Rebecca Riley’s doctor on the defense

By Lane Lambert
The Patriot Ledger
Posted Apr 10, 2010 @ 09:00 AM
BOSTON —
Years before she became a board-certified psychiatrist, Dr. Kayoko Kifuji was diagnosing children as young as 2 as bipolar and hyperactive – and prescribing powerful cocktails of mood-altering drugs to quiet them.
By the time Kifuji finally passed the psychiatric board exam – on her fourth try – one of her youngest patients, Rebecca Riley, had a little more than a year to live. Her parents murdered the 4-year-old by overdosing her with one of the drugs Kifuji prescribed.
Both of Rebecca’s parents are in prison for her murder. Her mother, Carolyn, was convicted in February; her father, Michael, in March.
Now the spotlight is on the controversial doctor who testified in both trials in exchange for immunity. Kifuji and her employer, Tufts Medical Center, face a malpractice lawsuit filed by Norwell attorney Brian Clerkin, the court-appointed administrator for Rebecca’s estate, which was created for the benefit Rebecca’s brother and sister, who are now 14 and 9.
Glimpses into Kifuji’s background and treatment methods are part of a lengthy deposition she gave in December in the civil suit. The final pretrial hearing in the case is scheduled for June 1.
Kifuji diagnosed Rebecca Riley and her sister with mental illness and prescribed drugs for both girls and their brother. Prosecutors in the parents’ murder trials said the Rileys killed Rebecca because they couldn’t get disability payments for her, as they had with their two other kids.
According to the plaintiff’s lawyer in the malpractice suit, Benjamin P. Novotny, of the Boston firm Lubin and Meyer, Kifuji said she “trusted the mother” (Carolyn Riley) to tell her how the children were behaving and reacting to the drugs. She relied almost exclusively on what Carolyn told her about the kids when diagnosing them and ordering increasing amounts of drugs for them.
Kifuji also trusted the mother to keep tabs on Rebecca’s heart rate and blood pressure for signs of problems with the four drugs she was on. Kifuji, a pediatrician who later became a psychiatrist, told Novotny during the deposition that she didn’t realize she had a blood pressure cuff in her office and could check the girl’s vital signs herself until after Rebecca was dead. She said she didn’t take Rebecca’s pulse with her fingers because Carolyn Riley told her the child’s pulse “was within normal range.”
Kifuji also told Novotny during the deposition:
She prescribed clonidine – the drug that killed Rebecca – during the child’s first visit to control the “impulsivity” that Carolyn Riley described. Rebecca was 2 at the time.
She originally came to the United States from her native Japan in 1990 to research dust allergies in children. She switched her training to psychiatry when she went to New England Medical Center in 1994.
In 2000, she took a job at Baystate Medical Services in Springfield because it meant she wouldn’t have to return to Japan for two years and wait for an H-1 work visa.
She diagnosed dozens of children as bipolar or having attention deficit hyperactivity disorder (ADHD) or both, and estimated that she prescribed drugs for 99 percent of her pediatric patients.
She usually saw Rebecca for 20 minutes at each office visit because she was seeing all three Riley children in an hour.
She explained that some researchers believe the area of the brain called the amygdala is different in people with bipolar disease. But she admitted she didn’t know where the amygdala is in the brain.
Kifuji’s medical career has taken her from Tokyo to Detroit and Boston. She was living in Somerville as of December.
She grew up in Kumamoto, Japan, on the southwest tip of the island of Kyushu, and graduated from Tokyo Women’s Medical College in 1981.
She’s been a permanent legal resident of the U.S. since 1990, and has held a medical license here since 1999.
She worked at Baystate in Springfield from 2000-03. Her outpatients there included the Rileys’ two older children, whom she also diagnosed as bipolar with ADHD.
After Rebecca’s death in December 2006, Tufts Medical Center placed Kifuji on paid leave after the psychiatrist agreed not to practice medicine. The state Board of Registration in Medicine reinstated her license this past September after Plymouth County District Attorney Timothy Cruz announced that a grand jury would not bring criminal charges against her.
In January, Tufts reaffirmed its support for Kifuji and her treatment methods, saying she provided “appropriate” care to Rebecca Riley. Kifuji began seeing patients again in the fall. As of December, she was seeing five outpatients – four children and one adult – and working with a state-funded child psychiatric access program.
Lane Lambert is at llambert@ledger.com.
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