Riley's estate gets $2.5 million in lawsuits settlement with psychiatrist

The Patriot Ledger
Lane Lambert
Jan 25, 2011

BOSTON -- The attorney for Rebecca Riley’s estate said Tufts Medical Center psychiatrist Dr. Kayoko Kifuji has settled a civil lawsuit for $2.5 million.

The Suffolk Superior Court settlement comes almost a year after the 4-year-old Hull girl’s parents, Michael and Carolyn Riley, were convicted of murdering her in December 2006 with an overdose of Clonidine, which Kifjui had prescribed.

Rebecca was 2 when Kifuji diagnosed her with bipolar disorder and attention deficit hyperactivity disorder. Rebecca was given Clonidine for attention-deficit hyperactivity disorder and Depakote for the bipolar condition.

Benjamin Novotny of the Boston law firm Lubin & Meyer confirmed the settlement Monday. The amount is the limit for Kifuji’s malpractice insurance with Tufts, where she continues to practice.
The settlement has been put into trusts for Rebecca’s older brother and sister, for education and other expenses. Their parents’ convictions keep them from claiming a share of the money.
“This is the best possible result,” Novotny said. “We got everything we could.”

In a prepared statement Monday night, Tufts said the interests of Rebecca’s brother and sister are best served by the settlement, rather than a lengthy civil trial that would again subject all those who cared about Rebecca to “the painful details brought forth during the criminal trials.”
Novotny said Tufts has also agreed to start an awareness program, so young doctors know the dangers of over-prescribing such drugs. Tufts declined comment on that but said the hospital will be looking for ways to expand education programs for caregivers who treat “psychiatrically ill children in troubled homes.”

Michael Riley was convicted of first-degree murder and Carolyn Riley of second-degree murder. The case revived a nationwide controversy over whether such drugs should be prescribed for children as young as Rebecca.

Kifuji drew widespread outrage for her role with the family, especially after she escaped indictment by a Plymouth County grand jury and regained her medical license.

Rebecca was found dead and lightly clad on the floor of her parents’ bedroom on Dec. 13, 2006. Plymouth County prosecutors said the Rileys deliberately overdosed Rebecca because they were unable to secure federal Supplemental Security Income (SSI) for Rebecca, as they had for their other two children.

Trial testimony showed that Kifuji relied mainly on Carolyn Riley’s reports of Rebecca’s behavior, while numerous witnesses said they’d raised concerns about the effects of the drugs right up to the night Rebecca died.

Kifuji testified under immunity at the Rileys’ separate trials, and proved to be a cautious, frustrating witness for prosecutors and defense attorneys alike.

Kifuji voluntarily gave up her medical license when the Rileys were charged in February 2007. A court administrator filed the civil lawsuit for Rebecca’ estate in 2008.

Kifuji was cleared of criminal charges by a grand jury in the summer of 2009. A couple of months later a state medical board said she could practice again. She regained her medical license and returned to Tufts. The civil case didn’t move forward until the Riley trials were completed in March, 2010.

Novotny said the lawsuit was settled in late December but that the money was placed into Rebecca’s brother and sister’s trusts in the last few days. Her brother is reportedly in foster care, while her sister may soon be adopted.

He said the lawsuit appeared doubtful after Kifuji was cleared and the Rileys were convicted, but was settled in part because of public outcry and questions about the medical care Rebecca Riley got.

Lane Lambert may be reached at llambert@ledger.com.
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Top Ten Legal Drugs Linked to Violence - "Time Mag"

TIME Magazine
Maia Szalavitz
January 7, 2011
When people consider the connections between drugs and violence, what typically comes to mind are illegal drugs like crack cocaine. However, certain medications — most notably, some antidepressants like Prozac — have also been linked to increase risk for violent, even homicidal behavior.

A new study from the Institute for Safe Medication Practices published in the journal PloS One and based on data from the FDA's Adverse Event Reporting System has identified 31 drugs that are disproportionately linked with reports of violent behavior towards others.

Please note that this does not necessarily mean that these drugs cause violent behavior. For example, in the case of opioid pain medications like Oxycontin, people with a prior history of violent behavior may seek drugs in order to sustain an addiction, which they support via predatory crime. In the case of antipsychotics, the drugs may be given in an attempt to reduce violence by people suffering from schizophrenia and other psychotic disorders — so the drugs here might not be causing violence, but could be linked with it because they're used to try to stop it.

Nonetheless, when one particular drug in a class of nonaddictive drugs used to treat the same problem stands out, that suggests caution: unless the drug is being used to treat radically different groups of people, that drug may actually be the problem. Researchers calculated a ratio of risk for each drug compared to the others in the database, adjusting for various relevant factors that could create misleading comparisons. Here are the top ten offenders:

10. Desvenlafaxine (Pristiq) An antidepressant which affects both serotonin and noradrenaline, this drug is 7.9 times more likely to be associated with violence than other drugs.
9. Venlafaxine (Effexor) A drug related to Pristiq in the same class of antidepressants, both are also used to treat anxiety disorders. Effexor is 8.3 times more likely than other drugs to be related to violent behavior. (More on Time.com: Adderall May Not Make You Smarter, But It Makes You Think You Are)
8. Fluvoxamine (Luvox) An antidepressant that affects serotonin (SSRI), Luvox is 8.4 times more likely than other medications to be linked with violence
7. Triazolam (Halcion) A benzodiazepine which can be addictive, used to treat insomnia. Halcion is 8.7 times more likely to be linked with violence than other drugs, according to the study.
6) Atomoxetine (Strattera) Used to treat attention-deficit hyperactivity disorder (ADHD), Strattera affects the neurotransmitter noradrenaline and is 9 times more likely to be linked with violence compared to the average medication.
5) Mefoquine (Lariam) A treatment for malaria, Lariam has long been linked with reports of bizarre behavior. It is 9.5 times more likely to be linked with violence than other drugs.
4) Amphetamines: (Various) Amphetamines are used to treat ADHD and affect the brain's dopamine and noradrenaline systems. They are 9.6 times more likely to be linked to violence, compared to other drugs.
3) Paroxetine (Paxil) An SSRI antidepressant, Paxil is also linked with more severe withdrawal symptoms and a greater risk of birth defects compared to other medications in that class. It is 10.3 times more likely to be linked with violence compared to other drugs. (More on Time.com: Healthland's Guide to Life 2011)
2) Fluoxetine (Prozac) The first well-known SSRI antidepressant, Prozac is 10.9 times more likely to be linked with violence in comparison with other medications.
1) Varenicline (Chantix) The anti-smoking medication Chantix affects the nicotinic acetylcholine receptor, which helps reduce craving for smoking. Unfortunately, it's 18 times more likely to be linked with violence compared to other drugs — by comparison, that number for Xyban is 3.9 and just 1.9 for nicotine replacement. Because Chantix is slightly superior in terms of quit rates in comparison to other drugs, it shouldn't necessarily be ruled out as an option for those trying to quit, however.

Read more: http://healthland.time.com/2011/01/07/top-ten-legal-drugs-linked-to-violence/#ixzz1DHvpV500