So much bluster, but foster kids’ drug nightmare continues

Miami Herald
By Fred Grimm
Gabriel Myers died for nothing.

His shocking death supposedly galvanized Florida. It would mean something, this suicide of a foster kid who had been drugged into nether-consciousness with antidepressants and antipsychotics never intended for any child, much less a 7-year-old.

A new law would be crafted. State-sponsored zombification of foster kids would be stanched. Something would be done.

More like nothing.

“I was shocked. I was devastated,” said Mez Pierre, a young survivor of the unrestrained psychotropic regimes used to addle Florida foster kids.

THE PERPLEXING PUSHBACK

Pierre, 23, joined a number of child advocates, state officials, political leaders and judges in the Gabriel Myers Work Group formed by the Department of Children & Families. They met a dozen times over the past year, exploring legislative fixes for this stunning propensity to subdue foster children with adult-strength pharmaceuticals.

The group was born out of our collective shame. Gabriel Myers had been addled with Lexapro, Zyprexa and Symbyax — a drug cocktail no real parent would countenance. On April 15, 2010, Gabriel locked himself in the bathroom of his Margate foster home, coiled a shower hose around his neck and shocked Florida into . . . nothing.

The widely supported bill designed to regulate the drugging of foster kids disappeared in the House of Representatives this week. Medical and drug-industry lobbyists, and a single powerful legislator, Rep. Paige Kreegel, chairman of the Health Care Services Policy Committee, managed to waylay the bill.

Bernard P. Perlmutter, director of the University of Miami’s Children & Youth Law Clinic, was surprised that “pushback came from doctors and psychiatrists, since the bill did little more than codify existing medical ethics standards and laws regarding consent from a child’s parents or judge, and assent from the child, before psychotropic medication could be administered.”

Kreegel feigned unfamiliarity with Myers’ case. “I am shocked that the chairman never heard about Gabriel Myers, especially after the months of work by a task force of leading experts and then work by the Senate,” said Broward child advocate Andrea Moore. “Unfortunately, we know there are other children who have been harmed by the unfettered use of these drugs as chemical restraints. If a highly publicized death is not enough to galvanize the Legislature, I do not know what will do it.”

SPIRITS IN SHACKLES

Mez Pierre now understands Florida’s priorities: Doctors matter. But foster children . . .

“They sent foster kids a message.” he said.

“You’re just not important enough to protect.”

Pierre, 23, grew up in so-called “therapeutic” foster homes from age 5 to 18, shuffling from one zombie warehouse to another, where psychotropic drugs left him perpetually listless, filled his head with strange, often suicidal thoughts and caused serious physical side effects.

The brutal effects ended when he left foster care at age 18 and quit the psychotropics. Without the pills, the supposedly unruly young man has finished three years at Broward College. “But what happened to me, what happened to Gabriel, it’s still going on,” Pierre said.

And all the work group meetings. All the talk. All the work. As if foster kids mattered.

It came to nothing.

Foster kids lose

Miami Herald
OUR OPINION: Still subject to over use of psycho-tropic drugs

State Sen. Rhonda Storms, a Valrico Republican, put up a Herculean fight on behalf of Florida’s foster kids this week, but a powerful bloc of doctors and psychiatrists defeated her in the Florida House.

The House leadership could have prevented this travesty. Instead, it caved to Florida’s powerful medical lobby and sacrificed some of the state’s most vulnerable residents.

The battle was over use of psycho-tropic drugs on youth in state care. After the 2009 suicide of 7-year-old foster child Gabriel Myers in Margate, the Department of Children & Families hired former Florida Department of Law Enforcement Deputy Commissioner Jim Sewell to investigate how drugs are used to control unruly foster kids.

Mr. Sewell pulled no punches in his report. Foster parents and doctors often resort to strong anti-depressants to keep children with emotional problems in line. Treatment of their underlying psychological problems take second place to keeping them drugged up.

Gabriel had been prescribed several such drugs before he hung himself, including anti-depressants linked to an increased risk of suicide among children.

The DCF sought better oversight of how doctors prescribe psychiatric drugs to foster children. The bill, sponsored by Sen. Storms, would have required doctors to seek the “assent” of older foster kids before they could be medicated and upheld current law requiring doctors to get consent from a parent or a judge in most cases before using drugs.

That’s reasonable — and, more important, in the child’s best interests. But physicians fought, saying they didn’t want government telling them what to do. Republican state Rep. Paige Kreegel, a Punta Gorda doctor, blocked the bill from even being heard in the House, though it had passed easily in the Senate.

Sen. Storms tried every legislative maneuver available to get around Rep. Kreegel, but the physicians won the day, and Florida’s foster children are worse off for it.

DCF ought to seek another way to control use of these medications until reason prevails in the House.

Drug’s use again in spotlight

Miami Herald
The mother of a Broward teen who died in 2003 believes it was because of an anti-psychotic drug he should not have been prescribed.
BY NIRVI SHAH

A Broward doctor reprimanded by the Food and Drug Administration for his drug-prescribing practices is facing accusations in a civil suit that he caused the death of a Weston teen after prescribing an anti-psychotic drug not approved for use in adolescents.

Norma Tringali of Tamarac believes the drug Seroquel, which Dr. Sohail Punjwani prescribed to her son Emilio, played a role in his death seven years ago. Punjwani is the same physician who was treating 7-year-old foster child Gabriel Myers before he committed suicide last year.

Earlier this week, pharmaceutical giant AstraZeneca agreed to pay state and federal government agencies $520 million to settle an investigation into the company’s marketing practices, which the Department of Justice said encouraged doctors to use Seroquel for young and elderly people for indications not approved by the FDA.

The settlement will yield about $8.5 million for Florida, split between the state’s Medicaid program, general revenue fund and a reward program for reporting Medicaid fraud.

Tringali’s case against Punjwani is expected to go to trial later this year.

All the other doctors and institutions named in the suit have settled with Emilio’s family, said her lawyer, Michael Freedland.

In the meantime, for Tringali, the civil penalty AstraZeneca has said it will pay provides some resolution.

“That is the thing — that is the answer,” Tringali said, through tears. “Emilio was taking something recommended for adults, not kids.”

Punjwani and his attorneys did not return several phone calls seeking comment.

After a year in Punjwani’s care, Emilio, who played water polo, had a heart attack and died. He was a junior at Piper High School in Sunrise. The lawsuit alleges that Punjwani’s care “deviated and departed from the prevailing professional standard of care exercised” by most doctors.

It goes on to say that Punjwani failed to monitor the effects of a combination of anti-psychotic drugs on Emilio’s heart, failed to perform regular cardiac testing and failed to consult with a cardiologist or other doctor with more experience with the heart-related side effects of anti-psychotic drugs, among other things.

But it is not certain whether the settlement will have a direct effect on the suit against Punjwani, said Tringali’s lawyer, Weston attorney Michael Freedland.

“She was always convinced that these drugs caused his death,” Freedland said of Emilio’s mother. “For her this settlement was some kind of vindication in a sense. It doesn’t necessarily relate to the exact same issue.”

Freedland’s office was simultaneously working on Tringali’s case and the whistleblower case that led to this week’s settlement with AstraZeneca. But rules about whistleblower suits meant they could not share anything about that case with Tringali until the settlement became public this week.

Punjwani was reprimanded by the FDA because he failed “to protect the rights, safety and welfare” of children enrolled in clinical drug trials.

“Your failure to conduct the requisite safety measures contributed to the unnecessary exposure of pediatric subjects to significant overdoses, which jeopardized the subjects’ rights, safety and welfare,” the FDA wrote.

Early last year, drugmaker Eli Lilly pleaded guilty to illegally marketing the anti-psychotic drug Zyprexa for unapproved uses. Freedland’s firm also worked on that case, which netted a $1.42 billion settlement.

“The issue relates to these drugs,” Freedland said. “The way Dr. Punjwani treated Emilio Villamar and the manner in which these drugs were prescribed is a picture of everything that’s wrong with this industry and the relationship between doctors and pharmaceutical companies.”

The settlement says that AstraZeneca targeted its illegal marketing of Seroquel at doctors who do not typically treat schizophrenia or bipolar disorder, including physicians who treat older patients, young patients and primary care doctors and to psychiatrists and other physicians for uses that were not approved by the FDA as safe and effective.

The civil penalty will repay Medicaid, Medicare and other programs that were billed for the drug, although it was being prescribed incorrectly.

In a statement, AstraZeneca said under the agreement, it still denies the allegations.

However, the international company, with U.S. headquarters in Delaware, entered into a corporate integrity agreement with the Office of Inspector General of the United States Department of Health and Human Services that will last for five years.