The Virginian-Pilot (Norfolk, VA.)
An Increased Dosage. A Suicide Victim. Lots of Questions
By Elizabeth Simpson
July 26, 2014
Dr. Waldo Ellison and Dr. Charles Parker, both psychiatrists in Virginia Beach, are accused in Virginia Board of Medicine documents of failing to adequately diagnose attention deficit disorder and monitor the drug they used to treat it, Adderall.
Although the patients in the cases are not identified in the documents, Kathy and Rick Fee of Virginia Beach said “Patient A” in the records is their 24-year-old son, Richard.
The couple filed a complaint in March 2013 after a Board of Medicine investigator interviewed them for several hours about their son’s treatment in response to a complaint filed with the board against the psychiatrists.
As complainants, the Fees received word Monday of the investigator’s findings, and the informal conference set for Sept. 10, which they plan to attend. At that time, the conference committee can exonerate the doctors of the investigator’s allegations. Or it can take a number of actions if members think the findings are valid, including a reprimand, probation, monetary penalty or referring the case to a hearing before the entire board, which can suspend or revoke licenses.
Michael Goodman, an attorney who is representing Ellison, said in an email response that he is reviewing the documents and has no comment at this time. Parker’s attorney, John Franklin, also declined to comment because of pending litigation.
The Fees filed a $2 million malpractice lawsuit in August against both psychiatrists; that trial is scheduled for July 2015.
Richard Fee’s case has been used to illustrate the concern about diagnosis of attention deficit disorders and the increasing use of prescription drugs such as Adderall and Ritalin. Some people claim the condition, which makes it difficult to focus and pay attention, is being overdiagnosed. The number of Americans using attention deficit medications rose by 36 percent between 2008 and 2012, according to one survey.
Thursday, Rick Fee said he believes the Board of Medicine’s investigator corroborated what he and his wife have been saying for years, and that they see this as a step toward addressing the “reckless” diagnosis of ADD and the prescription of stimulant drugs that can become addictive and damaging.
The Fees went public in a February 2013 New York Times story that led to appearances on national TV news shows. They said they believe their son was wrongly diagnosed with an attention deficit, which they believe led to his addiction to Adderall.
Addiction to such stimulants can cause aggression, lethargy, depression or sudden changes in social behavior. People who are abruptly taken off the medication, instead of being weaned off, can experience depression, fatigue and sleep problems.
Richard Fee’s condition deteriorated into sleeplessness, paranoia and hallucinations while on Adderall. His parents repeatedly tried to inform the two doctors that they did not believe their son had ADD and that he was abusing the drugs. He continued to receive Adderall prescriptions until October 2011, when he was cut off the drugs abruptly. On Nov. 8, 2011, his parents discovered he had hanged himself in his Norfolk apartment.
The Board of Medicine investigator said Ellison diagnosed Patient A with attention deficit disorder without adequate basis, such as gathering and documenting a history of childhood symptoms. The documents say he failed to monitor and manage the patient’s use of Adderall, which has a potential for abuse and addiction.
He didn’t use urine screens, pill counts or a contract with the patient, even after the patient’s family told him they suspected the young man was addicted to the drug and was showing paranoid and delusional behavior, the records said.
The Board of Medicine investigator alleged Ellison prescribed Adderall in increasing doses even though the patient was showing signs of drug abuse. Also, a neuropsychologist had diagnosed the patient with a different condition, schizotypal personality disorder, which the parents informed Ellison about.
The Board of Medicine records also include allegations involving two others: Patient B, a woman in her early 40s, and Patient C, her teenage daughter. In the case of Patient B, the board investigator said Ellison didn’t perform or document an adequate basis for diagnosing ADD and also failed to monitor and manage the patient’s use of Adderall. The documents said he provided early renewals or refills of Adderall to her on 25 occasions between January 2010 and May 2013.
The excessive doses played a role in “dangerous psychotic decompensation,” which led to an involuntary hospitalization for Adderall-induced psychosis.
The Board of Medicine report also said that Ellison’s medical records did not match information he gave to the board’s investigator.
In Parker’s case, which is separate from Ellison’s but has an informal conference hearing on the same day, the investigator said he failed to obtain emergency room records that showed a patient – whom the Fees say is their son – was hallucinating, and that he ignored and failed to address the diagnosis of schizotypal personality disorder, instead relying on an ADD diagnosis to prescribe Adderall.
He also failed to check the prescription drug monitoring program – a state database of prescriptions – to see whether other health providers had prescribed the patient medication.
The documents also outline Parker’s treatment of a 45-year-old male with a history of bipolar disorder.
Parker discontinued that diagnosis and treatment, opting for an ADD diagnosis and Adderall prescription.
The investigator said those decisions were “contrary to sound medical judgment.”