TALLAHASSEE (CBS4) ― The system meant to protect children in foster care failed because doctors and case managers routinely failed to complete treatment plans, failed to share information, or properly document the usage of powerful psychiatric drugs, according to the Department of Children and Families. One of the children that it failed was 7-year-old Gabriel Myers, who hanged himself in April.
However, the study also said it would be a mistake to blame Gabriel’s death solely on the drug Symbyax. The drug is an antipsychotic used to treat bipolar disorder, also known as manic depression. It can also be used as a treatment for clinical depression if two other drugs have failed to treat the depression.
The study from DCF said that numerous rule and laws on meds for children in foster care weren’t followed for all 6 and 7 year olds, according to CBS4 news partner the Miami Herald. Among the other findings reported:
In 86 percent of cases, the prescribing physician didn’t complete what’s known as a Psychotherapeutic Medication Treatment Plan, which helps case workers, legal guardians, judges and other physicians determine a child’s mental well being.
In 76 percent of the cases, the case worker didn’t provide parents with information about the psychotropic drugs their kids were being prescribed. Nor did the case worker help arrange transportation or phone conversations between the doctor and the child’s guardian.
In 89 percent of the cases where parental consent wasn’t obtained to medicate children, case managers failed to inform state lawyers that they were seeking a court order to administer the medication.
The study comes one year after a similar review that examined the drugging of children in state care under the age of 6. The committee probing the child-welfare system plans to issue a report by Aug. 20.
CBS4
Jasmine Kripalani Reporting
FORT LAUDERDALE (CBS4) ―
After a child in foster care hanged himself to death, officials from the Department of Children & Families met with child advocates to talk about ways to prevent another suicide.
DCF Secretary George Sheldon created the panel to investigate the death of 7-year-old Gabriel Myers who hanged himself in the bathroom of his Margate home where he lived with his foster parents.
The group was scheduled to meet in Fort Lauderdale and included expert comments from a medical director in Massachusetts, according to CBS4 news partner The Miami Herald.
Two adults who spent time in the foster care system are also scheduled to speak.
Gabriel had been prescribed psychiatric drugs including anti-depressants. His case prompted DCF officials to reevaluate its mental health policy.
A state review revealed certain policies and procedures set in place to protect children were ultimately ignored. In some cases, caseworkers did not seek another opinion from a psychiatrist when children 6 and younger were prescribed drugs to treat mental illnesses.
The group will meet again on July 6th in Tallahassee.
FORT LAUDERDALE (CBS4 I-TEAM) A task force investigating the tragic death of 7-year-old foster child Gabriel Myers met for the third time in Fort Lauderdale Thursday.
They heard powerful testimony from two former foster children about medication and treatment in the system.
Gabriel Myers had been living with a foster family in Margate for a few weeks when he hanged himself in April. It was later revealed that he was prescribed psychotropic drugs.
The task force is reviewing all children currently taking medications and at Thursday’s meeting they revealed a lack of coordination between various caretakers within the foster child system.
“There isn’t a single person playing the parental role and we need good communication between all parties playing the parental role,” said Dr. Rajiv Tandon a psychiatrist and task force member.
Former foster child Mez Pierre said he was first prescribed various medications when he was only five years old because he was considered a problem child.
“Just to know care , love and nurturing. Just imagine if Gabriel had gotten that, we wouldn’t be here today.” Pierre says he eventually found a mentor who helped him figure things out. Now he is a 22-year-old college student.
Former foster child Kim Foster also gave testimony to the task force. She was also given powerful drugs beginning at age 8. She says medication isn’t the answer for all children and other interventions should be considered.
She also criticized the business nature of the foster care system because foster parents receive payment for their services.
“You’re hiring people to be parents and you don’t get a lot of parenting out of it,” she said.
The group will meet again on July 6th in Tallahassee.
FORT LAUDERDALE, Fla. (AP) ―
Kimberly Foster was on psychotropic medications every day during the decade she spent in foster care.
Locked in a mental facility with green walls, barred windows and four-point restraints from the age of eight, Foster said her actions were easy to explain: she was sad she couldn’t be with her mother.
“They looked at me as a troublemaker instead of a child who is coming out of a troubled environment. If you cry, you’re depressed. If you act out in school, you’re a behavior problem. We’re so quick to put these diagnoses on children,” the 25-year-old Foster said Thursday in a meeting with officials from the Department of Children and Families. “Youth in foster care are overmedicated, overdiagnosed.”
As state officials wade through the systemwide failures that led to the suicide of 7-year-old foster child Gabriel Myers in April, two issues come up repeatedly: the alarming use of psychotropic medications and the inability of doctors, foster parents and case workers to track problems with such powerful medications.
About 2,699 children in out-of-home foster care, or about 13 percent, are taking psychotropic drugs. That compares with about 4 percent to 5 percent of children in the general population, according to a recent DCF study.
Problems range from simply incorrectly entering basic information like a child’s gender and age into a database to overloaded and inexperienced case workers who are expected to understand warning labels on psychotropic medications.
Even logistics of accompanying a foster child to a doctor’s appointment fell short. Forty percent of the 112 foster children’s files studied, were not accompanied to their appointment. Many were dropped off by medical transport, making it that much harder for an adult to communicate crucial details about the child’s treatment.
Some officials proposed further training for foster parents and case workers, while others worried a four-hour training session on psychotropic drugs and what to look for would change little. Especially in a system with a nearly 50 percent turnover rate among case workers.
“Global training is important but I don’t think it’s going to get us to the level of specificity that we need,” said William Janes, a member of the work group examining the boy’s death. He stressed the importance of case managers.
“It’s not about psychotropic medications solely,” he said. “It’s about the care that this boy did not get.”
Basic analysis of medications for children in state care — such as what medication they were taking, why and when it was prescribed, and whether it worked — is not being completed in many cases. That information was supposed to be collected beginning in 2005.
“But it did not see the light of day,” said Dr. Rajiv Tandon, a work group member who is a psychiatrist at the University of Florida. “This particular form was an integral part of that plan and it never happened.”
In Gabriel’s case, his foster parents and teachers reported disturbing behavior, including sexual advances toward classmates. At one point, the child admitted to trying to strangle himself.
Yet his doctor continued on the same treatment plan.
“The whole system broke down in the community,” Janes said. “Everybody involved in this case was disconnected from that level that we would expect at some degree.”
Mez Pierre, who entered the foster system at age 5, said he was given plenty of medication but very little emotional support.
“I felt like I was an animal in a farm being tested on,” the 22-year-old told DCF officials Thursday. “Irresponsibility is just not worth a life. We need to do whatever we can to make sure another Gabriel does not happen again.”
FORT LAUDERDALE, Fla. (AP) ―
A 25-year-old woman who spent a decade in foster care told Department of Children and Families officials she believes children in foster care are overdiagnosed and overmedicated.
Kimberly Foster made the comments to state officials Thursday in Fort Lauderdale.
Officials are reviewing system wide failures that led to the hanging death of 7-year-old foster child Gabriel Myers. Two issues keep returning: the alarming use of psychotropic medications and an inability for doctors, foster parents and case works to track these powerful medications.
TAMPA ― An investigative panel formed by Department of Children and Families Secretary George Sheldon to look into what led up to the death of a Margate boy living in foster home will convene Monday in Tampa.
Gabriel Myers, 7, died April 16th after he apparently hanged himself from a shower rod.
Sheldon has asked the group to conduct a full inquiry into the events that led up to the boy’s death including case management, judicial decisions and the contributing effects that psychotropic drugs and sexual abuse had.
“It is incomprehensible to me—even now—to understand how a child so young may have deliberately and consciously made a decision to end his life,” said Sheldon last month during a press conference on psychotropic drug among foster children. “Anyone who heard of Gabriel’s story was in disbelief; and parents everywhere are wondering to themselves: how could this happen?”
The panel is being chaired by Dr. Jim Sewell, a former assistant commissioner of FDLE.
Sheldon said he’s been disturbed by some of the initial findings of the work group in the case.
“Gabriel’s physician had prescribed several psychotherapeutic drugs, but this information was not reflected in our database,” said Sheldon. “There also was no evidence in Gabriel’s files that the statutorily required parental consent or a court order where obtained.”
According to documents released by the DCF, Myers was taken from his drug-abusing mother less than a year ago. He had apparently been sexually abused and exposed to adult videos since the age of three. Teachers had reported that he had exposed himself, and touched other children inappropriately.
The Margate foster home where Gabriel Myers allegedly took his life was the third for the boy in less than a year. The DCF documents obtained by the CBS4 I-Team show he first entered the foster care system on June 29, 2008. He was placed in a licensed home through Kids in Distress. Some days later, he was moved to the home of his aunt and uncle. He lived there for some three months until Broward Sheriff’s Office investigators received a report alleging sexual and physical abuse.
While investigators found no signs of sexual abuse, the uncle revealed he “did try corporal punishment” and hit the child with a belt. A Broward County judge issued an emergency order and moved Gabriel Myers back to the licensed home.
According to the documents, when Gabriel first entered the system, he had with him a prescription bottle of Adderall XR, a drug typically taken for Attention Deficit Hyperactivity Disorder (ADHD). The medication appeared melted. A new prescription was filled, but ultimately stopped. The DCF documents show Gabriel began seeing a psychiatrist soon after entering the system.
The psychiatrist later prescribed Lexapro, a drug for depression and anxiety, and Vyvanse for the child’s ADHD. In March, doctors took Gabriel off Lexapro, and put him on Symbyax, also for depression and possible schizophrenia.
All three of the drugs have an FDA-mandated “black box” warning — a statement on the prescription’s box which describes its possible adverse reactions, including suicidal thoughts.
A South Florida family has filed suit against a Fort Lauderdale doctor claiming he is responsible for their child’s death and this is not the first time the doctor has been the center of controversy.
Dr. Sohail Punjwani who gave mind altering drugs to South Florida children could soon be going to court to defend his reasoning for prescribing the drugs. The mother of one of the boys spoke out about her son on Thursday.
“He was like a zombie, my son was like a zombie all the time,” said Norma Tringali as she described the final days of her teen aged son Emilio Villamar.
Tringali told CBS4’s Ted Scouten that her son was diagnosed as bi-polar and was treated by Dr. Sohail Punjwani. She claims her son was given a cocktail of drugs and that some that were not approved for children.
Villamar died of a heart attack at 16. Tringali said she was shocked when she heard the same doctor was treating 7-year old Gabriel Myers, who hanged himself April 16th in the bathroom of his Margate foster home.
Investigators are checking claims that he hanged himself, while also on a cocktail of drugs, some not approved for kids.
“When I learned that he was under the care of Dr. Punjwani, I say to myself, I will go forward and talk about it because maybe somebody else can learn from my tragedy,” said Tringali, who actually filed the lawsuit four years ago.
Gabriel Myer’s death spurred DCF Secretary George Sheldon to appoint a work group to study the agency’s use of psychiatric drugs, and its compliance with a 2005 reform law on the use of such medications on children in state care.
Under the 2005 law, the Agency for Health Care Administration oversees a state program that monitors the prescribing of mental-health drugs to children under Medicaid, the state insurance program for the needy.
The program, called the Medicaid Drug Therapy Management Program, tracks the prescribing of mental-health drugs to children, and flags psychiatrists whose practices veer outside generally accepted protocols.
Among the practices that might draw attention: doctors with a high volume of prescriptions of mental-health drugs or potentially dangerous combinations of the medications. The program looks at the practices of about 17,000 doctors who prescribe medications to children on Medicaid, and about 300 to 450 end up red-flagged.
Dr. Sohail Punjwani, who was treating Gabriel and Emilio, had been red-flagged by the medication program every quarter that the list was kept, one of the administrators told CBS4 News partner The Miami Herald.
TALLAHASSEE — A new study from the Florida Department of Children and Families showed proper authorization was not obtained for 16 percent of Florida foster children who take anti-depressants and psychotropic drugs. The study was ordered after a 7-year-old boy committed suicide in Margate this year.
State records did not show the drugs he had been prescribed. The records also showed required consent had not been obtained from the boy’s parents or a judge.
The report showed that a total of 2,699, or 13.2 percent, of Florida children in out-of-home care have been prescribed at least one psychotropic medications. 59 percent of those children are between the ages of 13 and 17 years old.
73 children, or roughly 2.8 percent, who have been given psychotropic drugs are under the age of 5.
State records also showed that for 16.2 percent of the 2,669 children receiving psychotropic medicines, there was no authorization obtained.
DCF said it will be strengthening its reviewing of medications, conducting a weekly conference call about psychotropic meds, and other measures to better protect the children in foster care who receive psychotropic medications.
HIALEAH (CBS4) ― The mother of a 12-year-old autistic boy who died while in the care of a group home has filed a wrongful death and medical malpractice lawsuit claiming overmedication led to his death.
Martha Quesada spoke to reporters in Ft. Lauderdale on Wednesday. Her son Denis Maltez died in 2007 while he was at the former Rainbow Ranch group home in Miami.
“It’s especially hard because he died around Mother’s Day,” Quesada said, fighting back tears. “I have two other children, but this is when he passed away.”
At the time of his death on May 23, 2007 Denis was under the care of Miami psychiatrist Dr. Steven L. Kaplan. Kaplan is named in the lawsuit, along with the group home’s operator, David Glatt.
“This is a clear case of a 12-year-old child who perished because he was given a lethal combination of off-label, dangerous, anti-psychotic drugs to control his behavior without appropriate consent and supervision,” said Howard Talenfeld, who is Martha Quesada’s attorney.
The Miami-Dade County Medical Examiner found that Denis died of Central Serotonergic Syndrome. This resulted from the co-administration of multiple psychotropic medications with no monitoring or supervision, the suit claims. The drugs stimulated overproduction of serotonin – a naturally occurring chemical that help regulate a person’s mood. This proved lethal, the suit claims. Denis, who had severe autism, died in a van after being restrained by group home staff.
Quesada’s lawsuit comes a month after the death of Gabriel Myers. The 7-year-old foster child had been prescribed a variety of mental health drugs and later hanged himself. The state Department of Children and Families is now studying the use of psychiatric medication on foster children.
CBS 4 News Reporter Joan Murray spoke with DCF Secretary George Sheldon about the lawsuit. While Denis was “not” under DCF care, Sheldon says his death underscores the urgent need to look at the use of psychotropic drugs on children.
“What we have to do is learn from this experience,” said Sheldon. “Not only in the licensing of group homes, but we have to use the same kind of care a parent would use.”
Sheldon says he expects big policy changes on the state level. “We have to make sure there is a third party review of psychotropic drugs,” added Sheldon
CBS4
I-Team: Charges Could Be Brought In Boy’s Hanging
Task Force Begins Work On What Went Wrong, What To Fix
MIRAMAR (CBS4)
Gary Nelson Reporting
CBS4 News has learned that criminal charges could be brought in the hanging death of a seven-year-old foster child who died in his Miramar foster home April 16th. Investigators are looking at multiple issues, including the behavior of a 19-year-old babysitter who was watching the boy when he died.
Sources close to the investigation told CBS4 News reporter Gary Nelson that investigators have “questions” about the circumstances surrounding the death of Gabriel Myers, the foster child found dead just weeks after he was placed in the Miramar home.
“Who wouldn’t have questions after seeing your interview?” said one investigator. The official was referring to a CBS4 News interview with Miguel Gould, the son of the foster father, who was watching Gabriel the day he died.
In the interview with CBS4’s Nelson April 27th, Gould said he watched through a window as the boy fashioned a noose around his neck and hanged himself from a bathroom shower head. The sitter said the boy spoke, even as he hung suspended by his neck, his feet off the bathroom floor.
“I told him don’t do anything stupid, don’t do anything crazy,” the sitter said. “He told me he was going to kill himself.” The sitter told CBS4 he looked around the house for a screwdriver that he used to gain entry to the bathroom, but only after considerable time had passed. When he got into the bathroom the sitter said he saw the boy “with his head against the wall, dead.”
“He was out of control. I couldn’t control him. My parents couldn’t control him,” the sitter said of the foster child.
Investigators have reviewed the babysitter’s interview with CBS4 News as part of their death investigation.
A source close to the investigation told CBS4 News that detectives and the medical examiner have not determined the “cause and manner of death” in the case. “We have not concluded whether it was or wasn’t” a suicide, the source said. The case will eventually be forwarded to the State Attorney, who will determine what, if any, charges should be brought.
As the criminal investigation continues, a state child welfare task force appointed to investigate Gabriel’s death began its work Thursday in a large conference room jammed with bureaucrats and children’s advocates in Fort Lauderdale.
“This agency has got to get it right,” said Department of Children and Families Secretary George Sheldon. “I want to make sure that the system is right, and that Gabriel’s death had some meaning.”
At the task force meeting, the child welfare agency overseeing the foster home blamed the foster parents for leaving the boy with a babysitter who had not been screened as a caregiver.
“It was unbeknownst to us that he was in the home,” said Ellen Okrent, Vice President of Kids In Crisis, a contractor hired by the state. Under state law, foster parents must report who is living in the home to allow screening of those who might be watching the foster kids. The foster father at the home where Gabriel died has declined to speak with CBS4 News.
The DCF task force is expected to take several months to complete its work, but these are some of the preliminary findings by staff members:
– None of the professionals involved in Gabriel’s care recommended that he be institutionalized, despite “several occasions where he threatened… to kill himself.”
– Gabriel was being given powerful, psychotropic drugs known to increase the risk of suicide in children. The drugs were given to the boy without approval from a judge, despite state law that requires a judge’s order before such drugs are administered.
– State contractors in Gabriel’s case exercised “insufficient supervisory oversight.”
– There was “insufficient communication between professionals involved in Gabriel’s case.”
– Gabriel’s foster parents “did not comport with the requirements” of their agreement with the state.
In Memory of Gabriel Myers 