Update: Dr. Vernon L. Kliewer and the 3 year-old

3 year-old Destiny Hager was prescribed Seroquel and Geodon after being diagnosed with bi-polar by pediatric psychiatrist Dr. Vernon L. Kliewer of Kansas.

Following on from my previous post about 3 year-old Destiny Hager. [Pictured]

Destiny was prescribed Seroquel and Geodon after being diagnosed with bi-polar by pediatric psychiatrist Dr. Vernon L. Kliewer of Kansas.

Destiny died of fecal impaction and had “antipsychotic drugs present in concentrations considered therapeutic in adults.” The dosage of Seroquel was ramped up to 600 milligrams per day by Kliewer.

Kliewer subsequently entered into an agreement with the Kansas State Board of Healing Arts that would restrict his license to practice medicine and surgery by placing that licence on probation.

Kliewer voluntary excluded treating children under the age of six and was ordered to pay costs to the Kansas State Board of Healing Arts of $13,079, about £8,000. [Back Story]

Both Seroquel and Geodon were prescribed off-label in this particular case.

Seroquel is sold and marked in the United States by AstraZeneca.

Geodon is sold and marked in the United States by Pfizer.

Dine and Dash

The drug industry last updated its marketing code in 2002, when it banned “dine and dash” events in which drug makers provided free dinners to doctors who agreed to listen to brief sales pitches.

On the scale of things Kliewer hasn't really received much from the drug industry but he certainly has been entertained by both makers of Seroquel and Geodon.

Statistics, from 2010 to 2012 show that Kliewer was taken for three meals by Geodon reps [Pfizer] and was given a gift or item to the value of $99.

The same statistics show that Kliewer was taken for two meals by Seroquel reps [AstraZeneca].

Here's the list [taken from ProPublica Dollars For Docs Database]

Pfizer - 2010 - Meals - $6
Pfizer - 2010 - Items, Gifts - $99
Pfizer - 2011 - Meals - $85
Pfizer - 2012 - Meals - $99
AstraZeneca - 2011 - Meals - $36
AstraZeneca - 2012 - Meals - $276

Unfortunately the database only starts from 2010. 3 year-old Desting Hager died in 2006. Is it safe to assume that Kliewer had already been targeted by both Pfizer and AstraZeneca reps?

The money isn't really an issue here, it's more of the motive.

Why would Pfizer and AstraZeneca reps entertain a pediatric psychiatrist?


Answers on a postcard please to:

Off-Label Promotional Tactics
A.N.Y Pharmaceutical Company
PO Box 666


Bob Fiddaman

How Much For a 3 Year-old?

Destiny Hager, Aged 3

On April 3, 2006 three year-old Destiny Hager was carried through the doors of Morris County Hospital at 11:20 p.m, she had been complaining of a stomach ache.

An X-ray revealed her colon was blocked.

The following morning at 7:40 a.m., Destiny stopped breathing inside Room 11. A minister was called.

She was briefly resuscitated, just long enough for her to utter the words, "I love you", to her parents Greg and Angela Hager. Shortly after, Morris County called for a helicopter to transfer Destiny to Children’s Mercy.

Destiny was pronounced dead at 10:34 a.m. on April 4 following a 45-minute flight.

Could destiny's death have been prevented?

Let's look at some of the facts:

Destiny died of fecal impaction and had “antipsychotic drugs present in concentrations considered therapeutic in adults.”

Destiny had been diagnosed with diagnosed with bipolar disorder, she was prescribed Geodon and Seroquel. The dosage of Seroquel was ramped up to 600 milligrams per day by her treating pediatric psychiatrist Dr. Vernon L. Kliewer, MD.

Disciplinary action has since been imposed upon Kliewer.

So, what kind of action?

Well, he wasn't charged with anything, it was the Kansas State Board of Healing Arts who, along with Kliewer, entered into an agreement that would restrict his license to practice medicine and surgery by placing that licence on probation.

Kliewer voluntary excluded treating children under the age of six and was ordered to pay costs to the Kansas State Board of Healing Arts of $13,079, about £8,000. (final figure not seen in documents below)

This after it was found that Kliewer allegedly, with regard to the care and treatment of six patients, Destiny and five other children ranging in age from 2 to 5, deviated from the standard of care, inappropriately prescribed prescription medications, and failed to properly document the patients medical records. Kliewer did not admit to the allegations but for the purpose of the consent order did not contest the allegations.

Kliewer was ordered to complete the CPEP Patient Care Documenation Seminar, an interactive, eight-hour small group course.

Geodon has not been shown to be safe or effective in the treatment of children and teenagers under the age of 18 years old. [1]

The effects of Seroquel have only been studied in children aged between 10 and 17 years with mania and in children aged between 13 and 17 years with schizophrenia. There is not enough information on its effects in children to recommend its use in other age groups or for other conditions. [2]

Yet they were both prescribed by Kliewer to a 3 year-old girl.

Here's a tribute video I found on YouTube.

Rest in Peace little one.

Bob Fiddaman

[1] GEODON® Patient Information Leaflet
[2] SEROQUEL® Patient Information Leaflet