A Child's Death: Murder by Medication?
Since then the tragedy of Rebecca's death in Hull, Mass., has unfolded in unexpected directions. On March 23 her parents were indicted on first-degree murder charges, accused of deliberately overdosing their daughter with powerful psychiatric drugs prescribed after Rebecca's diagnosis with bipolar disorder and ADHD at age 2½. But a lawyer for Carolyn, 32, maintains the couple merely dispensed medicines as they had been told—and blames their physician Dr. Kayoko Kifuji. "The doctor never should have been prescribing these medications for a 2½-year-old," says attorney Michael Bourbeau. Dr. Kifuji denies any role in Rebecca's death.
The tragedy shines a light—in this case, a particularly harsh one—on a fast-growing trend in pediatric medicine. In recent years the diagnosis of bipolar disorder has skyrocketed among the young, who are often treated with potent drugs never tested on children (see box). As for Rebecca, her grandmother Valerie Berio says she was lovable and affectionate but also "a noisy, climbing, banging kid." In 2004 the girl's mother, Carolyn, took her and her sister Katie, now 6, to see Dr. Kifuji, a child psychiatrist at Tufts-New England Medical Center because of sleeping problems.
Concluding that both girls were bipolar—an older brother, Gerard, 12, had earlier been given the same diagnosis, as had their father, Michael—Dr. Kifuji put the toddler Rebecca on a combination of medicines: clonidine, a blood-pressure drug used as a sedative; Depakote, an anti-seizure medicine used as a mood stabilizer; and Seroquel, an anti-psychotic drug. That aggressive approach, while not uncommon, has raised eyebrows in the medical community. "At no time would I prescribe a medication for a child of this age without trying some kind of behavioral approach," says Dr. Thomas Anders, president of the American Academy of Child & Adolescent Psychiatry. (Dr. Kifuji, who has agreed to a temporary license suspension, declined to comment for this article, though Tufts has voiced its support.)
For years Carolyn and Michael, 34, had just been getting by on welfare and disability checks. In 2005 Carolyn's 13-year-old daughter from a previous relationship, who had been put up for adoption at a young age but had gotten back in touch with her mother, accused Michael of molesting her. (He was indicted and his trial is scheduled for May.)
According to a police report, social workers who checked up on the family because of teachers' complaints heard disturbing reports about Rebecca. Staffers at her preschool said she was lethargic much of the day but would perk up once her medications apparently wore off. "Every day, at approximately 2, Rebecca would start to come to life," one teacher told police. "She would start using words and attempting activities." A therapist who was treating Rebecca and Katie reported her concern about the type and quantity of medication given to Rebecca. She also said the child appeared to be neglected.
Jimmy McGonnell told the Boston Herald that his half sister Carolyn willingly overmedicated her children to please her husband, who supposedly couldn't stand disruptions. "When Michael was around, the kids were always in their bedrooms," said McGonnell, 23. He added that in recent months Rebecca had become "zombified," an assessment confirmed by his fiancé, Kelly Williams, 26. "You wouldn't even hear [Rebecca] coming," says Williams. "She would just crawl on my lap and sit there silently."
According to investigators, in the year before Rebecca died, her parents received at least 200 more clonidine pills than had been originally prescribed. On two occasions they allegedly told Dr. Kifuji that pills had been lost or damaged. The Rileys' attorney Bourbeau contends there was no deception. "In any normal family, pills are lost," he says. Any overmedications, Bourbeau maintains, were inadvertent. But Kifuji told police she explicitly warned Carolyn that extra doses of clonidine could be fatal.
An autopsy showed that Rebecca had died of intoxication from the combined effects of her bipolar medicine and an antihistamine she was taking for a cold. Valerie Berio insists her daughter is grief-stricken. The night she was taken to jail, she asked her mom to take care of Rebecca's ashes. "She said, 'Would you take Rebecca home with you,'" Berio recalls. "'I want you to keep her until I can have her again.'"