Tufts Medical Center

State regulators should more closely oversee hospital costs, including setting prices, limiting new programs that make money for hospitals but drive up overall costs, and even sitting in on contract negotiations with insurers, Paul Levy, chief executive of Beth Israel Deaconess Medical Center, said yesterday. On the final day of Patrick administration hearings into the state's escalating health care costs, hospital chief executives suggested a range of solutions but did not reach agreement on what to do first. Levy, who had testified on Thursday, was called back by Assistant Attorney General Thomas O'Brien to answer more questions. Levy said Massachusetts teaching hospitals have too many solid organ transplant programs, considering the relatively small number of patients who need transplant surgery. And, recently, after Brigham and Women's Hospital started a face transplant program, a doctor on Levy's staff said, ``We should do that, too,'' he said. ``I said no. Society has enough face

Ray Tye was one of Boston's biggest philanthropists, but he didn't much care for the title, and he was even less interested in drawing public attention to his private donations. The chairman emeritus of United Liquors, who died of cancer in his Cambridge home yesterday at 87, gave away millions, often covering the medical expenses of people described in news stories as unable to afford life-saving care. ``He always did this quietly,'' said his wife, Eileen. ``He never wanted his name chiseled into a hospital facade or put on a plaque.'' And he agreed to be the public face of the Ray Tye Medical Aid Foundation, established in his honor by his wife and friends, only because it might prompt others to contribute to the good will he saw as his life's work. ``Ray Tye was a great Bostonian and an even greater source of inspiration,'' Mayor Thomas M. Menino said in a statement yesterday. ``He did so much for so many, always offering help to those that needed it the most. His legacy of helping

BROCKTON - Michael and Carolyn Riley are still apparently deeply in love, relatives say, describing them as a couple who married 16 years ago after graduating from Weymouth High School and kept close as they struggled with mental disorders and money woes. But in a courtroom yesterday, prosecutors portrayed them as a murderous couple who, on a December night in 2006, gave a fatal overdose of psychotropic drugs to the youngest of their three children, 4-year-old Rebecca. She was found dead the next morning on the floor next to her parents' bed in their Hull home. Carolyn Riley, 35, was convicted last month of second-degree murder in the case. Yesterday, the case that has drawn national attention focused on Michael Riley, who is charged with first-degree murder. During opening statements, prosecutor Frank J. Middleton Jr. portrayed the father as a domineering, violent figure in the family who called Rebecca ``a little wench,'' among other perverse names. He said Michael Riley, in the week

Most see a group of accomplished chief executives and the companies they represent, many of the largest businesses in the state. Some know those executives as active members of civic organizations. Others look at the partnership and see a group of 13 white men and one woman. The demographics of the group that many think of as the ``new Vault'' aren't very different from those of the original Vault, a group of Boston business leaders who influenced local public policy decades ago. ``It's a great idea to have business people get together and do what they can to create jobs, so I'm all for it,'' said Kathleen Stone, president of the Boston Club, an organization for executive women. ``I do think that Boston would be even better served by a group of people that is more representative of the people who live and work here.'' So do other senior executives in Massachusetts who are women or minorities. But most interviewed on the subject declined to speak for the record, often citing business re

Tufts Medical Center says it has found a way to trim the high cost of nursing while improving care, but the plan prompted a protest yesterday outside the Boston hospital by nurses, who say it is an example of the intense cost-cutting pressure on hospitals statewide. Labor is typically a hospital's biggest single expense and one of the fastest growing, and nurses are the largest portion of that cost, with the average salary for a Massachusetts nurse rising nearly 40 percent from 2003 to 2008. Tufts administrators said they will save up to $3 million annually by increasing the number of patients assigned to each nurse, which will allow the hospital to hire fewer nurses. But they said cost was not the primary reason for the change, adding that they want to improve care and working conditions for nurses. The hospital is bringing on 35 technicians to free up nurses from unskilled jobs like transporting patients to imaging tests and tracking down missing meals, so they can focus on monitorin

A South Shore mother was found guilty yesterday of second-degree murder in the death of her 4-year-old daughter, Rebecca, who went to sleep one night after being given toxic levels of psychotropic drugs and never woke up. Carolyn Riley, 35, showed no visible emotion when the 12-member jury returned the verdict after 19 hours of deliberations in Plymouth Superior Court. Riley, her upper chest displaying a ``Rebecca 12-06-06'' tattoo that reflected her daughter's date of death, was handcuffed as soon as the word guilty was uttered by the jury forewoman. Before sentencing, Judge Charles Hely permitted the reading of a letter from Ashley Davidson, 17, Riley's first biological daughter, who as a toddler was removed from her mother's care, placed in a foster home, and eventually adopted. The teenager condemned her mother for the cruel fate she delivered Rebecca, as well as the tormenting memories left for her and Rebecca's two other siblings, ages 14 and 9, now both in foster homes. ``When I

A South Shore mother was found guilty yesterday of second-degree murder in the death of her 4-year-old daughter, Rebecca, who went to sleep one night after being given toxic levels of psychotropic drugs and never woke up. Carolyn Riley, 35, showed no visible emotion when the 12-member jury returned the verdict after 19 hours of deliberations in Plymouth Superior Court. Riley, her upper chest displaying a ``Rebecca 12-06-06'' tattoo that reflected her daughter's date of death, was handcuffed as soon as the word guilty was uttered by the jury forewoman. Before sentencing, Judge Charles Hely permitted the reading of a letter from Ashley Davidson, 17, Riley's first biological daughter, who as a toddler was removed from her mother's care, placed in a foster home, and eventually adopted. The teenager condemned her mother for the cruel fate she delivered Rebecca, as well as the tormenting memories left for her and Rebecca's two other siblings, ages 14 and 9, now both in foster homes. ``When I

BROCKTON - Jurors are expected to start deliberating today on whether a South Shore mother is a tragic figure whose daughter died of a rare, aggressive illness or a heartless con artist who used psychiatric drugs to kill her child. ``She had this little girl's life in the palm of her hand,'' prosecutor Frank J. Middleton Jr. said in his closing argument yesterday. ``And she poisoned her to death.'' But defense attorneys for Carolyn Riley, 35, described her as a kindhearted mother who placidly followed the advice of a Boston psychiatrist when she medicated her 4-year-old daughter, Rebecca. Attorney Michael Bourbeau pointed to the defendant in his closing statements, saying, ``Is that a mother trying to maliciously harm her child?'' The mother, who faces first-degree murder charges, has been an enigmatic figure in the three weeks of the trial before Plymouth Superior Court Judge Charles Hely. Even when prosecutors displayed blown-up photographs of her daughter's body as it was discovered

BROCKTON - Defense attorneys for a South Shore mother, who is accused of killing her preschooler with a drug overdose, began presenting their case yesterday, calling a forensic pathologist and the defendant's mother to take the witness stand and challenge the prosecutor's charges. The attorneys began with the most critical part of their defense: Medical testimony calling into question the prosecution case that 4-year-old Rebecca Riley died in December 2006 after her mother, Carolyn Riley, dispensed lethal amounts of psychotropic drugs. The girl, who like her two older siblings was diagnosed with bipolar and hyperactivity disorders, was on three medications before her death. Dr. Jonathan Arden, a former chief medical examiner in Washington, D.C., and now a private consultant, testified that his review of the case shows Rebecca died of ``atypical pneumonia,'' not an overdose of drugs, specifically clonidine. ``I'm confident this is a bacterial pneumonia,'' he said. The case, now in its t

BROCKTON - Defense attorneys for a South Shore mother, who is accused of killing her preschooler with a drug overdose, began presenting their case yesterday, calling a forensic pathologist and the defendant's mother to take the witness stand and challenge the prosecutor's charges. The attorneys began with the most critical part of their defense: Medical testimony calling into question the prosecution case that 4-year-old Rebecca Riley died in December 2006 after her mother, Carolyn Riley, dispensed lethal amounts of psychotropic drugs. The girl, who like her two older siblings was diagnosed with bipolar and hyperactivity disorders, was on three medications before her death. Dr. Jonathan Arden, a former chief medical examiner in Washington, D.C., and now a private consultant, testified that his review of the case shows Rebecca died of ``atypical pneumonia,'' not an overdose of drugs, specifically clonidine. ``I'm confident this is a bacterial pneumonia,'' he said. The case, now in its t

BROCKTON - A South Shore mother has yet to testify in her own defense and may never do so. However, jurors in her murder trial had the chance yesterday to observe her through two videotaped interviews, one led by a state trooper, another by Katie Couric of CBS News. Carolyn Riley, who is accused of killing her 4-year-old daughter through an overdose of psychotropic medications, voluntarily agreed to both interviews, which took place eight months apart in 2007 after her arrest. She also consented to two extensive audio-recorded interviews with State Police within a day of Rebecca's death in Hull on Dec. 13, 2006, much of which was also played for the jury earlier this week. With some notable exceptions, the mother's demeanor and statements were similar in the tapes: She flatly recited the three potent mood-altering drugs that all three of her children were on for bipolar and hyperactivity disorders. She said she followed the instructions of their psychiatrist, Dr. Kayoko Kifuji of Tufts

BROCKTON - Carolyn Riley sounded flat and halting as she recounted in a taped police interview how she thought her 4-year-old daughter had only a mild illness the day before she died. ``I just thought it was a cold,'' the 35-year-old Hull mother, her voice often barely audible, said in the recording played to jurors yesterday in her first-degree murder trial. Riley, who is accused of killing her daughter with a fatal overdose of psychotropic drugs, voluntarily submitted to the interview only five hours after Rebecca's body was found at her parents' bedside in Hull around 6 a.m. on Dec. 13, 2006. During much of the 75-minute interview with State Trooper Anna Brookes, Riley sounded like a parent with nothing to hide, recounting the multitude of mood-altering drugs that Rebecca and her two older siblings were taking for bipolar and hyperactivity disorders and naming the various physicians and psychiatrists that were in touch with the family. On the tape, she described the day of Dec. 12,

BROCKTON - A Hull woman accused of killing her 4-year-old daughter with an overdose of psychotropic drugs has been portrayed by prosecutors as lying about the most profound matters, such as how many pills she gave the girl just before she died. But testimony presented yesterday in Plymouth County Superior Court suggested that Carolyn Riley may have been far from truthful on more mundane issues, such as missing gifts cards at Walmart and Stop & Shop. Earlier in the trial, a school counselor testified that within a day of Rebecca Riley's death, Carolyn Riley, 35, and her husband, Michael, 37, appeared unannounced outside her office, saying that $200 in gifts cards that the counselor had regifted to them were missing, perhaps even stolen by housemates. The couple asked for help to get reimbursements. However, it appeared that the cards had been used by the couple. Yesterday morning, State Police Lieutenant Paul D'Amore told the 16 jurors that three months after Rebecca died, he was author

BROCKTON - A pathologist from Children's Hospital Boston testified yesterday that 4-year-old Rebecca Riley died when an aggressive bacterial pneumonia moved quickly through her small body weakened by toxic levels of sedating drugs. When asked by First Assistant Plymouth District Attorney Frank J. Middleton Jr. to identify what Rebecca died of, Dr. Sara Vargas said she believed both the severe illness and medications, specifically clonidine, played a role. ``I believe she died of acute bacterial pneumonia in a setting of toxic levels of drugs,'' Vargas said in the first-degree murder trial of Rebecca's mother, Carolyn Riley. The prosecution has charged the mother with killing her daughter by giving her a lethal overdose of drugs and showing a ``malicious failure'' to obtain medical attention for a severely sick child. Vargas's testimony, however, also at least partially backed up the defense case that a fast- moving lung infection, one that would catch even conscientious parents off gua

BROCKTON - Jurors in the first-degree murder trial of Carolyn Riley, accused of killing her 4-year-old daughter through a fatal overdose of psychiatric drugs, heard more yesterday about the child's father and how he may have influenced the atmosphere in the home prior to the girl's death. A Weymouth Housing Authority manager testified that Michael Riley, 37, had been banned since 2005 from spending overnights in the family's apartment there, the result of pending charges that included providing pornography to a minor. A social worker said the father's alleged beating of his son in 2006 triggered a renewed child-abuse investigation, and the mother, while remaining devoted to the father, filed a restraining order to protect the boy. A house guest also testified that the Rileys' three children often seemed ``more timid'' when their father was around. But Dr. Kayoko Kifuji of Tufts Medical Center, the psychiatrist for all three of the Riley children, portrayed the father as a positive infl

A psychiatrist for a 4-year-old girl whose mother is accused of giving her a fatal prescription drug overdose acknowledged Monday that she repeatedly increased the dosages after the mother reported the girl was aggressive and had trouble sleeping.

Psychiatrist testifies in Mass. trial of mom accused in drug overdose of toddler. A psychiatrist for a 4-year-old girl whose mother is accused of giving her a fatal prescription drug overdose acknowledged Monday that she repeatedly increased the dosages after the mother reported the girl was aggressive and had trouble sleeping.

BROCKTON - The mother of 4-year-old Rebecca Riley was depicted yesterday by a former housemate as a woman dominated by an autocratic husband who frequently yielded to his demands, including that she get their three children to quiet down by giving them earlier-than-scheduled dosages of their psychotropic medications. Kelly Williams, who used to live with the Riley family in Hull, quoted Rebecca's father as saying to his wife: ``You got to shut them up. Go get the medication.'' According to Williams, this dynamic played out in the period before Dec. 13, 2006, the day Rebecca died of what prosecutors say was an overdose of clonidine, one of the three mood-altering medications she was taking for bipolar and hyperactivity disorders. Williams's appearance ended what was the first full of week of testimony in the first-degree murder trial of Carolyn Riley, Rebecca's 35-year-old mother, in Plymouth Superior Court. The father, Michael Riley, faces the same charges and is being tried separately

BROCKTON - Five months before 4-year-old Rebecca Riley died from an alleged overdose of psychotropic drugs, a Weymouth social worker warned the girl's mother that the child seemed overmedicated and contacted the state's child protection agency to say the family relied on an alarming amount of mood-altering medications. In the first-degree murder trial of Carolyn Riley, Rebecca's mother, a social worker at South Bay Mental Health Center testified that she also repeatedly suggested that the mother obtain a second opinion on whether Rebecca, as well as her older sister, then almost 6, should be on three powerful psychotropic drugs. Both girls were diagnosed by the same psychiatrist with bipolar and hyperactivity disorder at age 2, and, according to witnesses, often looked so weak that they could not grip a crayon and draw. The mother, who had heard similar words of concern from staff members at Rebecca's preschool, consistently refused. ``She felt the medications were very effective,'' An

BROCKTON - Reimbursements for missing gift cards and refunds for Weymouth High School reunion tickets were among the preoccupations of the mother of Rebecca Riley, 4, only a day after the girl died, several witnesses testified yesterday. As the first-degree murder trial of the mother, Carolyn Riley, 35, entered its second day, several staff members at Weymouth public schools, where Rebecca's older siblings attended, testified about unannounced visits they received from the parents on the morning of Dec. 14, 2006. Just 24 hours earlier, their youngest daughter, Rebecca, had been found dead lying next to her parents' bed as a result of an overdose of psychiatric medications, prosecutors say. Surprised to see the mother waiting outside her school office, Kimberly Stetz, a former counselor at Abigail Adams Middle School, said she offered condolences to Riley and then listened as the mother raised a specific issue: ``She asked if I had the receipts for the gift cards.'' Stetz said the mothe