Another family annihilation and another coroner worried about citalopram.

 Another family annihilation..How many more will it take before citalopram is investigated? 

This is the Irish Medicines board’s job, NOT MINE!!! 

What are they waiting for? An Irish school shooting perhaps?

Inquests into the deaths of

Roxanne Jane RICHARDSON (1222/04)

Luke RICHARDSON (1223/04)

Grace RICHARDSON (1224/04)

Michael RICHARDSON (1225/04)

 

 

At 8.30am on Monday 12 July 2004 the bodies of Michael and Roxanne Richardson were discovered together with the bodies of their children Luke and Grace in the family home at East Gresford.

Roxanne Richardson, 30 old, had been stabbed in the chest and subsequently suffocated. Luke Richardson, 3 years old, had been suffocated in a face down position by a relatively soft object. 

Grace Richardson, 20 months, had been suffocated face up.

All three bodies had been ‘posed’ alongside each other on the bed.  The body on the bed closest to the wall of the bedroom was that of Michael Richardson, the 32-year-old father and estranged husband. 

He died of a self-inflicted gunshot wound to the head sustained after he had killed the other members of his family.

Treatment of Michael Richardson and findings of the coroner…

Treatment following self-harm –        

Family members raised the issue of Michael’s treatment at the Mater Hospital following his suicide attempt 17 months before this event. Amongst other things, they were concerned that he had been released too early.

The evidence of Dr Safranko, Michael’s treating physician in hospital, is that Michael received appropriate treatment and was released only after he was satisfied that Michael was not harbouring any suicidal ideation.  Michael appeared mentally well on release.

Unfortunately the treatment of the mentally ill/mentally disordered is often an issue at inquest.  Dr Safranko’s treatment of his patient was appropriate in the circumstances.

Michael was controlling and manipulative and his disposition remained the same in the hospital setting.  

One matter however, not obvious as an issue until evidence was taken at inquest, was Michael’s antidepressant medication prescribed by his General Practitioner.

Michael had been prescribed ‘Citalopram’ from the 13 April 2004.

Dr Safranko first flagged it as an issue during the course of his evidence. The question was ‘had this medication exacerbated Michael’s aggressive behaviour?’

At post mortem his Citalopram level was 0.9mg/L – high but not fatal.

Professor Alison Jones, Professor of Medicine and Clinical Toxicology considered the possibility of Citalopram contributing ‘to the odd behaviour of Michael Richardson and the possible murder of his family’.

Professor Jones states in here report:

“ Whether the Citalopram could have been responsible or exacerbated violent outbursts is a very controversial area in the medical literature and in medical practice with differing interpretations of the evidence……Citalopram is an antidepressant drug which acts by selective serotonin re-uptake inhibition (SSRI).  There is some level of belief and agreement that all SSRI drugs in high dose can produce delirium/serotonergic toxicity associated with disturbed behaviour of various sorts. There is less certainty about therapeutic doses and early behavioural change – where there are at least many reports of increased aggression, behaviour change, violent nightmares, homicidal acts and suicidal ideation”.

 

Professor Jones had considered all the evidence of Michael’s aggressive and worsening behaviour. She states it is suspected that he was taking well in excess of the dosage of Citalopram prescribed to him prior to the killings.

She opines: it is possible that the Citalopram may have contributed to bizarre behaviour, increased aggression and possibly murder/suicide.  It is also very likely that external factors such as the suicide of Mr Richardson’s grandfather have contributed, together with relationship issues.”

 

Whilst the evidence is inconclusive, the possibility that Citalopram may have been a contributing factor in these deaths cannot be discounted. I note there is ongoing research into the possible side effects of the drug.  The sadness here is that if Citalopram exacerbated Michael’s mental instability it did it at a time when he believed he was being helped. 

The issue of Domestic Violence –       The families were alarmed that Lisa Sales had flagged to the couple the possibility of domestic violence escalating and resulting in homicide.  Ms Sales’ evidence was that she wanted both Roxanne and Michael to understand that it all can go terrible wrong when people just ‘snap’.  She was highlighting the seriousness of their situation.

The families believed she may have planted a ‘seed’ in Michael’s mind that the only way to resolve these issues was to bring about the deaths of Roxanne and the children.  I do not agree.  Michael’s alarming behaviour needed to be confronted ‘head on’.  Roxanne’s acquiescence in applying for a Domestic Violence Order also needed to be rigorously challenged. Had an order been put in place, Michael’s firearms would have been seized and the police alerted to the violence in their home.

Ms Sales provided tremendous support for both Roxanne and Michael.  Unfortunately neither one of them headed her advice. The best she could do in the circumstances was to be there when support was required.  Ms Sales could not step away from the confidentiality of the relationship between her and her patient/client to alert police.

I do believe, however, that there should be legislative change to make mandatory reporting to police if a health professional (including counsellors) believes a person is at risk to themselves or others if they have access to firearms.

Conclusion

Detective Fox believes Michael intended to return home to his father’s place (where he was living) after visiting Roxanne and the children.  There were a number of indicators to support this including food that was being defrosted for dinner that night.

Detective Fox opines: “In all likelihood the murder of his family was not a planned act, but more a spontaneous decision made in a moment of rage”. I agree with this view.

Detective Fox believes the evening to have unfolded this way:

“From all the evidence it appears that the children were given their dinner, bathed and put to bed around their normal times.  Roxanne had already indicated she was not happy with Michael calling in and staying well into the evenings.  She had indicated to her mother earlier that afternoon that she wanted to tell Michael a few things. Her mother felt that by this she meant that she was going to tell Michael that the marriage was irretrievably over.  This combined with Michael’s annoyance at discovering the house locks had been changed, his unwavering belief that the separation was only temporary may have culminated in one of his ‘snaps’ he described to Psychologist Lisa Sales.

 

“It is most likely Roxanne was murdered first….the lack of blood from Roxanne on any floor is consistent with the initial stabbing having occurred in the main bedroom………

 “He used the knife to stab Roxanne in the upper chest.  The injuries to Roxanne’s left hand are indicative of defensive wounds in an apparent attempt to fend off the attack………

“She was then lifted onto the bed by Michael by Michael…..she was placed on her chest and her face was pressed down with a pillow into the bedding”  Detective Fox believes Roxanne would have struggled and this would account for some bruising found on her body.

“It is not known which child was murdered first; however one might assume that Luke was Michael’s next victim.  The basis for this is that Grace would not be able to leave her cot.  Due to her age she was least likely to be alarmed if she had heard her mother’s struggle or cries for help.  Michael hand may have thought that Luke on the other hand may have been woken by the noise and attempted to leave his bed.  In any case it appears that both children were still in theirs beds and were murdered whilst they slept.  Luke was suffocated by pushing his head down into his pillow using a second pillow, possibly the one lying on a chair adjacent to his bed.  He was then carried into the main bedroom and placed on the right side of his mother.  Grace was suffocated face up and similarly carried into the main bedroom.  She was placed on Roxanne’s left side on top of her mother’s outstretched left arm.  According to Dr Lee both children would have known little of their deaths……

“Michael has then prepared for his own death obtaining the rifle from his vehicle….He lay on the far side of the bed next to Luke.  He has placed the rifle on his chest under a pillow, which would have muffled any noise to some extent.  He then placed the end of the barrel under his chin and pulled the trigger.  Death would have been instantaneous”.

On that day, 11 July, Michael had written in his diary before visiting Roxanne “I am hurting so much nothing matters to me any more but ‘my family’.  They are getting taken from me”.

Findings

I find that Roxanne Richardson (nee Hopson) died on 11 July 2004 at 55 Durham Road, East Gresford. The cause of death is the ‘combined effects of stab wound of the chest and asphyxia’. The manner of death is ‘homicide’ by a person since deceased.

I find that Luke Richardson died on 11 July 2004 at 55 Durham Road, East Gresford.  The cause of death is ‘suffocation’. The manner of death is ‘homicide’ by a person since deceased.

I find that Grace Richardson died on 11 July 2004 at 55 Durham Road, East Gresford. The cause of death is ‘suffocation’.  The manner of death is ‘homicide’ by a person since deceased.  

I find that Michael Richardson died on 11 July 2004 at 55 Durham Road, East Gresford. The cause of death is a ‘gunshot wound to the head’.  The manner of death is ‘suicide’.

Recommendations

To the Minister for Police and Police Commissioner:

  • That the Firearms Act (Section 79) be amended to ensure mandatory notification to police by all health professionals (including counsellors) if they believe or suspect that a person is at risk of self harm or harming another by having access to firearms
  • That where an applicant for a Firearms Licence (in the first instance or for renewal) has attempted self harm at any time, the applicant must provide a comprehensive assessment by a psychiatrist as to his fitness to hold such a licence.  (My preferred position is that anyone with a history of self-harm be prohibited from holding or obtaining a firearms licence, however that may be far too restrictive).

 

To the Minister for Health and the Therapeutic Goods Administration:

    • That the use of Citalopram in the treatment of depression be monitored and further studied to determine its effectiveness in the treatment of depressive illness and to guard against any side effects that may exacerbate a predisposition to violent behaviour.

 

Comment

Detective Fox very sensitively makes this observation: “The tragic events of the 11 of July 2004 have had a significant impact on many beyond the Richardson and Hopson families.  The rural community of East Gresford was deeply saddened and shocked for some time.  The effect this has had on emergency personnel also cannot be understated”.

I commend Detective Fox for a most professional and comprehensive investigation into this terrible tragedy.  He is a fine officer and his integrity, decency and compassion for the families went far beyond what would have been expected from any investigator. Detective Fox’s application to duty reflects extremely well on the Commissioner for Police and other members of the Constabulary.

Magistrate Jacqueline M. Milledge

Senior Deputy State Coroner

12 June 2007

 

  


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