School Overdoses Girl on Her Medication

[zoobie]

Have you seen the consent forms they ask you to sign today? I wouldn't be at all surprised what Mom signed and agreed to this up front, in the stack of paperwork. I saw one where the child could be removed for surgery or evaluation for mental health care on the "prior consent" of the parents in the original documents. The ones attached to a school-based clinic are particularly egregious.

There is no way that a school district has a form allowing the school counselor to use her personal vehicle to drive the child home, break in, and administer psychotropic medications to the child. The story seems too crazy to be true. If it is true, the counselor should be prosecuted for numerous felonies.

[mathnerd]

I call BS.

 

1) the drugs themselves are very strong, and would be rare for a child.

2) the drugs are not likely to be dosed all 3 in the a.m.

3) the teacher's behavior seems incongruent

4) the counselor' behavior is also unexpected and incongruent

 

Nope; too many layers of unbelievable AND details presented to make it seem real and believable but actually has the opposite effect.

 

Most public schools are paranoid about liability. They will not transport a child home without permission. I am very sure that even in remote, rural corners of america, they are taught about liability and lawsuits and insurance etc.

How did the child gain entry into the house? How did the counselor know that the child could open the door and get in before setting out for that house? And if the mom finds missing items in her house now, can she blame the counselor for the "theft"? I can go on and on ...

 

I call BS too.

 

PS: I take it back if the OP is not talking about American schools (this happened abroad?)

[Maus]

I call BS.

 

1) the drugs themselves are very strong, and would be rare for a child.

2) the drugs are not likely to be dosed all 3 in the a.m.

3) the teacher's behavior seems incongruent

4) the counselor' behavior is also unexpected and incongruent

 

Nope; too many layers of unbelievable AND details presented to make it seem real and believable but actually has the opposite effect.

1-3 ring true, based on my own experiences, but if 4 is true, that counselor is seriously out of line, and will probably lose her job. She should be checking with the nurse, checking the child's file, and having the child wait in her office until Mom can be reached.

 

1. The drugs are strong, but *are* used to treat OCD, etc., even in children.  Our pediatric psychiatrist has discussed them with us as possibilities for our oldest two, and in that combination.  

 

2. Trazadone would not be taken in the morning, but the other two would.  A child dosing herself probably would not know that if Mom usually hands her the pills.  DS12 wouldn't make that mistake, because I taught him to take care of his own meds, and he is detail oriented.  DD10 totally would, because even though I've been trying to teach her, she isn't that aware.

 

3.  That is exactly how a number of adults who interact with my kids behave.  They assume psych meds are just like ADHD meds, because they've seen the later often, but haven't seen the former before my kids came along. (Kids with OCD severe enough to take that level of meds are rare.)  The stimulants given for ADHD have a more immediate and direct effect, just like drinking caffeine, so it is reasonable to assume the child missed a dose.  (The psych meds do not, as I mentioned up-thread.) They also tend to assume all bad days are mental illness days, even if the poor kid has the flu.  And they tend to panic at the idea of dealing with an unmedicated mentally ill kid, because, hey, the media has taught us to fear kids like that.

[Anne in CA]

I am not inclined to disbelieve it. School counselors are a mixed bunch IME, and not reliable sometimes. My cousin who was a fifth grade teacher told me to NEVER let my oldest see a school counselor when she was in school, a good friend who is in the middle of a custody dispute with a clearly abusive man is having a very hard time keeping her kids from seeing the school counselor. The school counselor also insists on pulling her dd out of class during math, which is her dd's worst subject and then her dd cannot do her homework. 

 

Also, I once told a story no one on the board wanted to hear and was told my story couldn't be true, so, again, I am sympathetic to the idea that this is probably true.

[LMV]

Wayyyy overstepping for the school.

 

I am surprised that they took her to the ER for a double dose of those meds though.Unless she is already at the top threshold of what a safe dose is, there really wouldn't be much to to at the ER, but wait it out.  I would have just monitored her at home and let her sleep off the double dose of Trazodone.  To each their own. 

 

 

DD is on those same meds plus 3 more.  There was a day that dh and I both gave her meds so she got a double dose.  When I called poison control, they said to just watch her also, so this isn't just a mom being Laissez faire about meds....(and I also work in pharmacy)

 

A lot of the inherent risk  would depend on what actual doses of the three drugs she was on and how much she actually took.  Did she just get a double dose or did she take a handful. Dosing may not be certain if the child self administered and is not reliable (as seems to be the case from the information shared) or mom may have been able to back calculate what she actually took based on the quantities left in the bottles and perhaps that did exceed a double dose.  Additionally since both TCAs and Risperidone have the potential to prolong the QT interval poison control may have recommended that the child go to the ED and at least get an EKG done.

 

I would start with being mad at the doctor who put my kiddo on that combination of medicine. Then I would let my anger continue from there.

 

I do feel sorry for the counselor, too, who made some really bad judgment. He or she will probably lose a job over this. If mom had been a little less vocal maybe the counselor could have received just a strong reprimand and a second chance.

 

But, mostly I feel sorry for the child. Her mom just blasted over Facebook that her daughter is a behavioral problem. That is bound to hurt.

 

I really think that unless you happen to be a fully licensed physician who is also board certified in child & adolescent psychiatry AND who has evaluated this child you really have nothing to back up your criticism.  If you do meet the above criteria then I would hope you would be a bit more professional in regards to safe guarding protected health information of your patients. The reality is that this cocktail of medications may be very appropriate prescribing within the standard of care. The issue didn't arise because the child took the medications as prescribed and had a problem. The problem seems to arise because the child took extra doses of the medication not as prescribed.

 

I really don't understand why you are sending your wrath to the prescribing physician and feeling sorry for a school counselor who (if accounting of events is accurate) at best exercised very poor judgment which could have resulted in significant harm or even death of a child, and depending on state laws may have actually committed a few felonies in the process. 

 

Lashing out at the child's mom does seem to be a bit of victim blaming.  Perhaps she does need a better filter, or perhaps she was just overwhelmed and terrified in the moment and turned to social media.  I will admit that is not how I process but there are many worse things I think this mom could have done. 

 

I call BS.

 

1) the drugs themselves are very strong, and would be rare for a child.

2) the drugs are not likely to be dosed all 3 in the a.m.

3) the teacher's behavior seems incongruent

4) the counselor' behavior is also unexpected and incongruent

 

Nope; too many layers of unbelievable AND details presented to make it seem real and believable but actually has the opposite effect.

 

Just to clarify:

-Risperidone is actually FDA approved for use in kids down to age 6 for certain diagnoses.  I would not say it was rare in the population of kids with those diagnoses who come through the ED where I work.

-Sertraline does tend to be activating enough that it is usually dosed in the morning. Most clinicians use once daily Risperidone and have no reason not to dose it in the morning (and may be even more likely to do this if they are giving other AM medications in an effort to improve adherence). I suspect you are thinking of extended release Trazodone in the context of off label use for sleep with QHS administration. This is possible, of course there is also immediate release Trazodone which is usally given in split doses through out the day.  If being used for pediatric depression it would be likely given this way.  As a caveat I will say that, in peds I see psychatry sometimes much more likely to stick with the TCAs because there is so much less testing of/ experience with the SSRIs (excepting Fluoextine) and SNRIs in children. In adults TCAs have largely been surpassed by the SSRIs and SNRIs and we are more likely to see TCAs being used off label for insomnia or chronic pain.

 

I'm not saying that what the counselor is reported to have done is in any way appropriate and if she really did everything that has been attributed then she should definitely be losing her job AND any license she may have. So perhaps you are right that this just didn't happen but sadly I have seen professionals at all levels exercise poor judgement and or practice outside of their accepted scope so it is not unfathomable to me that this could have happened.

[Chelli]

My friend's lawyer has told her not to post anymore about the incident on Facebook so I'm going to delete my OP since no one quoted it, but you are more than welcome to continue the conversation.

 

I have no idea how reliable my friend is. We reconnected on Facebook after going to high school together. As far as I've been able to tell via Facebook posts she's not a liar or a drama creator. I can honestly see this scenario happening while crazy it does ring true, and I know her dd was in the hospital because she posted a picture later of her dd smiling weakly while hooked up to the IV. If she's lying about the entire event, I guess that will be discovered soon enough, but it seems like it would be pretty easy for the school to say none of that happened. 

[Chelli]

Why would the school need to verify the administration of prescription drugs with the parents if they aren't themselves going to be giving them?  If they were in fact authorized to give them then there would have been no need to drive the child home.  The entire situation makes little sense to me.

 

Since the mom works third shift and is usually at home during school hours, I believe they were going to have her bring the drugs to the school but they couldn't reach her.

[Tap]

Risperidone is a strong me that is not used casually, but it is used to treat Autism and Aspergers (aggression/self harm) among other things.  Most of the patients I see in our pharmacy that take risperidone are children/teens.

 

Trazodone is not often used during the day, but it can be.  Most people get very sleepy from it, but not everyone. It is an antidepressant and one of the side effects is sleepiness, but the antidepressant function can be seen during the next day.  A medicine to improve sleep, is often one of the first meds we see prescribed for children with ASD. (Sleep issues are very common in ASD).  

 

I did not read the Facebook post (is that where the am dose is mentioned?), but if the mom was working a 3rd shift, maybe the 3am dose is because that is when the mom gets home?  A morning dose of risperidone doesn't quite get  in dds system fast enough to help her get to school and start her day.  While it is usually given once a day, I have dd take it twice a day to avoid the morning dip.  If the mom is up at 3am, it may make sense for her to take her meds at that time so the girl gets the most benefit during school hours.  If the child has an issue with getting up way too early in the morning, the 3am dose may be purposeful to help keep her asleep. 

 

DD is very violent. I could see her teachers trying anything possible to help dd keep her body under control.  I can see the counselor at this girls school being overly helpful and trying to solve this issue.  She likely has a heart of gold but just didn't think things through.  They saw the issue as one that had a simple solution....get the girls meds.  Her decision was a bad one, but her heart sounds kind to go so far out of the way for her student. I expect that she will likely lose her job over it. 

[Reefgazer]

If it's your information, then you're right.  Otherwise, it's violating privacy, IMO.  The difference between here and Facebook is that you are anonymous here; on Facebook, you are friended precisely because you are not anonymous.  Now for the rest of her life, that little girl's personal info is known to everyone in her mother's social circle.

There are many people on this forum who have received help with their health problems because so many of us are willing to "broadcast" our medical concerns and how we deal with our medical issues.  There's nothing inherently wrong with discussing illness, especially when it's for the greater good. And in this situation, making people aware of this kind of thing so it doesn't happen again is certainly for the greater good.

 

[Joanne]

1

 

 

Just to clarify:

-Risperidone is actually FDA approved for use in kids down to age 6 for certain diagnoses.  I would not say it was rare in the population of kids with those diagnoses who come through the ED where I work.

-Sertraline does tend to be activating enough that it is usually dosed in the morning. Most clinicians use once daily Risperidone and have no reason not to dose it in the morning (and may be even more likely to do this if they are giving other AM medications in an effort to improve adherence). I suspect you are thinking of extended release Trazodone in the context of off label use for sleep with QHS administration. This is possible, of course there is also immediate release Trazodone which is usally given in split doses through out the day.  If being used for pediatric depression it would be likely given this way.  As a caveat I will say that, in peds I see psychatry sometimes much more likely to stick with the TCAs because there is so much less testing of/ experience with the SSRIs (excepting Fluoextine) and SNRIs in children. In adults TCAs have largely been surpassed by the SSRIs and SNRIs and we are more likely to see TCAs being used off label for insomnia or chronic pain.

 

I'm not saying that what the counselor is reported to have done is in any way appropriate and if she really did everything that has been attributed then she should definitely be losing her job AND any license she may have. So perhaps you are right that this just didn't happen but sadly I have seen professionals at all levels exercise poor judgement and or practice outside of their accepted scope so it is not unfathomable to me that this could have happened.

 

I am actually quite familiar with the drugs and their uses.

[Slache]

I can't find this in the news. Can someone PM me the link?

[Mergath]

If it's your information, then you're right.  Otherwise, it's violating privacy, IMO.  The difference between here and Facebook is that you are anonymous here; on Facebook, you are friended precisely because you are not anonymous.  Now for the rest of her life, that little girl's personal info is known to everyone in her mother's social circle.

 

I guess I don't see how it's any different from me saying that my dd has green eyes or wears a size 6 girls jeans. It's not as if we, as parents, are never, ever going to share a single, solitary fact about our children. 

[Reefgazer]

Because people make judgments about a person's capabilities and faculties from medical information, and they don't from eye color. It doesn't matter that this is not right, it just is.

I guess I don't see how it's any different from me saying that my dd has green eyes or wears a size 6 girls jeans. It's not as if we, as parents, are never, ever going to share a single, solitary fact about our children.

[Word Nerd]

Yeah some schools don't even allow freaking Chapstick!

Or sunscreen.

[swellmomma]

Yeah that's so odd.  And did the 9 year old have a key?  My parents didn't give me a key at 9 because I was never left alone at 9.  But maybe other people give their 9 year olds keys.  And why is the medication left in a place for a 9 year old to access?  That's a bad idea too.  Especially for these sorts of drugs.

So many odd things about this story really.

I had a key to my home at 9, I was one of the many latchkey kids of my generation.  As for meds, both of my boys are on meds, the ones my oldest is on are rather potent.  I keep them all in 1 location in my house that even my 7 year old can easily access.  Just because a kid is on meds doesn't mean they are going to go down a bottle.  It is not a big deal to have meds in an easily accessible location.  This is not a toddler being talked about but a 9 year old.

 

As for the story itself,  Just transporting a child like that is grounds for getting fired here, you do not do that.  It is a major liability.  combined with the med overdose because someone decided the child needed to take a dose, and yeah I suspect there will be a lawsuit sooner rather than later on this situation.

[Lolly]

You go right on ahead and be mad at the doctor who put her on those meds.....and I will go right on, with being mad that my 8yo was born with wonky brain chemistry, that causes a mental illness that requires those meds.  

 

Those meds are not given out lightly, and especially not to a 9yo.  For a med like Risperidone, there will be a diagnosis to support its use. It isn't an antidepressant that will be give out with just a little conversation in the pediatricians office.  It is very strong, and very effective for some MH conditions.

 

1. If this did happen, the counselor should be fired and not ever be allowed to work in a school system again. This goes so far into incompetence in her job that it should never be forgiven (as in to get another job in a school/not as in cleansing the soul). Someone with that poor a level of congnitive thinking and memory skills should not be allowed to work in her job.

 

2. I do have a problem with drs overprescribing these meds and prescribing them incorrectly. A dx is easy to get. I have btdt. I have friends who have btdt. I know several dc who have been on these meds, including one of my own, who should not have had them prescribed. Do some kids benefit from them? Yes, but there are many, many who are on them who should not be. One dear friend who lauded the medications and the dr who prescribed them because they did make her dd managable (ironically her praise of the dr was what persuaded me to take my dd there) is now one of the most vocal critics I know. Turns out her dd did not have brain chemistry problems, she had brain formation problems. The meds simply mad her...passive (best word I can come up with) and docile. She was weaned from the medications and hasn't taken any for over 10 years now. So, yes, there has to be a diagnosis, but that diagnosis can be received with little more than a conversation. I am personal witness to the ease with which these meds can be and are handed out. (Fortunately, I realized the ridiculousness of my dd's dx and the tremendous lack of investigation into her issues before serious medications were dispensed. I refused them after a brief attempt with using them. Most parents I have witnessed just keep taking the doctor's advice and add on more drugs forming a nice daily cocktail for their dc to take. It is very hard to follow your mama gut and forgo the professional's orders/advice.)

[kroe1]

Why I initially berated the mom for posting on Facebook was because of the potential harm to this child, not only now, but also future job and mate prospects. How many times has Facebook changed the rules on what is public and private? Obviously, mom is posting to long ago friends who the OP said she is. She is not limiting to just a close circle of trusted friends. And, who knows when Facebook will make public everything again until we go back and change our settings.

 

Even on this board, I cringe at what gets posted sometimes. While there is an anonymous overlay, a good sleuth could figure out who many people are IRL just by putting all the posts together. Add in a agency that can track IP addresses or steal files from TWTM data base, and nothing is sacred.

[luuknam]

Why I initially berated the mom for posting on Facebook was because of the potential harm to this child, not only now, but also future job and mate prospects. How many times has Facebook changed the rules on what is public and private? Obviously, mom is posting to long ago friends who the OP said she is. She is not limiting to just a close circle of trusted friends. And, who knows when Facebook will make public everything again until we go back and change our settings.

 

Even on this board, I cringe at what gets posted sometimes. While there is an anonymous overlay, a good sleuth could figure out who many people are IRL just by putting all the posts together. Add in a agency that can track IP addresses or steal files from TWTM data base, and nothing is sacred.

 

You do realize that unless you're running for president, people are usually not going to bother going through decades old stuff, right?

[ChocolateReignRemix]

Why I initially berated the mom for posting on Facebook was because of the potential harm to this child, not only now, but also future job and mate prospects. How many times has Facebook changed the rules on what is public and private? Obviously, mom is posting to long ago friends who the OP said she is. She is not limiting to just a close circle of trusted friends. And, who knows when Facebook will make public everything again until we go back and change our settings.

 

Even on this board, I cringe at what gets posted sometimes. While there is an anonymous overlay, a good sleuth could figure out who many people are IRL just by putting all the posts together. Add in a agency that can track IP addresses or steal files from TWTM data base, and nothing is sacred.

 

There is literally zero chance that a future employer will be able to track down something about a person based on a Facebook post a mom made when the person was 9.

 

News story? Possibly, but only if the name is fairly unique and someone is willing to scroll through pages of search results looking for it.

[swellmomma]

1. If this did happen, the counselor should be fired and not ever be allowed to work in a school system again. This goes so far into incompetence in her job that it should never be forgiven (as in to get another job in a school/not as in cleansing the soul). Someone with that poor a level of congnitive thinking and memory skills should not be allowed to work in her job.

 

2. I do have a problem with drs overprescribing these meds and prescribing them incorrectly. A dx is easy to get. I have btdt. I have friends who have btdt. I know several dc who have been on these meds, including one of my own, who should not have had them prescribed. Do some kids benefit from them? Yes, but there are many, many who are on them who should not be. One dear friend who lauded the medications and the dr who prescribed them because they did make her dd managable (ironically her praise of the dr was what persuaded me to take my dd there) is now one of the most vocal critics I know. Turns out her dd did not have brain chemistry problems, she had brain formation problems. The meds simply mad her...passive (best word I can come up with) and docile. She was weaned from the medications and hasn't taken any for over 10 years now. So, yes, there has to be a diagnosis, but that diagnosis can be received with little more than a conversation. I am personal witness to the ease with which these meds can be and are handed out. (Fortunately, I realized the ridiculousness of my dd's dx and the tremendous lack of investigation into her issues before serious medications were dispensed. I refused them after a brief attempt with using them. Most parents I have witnessed just keep taking the doctor's advice and add on more drugs forming a nice daily cocktail for their dc to take. It is very hard to follow your mama gut and forgo the professional's orders/advice.)

See I do not have the same experience as you for getting a kid on meds.  I had to fight tooth and nail to get Dx for my kids and get meds started.  EVen when they were outright failing at life due to the issues, the Dr's still wanted to put off prescribing them.  THe meds have not made them docile, or different people, but they do help them deal with all the crap that crowds out the everyday and allows them to actually focus on school work, and talk to people, and not have to be restrained due to violence (though even with meds that still happens sometimes).  THe use of meds turned my home for utter hell to merely chaotic.  And yes my boys are on cocktails, one more so than the other, and it has been a life changer for them, especially the one with the bigger cocktail.  He actually has a chance t a future not in prison thanks to the meds.  SO I am not quick to judge doctor's or parents for using them.  

[Orthodox6]

1. If this did happen, the counselor should be fired and not ever be allowed to work in a school system again. This goes so far into incompetence in her job that it should never be forgiven (as in to get another job in a school/not as in cleansing the soul). Someone with that poor a level of congnitive thinking and memory skills should not be allowed to work in her job.

 

2. I do have a problem with drs overprescribing these meds and prescribing them incorrectly. A dx is easy to get. I have btdt. I have friends who have btdt. I know several dc who have been on these meds, including one of my own, who should not have had them prescribed. Do some kids benefit from them? Yes, but there are many, many who are on them who should not be. One dear friend who lauded the medications and the dr who prescribed them because they did make her dd managable (ironically her praise of the dr was what persuaded me to take my dd there) is now one of the most vocal critics I know. Turns out her dd did not have brain chemistry problems, she had brain formation problems. The meds simply mad her...passive (best word I can come up with) and docile. She was weaned from the medications and hasn't taken any for over 10 years now. So, yes, there has to be a diagnosis, but that diagnosis can be received with little more than a conversation. I am personal witness to the ease with which these meds can be and are handed out. (Fortunately, I realized the ridiculousness of my dd's dx and the tremendous lack of investigation into her issues before serious medications were dispensed. I refused them after a brief attempt with using them. Most parents I have witnessed just keep taking the doctor's advice and add on more drugs forming a nice daily cocktail for their dc to take. It is very hard to follow your mama gut and forgo the professional's orders/advice.)

 

A diagnosis IS easy to get.

 

A correct diagnosis is NOT always easy to get.

 

Two family members endured ten years of misdiagnosis before different doctors "got it right."  We would have been foolish to reject the profession and the life-saving benefits of the correct medications, once they were in place.  

 

So I am agreeing with much of what you write, Lolly. 

 

My concern is with people who hear about professional mistakes, and/or who experience the same, and err by walking away from finding a solution available from the field of psychiatry. 

 

[Mergath]

Why I initially berated the mom for posting on Facebook was because of the potential harm to this child, not only now, but also future job and mate prospects. How many times has Facebook changed the rules on what is public and private? Obviously, mom is posting to long ago friends who the OP said she is. She is not limiting to just a close circle of trusted friends. And, who knows when Facebook will make public everything again until we go back and change our settings.

 

Even on this board, I cringe at what gets posted sometimes. While there is an anonymous overlay, a good sleuth could figure out who many people are IRL just by putting all the posts together. Add in a agency that can track IP addresses or steal files from TWTM data base, and nothing is sacred.

If any potential mates are evaluating this girl by reading posts made by the mom when the girl was nine, I'd say she's better off without them. I mean, who does stuff like that?