Mea Culpa

I ran the same story twice unintentionally.  It started with the story I ran the day after Christmas.  Night before last I looked at it and realized I had put up the wrong document.  Then while fixing that, I decided I had more to say.  Then it took HOURS to get my finished article to post at all.  Suffice to say that I am not going to do any more fixing or alterations to either of my two identical posts with different titles.  I figure it is a story that should be repeated until no child is ever again used as research fodder by Dr. Jack-ass; or any other quack in a coat.

A MadMother In Pro Per

"pro per" adj. short for "propria persona," which is Latin for "for oneself," usually applied to a person who represents himself/herself in a lawsuit rather than have an attorney.

This is the report I wrote and served upon The State of Washington in Dependency Court in Yakima County Superior Court.  I was pleading for my son's release from Child Study and Treatment Center; a place I had been misinformed was a hospital; it is in fact a research facility. CSTC staff had documented that my son Isaac no longer needed to be at CSTC; but there had been no effort to move him.  I also served the state with a copy of the Home Care Plan I had developed based on what hospital staff recommended; even though I did not agree with the recommendations.  For one thing, staff insisted that 24 hour awake supervision was necessary; my first thought was, "how in the hell would I be able to sleep?  What the heck would a paid staff person do while everyone was sleeping?!" For this, and many other reasons, I believed the CSTC staff's recommendations were unrealistic, ill-informed, and cost prohibitive. I later discovered none of these professionals had ever sent a child disabled by iatrogenic injuries; i.e. physician caused drug-induced neurological and cognitive impairments.Prior to my son being released from CSTC to come home as the State's permanency plan always stated, CSTC had not ever discharged a seriously cognitively impaired kid home to live with their family. Why CSTC staff pretended to know how to do ssoemthing they had never done, remains a mystery.

CSTC's staff claimed that the recommendations were based upon their professional experience. The only thing staff knew to do, is the only thing staff had done in the past; that is, discharge patients to a residential care facility. In the little over a year between my having the below petition served on the state, on my own attorney, the GAL, and the court, and Isaac finally returning home, I found he Washington State Legislature had commissioned a literature review study to determine what setting and services were in the best interest of children and adolescents with serious behavioral difficulties like my son Isaac experienced. Specifically the study was to determine what kind of treatment services gave children, youth and their families the necessary support to succeed. The conclusion was children and youth were best served by assisting their families to take care of them in their family home since it is cost effective, i.e. less expensive, kids and families have better outcomes. Incredibly, the study concluded, the kids had fewer relapses and required fewer inpatient hospitalizations.  The study was done at the request of Washington State Legislature and cost $50,000.  The work itself was conducted on the same campus where  CSTC is located in Lakewood, Washington.  The study was staff claimed, unknown to them entirely; and never used by the professionals who insisted institutional, residential care was required for Isaac's care upon release from the state's pediatric psychiatric research facility.

When I asked why the research relevant to the discussion was not used, I learned CSTC staff were unaware of the study.  I then asked what studies, or standards the recommendation was based on? The answer: none. Not one staff member could provide any supporting evidence for it's professional recommendation for Isaac's post-discharge care. Adding insult to injury, CSTC staff claimed staff member's professional opinions had no bearing or any potential to influence the state's decision on placement of my son as a state ward. Truthfully, it was CSTC staff who first questioned the permanency plan that had been on every single Court Order from the time Washington State wrested custody away from me falsely claiming placing Isaac in  state custody was required for Medicaid to continue to pay for his medical care...I found out years later this claim was not true, the only benefit of making my son a state ward was that once he was a state ward, the State was able to defraud federal child welfare and Medicaid programs by claiming he had no family. It is against Federal Law to make a child a state ward to compel federal programs to reimburse states for a larger percentage of a child's medical care, residential care costs, it is fraud. CSTC staff were insistent that their recommendation of discharging my son to a Residential Care facility was the only option. Not once in the four plus years Isaac's was at CSTC had the staff tried to alter the state's permanency plan. It was only when I personally forced CSTC into putting in writing my son no longer needed to be at CSTC that staff members attempted to offer it's "professional opinion" on Isaac's custody. The fact is, CSTC staff had been aware throughout Isaac's incarceration at CSTC, the permanent plan on every single dependency Court Order was for Isaac to return home. This permanency plan was only disputed because CSTC staff balked at the idea of Isaac returning home to live. CSTC staff insisted that discharge to a residential care facility was the only viable option---I discovered staff recommended Residential Care since discharging brain damaged kids to such facilities was the only thing CSTC staff had experience doing in real world practice; not because staff had thoroughly investigated what may best serve Isaac's needs, nor did staff include either Isaac or myself in developing their professional recommendation for meeting Isaac's ongoing care requirements.

I wrote the report below and shad it served upon the State in February of 2004. Everyone, including my court-appointed attorney were served by a Process Server.  I was later told, "they never saw you coming."  My son finally came home on January 5, 2005.  At 660.90 a day, the year and a half my son was incarcerated at CSTC when he no longer needed to be, cost the taxpayers $361,842. There were kids waiting to be admitted the entire time; there always is.  Kids waiting to be admitted, just like my son waited---for over a year---from the time his psychiatrist informed Yakima County's children's resource manger Isaac needed long-term psychiatric inpatient treatment. The children's resource manager did nothing to facilitate my son's admission to CSTC for six months.

Isaac was admitted to CSTC when he was twelve and a half year old boy...

I brought him home a couple months before he turned seventeen.

When my son returned home in January 2005, the in-home services were provided by Catholic Community Services out of Pierce County which is across the State; the local mental health clinic CWCMH, refused to provide the services.  The services were much appreciated and were provided by wonderful people.  They were more than what was needed; as I had predicted.  We used the in-home care services for six months---before we determined that tolerating inappropriate, unnecessary services in order to have needed respite available, was too stressful.  The fact is, as I had maintained all along: respite care and appropriate therapeutic rehabilitation services are all we needed; these are still what we need.

The director of Yakima County Human Services, Steve Hill, and the DSHS Region II Children's Administrator, Ken Nichols, failed to do their jobs in an ethical manner. These two public servants failed to perform their ethical duties as public servants; their failure cost the people of the State of Washington over $300,000.; and unnecessarily deprived my son of his liberty for nearly two additional years.  A civil penalty of $1,000. a day is attached to such egregious deprivations of an individual's liberty. The penalty upon the individual, regardless of employment status, including publicly funded work for a government entity; it is a civil penalty that applies to every individual whose actions and/or whose failures to act cause a person to be deprived of their liberty in any locked facility. for those who are incarcerated, individuals are deprived of liberty if they remain incarcerated after serving their sentence. In the case of a people in locked psychiatric facilities, once staff have determined the person no longer requires treatment only available at a psychiatric inpatient hospital or in the case of Child Study and Treatment Center, a psychiatric research facility.  

CSTC had unethically obtained a Court Order in Pierce County Superior Court to Involuntarily Commit my son while simultaneously issuing bi-monthly progress reports to the Yakima County Children's Administration, Yakima County Human Services, GCBH RSN, and Yakima County Superior Court at dependency review hearings that Isaac would be better served in the community, i.e. he no longer needed to be hospitalized. I believe the court order for Involuntary Commitment was sought in Pierce County to prevent me following through with my statement that I could take him home since he was a voluntary patient. This appeared to be perceived as a threat by CSTC staff, particularly by Leah Landis, the psychologist for the unit Isaac was on. The woman actually referred to the kids as "our children" as if the kids belonged to CSTC, in her attempts to persuade me to not actively advocate for my son's release, asking that I at least wait until  "the studies" were completed.  When I asked for clarification, i.e.what studies Ms. Landis was referring to, I was told that because Isaac was a ward of the state, I didn't have the right to know what studies he was enrolled in, my consent, informed or otherwise was not asked for or needed I was repeatedly told by the Medical Director, Jon McClellan.

The fact of the matter is, until Pierce County Superior Court granted the Court Order which allowed CSTC to involuntarily treat my son, I was the only person besides Isaac, who had any legal authority to provide Informed Consent for his treatment at CSTC according to Washington State Law and federal Medicaid guidelines and protection for Human subjects research. In spite of this, the medical director of CSTC, Jon McClellan, a psychiatrist and federally funded psychiatric researcher, repeatedly told me I had no say in treatment decisions. In fact, Jon McClellan maintained he did not need my consent for my son's psychiatric treatment the entire time my son was an inpatient at CSTC; the research facility I had been led to believe was a hospital...

Conflicting claims about Isaac's need for inpatient treatment were maintained for months by CSTC staff in Washington State Superior Courts in two counties. Yakima County was informed that Isaac as ready to be discharged, while Pierce County granted a Court Order for extended involuntary treatment. Obviously, it's not possible he met the legal requirement for a involuntary inpatient treatment and that he was also  ready for discharge from inpatient treatment...The Pierce County Court Order in effect, "legally" deprived me of my parental rights to make decisions about his treatment, although I had effectively been deprived from the beginning of Isaac's stay at CSTC by Jon McClellan. I believe the Court Order was sought to prevent me from following through on my stated intention, take my son home. The court order made taking him home a felony crime. The court order was illegal---evidence of the order's illegality is contained in the written reports that CSTC staff issued every two months stating Isaac no longer needed inpatient psychiatric care, the entire time the court order was in effect...

9-15-2013

Post script: The report I submitted to the court in 2004 states that Isaac got the "recommended treatment;" more accurately, he was hospitalized, as his psychiatrist recommended. The years between Isaac aging out of the ATTACH day treatment program at age six in 1994, and going to CSTC in 2000, he went without day treatment and intensive in home services which were consistently the recommended treatment, but the method of treatment was never actually prioritized; or even available. Day treatment is a priority according to RCW 71.24.035 section 5b; it is a "priority" that is required to participate in the Federal Medicaid program. The mental health services required by the Early Periodic Screening Diagnosis and Treatment for a child's emotional and behavioral difficulties are clearly prioritized within the Revised Code of Washington and Washington State's Administrative Code; and required by numerous contracts between the Federal Medicaid program, the State Medicaid program, the Greater Columbia Behavioral Health Regional Support Network; Yakima County Department of Human Services, and the community mental health service providers, but never available for children and youth. Day treatment, and other EPSDT services for children are still unavailable to this day...  

I first posted my report on December 29, 2010

judge graphic credit Legal Juice

Age of Consent Can Mean No "Informed Consent"

CSTC

This post was posted mid December 2010 with a different title. It names the multiple drugs that my son was on in the two months before the date of the document, 10-8-2001.  I have also included a document where the research psychiatrist addresses my "concerns."  On December 31, 2011 I added the  paragraph on the discharge criteria and the TEOSS trial exclusions from ClinicalTrials.gov.

In Washington State a 13 year old can give consent for mental health and substance abuse treatment.  The thinking behind the law was that a teenager could obtain help that he or she felt was needed and not need a parent's approval.  I can see the logic in this.  I am so very aware of how this law was misused by the unethical psychiatrists at the state psychiatric facility for children in Washington and the psychiatrists  in  community mental health centers once he came home.

My son went to this facility in October of 2000 and turned 13 the following March.  In 2001 the Medical Director, a Federally funded researcher, had him on numerous drugs and when I protested, he told me I had no say!  Who was providing consent?  My lost son who could not hold a couple minute conversation, and often would not respond at all?  I know I never gave consent for any of what was done to my son.

It appears to me that this "researcher" was using my son in drug trials.  Obviously if he was, I did not give consent for that either.  Ultimately, shortly after the report below was written he put him on Clozaril, which to this day is not approved for use in juveniles under the age of sixteen.  By November of 2003, my son had tachycardia.  Still my protests went unheeded.  By November of 2004 his BMI was 34.3 and he weighed 246 lbs.  June of 2003 they added a trial of Abilify!  July of 2003 he was put on Depakote for aggression, not an approved use for Depakote..  January of 2004 Dr. Tom Semper lamented that Isaac had a QTC interval in the 440s which meant he couldn't be put on a trial of Geodon in addition to the clozaril, depakote, ativan, colace and miralax!

I know that during these two months this report covers, my son was given huge doses of many drugs which were not approved for use in children.  I know that when I went to see him I was terrified for him.  I know I was treated like shit when I dared voice my alarm at the horrifying deleterious effects the drugs were having on my son.  I thought my son was going to die.   And now I know he could have.  The research psychiatrist acted like a thug not a doctor.  My son begged me to take him out of there the whole time.  I wanted to,  because I know that what I saw was my son getting sicker and I believed then and believe now it was the massive amounts of toxic substances this man gave him--my son with a high IQ that loved to do so much and now...Remembers how he, "used to be able to do that."

In all reality I am truly stunned at the totally cavalier attitude about this sort of thing HOW THE HELL can the State of Washington justify letting this idiot keep his job??!!  Did the people of the State of Washington pay this man to do this to my son?  All of us are familiar with the Hippocratic oath, "First do no harm..."
Here is another Hippocrates quote that is apropos:

"When a doctor can not do good, he must be kept from doing harm."  Hippocrates

Showing he had no need for Informed consent, here is the document from my first post, dated 5-3-04.  This is when he discusses on paper my "concerns," which is what Quack Master Jack called my alarm and vehement protest of his using my son in his drug trials---of course he fails to mention that I had in fact been protesting the deleterious effects of the 'treatment' forced upon my son the since the summer of 2001. Of course he also didn't mention that I had confronted him about not complying with the Ethics Guidelines for Informed Consent that he had written for The American Academy of Child and Adolescent Psychiatry.

The fact of the matter is Informed Consent NEVER occurred.  And in this "Psychiatric Summary" he implies that my seriously ill son taking what is given him, is a sufficient substitute.  My son's taking the drugs constituted assent.  I know, as do all the medical staff at CSTC; my boy was coerced.  Informed Consent would need to be choice made based on the facts, and without being coerced.  The facts about these harsh drugs were never told to me by this research psychiatrist; and I'm sure he never had a meaningful conversation with my son about the risks or the potential benefits.  I found out the facts when I researched on my own.  When I read the actual studies detailing rates for death, iatrogenic illnesses, and disability; I cannot tell you the depth of the betrayal I felt.  The fact is, what Quack master Jack calls "concern" was outrage and protest.  My vehement protests were met with derision and ridicule; summarily  dismissed.  Additionally, the Court Order was obtained in order to prevent me from taking my son home, as I said I would. Once the Court order was obtained, I was told by staff that if I brought my son home, it would be a crime. Once CSTC obtained a Court Order in Pierce County Superior Court, it from then on would claim in Pierce County inpatient treatment was required, and telling Yakima County  Superior Court that he would better be better served by being released to live in the community.

My questions were answered with insufficient information, or ignored.  The fact that my son had PTSD and Temporal Lobe Epilepsy, a neurological condition which can have the same symptoms of schizophrenia made the diagnosis of schizophrenia suspect; the use of so many toxic drugs without I22nformed Consent, criminal.  Either one of these diagnoses should have excluded him from being enrolled in the TEOSS trials----

via: Clinical Trials.gov:

Treatment of Early Onset Schizophrenia Spectrum Disorders (TEOSS)

Exclusion Criteria:

• Risperidone (RIS), olanzapine (OLA)*, or molindone (MOL) for 8 weeks or more during THIS episode, with 2 weeks at the maximal dose (6 mg/day of RIS, 20 mg/day of OLA, or 140 mg/day of MOL)
• If using antidepressant and/or mood stabilizing medications, treatment for fewer than 30 days immediately before entry
• Intolerance or nonresponse to RIS, OLA*, or MOL during any previous treatment
• Bipolar affective disorder, post traumatic stress disorder, personality disorder, or psychosis not otherwise specified  (emphasis mine)
• Currently meeting DSM IV criteria for major depression episode
• DSM IV criteria for substance abuse or dependence with intention to continue illicit substance abuse
• Endocrinological or neurological conditions which confound the diagnosis or are a contraindication to treatment with antipsychotics  (emphasis mine) e.g. Temporal Lobe Epilepsy
• Mental retardation
• Risk of suicide or homicide that is not adequately controlled in the current setting
• Pregnancy or refusal to practice contraception during the study

For My Son, The Age Of Consent Meant No "Informed Consent"

CSTC

This post was posted mid December 2010 with a different title. It names the multiple drugs that my son was on in the two months before the date of the document, 10-8-2001.  I have also included a document where the research psychiatrist addresses my "concerns."  On December 31, 2011 I added the  paragraph on the discharge criteria and the TEOSS trial exclusions from ClinicalTrials.gov.


In Washington State a 13 year old can give consent for mental health and substance abuse treatment.  The thinking behind the law was that a teenager could obtain help that he or she felt was needed and not need a parent's approval.  I can see the logic in this.  I am so very aware of how this law was misused by the unethical doctors at the state psychiatric facility for children in Washington and doctors in our community once I brought my son home.

My son went to this facility in October of 2000 and turned 13 the following March.  In 2001 the Medical Director, a Federally funded researcher, had him on numerous drugs and when I protested, he told me I had no say!  Who was providing consent?  My lost son who could not hold a couple minute conversation; and often would not respond at all?  I know I never gave consent for any of what was done to my son.

It appears to me that this "researcher" was using my son in drug trials.  Obviously if he was, I did not give consent for that either.  Ultimately, shortly after the report below was written he put him on Clozaril, which to this day is not approved for use in thirteen year old adolescents.  By November of 2003 my son had tachycardia.  Still my protests went unheeded.  By November of 2004 his BMI was 34.3 and he weighed 246 lbs.  June of 2003 they added a trial of Abilify!  July of 2003 he was put on Depakote for aggression, not an approved use for Depakote..  January of 2004 Dr. Tom Semper lamented that Isaac had a QTC interval in the 440s which meant he couldn't be put on a trial of Geodon in addition to the clozaril, depakote, ativan, colace and miralax!

I know that during these two months this report covers, my son was given huge doses of many drugs which were not approved for use in children. I know that when I went to see him I was terrified for him. I know I was treated like shit when I dared voice my alarm at the horrifying deleterious effects the drugs were having on my son.  I thought my son was going to die; and now I know he could have.  The research psychiatrist acted like a thug not a doctor.  My son begged me to take him out of there the whole time.  I wanted to, because I know that what I saw was my son getting sicker and I believed then and believe now it was the massive amounts of toxic substances this man gave him--my son with a high IQ that loved to do so much and now...Remembers how he, "used to be able to do that."

In all reality I am truly stunned at the totally cavalier attitude about this sort of thing HOW THE HELL can the State of Washington justify letting this idiot keep his job??!!  Did the people of the State of Washington pay this man to do this?  All of us are familiar with the Hippocratic oath, which states, "First do no harm..." Well here is one that applies:

"Whenever a doctor cannot do good, 
he must be kept from doing harm."  
Hippocrates

Showing he had no need for Informed consent, here is the document from my first post, dated 5-3-04.  This is when he discusses on paper my "concerns" of course he fails to mention that I had in fact been protesting  since the summer of 2001.  Of course he doesn't mention that I had confronted him about not complying with the Ethics Guidelines for Informed Consent that he had written for The American Academy of Child and Adolescent Psychiatry.

The fact of the matter is Informed Consent NEVER occurred.  And in this "Psychiatric Summary" he implies that my seriously ill son taking what is given him, is a sufficient substitute.  My son's taking the drugs constituted assent.  I know, as do all the medical staff at CSTC; my boy was coerced.  Informed Consent would need to be choice made based on the facts, and without being coerced. The facts about these harsh drugs were never told to me by this research psychiatrist; and I'm sure he never had a meaningful conversation with my son about the risks or the potential benefits.  I found out the facts when I researched on my own.  When I read the actual studies detailing the risk of death, iatogenic illnesses, and disability; I can not tell you the depth of betrayal I felt.  The fact is my "concern" was protest.  My vehement protests were met with derision and ridicule; then summarily  dismissed.  The psychiatrist researcher gave my son multiple harmful drugs that were not approved for pediatric use, and were not approved by anyone but himself.

This Discharge Criteria was on every single bi-monthly report/review---Never was I given any educational materials, let alone a "range of appropriate materials."  My questions were answered with insufficient information or were ignored.  The fact that my son had PTSD and Temporal Lobe Epilepsy a neurological condition which has the same symptoms of schizophrenia---the diagnosis of schizophrenia is suspect, the use of so many toxic drugs without permission is criminal.

via: Clinical Trials.gov:

Treatment of Early Onset Schizophrenia Spectrum Disorders (TEOSS)

Exclusion Criteria:

• Risperidone (RIS), olanzapine (OLA)*, or molindone (MOL) for 8 weeks or more during THIS episode, with 2 weeks at the maximal dose (6 mg/day of RIS, 20 mg/day of OLA, or 140 mg/day of MOL)
• If using antidepressant and/or mood stabilizing medications, treatment for fewer than 30 days immediately before entry
• Intolerance or nonresponse to RIS, OLA*, or MOL during any previous treatment
• Bipolar affective disorder, post traumatic stress disorder, personality disorder, or psychosis not otherwise specified  (emphasis mine)
• Currently meeting DSM IV criteria for major depression episode
• DSM IV criteria for substance abuse or dependence with intention to continue illicit substance abuse
• Endocrinological or neurological conditions which confound the diagnosis or are a contraindication to treatment with antipsychotics  (emphasis mine) e.g. Temporal Lobe Epilepsy
• Mental retardation
• Risk of suicide or homicide that is not adequately controlled in the current setting
• Pregnancy or refusal to practice contraception during the study