State investigates three deaths at Florida psychiatric facility

Over medication and improper supervision may have caused the deaths of three patients at a privately run mental health facility in Florida last year.  That’s what a recently completed investigation by the Florida Department of Children and Families revealed when it looked into GEO Care’s South Florida State hospital.

Within just a few months last year, three patients died unnaturally in the care of the GEO Care psychiatric facility, South Florida State Hospital. Florida Department of Children and Families Spokeswoman Erin Gillespie says failing to report the incidents to the state’s abuse hotline is what launched the investigation:

“They reported the deaths to the Department of Children and Families because we contract with them to run the facility. But, that is not the same thing as reporting them to the state abuse hotline, which is in statute,” said Gillespie. “By law, if there is an incident like this, it has to be reported to the hotline for investigation. So, they have been re-trained on how to report abuse to the hotline.”

The alleged abuse included one woman who allegedly had her head slammed in a wall and one man who died in a tub full of scalding hot water, because staff failed to check on him every 15 minutes as required….both dead between the months of June and August 2011.

“Of course, we have deaths at these facilities all the time, because of natural causes, these people are not well. But, three deaths in a short period of time where it seemed there was a lapse in supervision is what prompted the review,” said Gillespie.

In another instance, a 50-year-old man with a history of suicide jumped to his death from the eighth story of a parking garage because he was without proper supervision.

Gillespie says with the review completed, they are now re-negotiating a contract with GEO, and included is their own Department investigator added to the facility and more training among the staff.

“It’s a difficult setting, you know, these patients have problems, and very in-depth medical care and so, because of the nature of their psychological problems, you have to have specially trained folks there and that’s what we worked with them on to make sure their all of their procedures were top of the line and they would be able to better work with the populations that they’re serving there,” said Gillespie.

Gillespie adds if GEO fails to report these incidents again, her agency will levy a financial penalty.

In a statement, a GEO Spokesman says the incidents are in no way indicative, or a reflection, of the “high quality operation that exists through the public-private partnership between GEO Care and the Florida Department of Children and Families.”

In addition to South Florida State Hospital, GEO Care also has three other mental health treatment facilities under its care.

Source: Sascha Cordner, “DCF reviews three deaths at GEO-run psychiatric facility,” WSFU, July 26, 2012.

UCLA psychiatrist Alexander Bystritsky sued over patient’s psych drug death

When former model and philanthropist Phyllis Harvey died last year at the age of 59, little note was taken. Brief paid obituaries appeared in Los Angeles and her hometown paper in North Carolina. There was no mention of how she died. Nothing was said about her struggle with alcoholism and mental illness. And there was no reference to one of the final projects she helped fund with nearly a half million dollars.

Those details now figure prominently in a medical board complaint and wrongful death lawsuit claiming her psychiatrist coaxed $490,000 in research funding from her while she was under powerful doses of psychotropic drugs that eventually killed her.

The suit filed on behalf of Brian Harvey by attorney Daniel M. Hodes accuses University of California, Los Angeles psychiatrist Dr. Alexander Bystritsky of causing Phyllis Harvey’s death with a dangerous combination of drugs that altered her heart rhythm.

Hodes says that Mrs. Harvey was hospitalized several times for heart abnormalities associated with drugs, and that emergency room doctors discontinued her medications only to have Bystritsky resume giving them to her when she was discharged.

Brian Harvey earned a fortune by selling an invention for coating electronic wires with recycled metal from beer cans. Following the sale of his company, he and his wife formed the Brian and Phyllis Harvey foundation to fund scholarships and other donations. The lawsuit claims Bystritsky knew of the couple’s wealth and charitable giving and insinuated himself into their lives with house calls, long chats and email with Phyllis Harvey while treating her undiagnosed mental illness. He allegedly touted his own credentials and convinced her to give large donations to research a device that might cure her.

The claim that a physician solicited research funds from a patient provides a new wrinkle in the debate over the relationship between doctors, wealthy patients and the overuse of prescription drugs.

“Was he continuing to treat her with these high-powered drugs to keep her as a patient?” said James J. Walter, a professor at the Center on Bioethics at Loyola Law School. “Every bioethicist would say that practice should be discouraged.”

The lawsuit filed in Los Angeles County Superior Court claims wrongful death due to medical negligence, fraud, fraudulent concealment and intentional infliction of emotional distress.

Numerous phone messages left for Bystritsky and his lawyer by The Associated Press were not returned.
The suit also names the UC Board of Regents as defendants, noting that they sent glowing letters of thanks to the Harveys for their donations.

A spokeswoman for UCLA said she could not discuss medical specifics because of privacy concerns but said UCLA will contest the lawsuit.

“The UCLA health care system is committed to the highest standards of patient care and safety,” said spokeswoman Roxanne Moster.

“This is a regrettable and unfortunate case for everyone involved and we extend our deepest sympathies to members of the Harvey family for their loss.”

Bystritsky began treating Harvey in 2004, five years after she was diagnosed as possibly suffering from bipolar disorder, early dementia or schizophrenia, according to documents in the case.

None of those diagnoses was ever fully confirmed by tests and Bystritsky soon had her on a regimen of several psychotropic drugs including Seroquel, a powerful anti-psychotic, said John Harwell, a lawyer who filed a complaint with the Medical Board of California last November on behalf of Brian Harvey.

The lawyers contend that drug, which is known to alter heart rhythm, killed her when she died in her bed April 5, 2011.

“Mrs. Harvey died from sudden cardiac death,” Harwell told the medical board, “the very kind of consequence warned against by the FDA in its required Black Box Seroquel warnings, the ones Dr. Bystritsky either ignored or of which he was ignorant.”

The medical board declined to comment on whether a complaint is pending before it.

Harvey had overcome alcoholism when she was younger, but she relapsed after her mother’s death in 2009, Harwell said. During one of several hospital admissions, she told a doctor she was drinking a bottle of liquor a day along with the sedative Ativan, a potentially lethal combination.

In the two months before her death, the lawyers said she was receiving nine different drugs including benzodiazepine sedatives, Invega, a drug for schizophrenia, and Seroquel which was prescribed by Bystritsky at 180 tablets in 17 days.

Heavy doses of drugs in large volumes led to hospitalizations for overdoses of benzodiazepines, leading to falls, disorientation and intoxication, Harwell said. Emergency room doctors discontinued her medications, but Bystritsky resumed giving them when she was discharged. At times, he said, she became delirious and had hallucinations that bugs were crawling on her skin.

The lawsuit claims that the psychiatrist told Harvey he might be able to cure her with a device he invented, but that he said he needed more money to continue research on the machine.

An Internet search shows that Bysrtritsky, who heads the anxiety disorders program at UCLA, was a partner in a privately held company called Brainsonix which is collaborating with UCLA and Harvard Medical School on an ultrasound device to modulate brain function and treat brain disorders including depression, autism, Parkinson’s Disease, epilepsy, obesity and other ailments.

His list of credentials shows that he was trained in neuroscience, psychopharmacology and psychiatry at Pavlov Medical Institute in Russia, New York University and UCLA. He also is a visiting full professor at Harvard University School of Medicine.

Harvey declined to seek criminal charges against Bystritsky because that might have required proving he intended to harm his patient, attorney Hodes said.

Experts said the case would be divided into two issues — the standard of care provided and ethical considerations involved in soliciting donations from a patient.

If true, “It would be a horrible indictment of the fund raising efforts of UCLA,” said Donna Darling, a former New York assistant district attorney who now represents plaintiffs in medical malpractice suits. “They should have known she was a patient.”

Attorney Harland Braun, who has represented doctors in malpractice cases, said Bystritsky may raise a strong defense that he was trying to help a gravely ill patient and had no intent to harm her. The fact that money was donated to his research, he said, suggests no desire for personal enrichment.

“Jurors have a tendency to trust doctors,” said Braun, “and If you can’t show the doctor had a motive to do harm, jurors will side with him.”

Source: Linda Deutsch, “Philanthropist’s death sparks unusual lawsuit,” Associated Press, August 4, 2012.

Psychologist sentenced to 20-30 years for killing daughter with baseball bat

An Oxford Village psychologist can’t explain why he got up early one morning in May 2011, walked down the hallway to his daughter’s room and beat her into a coma with a baseball bat as she slept.

Megan Robert, 20, died a few months later at a local hospital.

“I wish I could answer the question as to what would make a human being do what I’ve done,” Robert Kelly told Oakland County Circuit Judge Rudy Nichols before he was sentenced Wednesday.

Nichols ordered Kelly, 53, to spend 20-30 years in prison. He originally was charged with first-degree murder, but pleaded guilty to second-degree murder in June with the hope of avoiding a mandatory life sentence.

Kelly stood shackled Wednesday, tears streaming down his face as several people in the courtroom cried.

“I was a good dad and I don’t know why I did this,” he said. “If only I could bring back Megan. I ask for your prayers and your forgiveness.”

His attorney Sanford Schulman said Kelly’s undiagnosed mental illness caused the attack.

“Earthquakes happen, tornadoes happen, cancer happens, mental health happens,” Schulman said. “There was no motive, none. He loved his daughter.”

In an emotional appeal to the judge for a long sentence, Megan Robert’s aunt Sandra Bucklyn said her death deeply traumatized the family and left relatives with the same question police and prosecutors had — why?

“We are coming to terms that we will never really know why Kelly did what he did,” Bucklyn said. “But there is no punishment that fits this crime.”

In sentencing Kelly, Nichols said, “I’ve been doing this for 20 or so years, and this is going to go down as the biggest puzzle I’ve ever seen.”

Source: L.L. Brasier, “Dad gets 20-30 years for baseball bat beating death of daughter,” Detroit Free Press, July 12, 2012.

Montreal psych hospital under investigation after two patient deaths

MONTREAL – A Montreal hospital has come under intense scrutiny after two psychiatric patients were killed and a third patient was allegedly attacked in the course of several days.

The union representing health-care professionals at Notre-Dame Hospital says it warned management last year that staffing cuts to the psychiatric department could have consequences.

“We’re wondering whether there’s a link between these cuts and these events,” union president Guy Brochu said Thursday. When pressed, he could not immediately provide specific numbers on the staffing cutbacks.

“Could we have avoided (the deaths)?”

Two male patients — aged 69 and 77 years old — were killed by asphyxiation in the hospital’s psychiatric ward on June 16 and June 21.

One day after the second death, a 71-year-old female patient was allegedly assaulted in the ward; she survived the alleged attack.

Police were called in, and a 31-year-old psychiatric patient was arrested.

The man, Idelson Guerrier of Joliette, Que., has been formally charged with assault with a weapon and break and enter with criminal intent.

Police investigators are now trying to determine whether the suspect is connected to the deaths. A department spokeswoman said detectives have already questioned the man and may want to interrogate him again after he undergoes a psychiatric evaluation.

Initially, hospital staff did not suspect foul play in either of the deaths. Officials said both victims suffered from medical problems as well as psychological ones.

“These deaths seemed to be natural,” said hospital spokeswoman Lucie Dufresne.

The institution does not routinely call for autopsies when someone dies, but the attack changed everything for these two cases.

When police were called in, staff told them about the recent patient deaths.

It was only then that autopsies were carried out on the bodies and tests discovered that both men died by asphyxiation, Dufresne said.

The head of a patients’ rights group said Thursday he was troubled by the fact the deaths were initially blamed on natural causes.

“It sends shivers up the spine,” said Paul Brunet, president of the Conseil pour la protection des malades.

He said patients have a right to feel secure in a hospital and asked how an individual who was allegedly “that violent” found his way into the institution.

The hospital kept the deaths and the assault quiet for days.

Dufresne said officials needed the time to alert families of the victims, and of the other patients in the psychiatric ward, before going public.

The goal was to keep people from wondering about their loved ones.

She said the relatives of the victims and each of the approximately 70 patients in the unit were contacted before the hospital released the information late Wednesday.

She also sought to downplay concerns about security — and pointed out that the hospital is not a detention centre for people with violent behaviour.

Psychiatric patients have freedom to circulate, which Dufresne said is common in a hospital setting.

“Psychiatry in hospital is not a prison,” she said.

“So patients have a certain liberty… It’s a therapeutic place where people can recover.”

Dr. Paul Lesperance, chief of Notre-Dame’s psychiatric unit, said the suspect had been under the watch of his ward’s intensive-care specialists, a standard procedure for patients previously unknown to the team.

Hospital officials insist that, according to provincial norms, a sufficient number of employees were on duty when the deaths and the attack occurred.

But they say they have still launched an internal evaluation to determine whether improvements are needed.

The union president wonders whether the hospital will make enough changes.

On Thursday, one reporter took the elevator to the psychiatry ward and talked to several people without any problems. A security guard eventually caught up with her and asked her to leave.

Brochu said management answered the concerns last year by arguing that staffing levels at Notre-Dame fell within the guidelines and that other hospitals had comparable numbers of employees.

“If it’s like this everywhere, could the same event happen in other hospitals?” said Brochu, who added that he’s fielded union members’ complaints that the psychiatric ward is understaffed.

“We can’t just say that everything was done within the golden rule and accept that it continue like this.

“There has been a super-maddening event that was committed.”

– with a file from Melanie Marquis

Note to readers: This is a corrected story. Earlier versions wrongly said there was a charge of attempted murder, and listed the second death as having occurred on June 22.

Source: Andy Blatchford, “Deaths in the psychiatric ward: Montreal hospital under heavy scrutiny,” Winnipeg Free Press, June 28, 2012.

Polícia Civil do Estado do Rio de Janeiro (Rio de Janeiro Civil Police) need to check the shooter’s medicine cabinet

Twenty-three-year-old Wellington de Oliveira, a former student of the Tasso da Silveira primary school, in the town of Realengo, was at his former school earlier today on the apparent pretense of delivering a talk to a class when he opened fire on them mid-speech, killing 11 children and wounding 13 others.

If you ‘ve been following this story, you may have seen the news item in which one survivor/bystander remarked “Are we in the United States?”

As we have learned in the U.S. (as well as Finland and elsewhere), the people who commit these kinds of school murders and other mass shootings are often on a psychiatric drug or withdrawing from it–either condition has been known to make a person psychotic.

Some facts:

• The U.S. Food and Drug Administration has warned that antidepressants can cause suicidal ideation, mania and psychosis.

• The manufacturer of one antidepressant, Effexor, has even warned that the drug can cause homicidal ideation.

• In October 2006, a study came out in the Public Library of Science-Medicine journal, conducted by Dr. David Healy, director of Cardiff University’s North Wales department of psychological medicine, which found that the antidepressant Paxil raises the risk of violence.  Though the study focuses specifically on Paxil, Healy reasoned that other antidepressant drugs like Prozac, Celexa and Zoloft, most likely pose the same risk of violence.  “We’ve got good evidence that the drugs can make people violent and you’d have to reason from that that there may be more episodes of violence,” Healy said.

Other commonly prescribed psychiatric drugs carry similar warnings and side effects.  These drugs include:

• antipsychotics such as Seroquel and Risperdal, which can cause hostility, violence and suicidal thoughts);

• tranquilizers such as Xanax and Ambien, which can cause aggressive behavior, hostility, psychosis and rage and

• stimulants such as Ritalin and Concerta, known to cause aggression, mental/mood changes, psychosis and violent behavior.

Since 2004, antidepressants in the same class as Paxil, Prozac, etc. (known as SSRIs, or selective serotonin reuptake inhibitors) have carried an FDA “black box” warning—the agency’s strongest—stating that the drugs can cause suicidal thoughts and actions in children and teenagers.  The FDA later broadened the warning of a potential increased risk of suicidal behavior to include adults.  The warning calls for the monitoring of patients on antidepressants, especially when the dosage has been changed.

Additionally, eleven of the last “school shooters” were either taking or withdrawing from psychiatric drugs when they opened fire, resulting in 54 dead and 105 wounded.

These drugs have been linked to many, many other such mass murders and senseless acts of violence.

Hundreds of such cases dating back to the 1980s can be found on the web site “SSRI Stories” (www.ssristories.com/index.php).

President Dilma Rousseff, Governor Sergio Cabral, Minister of Education Fernando Haddad, Rio Police and others need to mount a concerted and coordinated effort to find out what drug an/or what kind of psychiatric treatment de Oliveira was on.

They need to ensure that full-range toxicology testing is done which detects not only alcohol and street drugs, but any prescription substance.

They then need to make the results known to a grieving public.

Mental health counselor Mary D. Hein charged with sexual exploitation of client, asking him to kill her husband

In October 2010, Wisconsin mental health counselor Mary D. Hein (a.k.a. Mary D. Duncan, who is listed by the Wisconsin Department of Regulation and Licensing as holding a professional counselor training license), was charged with three counts of sexual exploitation by a psychotherapist, one count of solicitation of first-degree intentional homicide and one count of obstructing an officer.

Specifically, she is accused of having sex with one of her clients and then asking him to kill her husband.

According to the criminal complaint filed against Hein, the client reported that Hein drugged him and had sex with him at his home in November 2009 and again in January and February 2010, during which time she requested he kill her husband.

The client, who had no intention of killing the husband, reported it to police.

According to an attorney who represented Hein, she was cleared of the charges in or around May 2011. See here.

Source: “Mary Hein charged with sexual exploitation,” WISN.com, October 12, 2010.

Psychiatrist, twice convicted of murder, loses appeal

In 2004, Australian psychiatrist Jean Eric Gassy was convicted of the October 2002 murder of Margaret Tobin , who he shot four times as she exited an elevator on her way back to her office.  He fled the scene, but was later tracked to Sydney and extradited to face the murder charge.

Tobin, who was at that time the Chief of South Australia’s mental health services, had been Gassy’s supervisor at Sydney’s St. George Hospital when she made a complaint about his behaviour.  That complaint eventually led to Gassy losing his license to practice medicine in 1997.

It had been reported that Gassy took a sick leave from St. George in 1994 for psychiatric reasons.  Tobin requested an investigation by the New South Wales Medical Board.  The Board in turn requested Gassy have a psychiatric assessment.  He refused and subsequently lost his job.

Prosecutor’s alleged that Gassy killed Tobin out of resentment.

The original 2004 guilty verdict was overturned by the High Court which raised concerns about instructions given to the jury.  But a May 2009 retrial ended in the same murder conviction for Gassy.

The South Australian Court of Criminal Appeal today rejected Gassy’s attempt to appeal the May 2009 conviction.  Gassy had argued that evidence of him suffering from a delusions should not have been admitted during his second trial.  But in refusing the appeal, the court opined that all of the evidence that Gassy suffered from delusional beliefs was relevant to the case against him and that evidence of this nature was a matter for the jury to assess.

Gassy continues to serve a life sentence over Dr Tobin’s murder with a non-parole period of 30 years.

He represented himself during his second trial and the subsequent appeal.

Psychologist jailed for husband’s murder in ’04 now in solitary on suspicion of plotting prison break

Convicted murderer Michelle Theer has been placed in an isolation cell while officials investigate whether she was plotting a prison break.

Theer, a former Fayetteville psychologist, has been in prison since December 2004, when she and her lover, former Army Staff Sgt. John Diamond, were convicted of murdering Theer’s husband.

Theer has been held in a single cell since April, when prison officials discovered that she tried to mail a map of the prison and other documents to someone on the outside, said Annie Harvey, warden of the N.C. Correctional Institution for Women in Raleigh.

“We take anything that could cause someone to escape very seriously,” Harvey said. “The best defense is to take everything seriously on the front end.”

Harvey declined to provide details about the map or the other documents that she said Theer appears to have been trying to mail.

She said prison officials regularly screen inmate mail that appears suspicious. The smell or size of a package could trigger a closer examination, Harvey said.

She said Theer, who is 41, initially was placed in administrative segregation. Her status was changed to disciplinary segregation when prison officials determined that enough evidence exists to investigate her case further.

Theer has pleaded not guilty, Harvey said.

If Theer is found to have been plotting an escape, Harvey said, the punishment would likely be maximum-custody confinement and a loss of privileges.

Theer’s husband, Air Force Capt. Marty Theer, was shot to death in December 2000 on a stairway outside Michelle Theer’s second-floor office on Raeford Road.

Prosecutors said Theer lured her husband to the stairwell so Diamond could ambush him.

Diamond was sentenced to life in prison in a military trial in 2001.

Michelle Theer was indicted in May 2002 and went on the run. She hid in south Florida, where she had plastic surgery done to her face, lived under an assumed name and planned to change her identity several times to start a new life. U.S. marshals apprehended her in August 2002.

Source: Greg Barnes, “Michelle Theer in isolation, officials probe possible prison break,” Fayetteville Observer, May 18, 2010.