Child psychiatrist Kayoko Kifuji has no regrets about diagnosing now-deceased toddler with bipolar disorder, prescribing her dangerous drugs

March 19, 2010

Three years after Rebecca Riley’s parents were arrested for murdering their daughter, the psychiatrist who prescribed the drugs that killed her says she has no second thoughts about her diagnosis of the little girl.

Dr. Kayoko Kifuji gave that response to Michael Riley’s defense attorney John Darrell Thursday morning, at the end of more than six hours of testimony she gave in two days in Riley’s murder trial in Plymouth Superior Court.

“Now that you’ve had this time for reflection, have you changed your mind about your diagnosis and treatment of Rebecca Riley?” Darrell asked her.

“No, I have not,” Kifuji answered.

Kifuji is on the staff at Tufts Medical Center. She diagnosed Rebecca Riley with bipolar disorder and attention deficit hyperactivity disorder when Rebecca was 2. She also prescribed clonidine and Depakote for the conditions.

Rebecca was 4 when she died at her family’s home in Hull on Dec. 13, 2006. A state medical examiner concluded that she died from a clonidine overdose. Michael and Carolyn Riley were charged with her murder in February 2007.

Carolyn Riley was convicted of second-degree murder in February of this year. Kifjui testified at her trial as well.

Kifuji voluntarily gave up her medical license after the Rileys were charged. A grand jury declined to indict her last year and she returned to practice at Tufts. 

On Wednesday, Kifuji said the Rileys struck her as “reliable parents,” not “med seekers” running a ruse to sedate their children.

Prosecutors say the Rileys intentionally overdosed their daughter.

Rebecca’s estate has sued the 55-year-old child psychiatrist. Prosecutors granted Kifuji immunity from criminal prosecution for her testimony.

Plymouth County First Assistant District Attorney Frank Middleton questioned Kifuji for five hours Wednesday in an exchange that largely replicated her prior appearance on the stand.

By meticulously guiding Kifuji through her medical records for each Riley sister – one dated entry at a time – Middleton established that Carolyn Riley upped her daughters’ dosages without Kifuji’s authorization and often requested prescription refills well before the particular pill supply was due to run out.

Kifuji acknowledged acquiescing to the requests. Although the psychiatrist said she scolded Riley for manipulating the girls’ drug regimens, Kifuji said most times she agreed to continue the increased dosages.

Rarely in the testimony did Michael Riley’s name arise.

During appointments at Tufts Medical Center, Kifuji said, Michael Riley always remained in the waiting room, and twice he declined offers to sit in while Rebecca’s health was discussed. Kifuji said Carolyn Riley did mention that her husband “helps out with the medication.”

Kifuji’s impressions of the defendant seemed largely based on conversations with Carolyn Riley. For example, Kifuji said she was told that Rebecca’s symptoms and those of her sister worsened when their father was forced to leave the Weymouth housing complex where the family lived because of abuse allegations.

Kifuji said she told the local housing authority in a letter “how damaging” Michael Riley’s absence had been for his daughters, whose medication was increased as a result.

Several times, Kifuji directly addressed jurors to explain her treatment rationale.

Prescribing the sleep aid clonidine, she said, seemed especially appropriate for a restless child like Rebecca, who was known to crawl out of her crib – she broke a wrist on one occasion – and one time ran out the front door.

“I didn’t want her to fall from a high place and break her neck or (run into traffic) and get killed,” Kifuji said.

“It does help to calm them down,” she said of the drug.

Middleton asked Kifuji if she ever suspected the Rileys might be “parental med seekers.”

“No, I didn’t,” Kifuji said, adding that, “as doctors, we tend to believe parents.” 

Source: John P. Kelly, "Psychiatrist: No second thoughts in Rebecca Riley case," Gatehouse News Service, March 18, 2010.