Notorious Psych Ward at Miami-Dade Jail Finally Shuttered

From this report in the Prison Legal News Website

In a historic culmination to decades of “horrific” living conditions and a pattern of constitutional violations, the Miami-Dade County Jail in Florida has finally closed the “Forgotten Floor” – the notorious ninth floor at the facility that was used to house mentally ill prisoners, often for months and years at a time, with levels of care so abysmal that prisoners routinely died.

“It is thrilling on one level but kind of sad that it has taken so long,” said Miami-Dade Judge Steve Leifman of the December 23, 2014 closure of the jail’s ninth floor. “A lot of people have been hurt or died up there.” Leifman, as chair of the 11th Circuit Mental Health Project, has been a long-time advocate for the mentally ill.

In 2013 alone, three mentally ill prisoners housed on the ninth floor died. On August 26, Joseph Wilner, 59, was found “unresponsive” in his cell; jailed for driving on a suspended license, he was in the unit reserved for the most acute mental cases.

In July 2013, Leifman was informed of the death of wheelchair-bound prisoner Joaquin Cairo. An employee with the jail’s diversion program told the court that Cairo said “someone propositioned him while in custody and when [he] declined they threw him against the bed and against the floor.” Cairo suffered a broken pelvis and died from internal bleeding.

“The neglect was despicable. Despicable,” Leifman said. “He should have been taken to a hospital immediately, and there is absolutely no excuse.”

Three months earlier another psych ward patient, Juan Matos-Flores, who was considered a suicide risk, died after jailers found him unresponsive on the floor of his cell. When staff tried to call 911 they were unable to do so because the phones on the ninth floor were programmed to block outgoing calls. Instead, employees were forced to call another floor to get help.

“It’s a floor that is specifically designed for people who are ill. It’s absurd,” Leifman said after learning of the telephone debacle.

When the ninth floor at the Miami-Dade County Jail closed, some 400 prisoners were transferred to six newly-refurbished wings at the Turner Guilford Knight Correctional Center, where the telephones allow 911 calls and cameras monitor prisoners in every cell.

[...]

The Miami-Dade County Jail, the nation’s eighth-largest, has been under federal monitoring since the U.S. Department of Justice concluded a three-year investigation in 2011 that found a “pattern and practice in constitutional violations” of prisoners’ rights due to deplorable living conditions.

Leifman was more blunt, calling conditions on the Forgotten Floor “horrific.”

“It was not built to be a psychiatric facility. It was built as a jail [with a cell] for one person, and here two and three people [were placed] in there that are very psychotic,” he said.

The public got its first glimpse of the infamous floor in 2006 when Leifman invited a television reporter and camera crew to document conditions as he guided a tour. “Human beings should not be treated like this. No blankets, no beds, no mattresses. We sleep on the floor,” one prisoner told CBS4 chief investigative reporter Michele Gillen, who found the faucets in cells were not working and prisoners were drinking water from the toilets. Leifman credited Gillen’s reporting with stirring public outrage which, in turn, prompted action.

“We have finally closed the ninth floor, thanks to you,” Leifman told Gillen in an interview. “I don’t think the public ever would have understood how horrendous the situation was, but for your reporting. And it led to where we are today.”

Physician Sentenced for $5.5 million Medicare fraud scheme involving fraudulent billings by a psychiatric hospital

As seen in this report

A Miami-area medical doctor was sentenced recently to 60 months in prison for his role in a $5.5 million Medicare fraud scheme involving fraudulent billings by a psychiatric hospital in Hollywood, Florida.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Special Agent in Charge Shimon Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.

Barry Kaplowitz, 54, of Aventura, Florida, a licensed physician, was convicted of making false statements related to health care matters on Feb. 20, 2015, following a six-week jury trial. In addition to the recent prison sentence, U.S. District Judge Cecilia M. Altonaga of the Southern District of Florida ordered Kaplowitz to pay more than $2.9 million in restitution.

According to evidence presented at trial, Kaplowitz served as the medical director at Hollywood Pavilion (HP), a state-licensed psychiatric hospital, from approximately 2008 to 2011. During that time, Kaplowitz signed false and fraudulent medical records in order to make it appear that HP’s patients qualified for and received intensive outpatient services, even though they did not. The evidence demonstrated that Kaplowitz signed patient files for over 400 patients certifying that he had provided mental health services to each of them, even though he never saw nor provided any treatment to the patients. HP used these falsified medical records to submit over 2,800 false claims to Medicare totaling over $5.5 million. Medicare paid $2.9 million on those false claims.

Five other individuals have previously been convicted and sentenced in this case:

• Karen Kallen-Zury, of Lighthouse Point, Florida, HP’s former chief executive officer, was sentenced to 25 years in prison;
• Daisy Miller, of Hollywood, the clinical director of HP’s inpatient facility, was sentenced to 15 years in prison;
• Michele Petrie, of Fort Lauderdale, Florida, the head of HP’s intensive outpatient program, was sentenced to six years in prison;
• Christian Coloma, of Miami Beach, Florida, the director of physical therapy for an entity associated with HP, was sentenced to 12 years in prison; and
• Christopher Gabel, of Davie, Florida, HP’s former chief operating officer, was sentenced to six years in prison.

Jurors to decide fate of South Florida psychiatrist, others in Medicare fraud trial

Highlights from an extended report in the Miami Herald

Barry Kaplowitz was a psychiatrist with a “robotic” signature who signed off on thousands of bogus treatments at a Hollywood psychiatric facility that bilked Medicare for millions — even when he was out of the country, prosecutors say.

“It’s not just any kind of signing; it’s robo-signing,” Justice Department prosecutor Andrew Warren declared during closing arguments at his Miami federal trial.

[...]

On Tuesday, Miami federal jurors resumed deliberating the fate of Kaplowitz, 54, an Aventura psychiatrist who worked part-time as the medical director of Hollywood Pavilion’s outpatient facility, and two other defendants on charges of conspiring to defraud Medicare and related offenses.

[...]

The other defendants are Melvin Hunter, 63, a Broward resident who worked as an admissions supervisor for Hollywood Pavilion’s inpatient facility, and Tiffany Foster, 49, an Alabama resident accused of taking bribes to refer mental health patients.

A fourth defendant, Christopher Gabel, 62, of Davie, the former chief operating officer, pleaded guilty in November to conspiring to commit healthcare fraud and pay kickbacks to patient recruiters. Gabel, who is serving a six-year prison term, testified that Medicare beneficiaries — including drug addicts with disability status — were admitted regardless of whether they qualified for treatment or even saw a doctor.

The latest trial followed the 2013 conviction of Hollywood Pavilion's chief executive officer, Karen Kallen-Zury, of Lighthouse Point, who was found guilty along with three other employees of conspiring to bilk $67 million from Medicare by filing phony claims for mental health services from 2003 to 2012. Medicare was tricked into paying $40 million to Hollywood Pavilion. Of those defendants, Kallen-Zury received the longest sentence: 25 years.

During the six-week trial, prosecutors presented evidence showing that Kaplowitz generated $6.5 million in false claims for Medicare patients who did not need psychiatric treatment, resulting in $3 million in tainted income for Hollywood Pavilion between 2008 and 2011. The psychiatrist was paid $1,250 a month over that period for showing up one day a week to sign charts and other paperwork to justify 2,800 false claims to Medicare, prosecutors said.

[...]

The prosecution of Kaplowitz, Hunter and Foster was the latest crackdown by the Justice Department and U.S. attorney's office against operators of mental-health facilities accused of fleecing the Medicare program.

Three previous major prosecutions led to the convictions of about 100 clinic operators, doctors, therapists and patient recruiters at American Therapeutic, Biscayne Milieu and Health Care Solutions Network in South Florida.

Several of those convicted defendants testified at the latest trial. Among them: Dr. Alan Gumer, a former medical director at the Hollywood Pavilion facility who is serving a 21/2-year sentence in the American Therapeutic case, and Keith Humes, a Hollywood Pavilion patient recruiter who is serving a seven-year prison sentence stemming from another Medicare fraud offense.

Psychiatrist Dr. Francisco J. Pages Called 'Clueless' About Drugs

As reported by WUSF News

Another corrupt shrink on the drug company payroll

A long-time Miami-area psychiatrist who prescribes heavy-duty drugs in abundance has not been doing it safely, the Florida Board of Medicine said Friday.

Dr. Francisco J. Pages, charged with mismanaging the care of nine patients, needs to be evaluated to see what his knowledge level is, the board decided at a meeting in Stuart. Pages needs training to make up the deficits and close supervision by another psychiatrist for at least two years, the board said.

“I’m not sure this physician understands the multiple medications he’s prescribing,” said board member Dr. Bernardo Fernandez of Coral Gables. “Some of these patients are on seven, even 10 medications. Sometimes he prescribes a medication that counteracts the medications (the patient is) already on.”

Dr. Zach Zachariah of Fort Lauderdale pulled no punches. “If you look at this case, it portrays a physician who is clueless, absolutely clueless,” he said.

Pages said very little, leaving that to his attorney.

“Uninsured, homeless citizens rely on Dr. Pages. He sees the patients no one else truly wants to see,” the lawyer, Philip Goss, said.

Goss said that while his client was “embarrassed” to be called before the Board of Medicine, he sees his problems not as lack of skill but as “improper record-keeping and lack of attention to detail.”

The Board of Medicine didn’t buy it. “It’s not inattention to detail,” said Dr. Sarvam TerKonda of Jacksonville. “It’s inappropriate prescribing.”

Regardless of their status, patients deserve the proper medicine, said Dr. Fernandez.

[...]

The board rejected a settlement negotiated between Pages and the Florida Department of Health as being insufficient. To the original terms -- a reprimand, $25,000 fine, some courses and two years’ probation – the board added an evaluation of Pages’ skills by a special team from University of Florida.

Technically, the psychiatrist could reject that offer and insist on a formal hearing, but attorney Goss said after the hearing that Pages would probably accept it.

The psychiatrist, who used to have an office, now practices only in hospitals, Goss said. He did not say which ones. The state DOH web site lists him as having privileges at six hospitals, but the list is clearly out of date since one of them has closed.

Pages was reported to DOH by the state Agency for Health Care Administration after his Medicaid prescribing patterns caused alarm, state records show. Pages lost the right to participate in the Medicaid program.

But not Medicare. Pages showed up as a fairly prolific prescriber for Medicare patients in ProPublica’s "Dollars for Docs” project, in which reporters analyzed the prescriptions filled for Medicare patients in 2012. ProPublica's searchable database shows Pages was responsible for about 15,000 claims for about 1,000 patients at a cost of $3 million. Among Florida psychiatrists, some wrote more prescriptions, but only one cost taxpayers more.

Pages is among the doctors who received money as a consultant for pharmaceutical companies, according to the ProPublica database. His two largest benefactors were Eli Lilly, which paid him about $20,000 for speaking in 2009-10, and Pfizer, from which he received about $16,000 in 2010 and smaller amounts in recent years, since the state investigation of his prescribing patterns began.

Judge allows portion of lawsuit filed by man locked up for 19 years

From a Report in the Journal Star

A federal judge ruled last week that parts, but not all, of a Florida man's lawsuit can go forward against his former doctors at the Lincoln Regional Center, where he was locked up for more than 19 years on a misdiagnosis.

For years, John Montin's doctors said his denials that he was mentally ill were evidence that he was.

But in 2013, his treatment team agreed with him. It was a medication-induced psychosis that led to an incident in Hayes County and his commitment at the Regional Center, the team said, and a judge let him out.

In July, Montin sued his former doctors, alleging:

• that his former doctors and treatment team members had deprived him of his rights, a so-called 1983 civil rights claim, and
• that they hadn't met the standard of care, a state medical malpractice claim.

He is seeking more than $22 million in damages for incorrectly being labeled mentally ill and for unnecessarily being held and subjected to treatments he didn't need. He also is seeking $760,000 in lost wages and $10 million in punitive damages.

In a decision that was neither all good nor all bad for either side, Senior U.S. District Judge Lyle Strom refused to dismiss Montin's case, a move the doctors had sought. But the judge also refused to let Montin go forward on a number of theories, including unnecessary bodily restraint.

While the doctors' annual reports might have kept Montin in the locked hospital for more than 19 years, they hadn't shackled him to his bed or otherwise physically restrained him there.

Montin also cannot go forward on a theory that his doctors hadn't made truthful disclosures in their reports. In other words, Montin had alleged that at some point the doctors had to know his diagnosis was wrong.

But Strom did allow Montin to go forward on a theory alleging that the doctors retaliated against him because he kept filing lawsuits.

And the judge refused to throw out the case on an argument by the Nebraska Attorney General's office, which represents most of the defendants, that the state employees couldn't be sued because they were acting essentially as part of the judicial process.

"The court disagrees," Strom wrote in the order.

Much much more at the link

Miami-Area Psychiatric Hospital Chief Operating Officer Christopher Gabel Pleads Guilty in $67 Million Mental Health Care Fraud Scheme

As reported in the Imperial Valley News

The former chief operating officer of a Miami-area hospital pleaded guilty today for his role in a mental health care fraud scheme that resulted in the submission of more than $67 million in fraudulent claims to Medicare by a state-licensed psychiatric hospital located in Hollywood, Florida, that purported to offer both inpatient and outpatient mental health services.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Special Agent in Charge Derrick Jackson of the U.S. Health and Human Services Office of Inspector General’s (HHS-OIG) Florida region made the announcement.

Christopher Gabel, 61, of Davie, Florida, the former Chief Operating Officer (COO) of Hollywood Pavilion LLC (HP), pleaded guilty before U.S. District Judge Cecilia M. Altonaga in the Southern District of Florida to one count of conspiracy to commit health care fraud and one count of conspiracy to defraud the United States and pay and receive health care kickbacks. Gabel was charged in an indictment returned on May 8, 2014.

According to Gabel’s admissions in connection with his guilty plea, between April 2003 and September 2012, HP submitted false and fraudulent claims to Medicare for treatment that was not medically necessary or not provided to patients. As COO during that time, Gabel supervised HP’s staff at both its inpatient and outpatient facilities, where Medicare beneficiaries were admitted to HP regardless of whether they qualified for mental health treatment, and were often admitted before seeing a doctor.

Gabel admitted that HP obtained Medicare beneficiaries from across the country by paying bribes and kickbacks to various patient brokers. Gabel instructed the patient brokers to falsify invoices and marketing reports in an effort to hide, and cover up the true nature of the bribes and kickbacks they were receiving from HP. From 2003 through August 2012, HP billed Medicare approximately $67 million for services that were not properly rendered, for patients that did not qualify for the services being billed, and for claims for patients who were procured through bribes and kickbacks. Medicare reimbursed HP nearly $40 million for those claims.

Karen Kallen-Zury, Daisy Miller, Michele Petrie and Christian Coloma were convicted at trial in June 2013 for their roles in this scheme. Kallen-Zury, HP’s former chief executive officer, was sentenced to 25 years in prison. Miller, the clinical director of HP’s inpatient facility, was sentenced to 15 years in prison; and Petrie, the head of HP’s intensive outpatient program, was sentenced to six years in prison. Coloma, the director of physical therapy for an entity associated with HP, was sentenced to 12 years in prison. Kallen-Zury, Miller and Petrie were ordered to pay nearly $40 million in restitution, and Coloma was ordered to pay more than $20 million in restitution.

The case is being investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Florida. The case is being prosecuted by Trial Attorneys Nicholas E. Surmacz, Andrew H. Warren and L. Rush Atkinson of the Criminal Division’s Fraud Section.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Team (HEAT), go to: http://www.stopmedicarefraud.gov

Disciplinary Hearing of Florida Psychiatrist Ronald Kurlander

As seen in the description on YouTube

On April 5, 2013 in Deerfield Beach, Florida psychiatrist Ronald Kurlander was disciplined by the Florida Department of Health. He was accused of prescribing drugs to people he had never examined or even met. The father of one of Kurlander's patients gave testimony as to the extensive damage caused by these drugs to his son. Kurlander is the one with the moustache and goatee with wire frame glasses seated to he left. He was fined over $30,000.00, given a reprimand, ordered to take a law and rules course, a drug course and a medical records course. Additionally, he has to undergo a risk management assessment.

Family therapist charged with domestic battery

A report from TampaBay.com

Michael Anthony Holder is a family therapist who conducts at-home "Dynamic Parenting Courses" to correct negative patterns in children's behaviors.

But he's in jail now, after Hillsborough County Sheriff's Deputies charged him with two counts of domestic battery, including the battery by strangulation of his 15-year-old stepson.

An arrest report says that during a domestic argument, Holder, 39, grabbed the boy by his neck, restricting his airflow, and that he inflicted several lacerations to the boy's arms and face and left a contusion on his left arm.

The report states that Holder denied strangling the boy, but admitted to having touched him in an attempt to get his stepson out of his living quarters.

The report lists Holder's place of employment as ACTS, a non-profit agency that provides services from help with substance abuse to mental illness to child protection.

Holder is being held at Orient Road Jail with no bond.

Restraint of foster kids questioned

A report from the Miami Herald

Last month, a 16-year-old Broward County girl was brought into Circuit Judge John A. Frusciante's courtroom for a hearing. She was handcuffed, her legs shackled with cloth restraints, with two armed deputies leading her by the arm.

Her offense? She's never been charged with one. A mentally ill foster child who was neglected by her mother and wound up in a psychiatric center, the teen was being restrained to keep her from running away, her attorney said.

The girl, who is not being identified to protect her privacy, is among scores of foster children in locked psychiatric centers in Florida recovering from abuse and neglect.

Now, the practice of restraining mentally ill foster children in court is prompting questions in both Broward and Miami-Dade counties.

In Fort Lauderdale, Walter Honaman, the 16-year-old's lawyer and an advocate for foster kids, is working with Frusciante and court officials to develop a voluntary policy to discourage deputies from handcuffing mentally ill foster kids who come to court.

And in Miami, a nurse practitioner who worked briefly as a director of patient care at Jackson Memorial Hospital's mental health center filed complaints with state regulators seeking to end the practice of restraining children who leave JMH's residential treatment center, or RTC.

''We bring these kids into the courtroom in handcuffs with armed deputies,'' said Honaman, who works for Legal Aid Service of Broward County. 'That's nuts. We don't maintain these kids' dignity, and we send the message that they are being punished. They are being treated like criminals. These are kids that need serious help.''

Administrators at Jackson have defended the use of ''walking restraints'' when children from their treatment center leave the facility, arguing many kids run away, which can endanger them.

The treatment center ''uses walking restraints for safety and prevention of elopement when clients are sent to an urgent medical appointment or court hearings that they can't miss early in their admission,'' Helga Mayrgundter, a program director for one of JMH's children's psychiatric units, wrote in an April e-mail.

Lorraine N. Nelson, a JMH spokeswoman, said the children's psychiatric unit uses walking restraints on less than 1 percent of its patients when they are being transported outside the facility, and follows all regulatory agency guidelines.

''The fabric restraints are only used when a patient is determined to be a flight risk and are removed immediately after a patient has returned safely to the facility,'' Nelson said. ``A board-certified psychiatrist with extensive experience in childhood trauma and behavioral management must write an order for the use of restraints.''

Jackson's use of foot restraints came under scrutiny beginning in April, when a new nurse administrator questioned the practice. The nurse, Lisa Burton, later filed complaints, including one to the Miami-Dade County Commission on Ethics and Public Trust.

The ethics commission ''conducted a thorough investigation of the allegations and ultimately dismissed the complaint,'' said JMH's Nelson. The commission findings, ''speak for themselves,'' she said.

In an April em-ail with other JMH administrators, risk manager Tish Batchelder wondered whether halting the restraints would lead to more escapes, thus ''putting patients in danger.'' But she also acknowledged: ``I hate the idea that we do it.''

Real leg shackles -- the metal kind -- routinely have been used for delinquent children who appear in court, though several public defender offices mounted a statewide campaign two years ago to end the practice. In most counties, shackling continues, said Miami-Dade Public Defender-elect Carlos Martinez, but The Florida Bar is lobbying for a new rule requiring hearings before restraints can be used.

Some judges say there is even less justification for restraining mentally ill foster kids who have not been accused of delinquency.

''It's a horrible stigma,'' said Miami-Dade Circuit Judge Cindy Lederman, who heads Miami's juvenile courts. ``These kids already have mental health problems. I would imagine this would exacerbate them. . . . These are not bad children, and they have not done anything wrong. They are just ill.''

Frusciante said he has been asking questions of treatment center and courthouse staff members who bring children to court in restraints. Among them: Do we have to do this?

''It was very disturbing,'' said Frusciante, who oversees child welfare cases in Broward. He said he wasn't disturbed enough to outright ban the practice at the courthouse, but he is working with Honaman to find ways to limit the use of restraints.

Most treatment centers elsewhere in the state have abandoned the use of restraints, according to internal JHM e-mails obtained by The Miami Herald.

''We do not use them here when we transport children,'' said Robyn Baskin, a children's program director at Personal Enrichment Through Mental Health Services in Pinellas County. If a child is too great a risk, Baskin said, travel will be postponed or additional staff is provided to ensure safety.

NIU Shooting Sharpens Debate Over Effects of Antidepressants

From the LA Times via the Lakeland Ledger

A young man reportedly taking the antidepressant Prozac has a history of significant psychiatric troubles, including self-cutting, obsessive thoughts and anxiety. But among the 27-year-old's current teachers and acquaintances, he has a reputation as a caring, dependable friend and a highly motivated student.

Surely, say mental health professionals, this recovery was brought about by Prozac.

The same young man, saying the drug makes him feel "like a zombie," abruptly discontinues his antidepressant and begins to behave erratically. Three weeks later, he steps from behind a curtain in a classroom at Northern Illinois University, his alma mater and begins shooting, killing five students and himself.

Just as surely, say critics of antidepressants' widespread use, this unraveling was brought about by Prozac.

Steven Kazmierczak's bolt-from-the-blue shooting rampage Feb. 14 reignited a long-running debate over the benefits and risks of antidepressants - taking them and discontinuing them.

"It's sad to watch this," says Ann Blake Tracy, executive director of the International Coalition for Drug Awareness and co-founder of a Web site, SSRIstories.com, that catalogs violent crimes like Kazmierczak's and links them to psychiatric drug use. "You find suicide, murder, rape, arson" - all caused by drugs such as Prozac, she says. "How did they convince us that this is therapeutic?"

Most in the psychiatric profession would counter that antidepressants overwhelmingly save lives, and salvage those hobbled by sadness and anxiety. They doubt that coming off these drugs - especially Prozac, which Kazmierczak was reported to have taken - led the Illinois man to kill.

[...]

Twenty years after Prozac appeared on the U.S. landscape, roughly 10 percent of American women and 4 percent of American men take an antidepressant regularly. The selective serotonin reuptake inhibitors, or SSRIs, and their close cousins have revolutionized attitudes toward mental illness and its medication. But they remain a lightning rod for controversy.

The role that antidepressants played in Kazmierczak's violent end probably will never be clear. Did Prozac, which Kazmierczak's girlfriend, Jessica Baty, said he had recently discontinued, help keep the 27-year-old's mental illness in check and, when halted, allow it to roar back? Or did it distort his personality, contort his thoughts and, when abandoned, cause a chemical storm in Kazmierczak's brain that spawned a fury of aggression?

The weight of clinical observations and psychiatric research favors the view that antidepressants helped Kazmierczak until the time he abandoned them. But skeptics charge that antidepressants may have caused or contributed to Kazmierczak's spasm of violence. And mental health experts acknowledge they cannot rule out that possibility.

Florida Taxpayers ripped of for a Billion Dollars by Psychiatric conflict of interest

The Psych Data Weblog has this short item on psychiatric conflict of interest in Florida.

Rajiv Tandon, Chief Psychiatrist, State of Florida, needs to be fired as an employee of the State. Check out the story in the St. Pete Times and then write a letter. Tandon received undisclosed amounts of money from every atypical antipsychotic maker.

As the "Chief Psychiatrist" Tandon invited only those psychiatrists who had been funded by atypical antipsychotic makers to a meeting where it was decided which antipsychotics to use in Florida. He neglected to invite anyone such as Yale professor, Dr. Robert Rosenheck, who said "There was never any evidence that warranted the amount of money we spend on atypicals," he said. "If you look at it independently, it is very clear the results say there is no benefit'' to atypicals (newer antipsychotics) over typicals. (older antipsychotics)

The cost to Florida taxpayers for these new atypical antipsychotic drugs over the last 5 years? $1.1 BILLION. These "new" antipsychotics at $8 per pill are no more "effective" than the older antipsychotic drugs such as Haldol and Thorazine at 5 cents per pill and have just as many horrendous side effects.

Naturally we had to follow the money

TV Shrink Dr, Phil pays bail for the ringleader of the 8 Florida teens arrested for beating another teenager and videotaping it

This sounds like "Doctor" Phil has gone and got himself involved in another sordid case for fun and profit.

A bondsman says TV's Dr. Phil has posted $30 thousand bond for the ringleader of the eight Lakeland teens accused of kidnapping and beating a girl in front of a video camera.

It's believed Mercades Nichols will be talking about the case on his nationally syndicated show soon.

Some parents had complained earlier this week that they could not afford the high bond set by the judge.

However, six of the eight were out of jail Saturday.

All eight teens face kidnapping and battery charges. Kidnapping carries a penalty of up to life in prison.

UPDATE: A spokesperson for Dr. Phil's show now admits that paying for Nichols bail was a mistake, stating that "certain staff members went beyond show guidelines." While it is not clear as to whether or not those staff members were disciplined, the statement says they've been spoken to.

We of course remember his statement regarding his interaction with Britney Spears

Psychologist Charged with Manslaughter in Drug Death

As seen in this Legal Blog

Last week Miami-Dade prosecutors charged psychologist Adam Feder with manslaughter in connection with the death of a woman who overdosed on painkillers. Feder was also charged with one count of trafficking illegal drugs and seven counts of obtaining a controlled substance.

Rachel Finzi began seeing Feder after she became depressed over the health of her boyfriend who had been severley injured in a car accident. Two years after Finzi started attending sessions with Feder, she overdosed from painkillers that were given to her by psychologist. The two had also begun dating; Feder was almost 40 and Finzi was 20.

On Monday, Finzi's family announced they were filing a lawsuit against Feder and the clinic he worked at, Compass Health Systems, with negligence. The lawsuit alleges that Feder used his sexual relationship with Finzi "to exert dominion and control over her." The suit also claims that the clinic was negligent because they failed to supervise Feder and let him have access to other doctor's prescription pads that he used to write Finzi prescriptions.

According to the State Attorney's Office, Feder was illegally writing prescriptions to supply Finzi with oxycodone. She died May 24, 2006, at his Miami apartment after swallowing several pills "at the conclusion of a heated argument" over a breakup. Feder told Miami-Dade police that Finzi vomited, complained of hearing problems and slept for much of the next 24 hours, but that he did not call for medical help because "she asked me not to," according to the arrest warrant affidavit.

When police asked Feder why he was illegally writing prescriptions, he claimed to not have a good answer to that. Police also recovered 27 grams of oxycodone and prescriptions in other names in his apartment.

When a Psychiatrist is a Bully

We recently came across this item in the Every Patient’s Advocate weblog, describing outrageous behavior by a psychiatrist who apparently has an expired and non-renewable license in Indiana, although his Florida License is in good standing

We note that there might not be anything sinister in this, by itself. He may have simply moved to Florida for the warmer weather.

Naturally the Shrink wanted his name removed. But he fails to realize the description given (a Healing Institute in Naples, Florida, of which there seems to be only one) makes it fairly easy for the internet savvy to find out who he is.

After that, finding the other allegations on his behavior

Psychologist charged in girlfriend's death

From the Miami Herald

A psychologist who works with substance abusers has been arrested after his younger girlfriend -- a former patient -- overdosed on OxyContin that authorities said he supplied.

Adam Feder, 40, of North Miami-Dade, is charged with manslaughter and trafficking in controlled substances.

Miami-Dade police say he supplied OxyContin to his girlfriend, Rachel Finzi, 20, of Lauderhill, who died in his North Miami-Dade apartment in 2006.

According to his online bio, Feder teaches at Florida International University and Florida Atlantic University as an adjunct professor. Neither school's website lists him in their faculty directory.

He works for the North Star Centre in Boca Raton, according to the clinic's website.

''Dr. Feder has published articles and made numerous presentations on a variety of topics related to the treatment of children, adolescents and substance abusers,'' according to his bio.

Mental Health Worker accused of lewd behavior

From the Saint Petersburg Times:

A residential aide at Pinellas Emergency Mental Health Services has been charged with two counts of lewd and lascivious exhibition in front of children under 16.

Marissa Rodriguez, 42, was accused of exposing herself twice to a group of juvenile girls at the facility, where she worked as a temporary employee.

The incidents happened Friday and again Sunday, according to an arrest affidavit.

In Friday's incident, Rodriguez showed a nipple piercing to several girls and "told them afterward not to tell any of the other staff," according to an arrest report.

On Sunday, Rodriguez confronted some of the patients because they had told staff members in a group session, and, in front of another staff member and juveniles, exposed her right breast, police said.

Police said they learned of the incidents when they went to the facility at 1614 Palm Way in Largo regarding an allegation of abuse. That complaint was found to be unfounded, but in the course of investigating it, they learned of the incidents involving Rodriguez, police said.

Rodriguez, of Gulfport, is being held in the Pinellas County Jail in lieu of $20,000 bail.

Haley VA Hospital Complaint Points To Psychology Trainees

In the past we had have a number of stories about psychiatrists and psychologists who plainly miss the boat when it comes to patient diagnosis and evaluations. Given that those clueless wonders were licensed professionals, we cannot help but be alarmed at this report. From the Tampa Tribune.

Veterans who go to James A. Haley VA Medical Center for mental health care are unknowingly treated by psychologists who are inexperienced and not fully licensed, according to a complaint filed last week with a state board.

Hiring unlicensed psychologists is legal, but Haley is skirting the state's requirements by not sufficiently supervising them as they treat patients, the complaint alleges. It was filed with the Florida Board of Psychology by Brian Nussbaum, one of Haley's licensed psychologists.

Nussbaum claims there are 12 unlicensed psychologists on a staff of 34. John Pickens, a regional VA spokesman, acknowledged there are unlicensed psychologists at Haley, but said there are only nine and that they are all closely supervised.

Even nine, if that number is accurate, is too many, Nussbaum said Tuesday.

"Being that they're freshly out of school, and when you're working with a population that is so complex and sensitive as combat veterans, this is not a population that you throw in people who don't have the necessary expertise," he said, adding: "I would hope that the VA would hire the most experienced, qualified psychologists to provide this care."

Nussbaum filed the complaint with the state Board of Psychology, part of the Florida Department of Health, in an effort to draw attention to what he says is a patient care issue.

The board ultimately, though, has no power over the VA hospital, said a health department spokeswoman.

Nussbaum also takes issue with the unlicensed psychologists using the title of "psychologist." Patients don't know they're being treated by someone who is essentially a post-doctoral resident in training, he said. It's not illegal, but it's unethical, he said.

Patients "may not want to see a trainee," said Nussbaum, who is the only psychologist with a license on the staff of four who work in Haley's Post Traumatic Stress Disorder Clinic. "If you're getting heart surgery, you want the licensed, expert surgeon."

The hospital says its unlicensed psychologists are on track to get their licenses, by completing the required 2,000 hours of supervised work - including two hours a week that is directly supervised and one hour a week that is face-to-face supervision.

In his complaint, Nussbaum alleges the unlicensed staffers are not getting that supervision, and that some work in clinics in New Port Richey, Brooksville and Zephyrhills and never even come into the Tampa hospital.

"If you have a complex patient, you need to have a mentor, a colleague that you can go to," Nussbaum said.

Pickens disputed the complaint and said psychology residents get even more than the two hours of direct supervision a week. All notes taken by those psychologists after every session are reviewed and signed by the lead psychologist, he said.

The mental health care veterans are receiving is not suffering, Pickens said, and he pointed out that Haley is a prime place for post-doctoral residents to study.

"Where better for graduate psychologists to learn, to work with veterans who have post-traumatic stress disorder?" he said.

Swift firing of psychologist from teaching position restores School Board confidence

Apparently the Volusia County School Board has had a recent string of bad publicity due to their own screwups, misdeeds, and general incompetence. So the opportunity to do something to do their job, and also improve their reputation was a welcome relief. From the Daytona Beach News Journal.

Volusia County School Board members said Thursday they support the firing of an Atlantic High School teacher after a past fraught with lawsuits, allegations and a sex scandal was exposed to school officials.

They also believe it's a one-of-a-kind case.

Connie Reynolds, 52, of Ormond Beach was hired this summer to teach biology, anatomy and physiology at Atlantic after working as a substitute the previous year. On Tuesday, she lost her job, a job she loved, leaving her "reeling," she said by telephone Thursday.

"I did . . . exactly what I was supposed to do," she said.

On her job application she checked "yes" to a box asking whether she ever had a professional license revoked.

Three years ago, the Montana Board of Psychology effectively ended Reynolds' 20-year career as a clinical psychologist when it confirmed an administrative law judge's determination that she had an inappropriate relationship with a client, according to reports in the Billings (Mont.) Gazette.

But Volusia school district personnel assigned to scrutinize her application never asked her why she had lost her license. Had they known it involved an inappropriate relationship with a client, Reynolds would not have been hired, said Nancy Wait, a district spokeswoman.

Several board members contacted Superintendent Margaret Smith and other district officials with concern. They said they were pleased with the administration's response.

An additional set of eyes will review teacher applications before hiring is complete, board member Candace Lankford said. "This isn't a pattern," she said.

Board Chairman Al Williams also called Smith on Thursday.

"I feel confident we don't have any other situations like this," he added.

Of four board members interviewed, Williams -- a former school personnel director -- was the only one who raised questions about Reynolds' firing.

"This person did something wrong when she was in Montana. Do you continue to punish her when she comes here?" he said. "If it wasn't anything toward a child . . . she made a mistake. You give her two or three probationary periods to make sure."

But he later said he wasn't questioning the call to fire Reynolds, adding it's a "tough decision."

Other board members expressed empathy for Reynolds, but qualified it.

"By the same token, my first concern is the students. If she as a mature person had an inappropriate relationship, that's a red flag," board member Judy Conte said.

Reynolds said she does not believe she has any legal recourse over the firing. State law allows a school district to terminate a teacher without cause within the 97-day probation period.

Reynolds said she was still hopeful Thursday that a school district somewhere might be willing to take a chance on her, adding that she had an excellent evaluation.

"Every day, I woke up and said, 'I get to do something where I'm loving everything I did,' " Reynolds said. "I was a good teacher."

In addition to convincing another school district to hire her, Reynolds could face another hurdle. Cheryl Etters, a spokeswoman for the Department of Education, said she could not comment on the status of Reynolds' temporary teaching certificate, citing a statute that refers to an "investigation" that must be kept confidential.

Update: Former psychologist loses teaching job over news of her sexual misconduct

A quick update from Montana TV station KTVQ

A former Billings psychologist who had her Montana license revoked after being accused of having inappropriate relationships with patients has lost her teaching job in Florida.

Constance Reynolds, 52, recently settled a lawsuit in Montana and agreed to pay an $800,000 settlement to the mother of one of her patients who is now deceased. The lawsuit had accused Reynolds of having an affair with the patient.

She had been teaching biology at a high school in Port Orange, Florida, but lost her job this week after officials there learned about her revoked license in Montana.

We also have this report from a local Florida newspaper reports. This one from the Orlando Sentinel

A rookie Volusia County teacher found herself unemployed Wednesday after officials discovered that she had once lost her psychologist's license in Montana following accusations of improper relationships with patients.

Constance Reynolds, 52, began teaching honors biology at Atlantic High in Port Orange this semester. Two weeks ago, she settled a lawsuit in Montana, agreeing to pay $800,000 to the mother of one of Reynolds' deceased patients. The lawsuit accused Reynolds of having an affair with the patient, according to published reports.

[...]

"Had we researched this and found out what we know now, we would not have hired her," Wait said. "It's a question of morality and ethics."

Reynolds passed a criminal background check and has on her record only a 10-year-old DUI from Montana, to which she pleaded no contest, according to her application.

Reynolds, who was earning $39,903 annually, was in a 97-day probationary period for new teachers. The School Board is expected to approve her termination at its Dec. 11 meeting. Reynolds was notified after school Tuesday after media inquiries called the district's attention to the situation.

Reynolds told the Orlando Sentinel that she had been honest on her application, which is why the firing took her by surprise.

"I didn't think it was going to be a problem," she said. "I thought I could make a difference in kids' lives."

Reynolds' moved to Central Florida, where she has family, about 2005 and worked briefly as a substitute teacher in Volusia last semester before being hired full time.

She was a psychologist in private practice for 12 years in Billings, Mont., but offered no references from that state, writing, "I do not have any contact with any of my former clients or colleagues in Montana."

This one from the Daytona Beach News Journal

When she was hired to teach science at Atlantic High School in August, Connie Reynolds escaped a nightmarish career disintegration far, far away.

Her past caught up with her this week.

Volusia County school district officials fired Reynolds after learning from the news media why she was stripped of her license to practice psychology in Montana, said Nancy Wait, a district spokeswoman. They also acknowledged a mistake in hiring her.

In 2003, Reynolds -- then working as a clinical psychologist in Montana -- was accused of an inappropriate sexual relationship with a female patient who later died in her care.

Reynolds denied the allegations but later lost her license. The patient's mother filed suit, claiming Reynolds improperly gave medications that led to her daughter's death. Reynolds settled the case earlier this month for $800,000, the Billings Gazette reported.

A tipster, Ken Kramer of Tampa, contacted The Daytona Beach News-Journal and other media organizations recently. Kramer is a board member of the Citizens Commission on Human Rights, a Scientology-affiliated organization that investigates and exposes psychiatric missteps.

Atlantic High Principal Ron Pagano fired Reynolds on Tuesday without cause because she had not yet completed her 97-day probation period.

Reynolds, 52, of Ormond Beach was making $39,903 annually to teach biology, anatomy and physiology.

When she applied for her job, she checked a box indicating she has had a license revoked. The application asked for the type of license and what state issued it but not why it was revoked. Reynolds, who noted on the application she has had no contact with any of her former clients or colleagues in Montana, said no one asked her about it during the hiring process.

Wait said the school district would not have hired Reynolds had it known about the allegations in Montana. Wait added the box marked "Yes" should have raised red flags.

"We should have done some further inquiries," she said, adding Superintendent Margaret Smith has met with personnel and professional standards staff to make sure procedures are in place to avoid such hiring mistakes in the future.

[...]

Psychiatrist Reprimanded in 2002 Drug Intoxication Death

I have been wondering if cases similar to this, which result in the death of a patient due to a patient's treatment (and where there is no expected danger of death) should a least be subject to a charge of 'medical' man-slaughter. As seen in this report

A Lakeland psychiatrist brought before the Florida Board of Medicine on Friday after one of his patients died of "multiple drug intoxication" will get a reprimand, pay a $6,000 fine and attend classes intended to prevent similar situations.

The discipline package requires Dr. Charles Dack to complete "Prescribing Controlled Drugs: Critical Issues and Common Pitfalls of Misprescribing" or a board-approved equivalent. He must attend 16 hours of continuing medical education in drug medication and pain-management consultations. And he will pay administrative costs, up to $6,109.33, for investigation and preparation of his case.

He agreed to that discipline in a proposed settlement, negotiated with the Florida Department of Health, that was given to the Board of Medicine. He didn't comment before or after the board agreed to accept the agreement without debating its terms.

Dack, certified in psychiatry with subspecialty certification in addiction psychiatry, hasn't had previous discipline from the board, DOH said.

Dack treated a woman for seven years for depression and back pain. Before her death in March 2002, the state's administrative complaint said, she was on 1,300 milligrams of morphine a day and on 300 milligrams a day of Elavil, an antidepressant that also can be used to treat chronic pain. In addition to those drugs, Dack also prescribed other medicines.

Another psychiatrist recommended in 1997 he change the medication and suggested more conventional pain management.

Dack wrote a letter in which he agreed she might benefit from a pain management program, the state said, but "failed to take steps to make certain patient M.T. sought the help of pain management specialists."

The complaint said Dack failed to properly recognize her dependence and tolerance for controlled substances and didn't properly consider the possibility of her exaggerating her pain level. It said he inappropriately escalated the "quantity and dosage of the prescribed narcotics for patient M.T. without objectively justifying and adequately documenting changes in the patient's condition."

The settlement agreement doesn't require him to admit or deny allegations made against him in the state complaint.