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The Lakeland Times | Minocqua, Wisc.

Jim Tait 02/01-02/28/17

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January 19, 2018

5/8/2009 8:04:00 AM
Northwoods' woman says risperidone killed her father
Case study: Bowman dies after showing classic Risperdal side effects

Richard Moore
Investigative Reporter

Risperdal kills.

That's the very simple, straightforward message one Northwoods' woman wants to spread to the world, and especially to Wisconsin residents: Risperdal kills, and Rhinelander resident Lisa MaKarrall says she knows because it killed her father.

One of the world's best-selling drugs, Risperdal, a highly controversial antipsychotic medication manufactured by Janssen Pharmaceutica, and its generic formulation have for years been popular among the medical establishment, used not only for FDA-approved treatments of schizophrenia, bipolar disorder and irritability associated with autism in children but for a broad array of "off-label" diagnoses such as deficit-hyperactivity disorder (ADHD), depression, anxiety, mood disorder, and aggression associated with late-onset dementia.

Especially in Wisconsin, doctors and nursing homes have continued to dispense the drug and other so-called atypical antipsychotics like it despite a 2003 FDA warning it could increase risks for diabetes and strokes, despite a 2005 FDA black-box warning that it could cause increased morbidity in elderly patients with dementia, despite a 2009 government report linking atypical antipsychotics such as Risperdal to an increased risk of cardiac death, and despite other studies showing the drugs to be no more effective and causing no fewer side effects than older atypical antipsychotics.

In 2005, FDA whistleblower Dr. David Graham estimated that off-label use of atypicals could cause as many as 62,000 excess deaths a year.

That's 170 deaths a day, and Rhinelander resident Lisa MaKarrall firmly believes that on June 19, 2008, her father, Bruce Bowman, became one of those casualties.

Cause of death?

The story starts about seven months earlier, in the early fall of 2007, when Bowman fell at home and was admitted to Taylor Park Nursing Home in Rhinelander for rehabilitation. The stay was short, though, and he returned home, only to fall again in early November of that year.

That landed him back in Taylor Park on Nov. 5, 2007, where he fell once more three days after arriving.

Even though those falls had occurred, and he had suffered a seizure in October, no one attending Bowman upon his admission to Taylor Park thought he had any potentially fatal condition. In assessments given Nov. 8, 2007, Dec. 15, 2007, Jan. 7, 2008, Jan. 29, 2008, Feb. 20, 2008, April 24, 2008, May 11, 2008, and May 15, 2008, assessors answered 'no' to the question: Does the patient have an end-stage disease with six or fewer months to live?

Yet, five weeks to the day after the May 15, 2008, assessment, Bowman was dead.

How did it happen? What killed him?

To the doctor signing the death certificate, Dr. John Frost, it was Marchiafava-Bignami, a rare disease associated with chronic alcoholism. But only several hundred cases have ever been diagnosed worldwide, and MaKarrall says her father wasn't an alcoholic and hadn't even had a beer in 10 years.

Bowman's records show conflicting reports about past known alcohol use, but even if he had the syndrome, it is certainly debatable whether that was the immediate cause of death. Bowman was in fact being treated with thiamine, a therapy that, with vitamin B-12, has proven to be effective in boosting recovery in those diagnosed with the syndrome.

Indeed, others viewed the immediate cause of death as that of MRSA pneumonia, possibly having progressed from aspiration pneumonia, which is caused by inhaling foreign material such as food, liquids, and secretions from the mouth into the lungs.

MRSA pneumonia was in fact the documented cause of Bowman's last admission to the hospital from Taylor Park Nursing Home.

That's important because increased deaths due to pneumonia in patients taking risperidone - the drug has been linked to aspiration pneumonia due to the swallowing difficulties it can induce - was one of the reasons the federal Food and Drug Administration issued its 2005 black-box warning about the risks of using atypical antipsychotics to treat elderly patients with dementia.

To MaKarrall, that just about says it all: Risperdal killed her father, she says, and she further points to documented physical symptoms her father suffered during the months he took risperidone as further evidence that his is a textbook case of risperidone death.

Whatever the accuracy of that claim, there is no doubt Bruce Bowman's physical symptoms, as documented in his medical records, are identical to the side effects that multiple studies have confirmed in others taking risperidone.

What's more, Bowman's records clearly indicate that risperidone was not fulfilling its prescribed purpose - controlling his aggression - and several medical personnel raised concerns about the effects of the drug on his health.

In the end, though, while prescribers periodically reduced the dosage or withdrew the drug for short stints, after which Bowman inevitably improved, time and again the medical community returned him to the medicine, and in ever-increasing doses.

Bowman timeline

In the months after Bowman entered the nursing home in November 2007, there's no question he became increasingly agitated. The question was why.

MaKarrall says one of the reasons for his distress, apart from being away from home, was his roommate, whom she described as "babbling nonstop," and the people Bowman ate with in the dining room, whom MaKarrall says also "babbled, cried and yelled."

As his anxiety grew, so did his aggression, and on Dec. 12, 2007, the nursing home started him on Risperdal. The next day, they also moved Bowman into his own room in an attempt to ameliorate one of the environmental, or nonpharmacologic, factors associated with his agitation.

On the face of it, those orders - a simultaneous effort to remedy the agitation with medication and with environmental solutions - would violate federal nursing home guidelines for administering antipsychotics for dementia, which call for environmental solutions to be exhausted before trying the drugs.

Risperdal and other atypicals are supposed to be drugs of last resort, in other words, not of first resort.

The Omnibus Budget Reconciliation Act (OBRA) of 1987 limited the use of psychotropic medications in residents of long-term care facilities, requiring that medical, environmental and psychosocial causes of behavioral problems must be ruled out, and nonpharmacologic management must be attempted, before psychotropic drugs are prescribed to nursing home residents, federal guidelines state.

For dementia, those guidelines call for the facility to first identify or rule out environmental or psychosocial stressors, to try medical or environmental solutions, and, if those fail, to give the drug - but only if it is needed to maintain functionality.

The nursing home should have been well aware of those guidelines. The February 2005 newsletter of the Wisconsin Association of Medical Directors, an association of nursing home directors, laid out them out explicitly.

"Before giving antipsychotic medication for disruptive behavior, CMS guidelines say facilities should try nonpharmacological management, which may include identifying other possible causes, such as boredom or pain; adjusting schedules to residents' behavior patterns, such as allowing a farmer to rise early; and offering activities specific to residents' abilities and needs," the newsletter states.

The newsletter cautioned that some behaviors, either those that were not persistent or caused by preventable reasons, did not qualify for antipsychotic treatment.

"If a behavior causes danger to the resident or others, or if uncontrolled crying, yelling screaming, and/or pacing impairs functional capacity, the use of antipsychotics may be appropriate," the newsletter stated. "By themselves, the following are inappropriate target behaviors: wandering, insomnia, poor self-care, unsociability, restlessness, indifference to surroundings, impaired memory, fidgeting, anxiety, nervousness, depression (without psychosis), uncooperativeness, and agitation not a danger to self or others."

Bowman's case: Justified or not?

At first glance, the nurse's notes from early December would seem to indicate a justified use of Risperdal.

In a Dec. 12 report, nurse practitioner Pam Thul-Immler reported that, five minutes into lunch, Bowman was focused "on peer," restless and moving away from the table. But she also reported that he had kicked his roommate in the calf, unprovoked, according to a nursing home staff member named Eddie.

All in all, to Thul-Immler, it seemed the right time for risperidone.

"New physical aggression to peers, generally frustrated and angry," she wrote in her assessment. "His risk for dangerousness is significant - both to self and peers. He has demonstrated anger toward roommate."

Thul-Immler recommended risperidone at .25 mg daily "for physical aggression to peers in context of dementia," and she said she had discussed that recommendation with Dr. John Frost, who had called in the order.

Interestingly, though, six days later, officials were looking at the kicking incident in an entirely different light. Now it was believed that Bowman had kicked his roommate accidentally after starting risperidone.

"The gentleman was believed to have kicked a peer one week ago," she wrote in her Dec. 18 assessment. "After investigation, nursing manager believes involuntary movements may have been the cause of Mr. Bowman's kicking out. Risperidone had been started 12/12."

So, in other words, if the follow-up investigation was true, the drug given to Bowman to control his aggression - risperidone can cause involuntary movements - was prescribed before officials perceived any danger of physical aggression, and was in fact the cause of it.

Indeed, the Dec. 18 chart review showed "no evidence of [physical aggression to peers] overall."

Nonetheless, that did not cause Thul-Immler to back away from the risperidone recommendation. She advised continuing the drug for four to six weeks while "the team" monitored whether it should be discontinued.

In actuality, the staff continued to increase the risperidone. After speaking with Thul-Immler, a nurse asked Frost in a Dec. 21, 2007, physician's communication if he would up the dosage because of Bowman's agitation toward a peer, which turned out to be his roommate, Bowman having been moved back into the nonprivate room that staff considered one of the causes of the aggression in the first place.

Frost did, to .25 BID (that is, twice a day rather than once a day), as well as "prn" (when necessary).

That apparently did the trick. The agitation subsided, but by Jan. 15, 2008, according Thul-Immler, Bowman was restless.

"His physical aggression has not recurred, but he has daily marked restlessness and yelling that respond variably to meeting his needs and redirection," Immler wrote in her consultation report Jan. 15.

So, even though the physical aggression that might not have been physical aggression in the first place but a risperidone side effect was absent, and though the patient had been responding in part to environmental solutions, and though risperidone is not considered an appropriate drug with which to target restless behavior, that's exactly what Thul-Immler's report states she did.

In fact, she recommended ramping up the dosage even more. The physician order sheet for that day shows an increase to .5 BID for dementia and physical aggression.

"Advance risperidone to .25 mg tid (from bid)," she wrote in the recommendations section of the report, meaning to three times a day. "In 1 week, if still restless and no significant orthastosis may increase risperidone to .5 bid."

By Jan. 29, however, Thul-Immler concluded, the risperidone wasn't working very well, and she began to tie Bowman's outbursts to an anti-seizure drug, Keppra, which he had been taking since suffering a seizure in October 2007.

"Mr. Bowman has responded poorly overall to risperidone for his physical aggression/outbursts secondary to dementia," Thul-Immler wrote in her Jan. 29 report.

She then noted that Bowman "may well be having neuro/cognitive agitation to Keppra (literature cites greater than 10 percent of cases)," even though the drug had kept him seizure-free.

In fact, the percentage is 13 percent, and that number sent Thul-Immler back to the doctors to discuss the possibility of an alternative anti-seizure medication that might also stabilize Bowman's mood.

She repeated her concerns on Feb. 5, 2008: "I remain concerned that his Keppra 500 mg bid may be contributing to agitation, outbursts and recent physical aggression," she wrote. She again mentioned that a "call had been place to Dr. Pallagi" to discuss an alternative medication.

Thul-Immler also suggested that changing Bowman's environment might help.

"I support a smaller supervised environment for meals as this is the setting where a number of intrusive behaviors have occurred," she wrote.

That same day Bowman was put in the so-called Diner's Club, a small lounge with two other people. By the end of March, Thul-Immler reported, the Diner's Club switch was helping.

In her March 5 report, Thul-Immler stated that she had finally discussed an alternative seizure medication with a doctor on Feb. 14, and he had in fact approved an alternative drug. Overall, she wrote, Bowman appeared physically healthy.

"Mr. Bowman continues with occasional unpredictable explosive episodes on Keppra with no evidence for medical illness, slight weight loss," she wrote.

Meanwhile, the risperidone flowed on at the higher dosage level of .5 bid.

Risperidone side effects?

If Bowman's aggression was improving, he physical abilities were not. He began to have trouble walking and swallowing. He fell in late February, and tore the skin on his hand in March, and, then, on April 24, he choked on a cheese sandwich, suffering severe aspiration.

Bowman was rushed to the emergency room.

The inability to swallow and aspiration are classic side effects of risperidone, and that did not go unnoticed on April 24. In addition, the nurses' notes of that incident state that Bowman was unable to chew or speak.

"He was making chewing movements with no speech or air exchange," the notes state, and an evaluation of the incident signed May 2 cited Bowman's tongue pumping - all classic and acknowledged side effects of risperidone.

That risperidone could be the culprit also did not go unnoticed in the emergency room on April 24. After returning him to Taylor Park, doctors discontinued the drug.

Without Risperdal, Bowman's physical improvement was immediate, MaKarrall says.

"We - his family - noticed a big improvement in his ability to talk, his hands straightened out, he was alert, happy, laughing and smiling," she says. "He also ate and drank with no problems swallowing and was able to hold his own drinks."

The nurses noticed improvement, too. Over the next several days, off the Risperdal and on a pureed diet, the nurses' notes indicate a palpable change for the better. His coughing stopped. He wasn't choking.

By April 30, he started to regain his speech. The notes don't say that explicitly but they do acknowledge he was talking again: "Stated he doesn't like the texture of his food," the notes state.

Thul-Immler noticed improvement, too.

"Since (discontinuing risperidone), no recurrence of aspiration, and level of alertness, interaction have improved," she wrote in her April 29 health consultant recommendations.

At the time, doctors were planning to reduce Keppra and replace it with Lamictal to deal with the reactive aggression, but, in the meantime, she asserted in her April 29, 2008, report, "if recurring agitation/aggression occur, consider advancing memantine (a relatively new Alzheimer's drug)."

Nowhere in the April 29 recommendations does Thul-Immler recommend restarting risperidone. In fact, she stated, the goal was exactly the opposite, which she hoped would be possible with Keppra's replacement.

"Goal of psychotropic med treatment was/is reduction of antipsychotic after Keppra," she wrote.

The slide goes on

Unfortunately for Bowman, though his physical and mental condition might have improved without risperidone, his emotional distress was on the increase: The nurse's notes during this period indicate "increased agitation" and aggression toward staff.

On May 3, 2008, he was screaming profanity in demanding that he be removed from the noisy dining room, where staff had apparently returned him. On May 4, personnel moved him again to the quieter lounge area, where, as he had before, he "ate well and had no agitation."

Then, on May 8, 2008, doctors OK'd a restart of Risperdal "as long as it is a small dose," the nurses' notes state.

"He was sent to the Emergency Room, came back with his Risperdal discontinued," writes nurse Beth Ann Walton of her nursing home visit May 8. "He seemed to perk up a bit, was a bit more interactive with the staff, but now in the past week, he has become more agitated and in the last day or so, he has started to exhibit some physical aggression toward staff, as well as targeting his roommate."

The plan would be, she said, to restart Risperdal at a lower dose - .25 mg daily, with an additional .125 dose available as needed in a 24-hour period for agitation and aggression - and, on May 12, to begin decreasing the Keppra.

As soon as Bowman was back on the Risperdal, MaKarrall said, her father's physical condition deteriorated immediately, and he again began to exhibit classic symptoms of risperidone side effects.

"Shortly after starting back on the Risperdal, dad started having a hard time again swallowing, talking, his hands went into claw-like positions, he was zombie-like, drooling and coughing all the time," MaKarrall says.

Meanwhile, the smaller Risperdal dose appeared not to work. Nurse notes indicate Bowman continued to show aggression on May 11, May 12, May 13, and May 14. Staff apparently tried to manage the increased aggression by increasing both Lamictal and Keppra.

As the days ticked by into late May, Bowman now had other problems. Following the Risperdal restart, he began to fall. He fell on May 11, and he fell again on May 15 after attempting to self-transfer from his bed. Later that same day, he was found lying on the floor, and a wheelchair alert was issued.

He was again found on the floor the next day.

In late May, as nurses noted Bowman's aggression, they also maintained risperidone dosage. On May 28, 2008, for example .25 risperidone was given prn (when necessary).

Just three weeks after Walton had ordered risperidone restarted, she returned for another visit, on May 29, and found Bowman had rapidly deteriorated and now was experiencing a possible dystonic reaction, which is an adverse motor effect that often occurs shortly after narcoleptic drug therapy and is characterized by intermittent spasmodic or sustained involuntary contractions of muscles in the face, neck, trunk, pelvis, and extremities.

The most common causes of drug-induced dystonic reactions are antipsychotics and antidepressants. At the time, Bowman was not taking any anti-depressants.

"He was showing some upper body rigidity Tuesday, but yesterday and today it has become more pronounced," Walton wrote. "Staff has asked me to see him. He is able to swallow by taking in very small amounts. His upper body is rigid with his neck thrown back in a rigid sort of movement."

Walton contacted Frost, she reports, "as this is a fairly significant change in his condition, wondering if this is related to his neurological illness or a possible medication reaction. I did not see via the literature that the Keppra or Lamictal would cause reactions."

Just the opposite, in fact. Keppra is an anti-Parkinson's agent that has been used in some cases to treat dystonic reactions. Even so, Walton reports, after talking with Frost, they decided to decrease the Keppra. She does not mention decreasing risperidone.

Ultimately that day, she dispatched Bowman to the emergency room. There, though, doctors refused to admit him. Instead, in consultation, they determined him to be "terminal" and ordered Bowman returned to the nursing home "with care, comfort, dignity and respect," according to the emergency room report that day by the attending physician, Dr. Peter Zenti.

Likely role

Not everyone missed risperidone's likely role in Bowman's dystonic distress.

On the following day, May 30, Frost ordered all risperidone stopped and Bowman's primary care team acknowledged the drug's probable part in Bowman's deteriorating situation.

"Mr. Bowman has developed an acute dystonia, likely multi-factorial - underlying disease and sensitivity to dopamine blockade of risperidone," Thul-Immler wrote of Frost's and Walton's May 30 assessment.

What no one mentioned was the fact that Bowman probably had something else - aspiration pneumonia, an acknowledged side effect of risperidone.

After he was returned to Taylor Park, Bowman's family visited, and MaKarrall says they were shocked at what they found two days later, on May 31.

"Upon coming in, we saw dad lying flat in bed, pants around his knees, door wide open, no privacy screen and burning up with fever," MaKarrall said. She insisted he be admitted to the hospital.

Personnel again returned Bowman to the emergency room, and this time Dr. Christopher Koeppl found an infectious disease.

"He has had further difficulty with swallowing and swallowing study revealed aspiration, his diet has been adjusted accordingly," Koeppl wrote in his emergency room report of May 31, 2008.

His first diagnostic impression? Right upper lobe pneumonia, "possibly aspiration type." Koeppl started Bowman on Class IV antibiotics and admitted him to the hospital. Further testing revealed MRSA pneumonia.

Bowman remained in the hospital for six days before returning to Taylor Park with a diagnosis of pneumonia and a prognosis of death. There are conflicting records of what medications Bowman received in the two weeks he had left to live, but officially he was off the Risperdal.

But the pneumonia did not improve, and Bowman continued to weaken.

On June 19, 2008, doctors pronounced Bruce Bowman dead. Written on the form releasing his body to a funeral home was a specific malady: MRSA pneumonia.

Did Marchiafava-Bignami kill Bruce Bowman, as his death certificate states? Did MRSA pneumonia kill him? Did the MRSA stem from risperidone-induced aspiration or aspiration pneumonia? Those are obviously debatable questions. What's not debatable are the timeline and symptoms Bruce Bowman's record reveals.

To MaKarrall, who is still seeking to have the cause of death changed on the death certificate, the record is convincing enough that her father suffered a risperidone overdose.

"Let's just say that a doctor in Rhinelander was right diagnosing my dad as the 151st person in the world with Marchiafava-Bignami," she says. "That doesn't cause trouble swallowing or rigidity. Only Risperdal does. That's why the FDA does not approve its use on dementia patients."

Next: The state's medical consent forms - what Bruce Bowman's family was told - and wasn't.

Reader Comments

Posted: Wednesday, July 5, 2017
Article comment by: Sharon Cappella

Unfortunately, this story does not surprise me at all but instead sickens me with its familiarity. I am convinced that my 80-year-old mother died in 2014 from complications--not due to the "mild stroke" she suffered in 2013--from MEDICATIONS. Most notably were high doses of Xanax which almost killed her from the mania it caused--landing her in a Yale-New Haven Hospital SOMA bed while she withdrew from the drug like a frightened, angry animal. Then Keppra--administered to her for the seizure caused by Xanax and never again to be withdrawn, despite it causing her to lose motor coordination and drool profusely. And if those were not enough, she landed in YNHH one year and three months after her stroke from the nursing home which sent her there for "agitation" (i.e., fighting back against and hitting nurses who mistreated her and tried to forcibly administer medication to her). At YNHH, she was prescribed--without the consent of her conservator (me)--by an APRN risperidone, the anti-psychotic meant only for the treatment of severe mental illness and its uncontrollability. But despite the black-box warning issued against the drug for use on elderly patients due to its high mortality rate in the elderly, those with dementia, and those with BRAIN DAMAGE SUCH AS THAT CAUSED BY STROKE, she would begin a rollercoaster ride with this drug for the next eleven months leading up to her incapacitation, wheelchair-bound and barely functioning, and death. Despite my taking her home and weaning her off risperidone under her doctor's explicit care, she contracted the earmark aspirating pneumonia classic to the drug's vast array of deadly side effects. Back in the hospital and released to nursing homes, one and then another and another served her more and more drugs, diagnosing her with "dementia" which had not at all been present upon the onset of her stroke, from which her doctor said that she was recovering. In short, risperidone, along with Xanax and Keppra, caused the vast array of deadly side effects in her, leading to her death in May of 2014. These side effects included: confusion, agitation, constast and uncontrolled drooling, tardive dyskinesia (a loss of motor control resulting in involuntary muscle movement, as described to have been suffered by the poor man in the article), loss of clear speech the recovery she had been making from her aphasia, inability to swallow, aspirating pneumonia, slowed mental ability, decreased alertness, inability to keep her balance or retain strength to walk, an almost catatonic wakefulness toward the end, and finally a drop in blood pressure leading to her death. This from a woman who, AFTER her stroke, came with a friend and me to Denny's to eat normal dinners, played Scrabble with us, formed words by herself, went through informal speech therapy to speak more clearly--despite pre-stroke hearing loss, walked into the New Haven Greenhouse on her own, and went out and about a normal daily routine, just months before. There is no question in my mind--and the minds of my friends who were with her, too--what killed her. And I intend to write more about this to help spread the awareness of this horror. Those on this page seem to know what I know well and this must be told in order to prevent the senseless deaths of the defenseless elderly and others to carelessness and malpractice and medication--rather than to illness or old age. Thank you for letting me speak my piece.

Posted: Wednesday, May 6, 2015
Article comment by: shane clauer

I was forced 6 resperidone shots and I was tortured physicaly and mentally and I am dying from it. Beetown, WI

Posted: Thursday, November 18, 2010
Article comment by: Jeanie McCormack

I can't believe the story I have just read. My husband was admitted to a nursing home in Australia 16th June 2008 for Dementia that he developed after cardiac bi-pass surgery in November 2004. It was a couple of years before we associated the surgery with his dementia as at first he was diagnosed with and treated for depression and was only diagnosed with Dementia in May 2007. He also had seizures after this but I can't remember the drug he was given for this. (I could find out). I did not make the decision to admit him, it was actually my two daughters who had Power of Attorney who did this as they said I obviously wasn't coping. I admit I was finding it very hard caring for him at home but have regretted this fact every day since he was admitted to the nursing home and especially every day since he died there not long after. After being admitted to the nursing home he became more aggressive (he had started to show signs of aggression before he was admitted and was not allowed back at the respite centre he had attended twice a week). I received a phone call telling me that an ambulance had been called to take him to the Gold Coast Hospital for reassessing and he would have a police escort as he was considered dangerous. In the emergency dept I met him and we were told to wait in a room until a doctor could assess him. (I later saw a security officer standing outside the room but didn't know he was there at first) My poor husband was beside himself with anxiety and fear saying that he just wanted to go home and would I look after him and we would stick together and not let them do anything to him. The resident doctor actually said there wasn't anything wrong with him and he was to go back to the nursing home. However, they refused to have him and I was asked would I take him home. I said yes but someone higher up decided that this wasn't appropriate and the nursing home had to take him back. Eventually I drove him back to the nursing home (even though he had gone by ambulance and police escort to the hospital. On arrival the staff were most definitely not happy to have him back and stated that they would just have to whatever measurements they could to ensure that he did not harm the staff again (apparently he had punched one nurse as she tried to give a sponge bath, a fact that we often wondered why they did this when on booking him in we had stated that he liked to have a shower every morning. This rarely happened. It was then that they started him on risperidone. We were shocked the next time we visited as was like a zombie and mostly slept all the time. After several months like this his condition deteriorated and he started having falls and eventually couldn't walk, talk or swallow. He did aspirate a couple of times and became quite ill and I was called at work on the Thursday afternoon before Easter 2009 by my distraught daughter saying the doctor was there and he demanded to know whether we wanted to have a peg tube inserted into his stomach or would he commence morphine. I rushed there straight away and because two of my daughters are registered nurses they, and the nurses in the nursing home, advised against the operation I agreed to start him on morphine. We requested that they wait until I collected my son from the airport (he is in the RAAF and originally wasn't even coming home for Easter but I had rung him only a few days before to say I thought he should come home at his father was going downhill.) It was all still a big shock to all of us that it had come to this so soon as my knowledge of nursing home patients meant that they could linger there for years (my grandmother lasted 10 years) and we thought that he would do the same. We all said our goodbyes to him that night and after we left they commenced morphine. He lingered for four days before eventually passing away at 2345 on Monday night 13th April 2009. We all stayed with him for the four days and it seemed like he was squeezing every minute out of the holidays before finally giving in. We have all been wracked with guilt ever since at having him admitted in the first place and then wondering if we had hastened his death as we had read that risperidone could advance death in dementia patients. Even now 21 months later I still feel that I should have been able to care for him at home and he would still be alive if only he hadn't been admitted to the nursing home.

Posted: Thursday, February 18, 2010
Article comment by: julie sione

We are in the investigation stages of a class action lawsuit involving non FDA approved Risperdal/Risperidone use in elderly patients with dementia. Any information provided is extremely helpful. In CA, OR and/or AZ right now but may branch out to other states.

Posted: Tuesday, July 21, 2009
Article comment by: Jake Kurt

About 10 year's ago in Edmundston been given to me dose of 1mg.That day I came home,I diden't took 1mg that day(I break madication in to 4 pieces and iI took smallest.It reacts quick,You freez,rapid hart beep,can't swallow,bonne dry mouth(need to drink water,8 glasses between dry to flushed untill in the morning)-About 10 yrs.later here in Fredericton hospital whithout my consent been mixed in to my apple juice & I only sipped 5ml.I HAD SAME SYMPTONS.Key point is i only tooked Apo Lorazapem last 10 years only one ocassion Risperidon.Yes Risperidon will kill you if you dont have the sikness & wrongfully given to you.Regards.Now Im working on with gv. to remouve that entry from my madical history which can leed my deaths.

Posted: Wednesday, June 3, 2009
Article comment by: Lisa MaKarrall

Anyone who would like to contact me regarding similar reactions to Risperdal...especially in the elderly, my email address is lmakarrall@yahoo.com
Lisa MaKarrall

Posted: Thursday, May 28, 2009
Article comment by: Susan Hatzel

I am in New York.
I don't know what to say after reading this article - my father died on Saturday a few weeks after starting on Risperdal. He stopped eating and drinking (not swallowing) and became non responsive. I raised all the concerns with the doctors who said that risperdal was used all the time and the warnings only applied to long term use.

I am not sure if risperdal killed my father. He was hallucinating before he started on it, though the later neurologists involved said they thought Alzheimers was a misdiagnosis since the onset was so sudden and severe, and their diagnosis was toxic delirium. After risperdal, he seemed like he was dying. It is a long story, two hospitals, one nursing home, many doctors. Later he was changed from risperdal to seroquel, which I believe is in the same class and has the same warnings about the elderly. Klonopin and ativan were also used. He had never been on those type of meds before.

What can I do? Can I get in contact with this family member you mention in the article? Are there action groups?

It is a terrible feeling that even though we advocated so hard for him the doctors still did as they wanted and maybe that's what killed him.

Posted: Wednesday, May 27, 2009
Article comment by: justin

hi, i was taking risperidone and i think i got type 2 diabetes from it i was wondering if there was a way of starting a lawsuit or if you already have, could you in some way help me.

Posted: Wednesday, May 27, 2009
Article comment by: risperdal


Posted: Thursday, May 14, 2009
Article comment by: Lisa MaKarrall

I do agree with Erin that families have to be proactive. My family also had a Guardian in place. However, unfortunately I wasn't able to piece together most of my Dad's puzzle until after I was sent his files from Ministry Medical, Saint Mary's Hospital and Taylor Park. We have not yet recieved all of them after requesting them several times from all the above places, even though they are violating HIPPA laws by not sending them.
Every single family that signed a Medication Consent Form from 2005 on, who had a family member at Taylor Park who was given Risperdal, was given false information. Since they are both under the same Corporation, this might even include patients at Friendly Village. (not sure of that) I was told by several of the RN's out at Taylor Park that the dementia ward had been blanketed with this drug for years. How many patients do you think have died at Taylor Park because of this drug? The lucky ones died suddenly of a stroke or cardiac arrest and their families will never know the drug killed them. The unlucky ones like my Dad suffered a horrible death after aspirating and contracting pneumonia from his throat closing due to the Risperdal. My family suffers from guilt that we didn't do more to protect him. Again, how many elderly people out there die of pneumonia?
One thing Richard's articles didn't mention is that no one even knew about the Black Box Warning out at Taylor Park until June 10th, when I met with all the head staff and a representative from their corporate office out there and showed them the research that I had done. In other words, none of the nursing staff was trained to recognize the side effects of the drug. They gave him several swallowing tests all the while feeding him the drug causing his difficulties. If my concerns had been addressed then, this would have ended things right there. At the time of that meeting my Dad had already been issued a death sentence having contracted MRSA pneumonia. Hospice was set up before he left the hospital, that was the shape he was in. But, even though it wouldn't help my Dad, I had become so attached to some of the residents out there that I couldn't leave them at the mercy of this drug.
Then the buck passing, lying, and butt covering began on just about every agency and medical professional's part that I contacted. Believe me I didn't miss many in this state and at this point I still have no idea who will help put a stop to this drug.
I'm certainly not satisfied with the legislation Dan Meyer's office is working to get passed, requiring mandatory updated Medication Consent Forms. Having said that, outside of Richard Moore and Gregg Walker at the Lakeland Times, Dan Meyer's office was the only one that listened and didn't blow me off. I don't know what I would have done without Tim Fiocchi and Jennifer Western from Dan's office and they will always have my deepest thanks. But, in most cases the DHS (not that I trust anything that has come out of that office) only visits the nursing homes once a year. I want this drug to stop being given to dementia and Alzheimer's patients, period. It's not effective and there is too much risk.
Once the DHS started investigating my Dad's case they found out these issues were statewide problems. But almost a year later, no one has put a stop to this, due to greed, covering mistakes, influence and money from the drug companies, or the complete lack of caring for the elderly...I'm sure they all have a reason. Where is the outrage? Why is it that we have heard about nothing but the Swine Flu in the last few months from the same people who have known for almost a year that thousands of elderly people in nursing homes in this state have probably died because of Risperdal. Maybe if my Dad and the people out at Taylor Park had contracted the Swine Flu the DHS and law makers in this state would have paid attention. Or if they had been pets that received tainted pet food from China it would have made national news in days and the product poisoning them would have been pulled off the shelves just as quickly.
My Dad and all the other residents that have gone through the nursing homes in this state and others, have paid taxes all their lives to support the jobs of the people that are supposed to be protecting them. These are the first lines of the Dept of Health Sevices Mission Statement:OUR MISSION
Protecting and promoting the health and safety of the people of Wisconsin
Assure the health, safety, and well-being of Wisconsin citizens while emphasizing prevention.
Make Wisconsin a national leader in reforming health care.
Improve the lives of Wisconsin seniors and people with disabilities.
So could someone please tell me again why absolutely nothing has changed across this state in regards to this issue after almost a year? Dan Meyer's office can only do so much and is limited when it comes to the medical aspects. That is the duty of the Dept of Health Services.
Many people have dropped the ball on this, but the question should be now that the truth is out there who is going to pick up the ball? I want everyone to know that I have forwarded these articles to Congressman Obey's office, Senator Feingold's and Kohl's offices and Governor Doyle's office. I will let Richard and the Lakeland Times know if I hear anything.
I also sent these articles to CNN and Oprah this morning and to Senator Grassley's office the other day. I'm thinking I might hear from them sooner than I hear from anyone in this state.
This weekend will find me sending them to other news organizations nationwide until someone pays attention. Thanks to Richard Moore for the great job he did on these articles and all the research and hard work he put into this.
I will keep him posted on any new information so he can do some updates in future editions. Keep the comments coming as I feel better reading them. Lisa MaKarrall

Posted: Wednesday, May 13, 2009
Article comment by: Kay Samz

What price do you put on life? Who pays the price? The elderly in the nursing homes on medications they or their families know anything about. They depend, along with their family, on the knowledge of that facility for the care, both medical, physcial and mental. The family, from beginning to the end along with the patient, are completely dependent upon the information given throughout their stay. Who spends the most time with your family memeber, the nurses. Yet in the bill that is going to be presented in Madison CANNOT make it a law that the nurses giving the meds along with the nurses or anyone caring for your loved one, must be trained to reconinize side effects of medications. How sad. Only the Department of Health in Madison can do that. If they, the DSH can't do their job keeping the paper work updated about black box meds,do you really think that they are going to see that your family member is being and you are being educated and watched for adversed side effects? Think again. I saw first hand, how Bruce Bowman went into the nursing home WITHOUT a death sentence and ended up dying from the use of a drug that had a Blackbox warning. Rich, I thought you did a wonderful job on the articles until the last one. What came to me was: You made a wonderful wonderful cake. When it was time to frost it, you left something out. I was left with the impression the story ends with the statement that its alright to use risperdal. Where are the human ties that goes with the care and death of a loved one? How was and is the effect of losing someone to a drug effecting the family? The law? The Family? Educating? The rebate to the state for using drugs from the companies? Could some of this be the missing ingredents in the frosting? The patients I saw, with the same side effects sitting in their wheelchairs were soon gone? I often wonder if their families had the correct and current information needed so they wouldn't have to lived with the "What happened question and they went so fast statement." I hope you have a continuation of your investigation into both the Madison end and the nursing home end of the laws and disburstments of meds. Hopefully someone out there will have the power and insight to change the laws pertaining to med and hold accountable those that are responible for tradgities such as Bruce.

Posted: Tuesday, May 12, 2009
Article comment by: Erin

This is a sad story, but this should also be a REMINDER to be PROACTIVE in your loved ones care. If you do not agree to the treatments and they are unhappy, then maybe it is time for a transfer and a new physician. Also another reminder, have "Advance Directives" or a Power of Attorney in order so you have the power to do these types of things if needed.

Posted: Monday, May 11, 2009
Article comment by: Mary Connor

Having seen what this drug has done to my daughter, I certainly believe that it was the cause of his death. Is it a case of the Emperotrs new drugs that in spite of the adverse effects and the lackof any benefits that they continued to give this drug. As it is all experimental any way, why persevere with a failed (dangerous) experiment? Why not try anopther drug? First do no harm!

Posted: Saturday, May 9, 2009
Article comment by: Joe

A riveting series. One can't help wonder if Rispirdal was used to control Mr. Bowman rather then treat him. As a NAMI member it is now clear that NAMI Executive Director Laurie Flynn's 1997 statement was unrealistic to say the least, "The introduction of atypical antipsychotics as first-line medications represents an unrivaled turning point for the more than five million Americans suffering from the most debilitating brain disorders."(1) So much hope, funding and focus was subsequently lavished on the atypicals to the exclusion of other services and supports historically in short supply. (1)www.nami.org/Content/ContentGroups/Press_Room1/19971/December_1997/New_Atypical_Antipsychotic_Drugs_Recommended_As_First-line_Medications_For_People_With_Serious_Brain.htm

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