Dosed in juvie jail: Troubled doctors hired to treat kids in state
By MICHAEL LAFORGIA
Palm Beach Post Staff Writer
Posted: 2:06 p.m. Sunday, June 19, 2011
By the time Florida started paying Dr. Gold Smith Dorval to counsel and medicate jailed children, the Pembroke
Pines psychiatrist already had experience with kids in state custody.
He had used them, authorities said, to bilk the government out of money for the poor.
When Dorval pleaded no contest to a felony grand theft charge, it should have barred him, by law, from working for
Florida's Department of Juvenile Justice.
And, like Dorval, other doctors have emerged from past troubles and gotten jobs at DJJ - with authority to prescribe
drugs to kids in state jails, a Palm Beach Post investigation has found.
Some psychiatrists took DJJ jobs after they were cited for breaking the law, making grave medical missteps or
violating state rules. Others were hired after they were accused of overmedicating patients, sometimes fatally.
All were empowered to prescribe drugs to jailed kids as powerful antipsychotic pills flowed freely into Florida's homes
for wayward children.
"It's appalling. A psychiatrist is a psychiatrist. They're licensed, they've been to medical school, and there is a certain
trust placed in that person's judgment when they tell you that this child needs to be medicated," said John Walsh, an
attorney with the Palm Beach County Legal Aid Society who has represented children in juvenile court. "This just
illustrates that we always have to be on guard with children."
In two years, Florida bought hundreds of thousands of tablets of Seroquel, Abilify, Risperdal and other antipsychotic
drugs for children housed in state-run jails and programs. The meds were administered in a juvenile justice system
that doesn't track prescriptions and has no way of telling whether doctors are prescribing to make kids easier to
In some jails and homes, pills were prescribed by psychiatrists who took huge speaker fees from companies that
make antipsychotic drugs, The Post found. In others, the task fell to doctors with troubled pasts.
In response to the newspaper's first reports, published last month, DJJ Secretary Wansley Walters launched an
investigation into the department's use of antipsychotic drugs. DJJ officials declined to discuss The Post's latest
findings, citing the probe.
Spokesman C.J. Drake acknowledged, though, that the department has struggled to find psychiatrists willing to work
in jails and programs. He also said DJJ sometimes has relied on companies that employ a stable of doctors, rather
than signing a contract with a single physician.
As a result, Dorval went to work in a Broward County jail for children - even though he would have failed a state-
mandated background check required by the contract.
Doctor's bogus billings
In the late 1990s, Dorval claimed he was providing juvenile delinquents and other vulnerable children with needed
therapy. Instead, state investigators said, he used bogus counselors to bill Medicaid for more than $350,000 in
He charged the government for offering more than 24 hours' worth of children's therapy in a single day, investigators
said, and structured the scheme around kids who were homeless or in DJJ custody or foster care.
He tended to bill "for those children that the system 'lost,' " according to an affidavit for his arrest.
Originally charged with four felonies in Broward, Dorval pleaded no contest to one count of grand theft in 2004.
Later, to keep his medical license, he agreed to pay $10,000 and was suspended, reprimanded and put on four
Although a judge withheld a formal finding of guilt, the plea disqualified Dorval from seeing patients in a juvenile jail.
Even so, his employer, Miami-based Compass Health Systems, sent him to work at the Broward Juvenile Detention
Center between August and December 2007.
No one screened his background beforehand.
In written responses to questions, Dorval said he was doing as he was told when Compass sent him to work in the
Broward juvenile jail.
"At that period you cited, the psychiatrist that was seeing patients at the DJJ was out. Therefore I was designated by
the management office to go and cover for that psychiatrist, until they switched me again to another place. I was not
aware of any wrongdoing," wrote Dorval, who stressed that he never signed a contract with DJJ. "I am only an
employee. Wherever they send me to work I have to go."
As for the criminal charges, he offered this explanation: "This case was a simple matter that became complicated,
because my first lawyer messed me up." After wrangling over the facts, "they decided to offer me a plea that would
allow me to get a chance to fight for my license to practice medicine," he wrote. "It was a real nightmare that
generated in me a post-traumatic syndrome that I will never forget."
DJJ officials declined to comment on Dorval's hiring, again citing the investigation.
Compass officials didn't respond to questions about Dorval.
DJJ had no contract with Compass as of May, records show.
Patient's death missed in screening
In state-operated jails and programs, the rules say DJJ must screen doctors' backgrounds and verify that physicians'
hold valid medical licenses. In privately run programs, which house the majority of children in the department's
custody, that responsibility falls to contracted companies.
Such screenings don't catch everything: Doctors who kept their licenses after the state accused them of serious
lapses have gone on to work in juvenile jails and homes.
Dr. Charles J. Dack is an example. For six years, Dack, a Lakeland-based physician who is board-certified in
addiction and child psychiatry, prescribed a cocktail of antidepressants and powerful painkillers, including
methadone and morphine, to a patient named Mary Tuxbury.
Eventually, Dack ramped up the doses of pills Tuxbury was taking, keeping her "at a toxic level of morphine for
approximately two and a half years," regulators from the state health department said. In March 2002, Tuxbury was
found dead. She was 42.
An autopsy showed she died of "multiple drug intoxication, namely opiates and tricyclic antidepressants."
Regulators charged Dack with failing to meet care standards and inappropriate prescribing. Dack settled the
allegations in August 2007. He admitted no wrongdoing but agreed to pay a $7,000 fine and complete a course on
A year later, he was hired to care for children at three privately run programs in Central Florida: Wilson Youth
Academy, Peace River Youth Academy and New Beginnings Youth Academy. He worked in the homes until April.
Dack didn't respond to messages seeking comment.
Doctor hired after child's death
Other DJJ doctors weren't cited by regulators, but they were accused in court of fatal neglect. Roughly one in eight
of the psychiatrists who have worked for DJJ in the past five years has settled a malpractice lawsuit in Florida,
Among these was Dr. Samuel McClure. As a psychiatrist in Orlando, McClure diagnosed an 11-year-old boy named
David Morganthal with attention deficit disorder. He prescribed powerful, mind-altering drugs for David - even though
the child was much smaller than other kids his age, according to court documents.
One morning in November 2001, David's mother woke to find her son dead on the floor of her double-wide mobile
home. When they laid David out at the morgue, he measured less than 4-foot-2 and weighed 49 pounds.
Lab tests showed his blood contained an unusually high concentration of an antidepressant: about 60 percent more
of the medication than doctors had expected.
The drug, mirtazapine, still hasn't been approved as safe for children. David was taking the drug along with another
antidepressant that hasn't been approved for kids, citalopram.
The autopsy concluded the boy probably died from a seizure and heart problems caused by "reaction to prescription
In 2004, Patty Morganthal sued McClure, the health care company he worked for and others over the death of her
son, alleging medical negligence.
While the civil suit still was pending, McClure was hired in January 2006 to care for kids in DJJ's Frances Walker
Halfway House and Brevard Group Treatment Home.
A year later, records show, McClure's insurance company paid $500,000 to settle Morganthal's case.
McClure worked in DJJ programs until June 2009. He couldn't be reached for comment.
Still another DJJ doctor got hired after he accidentally overmedicated kids with an antipsychotic drug during a clinical
In summer 2006, Dr. Sohail Punjwani of Lauderhill tested the Pfizer drug on seven children between the ages of 10
and 16. Six of those kids were overdosed, according to a 2010 warning letter to Punjwani from the federal Food and
One 13-year-old "was overdosed on study medication for 20 consecutive days," the FDA said, and he emerged
experiencing "sedation and dizziness."
Eighteen months later, Punjwani, who is board-certified in adult and child psychiatry, went to work in the Broward
Juvenile Detention Center, placed there by his employer, Compass. He evaluated kids in the jail until June 2008,
Soon after, while working for the state foster care system, he began seeing a difficult patient, 7-year-old Gabriel
Myers. Punjwani prescribed mind-altering drugs for the boy, including a combination of an antipsychotic and an
antidepressant. In April 2009, Gabriel hanged himself in the shower of his Margate foster home.
A work group formed to study the death never assigned blame to Punjwani, and he was not disciplined by state
regulators in the widely publicized case.
A 2010 report by the FBI's Behavioral Analysis Unit, which consulted with a forensic psychiatrist on staff at Walter
Reed Army Medical Center, concluded "the medications that were prescribed for Gabriel may have contributed to his
actions directly prior to and during" his death.
Drug error blamed on nurse
In an interview, Punjwani said Pfizer's 2006 study was flawed, citing a 2010 FDA warning letter to the drug company,
and added that his medication errors stemmed from a mistake by a nurse. He acknowledged, though, that he failed
to build in a control that would have prevented overdosing.
Punjwani said he saw "very few" children at the DJJ jail who were taking mind-altering drugs. For these kids, he
simply reviewed their files and maintained them on their meds, he said.
And in Gabriel's case, Punjwani said he feels he was a scapegoat.
"My care was totally appropriate and, according to some psychiatrists, went above and beyond the standard of care
in the clinical community. Because I saw the patient on time, I had appropriate follow up, I had documentation," he
The way his critics portray him, "I look like a child killer," he added. "It's sad. I've been in practice in psychiatry for 25
years, a double board-certified child psychiatrist. Of course there are some bad outcomes. But that does not mean
malpractice. That does not mean I've been hurting people."
Two-hour consultations adequate?
At a minimum, state contracts required these and other doctors to spend two hours a week evaluating jailed children.
Every week, in jails and homes that can hold a combined 6,000 boys and girls statewide, children line up to see the
Paul DeMuro, a former head of Pennsylvania's child welfare system, questioned whether two hours was enough to
evaluate each child, assess progress and write prescriptions.
"If you're looking at two hours of consultation a week, and there are 100 kids, and 20 or 25 are on psychotropic
medications, how much attention can they give those kids?" said DeMuro, who works as a consultant for juvenile
justice policy-makers nationwide. "What else are they going to do other than push pills?"
Doctors who have worked for the DJJ
A look at the credentials and work dates of physicians who have prescribed medications to juveniles at DJJ facilities:
Dr. Gold Smith Dorval
Licensed: April 24, 1989
Medical school: Universite D’Etat D’Haiti
Based: Pembroke Pines
Past troubles: Pleaded no contest to felony theft in 2004
Worked for DJJ: August-December 2007
Dr. Charles Dack
Licensed: June 13, 1980
Medical school: New York University
Past troubles: Disciplined for overprescribing medication to a woman until she overdosed and died in 2002
Worked for DJJ: September 2008 to April 2011
Dr. Samuel McClure
Licensed: Oct. 11, 1979
Medical school: University of Florida
Past troubles: Sued for medical malpractice in the death of an 11-year-old boy who overdosed on medications
Worked for DJJ: January 2006 to June 2009
Dr. Sohail Punjwani
Licensed: Oct. 20, 1988
Medical school: University of Karachi’s Dow Medical College, Pakistan
Past troubles: Cited by FDA for medication mistakes during a clinical trial on children; prescribed mind-altering drugs
to Gabriel Myers, a 7-year-old who hanged himself in 2009
Worked for DJJ: December 2007 to June 2008
ABOUT THIS STORY
Last month, Palm Beach Post investigative reporter Michael LaForgia reported that Florida has supplied children in
state juvenile jails with heavy doses of powerful antipsychotic medications and that the pills can cause suicidal
thoughts and other dangerous side effects. Michael’s investigation discovered that in state-run jails and residential
programs, antipsychotics were among the top drugs bought for kids — and they routinely were doled out for reasons
that never were approved by federal regulators.
ABOUT THE REPORTER
Michael LaForgia has reported on Florida’s pill mill crisis, spurring arrests and reforms at the state and local levels,
and exposed loopholes in Florida law that put children at risk in summer camps. He joined The Post in 2006.