In all, Gabriel had been prescribed four psychiatric drugs, two or three of which he was taking at the time of his death, said Jack Moss, Broward chief of the state Department of Children & Families. Moss said he is not sure which medications the boy was taking because Margate police took the foster home’s medication log as part of an investigation into Gabriel’s death last week.
Three of the psychotropic drugs carry U.S. Food and Drug Administration ”black box” label warnings for children’s safety, the strongest advisory the federal agency issues. Three of the medications are not approved for use with young children, though they are widely prescribed to youngsters ”off label” — meaning doctors can prescribe the drug even if not formally approved for that use.
In 2005 — reacting to a series of stories in The Miami Herald that as many as one in four foster children were prescribed potentially dangerous mind-altering drugs — state lawmakers approved a law aimed at curbing their use. Children’s advocates now question whether the law is being ignored.
Gabriel was being treated by a Broward psychiatrist who is on a list of Florida doctors that the state Agency for Health Care Administration red-flagged as having ”problematic” prescribing practices, said Robert Constantine, director of AHCA’s Medicaid Drug Therapy Management Program, which tracks prescribing of psychiatric drugs to children.
The list flags doctors with a high volume of prescriptions of mental-health drugs or potentially dangerous combinations of the medications.
Dr. Sohail Punjwani has been on the list every quarter in which regulators have monitored the prescribing of psychotropic drugs since the program was created in 2006, said Constantine, a professor at the University of South Florida’s Mental Health Institute. The practices of about 17,000 Florida doctors who prescribe medications to children on Medicaid are studied every quarter, and about 300 to 450 end up red-flagged on the list.
And though Florida law requires that either a parent or judge consent to the use of psychotropic drugs on foster children, a source with knowledge of the boy’s case said Gabriel already had been taking a three-drug cocktail when Broward Circuit Judge Lisa Porter was informed at a March 11 hearing. The judge approved the medications over the objection of a court-appointed guardian, the source said.
”We are devastated,” said Jon Myers, the boy’s maternal uncle, who cared for him from June through October 2008. “Gabriel’s problems could not be solved by a pharmacy.”
Four feet tall and 67 pounds, with short-cropped brown hair, Gabriel was a bright, charming and often sweet little boy, those who knew him say.
But he already had a sad past hinting at a troubling future. Records obtained by The Miami Herald show Gabriel may have been molested by an older boy while he was living with grandparents in Ohio, while his mother was in jail.
On Thursday, Gabriel locked himself in a bathroom and hanged himself with a detachable shower head after arguing with the 19-year-old son of his foster dad about his lunch, Moss said.
DCF petitioned a judge on Tuesday to unseal the boy’s records in response to requests from The Herald and other media, spokeswoman Leslie Mann said.
South Florida Sun-Sentinel
LAUDERDALE – The number of foster children in Florida prescribed mood-altering drugs has been significantly underreported, according to the early results of a statewide study sparked by a 7-year-old boy’s suicide in Margate.
The revelation came Thursday at the end of an intense, day-long hearing by a panel appointed to scrutinize Gabriel Myers’ tumultuous journey through the child welfare system that ended with him hanging himself at his foster home on April 16. Gabriel had been prescribed two psychotropic drugs
That number will rise markedly when DCF releases the findings of its current study next week, Cooper said.
“I don’t know by how much, but it will be significant,” he said.
In Gabriel’s case, he only was listed in the database as being on Adderall, an attention deficit/hyperactivity drug, that he had been taken off of months before his death, said DCF Secretary George Sheldon. The two drugs that Gabriel was taking when he died–Symbyax and Vyvanse–had not been approved by either his parents or a judge–a violation of state law.
Child welfare officials acknowledged that failure Thursday to the six-member panel as they traced the last 10 months of Gabriel’s life. Throughout the eight-hour hearing, questions arose about communication between social services providers and whether vital information about Gabriel’s behavior and background was being shared and acted upon quickly.
No one checked to see why Gabriel had been prescribed Adderall before moving to Florida from Ohio or if he had been on any medications prior to that. No one obtained a copy of his child welfare history from Ohio until after his death.
In his last month, Gabriel saw his world turned upside down–going to a new foster home, changing therapists, changing after-school programs and his mother being transferred from the Broward County Jail to an Ohio jail. His behavior worsened during that time with him destroying property and threatening to hurt others.
“Was Gabriel spiraling out of his control or was his environment spiraling out of control?” asked panel member Bill Janes, DCF assistant secretary for substance abuse and mental health.
Sheldon, who attended part of Thursday’s hearing, told the panel he wants every aspect of Gabriel’s case investigated and people held accountable.
“We got to get every component of this system right,” he said. “When you deal with children, no one can have a bad day.”