Who Failed Rebecca?
MayorBob.
Posted to Etcetera on Fri Apr 18, 2008 at 06:20:59 AM EST (promoted by port1080). RSS.
Rebecca Riley's story is the horrific stuff you'd expect to see at a cineplex. Before the 4-year-old from Boston died in December 2006, she had been on a steady regimen of some very strong psychotropic drugs, prescribed by a doctor to treat her bipolar condition. Allegedly, her parents used her in a scheme to collect Social Security disability payments. Bottomline is that the parents are facing second-degree murder charges and the doctor is being sued by Rebecca's estate as the "primary cause" of her death.
Rebecca (whose story was touched on during a PBS Frontline documentary) was 28 months old when she was first seen by Dr. Kayoko Kifuji. Rebecca's parents claimed the child had been experiencing mood and behavior swings. Kifuji diagnosed Rebecca with bipolar disorder and prescribed three powerful drugs to deal with the condition: Clonidine, Seroquel, and Depakote. Rebecca remained on a regimen of the three drugs for the following two years. Rebecca's autopsy indicated a fatal level of Clonidine in her body.
Massachusetts authorities still haven't set a trial date for Michael and Carolyn Riley. They are charged with lying to Dr. Kifuji and doping up their daughter in order to qualify her for Social Security disability benefits. According to Dr. Kifuji, the parents admitted increasing Rebecca's dosages the last year of her life against her instructions. Six weeks before the child's death, the nurse at Rebecca's daycare had communicated her suspicions that she was overmedicated to Dr. Kifuji, telling her the child appeared like a "floppy doll" when she was at the daycare.
Rebecca's estate is suing Dr. Kifuji, charging her with malpractice. The malpractice complaint (pdf doc) lays out the accusations against the doctor. Lawyer Andrew Meyer, who represents the estate, sums it up with: "This child was subject to mostly telephone prescriptions and a slipshod diagnosis. They made her a 4-year-old zombie. We don't believe that she did suffer from bipolar or that this was the appropriate medication." John Darrell, Michael Riley's lawyer, says the lawsuit "raises an interesting question" of just who should be held responsible. Meyer says that, even if the Rileys both are convicted, it wouldn't let Kifuji off the hook:"The primary responsibility falls on this doctor. The failure of this doctor to respond to the warnings she was given and to thoroughly investigate the symptoms that her medication was causing ended with this very sad result here of a young girl dying."
Before the Rebecca Riley case, Dr. Kifuji had practiced six years in the US, treating a number of juveniles for bipolar disorder. However, Rebecca's death sparked concerns about diagnosing bipolar disorder in the very young. It was a diagnosis rarely made before the middle of the last decade. Since medical researchers published studies in 1995 verifying the condition could occur in the very young, diagnoses have been on the rise. One study of mentally ill children indicated the diagnosis of bipolar disorder rose from three percent to as high as 15 percent from 1990 to 2000 in Massachusetts. Data on the diagnosis and treatment for children under the age of six is not readily available. But Dr. Janet Wozniak, director of the Pediatric Bipolar Program at Massachusetts General Hospital, asserts that it's important to diagnose and treat the condition as early as possible but concedes doing so with preschoolers is "uncharted waters."
