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Age of Autism Comment of the Week: 4/24

12 Year Old With Autism Dies from Prescription Drug Overdose: Doctor Booted from Medicaid

Pills for babies Are poor children with disabilities more likely to be drugged than those from wealthier families?  This story raises many valid questions for our community. From the Miami Herald:

State healthcare regulators have booted from the state Medicaid program a Miami psychiatrist who had prescribed a cocktail of potent mental health drugs to an autistic, 12-year-old boy who later died of complications from over-medication.

The Florida Agency for Health Care Administration, which oversees the state Medicaid program for the needy and disabled, has notified Dr. Steven L. Kaplan that he has been terminated from the insurance program effective May 17, said Tiffany Vause, an agency spokeswoman in Tallahassee.

Vause said Kaplan, like all Medicaid providers, had signed a ``voluntary contract'' with the state. ``The agency elected to terminate the agreement as it was believed to be in the interest of the program to do so.''

``We will be working to ensure a smooth transition of care for his patients,'' Vause added.

Kaplan declined to speak with a Miami Herald reporter Tuesday.

Kaplan, who treats about 800 patients -- most of them disabled or impoverished children -- was the subject of a report in The Miami Herald on Monday. The story said administrators at three state agencies had expressed concerns about Kaplan's prescribing of psychiatric drugs to disabled children before and after the May 23, 2007, death of 12-year-old Denis Maltez.

Denis, who weighed 70 pounds, had been on three different mental health drugs, two of them in the maximum dose, at the time he died, a consultant for the state Agency for Persons with Disabilities wrote.

``In combination, all three of these agents have additive effects as a central nervous system depressant,'' the consultant, psychiatrist Jorge J. Villalba, wrote. The drugs, he added, ``may have been contributing factors in the client's death.''


The Miami-Dade Medical Examiner's Office attributed the boy's death to serotonin syndrome, also called serotonin toxicity, which can occur when an excess of medications causes the body to produce too much serotonin, a chemical that helps brain and nerve cells to function.

Over the past few years, the University of South Florida, acting on behalf of the state healthcare agency, sent Kaplan several letters suggesting he reconsider his prescribing practices.

``He said he had been practicing long enough to know how to treat his patients and was tired of being told what to do,'' a pharmacist working for USF wrote following a visit to Kaplan's office in May 2009.

Most affected by Kaplan's termination will be clients of Florida's Agency for Persons with Disabilities, many of whom have been treated by him.

Melanie Etters, an APD Tallahassee spokeswoman, said the healthcare agency will notify Kaplan's patients that he will no longer be able to receive Medicaid payments.

``APD will also let [disability caseworkers], residential providers, and Family Care Council members know about Dr. Kaplan's termination as a Medicaid provider. We will also let them know of other psychiatrists serving the Miami area,'' Etters wrote in an e-mail to The Miami Herald.


``APD is supportive of this reasonable and responsible action by our sister agency to protect the health and safety of the people we serve,'' Etters added.

Martha Quesada, Denis' mother, declined to speak with a Miami Herald reporter Tuesday. Her lawsuit against the psychiatrist is pending in Miami-Dade Circuit Court.

``Unfortunately, Florida has no procedure to protect the patients of physicians who write behavioral healthcare prescriptions that exceed thresholds and who blatantly ignore the `red flag' letters from the University of South Florida Medicaid Drug Therapy Program,'' said Quesada's attorney, Howard Talendfeld.

``Nor does the state tell the parents or guardians of mentally disabled persons or foster children that these drugs prescriptions may be dangerous or monitor whether or not the physicians obtained informed consent from them.''

Read more:



This press is ridiculous. I have read a lot of press on this and this blog is obviously run by Scientologists or some other radical and Off the Wall faction. These writings clearly demonstrate a profound lack of understanding as to how children and /or adults come into the system and how they are cared for. Anyone who knows tha actual facts of this case (not just the MQA allegations)would know that upwards of 7 board certified psychiatrists in multiple venues concurred on the treatment and frankly Dr. Kaplan had done nothing but continue the agreed upon regime. Additionally, it is worth noting that had this been an actual malpractice case with merit, the good Dr. Kaplan would not be practicing today. Incidentally, this case was resolved in 19 days! THAT's RIGHT.... 19 DAYS!

This physician is an excellent DR. who actually spends time with his patients and who is dedicated to working with those that are disabled. He is valued in this community and those seeking to malign such an individual shoudl actually get all the facts.


Carolyn Gammicchia


I can relate to your post. Folks that don't know ASD and work with it each day don't realize how diligent parents of kids with ASD have to be. We almost "aquire autism" because we live with it and our stress levels go up when we have to transition or have unexpected change due to what transpires for our kids.

I do think this happens to many of us and it's viewed incorrectly. If a person is not living as a care provider for someone with ASD 24/7 they will never know what that is like. They will never know that we have to be prepared for anything, need to show our kids histories, especially if there is SIB, and take our kids to numerous professionals because the majority just don't get it.

Sad really that we are judged this way, inappropriately diagnosed, and they not offered assistance for what we really need.

Hang in there and know you are doing what is best for your child.


Regarding the comments about DANs/supplements not being affordable... my experience has been that not all DANs are unaffordable, one just has to search out who they can afford.

We started out biomed journey with a integrative health nurse practitioner who works under a doc. She was able to do every "starter" biomed test, supplement, etc... and charged a low, flat office fee that was partially reimbursed by insurance. There are at least two other DAN MD's in my state who are family doctors as well - they don't charge any more than a regular visit to a GP/Ped would charge.

We happen to see a "big" DAN now who does charge a large amount - but not all DANs do, especially if you need basic, starter information and don't need some sort of specialist. Are some DANs completely unaffordable, even for those parents who make a decent salary? Of course. But this is a sweeping generalization I would like to see go away - especially as I think it discourages new biomed parents from ever starting - they just assume ALL DANs are too expensive and never bother to actually look around.

We had all our in-state DAN appointments covered by insurance. Our insurance also does cover many prescription scripts, like mb-12 injections, DMSA, GSH, Valtrex, anti-fungals, p5p creams, Enhansa, and others.


How very sad for the family. I don't remember the story but I imagine if the child was on Medicaid, there is a chance the family wouldn't have been able to afford biomed treatments. That doesn't excuse the doctor from not taking more caution with their prescribing ability, and maybe the parents didn't realize it was within their rights to turn down those prescriptions. The doctors can be really push when it comes to RX, we all have seen it.


Love the euphemisms in the article -- "mental health drugs" and "behavioral healthcare prescription" instead of psychiatric drugs.

Theresa O

Pfizer's trials for Geodon (kiddie bipolar drug) recently hit a small snag because doctors supervising the trials allowed more than two dozen kids to OD. The FDA issued a warning letter, which according to the Associated Press, is not legally binding. Business as usual for Big Pharma and the FDA. No one cares. (

The article above says that Dr. Kaplan has been barred from receiving future Medicaid payments, but I didn't read anything to indicate that the AAP or the APA is censuring him. Isn't this an issue for them? Of course not. They're on the drug company gravy train, too. They're probably scratching their heads over the idea that anyone could have too much medication.


I took my son (hardly 12) he is 24 to the psy. this past Jan. Spent 400 dollars to see him because it was suggested it might help get SSI. The psychiatrist told me that the next visit I was to bring a list of all the drugs my son has ever taken over his life time and from that he was pretty sure he could pinpoint the right medicine my son would need.

The Psy. zeroed in on obsessive compulsive disorder - and he says I have it too!? All this in the short hour he saw us. He says I am obsessed because I just so happened to have all my son's medical records that I brought with us. I also have a short page summarizing it all too. All this obssessing on my part and still I did not have all the medicine he has ever taken on one sheet. Just goes to prove you can never obssess enough (well I have that now!) Does that really make me obsessive? OR Just trying to save money and time when we go to these guys?

It took me a week to get all the meds. together because guess what I was missing one medical record from a psy we saw up in Michigan, and she had given alot of different medicine. It is a wonder my son is not dead from an over dose from her because the medicine she gave us caused his undignosed myclonic jerks (undignosed epilepsy with grand mals to go undignosed). Get that - Undignosed grand mal seizures to get worse. The school even called me three or four times worried about the jerking and his stares they were scaried to death they were also going to witness an undignosed grand mal seizure were he falls and breaks his neck, face, or nose.

Right now he is on anti-seizure medicine which took five very long years to finally get on and only after we had gone through the depths of


Untill we are found the right one. Even this one - I promise you- it is not my same easy going son like before.

So I did not go back. We need SSI, but we do not need some more medicine.

Tink in Pink

Isn't Micheal Jackson's Dr being charged with Murder for Overdosing him? And this Dr. is able to do it to a kid and it goes unnoticed our system needs some overhauling!

Kim Spencer

I recently met another autism mom whose child was the same exact age as mine (9), and the stories of severe autistic behaviors thru toddlerhood were almost identical. While I started biomed/diet at 3, this mother trusted her child to a psychiatrist. This child was pulled out of school at 4 because he was too violent for anyone to handle and has never gone back. My child is mainstreamed in 3rd grade, on grade leve, with few supports. This child weighed 150 lbs, my son a healthy normal 75. This child was still not potty trained and sat in his poop and smeared it daily. My child was potty trained at 5 1/2. This child was so violent that he was going to have to be institutionalized because his family could not handle him anymore. My son is in the living room right now playing video games with friends. This child was on a cocktail of 4 adult drugs, all at adult doses. My child has never taken a psychotropic drug. My heart cries for that boy. His parents trusted that doctor. Not me.


Red flag for me when a kid with autism is seeing a psychiatrist. There should be no need for that with bio-medical interventions. I must add, though, that if DAN doctors and supplements were more affordable or covered by any insurance it would make a huge difference for alot of families. If anyone knows if a DAN doc or supplements are covered by an insurance card please let me know so I can fix my kid and our financial situation.


What was the child taken ? I always feel my son is over medicated so I try and educate myself on what he should and should not , Sometimes I feel his doc play the guessing game and at whos expense?


OK, where is Trine Tsouderos on this story? Yes, I realize this incident is out of Florida - but nevertheless - Trine, in all her journalistic glory and infinite wisdom, needs to weigh in! After all, children are being used as guinea pigs, are they not? Isn't that what she was so concerned about? This seems like the perfect opportunity for her.

It is outrageous what is being done to foster and special needs kids here in Florida. If reporters TRULY wanted to tell a story of abuse, they would heavily cover the routine use of psychotropic medications on children "in the system."

But no, we've got to dig up a contentious divorce case and extrapolate child abuse from vitamin supplementation.

Grrrr . . .


Finally, a doctor is hit in the wallet when a child dies of an Rx drug overdose. Of course, he should have had his license to practice taken away, but at least he's booted from Medicaid which should make other drug-happy doctors take heed.


doctors apparently learn a lot in med school. when do they learn that they no longer need research to support their treatment decisions? they reach a level where they are immune to parent and colleague input and concern that contradicts their decisions. and we're back to this painfully basic reminder that drugs have interaction and cumulative effects that need to be studied and considered, especially with children. but no thanks, we also don't need to study this basic principle as it pertains to our supersized vax program. we know it's safe, we don't need any research on that. no matter what happens to the countless victims or what the whistle blowers say.

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