On February 18, 2009, Attorney General Jerry Brown announced the arrest of a nurse, physician and a pharmacist of a skilled nursing facility operated by the Kern Valley Healthcare District in Lake Isabella, Kern County. All were charged with elder abuse for forcibly administering psychoactive medications for their own convenience and for causing the deaths of three residents.
Facing criminal charges are Gwen Hughes, the former director of nursing, Debbi Hayes, the former pharmacist, and Dr. Hoshang Pormir, a staff physician and the facility's medical director. Hughes and Hayes are also charged with assault with a deadly weapon.
The allegations are reminiscent of One Flew Over the Cuckoo's Nest. Gwen Hughes, the former nursing director, is reported to have ordered staff to inject numerous residents with powerful, dangerous antipsychotic medications without any medical justification. According to the charges, groups of staff held down at least two residents and injected them with drugs that reduced them to a zombie-like state. In addition to the three deaths, other residents suffered severe medical and psychological trauma. When drugging triggered behavioral problems, even stronger drugs were ordered and administered. Many residents and family members were not informed that psychoactive drugs were being used.
The year-long investigation by the Attorney General's office was triggered by a Department of Public Health investigation in January 2007 that first documented the widespread drugging and brought a rare finding of "Immediate Jeopardy."
"These people maliciously violated the trust of their patients, by holding them down and forcibly administering psychotropic medications if they dared to question their care," Attorney General Brown said. "This is appalling behavior, which amounts to assault with a deadly weapon."
"Deadly weapon" is an apt description of antipsychotic drugs when used in this fashion. The U.S. Food & Drug Administration (FDA) has issued its most dire warning – known as a black box warning – that antipsychotic drugs cause elders with dementia to die. Although the FDA has never approved use of antipsychotic drugs to treat dementia, it is estimated that up to 40 percent of nursing home residents with dementia are subjected to antipsychotic drugs, such as Zyprexa, Seroquel, Risperdal and Haldol.
The Attorney General's action closely follows a landmark settlement by the U.S. Department of Justice (DOJ) on January 15, 2009 of criminal and civil charges against Eli Lilly for illegally marketing Zyprexa to doctors for unapproved use by elders and children. The company agreed to pay a record $1.415 billion in criminal and civil penalties.
The U.S. DOJ accused Eli Lilly of targeting its illegal marketing of Zyprexa to doctors who treat the elderly in nursing homes and assisted living facilities. According to DOJ, Eli Lilly did so despite lack of FDA approval for this purpose and known severe side effects for this population. Reportedly, Eli Lilly promoted use of Zyprexa by claiming it would help facilities sedate residents who would otherwise require more care.