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Case involving death of autistic boy may end quietly

A Miami psychiatrist accused of overmedicating a 12-year-old boy who died may walk away from the long, strange case on Friday without any major penalty.

Dr. Steven Leslie Kaplan and state officials have agreed to settle the complaint against him with a $5,000 fine, a couple of short courses and a “letter of concern.” No probation, not even a reprimand  – nothing strong enough to trigger a report to a federal disciplinary-action databank.

It’s up to the Florida Board of Medicine whether to accept the settlement. The Department of Health, which investigates and prosecutes cases before the board, has filed documents asking for a "yes" vote because DOH doesn’t think courts would accept anything stronger.

After all, the First District Court of Appeal already threw out an emergency suspension order that DOH issued in May 2010. Dr. Ana Viamonte Ros, then-secretary of DOH, issued the suspension soon after The Miami Herald published a long article about the death of Denis Maltez, a child with severe autism living in a group home.

When Kaplan took over Denis’ case, he continued adult-strength prescriptions for two anti-psychotics, a tranquilizer and a mood stabilizer that can be dangerous, but records suggest he rarely saw the child. Three agencies raised concerns that Denis was overmedicated but the regimen continued.

After Denis’ unexpected death in May 2007, the medical examiner attributed it in part to overmedication. However, an expert who reviewed the case for DOH offered a different opinion.

Tampa forensic psychiatrist Emily Lazarou wrote that while Kaplan’s treatment of Denis fell below the standard of care in several respects, including his medication management, she didn’t think this caused Denis’ death. Her report did not say what she thought the cause was.

In quashing DOH’s emergency suspension of Kaplan just a few weeks after it was issued, the appellate court said such an order is justified only if there is an “immediate danger to the public.” If there had been an immediate danger, the court said, DOH should not have waited three years to file a suspension.

Indeed, as reporter Carol Marbin Miller wrote in her article, the State Medicaid program had asked the licensing authorities to investigate Kaplan in 2008, but the complaint was dismissed.

Even if the medical board accepts the proposed settlement without seeking harsher penalty, Kaplan will not have escaped unscathed. He paid a $1-million settlement to Denis’ mother, records show, as well as five years' worth of attorney’s fees.