How Much can a Psychiatrist Charge to Visit With a Dead Research Subject?


At the University of Minnesota, the answer is apparently $1,446.

Have a look at the following exchange between Chris Barden, an attorney representing the mother of Dan Markingson, who killed himself in an antipsychotic trial at the University of Minnesota, and Charles Schulz, the Chair of the Department of Psychiatry. The exchange starts around page 207 of the original deposition transcript, which corresponds to page 186 on Scribd.

Q. Okay. Doctor, I want to call your attention to — all right. See at the top there where it says check date of 17 October 2005, right?

A. Yes.

Q. And it says, “Sponsor: AstraZeneca Pharmaceuticals, LP,” correct?

A. Yes.

Q. Okay, and it says, “Site: Stephen Olson,” has a number for him, correct?

A. Yes.

Q. Okay, and at the bottom it says, “Regents of the University of Minnesota,” and it’s Quintiles, Wachovia Bank check for $30,622, correct?

A. Yes.

Q. Okay. I’d like to call your attention to the patient visit about two-thirds of the way down, patient ID No. 13. Were you aware that’s Dan Markingson’s number?

A. No.

Q. Okay, and then you see a visit ID was visit 19. Do you see that?

A. Yes, I do.

Q. Do you see the date was May 8, 2004.

A. I do see that.

Q. And do you see the payment was made for $1,446 on that day for that visit?

A. For that line, I saw, yeah.

Q. For that visit?

A. Uh-huh.

Q. Yeah. Does that date ring a bell to you? Are you familiar with any of the dates in this study?

A. No.

Q. Yeah. Dan Markingson was deceased on that day.

A. Okay. Sorry.

Q. So he really didn’t have a visit 19.

A. Okay.

To summarize: on the date when the body of Dan Markingson was discovered, the CAFE study team billed Quintiles, the Contract Research Organization managing the study, for $1,446. What should we make of this?  The most charitable interpretation, I suppose, is that there was a clerical error of some sort (although even that charitable interpretation suggests a vast disconnect between the machinery of clinical trials and the patients who subject themselves to them.)  Give the history of this particular study, however, it is hard to avoid the suspicion that something darker may have been going on. These “clerical errors” are starting to add up.

We know, for example, that the CAFE study coordinator, Jean Kenney, falsified the initials of a physician on study records. This fact was discovered by the Minnesota Board of Social Work. We also have reason to believe that something funny was going on with the “evaluation to consent” forms that Olson and Kenney supposedly administered to determine whether subjects were able to give informed consent.  The same goes for the HIPAA authorizations that the CAFE study team was supposed to give to potential subjects.  (For background, see this post and this one.)  In fact, the CAFE study team doesn’t even seem capable of saying how many subjects were enrolled in the study.  Depending on what source you believe, the number of subjects ranges from 17 to a figure “in the 20s.”

If harmless clerical errors were to blame for oddities like this, that fact should be easy to clarify simply by looking at the relevant documents.  But if there are systematic issues with the administration of clinical trials that makes it possible to bill for a visit with a dead subject, those issues would be important for other universities and private trial sites as well.  Yet whenever I have requested access to documents, the University of Minnesota has found a way to say no.  The continued refusal of the university to investigate Markingson’s death can only fuel the suspicion that it has much more to hide.

Please consider signing the petition to investigate the death of Dan Markingson.


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