TOPEKA, Kan. (AP) — Topeka police say a 2-year-old girl has been found dead from an apparent animal attack, and that two dogs have been seized.

Police said in a release Sunday that officers responded to a report of a missing child Saturday night. When they arrived at the residence, officers found the child dead in the yard of the home.

Police said the child had been the “victim of an animal attack” and that officers also seized two dogs from the fenced yard.

Officers interviewed people involved and have sent the case to the Shawnee County district attorney’s office for review.

The child’s name hasn’t been released.

TOPEKA, Kan. (AP) — A northeast Kansas man faces about 27 years in prison for the fatal shooting of an 18-year-old man.

The Topeka Capital-Journal reports that 23-year-old Kelsey Lee Fairchild of Overbrook was sentenced Friday for the 2015 killing of 18-year-old Colton Christenson. Fairchild was sentenced to three prison terms totaling 27 years and one month.

He pleaded guilty earlier to intentional second-degree murder and two counts of aggravated robbery. Court records show that Fairchild was trying to steal $500 worth of marijuana during a drug buy when he shot Christenson.

He apologized to Christenson’s family at the sentencing hearing.

As part of the plea, prosecutors dismissed felony counts of aggravated assault and criminal discharge of a firearm in an occupied vehicle and a misdemeanor count of drug possession.

By Julie Appleby, Mary Agnes Carey

Even as the cost of EpiPens dramatically rose, so did the number of prescriptions written for patients in Medicare, sending the program’s spending on EpiPens skyrocketing nearly 1,100 percent from 2007 to 2014, a new report shows.

During the same period, the total number of Medicare beneficiaries using EpiPens climbed 164 percent, from nearly 80,000 users in 2007 to more than 211,000 in 2014, according to the analysis by the Kaiser Family Foundation.

While the report does not delve into what’s behind the increase, factors could include increased awareness among people with allergies, marketing efforts and access to insurance coverage.

The abrupt rise is notable because many people think that life-threatening allergies are less common among the elderly. In addition, epinephrine — the active ingredient in EpiPens — can pose greater risks to older adults.

Food and Drug Administration labeling urges caution when prescribing to this age group. “That level of increase gives me pause,” said Martha Twaddle, senior medical officer for Illinois at Aspire Health, which provides home-based supportive care for people with serious illness.

She did not work on the study.

Epinephrine — the active ingredient in EpiPens — can cause side effects including chest pain, rapid increase in blood pressure or irregular heart rhythms, which could be fatal for people with certain medical conditions, including heart disease. The foundation study comes amid ongoing scrutiny — including congressional testimony Wednesday by Mylan CEO Heather Bresch — over EpiPen price increases.

EpiPens are used in cases of severe allergic reactions. Costs for a two-pack of the pens has gone from about $94 in January 2007 to $609 in May of this year.

In response to criticism of its price increase, Mylan announced in late August that it would make a generic version and price it at half of its current brand name price.

The new numbers from Medicare could add fuel to the debate over these price increases and voters’ demands that Congress take action to roll back the cost of the popular medication.

The health insurance program for senior citizens and disabled people spent about $6.4 million on the devices in 2007, but that climbed to $75.3 million in 2014, with sharp price hikes by the manufacturer driving much of the increase.

Those figures reduce the amount spent based on estimates of how much Medicare saved in rebates from manufacturers, although the agency would not disclose the exact amounts. Still, when patients show up in emergency rooms with life-threatening allergic reactions, epinephrine is a first line of defense, said Robert Glatter, emergency room physician at Lenox Hill Hospital in New York City.

Those whose allergic reaction isn’t immediately life threatening would more likely get a mix of steroids and antihistamines, he said. All patients with suspected severe allergic reactions — even the elderly — are given either a prescription or an actual epinephrine auto injector upon discharge, he said.

“We tell them to have it and use it if they have a lip or tongue swelling, shortness of breath, a skin rash [or other symptoms] of a problem,” said Glatter, adding that adults tend to become more susceptible to food allergies as they age.

Increased awareness among doctors and patients about the importance of epinephrine could account for some of the increase seen in the study, said Richard Lockey, a past president of both the World Allergy Organization and the American Academy of Allergy, Asthma & Immunology.

“Most people survive an allergic reaction … the people who don’t survive are those who don’t get epinephrine or don’t get it soon enough,” said Lockey, who says it is necessary to balance this idea with the possible risks epinephrine poses for older patients. “It’s a matter of clinical judgment.”

Although Medicare is generally thought of as the government health program for older people, about 16 percent — or 9.1 million beneficiaries — are younger than 65. They are generally disabled or have kidney problems requiring dialysis. According to foundation researchers, although the majority of Medicare EpiPen users were older than 65, a disproportionate share – 35 percent — were younger than 65. Additionally, 26 percent were between 65 and 69. Use fell off with age, with only 15 percent of the users being between age 75 to 85.

“You can come up with a ton of reasons why the under-65 population might see an increase in EpiPen use,” said James Goodwin, an expert in geriatric medicine at the University of Texas Medical Branch in Galveston. He did not work on the study.

As for the overall increase, Goodwin said there are likely many factors and it isn’t necessarily evidence of overutilization. Still, Goodwin said he specializes in patients older than age 80 and has never prescribed an EpiPen, nor had three of his colleagues, who work with slightly younger elderly patients.

One geriatrician said he has patients who are on it with prescriptions from their allergists, who weigh the pros and cons of having the drug. Those physicians “are the ones to say your allergy is serious enough to potentially become life threatening.”

At the American Geriatrics Society, epinephrine is not included on the organization’s list of potentially inappropriate medicines, said Nicole Brandt, a professor at the School of Pharmacy at the University of Maryland.

“When you look at in context of someone having a severe anaphylactic reaction, which is life threatening, you want access to treatment,” Brandt said. Doctors should caution patients about the appropriate use of the devices and encourage them to seek additional medical attention if they experience side effects, she said.

She suggested the increase in Medicare prescriptions seen in the study reflects access to insurance more than overuse.

Since Medicare drug plans cover part of enrollees’ total drug costs, beneficiaries in prescription drug plans pay less that the full retail price. But beneficiaries still paid significantly more of their own money for EpiPens during the seven-year period studied in the report. Average out-of-pocket spending for beneficiaries with Medicare drug coverage nearly doubled for each EpiPen, from $30 to $56. The report does not include price increases beyond 2014.

Still, those costs are far less than what some people with private insurance might pay, particularly those with high deductibles. As a result, at least one doctor — geriatrician David Barile from Princeton, New Jersey — who did not work on the study, speculated that the rise in Medicare use of EpiPens might simply be older people getting them for their grandchildren.

— Liz Szabo contributed to this report. Kaiser Health News coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

 

ROXANA HEGEMAN, Associated Press

WICHITA, Kan. (AP) — The Obama administration has proposed barring states and other recipients of federal family planning grants from placing their own eligibility restrictions on where the money can go.

The move undermines efforts by 13 Republican-led states to prevent such money from going to Planned Parenthood.

The Department of Health and Human Services is accepting public comments about the proposed changes until Oct. 7.

Title X is a federal program designed to provide contraception services, pregnancy tests, screening and treatment for sexually transmitted diseases and cancer screenings at little or no cost to low-income patients. It does not pay for abortions.

Planned Parenthood relies on Title X to provide services to 1.5 million patients across the country, making it the medical provider for about a third of patients served by the program.

BURLINGTON, Wash. (AP) — The Latest on a fatal shooting at a mall in Washington state (all times local):

BURLINGTON, Wash. (AP) — Authorities say the suspect in the deadly Washington state mall shooting said nothing when he was apprehended and was “zombie-like.”
Island County Sheriff’s Lt. Mike Hawley said he spotted 20-year-old Arcan Cetin Saturday evening in Oak Harbor, Washington, from a patrol car and immediately recognized him as the suspect.

OFFICIAL: Here is a DOL photo of the suspect: Arcan Cetin, 20-yr-old Oak Harbor resident. pic.twitter.com/fypj6aBBJ2

— Sgt. Mark Francis (@wspd7pio) September 25, 2016

Hawley said at a news conference that his office had received information that Cetin, who is from Oak Harbor, was in the area. Hawley said Cetin was unarmed: “He said nothing. He was kind of zombie-like.”

A gunman opened fire at the Cascade Mall in Burlington, Washington, Friday night, killing four females and a male before fleeing. Law enforcement staged a massive search over more than 20 hours for the suspect.

Authorities say Cetin had a previous arrest for simple assault and had immigrated from Turkey. At a news conference Saturday night, Lt. Chris Cammock of the Mount Vernon Police Department said the suspect was a “legal, permanent resident of the United States.”

The Seattle Times cites Skagit County court records showing three domestic-violence assault charges for 20-year-old Arcan Cetin in both Burlington, Washington, and Island County, with the victim identified as Cetin’s stepfather. The newspaper reports Cetin also was arrested for drunken driving.

Court records show Cetin was told by a judge on Dec. 29 that he was not to possess a firearm, the newspaper reported.

However, the stepfather urged the judge not to impose a no-contact order, saying his stepson was “going through a hard time.”

—-

7:31 p.m.

Authorities say the suspect in a deadly shooting at a Washington state mall shooting is in custody.

The Skagit County Department of Emergency Management said via Twitter Saturday evening that the suspect had been captured. No other details were immediately available. A news conference was set for Saturday night.

A gunman opened fire at the Cascade Mall in Burlington, Washington, Friday night, killing four females and a male before fleeing. Law enforcement staged a massive search over more than 20 hours for the suspect, initially described by witnesses as a young Hispanic male wearing black.

Authorities had said that a rifle had been found at the scene.

The motive was unknown for the shooting about 60 miles (97 kilometers) north of Seattle. The FBI was assisting local authorities, but it said there was no evidence to point to terrorism.

___

Gunman captured tonight by authorities, Details forthcoming, Press Conference tonight at 1800 Continental Pl. Time TBA

— Sgt. Mark Francis (@wspd7pio) September 25, 2016

—

6:10 p.m.

Dozens of people attended a prayer service for the victims of a deadly mall shooting in Washington state.

The Saturday evening gathering was held at Central United Methodist Church in Sedro-Woolley, Washington. The Rev. Cody Natland lit five candles on a table in front of the church, one for each victim.

Authorities say a gunman opened fire at Cascade Mall in nearby Burlington Friday night, killing four females and a male.

No identities have been released yet, and a search for the gunman continued.

Images of shooter #CascadeMallShooting pic.twitter.com/hYGjH247fp

— Sgt. Mark Francis (@wspd7pio) September 24, 2016

___

2:50 p.m.

Relatives and friends of victims in a deadly mall shooting in Washington state have gathered at a church.

Red Cross counselors and a golden retriever therapy dog were on hand Saturday at His Place Community Church in Burlington, Washington.

Authorities say a gunman opened fire at Cascade Mall Friday night, killing four females and a male.

No identities have been released yet, and a search for the gunman continued.

___

2:10 p.m.

Noel Cuevas says he was eating dinner with his family at a Washington state mall when a gunman opened fire, killing five people.

He said Saturday that he saw people running and a woman told them to evacuate. He described a chaotic scene Friday night as people ran and businesses shut their doors.

Cuevas grabbed his 5-year-old daughter and ran with his wife outside and across the street.

He said everyone was terrified.

The 39-year-old Cuevas later returned to Cascade Mall in Burlington, Washington, to retrieve his truck parked near a cordoned off area.

He said he went home Friday and made sure his doors were locked because the gunman remained on the loose.

___

11:22 a.m.

A woman who was inside a Washington state mall when a gunman opened fire – fatally shooting five – says she’s “thankful for my life this morning.”

Nineteen-year-old Joanne Burkholder was watching the movie “The Magnificent Seven” in a theater at the Cascade Mall on Friday night when police and security came in and told them they needed to evacuate.

She said she heard screaming as they were escorted out into the parking lot in Burlington.

She said: “I’ve never been so terrified in my life.”

Authorities say a gunman who killed four females and a male in the Macy’s store at the mall was still on the loose Saturday.

___

10:30 a.m.

Worried residents fear for their safety as authorities search for a gunman who killed five people at a mall in Washington state.

Maria Elena Vasquez of Burlington attended a community gathering Saturday following the Friday evening slayings at the city’s Cascade Mall. She said “it’s nerve-wracking” and she’s nervous about taking her 7-year-old daughter to her soccer game.

Police said early Saturday they didn’t know the gunman’s identity and urged the community for help in identifying him.

Burlington is a city of about 8,000 people about 60 miles north of Seattle.

___

9:21 a.m.

Authorities say a gunman who fatally shot five people at a Washington state mall initially entered the shopping center without a weapon, but 10 minutes later, went inside Macy’s with a rifle and opened fire.

Mount Vernon Police Lt. Chris Cammock said Saturday that authorities recovered the weapon from the scene. He described it as a “hunting type” rifle.

Cammock says officers are reconstructing the entire scene at the Cascade Mall in Burlington, scanning for evidence.

More than 200 officers from more than two dozen agencies responded to the mall following the shooting Friday evening. Four females and a male were fatally shot.

TOPEKA, Kan. (AP) — More lawsuits have been filed against a former physician assistant accused of sexual battery and other crimes at a Veterans Affairs hospital in Leavenworth.

At least three lawsuits were filed earlier this year in U.S. District Court in Kansas accusing Mark Wisner of conducting unnecessary and improper genital examinations at the Leavenworth VA Medical Center.

Wisner surrendered his medical license last year after at least seven patients accused him of abuse. He agreed in a consent order last year that he violated the law by having inappropriate sexual contact with patients and overprescribing medication.

The Topeka Capital-Journal reports court records show Wisner now faces a dozen lawsuits, with the latest filed last week. The new lawsuits also accuse Wisner of improper genital examinations.

KANSAS CITY, Mo. (AP) — A 19-year-old Kansas City woman has been charged in connection with an accident that killed a 25-year-old man after he got out of a vehicle stopped along a Kansas City highway.

The Kansas City Star reports police say the victim asked an Uber driver to pull over along Interstate 435 early Saturday because he was sick. Police say the driver stopped on the highway shoulder and the passenger got out. A car then left the roadway and struck the victim and the vehicle he had been in.

The victim’s identity hasn’t been released.

The Jackson County prosecutor’s said in a release Alannis J. Bremer was driving the car that hit the victim and was charged Saturday with involuntary manslaughter and second-degree assault. It’s unclear if Bremer has a lawyer.

Missouri Gov. Jay Nixon on Friday granted pardons to seven men and two women, including a man who is now working as a part-time police officer in Kansas, according to a media release.

Zane Goforth was pardoned after he was originally charged in Daviess County, Mo., in 2008 for pursuing wildlife illegally for fishing without a license.

He is currently working as a corporate pilot and as a part-time Kansas police officer in the Jackson County, Kansas community of Holton

Nixon’s office said each of those granted pardons has completed his or her sentence and become a law-abiding citizen.

“Since being paroled or discharged from probation, each of these men and women has gone on to live law-abiding lives, including some who served in the military,” Gov. Nixon said.

“Through their conduct, they have demonstrated they are deserving of a pardon.”

TOPEKA, Kan. (AP) — A 60-year-old Topeka man has been sentenced to more than 13 years in prison in the death of his former wife.

Colin Edward Pritchard was convicted in June of intentional second-degree murder in the 2015 shooting death of his former wife, 51-year-old Cindy Pritchard.

The Topeka Capital-Journal reports he was sentenced Friday after a two-hour hearing that included comments from some of Cindy Pritchard’s seven children, as well as her mother, father and other relatives.

Pritchard’s defense attorneys sought to have his sentence reduced to three years and five months, contending he had acted in self-defense after his former wife pulled a pistol from a hiding place in a sofa.

The judge sentenced him to 13 years and nine months.

LINN COUNTY – Law enforcement authorities in Linn County are investigating a case of illegal hunting at the Marais Des Cygnes Wildlife Area.

On Tuesday, a public lands officer observed a small game hunter from out of state, walking on a road near a closed hunting area, according to Mitchell Fall, a warden with the Kansas Department of Wildlife Parks and Tourism.

During questioning and the immediate investigation, authorities determined there were four hunters in the area and one was missing.

Game Wardens and Deputies from the Linn County Sheriff’s Department set up a perimeter and ultimately found the missing hunter hiding on the refuge.

Two hunters were charged with hunting in a closed area, an area provided for wildlife to rest away from hunters, according to Fall.

Wardens also confiscated squirrels and a rifle.

Amount of court costs and fine were not available.

By Dan Margolies

Children’s Mercy Hospital is partnering with Olathe Medical Center to provide pediatric urgent care and specialty clinics at an as-yet unbuilt facility on OMC’s 250-acre campus at 151st Street and Interstate 35.

The partnership is the first between the two hospitals. It will allow OMC to take advantage of Children’s Mercy’s wide range of expertise in treating children, especially those with complex medical conditions.

“It ties in with our vision of providing a full continuum of care on the Olathe Medical Center campus,” Olathe Medical Center CEO Frank H. Devocelle said in an email. “We will be able to offer an enhanced level of services for children.

“This collaboration will also complement both the expansive pediatric primary care network of Olathe Health System and the new obstetrics wing with Level II Neonatal Intensive Care Unit currently under construction at Olathe Medical Center. The new NICU and The Birth Place will open in spring 2017.”

The partnership agreement comes amid more than $100 million in ongoing expansion projects at Olathe Medical Center, including a new, four-story obstetrics wing.

OMC is part of a larger system that includes Miami County Medical Center and about three dozen clinics. Including its primary and secondary service areas, it serves Johnson, Miami, Franklin and Linn counties.

Children’s Mercy operates two hospitals, one in Kansas City, Missouri, and the other in Overland Park, Kansas. It also operates outpatient and regional centers in both states. The latest U.S. News and World Report hospital survey ranked it nationally in 10 pediatric specialties.

Dan Margolies, editor of the Heartland Health Monitor team, is based at KCUR. You can reach him on Twitter @DanMargolies.

BURLINGTON, Wash. (AP) — Authorities say a fifth person has died following a shooting at a shopping mall north of Seattle.

A spokesman for the Skagit County Emergency Operations Center says the unidentified male victim died early Saturday at a Seattle hospital. Four female victims died earlier following the Friday night shooting at the Cascade Mall in Burlington, Washington.

Here is the shooter. We believe just one shooter. Notify authorities if you see him. Armed with rifle. pic.twitter.com/GXeWCPYnx5

— Sgt. Mark Francis (@wspd7pio) September 24, 2016

Authorities continue to search for the shooter. A Washington State Patrol spokesman says police were seeking a Hispanic man wearing black and armed with a “hunting-type” rifle last seen walking toward Interstate 5. Authorities say the motive was unknown for the shooting about 60 miles (97 kilometers) north of Seattle.

EMS starting to enter to attend to injured inside Mall w/ police escort and after initial clearance. pic.twitter.com/Nkfb7co6sa

— Sgt. Mark Francis (@wspd7pio) September 24, 2016