Wednesday, September 13, 2006

Austin psychiatrist's medical license suspended after he is deemed a threat

Medical board said he endangered 7-year-old, household member.


AMERICAN-STATESMAN STAFF
Wednesday, September 13, 2006

A panel of the Texas Medical Board suspended the license of an Austin psychiatrist after it said he improperly medicated a 7-year-old with Prozac and another drug and mishandled the care of a household member who overdosed on drugs he prescribed.

Dr. Sergio Silva, whom the board said is 38, could not be reached for comment Tuesday. The answering machine at his Bee Cave Road office said that "due to circumstances beyond our control," it would not be possible to leave messages for Silva or reach him "in any way" until next week.

The temporary suspension was the strongest and fastest action to remove him from practice, medical board spokeswoman Jill Wiggins said. The three-member panel said it was necessary because Silva presented "a continuing threat to the public welfare and a real and present danger to the health of patients."

The panel's order says Silva's behavior last year caused the 7-year-old to be hospitalized with homicidal and suicidal thoughts and the household member to be endangered. It also says Silva lost his medical privileges at Seton Shoal Creek psychiatric hospital because of threatening and disruptive behavior.

Silva can appeal the disciplinary action.

Based on the medical board's records, which give one side of the story, board staff members allege that Silva was treating a 7-year-old boy for anxiety and attention deficit disorder in April 2005 with Prozac, which is approved for major depression and obsessive-compulsive disorder in children, and Strattera, which is used to treat attention-deficit (hyperactivity) disorder in children.

The boy's mother told Silva that he had a reaction to Strattera, so Silva reduced the dosage. The child's behavior did not improve, and Silva increased the Prozac dose and later boosted the Strattera, believing that the boy's mother was not complying with his medication orders.

The boy's behavior worsened and grew violent, causing Silva to again say the mother was not complying. She suggested that he draw the child's blood and see for himself.

The mother said she thought the bad behavior, which later became suicidal, was a reaction to the medicine; Prozac and Strattera each warn that they can increase suicidal thoughts in children. Silva threatened to report her to Child Protective Services.

Another psychiatrist found high levels of Prozac in the boy's blood.

The new doctor hospitalized the boy, and the Prozac and Strattera were stopped. The child's agitation ended, and an expert hired by the board concluded that a drug-to-drug interaction had occurred.

Several months later, Silva asked the boy's mother to contact him because he was concerned that she had misrepresented the boy's medical history. Silva later filed a complaint against her with Child Protective Services, alleging medical neglect, the order says.

In the case alleging improper treatment of a member of his household, the order says Silva was prescribing "multiple controlled substances" for his office manager and life partner, who overdosed on Xanax, Tylenol and codeine in May 2005.

After Silva tried to take care of the man for two or three days, he was admitted to Seton Medical Center's intensive care unit, the order says.

Silva did not kept medical records justifying the prescriptions, yelled at the ICU doctor and verbally abused the staff, the order says.

maroser (at) statesman.com; 445-3619


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