves in patients' deaths while leaving key questions unanswered, or even unasked.

At least five times state officials concluded investigations into suspicious deaths in 2007 before receiving autopsy reports, a review by The Atlanta Journal-Constitution shows. In a sixth questionable case, the patient's family declined to have an autopsy performed.

The investigations into these six suspicious cases, detailed in reports filed during the first quarter of 2007, show that the state still completes inquiries without always fully examining factors that led to patients' unexpected deaths. The Journal-Constitution reported in January that at least 115 patients from the seven state hospitals had died under suspicious circumstances from 2002 through 2006 and that state investigations had often been incomplete.

In a January case, a patient at Central State Hospital died three days after a doctor warned that the man may have been prescribed a lethal dosage of an anti-psychotic drug. Yet the state investigation concluded without examining whether the medication contributed to the man's death.

In February, a 24-year-old patient at Southwestern State Hospital died in what the facility's clinical director described as "a medical mystery." The doctor added, "Twenty-four-year-old men don't die from unknown causes very often." But investigators cleared the hospital without waiting for autopsy results. State officials say their long-standing system of self-policing is effective and allows them to revisit conclusions about deaths if new information emerges.

Outside review sought

But in response to the Journal-Constitution's latest findings, advocates for mental health consumers and experts in psychiatric care said they had expected more thorough death examinations in response to the newspaper reports, subsequent criticism from state legislators and a recently announced investigation of the hospitals by the U.S. Justice Department.

"It can't be a definitive report if the autopsy has not been factored in," said Dr. Sidney Weissman, who teaches psychiatry at Northwestern University's medical school in Chicago and serves on a panel that reviews deaths in Illinois' state hospitals.

Ellyn Jeager, of the advocacy group Mental Health America of Georgia, said: "It's another reason why they shouldn't be investigating themselves . . . There needs to be independent oversight."

Gwen Skinner, director of the mental health division of the Georgia Department of Human Resources, which runs the hospitals, said at a recent meeting that she supported the idea of outside review. Last week she ordered the hospitals to request an autopsy on every patient who dies under state control. Previously, local coroners and patients' families had the discretion to request or decline autopsies.

Regardless, Human Resources officials contend the current system produces thorough, timely investigations.

Within 30 days of a patient's death, the mental health division's investigative unit is supposed to file what it calls a "final report." Those reports typically include a chronology of events leading to the death, interviews with hospital workers involved with the patient, and conclusions about whether the facility is culpable.

Neither autopsy reports nor death certificates, which also list the cause of death, generally are available in 30 days, said Mona Givens, who heads the investigative unit. The agency's medical director later goes over documents related to the cases, including internal reviews by physicians. The medical director then "makes the decision about the [quality of] medical care and can effect any changes that she thinks are necessary," Givens said.

Whether to conduct additional investigation is decided "case by case," Givens said.

'Mystery' death

Officials said late last week they could not say whether recent cases warranted further examination.

Among them was the "mystery" surrounding the death of the 24-year-old patient at Southwestern State in Thomasville.

The man had been hearing voices telling him to kill himself and others, the state's report says. The man's identity, like that of others who died during the first three months of 2007, was redacted from public documents; as a result, the newspaper could not obtain autopsy reports or other patient information.

The hospitals' policies call for complete physical examinations of newly admitted patients. But staff members at Southwestern State decided the 24-year-old was too agitated to provide samples for routine lab tests. Thus, reports say, doctors had no idea what was wrong with him about a day into his stay when he exhibited a "change in level of consciousness."

Still, before autopsy results came in, investigators concluded the hospital's staff acted "in accord with hospital policy and procedure."

Such conclusions are common, the Journal-Constitution found, even when the investigators' reports contain contradictory information.

When a 46-year-old patient at Central State died of an apparent intestinal obstruction in January, employees at the Milledgeville hospital told state investigators they had not been tracking the man's bowel movements. Many anti-psychotic medications cause severe constipation, and hospital officials acknowledge that monitoring bowel functions is crucial.

When the Central State patient became ill, "I thought maybe it was something he ate," a licensed professional nurse told investigators. "We were not monitoring his input or outtake. We would not have monitored unless he had a problem."

The investigators, however, reported only that forms recording the patient's bowel movements were missing from his medical chart. Their conclusion: "All policies and procedures were followed."

Conflicting conclusions

The failure to reconcile hospital employees' statements with the investigators' conclusions is among the glaring omissions in cases from 2007 that the newspaper reviewed.

The investigation into the death of the patient whose anti-psychotic dosage had been flagged by a physician made no attempt to determine what role the medication played, if any, documents indicate.

The 64-year-old man had been transferred to Central State from Georgia Regional Hospital/Atlanta three days earlier. The physician who examined him in Central State's admissions unit questioned whether doctors in Atlanta had prescribed too high a dosage of a medicine called Zyprexa. The Central State physician, Dr. Louis Barton, told investigators he disagreed with the patient's diagnosis and "could not reconcile or continue to recommend the medication prescribed" in Atlanta.

Even if he needed Zyprexa, Barton said, his dosage was potentially lethal for a person his age, especially one with dementia. Zyprexa is thought to increase the risk for a stroke in such patients.

His supervisor rejected his concerns, Barton told investigators.

"The referring physicians were not practicing the standard of care," Barton said. But "I have been instructed to order what the referring physicians recommend and [let] the client's attending physician make any adjustment."

At Central State, doctors instructed nurse's aides to keep the man within their sight at all times. On the man's third night there, he kept getting out of bed and, because of his unsteady gait, workers feared he might fall. So an aide sat with him in his room.

The aide told investigators the man said he used to be a math teacher and, to pass the time, he helped her with homework for a math class. She left after the man went to sleep. When she returned two hours later, he had died.

Investigators did not know what caused the man's death. But, their report concluded, "all policies and procedures were followed."

Except for one.

The investigators said the nurse's aide had engaged in "activities other than official business" by doing her math homework with the patient. They recommended that she be disciplined.

Federal Investigation to probe Georgia state mental hospitals after reports of 115 suspicious deaths

Sometimes, important stories are buried beneath the mass of other national news. Here is one such story from the Atlanta Journal Constitution. (Note: free registration required)See also this important AJC investigation series "A Hidden Shame"

Federal officials are opening an investigation that could force Georgia to dramatically improve conditions at its state psychiatric hospitals, where an Atlanta Journal-Constitution investigation found that overcrowding, understaffing, abuse and neglect have contributed to scores of suspicious deaths.

The U.S. Justice Department's Civil Rights Division notified Gov. Sonny Perdue's office of the investigation as state lawmakers prepared to adjourn a legislative session in which several proposals calling for an overhaul of the mental health system failed to win passage.

Although attempts to secure more funding and independent monitoring of the system appear to be dead, a resolution creating a reform commission is pending as the General Assembly enters its final day.

The federal intervention came three months after the AJC found that at least 115 hospital patients had died under suspicious circumstances from 2002 through 2006. The AJC series, "A Hidden Shame," also reported on more than 190 cases of physical and sexual abuse of patients.

The Justice Department letter said its investigation of the seven state-run mental hospitals will look at "protection from harm," medical care and discharge planning. "We encourage the state to cooperate with our investigation," the letter said.

News of the Justice Department's involvement drew praise —- and a measure of regret —- from a relative of one of the deceased patients.

"It's such a shame the federal government has to step in to save lives of innocent citizens in the state of Georgia," said Janie Webb-Miller, whose brother Michael Webb, 59, of Duluth died in December from a bowel obstruction after spending three weeks at Georgia Regional Hospital/Atlanta. "Where are our elected officials? You hate to think your own state doesn't care enough to do something."

Officials at the state Department of Human Resources, which operates the hospitals, would not comment in detail Thursday on the investigation, saying they don't know what course the inquiry will take. But, said Dena Smith, a Human Resources spokeswoman: "As with any investigation or any inquiry or anything, we intend to always cooperate fully as a partner with this investigation."

The department has acknowledged problems in the facilities but disagreed with the number of deaths being characterized as "suspicious." Regardless, the agency says it is working to improve conditions.

Repeated citations by federal and state inspectors have failed to correct chronic problems, the AJC found. At Georgia Regional Hospital/Atlanta, for instance, federal inspectors found that problems such as overcrowding, fighting among patients and a lack of therapy sessions were present both in 2002 and in 2006, even though hospital officials had promised to address those issues.

Bert Brantley, a spokesman for Perdue, said the governor was busy monitoring the end of the legislative session and had not seen the letter, which was sent Wednesday.

A spokeswoman for the Justice Department in Washington said Thursday that the investigation will formally begin next week.

"We're hoping to work cooperatively" with Georgia officials, said the spokeswoman, Cynthia Magnuson. Such probes are complex and often lengthy, she added.

Under a federal civil rights statute to protect people in government institutional care, Justice has investigated conditions in facilities for the mentally ill and those for the mentally retarded in several states.

In North Carolina's state hospitals, the department in 2004 identified staffing shortages, deficient treatment and discharge planning for patients, inappropriate seclusion and restraint of patients, and use of medications that investigators deemed a "chemical restraint." In Vermont in 2005, the department cited a state hospital for its "cell-like" rooms and "dehumanizing" conditions.

If its investigation warrants, the Justice Department could file a lawsuit in federal court seeking to force Georgia officials to overhaul the hospitals.

In January, the National Alliance on Mental Illness, a consumer advocacy group, asked the Justice Department to investigate what it called "unacceptable and intolerable" conditions in Georgia's mental hospitals.

The federal intervention is necessary, said Ron Honberg, NAMI's director of policy and legal affairs. The AJC investigation, he said, "described what is nothing short of a crisis, and with large numbers of people dying as a result of abuse and neglect."

Citing the lack of new funding from the Georgia General Assembly, Honberg said, "I don't see anything [being] done to address the problems."

Zyprexa and Quack Psychiatry

Excellent article by Rick Davis. We hope to see more by him.

Since its approval, Zyprexa has been exposed as responsible for a high incidence of stroke, diabetes, endocrine, cardiac problems and movement disorders. And yet, the drug has been routinely prescribed to adults of all ages and to children, despite the fact that the FDA has not approved Zyprexa for pediatric use.

In the July 2002 issue of Pharmacotherapy, P Murali Doraiswamy, the chief of biological psychiatry at Duke University, published a review of adverse events reported to the FDA by Zyprexa patients that found 289 cases of diabetes, 100 patients with ketosis (a serious complication of diabetes), and 22 cases of pancreatitis, a life-threatening condition. The review documented 23 deaths, including a 15-year-old adolescent who died of necrotizing pancreatitis.

[...]

Sales of Zyprexa, dwindled in the last quarter of 2005, as news of the drug's lethal side effects made headlines. In June 2005, word got out that Lilly had agreed to pay $690 million to settle a lawsuit filed on behalf of about 8,000 Zyprexa patients who alleged they had not been warned of the drug's increased risk of diabetes.

[...]

In every state, Zyprexa represents a big line-item expense to Medicaid at a time when most states are facing a budget crisis. US sales of all antipsychotics doubled between 2001 and 2004, largely because of purchases by Medicaid. On September 29, 2005, Bloomberg News reported that Medicaid programs may reduce the $5.5 billion it spends annually on schizophrenia drugs for the poor after a study found a cheaper generic about as effective as nongenerics, including Zyprexa. "The 40-year-old drug perphenazine costs less than $1.50 a day," Bloomberg wrote, "while the newer medicines can cost 10 times as much."

[...]

The state of Georgia has removed Zyprexa from its preferred drug list and any Georgia doctor who wants to start a Medicaid patient on Zyprexa, must now submit a clinical rationale stating why it's the only drug appropriate for the patient, according to the November 28, 2005 Indianapolis Business Journal (IBJ). Illinois, Tennessee, Pennsylvania and Louisiana also require doctors to obtain prior authorization before prescribing Zyprexa, according to the November 2005 Indianapolis Business Journal. Georgia spokeswoman Julie Kerlin told IBJ that removing Zyprexa from the list in 2004 has saved the state nearly $7 million, which means Lilly lost $7 million in one state alone.

Georgia psych facility to close down

The board of directors for University Hospital in Georgia has voted to stop taking psychiatric inpatients Sept. 12 and to close the Behavioral Health Center on Sept. 30.

The move follows a steady decline in the number of mental health patients and services at University, which stopped offering outpatient services in October 2001 and has been unable to recruit psychiatrists to replace those who have retired, officials said.

The unit has gone from having an average of 19 patients a day in 2000 to only 1 or 2 on some days recently, said Jason Moore, the chief operating officer for University.

Another place that is going under.