Medical Board Reprimands Glendale, CA Psychiatrist Abigail M. Stanton; Negligence Resulted in Patient Suicide

August 23, 2022

Effective April 28, 2022, the Medical Board of California reprimanded Glendale, CA psychiatrist Abigail Stanton for gross negligence and repeated negligent acts regarding a patient who committed suicide while under her care.

The patient, identified in the Board’s document as “Patient 1,” was a 36-year-old male who first came to Stanton’s office on May 9, 2016, suffering from anxiety. Patient 1 had a history of passive suicidal ideation and a history of "cutting" at the age of 18. Stanton’s records reflect that Patient 1 had stopped drinking.

Stanton suggested Zoloft to treat the anxiety, but Patient 1 declined it and indicated he preferred to take Valium for "severe" anxiety on an intermittent basis.

Stanton prescribed Valium, 5 mg, 20 pills, with one refill and instructed Patient 1 to take one-half pill to start as a “test dose.” She referred Patient 1 to the Anxiety and Depression Association of America and discussed cognitive behavioral therapy for anxiety disorders.

Stanton saw Patient 1 in follow-up on June 21, 2016. Patient 1 reported that the Valium was working. He had been taking it three days per week. She provided him another Valium prescription at the same dose and quantity as on May 9, 2016, with two refills.

Stanton saw Patient 1 in follow-up on August 16, 2016, and November 15, 2016. The patient remained stable on the Valium. On each occasion, Stanton prescribed Valium, 5 mg, 20 pills, with three refills, to be taken as needed.

Stanton again saw Patient 1 on March 14, 2017. She increased the amount of Valium in each prescription from 20 pills to 30 pills, with three refills, to be taken as needed for "panic." She noted that Patient 1 was doing well and using Valium responsibly. However, Stanton's records contain no explanation for the increase in the amount of Valium.

Stanton saw Patient 1 on July 18, 2017. Stanton reported increased use of Valium from three times a week to daily as a result of "marital issues." Stanton noted she would try to decrease Valium over the next two months and reevaluate use of an SSRI antidepressant. She advised Patient 1 to abstain from alcohol use. She increased the Valium prescription to 5 mg, 45 pills, with one refill.

Patient 1's final visit with Stanton was on September 12, 2017. At that time, Stanton noted that she was concerned that Patient 1 was taking Valium every day. The Valium was wearing off in that the dose did not last very long. Stanton believed Patient 1 had something more than an intermittent anxiety problem, and she determined that an SSRI was needed. Stanton's records document that Patient 1 had recently separated from his wife, which caused him increased anxiety and sorrow. She documented no suicidal ideation.

Stanton discontinued the patient’s Valium. She did not however discuss, and/or document a discussion of possible withdrawal symptoms. She prescribed Zoloft, 25 mg, 30 pills, with instructions to take one-half pill per day to reduce side effects. She also prescribed trazodone (also an antidepressant), 50 mg, 30 pills with instructions to take one pill at bedtime as needed for insomnia. Stanton provided two refills of each prescription.

Stanton had been seeing Patient 1 in intervals of three months. She did not schedule and/or document a follow-up visit to address the trial of Zoloft before the three-month prescription of Zoloft would have run out.

Stanton denied a pharmacy's refill request for Valium for Patient 1 on September 14, 2017.

On October 2, 2017, Patient 1 committed suicide by hanging.

The standard of care for discontinuation of Valium requires that it not be done abruptly, but should be done slowly and carefully.

Stanton was grossly negligent in her care and treatment of Patient 1--a patient with increasing levels of anxiety--when she abruptly discontinued Valium after prescribing it to Patient 1 for 18 months in increasing dosages.

The standard of care for prescribing Zoloft at a low dosage, such as 12.5 mg per day, for a patient with anxiety, is to schedule timely follow-up visits to assess the patient.

(Psychcrime note: It should be noted that Zoloft and all SSRI antidepressants carry an FDA “black box” [strongest] warning that the drug may cause suicidal ideation and suicide risk. Similar warnings have been issued by the drug regulatory agencies of Australia, Canada, the European Union, Germany, Ireland, Italy, Japan, New Zealand, Russian, and the United Kingdom.)

Stanton was grossly negligent in her treatment of Patient 1, whose anxiety was escalating, when she prescribed Zoloft for a three-month duration without scheduling an earlier follow-up visit to assess his progress.

Source: Decision in the Matter of the Accusation Against Abigail Mary Stanton, M.D., Physician’s & Surgeon’s Certificate No. G 62736, Case No. 800-2017-038145, Medical Board of California, March 29, 2022.