Tufts Medical Center physician Dr. Kayoko Kifuji on Jan. 25 testified as a prosecution witness in the trial of Carolyn Riley concerning the death of the latter's four−year−old daughter Rebecca Riley.
Kifuji was a much−anticipated witness in the trial. Riley is accused of intentionally fatally overmedicating her daughter Rebecca. Kifuji in August 2004 began prescribing bipolar disorder and ADHD medication for then two−year−old Rebecca.
Rebecca died on Dec. 13, 2006 in her home in Hull, Mass. at the age of four. Her parents, Carolyn and Michael Riley, in February 2007 were both charged with first−degree murder, though they claim that she died of an accelerated form of pneumonia. Michael Riley will be tried separately from Carolyn at a later date.
"This is a sad case, no matter which way it ends up," John Darrell, Michael Riley's attorney, told the Daily. "It's just a very, very sad case."
Dr. Sara Vargas of Massachusetts General Hospital, an expert witness for the prosecution, told the court that according to toxicology tests, Rebecca died from a combination of untreated pneumonia and various medications.
Autopsy results showed that Rebecca's body contained Clonidine, a sedative blood pressure medication; Depakote, a mood stabilizer; a cough suppressant; and an antihistamine.
Kifuji's testimony marks her first public statement regarding her former patient's death.
Kifuji testified that her diagnosis was primarily based on Carolyn Riley's description of her daughter as aggressive and disruptive. She in 2004 prescribed Clonidine to Rebecca for ADHD; the next year, she prescribed Depakote to treat bipolar disorder.
Kifuji went on to approve a double dosage of the medication after Carolyn Riley told her that she was giving Rebecca twice the daily recommended amount.
Kifuji in February 2007 temporarily gave up her medical license but last year returned to her psychiatry practice after a grand jury did not indict her of any criminal charges.
Defense attorneys, however, allege that Kifuji failed to adequately warn the Rileys of the potentially harmful nature of the drugs.
The Patriot Ledger reported that questioning grew tense as defense attorneys portrayed Kifuji as a negligent physician whose alleged carelessness played a role in Rebecca's early death.
Darrell said that the drugs had weakened Rebecca, leaving her more vulnerable to pneumonia. Attorney Michael Bourbeau, who is defending Carolyn Riley, declined to comment.
Prosecutors allege, however, that Carolyn and Michael Riley pushed Kifuji to diagnose Rebecca with mental disorders in an effort to gain federal disability benefits.
Federal authorities had previously denied federal disability benefits for Rebecca. Prosecutors say that the parents intentionally overdosed Rebecca because they thought they could not gain any money from her.
Darrell said that another application for Social Security benefits was pending when Rebecca died, and this could not therefore be a motive to overdose her.
"There was no final decision on Social Security benefits," he said. "In fact, there was a hearing pending."
Darrell added that Carolyn and Michael Riley are both on federal disability themselves due to health issues. He said that they would never consciously harm Rebecca.
"It's such an evil thing to say," he said. "They cared for their daughter. It's just that simple."
Testimony from witnesses in the trial, who range from Rebecca's teachers to neighbors and friends of the family, suggested neglect on the part of the parents.
Victoria Silberstein, principal of the Elden Johnson Early Childhood Center, testified that she had attempted to contact the state Department of Social Services out of concern for Rebecca. Teachers Jym−Ann Curtis and Kathleen Yuscevicz testified that Carolyn Riley never responded to their calls or written notes about Rebecca's health.
Hull native Kelly Williams lived with the Rileys for several weeks before Rebecca's death. She testified that she had seen Rebecca suffer for four days leading up to her death and that she had begged Carolyn and Michael Riley to bring Rebecca to a doctor.
There is also a pending civil malpractice lawsuit against Kifuji that Rebecca Riley's estate filed in April 2008.
The suit claims Kifuji is responsible for a "failure to inform and to warn of the risks involved in or associated with the plaintiff's decedent's condition and failure to inform and to warn about the treatment of said condition."
"We definitely have a number of experts who are ready to testify that Dr. Kifuji violated standards, that she violated standards of care, that she breached duties that she owed to Rebecca," attorney Benjamin Notovny, who represents Rebecca Riley's estate in the malpractice lawsuit, told the Daily.
Darrell agreed that Kifuji should bear some of the blame and said that she gave Rebecca inappropriate medication for her diagnosis.
"It's clear that this doctor has some responsibility for the medicine that she prescribed, recognizing that Clonindine is not authorized for children, period," he said. "It is not authorized to be used for bipolar [disorder] or ADHD. It is strictly an adult's high−blood−pressure medicine."
Tufts Medical Center, however, in January cleared Kifuji of wrongdoing following an extensive review and affirmed the hospital's continuing support for her.
Notovny said that the lawsuit against Kifuji seeks an indeterminate amount of monetary damages for the loss of Rebecca. The counsels for Kifuji and Rebecca's estate are currently exchanging information.
The trial taking place in Plymouth Superior Court ended on Feb. 4. A jury is currently deliberating and will soon decide Carolyn Riley's sentence.
Kifuji, who is being represented by attorney Bruce Singal, testified in the trial under immunity and thus cannot be criminally charged based on her testimony. Singal declined to comment on the case.
Michael Riley's trial is scheduled to begin March 8. Darrell said that he expected that Kifuji will be called to the stand once more.
