Boston Globe Article: Kin sue Harvard over son’s suicide

Parents Forum
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<p>"Harvard sophomore John Edwards was studying to become a doctor and training for the Boston Marathon in June 2007 when he sought help at the university’s Health Services because he could not study for as many hours as some of his friends.</p>

<p>A nurse practitioner prescribed a drug to treat attention deficit hyperactivity disorder, a condition the overachieving Edwards had never been diagnosed with. Later, she prescribed two powerful antidepressants, Prozac and Wellbutrin, when he began complaining of anxiety, depression, and other side effects. Meanwhile, he was taking a fourth drug for acne, Accutane, that has been linked to suicidal thoughts.
“The Wellbutrin is having the effect that we were seeking . . . but unfortunately I feel like it has canceled out the anxiety-reducing effects of the fluoxetine [Prozac], as recently I’ve been pretty nervous,’’ Edwards wrote in a Nov. 27, 2007, e-mail to the nurse practitioner, Marianne Cannon. “Let me know if I should schedule to come in and meet with you soon, or if I should change the med plan.’’</p>

<p>Cannon replied that she was concerned and told Edwards to schedule an appointment with her. Two days later, Edwards, 19, of Wellesley committed suicide in a bathroom at Harvard Medical School by suffocating himself with a plastic bag.</p>

<p>His father, John B. Edwards II of Wellesley, filed a suit Wednesday in Middlesex Superior Court alleging gross negligence by Cannon; Dr. Georgia Ede, who was the doctor who supervised her; and Harvard College, for causing his son’s wrongful death…"</p>

<p>Link to rest of the article:
[Kin</a> sue Harvard over son’s suicide - The Boston Globe](<a href=“http://www.boston.com/news/local/massachusetts/articles/2009/12/04/kin_sue_harvard_over_sons_suicide/]Kin”>http://www.boston.com/news/local/massachusetts/articles/2009/12/04/kin_sue_harvard_over_sons_suicide/)</p>

<p>I read this article in the Boston Globe this morning and it got me to thinking about how, as parents, we should address our college students’ health issues when they are away from home. It’s obviously, in light of present day stresses and reported tragedies, an important consideration. </p>

<p>There is much that disturbs me in this article, but I assume that there are also probably many unreported details and that hinders me from rushing to judgment about who is at fault. Mostly, I cannot understand why a bright young man would take these all of these drugs and why if the father knew about the ADD drugs, anti-anxiety meds and the accutane he didn’t feel that he should intervene somehow. Accutane in particular has been publicly vilified for a long time and linked to multiple suicides.</p>

<p>I am wondering if this is common practice at college health services–the prescribing of these kinds of drugs without a proper psychiatric workup. I would hate to think that if my D went to health services that she would come out with some crazy pill cocktail. Any thoughts or experiences to share in this vein?</p>

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<p>Do colleges get a full medical record for the kids they admit or just a record of immunizations? It seems to me that if a kid went into the health services and complained of difficulty to concentrate, the nurse might have prescribed the right thing absent contra-indications which might not have been revealed to her.
What bothered me about this article is that since the family lived a 20 minutes’ car drive away and was told by the son of the drugs that were being prescribed by UHS, why the family did not intervene and, more importantly, bring the kid back to his own doctor.
It seems to me, prima facie, that the family is trying to deal with its grief by blaming the university when it could have been far more involved in treating the student, knowing his medical history much better than anyone else.</p>

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<p>marite: By law an immunization record is required, and Harvard also asks that a comprehensive medical questionnaire be filled out and that the student’s physicians send any necessary medical records that would be relevant to treatment of the student. This is pretty standard for all colleges, I think.</p>

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<p>Of course, my kids have never been sick, so all I remember sending is their immunization records. The kids did fill out a questionnaire but it was very basic, and since they had never been sick, no follow-up to questions were needed.</p>

<p>I still wonder why on earth the parents did not bring that student back to Wellesley to be seen by a physician who would be totally knowledgeable about his medical history.</p>

<p>That said, it is a cautionary tale about sending one’s child with medical issues very far from home.</p>

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<p>Why wouldn’t a parent instruct their kid to go to a doctor in Cambridge rather than rely on a nurse practitioner in the student health center for serious depression issues? I am assuming that the parents didn’t know he was ill.</p>

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<p>wow. I am really surprised that a NP would prescribe so many drugs without corresponding physician’s diagnoses, and that the parents were not more involved. we just went through something a little similar: D was diagnosed with ADHD last summer just prior to beginning her freshman year. long story short: the psychologist who diagnosed her recommended not starting meds until we saw how she was doing in school. when it became evident that meds would be helpful, D’s university health center refused (rightly so, I think) to prescribe meds because the diagnosis had not been made there. we had to find a local psychiatrist to treat her, which is not easy from half way across the country, and then we (H and I) and D had to meet with the psychiatrist before any meds were prescribed.</p>

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<p>I was expecting to read something ridiculous - after all, how can a school be responsible for someone’s suicide? </p>

<p>But the facts laid out here make the case much more murky. That is indeed a long list of drugs that seem to have been hastily prescribed. But of course, perhaps all of the details have not emerged yet (for example, did the student disclose the fact that he was taking the acne drug to the psychiatrist? Did she even ask? If she did ask and he did not disclose it, that might absolve her of the biggest problem. Furthermore, people taking that drug need to check in with their doctor regularly and are asked if they are depressed/suicidal. What happened during those check-ups? Did he disclose depression yet continue to have his prescription for the drug renewed? Then responsibility may lie on his HOME doctor)</p>

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<p>I had some of the same thoughts. A psychiatrist needs to examine someone before prescribing medicine for ADD - - a medical doctor or NP could not initiate that, IIRC. The way the article is written it says that the NP prescribed a medicine for ADHD, so either the words were not well chosen or this is truly a weird mess. A medical doctor (I have no knowledge of NPs) could write a prescription refill for ADHD, but it is NOT on his prescription.</p>

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<p>This young man was an adult student. </p>

<p>His father was surprised to learn he was given adderral when he was never diagnosed with adhd. I’m not sure from the article if his parents were aware of anything else until after his death. It would be up to the son to share everything and at some point this drug cocktail may have made it impossible for him to share with his family.</p>

<p>It shocks me to know many, many students routinely use adderral as a study aid. It shocks me how easy it is to get a script for this drug.
This is a national health problem.</p>

<p>and accutane should never have made it to market.</p>

<p>This is murder as far as I am concerned.</p>

<p>I wonder what the % of college kids taking adderral is. Our young adults have been weaned on taking drugs. Why would they think any of this was dangerous.</p>

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<p>In my personal experience NP’s are way too happy with the prescription pad. I would never again want be treated by one, and certainly not accept multiple, possibly interacting drugs without a second opinion by a real doctor.</p>

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<p>About a month ago, I read an article that stated Merck has withdrawn Accutane from the market–not because of the previously suspected psychiatric-linked problems, but because of reports of irritable bowel syndrome and other intestinal disorders. Their statement did not admit that they agree with the findings, but that they no longer want to spend the money to fight the lawsuits. However, the generic equivalent is still available in some places.</p>

<p>This is a pill-happy society. And it isn’t just college kids partaking.</p>

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<p>“A nurse practitioner prescribed a drug to treat attention deficit hyperactivity disorder, a condition the overachieving Edwards had never been diagnosed with.”</p>

<p>I suspect that he did what, unfortunately, some college students do: fake the systems of ADHD so they are prescribed amphetamines. That actually may have been what triggered his other problems. </p>

<p>I do agree also, however, with those concerned about the NP’s prescribing meds.</p>

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<p>Judging from the content of the emails sent by the young man, he certainly didn’t sound like a guy in crisis and he was told to schedule an appointment with the concerned NP, which he did not. </p>

<p>I agree with sax about the use of adderall by many college students as a study aid. It is not like the No Doze of bygone years!</p>

<p>NP prescribing those kinds of meds was disturbing. But one wonders if doctors, with their scheduled 12 minutes with each patient, are just as guilty of quickly prescribing meds to patients without digging much deeper.</p>

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<p>I have long had concerns about how student health services operate. It’s not a coinsidence that students often refer to is as “student death service”. In my opinion, they are far too reliant on Nurse Practitioners and don’t take student complaints seriously.</p>

<p>A story from my past - when I was a grad student at a top 10 university with a major, well-respected medical center, I had some pains in my rib cage. I was in my 30s at the time. I went to student health and saw a NP. She told me I probably had strained a muscle (although I wondered how I would do that sitting in the library 18 hours a day!) and told me to take aspirin (or Tylenol, or something like that.) The pain continued to get worse and I started to have problems breathing. I went back. Same recommendation. Yet more pain. I went back and asked to see a doctor. I was told I couldn’t and the NP told me I had to be patient (even though I was in excruiating pain and could not lay down at night to sleep.) I finally decided to go to the emergency room at the university’s hospital. Turns out I had pleuresy which had evolved into pnuemonia because I hadn’t been given adequate pain meds and, therefore, I wasn’t breathing well enough to clear my lungs. 2 days later, on proper meds, I was feeling 100% better. </p>

<p>The student heath service called me to follow-up on my ER visit. I told them I would only come in if I could talk to the director. For some reason they relented. I told him what happened and he explained that NPs were the main care providers by design. He also told me they are very reluctant to hand out pain meds because kids abuse them. I explained that I was a grad student in my 30s, in obvious pain, and was not looking for a cheap thrill. I had asked to see a doctor and was refused, and if I hadn’t taken the initiative to go to the ER, I could have ended up dead. Many 18-22 year olds wouldn’t have gone to the ER.</p>

<p>I had a friend who at the same time had a similar experience at student health . . . she had a serious blood condition they insisted was spider bites!! </p>

<p>A few months later I had a student who told me she needed to miss class because she had cancer and was going for a treatment. I asked if she was being treated by Student Health. If she had said yes, I would have found a doctor for her . . . there was no way I would ever let a student go the Student Health Service if I could prevent it.</p>

<p>I know this is not heartwarming for all the parents here. I have college-age children of my own, both with medical issues and neither relies on the Student Heath Service at their schools. I was insistent we find private doctors in their area to treat them if necessary while they are away from home and their regular doctors.</p>

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<p>“In my personal experience NP’s are way too happy with the prescription pad. I would never again want be treated by one, and certainly not accept multiple, possibly interacting drugs without a second opinion by a real doctor.”</p>

<ol>
<li><p>Absolutely agree. I recently found another primary care doc because the previous one kept referring me to her NP. I’m not often ill, but when so I want more horsepower behind the decisionm to prescribe medication.</p></li>
<li><p>I am not impressed with the track record of mental helalth care providers. It seems the exception rather than the rule that they resolve problems in the young. Time is a healer. But if the answer is to prescribe medication - well, that’s what psychiatrists are for.</p></li>
</ol>

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<p>My son has told me that the general feeling among students at the University of Chicago is never to go to the student health center for anything remotely serious, and that one should simply go straight to the emergency room at the university hospital – which is right next to the campus.</p>

<p>Fortunately, I never had an occasion to go seek medical attention in college. None of my health problems really started until law school.</p>

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<p>such a sad story…even sadder, when i saw the title of the post, my first thought was, which one? there have been several suicides in the past couple years</p>

<p>however, i think nsm might be right. many students do intentionally fake ADD symptoms in order to obtain stimulants.</p>

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<p>Faking symptoms to obtain stimulants doesn’t absolve the NP in this case.</p>

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<p>I don’t understand how a nurse can just prescribe medication without the patient seeing an actual doctor first. Then again, I don’t know anything about the nursing field, so I don’t know what exactly they are taught about drug prescription protocols.</p>

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<p>My hypothesis is, that most of the time, NP’s and “protocols” are an efficient model of care in this setting. I’d bet the NP is not culpable(in terms of big $$$ med mal), but someone “higher up” is. Maybe some poor schmuck they got to “supervise”.</p>

<p>My fear is, we will see more “efficiency” in the future.</p>