Tuesday, January 26, 2010

The Sickest Trial I Ever Saw

I'm not even going to able to highlight this post, readers, because I can't read these articles again. Makes me ill.

Parents to stand trial separately in overdose

The case restarted debate in the psychiatric community about whether young children can be accurately diagnosed with bipolar disorder, and if so, whether they should be treated with powerful drugs meant for adults.

A state medical examiner found that Rebecca died of a combination of clonidine, a blood pressure medication the girl had been prescribed for ADHD; Depakote, an antiseizure and mood-stabilizing drug prescribed for bipolar disorder; and two over-the-counter drugs, a cough suppressant and an antihistamine. The amount of clonidine alone in Rebecca’s system was enough to be fatal, the medical examiner said."

: Prescribing Our Kids to Death

The Perfect Child

What, one that draws a state check for you?

"Case spotlights disability system; First Riley trial set to begin Tuesday" by Patricia Wen, Globe Staff | January 17, 2010

BROCKTON - Indigent parents who fabricated behavioral problems in their children to get disability payments for mental disorders....


In a highly unusual criminal trial set to start on Tuesday, prosecutors are expected to allege that stricter eligibility rules did not stop a financially strapped Hull couple, Carolyn and Michael Riley, from concocting an elaborate scheme involving powerful psychotropic drugs. By 2006, everyone in the family was on the federal disability rolls, except for the youngest child, 4-year-old Rebecca, whose application had been denied.

Gee, the insurance companies got you coming and going, huh? Feds approve their poisons, then hand out tax money to shove them down kids' throats!

As the parents were appealing that decision, Rebecca died in December 2006 of an alleged overdose of psychiatric drugs that she had been prescribed for bipolar and hyperactivity disorders. The parents now face first-degree murder charges. The case triggered nationwide controversy over how psychiatrists could prescribe such potent drugs to young children, but it also provided a rare glimpse into how struggling families utilize and potentially exploit the government’s disability system, in particular the fast-growing cash-assistance program to help indigent families with mentally disabled children....

How could they pre$cribe?

The FA$T-GROWING CA$H A$$I$TANCE $Y$TEM from the government, huh?

By November 2006, a nurse at Rebecca’s preschool reported that the girl often seemed overmedicated, looking at times like a “floppy doll.’’

Meanwhile, Supplemental Security Income, or SSI, disability checks sustained the family’s finances. Both parents, who worked only sporadically, qualified for medical and psychological reasons, while the two oldest children were on disability primarily for psychiatric conditions. Federal officials say they cannot divulge a family’s disability payments; however, given that the typical monthly payment for each SSI disability recipient in Massachusetts is $700 a month, authorities say, the Riley family could have received about $2,800 a month or $33,600 a year....

Yeah, the KIDS WERE a CASH COW, now OPEN UP!

Prosecutors say that Rebecca’s parents were so focused on these checks that they ignored her rapidly declining health in early December 2006. On Dec. 11, she allegedly vomited in Quincy’s Social Security office, causing the father to erupt in anger when the family had to leave the office early. In the early morning hours of Dec. 13, she died while sleeping on the floor next to her parents’ bed.

The government says an autopsy report found the girl died from excessive amounts of psychiatric medications, though the defense attorneys say their medical experts dispute the autopsy findings and the parents could not have anticipated how quickly Rebecca’s health spiraled out of control that day.

With opening statements in Carolyn Riley’s trial set to begin this week in Plymouth County Superior Court in Brockton, numerous workers from the Social Security Administration are on the witness list, as well as relatives and friends who are expected to testify about the parents’ preoccupation with disability benefits. A judge, who reviewed grand jury testimony, stated there is ample testimony suggesting that “the defendants had a financial interest in having Rebecca and the other children diagnosed with bipolar and ADHD.’’

Yeah, and SO DID a LOT of OTHERS!!!!

It remains unclear just how alert Dr. Kayoko Kifuji of Tufts Medical Center might have been to the possibility that Rebecca’s parents might have been financially motivated to keep their daughter on drugs, or exaggerate symptoms, for the sake of disability benefits. The psychiatrist, who was the subject of a grand jury probe but was not indicted, is expected to testify, her lawyer said.

She was granted immunity; why leave that out?

Some pediatricians and lawyers who work among low-income families say they believe childhood disability insurance fraud for mental disorders is rare, though they are alert to possible misrepresentations when dealing with indigent or troubled parents. Dr. Marilyn Augustyn, who specializes in behavioral pediatrics at Boston Medical Center, said some low-income parents inquire after hearing about others getting disability checks for children with hyperactivity disorder. Some have asked, she said, “Maybe I could get SSI?’’

Yeah, this happens a LOT MORE than you would think!!!

That's why we have an EPIDEMIC of OVER-MEDICATED KIDS!

Augustyn said that the bureaucracy of securing benefits is “a nightmare,’’ and she believes generally only the most determined, and deserving, families will go through all the steps. At the time that Rebecca’s parents were applying for benefits, the nation continued to see a soaring number of children receiving disability benefits for mental disorders....

And CUI BONO, drug companies?

And during those same years, the mental disorder diagnosis grew faster compared with other categories. It went from being roughly 32 percent to 52 percent of all children receiving disability benefits. Many child advocates say these rising numbers show the government takes seriously the impact of mental disabilities on children and families, and are confident that scams are only a tiny fraction of all claims....

Yeah, NO THOUGHT to PRESCRIPTIONS that are NOT REALLY NEEDED -- from the government allegedly looking after YOUR HEALTH, America!



Mother of dead girl ‘indifferent,’ prosecutor says

Jurors looked visibly struck by one large display of Rebecca as she was found by ambulance workers on the day she died. With a pinkish foam coming out of her mouth, the girl was clad only in a pull-up diaper and was lying next to her parents’ bed, where she had apparently come to seek comfort as she had done while vomiting and coughing in the days before.

Oh, that poor kid!!!

: Testimony details mother’s actions

And WHERE was the STATE all this time?

"Social worker says she warned family; Testifies she also told state about drugs prescribed" by Patricia Wen, Globe Staff | January 22, 2010

BROCKTON - Five months before 4-year-old Rebecca Riley died from an alleged overdose of psychotropic drugs, a Weymouth social worker warned the girl’s mother that the child seemed overmedicated and contacted the state’s child protection agency to say the family relied on an alarming amount of mood-altering medications.


They CONTINUED to SUPPLY the CHECKS though, right?

In the first-degree murder trial of Carolyn Riley, Rebecca’s mother, a social worker at South Bay Mental Health Center testified that she also repeatedly suggested that the mother obtain a second opinion on whether Rebecca, as well as her older sister, then almost 6, should be on three powerful psychotropic drugs. Both girls were diagnosed by the same psychiatrist with bipolar and hyperactivity disorder at age 2, and, according to witnesses, often looked so weak that they could not grip a crayon and draw.

The mother, who had heard similar words of concern from staff members at Rebecca’s preschool, consistently refused. “She felt the medications were very effective,’’ Angela Smith testified yesterday in Plymouth County Superior Court.

Yeah, we care about kids here in AmeriKa! Send 'em off to war over lies and drug the f***ing s*** out of 'em -- literally!

In the case that has triggered nationwide controversy over potent psychiatric medications for young children, Smith also testified that she told the child protection agency that the mother, who was on pills for depression and migraines, may be overmedicating herself and unable to care properly for her children. The agency, then called the Department of Social Services, opened an investigation into the family in 2006, though not immediately when Smith contacted them.

Kids should not be getting ANY of this S***!

One wonders HOW the HUMAN RACE EVER MADE IT SO FAR without their MEDS!!!

The social worker’s statements bolstered the government’s depiction of the 35-year-old Hull woman as an overwhelmed mother who used psychiatric medications to control her children, and who exaggerated their behavioral issues so they would qualify for federal disability benefits for mental disorders. She, and her husband, Michael Riley, are accused of killing Rebecca, their youngest child, with an overdose of her medications, seemingly in part to quiet her down during a escalating sickness that saw the girl repeatedly vomiting and coughing.

Michael Riley is being tried separately on the same charges.

Also yesterday, the children’s psychiatrist, Dr. Kayoko Kifuji, was portrayed by a Springfield mental health counselor as quick to prescribe potent drugs to the Riley children when they were as young as 2, in response to behavioral complaints from their mother.

Traccie Hillion, who worked with Infant and Toddler Services in Springfield, said she was present at a meeting in April 2003 when Carolyn Riley and her daughter, Kaitlynne, then 2, met with Kifuji, who was practicing in Springfield. The mother said Kaitlynne was exhibiting aggressive behavior and sleep problems.

Hillion, who had known the girl since birth as part of an early intervention program, told the psychiatrist that she thought Kaitlynne had “pretty typical toddler behavior.’’ Despite this input and Hillion’s belief that Kaitlynne did not have to be on drugs, Kifuji that same day prescribed Depakote, a mood-altering drug, for the girl, Hillion said.

When Rebecca was 2, she too was prescribed psychotropic drugs, after the mother reported aggressive, sleepless behavior to the psychiatrist.

Yup, just takes a scribble for a kickback.

Hillion’s account, as well as testimony from numerous clinicians and educators who knew the family, suggest that Rebecca’s mother and Kifuji persisted with an aggressive medication-oriented approach toward behavioral issues, even when many others saw the children as relatively normal and worried about their consumption of such powerful drugs.


Defense attorneys, who have yet to present their case, have said that Carolyn Riley was a loving mother who was trying to get early treatment for her children, knowing they had a family history of bipolar disorder and other mental conditions. They have said the mother followed the prescribing advice of Kifuji, now a Tufts Medical Center psychiatrist, who is expected to take the stand. Kifuji faces a medical malpractice suit filed by the estate of Rebecca Riley.

According to a court document, the defense may call as a witness Dr. Janet Wozniak of Massachusetts General Hospital, who is nationally known for a pharmacological approach toward bipolar illness in children. The defense is also expected to present medical specialists who will say that Rebecca died of rapid-onset pneumonia, not drugs, and that Carolyn could do nothing to prevent her December 2006 death.


And their were even ROOMMATES that saw?

"Housemate details Riley child’s final night; Testifies parents used medications to quiet children" by Patricia Wen, Globe Staff | January 23, 2010

BROCKTON - The mother of 4-year-old Rebecca Riley was depicted yesterday by a former housemate as a woman dominated by an autocratic husband who frequently yielded to his demands, including that she get their three children to quiet down by giving them earlier-than-scheduled dosages of their psychotropic medications.

(Blog editor just shakes head from side-to-side, sighs, and drops chin to chest)

Kelly Williams, who used to live with the Riley family in Hull, quoted Rebecca’s father as saying to his wife: “You got to shut them up. Go get the medication.’’

Well, that cute little girl won't be making anymore noise, damn you!


According to Williams, this dynamic played out in the period before Dec. 13, 2006, the day Rebecca died of what prosecutors say was an overdose of clonidine, one of the three mood-altering medications she was taking for bipolar and hyperactivity disorders. Williams ended what was the first full of week of testimony in the first-degree murder trial of Carolyn Riley, Rebecca’s 35-year-old mother, in Plymouth Superior Court....

Yeah, amazing how the Globe stays on top of this trial, 'eh?

See: Typical Terror Trial Coverage

Williams’s statements before the 16 jurors was the first detailed look at the home environment in the days before Rebecca died. In the latter part of 2006, Williams, her 6-year-old son, and her boyfriend, James McGonnell, who is Carolyn Riley’s half-brother, rented a Hull house with the Rileys. Money was tight, and Michael Riley and McGonnell often feuded, she said....

Through tears, Williams described the catastrophic night in 2006 when Rebecca died.

Williams, who worked part time at Dunkin’ Donuts, said that Rebecca, after coping for several days with what seemed like a bad cold, suddenly became much more ill. Aside from vomiting and coughing, and becoming flush with fever, the preschooler began to wander about the house, barely responsive when her name was called and seemingly “zoned out completely.’’

Williams said she and McGonnell kept asking Rebecca’s parents to take the girl to the doctor. The father, however, was preoccupied with a dispute over his disability benefits requiring visits to the Social Security office in Quincy and kept demanding that his wife keep Rebecca quiet. He apparently became livid when Rebecca, during one trip on Dec. 11, 2006, vomited in the Social Security office, cutting short their visit.

Carolyn Riley insisted to Williams that she would be taking Rebecca to the doctor, but kept putting it off even as Rebecca’s condition seemed to worsen, Williams said. On the night before Rebecca died, when she allegedly kept knocking on her parents’ closed bedroom door asking for her mother, the father kept ordering the girl to go back to her own room, Williams said....

Oh, my God, that POOR LITTLE GIRL!

Ultimately, after Rebecca kept moaning for her mother, Carolyn Riley persuaded her husband to let the girl sleep on the floor next to their bed. The following morning, the girl was found dead.

Where she finally found peace, I suppose.

While Williams had testified before the grand jury that she believed Rebecca’s condition was so serious she had nearly wanted to call an ambulance herself, she testified yesterday that she had never thought the girl was in a life-threatening situation. As for Rebecca dying, Williams said, “It never crossed my mind that that would happen.’’

I wonder what else could have been done that would have made that thought cross the mind.

BROCKTON - Speaking publicly for the first time since the death of 4-year-old Rebecca Riley, a Boston child psychiatrist testified yesterday that the girl’s mother, Carolyn Riley of Hull, acknowledged occasionally giving her daughter more than the authorized dosage of certain medicines, at times even doubling them.

Despite these admissions, Dr. Kayoko Kifuji of Tufts Medical Center said she was justified in prescribing potent psychotropic drugs for the girl at age 2 and trusting that the mother would generally administer them appropriately....

Yeah, money make$ you $ee $ome $trange thing$ after a while.

Kifuji appeared on the stand yesterday only after the state granted her immunity from prosecution....

Yeah, that aspect of the case has been kept RATHER QUIET by the Glob, notice that?

Kifuji, who received her early medical training in Tokyo before coming to the United States in the mid-1990s, had also faced potential criminal charges for her role in Rebecca’s death, but, after a lengthy investigation, a grand jury last summer declined to indict the doctor. After that announcement, Kifuji resumed seeing patients at Tufts Medical Center....

Yeah, hi, I'd like to cancel my appointment with Dr. Kifuji.

No, I won't be rescheduling.

As described by Kifuji yesterday, her psychiatric practice seemed focused on pharmaceutical approaches, with far less attention paid to direct conversations with her young patients or probing the child’s family background for signs of emotional strife or financial hardships that could affect their lives.


Kifuji acknowledged that she did not seek input from Rebecca’s preschool teachers or social workers, many of whom described her as sweet and cuddly but sometimes overmedicated; and she rarely spoke to Rebecca’s father or other doctors. Kifuji also revealed yesterday that the mother frequently increased dosages of medications, and even introduced new ones, without the doctor’s authorization. Kifuji said she warned the mother not to do that in the future, but also sometimes made official what the mother had been doing informally.


For instance, Rebecca was initially prescribed one tablet of clonidine, a sedating, mood-stabilizing drug each night. But within a few days, Carolyn Riley acknowledged she was giving the girl two full tablets. Eventually, Kifuji said, she authorized that dosage each night.

What, the little girl start developing a tolerance for the stuff?