before his death, Gabriel Myers, the 7-year-old Broward boy who hanged
himself in the shower of his foster home, had been prescribed a
powerful mind-altering drug linked by federal regulators to an
increased risk of suicide in children.
In all, Gabriel had been
prescribed four psychiatric drugs, two or three of which he was taking
at the time of his death, said Jack Moss, Broward chief of the state
Department of Children & Families. Moss said he is not sure which
medications the boy was taking because Margate police took the foster
home's medication log as part of an investigation into Gabriel's death
Three of the psychotropic drugs carry U.S. Food and
Drug Administration ''black box'' label warnings for children's safety,
the strongest advisory the federal agency issues. Three of the
medications are not approved for use with young children, though they
are widely prescribed to youngsters ''off label'' -- meaning doctors
can prescribe the drug even if not formally approved for that use.
2005 -- reacting to a series of stories in The Miami Herald that as
many as one in four foster children were prescribed potentially
dangerous mind-altering drugs -- state lawmakers approved a law aimed
at curbing their use. Children's advocates now question whether the law
is being ignored.
Gabriel was being treated by a Broward
psychiatrist who is on a list of Florida doctors that the state Agency
for Health Care Administration red-flagged as having ''problematic''
prescribing practices, said Robert Constantine, director of AHCA's
Medicaid Drug Therapy Management Program, which tracks prescribing of
psychiatric drugs to children.
The list flags doctors with a high
volume of prescriptions of mental-health drugs or potentially dangerous
combinations of the medications.
Dr. Sohail Punjwani has been on
the list every quarter in which regulators have monitored the
prescribing of psychotropic drugs since the program was created in
2006, said Constantine, a professor at the University of South
Florida's Mental Health Institute. The practices of about 17,000
Florida doctors who prescribe medications to children on Medicaid are
studied every quarter, and about 300 to 450 end up red-flagged on the
And though Florida law requires that either a parent or
judge consent to the use of psychotropic drugs on foster children, a
source with knowledge of the boy's case said Gabriel already had been
taking a three-drug cocktail when Broward Circuit Judge Lisa Porter was
informed at a March 11 hearing. The judge approved the medications over
the objection of a court-appointed guardian, the source said.
are devastated,'' said Jon Myers, the boy's maternal uncle, who cared
for him from June through October 2008. ``Gabriel's problems could not
be solved by a pharmacy.''
Four feet tall and 67 pounds, with
short-cropped brown hair, Gabriel was a bright, charming and often
sweet little boy, those who knew him say.
But he already had a
sad past hinting at a troubling future. Records obtained by The Miami
Herald show Gabriel may have been molested by an older boy while he was
living with grandparents in Ohio, while his mother was in jail.
Thursday, Gabriel locked himself in a bathroom and hanged himself with
a detachable shower head after arguing with the 19-year-old son of his
foster dad about his lunch, Moss said.
DCF petitioned a judge on
Tuesday to unseal the boy's records in response to requests from The
Herald and other media, spokeswoman Leslie Mann said.
told The Miami Herald that he is board certified as a child
psychiatrist. He did not recall Gabriel, but Punjwani said he was part
of a ''huge'' group practice and may have been one of many clinicians
to treat the boy.
Punjwani defended the use of psychiatric drugs
on children, even if they are not approved for such use, saying the
lack of approval stems from the reluctance of drug makers and the
medical establishment to launch clinical trials on children.
The anti-psychotic drugs, he added, are used routinely to treat mood instability and insomnia among children.
originally had been prescribed Vyvanse, an attention
deficit/hyperactivity disorder drug approved for kids aged 6 through
12, Lexapro, an anti-depressant which is not approved for children, and
Zyprexa, an anti-psychotic drug that also is not approved for kids,
Both Punjwani and Moss said they think the Lexapro and
Zyprexa were discontinued in recent weeks, and that a drug called
Symbyax -- which contains the medication in Zyprexa along with another
antidepressant -- was substituted.
Symbyax, recently approved for
severe depression, is among a group of commonly prescribed
anti-depressants, such as Prozac and Paxil, that the FDA warned in 2003
were linked to an increase in ''suicidal thoughts or behaviors'' among
children. Symbyax is not approved by the FDA for use on children.
David L. Katz, professor of public health at Yale University's medical
school, called the use of such drugs on youngsters ''extremely risky,''
He questioned whether the boy needed to be taking such powerful
medications absent a diagnosis of schizophrenia. ''These are
medications that are potent and potentially dangerous,'' Katz said.
``They certainly are powerful drugs for anybody, let alone a 7-year-old
Jon Myers, the uncle who cared for Gabriel after abuse
investigators found him in a car in a Denny's parking lot after his
mother had passed out, questions whether Gabriel needed such potent
medications to begin with.
Myers said the boy's pediatrician had
discontinued all psychotropic drugs while Gabriel lived with him, and
the boy did well, earning A's and B's at the Hollywood Christian
''We did not have any issues with him having tantrums,'' Myers said. ``He would get upset, like little boys do.''
week or two before Gabriel died, his grandfather in Ohio expressed
concerns that the boy sounded overmedicated. ''My father said that the
last conversation he had a couple of weeks ago Gabriel sounded like he
was too drugged,'' Myers said.
``He sounded like he was doped up.''