Suit Can Proceed Against Psychiatrist Who Prescribed Drugs to Four-Year-Old Who Died

Child’s death is symptom of larger issue now unfolding in court

On March 5, 2009, a Suffolk County (Massachusetts) malpractice board determined that there was enough evidence with which to file a civil lawsuit against psychiatrist Kayoko Kifuji for malpractice.  Kifuji is the psychiatrist who diagnosed the late Rebecca Riley with bipolar disorder and attention deficit hyperactivity disorder and prescribed her the antipsychotic drug Seroquel and the anti-seizure drug Depakote (as well as the blood pressure drug Clonidine).  Riley was four years old at the time of her death.

During a March 3rd hearing on the allegations, the board determined that Kifuji prescribed too many doses of Clonidine and the other drugs.

The charges were brought before the board by Boston attorney Krysia Syska of the firm Lubin & Meyer, who is representing Rebecca Riley’s estate.

Plaintiff expert witness, Dr. Howard Goldman of Bradenton, Florida, supported Syska’s allegations in a letter to the board.  He also said that Kifuji did not properly monitor Rebecca’s medical condition.

Kifuji voluntarily surrendered her license to practice shortly after police charged Rebecca’s parents with trying to kill their daughter by administering too many doses of the prescription drugs.

Kifuji diagnosed Rebecca with bipolar and attention deficit disorder when she was two years old.

There are several reasons that this is an important case for medical malpractice attorneys to monitor:

1. The psychiatric drugs prescribed to Rebecca Riley (Seroquel and Depakote) are not FDA-approved for use in children.  While doctors are not bound to prescribe a drug only for its FDA-approved use, it may be a gross violation of the standard of care to prescribe such drugs to infants and toddlers presenting with behavioral issues.

2. Since 1994, there has been a 4000% increase in the diagnosis of bipolar disorder in children and a subsequent five-fold increase in the number of antipsychotic drugs prescribed to them—2.5 million prescriptions.¹  The emergence of “pediatric bipolar disorder” has been widely credited to psychiatrist Joseph Biederman of Harvard University and Massachusetts General Hospital (MGH).²  Prior to that time, this diagnosis was rarely, if ever, applied to children.  Biederman authored or co-authored studies suggesting the existence of “pediatric-onset bipolar disorder” which began appearing in 1995.³  By 1996, he was declaring that nearly a quarter of the children he was treating for attention deficit disorder also met his criteria for bipolar.⁴  However, the integrity of his research and conclusions has since been called into serious question:  In June 2008, a Congressional investigation found that Biederman had been paid $1.6 million in consulting fees by drug makers between 2000 and 2007 but failed to report most of it to Harvard officials for several years.  He subsequently was stopped from participating in any drug industry-financed activities (such as speaking engagements) as well as any such financed activities within MGH.  Pediatrician Lawrence Diller, author of Should I Medicate My Child, publicly denounced Biederman as being “morally culpable in providing the ‘science’ that allowed Rebecca [Riley] to die.”⁵  This same “science” has allowed many more children to be prescribed these drugs.

3. Kifuji has admitted that she was influenced to diagnose children with bipolar disorder and prescribe them antipsychotics drugs by Biederman.⁶

As these drugs are not approved for use in children and carry warnings for life threatening side effects that include rapid weight gain leading to diabetes, one can see that there are likely other “Kayoko Kifuji’s” out there who are committing malpractice on other children.

Biederman is now also emerging as a key witness in another suit—a huge, multi-state action brought on behalf of more than 2,000 patients, including children, who claim to have been injured by antipsychotics—and was ordered to provide a deposition to plaintiff’s lawyers.  Biederman is not a defendant in the case, but the plaintiffs’ lawyers submitted more than two dozen documents aiming to present him as an example of how drug companies and researchers conspired to boost “off-label” prescriptions—those that are for non-FDA approved uses—such as what occurred in the case of Rebecca Riley.  The contents of Biederman’s deposition (posted on the Internet at www.windhover.com/pdf/biedermanday1.pdf and www.windhover.com/pdf/biedermanday2.pdf) reveals heretofore hidden areas of pharmaceutical “research.”  Additionally, a March 20th Wall Street Journal story reported that documents have come to light in the case suggesting that Biederman told Johnson & Johnson (maker of the antipsychotic Risperdal) prior to commencing a Risperdal trial, that he expected positive results.⁷

The lawyers for the Estate of Rebecca Riley contend that Kifuji’s actions and omissions are to blame for the girl’s death.⁸  While the recent Supreme Court ruling against pre-emption takes a great deal of risk out of bringing product liability suits, plaintiff’s attorneys should also ensure in all cases of patient harm or death that the prescribing psychiatrist is also named as a defendant.

State and federal law enforcement agencies should be paying close attention to the Senate investigation and deposition of Joseph Biederman as it would seem that generating phony research to “prove” the existence of bipolar disorder in children, by which psychiatrists were convinced to prescribe dangerous antipsychotic drugs, should be criminally investigated and prosecuted.

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