A Child's Death - Still A Mystery

  Today's post does not deal with the North Broward Hospital District.
  Instead, it raises a number of unanswered questions involving Florida's system of care for mentally ill children.
 Today's Miami Herald carried a story confirming how seven-year-old Gabriel Myers died while under the "protection" of the Florida Department of Children and Families.
According to the Broward Medical Examiner's Office, the child died of asphyxiation after hanging himself with a shower hose in a Margate foster care home supervised by the DCF.
As the headline in today's Herald story says:

Autopsy proves boy hanged himself, but why is mystery”

ess than a week after threatening to kill himself at school, Gabriel was found hanging from a bathroom shower hose by his 19-year-old “foster” brother last April.
Several weeks later, I sent the following email to George Sheldon, my old friend and former co-worker with the Florida Attorney General's Office who is now secretary of the Florida Department of Children and Families.
  While the Broward ME's office has issued it's report,
I'm still waiting for George's response.
 Broward's seven year old Gabriel Myers hanged himself with a shower hose as a foster children living under the protection of Florida's Department of Children and Families services.
 At the time of his death,  Gabriel had been given a pharmaceutical cocktail of powerful psychotropic drugs -- despite FDA warnings against the use of such drugs for mentally ill patients under 18.
 The drugs were administered to Gabriel via prescriptions written by Dr. Sohail Punjwani, a DCF funded psychiatrist -- who is also paid by drug companies to test the effects of psychotropic meds on mentally ill minors and adults.
 Known to cause suicidal tendencies in young patients, media reports indicate the drugs administered to Gabriel by Dr. Punjwani included:
        - Lexapro, manaufactured by  Forest Laboratories.
        - Zyprexia, manufactured by Eli Lilly Company.
        - Symbyax, also manufactured by Eli Lilly.
        All three drugs carry specific warnings against their use by "children under 18."
       While paid to provide psychiatric care to a "huge" number (Herald story)  of mentally ill children in the custody of DCF, Dr. Punjwani is also medical director of Compass Health systems which describes itself as the "largest provider of mental health services in South Florida (web site)."
       In addition, Dr. Punjwani also is also director of research for mentally ill adolescent patients at Fort Lauderdale Hospital as well as director of mental health care for mentally ill students enrolled in Broward's Elaine Gordon Treatment Center a school for mentally ill kids funded and operated by the Broward School Board).
       Finally, Dr. Punjwani is also employed as the lead clinical trials investigator testing psychotropic drugs on mentally ill patients for the Segal Institute for Clinical Research in Miami.
       A list of the drug manufacturers that have paid the Segal Institute to conduct clinical trials of their psychotropic drugs includes Forest Laboratories, Shire Pharmacueticals and Eli Lilly -- makers of the drugs that had been given to Gabriel Myers despite FDA “black box” warnings against their use by children.
     Again, in its web site, the Segal Institute lists more than 80 pharmaceutical firms as clients who paid the Miami firm to conduct clinic tests of their drugs.
    Compass Health Systems and the Segal Institute for Clinical Research are both operated by Dr. Scott Segal, a Miami psychiatrist with a national reputation for conducting clinical trials of psychotropic drugs.
      Dr. Punjwani is also employed by Dr. Segal's Compass Health.
      Segal also lists himself as Medical Director of Atlantic Shores hospital in Fort Lauderdale (a psychiatric facility).
       In the June 2009 issue of The BHC (Behavioral HealthCare) Journal, Dr. Segal was interviewed at length about a clinic trial of psychotropic drugs for children and adolescents being conducted by his company.
       In the interview, Dr. Segal notes that while the drug companies have lost money due to the FDA warnings against the use of the drugs currently being tested by his company, "we have used it in adolescents and children in the past and it seems to give a robust response."
     In addition, CBS Channel 4 did a segment with Segal promoting his testing program for drugs for “troubled” teens. In the interview, Segal specifically mentions that his firm is testing a psychotropic on kids that is currently not recommended for youngsters 18 and under.
     Again, on the web sites promoting Segal's Compass Health System and his clinical research Institute, we're told his firm works with a South Florida population of 120,000 outpatients and 80,000 inpatients while conducting clinical trials for various meds. 
     Which begs a very troubling cut-to-the-chase question:
     Just how many mentally ill kids "protected" by DCF are also used in clinical trials for various psychotropic meds by the research shrinks  at Compass Health and the Segal  Institute?
      Some additional data from the Broward Regional Health Planning Council.
      In 2008, where Punjwani serves as director of adolescent psych care the Fort Lauderdale Hospital:
- Admitted 671 mentally ill adolescent patients - with an average length of stay of 10.6 days. (this compares to an average length of stay of 4.0 days for 739 adolescent psych patients admitted to Memorial Regionals psych ward... and 2.7 days for the 631 adolescent psych  patients admitted to University Hospital. With 16 beds for mentally ill kids, Fort Lauderdale Hospital has the largest number of adolescent psych beds in Broward.
- And also, Fort Lauderdale Hospital admitted 3,419 adults mentally ill patients in 2008 (the largest number of psych patients in Broward) with an average length of stay of 6.1 days...
- Again, Atlantic Shores, where Dr. Segal serves as medical director,  admitted  1,959 adult psych patients with an average length of stay of 7.6 days in 2008. 
 NOTE TO BLOG READERS:  For a stunning example of
 a giant governmental agency blithely ignoring the "frightening elephant in the living room" that I've described (and boldfaced) in this post, read the DCF findings on Gabiel's death on the agency's web page.

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