Lawsuit says too many psychiatric drugs killed boy

Miami Herald
PSYCHIATRIC DRUGS
A disabled boy was lethally overmedicated, a lawsuit contends, as outrage continues over a child’s suicide while on several drugs last month.
BY CAROL MARBIN MILLER
cmarbin@miamiherald.com

Amid a wide-ranging debate over the proper use of mental health drugs on troubled children, the mother of a disabled boy who died in 2007 is claiming in a lawsuit the boy was overdosed by a cocktail of psychiatric drugs, including two powerful anti-psychotics.

Martha Quesada, the mother of 12-year-old Denis Maltez, filed a wrongful death and medical malpractice lawsuit Monday in Miami-Dade circuit court, claiming Denis’ psychiatrist, Dr. Steven L. Kaplan, and the now-shuttered Rainbow Ranch group home overmedicated Denis and failed to properly monitor his condition.

Denis, who was diagnosed with autism, died of serotonin syndrome, according to a 2007 autopsy by the Miami-Dade Medical Examiner’s office.

The rare condition, which can be life-threatening, occurs when a combination of drugs — particularly mental-health drugs — causes the brain to produce an excess of serotonin, a chemical produced by nerve cells that regulates mood. The condition can cause rigidity and tremors, as well as confusion and high blood pressure, said Dr. Carlos Singer, a professor of neurology at the University of Miami’s medical school.

”I miss him so much,” Quesada, 31, of Hialeah, said of her son, who died a week after Mother’s Day. “This month, for me, is hard because of Mother’s Day. This Saturday will be two years since he died. The last time I saw him it was Mother’s Day.”

”I know I am happy, because I have two other children,” Quesada said. “But I am also sad, because my other son died. It’s hard.”

Denis died May 23, 2007. He had gone by van with others from the group home to get a haircut at a local flea market. In the parking lot, he became aggressive, kicking and biting group home staff. An autopsy report said he became unresponsive shortly after staff restrained him while he lay on his stomach on a bench seat in the van.

Quesada’s lawsuit was filed amid a high-profile investigation by the Department of Children & Families into the death last month of Gabriel Myers, a 7-year-old foster child who had been taking a cocktail of mental health drugs. DCF Secretary George Sheldon appointed a task force to study Gabriel’s case, and the use of psychiatric drugs on foster kids.

‘TOUGH’ TO HANDLE

Kaplan did not return calls for comment. In a June 2007 article in The Miami Herald, Kaplan said ”it’s possible” Denis would have been sleepy at school if he had not been given his medications at the right times. But, Kaplan added, “I never saw him dopey or sleepy.”

”He was all over the place, a tough little guy to handle but very likeable,” the psychiatrist said at the time.

Rainbow Ranch’s owner, David Glatt, whose group homes were shut down by the state in June 2007, could not be reached for comment.

Denis, whose autism was severe, was sent by his mother to a state-funded group home in 2003 after he tried to choke his younger sister. Quesada never relinquished her right to raise the boy, but was afraid his violent outbursts were a danger to her two other children.

According to the 28-page lawsuit, Glatt stopped taking Denis to doctors at Jackson Memorial Hospital after he arrived at the group home in May 2006, and substituted Kaplan ”without the consent of [Denis’s] mother.” Kaplan was treating several group home clients, the suit claims.

Kaplan prescribed and refilled four mental health drugs: Seroquel and Zyprexa, both anti-psychotic medications; Depakote, an anti-seizure drug sometimes used to stabilize moods; and Clonazepam, a tranquilizer. The lawsuit says the drugs were used “as chemical restraints to control Denis’s behavior.”

Though some of the medications are not approved by the Food and Drug Administration for use on children and carry strong warnings about possible side-effects, Kaplan ”took no steps to ensure that Denis was not suffering any adverse effects from these medications,” the suit claims.

In fact, the suit claims, Kaplan examined the boy only once between between May 26, 2006 and May 23, 2007, the day Denis died.

There were warning signs that the drugs may have been harming the boy, according to the suit, filed by by Fort Lauderdale attorneys Maria Elena Abate and Howard Talenfeld. In June 2006, teachers at Denis’s school, Ruth Owens Kruse Educational Center, reported the boy was sleeping through class.

UP AND DOWN

Acting on concerns from his teachers, Denis was hospitalized twice, first on July 17, 2006, at Miami Children’s Hospital for emergency treatment, and, later on Aug. 4, 2006, at Baptist Hospital’s emergency room. Doctors at Baptist recommended that the dosage of one of the drugs, Depakote, be reduced, the suit claims.

The lawsuit says the dosage was, indeed, reduced, but then increased again about six months later. That winter, the suit claims, the Department of Children & Families child abuse hot line received a call that Denis was being overmedicated, and that Rainbow Ranch staff “were not seeking medical attention for Denis when he was overmedicated.”

DCF would not discuss the investigation with a reporter Tuesday.

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