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‘Emergency’ action took 4 yrs.

By Carol Gentry
5/10/2010 © Health News Florida
Four years ago, the Department of Health was warned that psychiatrist Steven L. Kaplan was dangerously overmedicating children, state records show. DOH got around to filing an "emergency" suspension of Kaplan last week, three years too late for one little boy.

The emergency suspension order by State Surgeon General Ana Viamonte Ros released late Friday makes no reference to the warnings about Kaplan that it received from the Agency for Health Care Administration's Medicaid unit in May 2006. The order says it received a complaint about Kaplan in November 2009 and began its investigation at that time.

The DOH's emergency order does not name the patient beyond his initials, but the circumstances make clear it was Denis Maltez, an autistic boy who lived in a state-licensed group home for foster children called Rainbow Ranch. He was Kaplan's patient for a year before dying at age 12.

As the Miami Herald reported last month, three agencies -- AHCA, the Department of Children and Families, and the Agency for Persons With Disabilities -- all voiced concerns about Kaplan's prescribing practices for years but no action took place as Kaplan continued to prescribe for hundreds of children in foster care.

The state Medicaid program acted only after the Herald report, removing Kaplan as a provider effective next week.

The Herald report, based on documents that became public in a lawsuit, indicates that DOH knew about Kaplan in 2008 but didn't act. It turns out that DOH knew about Kaplan much sooner than that -- a year before Denis died.

Records provided by AHCA show that the Medicaid Program Integrity Office notified the DOH Division of Medical Quality Assurance in writing on May 12, 2006 about problems with Kaplan's "prescribing habits" as they pertained to "antipsychotic medications for Medicaid recipients/patients."

A low-level staffer at DOH wrote back on May 26, 2006 asking for medical records, consultants' reports and any other documents that would be helpful. 

Tiffany Vause, a spokeswoman for AHCA, told Health News Florida last week that those records and reports were provided at the time.

However, it was a full year later --only a few days before Denis died, in fact -- that a medical malpractice investigator for DOH notified AHCA that an investigation had been initiated.

The complaint was dismissed a year later, apparently, although none of that is mentioned in the emergency order.
DOH does not discuss complaints in which no "probable cause" is found by a committee of the Board of Medicine. Officials at DOH say the law does not permit them to do so.

A phone call to Kaplan's office upon the release of the suspension order was not returned. Health News Florida has asked DOH to explain how the agency will justify issuing an "emergency" suspension order on events that occurred in 2006.

--Carol Gentry, Editor, can be reached at 727-410-3266 or by e-mail.