Author Topic: Death due to Restraint at Star Ranch RTC- Ingram, Tx  (Read 25700 times)

0 Members and 1 Guest are viewing this topic.

Offline Deborah

  • Posts: 5383
  • Karma: +0/-0
    • View Profile
Death due to Restraint at Star Ranch RTC- Ingram, Tx
« Reply #180 on: June 02, 2007, 12:37:34 AM »
It's true, restraint is needed on a rare occasion to protect someone from hurting themselves or others.
The problem with restraint in the industry is that it is used too frequently. It's not always used for safety, but for punishment and convenience. Also used to establish authority. Kids are 'baited'. Illegal restraints are used. De-escalation is not even attempted. Poorly trained, sadistic, and/or young adults performing the restraints. They often have 3 or 4 adults on a small child. The restraint is held too long. Staff ignore the child when they say they can't breath, you know, "faking". Some programs lie about their use of restraint.

Restraints can be accomplished without blocking the airway and killing a kid. How is it an adult (or several usually) can't restrain a child safely, when it becomes absolutely necessary?

Here's a real simply option
http://www.fornits.com/wwf/viewtopic.ph ... 650#237650
http://wwf.fornits.com/viewtopic.php?p=120211#120211
http://wwf.fornits.com/viewtopic.php?p=119744#119744

InterMountain was supposed to go restraint/seclusion free. Might check and see how it's going.
http://www.fornits.com/wwf/viewtopic.ph ... 294#165294
Google around. I know there are others.
Contact APRAIS
http://www.fornits.com/wwf/viewtopic.php?p=53648#53648
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »
gt;>>>>>>>>>>>>>><<<<<<<<<<<<<<
Hidden Lake Academy, after operating 12 years unlicensed will now be monitored by the state. Access information on the Federal Class Action lawsuit against HLA here: http://www.fornits.com/wwf/viewtopic.php?t=17700

Offline GOATFLAVOR

  • Posts: 19
  • Karma: +0/-0
    • View Profile
THANK YOU
« Reply #181 on: June 02, 2007, 02:38:06 AM »
Thank you for attempting to answer my question instead of blindly attacking the character of someone you know nothing about.

I have seen the good, bad, and ugly
I have seen it misused and misguided
I have also seen situations where children's safety was on the line
and it was needed

the bottom line is support

child care in texas is grossly under supported
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »

Offline Anonymous

  • Newbie
  • *
  • Posts: 164653
  • Karma: +3/-4
    • View Profile
Re: Death due to Restraint at Star Ranch RTC- Ingram, Tx
« Reply #182 on: August 20, 2008, 02:50:18 PM »
http://www.dallasnews.com/sharedcontent ... 052b6.html
Some Texas foster kids' doctors have ties to drug firms

11:20 AM CDT on Sunday, August 17, 2008
By EMILY RAMSHAW / The Dallas Morning News
http://www.gwenolsen.com. "I saw firsthand several circumstances where my minimization of side effects or misinforming a physician had actually resulted in the patient being damaged and/or killed."

Ms. Olsen, who could not be reached for comment, came forward after her 20-year-old niece who had been taking Paxil committed suicide, according to published reports - first attempting to hang herself from a ceiling fan, then setting herself on fire.

How it works
All children entering Texas' foster care system get a routine health screening, and any who show symptoms of mental illness receive psychiatric evaluations. Until this year, the doctors who performed those exams were chosen by individual foster parents, caseworkers or the directors of residential treatment providers - the only stipulation being that they accepted patients on Medicaid.

Child-welfare watchdogs say these doctors, many of whom were in private practice or affiliated with private mental hospitals, operated for years with little oversight. Short on time and swamped with patients, some rarely spent more than a few minutes with their foster patients, they said, and relied on drugs instead of more time-consuming behavioral therapy.

Often, children missed doctors' appointments and doses of medicine - the result of poor record-keeping as they were shuttled between foster families and facilities.

In April, the state implemented a new health care system for foster children, one that makes appointments and selects doctors for them using a standardized list. Under the new program, any children with diagnoses other than minor depression or attention deficit hyperactivity disorder must be seen by a child psychiatrist. The system also keeps track of all the children's medical records, creating a "continuity of care."

Despite the heightened regulations, however, many of the doctors on the list are the same as were seeing many foster children before.

Texas health officials acknowledge past problems with foster children being overmedicated. A scathing 2004 report by the state comptroller found hundreds of foster kids as young as 3 were being given psychiatric drugs; one older child had 14 prescriptions for 11 different medications, at a monthly cost of more than $1,000.

But state health officials say that since 2005, they've made significant strides, reducing the share of kids taking psychiatric medicine from 38 percent to 32 percent. They've also whittled the number of 3-year-olds on mind-altering drugs by more than 25 percent and reduced the number of juveniles on five or more drugs by 20 percent, according to state data.

Prescriptions still common
Experts say the raw numbers are still high. In fiscal year 2007, nearly 15,000 of the 40,000 Texas children in state custody were prescribed at least one behavioral drug, costing the state $37.9 million.

It's hard to tell how this compares with the broader population; there are few national studies documenting the number of children on psychiatric drugs. In a 2006 analysis of more than 2 million patients served by Medco Health Solutions, a pharmacy benefit manager, 4.3 percent of children under 19 were on an ADHD drug, and 2.4 percent were on an antidepressant. Less than 1 percent were taking antipsychotic drugs, which are considered the most powerful.

Of the top five drugs most often prescribed to Texas foster children in 2007, two psychotropic drugs - Risperdal and Seroquel - were not approved for use in juveniles. Risperdal, an antipsychotic, has since been approved.

Many adult drugs are commonly prescribed to juveniles without federal approval, and not just foster kids. But some that have been proved perfectly safe in adults have had dangerous effects on children, including hallucinations and suicidal tendencies that have led to so-called black box warnings on drug labels.

And even drugs approved for use in children, while effective in treating mental illness, can have serious side effects, including twitching and tremors, muscle stiffness, severe exhaustion and excessive weight gain. Some studies have found that placebos are as effective as certain psychiatric drugs at treating juvenile depression, raising questions about the usefulness of the drugs in the first place.

Despite doctors' relationships with drug companies, there's no evidence that clinical trials have ever been run on foster children in Texas. The most prominent case of experimentation on foster children occurred in New York City in the late 1980s and early 1990s, when the city's child welfare administration enrolled hundreds of kids in AIDS drug trials.

The trials, which proved highly successful and dramatically reduced pediatric AIDS deaths, still sparked outrage years later over allegations that the children were enrolled without proper consent.

"It makes me wonder what real safeguards there are here to protect foster children in Texas from being involved in clinical trials," Jack Downey, president and CEO of the Children's Shelter of San Antonio, said of the Texas doctors' drug company relationships. "Whether any wrong is being done or not, there's certainly the perception" that doctors are benefiting from the foster care prescriptions.

Ties to companies
The News' review of the top-prescribing psychiatrists and clinics turned up many with financial relationships with pharmaceutical companies. Among these connections:

.An El Paso psychiatrist who prescribed psychiatric drugs to nearly 300 foster kids between 2002 and 2005 won nearly $150,000 in research funding from Pfizer and Eli Lilly, according to the Web site of the university he is affiliated with. He was also a guest lecturer for an AstraZeneca-sponsored conference at a California beach resort, according to the conference's brochure. He did not return repeated phone calls to his office.

.A Houston psychiatrist who prescribed psychiatric drugs to 490 foster children since 2002 has helped run ADHD, depression and schizophrenia clinical trials. His research facility has received funding from Eli Lilly, Glaxo SmithKline and Janssen, according to the facility's Web site. He did not return phone calls, and his assistant said he no longer works with foster children.

.A Houston doctor has given talks at Eli Lilly-funded events, held teleconferences for Eli Lilly sales representatives, and has pitched one of the company's drugs in speeches, according to her practice Web site. She has prescribed drugs to nearly 150 foster children. She did not return phone calls seeking comment.

Psychiatrists who work with foster children and for drug companies say one doesn't influence the other. Dr. Giancarlo Ferruzzi, a San Antonio psychiatrist who treats foster children and has consulted for at least five pharmaceutical firms, said professional relationships with drug companies have no effect on his prescribing patterns. And, he said, he frequently relies on drugs from companies he's never worked for; anything else "would be a dereliction of duty."

As a psychiatrist who treats children in foster care and also conducts clinical trials for new drugs, Dr. Carlos Guerra of Houston works with lots of pharmaceutical companies.

"But I don't sit there and think, 'Hey, a Concerta rep came in today,' " he said. "There is more data out for the newer drugs, which makes doctors more likely to use them. That's why it appears there's something unethical going on with the drug companies when there's not."

Fighting for her son
Mary Kitchens was in the next room when her autistic 8-year-old dropped a lighted candle onto her bed and was unable to communicate what he'd done. After the house burned and Ms. Kitchens depleted her other children's college funds to put Evan in a private psychiatric hospital, the state took custody of her son, telling Ms. Kitchens the second-grader was a danger to his family.

The piles of leftover drugs in Ms. Kitchens' carefully appointed Bandera home tell the rest of the story. Seroquel. Lithium. Depakote. Losartan. Trileptal. Risperdal. Concerta.

"You name it," Ms. Kitchens said wearily, her voice breaking with each drug's name. "He was given three times the amount given to adult patients. Each of these drugs was given to us by a child psychiatrist."

In foster care in a residential treatment center, Evan, who was not treated by doctors discussed in this report, grew progressively worse. He ballooned from a size 8 to a size 14 - a side effect of many psychiatric drugs. His eyes crossed, and he convulsed with tremors. He had nightmares and panic attacks and hallucinated that bats were chasing him.

Ms. Kitchens, horrified that she'd ever agreed to turn over her son, took out a loan and hired an experienced attorney. On her 40th birthday, she brought Evan home, carefully weaning him off all but one of the medications. Evan's behavior is far from perfect, Ms. Kitchens says, but he's safe and he's happy.

"He was supposed to be in state care, but nobody was looking after Evan but me," said Ms. Kitchens, watching the boy, now 12, wriggling on the kitchen floor with Puppy, his dachshund. "Now my kids don't take medications. I won't ever trust doctors again."

Are drugs needed?
Brett Ferguson, a Kerrville attorney who has represented the interests of foster children, said many in-custody diagnoses seem unwarranted. Almost every child he has represented has been placed on a psychiatric drug while in state care, Mr. Ferguson said, even for minor behavioral problems. Some were so drowsy with medication that they could hardly communicate, he said, and caseworkers refused his requests to reduce their dosages.

"The state takes a child that is upset, crying, yelling and screaming because they've just been taken from their families and, with all those symptoms, prescribes them medication," Mr. Ferguson said. "They think that if the child is unruly, it's easier to deal with them by medicating them than by counseling."

One former operator of a foster treatment center, who spoke only on condition of anonymity for fear of damaging his business relationship with the state, said that half of the children at his facility "could've done with less" psychiatric medication or none at all - and that many were already "zombies" by the time they arrived.

"It's a medical model. We didn't have any other options," said the operator, who acknowledged that sometimes doctors didn't even spend 10 minutes with a child before prescribing a drug. "I always questioned, 'If they didn't need them out there in the real world, why do they need them in here?' But I wasn't about to go against the doctor's orders."

Curbing this kind of overmedication has been a priority, said Darrell Azar, communications manager for the Texas Department of Family and Protective Services. So far in 2008, nearly 22 percent of all Texas foster children have been prescribed psychiatric drugs for more than 60 days, down from 26 percent in 2005.

The percentage is expected to keep dropping - the result of the new health management program and a review this fall of the state's drug procedures for children in foster care.

"We're a lot more confident today that children who don't need these medications aren't getting them," Mr. Azar said.

AT A GLANCE: MOST COMMON DRUGS
Of the top five psychotropic drugs most commonly prescribed to Texas foster children in fiscal year 2007, four cost more than $100 per prescription, and two cost more than $200 per prescription - some of the most expensive drugs given to foster kids. The following five drugs alone accounted for half of the $37.9 million the state spent on psychiatric drugs for foster children in 2007:

RITALIN
Company: Novartis
What it treats: Attention deficit hyperactivity disorder, or ADHD
Foster children who took it in 2007: 4,439
Total cost: $3.4 million

RISPERDAL
Company: Janssen
What it treats: Autism, schizophrenia
Foster children who took it in 2007: 3,753
Total cost: $6 million

CLONIDINE
Company: Now a generic
What it treats: ADHD
Foster children who took it in fiscal year 2007: 3,450
Total cost: $215,500

SEROQUEL
Company: AstraZeneca
What it treats: Schizophrenia and psychotic disorders
Foster children who took it in FY2007: 3,418
Total cost: $6.5 million

ADDERALL
Company: Shire
What it treats: ADHD
Foster children who took it in FY2007: 3,169
Total cost: $2.6 million

SOURCES: Department of Family and Protective Services, Texas Health and Human Services Commission

OUR METHODOLOGY
The Dallas Morning News researched this report by starting with a list of all Texas doctors, psychiatrists or clinics that have received state Medicaid payments since 2002 for prescribing mind-altering drugs to children in state foster care.

Focusing on the 300 doctors who have filed more than 200 Medicaid claims since 2002 for prescribing psychiatric drugs to children in foster care, a reporter found that 25 had close ties to drug companies - meaning they had received consulting contracts, grants or other substantial funding. Two dozen more had minor affiliations, receiving small grants, speaker's fees or other honoraria. This information was found by:

.Scanning the "financial disclosure" section of hundreds of studies published in medical journals

.Searching university Web sites for lists of pharmaceutical grants awarded to researchers

.Reviewing records of pharmaceutical drug trials for the names of doctors and clinics running the experiments

.Obtaining programs and fliers from drug company-sponsored conferences and lectures, which featured some of these Texas doctors as guest speakers

The News tried to contact all 15 of the doctors mentioned in today's package. Five returned phone calls. The major drug companies mentioned in the series were also asked to respond, though most did not.
« Last Edit: December 31, 1969, 07:00:00 PM by Guest »