Florida Psychiatrist Mark Agresti sued over treatment of West Palm Beach woman who killed daughter and herself

Here is the Local TV WPBF News Reports



with this related report

Bradley Brooks was so concerned about his 10-year-old-daughter Alexandra, on Sept. 12, 2013, he asked the police to check the home she shared with her mother Pamela Brooks. Police went to the home located at 139 Gregory Place and found Alexandra and Pamela inside, both stabbed to death. Pamela Brooks was found with 130 self-inflicted stab wounds. Her daughter was found with 30 stab wounds. Police ruled the case a murder-suicide.

The girl's father is now suing a psychiatrist and a substance abuse counselor who were treating Pamela Brooks.

According to the lawsuit, Pamela Brooks had a lifetime of alcohol abuse. Beginning in 1999 her alcohol abuse began causing problems in her life. The lawsuit also states, Bradley Brooks filed an emergency request for custody of their daughter back in May of 2013, just weeks after her mother was arrested for DUI. The lawsuit states, Pamela Brooks was ordered to a comprehensive psychological evaluation and was seen several times by the doctor. Her next scheduled appointment was for Sept. 13, 2013. She and her daughter were found dead inside their home Sept. 12, 2013.

According to the lawsuit filed last week, Brooks doctor is accused of "Failing to clearly communicate that Pamela Brooks was at risk of inflicting harm to herself or to others," and "Failing to refer Pamela Brooks to a physician trained in the management of patients suffering from severe depression," the suit states.

Both the doctor and counselor are accused of negligence.

And as reported in the Palm Beach Post

A psychiatrist and a substance abuse counselor who were treating a West Palm Beach woman who killed herself and her 10-year-old daughter in September 2013 have been sued in connection with the deaths that stunned the community. In the lawsuit filed last week in Palm Beach County Circuit Court, family members of Pamela and Alexandra Brooks blame Dr. Mark Agresti and counselor David Dashev for the murder-suicide.

The two “knew or should have known that Pamela Brooks was at risk of inflicting harm to herself, or to others,” according to the lawsuit filed by attorney Glenn Crickenberger, who works for the Stuart law firm of famed lawyer Willie Gary. “However, (they) failed to refer Pamela Brooks to a physician trained in the management of patients suffering from severe depression.”

Brooks, 48, was found dead in the living room of her Gregory Place home with 130 self-inflicted stab wounds. The body of her daughter was found in the kitchen with 30 stab wounds, the suit says. The deaths so shocked the community that the city’s then police chief took the unusual step of calling a press conference to announce they had been ruled a murder-suicide. The grisly scene was discovered by Brooks’ ex-husband, Bradley, who broke into the home because he was concerned about his daughter, a King’s Academy student.

Dashev, former chief operations officer of the Mental Health Pavilion at what is now West Palm Hospital, declined comment on the suit. Agresti couldn’t be reached.

Pamela Brooks had been ordered to seek treatment from Agresti and Dashev by Circuit Judge Thomas Barkdull in May 2013 after Bradley Brooks filed an emergency request for custody of the couple’s daughter. The request came weeks after Pamela Brooks was arrested for driving under the influence.

The lawsuit, filed on behalf of Bradley Brooks and his ex-wife’s parents, Martin and Evelyn Hewson, details Pamela Brooks long struggle with alcohol abuse. It also indicates she initially responded to treatment by Agresti and Dashev. Treated daily with Antabuse, a drug designed to reduce cravings for alcohol, medical records in June and July 2013 showed she was “compliant and that her spirits were good,” the lawsuit says.

In August, the tenor of the notes changed. They indicate she had resumed drinking. Questions were raised about whether she needed residential care. “There was a discussion with Ms. Brooks regarding depression and the presence of suicidal ideation,” the suit says.

From Aug. 16 to Sept. 6, 2013, she was seen about 10 times by Agresti and Dashev. “During several of these visits Pamela described her overall condition as being characterized by anxiety and tension,” the suit states. “She described herself as feeling overwhelmed, angry and upset stemming from her DUI and all the changes in her life that the DUI has caused.” A day before her next appointment, she killed herself and her daughter.

The suit accuses Agresti and Dashev of negligence. It seeks an unspecified amount in damages.

New details in the case of Rochester psychiatrist accused of hiding body in backyard

As Reported by WHEC TV

We've learned new details about the discovery of a missing man's body in the backyard of a Rochester psychiatrist's home.

The body of Matthew Straton was discovered on Rowley Street last January.

Police say Doctor William Lewek, who lives at the home, admitted to moving Straton's body and partially burying it. He's charged with tampering with evidence and faces drug charges.

He is not charged in Straton's death. The Monroe County District Attorney's Office says they know the cause of death for Straton, but for privacy reasons they won't reveal it. Prosecutors say it's not going to result in any new charges against Lewek.

We also learned Wednesday that police came to Lewek's house three times looking for Matthew Straton before Lewek admitted that Straton's body was buried in his backyard.

At that time, police had phone records that showed Lewek and Straton talked on the phone before he disappeared. When they showed up at his house last January 15 with a search warrant, Investigator Nicolas Mazzola testified that Lewek told him Straton died from a drug overdose and he buried his body in his backyard.

We asked Assistant District Attorney Kelly Wolford why she thought Lewek waited to reveal the body. She says, "Well it tells me that he didn't want police to know until he had no choice."

Matthew's mother Kym Straton says, "I think the third time he had to admit to it because someone turned him in. He had to admit to it, he was there."

At the hearing on Wednesday, things got a little testy. We overheard Judge Christopher Ciaccio threaten to send Defense Attorney Matt Parrinello to jail if he repeated a question one more time. Parrinello's next question was different. The lawyers are back to argue whether Lewek's statements can be used at trial on January 28.

You may also remember Lewek was arrested in Irondequoit last month for driving while ability impaired by drugs. At the hearing, the judge warned him that if he's caught again using illegal drugs or driving under the influence, the judge will revoke his bail and send him to jail.

East House Receives Grants To Help Former Rochester Psych Patients

From this short report on WXXI of Rochester NY.

East House, a local organization that provides services for adults in recovery from substance abuse and mental health disorders, has been awarded more than $500,000 in two state grants. The money will help people who are no longer being served by the Rochester Psychiatric Center and other inpatient psychiatric units.

The grants, administered through the Monroe County Office of Mental Health, will provide services to 116 people in a six-county area including Monroe, Wayne, Livingston, Genesee, Orleans and Wyoming Counties.

Of note is prospect that the Rochester Psychiatric Center is offloading these clientele because they will be accepting more patients

Some neighbors in the Upper Mount Hope area are expressing concern over the recently announced proposed changes to the Rochester Psychiatric Center. A spokesperson for the New York State Office of Mental Health confirmed to 13WHAM News that it plans to add 29 forensic beds to the building on Elmwood Avenue.

The facility was recently in the news because of the murder of a patient

Rochester man charged with criminally negligent homicide in Psych Center assault death

As reoirted in the Watertown Daily News

Many more details at the link

A Rochester man has been charged with criminally negligent homicide after being accused of assaulting a fellow St. Lawrence County Psychiatric Center patient who later died as a result of his injuries.

Jose D. Miranda, 64, a patient of the Rochester Psychiatric Center, 1111 Elmwood Ave, was arrested Tuesday by detectives on a sealed St. Lawrence County Court indictment, according to a news release from Ogdensburg police.

Miranda was then transported to St. Lawrence County Court, Canton, and arraigned before Judge Jerome J. Richards on one count of criminally negligent homicide, a felony.

At arraignment, he was ordered held without bail and sent to the St. Lawrence County jail, Canton.

Officers of the Ogdensburg Police Department Criminal Investigations Unit allege the victim, Robert D. Harrienger II, 58, a native of Adams, was assaulted by Mr. Miranda about 6 p.m. May 12 at the St. Lawrence Psychiatric Center’s Trinity Building.

Mr. Harrienger was transported by the Ogdensburg Rescue Squad to the Claxton-Hepburn Medical Center to be treated for head injuries. Due to the extent of his injuries and his condition, Mr. Harrienger later was transferred to Upstate Medical University, Syracuse, where he died several hours later.

An autopsy performed by the Onondaga County medical examiner’s office ruled the cause of death to be homicide.

Mr. Harrienger’s obituary said he was a general laborer in the garage of the psychiatric center for 20 years until retiring because of disability.

Miranda was a patient at the center. After the assault, he was transferred to a state psychiatric center in Marcy.

His arrest was a result of a lengthy investigation. During the investigation, he remained in state custody under psychiatric care.

Miranda, originally of the Bronx, has a long history of violent crimes, including a manslaughter conviction in 1972

You would expect that hospitals would be safe places for people, not a place where you take your life in your hands.

Healthcare Serial Killings

As seen in this longer article by Joyce Frieden, News Editor, MedPage Today

Healthcare Serial Killings

The number of serial killings committed by healthcare providers has leveled off in the U.S. in recent decades, although it is rising internationally, Eindra Khin Khin, MD, said in Chicago at the annual meeting of the American Academy of Psychiatry and the Law.

According to the literature, the number of cases of healthcare serial killings overall rose from 10 in the 1970s to 21 in the 1980s, 23 in the 1990s, and then to 40 in the years 2000 to 2006, said Khin Khin, who along with her colleagues presented a poster on the topic.

One reason the rates of healthcare serial murders are rising internationally, but not in the U.S., is electronic medical records (EMR), Khin Khin, of George Washington University in Washington, told MedPage Today in a phone interview. She noted that several serial killers, including physician Michael Swango, first got into trouble in the U.S. and then went overseas.

"We know that in America, with the implementation of the EMR system, that really decreases the potential for these incidents," she said. "You can't just take out medications and start injecting someone; everyone's accountable because of EMR. But in most parts of world, they don't even have EMR."

"At least in the [United] States, because of incidents in 1990s and 2000s, we've really beefed up on the credentialing system, and institutions have started to communicate with each other better," she continued. "People are not shedding enough light on the international phenomenon, and the global community has a little bit to catch up on in implementing guidelines and regulatory measures."

In terms of the site, the vast majority of killings (72%) occurred in a hospital, with the remainder occurring in nursing homes (20%), patients' homes (6%) and outpatient settings (2%).

Among the killings occurring in hospitals, the biggest percentage (38%) were committed on medical/surgical units, followed by the intensive care and critical care units (18%); the rest were spread among other wards including geriatrics, pediatrics, psychiatry, neurology, and the emergency department.

As to the method used, the majority of killings -- 52% -- were done via lethal injection, followed by unknown methods (25%), suffocation (11%), and water in the lungs (4%). Air embolus and oral medications were each used in another 3%, while equipment tampering and poisoning accounted for 1% each.

Among the drugs used were opiates and opioids (23%), potassium chloride (17%), insulin (13%), and other neuromuscular-blocking drugs (9%). More than half of killers (60%) were RNs, followed by aides (18%), physicians (12%), and non-RNs (8%).

Healthcare serial killers have a variety of motivations, according to Khin Khin, including:

• "Visionary": This rare type of serial killer is psychotic and kills in response to visions. For example, serial killer Herbert Mullin slaughtered 13 people because he thought he was preventing California from suffering an earthquake, she said.
• "Missionary": These killers are trying to rid the world of people they see as "immoral or unworthy," Khin Khin said. One example is Thomas Cream, a physician in late 1800s England who killed the prostitutes who came to him for abortions.
• "Thrill-Seeker": These people get a "high" from killing and are very sadistic.
• "Lust Killer": These killers -- Swango is a good example -- get sexual pleasure from murder.
• "Power/Control-Oriented Killer": These people kill to gain and exert power over their victims; they may have a sexual tone but they are not motivated by lust, said Khin Khin. Physician Harold Shipman is an example of this type of killer.
• "Gain-Motivated": This group kills for psychological or tangible gain, which may come in the form of relieving a burden or in monetary profit. This can also take the form of Munchausen by proxy, such as the case of Richard Angelo, a nurse who injected patients with medications to paralyze their respiratory muscle, causing the patients to code. "When the code happened, he'd perform very well and colleagues would praise him, and he really liked that so he kept on doing it," she said.

Healthcare professionals who are concerned about a co-worker who might be involved in such activity can watch for certain "red flags," according to Khin Khin, including:

• Unexpected deaths given patients' illnesses
• A higher death rate with the suspect on duty
• Multiple deaths in which the suspect is the last one seen with the victims
• A suspect who is overly interested in death and dying
• A suspect who is always available to "help"
• A suspect who frequently moves from one facility to another
• A suspect who has falsified information in the past

The researchers recommended several steps for preventing healthcare serial killings, such as educating staff members on the issue, designating a national or international regulation and monitoring body, routine institutional monitoring of high-alert medication use and monthly morality/cardiac arrest rates, and consensus guidelines for managing suspicious situations.

Unaddressed are the psychiatrists who do not kill, but instead who are content to cripple and crush the lives of their patients.

US soldier who shot five troops was 'broken' by counsellors

As seen in the Telegraph

Army Sgt. John M. Russell, 44, has been charged with murder and aggravated assault in the Baghdad shootings, which his father said took place about six weeks before the end of his third tour of duty in Iraq.

Wilburn Russell, 73, alleged his son had been treated poorly at the stress centre and had e-mailed his wife calling two recent days the worst in his life.

"I hate what that boy did," said Mr Russell, speaking in front of the two-story suburban home his son is buying with his wife. "He thought it was justified. That's never a solution."

Excerpts of his military record, obtained by The Associated Press, show Sgt. Russell previously did two one-year tours of duty in Iraq, one starting in April 2003 and another beginning November 2005. The stress of repeat and extended tours is considered a main contributor to mental health problems among troops serving in Iraq and Afghanistan.

His father said the soldier, an electronics technician, was at the stress centre to transition out of active duty. He said his son was undergoing stressful mental tests that he didn't understand were merely tests, "so they broke him."

"John has forfeited his life. Apparently, he said (to his wife), 'My life is over. To hell with it. I'm going to get even with 'em,"' he said.

"He lived for the military," Mr Russell said. "We're sorry for the families, too. It shouldn't have happened."

The soldier's son, John M. Russell II, said that he has communicated with his father by e-mail regularly. In the last message he received from him, April 25, his father sounded normal and planned to be back in Texas to visit in July.

"He's not a violent person," he said. "He's just a loving, caring guy.

He doesn't like to see anyone get hurt. For this to happen, it had to be something going on that the Army's not telling us about."

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Sacramento judge castigates psychiatrist who vouched for killer

A Report from the Sacramento Bee

Napa State Hospital's attempt to release a killer into community treatment in Sacramento was based on the "horrifying" testimony of a psychiatrist who "clearly committed perjury in this court," a judge said Monday.

Sacramento Superior Court Judge Kevin J. McCormick made his comments about the Napa psychiatrist, Dr. Nathan Thuma, when he ruled from the bench that Ronald Benjamin Toppila is not fit for outpatient treatment and must remain in the mental hospital for killing his mother four years ago.

In a decision that will keep Toppila confined indefinitely on a jury's verdict that he was not guilty by reason of insanity, McCormick lashed Thuma for recommending in March that the defendant be released into community treatment even though at that time the psychiatrist had examined the client for barely a half hour.

McCormick said Thuma "could not have had enough information" to make the recommendation and that it was "beyond belief" the doctor could have reviewed Toppila's medical records in the short time he'd been on staff at Napa.

Thuma demonstrated "a total lack of independence and judgment" by concluding that Toppila did not present a danger because, in quoting the psychiatrist, "we all trust Mr. Toppila," McCormick said. The judge said Thuma's "demeanor and manner" in court "could only be described as horrifying."

"He clearly committed perjury in this court," McCormick said of Thuma. "He testified inconsistently at varying times. He showed a complete lack of any insight whatsoever into Mr. Toppila's history."

Thuma did not return a telephone call for comment Monday. A spokeswoman for the state Department of Mental Health said agency director Stephen Mayberg plans to review the judge's comments about Thuma.

"He would take it very seriously and look into it," the spokesman, Nancy Kincaid, said.

"If the judge expressed concern over someone's testimony or professional performance, that would be looked into both by the director of the department and by the executive director at the hospital."

McCormick did not specifically identify areas of Thuma's testimony where he thinks the psychiatrist lied under oath. In Thuma's testimony on Oct. 27, however, he wound up on both sides of a question on whether he thought Toppila had "malingered" to sway the therapists who were evaluating him. There were also inconsistencies in Thuma's testimony over whether he was aware of evaluations done on Toppila before the Oct. 7, 2004, beating death of his 86-year-old mother, Hilma Tone.

Deputy District Attorney Dawn Bladet hailed the judge's ruling, saying in an e-mail: "Toppila's continued confinement in Napa State Hospital is necessary to protect the public safety interest."

Toppila's lawyer, Robert J. Saria, said Toppila and his client's family were disappointed by the ruling. Saria said Toppila "is committed to returning to Napa and pursuing his treatment plan and engaging in all the treatment he is required to."

Toppila, 68, a long-time licensed clinical social worker, stabbed his mother 52 times and also bludgeoned her in the fatal attack in her South Land Park apartment.

Judge McCormick said he was also disturbed by the testimony of Antonio Alocer, an official from the Central Valley Conditional Release Program, which would have coordinated Toppila's community placement if he was released from Napa. McCormick said no treatment plan had been determined for Toppila in the event of his release. The judge said Alocer "could not tell me" where Toppila would be placed.

Alocer could not be reached for comment Monday.

"I cannot state with any degree of certainty based on the evidence that I heard in this courtroom that Mr. Toppila no longer poses a danger to the health and safety of others," McCormick said.

Psychiatrist guilty of misconduct after freeing dangerous patient

From a Report out of Plymouth, England

A Plymouth psychiatrist who released a dangerous schizophrenic from a mental health ward hours before he tried to kill his mother was today found guilty of 'recklessly' putting the public at risk.

Dr Andrea Tocca described the 39-year-old as 'no danger to himself or others' and discharged him from Derriford Hospital in Plymouth, Devon, a day after he assaulted a female patient.

Soon after arriving home, the man, referred to as GA, told his mother: 'I know what I have to do to you' and battered her repeatedly over the head with a spade.

Dr Tocca was found guilty of misconduct after the GMC panel decided that he had 'recklessly put the public at risk' in releasing GA from the ward.

Panel chair Ralph Bergmann said: 'This panel is particularly concerned by your decision to discharge GA on April 25, 2006.

'You had been responsible for the care and treatment of GA for some three months prior to discharging him.'

Mr Bergmann said during this time he had been informed by the patient's previous doctor in Torquay that 'if GA became acutely psychotic, his mother may be at risk.

'He (the doctor) had also informed you that GA had made two very serious suicide attempts.

'The panel accepts the proposition put forward by your counsel that your conduct in discharging GA amounted to a single episode of significant error.

'However, you had access to GA's medical history, you had become very familiar with his condition and you ought to have been very alert to the risks and potential consequences of discharging him.

'Your decision to do so leaves the panel in no doubt that this was serious misconduct on your part.

'As the consultant psychiatrist responsible foe the care and treatment of a vulnerable patient, you behaved irresponsibly and recklessly in allowing GA to be returned to the community.

'You thereby put at risk not only the patient but also his mother and the public.

'Taking all these matters into account, the panel has determined that your fitness to practise is impaired because of your misconduct.'

The GMC panel will now consider whether to kick Dr Tocca out of the medical profession.

The hearing was told that Dr Tocca did not read GA's medical notes and decided to 'make up his own mind' about the patient.

On April 24, GA assaulted a female patient on the unit by holding her in a headlock and punching her.

His medical records show that he had also threatened other patients and believed that the staff on the unit were trying to kill him.

Marios Lambis, for the GMC, said: 'At 9.55am on April 25, Dr Tocca made an entry in GA's notes stating that in his view, that assault on the female patient was not a product of his mental state but rather a result of the high level of stress he was experiencing on the unit.

'He recorded that once the police had completed their investigation into the assault, he would discharge GA, and twenty minutes later he recorded: ''In my clinical opinion, GA is not detainable under the Mental Health Act and he is not really a danger to himself or to others.'''

In a statement read to the panel GA's mother, referred to as Mrs A, told the hearing that Dr Tocca telephoned on April 25 to say her son had assaulted a patient but he was sending him home.

[...]

The GMC heard that GA had developed brain damage after falling from a tree swing at the age of 12 and became 'passive and apathetic.'

In 1991, at the age of 22, he was admitted to hospital in Manchester with paranoid psychotic symptoms, the hearing was told.

Mr Lambis said: 'He would not let anyone into his flat, his furniture was broken and he was talking in an incomprehensible manner.

'He had become suspicious and withdrawn.'

In 1993, he was diagnosed with paranoid schizophrenia and was admitted to acute mental health units nine times over the following three years.

Two years later he made threats to kill his grandmother.

GA took an overdose in 2003 and was later sectioned.

On August 8 2005, he set fire to his mattress five times before lying on it and burning himself in a suicide attempt.

He spent 11 weeks in the burns unit at Frenchay Hospital in Bristol.

Dr Tocca admitted being told by GA's doctor that he became acutely psychotic his mother may be at risk.

He also admitted that he ought to have known that GA had made threats to kill his grandmother and had shown previous incidents of violence, and he discharged GH when he ought to have known he should not have been discharged.

Psychiatrist faces review in wake of massacre - Hearing to decide competency of Toronto doctor who treated man who killed his wife and children

As seen in the Globe and Mail. Edited for Space

The competency of a Toronto psychiatrist who was treating Chau Huc Minh at the time he massacred his family in 2006 is under scrutiny by the College of Physicians and Surgeons of Ontario.

The College has scheduled a hearing to determine whether the psychiatrist - Dr. Hung-Tat Lo - is competent to continue practising in light of his actions in the Chau case and 15 other unspecified cases.

The main complaint behind the hearing appears to be one lodged last year by Mr. Chau's sister, Jenny Chu. Ms. Chu alleged that Dr. Lo refused her plea to have Mr. Chau sent to a hospital for an assessment and possible treatment on Jan. 6, 2006. Five weeks later - on Feb. 9, 2006 - Mr. Chau used a meat cleaver to inflict fatal injuries on his wife, Shao-Fang, his three-year-old daughter, Vivian, and his five-month-old baby, Ivan.

A CPSO document states that its disciplines committee will decide whether Dr. Lo "failed to maintain the standard of practice and is incompetent in his care and treatment - including, but not limited to - his assessments, diagnoses, treatment and record-keeping, of 15 patients whose identities have been made known to Dr. Lo, between about July, 1983, and July, 2007."

It said the probe will also consider whether Dr. Lo displayed "a lack of knowledge, skill or judgment or disregard for the welfare of his patients of a nature," to the point that his practice should be restricted or terminated.

In the meantime, Dr. Lo has been told to submit sample medical charts and other patient information at least once every two weeks to a doctor appointed by the College to monitor his work.

CPSO spokesman Jill Hefley said in an interview yesterday that a complaint is referred to a disciplines hearing only if there has been a determination that "reasonable and probable cause" exists to believe it may be well founded.

Ms. Chu complained that she told Dr. Lo that her brother's behaviour had grown alarmingly erratic. "I was concerned that he might hurt his two young kids and wife" she said in her complaint. "Therefore, I urged Dr. Lo to send him to hospital with detailed descriptions of his strange behaviour."

[...]

Upon leaving Dr. Lo's clinic that day - Jan. 6, 2006 - Ms. Chu claimed that she tried to coax her brother to go straight to the hospital. She said that Mr. Chau became furious, and said: "Even Dr. Lo said that I was okay. Why must you make me go to a hospital?"

Mr. Chau was found not criminally responsible in the killings earlier this week by a Toronto judge.

According to a transcript from Mr. Chau's 2007 preliminary hearing, Dr. Lo denied that Ms. Chu asked him to admit her brother to hospital at the Jan. 6, 2006, meeting. Dr. Lo acknowledged that he saw Mr. Chau for just 140 minutes during the 12 years that he treated him. However, Dr. Lo, who stated he sees 15-20 patients a day, said that he didn't see it as necessary to spend more time with Mr. Chau.

Dr. Lo's office was closed this week, and he did not return telephone messages.

Peter Lindsay, Mr. Chau's defence lawyer, expressed misgivings yesterday about the quality of care his client was given. "The compelling story here is that Dr. Lo sees him so little. If you do the math, he saw him for just over 11 minutes a year. I'm not a doctor, but I think that's far short of what he should be seeing this guy."

[...]

Other victim

Chau Huc Minh was not the first of psychiatrist Hung-Tat Lo's mentally ill patients to explode into violence.

In 2004, two years before Mr. Chau's killing rampage, a 36-year-old Chinese immigrant, Xuan Peng, drowned her four-year-old, autistic baby in a bathtub at her Scarborough home.

She had been under Dr. Lo's care at the time.

According to a 2005 bail ruling that freed Ms. Peng pending her first-degree murder trial, Dr. Lo was treating her for a bipolar disorder at the time that her daughter, Scarlett, drowned.

The presiding judge at the bail hearing was Ontario Superior Court Judge David McCombs.

He was persuaded to grant Ms. Peng bail partly based on testimony from Dr. Lo, who said that she was capable of being managed in the community and agreed to supervise her treatment.

[...]

Police arrested Ms. Peng seven months after Scarlett's death. Last March, she was found guilty of second-degree murder, notwithstanding her history of mental illness.

Psychiatrist in Murder Suicide

A report from Beirut, Lebanon

A psychiatrist committed suicide Wednesday morning after shooting dead a father and his two daughters.

Jack Hreiki, a 42-year-old psychiatrist, shot a 26-year-old lawyer, Chantal Ghanem; her sister Cheryl, a 29-year-old accountant; and their father Ghassan, a 58-year-old engineer; in the town of Batroumin in the northern province of Koura.

The victims were on their way to work in Tripoli when they were shot with a pump-action shotgun.

Hreiki, whose fellow townsmen described as a "psychiatrist in need of a psychological assistance," then went home and committed suicide.

A security source told The Daily Star that Hreiki knew his victims, as he was in love with Chantal, who had rejected him, for three years.

The source said Hreiki waited for the Ghanem family to leave for work, and when he blocked their path carrying a shotgun, the father stepped out from the car in an attempt to dissuade him from shooting. Ghassan was targeted first.

Hreiki then shot and killed the man's two daughters, who had witnessed the first shooting from the car.

Hreiki had repeatedly threatened Chantal, the sources said, and the Ghanem family had alerted the Internal Security Forces.

The homicide is the third this month [...]

The Perils of Industrial Mental Health: Documents were forged, and falsified,

From the Philidelphia Inquirer

The social workers who were supposed to watch over 14-year-old Danieal Kelly didn't do much of anything while she slowly died of starvation and neglect.

But they got very busy after she died, according to a grand-jury report.

The call came Aug. 4, 2006. She'd been found dead, looking like a victim of a concentration camp, with rotting bedsores and weighing 42 pounds.

That afternoon, workers for MultiEthnic Behavioral Health Inc. scrambled to forge documents to make it look as though they had been visiting the girl and her family, as they were being paid to do by the city's Department of Human Services.

In the months before the girl's horrific death, the workers for MultiEthnic were not the only ones who failed to do their jobs - or to try to cover their tracks afterward - according to the grand-jury report.

"The fate of a sweet and promising child depended on the willingness of a number of particular adults to do the bare minimum of what they were supposed to do," the report says.

". . . Had just one of them performed their duty or done their job, Danieal would be alive today."

The DHS caseworker assigned to the family, Dana Poindexter, ignored warnings that the girl was at grave risk, the report alleges, and later lied to the grand jury to make it appear he had been doing his job.

Months after her death, a homicide detective found the case file - at the bottom of a box filled with food wrappers and dusty unopened letters, some of which were four years old.

Poindexter testified he didn't know that Kelly was entitled to go to school, or that it was against the law for a parent not to provide necessary care. "He must have been asleep during his training," one expert told the grand jury.

Pressed to provide a summary of the case a year before her death, Poindexter wrote an account that the grand jury called "pathetic," "self-serving," and "almost certainly false."

Poindexter, who had been suspended three times for poor performance, testified that he prepared many documents and put them in the Kelly case file.

"The grand jury has no doubt that he never prepared these documents," the report said. He is charged with perjury, along with endangering the welfare of children.

Reached by phone, Poindexter, 51, declined to comment. He was suspended again by DHS yesterday.

Another DHS worker, who did not bother to enter the girl's room during her last visit, backdated her report, the grand-jury report said.

And a supervisor admitted she falsified case records to make it seem that DHS had investigated old neglect reports involving the Kelly family and found them "unsubstantiated." Called to testify, she told grand jurors that was common practice at DHS; she said it was a bureaucratic procedure that helped hasten services to families.

That supervisor, Martha Poller, is still with DHS and recently was given a new job: project manager for a team that will examine child-fatality cases. During a news conference yesterday, District Attorney Lynne M. Abraham said she was incredulous that Poller had been entrusted with that new duty.

Poller did not return phone calls yesterday seeking comment.She was not charged.

The 258-page report brims with outrage and fierce criticism of the people involved in Kelly's case - not just of the nine people who were charged, but also the people who ran DHS, the investigators who responded to the death, and even a Public Health Department official who tried to squelch her employees from talking about the case.

The findings in the report echoed, in part, the findings of a DHS review panel that found deep problems at DHS and suggested sweeping reforms.

"What I can tell you is: The internal accountability was weak, and the demand for external accountability from providers was equally weak," said Carol Spigner, the head of the panel.

"When that happens, there are a lot of risks in the system."

The grand-jury report found that the management failures began years ago, before Danieal Kelly even arrived in Philadelphia.

DHS workers complained that MultiEthnic was not visiting families as required and was falsifying records to cover it up.

An investigator for DHS found that the fraud charges were likely true. But the agency wasn't fired. Cheryl Ransom-Garner, who later became DHS director, summoned Mickal Kamuvaka and the other directors of the agency and "read them the riot act," the report said.

Later, a DHS evaluation lauded MultiEthnic for its "energetic" performance, calling it "remarkable." When called before the grand jury, Ransom-Garner said she didn't remember hearing any complaints about the agency - a response the grand jury called "incredible."

Ransom-Garner did not return calls seeking comment. Kamuvaka could not be reached for comment.

These missed chances to check up on MultiEthnic would be repeated again and again, the report found.

The agency's caseworker assigned to the Kelly family, Julius Murray, allegedly visited the home only a few times, and the investigation found no evidence he ever met the child.

In previous cases, Murray and other caseworkers allegedly would have families sign batches of blank forms, attesting to visits that never happened. Murray is charged with doing the same thing in the Kelly case.

The fraud was no aberration - "it was MultiEthnic's modus operandi," the report said.

After the girl's death, the grand jury found, the cover-up kicked into high gear.

A secretary, Vanessa Jackson, was told to come in on her day off on orders from Kamuvaka, "Dr. K." The problem: DHS was coming over for the Kelly family file at 4 p.m., and "Dr. K didn't have much of a file."

She was put to work fabricating notes for home visits that never happened, while another employee sat forging quarterly reports.

"I don't want them to test the notes for the ink to see if they had been written earlier," Jackson quoted Kamuvaka as saying.

They kept a courier from DHS waiting for 20 minutes while they assembled the file.

Like Poindexter, the next DHS worker to get the case, Laura Sommerer, didn't find anything wrong with MultiEthnic's performance. She visited the home June 29 and allegedly saw nothing amiss. She later said she didn't try to speak to the girl.

After the girl died, Sommerer's boss asked her for her report on the June visit; she gave it a day or two later.

But after investigators analyzed her computer, Sommerer admitted she didn't write the report until after the girl died. The grand jury called that "an obvious attempt to cover up her negligence."

During the investigation, the top official in the Health Department also tried to squelch information about the case, the grand jury said.

The doctor who performed the autopsy, Edwin Lieberman, said he was told to keep quiet about the case by Carmen Paris, then the department's acting commissioner.

Edward McCann, who heads the homicide unit for the District Attorney's Office, said that Paris told him it was a miscommunication.

Donald Schwarz, deputy mayor for health, said Paris was suspended pending a hearing today.

In October 2006, after The Inquirer published reports on deaths of other children under DHS supervision, Ransom-Garner at first prepared a counteroffensive - an opinion piece attacking the paper's findings.

She admitted that she didn't bother telling Mayor John F. Street much about the Kelly case "because it wasn't in the press."

But then someone showed Street the photographs of Danieal Kelly. The next morning, on Oct. 20, she was called into the office of Managing Director Pedro Ramos.

"This is the case that is going to take the mayor down," Ransom-Garner quoted him as saying.

There would be no opinion column. Instead, Street fired Ransom-Garner and her top deputy.

Karadzic’s alter ego

More on the prospects for mad psychiatrist Radovan Karadzic.

The July 30 extradition of former Bosnian Serb leader Radovan Karadzic to the Netherlands, following his July 21 arrest, put an end to many years of efforts to bring one of the world’s most wanted fugitives to justice. After 12 years on the loose, Karadzic will face charges of genocide and crimes against humanity, committed during the 1992/95 war in Bosnia, before the United Nations war crimes tribunal for the former Yugoslavia in The Hague.

Many people remain shocked that the one time president of Republika Srpska, allegedly responsible for carrying out massive ethnic cleansing during the Bosnian war, was living a normal life in Belgrade, just like any ordinary citizen. Those more familiar with his numerous transformations, however, were not as surprised.

A graduate psychiatrist, poet and politician, Karadzic was captured spending his days practising alternative medicine, giving lectures, contributing to a health magazine and even running his very own website. Pretty bold, many would say, but, on second thought, these proved to be quite successful tactics because media reported a number of people who have known and been in touch with “Dr Dragan Dabic” are utterly stupefied after finding out who he really was.

[...]

In spite of being officially married to psychiatrist Ljiljana Zelen-Karadzic, with whom he has two children, Sasa and Sonja, Karadzic was reported to have a girlfriend, Mila, during the time he spent as Dr Dabic. She often accompanied him to his lectures and was introduced, by Karadzic, as his associate, media reports claim.

Zoran Pavlovic, the software engineer who worked on Dabic’s website, told the AP Karadzic had a framed photograph of four boys in his two-room apartment in the suburb of New Belgrade, who he claimed to be his grandsons living in the US. Karadzic said he had lived in New York, where he had earned his diploma. “He told me he travelled often to America and I had no reason to disbelieve him,” the software expert told the AP.

Karadzic did not miss out on social life either, as reports say he frequently visited the Madhouse bar in his neighbourhood. There, he enjoyed drinking red wine and listening to the traditional gusle, which he occasionally got to play himself. On its walls, the small pub had pictures of him and his one time close associate Ratko Mladic, the chief of staff of the Bosnian Serb army during the Bosnian war and the next top wanted fugitive on the list of The Hague tribunal.

As the days of healer Dabic are now over, Karadzic has removed the long beard and hair hiding his face. He has also announced he would defend himself at the tribunal. However, how could any defense rebut the charges, as the war in Bosnia saw the worst atrocities in Europe since the end of World War Two?

Karadzic: Psychiatrist-turned 'Butcher of Bosnia'

From the profile on Radovan Karadzic seen on CNN

Radovan Karadzic, whose Interpol charges listed "flamboyant behavior" as a distinguishing characteristic, was a practicing psychiatrist who came to be nicknamed the "Butcher of Bosnia."

Twice indicted in 1995 by the U.N. International Criminal Tribunal for the former Yugoslavia, Karadzic faces charges of genocide, complicity in genocide, extermination, murder, willful killing, persecutions, deportation, inhumane acts, terror against civilians and hostage-taking.

While president of the so-called Serbian Republic of Bosnia-Herzegovina, Karadzic's troops were reported to have massacred over hundreds of thousands of Muslims and Croats during a campaign of "ethnic cleansing." Early estimates of the death toll from the 3-year war ranged up to 300,000, but recent research reduced that to about 100,000.

The U.S. State Department had a $5 million reward for information leading to his capture. His arrest brings an end to more than 10 years as a fugitive.

Psychiatrist Regrets Becoming A Whistle-Blower

A report from the Sunday Mercury; Birmingham (UK)

A doctor turned NHS whistleblower has revealed her regret at going public with claims of patient abuse at Midland hospitals.

Psychiatrist Rita Pal, from Sutton Coldfield, says her career was 'assassinated' after she made allegations that seriously ill elderly patients were being helped to die by NHS staff.

Dr Pal, 36, presented a dossier of evidence to the General Medical Council but it questioned her sanity - and discussed launching an inquiry into whether she was Wt to practise.

She was later awarded a lucrative settlement against the regulatory body and is still pursuing legal action against it.

Yet Dr Pal has now been banned from practising medicine after the GMC ruled she is no longer registered as a medical practitioner 'for administrative reasons'.

The psychiatrist says she regrets ever speaking out.

"Whistleblowing doesn't work," she told the Sunday Mercury.

"It has cost me an awful lot, my career is assassinated but that's the price I paid.

"It is a long and lonely road, and in the end, I'm left wondering if it was worth it."

Dr Pal said she was first branded a troublemaker soon after beginning her career.

"Fresh out of medical school in 1998, I started work at North Staffordshire Hospital as a house officer continuing my training," Dr Pal recalled.

"It was very intense, with 120-hour weeks, but I had no problems for the first three months.

"Then I was moved to a ward for elderly and emergency patients. I faced an emergency with a patient and there wasn't the basic equipment there.

"I was able to stabilise the patient but phoned the nursing director to say more staff and more equipment was needed as basic care wasn't been met.

"This didn't go down well.

"Other doctors had suffered with poor facilities but no-one ever raised concerns. Patients kept dying and no-one was doing anything."

Dr Pal's outspoken concerns brought her further anxiety.

"I then found myself in a complete nightmare," she said.

"Two weeks later I was accused of disposing of a needle on a day when I wasn't even on the ward. It's a criminal offence under health and safety to dispose of a needle.

"I faced a hearing where I represented myself, and the chargeswere dropped. But I'd already got a name for myself as a 'trouble-maker'.

"The pressure on me to leave was awful and I was advised to move into general practice.

"I moved to Birmingham to do surgery but I had no references and 'whistleblowing' follows you around.

"In 2000, I contacted a newspaper about the elderly patients who were being neglected and worse, being given drugs that hasten death.

"I thought if I raised concerns about healthcare, conditions would at least improve.

"I've had 10 years of fighting for accountability - I feel let down by the NHS.

New York psychiatrist settles malpractice lawsuit

As reported in News Day

A former psychiatrist who confided to a patient that he wanted to kill six people, and asked the patient to help him find a handgun, has settled a medical malpractice lawsuit with the man.

Richard Karpf agreed to pay $365,000 to Dennis White, a former patient who called police in January 2003 telling them of Karpf's intentions. The settlement came Monday, while a Nassau County jury was in its second day of deliberations in the civil lawsuit.

Karpf was arrested after purchasing a pistol and silencer from someone who turned out to be an undercover officer. He pleaded guilty in 2004 to illegal weapon possession and was sentenced to three months in jail. He remains on probation through next year.

Attorneys for both sides said they were satisfied with the settlement.

Convicted killer working as psychiatrist - Patients don't know he killed his wife

From the Sydney Morning Herald:

The family of a woman killed by her psychiatrist husband in 1987 is disgusted he was later able to be reregistered to practise.

Dr George Sliwinski shot his former wife Alice in 1987 and was sentenced to eight years' jail after pleading guilty to manslaughter on grounds of diminished responsibility.

Dr Sliwinski had been struggling with alcoholism and the use of prescription drugs, which during the 80s had led to a number of breakdowns and admissions to psychiatric hospitals.

After being released on parole in 1990, in 1994 Dr Sliwinski successfully appealed to the Medical Tribunal of NSW to be reregistered.

Since 1996 he has been employed as a psychiatric registrar at Gosford and Wyong hospitals.

The Australian Medical Association opposed his reappointment, Fairfax has reported.

News that Dr Sliwinski was again practising has alarmed his late wife's family, with the victim's sister, Noleen Tasoulis, saying it was "disgusting".

But Dr Sliwinski has been defended by his colleagues and NSW Health.

A spokeswoman for the Northern Sydney Central Coast Area Health Service said there had been no formal complaints about his work.

"All appropriate background checks required at the time of his employment were conducted," she said.

Senior psychiatrist Chris Tennant defended his colleague, saying Dr Sliwinski "met all the conditions imposed on him by the board".

Many of Dr Sliwinski's current patients do not know of his past, as he is under no obligation to tell them, Fairfax says.

Of course, there's been a small uproar over this discovery. We also have this extended report

NINE years after he shot and killed his wife, George Sliwinski was back in his job as a psychiatrist, treating mentally ill patients in public hospitals.

Dr Sliwinski himself had a history of mental illness. This led him to either leave or be dismissed from four medical facilities in the 1980s. In 1987, after a decade of chronic drug and alcohol abuse, he shot his former wife, Alice, four times, a month after their divorce. One of the shots, to her head, killed her.

But Dr Sliwinski was released on parole in 1990. And he was employed as a resident medical officer at the Central Coast Mental Health Service in July 1994, shortly after successfully appealing to the Medical Tribunal of NSW to be re-registered. The Australian Medical Association publicly opposed the re-registration.

Dr Sliwinski was employed as a psychiatric registrar at Gosford and Wyong hospitals in 1996, and continues in this role.

But, to this day, many of his patients are unaware of his past - and there is no obligation for DrSliwinski or authorities to tell them.

The case of Dr Sliwinski raises difficult issues of a patient's right to know the record and background of their doctor and the ability of someone to redeem themselves and begin a new life.

In 1994 the Medical Tribunal said it had "some difficulty" deciding whether he was fit to be a doctor. But it concluded he was suitable because he did not intend to kill his wife, had no history of violence and was supported strongly by three psychiatrists who gave evidence that he had been fully rehabilitated and was very unlikely to relapse.

And yet questions remain unanswered. The Health Department will not reveal how it monitored Dr Sliwinski to ensure he met strict conditions imposed by the tribunal, such as regular urine and/or blood tests, psychiatric treatment and constant supervision. The tribunal also appeared to be unaware that Dr Sliwinski's wifealleged he had a history of violence against her. It found the killing was an "isolated occasion", despite her allegations, set out in an Apprehended Violence Order summons issued in the year before her death.

The Royal Australian and New Zealand College of Psychiatrists - which is responsible for ensuring the suitability of psychiatrists - has refused to comment on what processes it undertook to assess him. And in the 1990s the NSW Medical Board was not required to independently notify employers of a doctor's restrictions. A spokeswoman for the board, Edwina Light, said it was prohibited from revealing why DrSliwinski's strict conditions were lifted in 1999.

Doctors are not legally obliged to tell patients they are working under conditions or have been deregistered in the past, and the Health Department has no policy requiring disclosure.

Dr Sliwinski went on trial in the Supreme Court for the murder of Alice on October 1, 1987, a month after they divorced.

He pleaded guilty to manslaughter on the fourth day of his trial, in 1988, and was sentenced to a maximum of eight years' jail.

He had shot Alice four times but said he could not recall the incident and successfully argued diminished responsibility because of his intoxicated state.

In sentencing him, Justice Ray Loveday said there was no motive for the killing and described it as "quite bizarre".

According to the tribunal's 1994 judgment, he had been abusing alcohol and a cocktail of prescription drugs, mostly tranquillisers, for almost a decade and had sought psychiatric help several times from 1979, including stays at psychiatric hospitals in 1985 and 1987. He feared "dying and going mad".

His drinking dated back to the late 1960s, when he drank on the job as a medical trainee because he found attending cancer wards difficult.

His father died of bone cancer when Dr Sliwinski was 11 and his mother had schizophrenia.

The drug addiction began in 1977 after his first wife, Barbara, left him with their children and a doctor gave him Serepax after he was unable to administer anaesthesia due to a panic attack at Moree Hospital.

However, in its judgment in 1994 the tribunal concluded that Dr Sliwinski was not an intrinsically violent person. "[The shooting] does not indicate a tendency to vice or violence or any lack of probity. It has neither connection with nor significance for any professional function. There is no evidence that the appellant [previously] committed acts of violence towards his ex-wife or any other person …" the tribunal said.

However, a summons was issued to Dr Sliwinski over an allegation that he assaulted her by attempting to choke her in August 1986.

The AVO application, seen by the Herald, alleged that Dr Sliwinski, who had been drinking heavily, said to his wife, "If I hear you have done anything to foul up my career I will kill you", and had assaulted her three or four times during their five-year marriage. The AVO was withdrawn by his wife.

Three years before the killing, he was twice told to take sick leave from his job as a psychiatric registrar at Morriset Hospital due to his depressed mental state and concerns that he was suicidal.

He was also told to take sick leave from the Mater Hospital in Newcastle not long after that.

In 1987 he was sacked from a practice at Kilburn Bay and told to seek psychiatric help. He had come to the North Coast after he left Moree Hospital in 1980 after "difficulties with the Medical Board, [and] with the Hospital Board", and moved to Newcastle, the tribunal said.

He had been investigated by the Medical Board for failing to attend to an unconscious patient at Moree who had had a stroke, and was cautioned over the incident.

A spokeswoman for the Northern Sydney Central Coast Area Health Service, Jenny Dennis, said: "All appropriate background checks required at the time of his employment were conducted." She later confirmed "this included the NSW Medical Board".

"Central Coast Mental Health Service can confirm that Dr Sliwinski complied with the restrictions placed on him by the Medical Board," she said. She said there had been "no formal complaints about his work".

Ms Light, said it was the responsibility of the Royal Australian and New Zealand College of Psychiatrists to determine whether Dr Sliwinski was fit for psychiatry. The college would not comment.

The board's registrar, Andrew Dix, said it regularly monitored conditions. "It's up to the doctor to comply but if they don't comply we know about it very quickly because we've got a data base following this," Dr Dix said.

Alice's sister, Noleen Tasoulis, said the family was devastated that Dr Sliwinski was practising psychiatry. "I think it's disgusting," Mrs Tasoulis said.

She alleged that at the time of his marriage to her sister he was a "violent" alcoholic and her sister supported him with $335,000 she won in a lottery just before they married. "The seven years that he was married to my sister … he was in various [psychiatric] clinics … so it seems rather unbelievable that he could even practise."

Dr Sliwinski had a solicitor, Denis Williams, contact the Herald to arrange an interview yesterday to respond to questions about his past and what monitoring he was subjected to by the area health service.

Dr Sliwinski did not show up but a senior psychiatrist, Chris Tennant, who is a visiting medical officer at Gosford and Wyong hospitals, did, and strongly defended him.

Professor Tennant said "he met all the conditions imposed on him by the board".

He said whether he told the tribunal he was considering a career in psychiatry was irrelevant. "It's not their business," he said.

He declared the Herald "mother f---ers" after the meeting.

Mr Williams said Dr Sliwinski's suitability had been "extensively considered" by the college and the tribunal. "There's been no record anywhere of this bloke not doing the right thing since the day he was readmitted," he said.

Asked whether Dr Sliwinski divulged to the tribunal that there had been other allegations of assaulting his wife, Mr Williams said: "It's too long ago."

Asked about the alleged threat Dr Sliwinski made to his wife that he would kill her, Mr Williams said: "I think we'll end this now. Goodbye."

Psychiatrist: I didn't think patient would take murder plot 'literally'

Sounds like the Shrink is either lying, or is an idiot. As seen in NewsDay

[...] Karpf said he viewed White as a friend, and he said he was hurt when White turned him in to police in January 2003 after Karpf revealed a plot to kill people and dump their dismembered bodies in shark-infested waters.

"I didn't feel he would take me literally," Karpf said. "I felt he would take it as it was -- as a fantastic, concocted story. ... It was such a fantastic story, who would believe it?"

Karpf, 55, of Great Neck, testified for a second day Thursday in a medical malpractice suit brought against him by White, 43. White is seeking unspecified monetary compensation.

White was Karpf's patient for more than six years in December 2002, when Karpf said he began sharing details of a plot to commit murder. Talking about the plot was "just an excuse to have this relationship with him," Karpf said.

"I just thought that he would be impressed by the story, by the fact of the life he led," Karpf said, under questioning by White's attorney, Ruth Bernstein, of Manhattan.

"He was the kind of a guy people would be afraid to mess around with." Karpf said he created a list titled, "Motives for Murder," based on something he saw he in a television movie, "The General's Daughter."

Among the "motives" were profit, revenge, humiliation and "homicidal mania," he testified. He said he wrote the list because "I was having a mental breakdown at the time."

He said he did not remember whether he showed the list to White. After learning of the plot, White called police and cooperated with their investigation.

Karpf acknowledged that he asked White for help to buy a gun, a silencer, ammunition, an axe, cleaning supplies and a van. He said he drove with White on Jan. 8, 2003, to a bank to withdraw money. Later that day, they met with an undercover officer posing as a gun dealer, Karpf said. Police said Karpf was arrested after paying the officer $1,600 for a gun, silencer and ammunition.

Karpf pleaded guilty in 2004 to third-degree criminal possession of a weapon and was sentenced to three months in jail, time he already had served. He surrendered his medical license after his guilty plea. Karpf said he didn't need White's help to purchase a weapon.

[...]

After his arrest, Karpf said, he was hurt "by the fact that he [White] got the police involved."

Attorney: Ex-patient feels threatened by psychiatrist

A report out of New York State, as seen in Newsday

Richard Karpf was bullied as a child and kicked out of his apartment by roommates while attending a Mexican medical school.

Dennis White started having panic attacks when he was 6 and suffered from sleep disorders and depression as an adult.

Their lives crossed in 1996 when Karpf became White's psychiatrist. Six years later, White called police and said Karpf had revealed a plot to kill people and feed their dismembered bodies to sharks.

Yesterday, the two men met again as White's medical malpractice trial against Karpf opened in State Supreme Court in Mineola.

In opening arguments, lawyers debated whether White remains psychologically damaged after, he told police, Karpf asked him to help purchase a gun with a silencer. White, 43, suffers from post-traumatic stress disorder from the incident and is still afraid of Karpf, said his attorney, Ruth Bernstein of Manhattan.

"Dennis believes every day of his life that the defendant is still coming after him," Bernstein said.

Karpf, 55, pleaded guilty to third-degree criminal possession of a weapon in 2004 and was sentenced to three months in jail, time he already had served. He is on probation through next year.

After White contacted police, they arranged for Karpf to meet an undercover officer, whom Karpf paid $1,600 for a .22-caliber semi-automatic handgun, a silencer and boxes of ammunition in the parking lot of the Westbury Home Depot.

Karpf, who surrendered his medical license after pleading guilty, insisted that the plot was a fantasy and he had no intention of carrying it out.

Karpf's attorney, CaraMia Hart of Manhattan, conceded that he told White of a "completely inappropriate plan" to commit murder and he was "appropriately" prosecuted. But she questioned whether White suffers more now than he did six years ago. "Was Dennis White hospitalized at any point? Rendered incapable of working?" Hart said.

Since Karpf's arrest, White has married and become a father, she said.

Bernstein said Karpf's patients did not know he suffered a "lifelong mental illness" while he continued to practice at his Garden City office.

"This very sick man had a license to practice medicine," she said. "How would anyone know that he was spiraling downward?"

On Dec. 26, 2002, she said, White walked into Karpf's office and found him "disheveled." Karpf asked White, a mechanic, to help him buy a car and a boat. Later, Karpf asked White about buying a gun and finding shark-infested waters. "Dennis was starting to think there was something very wrong," she said.

Psychiatrist Pleads Not Guilty To Murder

As covered widely in the Australian press, and as seen in the Australian

A FORMER NSW psychiatrist has pleaded not guilty to the shooting murder of South Australia's former mental health chief, Margaret Tobin, in 2002.
Appearing in the South Australian Supreme Court today, Jean Eric Gassy, 52, declared emphatically he was not guilty when asked to plead to the murder charge.

Dr Tobin was fatally shot as she walked from a lift on the eighth floor of an inner-city office building in Adelaide in October 2002.

She was 50 years old.

Justice Trish Kelly said the trial would be listed for hearing at the earliest opportunity.

Dr Tobin's widower, Don Scott, said outside court the day had been an emotional one for him.

Mr Scott said he would attend the trial, even though it might bring back “horrific” memories for him.

Representing himself, Mr Gassy was remanded in custody for a directions hearing in two weeks.

He flagged his intention to apply for a “suppression order” from the court, but Justice Trish Kelly suggested he raise it at the directions hearing.

Prosecutor Peter Brebner QC asked the court for more time to prepare the Crown case, because of the large number of witnesses expected to be called.

“Checking their availability will take quite some time,” Mr Brebner said.

As noted in this news item from Adelaide Now, this is a re-trial, due to the original conviction being overturned due to technical errors by the Judge in the case.

A Supreme Court judge has told prosecutors that the retrial of the man once convicted of the shooting murder of Dr Margaret Tobin should be held as soon as possible.

Justice Trish Kelly today said that a retrial for Jean Eric Gassy should be held as soon as possible.

"From the court's point of view, this matter should proceed in August," Justice Kelly said.

Gassy, 51, today pleaded not guilty to murder and plans to represent himself at trial.

The former Sydney psychiatrist was jailed for life with a 34-year non parole period for the shooting murder of Dr Tobin in October 2002.

Dr Tobin, then South Australia's mental health chief, was shot four times as she walked from a lift at her city office building.

Earlier this month, the High Court of Australia overturned Gassy's murder conviction and sentence.

The High Court found that Supreme Court Judge Ann Vanstone had erred in her directions to the jury during their deliberations in Gassy's original trial.

Prosecutor Peter Brebner QC said more than 160 witnesses were likely to be called when the matter again goes to trial.

Dr Tobin's widower Don Scott attended this morning's hearing, which lasted a little over two minutes.

Gassy will be back in court in June, when another judge will set a date for the trial.

Psychiatrist 'let crazed bodybuilder free to kill and dismember two women,' tribunal hears

We often assume the psychiatrists are capable of fulfilling their duties regarding public safety at a basic level, especially regarding real, not imagined threats. It seems that our trust was unwarranted in this case involving the gruesome murder of two young women. Report from This Is London

A schizophrenic killed two women after a senior psychiatrist discharged him from hospital against the advice of other doctors and the man's own family, a medical tribunal heard yesterday.

Dr Eric Birchall, 70, released bodybuilder Mark Corner into the community, telling GPs he posed little risk to the public. But less than a year later 29-year-old Corner - who was a cannabis smoker, had a history of violence and harboured murderous thoughts - killed two prostitutes in separate attacks.

He butchered Hanane Parry, 19, and 25-yearold Pauline Stephen before dumping their body parts in bin bags in a Liverpool alleyway. Other parts were found in his freezer. Both women were so badly mutilated that police were unable to say exactly how they died.

Corner was sentenced to indefinite detention under the Mental Health Act after admitting manslaughter on the grounds of diminished responsibility.

Yesterday, a hearing of the General Medical Council in Manchester was told that Corner, who had mental health problems from the age of 12, had been sectioned in 2002 after trying to stab a female neighbour with a kitchen knife.

Corner told one doctor he had an "abnormal interest in girls who died and were dismembered".

Experts concluded he was likely to become dangerous if he went back to using alcohol, cannabis and cocaine. A mental health tribunal ruled that Corner, from Everton, should not be released.

But Dr Birchall agreed to discharge Corner from the Ferndale mental health unit in Liverpool less than a month later, telling his GP the risk to others was low.

Within a fortnight Corner had taken an overdose of paracetamol. He told doctors he had stopped taking medication for his schizophrenia and had begun drinking and smoking cannabis.

Corner's father pleaded with the doctors to readmit his son, but again Corner was discharged.

In the months before the killings he missed two of three outpatient appointments and was seen just once by his GP. He also admitted taking up to 70 Ecstasy tablets a week and hearing voices again.

The panel was told that Corner was arrested in July 2003 and charged with the murder of both prostitutes.

He was convicted of their manslaughter and detained indefinitely in that December.

An inquiry said Dr Birchall had committed "grave errors of judgment" when he discharged Corner. His claim that the risk was "low" was "inaccurate and misleading".

Yesterday, Craig Sephton, for the GMC, told the tribunal: "It is not part of my case to say that Dr Birchall was responsible for those murders but it is our job to find out what happened.

"We suggest that he did not devise an adequate care plan. We say that Dr Birchall did not adjust the care plan to accommodate the new features of the case."

If found guilty of misconduct Dr Birchall, who no longer works for the Mersey Care NHS Trust, could be struck off the medical register and banned from practising.

The tribunal continues.