District Attorney seeking to have medical board reopen investigation of Kayoko Kifuji, child psychiatrist who treated Rebecca Riley, deceased age four.

April 5, 2010

Rebecca Riley was only four years old when she was found dead of an overdose of clonidine, a blood pressure drug commonly used in children diagnosed as having “bipolar disorder” and “attention deficit hyperactivity disorder.”

Kayoko Kifuji, of Tufts Medical Center, is the child psychiatrist that prescribed clonidine and the psychiatric drugs Depakote (an anti-seizure drug) and Seroquel (an antipsychotic) for Riley and her two older siblings.

Following Riley’s death, Kifuji entered into a voluntary agreement with the Massachusetts Board of Registration in Medicine to halt her practice.  She was investigated by a grand jury that declined to indict her.  The Board also completed its inquiry.  Kifuji was allowed to return to practice last fall.

Riley’s parents were both charged with murder in Rebecca’s death.  Both testified they had only followed doctor’s orders in administering the drugs to Rebecca.  Both were recently found guilty in separate trials.

Kifuji was granted immunity from prosecution in exchange for her testimony in both trials.

The psychiatrist’s testimony regarding her treatment beliefs and practices has generated reactions ranging from shock and confusion to outrage directed at what is perceived as Kifuji’s role in Riley’s death.

Because the testimonies offered at the grand jury and medical board hearings were kept secret, the Riley trials provided the public the first details of Kifuji’s management of the Riley children.  Some of the facts from the transcripts include:

Kifuji diagnosed at least two of the Riley children, while toddlers, with mental disorders after only a one-hour consultation, did not order appropriate blood work while they were on potent pills and seemingly ignored input from preschool teachers and other clinicians who said the children seemed weak and overmedicated.

Kifuji believed testimony from the children as young as three regarding “hallucinations” about monsters to support the bipolar diagnosis while discounting any other information reported by the children as “unreliable.”

Kifuji repeatedly allowed, without drawing any effective limits, Carolyn Riley to increase the doses of clonidine she gave her children.  For her last month of life, Kifuji overall prescribed 835 pills to Rebecca.

Rebecca at age three, gained nine pounds in two months on Zyprexa, the first antipsychotic drug she was prescribed by Kifuji.

Kifuji waited 15 months into treatment before recommending counseling/psychotherapy for Rebecca.  There is no mention of ever recommending any parenting or family therapy for the parents.

Kifuji continues to insist her diagnosis was
correct even when it was pointed out that the children’s symptoms literally disappeared overnight when the mother was out of the home for four days and the father was left in charge of the children.

Based on these revelations, Plymouth County District Attorney Timothy Cruz said he plans to ask the Board of Registration in Medicine to reopen its investigation of Kifuji, who he has said turned a blind eye to the numerous signs that the parents were troubled and reckless in dispensing drugs.

“Dr. Kifuji is unfit to have a medical license,” he said.  “If what Dr. Kifuji did in this case is the acceptable standard of care for children in Massachusetts, then there is something very wrong in this state.”

Cruz said he plans to assemble the transcripts of her testimony, among other things, to present to the licensing board.  According to Cruz, that information shows not only that Kifuji operates on the controversial idea that toddlers can be diagnosed with bipolar disorder, but that she was negligent in her assessment and follow-up with patient.

Source: Patricia Wen, “Father guilty in girl’s fatal drugging,” Boston Globe, March 27, 2010; Lawrence Diller, “Wholesale sedation of young children: Medically, morally indefensible,” Patriot Ledger, March 27, 2010 and Lane Lambert, “Rebecca Riley’s doctor now the target of a grand jury,” Patriot Ledger, May 1, 2009.