Doctor Sued After Orlean Suicide — (Cape Cod Online)

SSRI Ed note: Doctor keeps trying different SSRIs for woman upset about broken ankle, none work but he keeps medicating her until she commits suicide. Husband sues.

Original article no longer available

Cape Cod Online

January 27, 2005

By Robin Lord, Staff Writer

BARNSTABLE – The husband of an Orleans woman who committed suicide in 2003 filed a lawsuit yesterday, claiming the psychiatrist who treated her failed to monitor her closely enough while she was on antidepressants.

Charles Callahan alleges that Dr. Theodore Jellinek, a Sandwich psychiatrist, was negligent in the care of Callahan’s wife because he did not recognize her symptoms of suicide and act to protect her.

Mary Callahan shot herself on April 25, 2003, with her husband’s pistol. At the time of her death, she had been under Jellinek’s care for about six months and had taken a series of antidepressants, including those known as “selective serotonin reuptake inhibitors,” or SSRIs, the lawsuit contends.

“It was a very dramatic change in her behavior,” said Bruce Bierhans, the Wellfleet attorney representing Callahan. “It’s a very, very close family and they were devastated.” Callahan has three grown daughters.

The lawsuit was filed in Barnstable Superior Court yesterday. No hearing date has been scheduled.

Callahan was out of town and could not be reached, according to Bierhans.

Jellinek did not return calls made to his office or home yesterday.

SSRIs, such as Prozac, Zoloft and Paxil, have been in the news in recent months as possibly causing suicidal tendencies in children. Bierhans said the drugs are known to worsen symptoms in adults.

“It’s something that from the pharmaceutical perspective will probably be debated for years, although from the new (Food and Drug Administration) guidelines it’s clear there is a concern about suicide as a side effect,” he said.

“No psychiatric history”

According to the lawsuit, Mary Callahan “had no psychiatric history” before March 22, 2002. On that date, she fractured her ankle at a movie theater, requiring surgery and rehabilitation.

“Prior to the injury, M. Callahan was a vibrant and active 57-year-old woman who was a licensed registered nurse and was also proprietor of her own gift shop, located in Chatham,” the lawsuit says.

Mary Callahan became depressed after the ankle injury, according to the lawsuit, and went to Jellinek for treatment. He prescribed antidepressants and anti-anxiety medications including Celexa, Lexapro, Zoloft, Wellbutrin and Ativan. Jellinek started drugs, stopped them and retried them “with frequency,” when Mrs. Callahan failed to respond, the lawsuit claims.

The prescribing information for physicians on the Web site for Zoloft, a Pfizer pharmaceutical, states that the medication is indicated for “the treatment of major depressive disorders in adults.”  The information notes that a “causal role” for antidepressants in inducing suicidal behavior “has not been established.”

Zoloft warning

But, in bold print, the next paragraph warns: “Nevertheless, patients being treated with antidepressants should be observed closely for clinical worsening and suicidality, especially at the beginning of a course of drug therapy, or at the time of dose change, either increases or decreases.”

Bierhans said Mrs. Callahan raised concerns with her psychiatrist about the side effects of the drugs, even at one time bringing in an article in a trial lawyers publication, which discussed the side effects of worsening symptoms. But, Jellinek dismissed her concerns, Bierhans said.

Bierhans contends in the lawsuit that Jellinek did not follow the standard of care called for in a patient in Mrs. Callahan’s condition. The standard of care, in part, according to the lawsuit, included “periodic assessment of continued clinical response and maintenance of an effective medication regimen for as long as necessary.”

The lawsuit contends, among other things, that Jellinek failed to assess or document Mary Callahan’s risk of suicide, and continued to prescribe even after he saw her poor reaction to the drugs.

(Published: January 27, 2005)