Landmark Decision: Jury awards $635,177 Damages for Memory Loss from Electroshock
Fri, 8 Jul 2005
Below is a press release by Linda Andre, president of Committee for Truth in Psychiatry (CTIP) about the first ever lawsuit in which a jury found a psychiatrist who referred a patient for intensive electroshock procedures (practitioners prefer to call it, electroconvulsive treatment ECT) that left her permanently impaired. The patient, Peggy S. Salters is a 60 year old former pshychiatric nurse. She was subjected to 13 electroshocks within the span of 19 days. The defense expert psychiatrists--one who testified, the other who was not called to testify but was deposed under oath--justified the "treatment" and failure to inform the patient about the risks.
The jury found that her loss of 30 years of memory and cognitivie impairment--which are demonstrable symptoms of brain damage--was due to ECT.
The reason that patients have been unable to convince a jury until now that ECT-induced brain damage, is that the powerful psychiatric profession has succeeded in manipulating the perception that the testimony of psychiatric patients does not qualify.
Although the doctor who actually administered the electroshocks was not found guilty, the referring psychiatrist was. This should send a warning to physicians who refer patients for ECT without a thought about their own liability, in the event of harm.
Many of you may not even be aware that each year, 100,000 patients in the US undergo electroshock--many against their will.
There is concern among patient advocates that the tarnished reputation of the antidepressants which have been scientifically proven not significantly more effective for the treatment of depression than a sugar pill, that psychiatry will attempt to rehabilitate ECT, a procedure that, to some degree, causes brain damage. In the case of Peggy Salters--ECT wiped out a lifetime of memory, including her 30 year marriage and the birth of her children.
As this case demonstrates, the practice of ECT, like the irresponsible over prescribing of psychotropic drugs, is dissociated from the body of evidence confirming its harmful effects on cognitive function and memory for a significant number of patients. ECT causes persistent cognitive impairments and long-term memory loss in 25% - 30% of patients, while its efficacy in relieving depression is admittedly short lived-about four weeks--at most, six months of mood improvement.
ECT practitioners constitute the most zealous fraternity within the psychiatric establishment: Max Fink, MD and Richard Abrams, MD stated in 1998: "For over 50 years we clinicians have administered electro-convulsive therapy with little to guide us in deciding whether or not a particular induced seizure is an effective treatment." 
A confounding problem for psychiatry especially is the profession's failure to examine its therapeutics from patients' perspectives--and psychiatry's failure to put its therapeutic armamentarium to a meaningful scientifically valid, unbiased test that would determine the risk / benefit--and, therefore, the legitimacy of exposing patients to its interventions.
Current ECT promoters claim that the introduction of oxygen and anesthesia made ECT safe: "nothing equal to it in efficacy or safety in all of psychiatry." 
However, where memory loss and cognitive function are the issue, practitioners' claims about the safety of "improved" ECT have not been substantiated. Indeed recent UK studies and meta-analyses found no evidence of reduced memory loss with current ECT methods: "At least one-third of patients reported persistent memory loss. Levels were between 29% and 79%." 
A meta-analysis published in The Lancet confirms the poor quality of ECT clinical trials and validate ex-patients' complaints about cognitive impairment:
"the limited randomized evidence on efficacy of ECT.does not prove a clear quantitative estimate of the degree of short-term cognitive impairment associated with present methods of ECT;" or "for how long it may persist after symptomatic recovery." Most importantly, the authors confirm that: "very little randomized evidence exists on the possible long-term cognitive effects of ECT;" and "existing trials rarely use primary outcomes that directly inform clinical practice and do not investigate what might reasonably be considered good practice." 
ECT is dominated by medical cowboys who push the limits of intensity of electric shock as they please. When questioned under oath, they acknowledge no safety standards by which practitioners can be held accountable.
In his deposition (May 24, 2005) in Peggy Salters' case, Dr. Fink defended the administration of 13 intensive ECT in 19 days which caused her permanent memory loss stating:
"There are no absolute limits on the low side or to the high side if you're going to give a patient a treatment... I have personally treated patients twice a day.
And there was a time when I gave patients eight treatments in one sitting, you know, on an experiment that we did many years ago.
So, yes, I have treated patients with eight seizures in a morning up to eight. ... It was called multiple monitored ECT. It was a government supported project in an effort to find out if we can speed up the response." 
Just as psychiatry has justified aggressive prescribing of psychotropic drugs by claiming they were "safe and effective," they have justified all manner of brain damaging procedures--including lobotomies. ECT practitioners justify any amount of electroshock by making unsubstantiated claims about their safety and efficacy.
Like psychopharmacology, ECT is a lucrative business. Leonard Frank outlined the economics of ECT succinctly in testimony :
"ECT is a money-maker. An in-hospital ECT series can cost anywhere from $50,000-75,000. Using a low figure of 100,000 Americans who are electroshocked annually, most of who are covered by private or government insurance, ECT brings in $5 billion a year." ECT promoters are its stakeholders-they include device manufacturers, hospitals and practitioners. 
1. Fink, M and Abrams, R. EEG Monitoring in ECT: A Guide to Treatment Efficacy, Psych Times, May 1998, Vol. XV Issue 5 at: http://www.psychiatrictimes.com/p980570.html)
2. Deposition of Max Fink, MD, Hauppauge, NY, May 24, 2005, pp 40-41 in Fourth Judicial Circuit Court, Richard County, South Carolina Case: 03-CP-40-4797
3. Max Fink quoted in Boodman, SG, Shock therapy: It's back, The Washington Post, September 24 1996, Page Z14.
4. Rose D, Fleischmann P, Wykes T, Leese M, Bindman J: Patients' perspectives on electroconvulsive therapy: systematic review. British Medical Journal: 326 (7403), 1363-1367, 2003, June 21.
5. UK ECT Review Group, Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. The Lancet 2003 (March 8); 361: 799-808.
6. Testimony of Leonard Roy Frank at a Public Hearing on Electroconvulsive "TREATMENT" before the Mental Health Committee of the New York State Assembly, 18 May 2001 at http://www.stopshrinks.org/files/ny_hearing051801lfrank.htm
Dr. Fink's website states that he is working on a book, History of Convulsive Therapy, with two co-authors: "the Toronto (Canada) Professor of History of Medicine, Edward Shorter and the Reader in Psychopharmacology David Healy of Wales UK."
His choice of Edward Shorter as co-author is a no brainer. Professor Shorter has already written the praises of ECT with glowing enhusiasm, calling ECT "A treatment of proven safety and reliability." He has fully endorsed Fink's position, and in a recent article in Psychiatric Times, "The History of ECT: Unsolved Mysteries," Shorter bemoaned ECT's fall from grace in the 1960s and 1970s, blaming its decline on the impact of One Flew Over the Cukoo's Nest. Shorter suggests that the move away from using ECT as a first-line treatment of depression in the 1940s and 1950s, when it was relegated to "merely an approach to treatment-resistant depression in the 1990s" is a medical calamity: "It is as though penicillin had entered a fallow period because of opposition from Christian Science."
But what, one wonders, is David Healy's role in co-authoring a book whose objectivity is undermined by the conviction of two of its authors that ECT should be applied much more widely.
Linda Andre is writing a critical history of ECT in which she examines the scientific evidence that ECT practitioners fail to acknowledge or cite, and she provides documented testimony of patients. She is looking for a publisher.
Contact: Vera Hassner Sharav
. -------- Original Message --------
Subject: First ever jury award for ECT amnesia
From: Linda Andre
Date: Thu, July 7, 2005 8:36 pm
A South Carolina woman has become the first survivor of electroconvulsive therapy (ECT, shock treatment) to win a jury verdict and a large money judgment in compensation for extensive permanent amnesia and cognitive disability caused by the procedure.
Peggy S. Salters, 60, sued Palmetto Baptist Medical Center in Columbia, as well as the three doctors responsible for her care. As the result of an intensive course of outpatient ECT in 2000, she lost all memories of the past 30 years of her life, including all memories of her husband of three decades, now deceased, and the births of her three children. Ms. Salters held a Masters of Science in nursing and had a long career as a psychiatric nurse, but lost her knowledge of nursing skills and was unable to return to work after ECT.
The jury awarded her $635,177 in compensation for her inability to work. The malpractice verdict was against the referring doctor, Eric Lewkowiez. The jury could not return a verdict against the other two doctors because of one holdout vote for acquittal. The hospital settled its liability for an undisclosed sum early in the trial.
Former patients have reported devastating, permanent amnesia and cognitive impairment since ECT was first invented in 1938, but that has not hindered the treatment's popularity with doctors. The first lawsuit for ECT amnesia, Marilyn Rice v. John Nardini, was brought exactly thirty years ago, and dozens of suits have followed. While there have been a few settlements, including one for half a million dollars, no former patient has won a case until now.
Psychiatrist Peter Breggin, who served as Ms. Salters' expert witness, was also the expert in Rice v. Nardini, and has appeared for plaintiffs many times over the past three decades without success. Psychologist Mary E. Shea presented extensive neuropsychological testing proving to the jury's satisfaction that Ms. Salters suffers dementia due to ECT brain damage.
Expert for the defense was Charles Kellner of New Jersey, formerly of the Medical University of South Carolina. He testified that giving Ms. Salters' 13 shocks in 19 days, instead of 26 days as is usual, was not a violation of the American Psychiatric Association guidelines. However, his assertions that Ms. Salters' severe suicidality justified the controversial treatment could not be substantiated by the medical records. 82-year-old Max Fink of New York, widely regarded as the "grandfather of shock" and the author of many books and articles on ECT, was scheduled to testify for the defense, but in the end only watched the trial from the courtroom. The defense did not call him as a witness due to incriminating statements made under oath at his deposition.
For the past three decades, defense attorneys have won case after case by the same strategy: browbeating the jury with the plaintiff's psychiatric history, playing upon the prevailing cultural notions that mental patients are incapable of telling the truth and doctors don't lie; even claiming that mental illness causes amnesia and brain damage. Even neurological testing showing brain damage has been brushed aside. Peggy Salters' case is the first in which a former ECT patient has been believed. She says she sees it as a victory for all ECT survivors.
Attorney for Ms. Salters, Mark Hardee, can be reached at (803) 799-0905. Peggy Salters can be reached at (803) 736-4444. Fink's deposition is available from either of them.
Richland County, South Carolina
Peggy S. Salters vs. Palmetto Health Alliance, Inc., d/b/a Palmetto Baptist Medical Center; Robt. Schnackenberg, M.D., Individually, Eric Lewkowiez, M.D., Individually, Columbia Psychiatric Associates, P.A.; and Kenneth Huggins, M.D., Individually
Filed October 03, 2003
Decided June 17, 2005