Psych Crime Reporter

April 21, 2010

Psychiatrist Steven L. Kaplan ousted by Florida Medicaid, relative to death of 7-year-old

State healthcare regulators have booted from the state Medicaid program a Miami psychiatrist who had prescribed a cocktail of potent mental health drugs to an autistic, 12-year-old boy who later died of complications from over-medication.

The Florida Agency for Health Care Administration, which oversees the state Medicaid program for the needy and disabled, has notified Dr. Steven L. Kaplan that he has been terminated from the insurance program effective May 17, said Tiffany Vause, an agency spokeswoman in Tallahassee.

Vause said Kaplan, like all Medicaid providers, had signed a “voluntary contract” with the state. “The agency elected to terminate the agreement as it was believed to be in the interest of the program to do so.”

“We will be working to ensure a smooth transition of care for his patients,” Vause added.

Kaplan declined to speak with a Miami Herald reporter Tuesday.

Kaplan, who treats about 800 patients — most of them disabled or impoverished children — was the subject of a report in The Herald on Monday. The story said administrators at three state agencies had expressed concerns about Kaplan’s prescribing of psychiatric drugs to disabled children before and after the May 23, 2007, death of 12-year-old Denis Maltez.

Denis, who weighed 70 pounds, had been on three different mental health drugs, two of them in the maximum dose, at the time he died, a consultant for the state Agency for Persons with Disabilities wrote.

“In combination, all three of these agents have additive effects as a central nervous system depressant,” the consultant, psychiatrist Jorge J. Villalba, wrote. The drugs, he added, “may have been contributing factors in the client’s death.”

The Miami-Dade Medical Examiner’s Office attributed the boy’s death to Serotonin Syndrome, also called Serotonin Toxicity, which can occur when an excess of medications causes the body to produce too much serotonin, a chemical that helps brain and nerve cells to function.

Over the past few years the University of South Florida, acting on behalf of the state healthcare agency, had sent Kaplan several letters suggesting he reconsider his prescribing practices.  “He said he had been practicing long enough to know how to treat his patients and was tired of being told what to do,” a pharmacist working for USF wrote following a visit to Kaplan’s office in May 2009.

Most affected by Kaplan’s termination will be clients of Florida’s Agency for Persons with Disabilities, many of whom have been treated by him.

Melanie Etters, an APD Tallahassee spokeswoman, said the healthcare agency will be notifying Kaplan’s patients that he will no longer be able to receive Medicaid payments.

“APD will also let [disability caseworkers], residential providers, and Family Care Council members know about Dr. Kaplan’s termination as a Medicaid provider. We will also let them know of other psychiatrists serving the Miami area,” Etters wrote in an e-mail to The Herald.

“APD is supportive of this reasonable and responsible action by our sister agency to protect the health and safety of the people we serve,” Etters added.

Martha Quesada, Denis’ mother, declined to speak with a Herald reporter Tuesday. Quesada’s lawsuit against the psychiatrist still is pending in Miami-Dade circuit court.

“Unfortunately, Florida has no procedure to protect the patients of physicians who write behavioral health care prescriptions that exceed thresholds and who blatantly ignore the ‘red flag’ letters from the University of South Florida Medicaid Drug Therapy Program,” said Quesada’s attorney, Howard Talendfeld.

“Nor does the state tell the parents or guardians of mentally disabled persons or foster children that these drugs prescriptions may be dangerous or monitor whether or not the physicians obtained informed consent from them.”

Source: Carol Marbin Miller, “Medicaid ousts Miami psychiatrist who gave potent drugs to boy who later died from overmedication,” Miami Herald, April 21, 2010

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11 Comments »

  1. Seems funny to me that , you go to the doctor for help , Then you get that help , something goes wrong and then a Doctor is blamed . If as you put other Doctor’s felt the child should have been on some thing less , Why didn’t they do something about it ??? I feel for the mother , however why did she not get a second opinon ? Im sorry I dont feel like all the fact are there !!!!

    Comment by Toni Roy — June 8, 2010 @ 7:55 pm | Reply

    • Dear Toni Roy,

      What is known is that Dr. Kaplan received numerous letters of concern about his excessive prescribing practices with regard to Denis Maltez, who ultimately died of the effects of excessive prescribing. Kaplan did not want to be told how to practice medicine, according to what is being reported in the media and by the Florida Surgeon General. The facts are there.

      You are partially right: Why did these other people not do something about it? Well, they did warn Kaplan. They did express their concern for his prescribing practices numerous times. The right things were done, but perhaps a little too late to save a child’s life.

      Another thing that is evident (at least to me) is that psychiatrists like Kaplan apparently have no feeling for the sufferings of others and perhaps don’t even like children very much.

      Comment by Psych Crime Reporter — June 8, 2010 @ 8:13 pm | Reply

      • Ok , what about this , paper write’s..Over the past few years the University of South Florida, acting on behalf of the state healthcare agency, had sent Kaplan several letters suggesting he reconsider his prescribing practices.Why did they not take this child to another doctor ? why did the mother not be more involved reguarding her child being over medicated ? Now this child is now in the hands of god , the mother wants too do something about it . As a mother this makes me very upset , If my child was on ANY meds , I would do my homework . I will say im not as smart as most but , Now this doctor get’s all the heat . This doctor does his job and now is under watch ? Where was the pedatric doctor ? He should have played a part of this as well . And the state … well if they thought for one min. this child was under the wrong care maybe they should have done something . So maybe the mother should go after the state for not doing thier job . I really dont have all the facts but , I do feel for the child as well as the doctor !

        Comment by Toni Roy — June 8, 2010 @ 9:09 pm

      • All of what you are saying is true but that does not excuse the psychiatrist’s actions or inactions. He was warned, he was warned, he was warned and he was warned. He insisted he knew how to practice medicine and would not be told. And now a child is dead. Sure, perhaps the mother and others can share in the responsibility for failing this boy but Kaplan had the prescription pad and he had ethical and professional obligations. He WILLFULLY failed.

        Whoever you are, please stop standing up for a psychiatrist who killed in the name of help and who drugged a kid into submission for his own convenience and income.

        Comment by Psych Crime Reporter — June 8, 2010 @ 9:17 pm

      • “Another thing that is evident (at least to me) is that psychiatrists like Kaplan apparently have no feeling for the sufferings of others and perhaps don’t even like children very much. ” You’re a reporter and you write such a statement?? You’re a moron who is protected by Freedom of Speech , but you should be in another line of work obviously.

        Comment by BR — October 19, 2013 @ 6:24 pm

      • Aww, what’s the matter? Did I hurt your feelings? Strike a little too close to home for you? Are you a psychiatrist? Are you married to one (or perhaps having an affair with one)?

        So, which is it?

        I am not going to stoop to your name-calling level, but you obviously haven’t really don’t your homework. I am not a reporter. Nowhere do I claim to be a reporter. I am a blogger who mostly re-posts news articles from elsewhere on the net. Yes, I have the protection of the First Amendment, as do you but one thing I have that you don’t have is manners.

        Sue

        Comment by Psych Crime Reporter — October 21, 2013 @ 1:25 pm

  2. Whom ever I am ? It’s states who Iam ..Toni . Im not standing up for him . I would just like to know all the facts ! was the child in his office at the time of death ? who was giving him the med ? a care taker ? why is it ONLY the doctor in trouble ? Is the State not also here to protect children ? why didn’t they put thier foot down ? A child is now dead , that is very sad but , at the same time I cant help but , to wonder the child was under the meds for a few years , were they the same meds ? did he ever have a reaction to the meds before ? I just feel that other parties should be in the boat as the doctor . You ALWAYS have a choice to change your doctor , why didn’t that happen if this was going on for a few years ???

    Comment by Toni Roy — June 9, 2010 @ 2:15 pm | Reply

    • If you read the first article about this boys death which I did about 30 minutes ago, then stumbled across
      this one, the mother gave the child to a group home because she felt she couldnt handle or care for him, but
      did not give up her parental rights, and was active in his life and did not give the group home permission to
      switch from the doctor he was seeing when he was living with her to Kaplan and in that article she had a lawsuit with the state about that issue, she had no idea he was seeing Kaplan or taking those drugs which were 20 mg Zyprexa, 800 mg seriquil, antipsychotics- .5 mg klonopin a tranquilizer , 2000 mg of depakote mood stabilizer. these are heavy drugs some of them maximum doses for adults. So a caregiver at the group home had to be giving him the meds but dcf did 6 investigations getting many letters from the very place were he was living. so for 1 this dr. should not in my own oppinion be working for 2 this group home shouldnt be either for 3 dcf needs to be thrown under the bus also. This is just an outrage it said that all the kids there were lethargic and falling asleep all day and coulnt walk? wtf! This makes me so mad!

      Comment by mary — April 11, 2011 @ 8:19 am | Reply

  3. @ Psych Crime Reporter

    This press is reidiculous. I have read a lot of press on this and this blog is obviously run by Scientologists or some other radical and Off the Wall faction. These writings clearly demonstrate a profound lack of understanding as to how children and /or adults come into the system and how they are cared for. Anyone who knows tha actual facts of this case (not just the MQA allegations)would know that upwards of 7 board certified psychiatrists in multiple venues concurred on the treatment and frankly Dr. Kaplan had done nothing but continue the agreed upon regime. Additionally, it is worth noting that had this been an actual malpractice case with merit, the good Dr. Kaplan would not be practicing today. Incidentally, this case was resolved in 19 days! THAT’s RIGHT…. 19 DAYS!

    This physician is an excellent DR. who actually spends time with his patients and who is dedicated to working with those that are disabled. He is valued in this community and those seeking to malign such an individual shoudl actually get all the facts.

    AD

    Comment by AD — May 21, 2011 @ 4:29 pm | Reply

    • “This blog is obviously run by Scientologists…”

      And your IQ is obviously in the double digits.

      Nowhere in your little rant is the fact that the Department of Health was warned about Kaplan’s overprescribing more than once by the state Agency for Health Care Administration’s Medicaid office and that—oh yeah—a 12-year-old boy died from an overdose of drugs prescribed by the “excellent Dr.” Kaplan. And then Medicaid kicked his ass out—no more state/federal reimbursements for the kid-drugger.

      Not everyone who protests the crimes and misconduct of psychiatrists is a Scientologist but morons like you, who have no better defense of these prescription-pad kid killers, always resort to that. There is no defense for a doctor who prescribes to a kid to the point of death.

      Comment by Psych Crime Reporter — May 23, 2011 @ 10:18 am | Reply

  4. If the “excellent Dr. Kaplan” is so worth defending, why is HE not board certified?

    Comment by itty — March 5, 2012 @ 1:30 pm | Reply


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