KMSP-TV has been punching above its weight lately. First they did a story on the Markingson case that I commented on earlier on Community Voices. See: "Send in the Wackos..." Their latest effort in the Investigators series is quite good and thought provoking. Long time newsies will recognize the narrator for this piece, the excellent Trish Van Pilsum.
This new piece is titled "U Insider" where insider is being used in the same way that it is used in the phrase "insider trading." I'd encourage those interested to watch the video - link given above - or at the same location the case is outlined in text form. I've also put up most of the report on my blog The Periodic Table with highlighting of the very best parts...
So what's the short version? (source of all quotations)
1. A university employee was allegedly harrassed into taking a supervisor on an illegal mule deer hunt on a reservation in South Dakota. She was cited, admitted guilt, and paid a fine.
The Standing Rock Reservation is in South Dakota -- 430 miles from the Twin Cities campus, and U officials -- like the vice president of university services -- would very much like to play up that distance.
"I really don't have any comment about something that happened off university property or off university time," Vice President of University Services Pam Wheelock told Fox 9.
Louden pleaded guilty to the two citations. Off campus? Sure -- but very much a universtiy issue because according to an anonymous complaint filed with the U, Louden repeatedly harassed one of her subordinates to take her on the hunting trip in the first place, calling him dozens of times until he relented. He ended up paying a $250 fine for aiding and abetting the illegal hunt.
Professor David Schultz, a nationally recognized expert on business ethics at Hamline University, had this to say:
That seems perfectly inappropriate. "This is using your position of authority for purposes of getting something from your subordinates that seems completely illegitimate."
The U says its own internal investigation found no evidence of harassment. They wouldn't say if they checked Louden's phone records -- something they wouldn't turn over to the Fox 9 Investigators, citing privacy.
"That's all the comment I have," Wheelock said. "It was investigated and closed without discipline."
The U also wouldn't tell Fox 9 if they reviewed the poaching criminal file. The Fox 9 Investigators obtained it through the federal Freedom of Information Act.
2. A University of Minnesota supervisor apparently rigged bids for a contractor friend.
What appears to be tiny, toy people scurrying atop a cold, windy roof on the U's East Bank are real bidders taking part in a process that is supposed to be a level playing field. No one company should have an edge in order to protect the taxpayer.
"Certainly, it sends up the red flags," Schultz said.
Yet, anonymous facilities management workers complained that Louden rigged the system, eliminating the competition for a roofing company owned by a guy she's known for a long time. The business is Skyline Building Envelope Consultants, mostly roofing consultants. The man is Rod Schalesky.
An internal investigation by the university dismissed the complaint after Louden insisted their relationship was purely professional, but the U's own investigation failed to note the following things revealed in e-mails obtained by the Fox 9 Investigators:
Unfortunately for that claim, e-mail records obtained by the KMPSP investigators revealed that:
1. Schalesky said he would drop proposals at Louden's home for her to review -- a practice that other consultants for several companies in the same business say is unheard of.
2. When Schalesky moved from his home and office, Louden told him in an e-mail, "If you need something, let me know."
3. Twice before, Schalesky's company was to present competitive bids on large products, and he discussed his bids with Louden. This, according to U policy, is supposed to be a confidential process.
4. The university paid Skyline's liability insurance so the company would work on a U project.
U officials say Skyline's work was still a bargain, but the e-mails show that the finance folks -- even Beth Louden's boss, Mike Berthelsen -- didn't like it. Still, the insurance got paid and Skyline got the job.
"I don't believe that violates any policy," Wheelock said repeatedly when asked whether such payments were appropriate.
The university apparently dismissed a complaint that the bidding was organized to favor the bidding by the company Skyline owned by Loudon's friend Schalesky:
but according to e-mails, it appears she and her staff did just that.
Instead of considering the inspection of several buildings as one big project, which would have to be put out for bid, she told them to break up the inspections building by building. That kept prices low enough that Skyline would be given the work without bidding for it.
A pile of purchase orders show Skyline pulled in hundreds of thousands of dollars over the past 5 years.
So why would UofM supervisor Louden try to give Skyline/Schalesky the edge?
A few years back, the Loudens wanted to join a class-action lawsuit against the company that made the old shingles on her house, but before she could, she needed an inspector to sign off that her shingles were bad. A former inspector for Skyline did just that.
Yet, when asked how much Louden paid for that inspection, Schalesky told Fox 9, "There was no inspection."
Schalesky owns Skyline, and at first, he denied his company helped Louden with her lawsuit; however, when Fox 9 told him his former inspector had spoken with reporters, Schalesky said, "He went out there and picked up a sample of the shingles that had fallen off the roof."
The former Inspector said there was more to it than that, and settlement documents appear to confirm it. He says he took three samples from the roof and took photographs before filling out paperwork. Fox 9 checked to see what was actually required for the settlement -- photos and a sample from the roof.
The inspector said he didn't get paid for what he described as a $200 to $300 job. Why? Schalesky told him Louden was a good customer. Schalesky does not dispute it was done as a favor to Louden.
But according to Professor Schulz:
"There is no such thing as a small favor."
3. Have "favors" been done by University of Minnesota employees at the Loudon residence?
Favors? The U's investigation checked out complaints that Louden had employees working on her home or property. She denied it. That was good enough for the U auditors -- but Fox 9 spoke with neighbors who say they've seen university vehicles coming and going from Louden's house during the day.
4. Complaints were made about unnecessary spending
One of the complaints about her said she spent what she wanted on things like food for meetings and gatherings. Two years of food receipts show the department spent $12,299 on food bought from local business for routine meetings -- most involving Louden or her workers. By way of comparison, the University of Wisconsin's facilities department didn't spend a dime because budgets are just too tight.
According to a memo written by Louden, she and 9 others planned to head to Las Vegas for what's billed as the largest trade show for custodial supplies in North America.
Conference officials say the average size of groups attending was just 5, and none of the Big 10 universities the Fox 9 Investigators checked with -- Wisconsin, Iowa, Ohio State, Illinois, or Michigan -- sent anyone to Vegas this year. Wheelock didn't know the U planned on sending people until Fox 9 told her.
So there you have it...
Nothing to see here, move along?
This situation certainly reminds me of the way the U of M has handled the Markingson case. But of course the death of a clinical trials patient is a much more serious matter.
But as an indicator of the institutional culture at the U, this case speaks volumes. The discrepancy between words and actions is obvious. Most of us can recognize why the situation described above is wrong and have witnessed similar behavior in our own lives. To the lay person the Markingson case may at first seem complicated and beyond comprehension, because who is to decide when doctors disagree?
This is but one more example of why an outside investigation of the Markingson case is necessary.
KMSP has recently called attention to the scandal and tragedy of the Markingson case in which a young man committed suicide while enrolled in a clinical trial at the University of Minnesota. The position of the university is that nothing wrong has been done by the U, the matter has been thoroughly investigated, nothing to see here. Move along.
If you have some time and have not already seen it, I'd urge readers to click the link above and have a look at the KMSP video.
Of course the university immediately tried to brush the matter off. As a recent post in MinnPost put it:
In a letter sent Tuesday to the U of M's medical community, Dr. Aaron Friedman, the dean of the university's medical school, said Baillon's report was "full of inaccuracies and unsubstantiated claims," although he did not detail them.
This is of course standard operating procedure by now at the U. What exactly were the inaccuracies and unsubstantiated claims? These blanket denials are insufficient given the evidence in the record.
One of the claims that the U has used many times is that sufficient investigation has already done that has exonerated the U of M. This claim has been demolished by Professor Trudo Lemmens, a faculty member in the law school at the University of Toronto. In an excellent summary Professor Lemmens has taken each of the proceedings the U claims has exonerated them and illustrates why this is not the case. I strongly recommend that anyone with an interest have a look at this summary on ScribD. (Unfortunately because of the way it is formatted and the length, it would be difficult to summarize here.)
I've posted before on the Markingson case at the University of Minnesota. See for example:
May 20, 2013: The Markingson Case: A Tragedy But Not A Scandal?
"It is critical for the University of Minnesota to regain its good name and to take steps to see that something like this never happens again.
To defend the behavior of the University in the Markingson case is a fool's errand."
June 5, 2013: Response to University of Minnesota President's Letter
I am perplexed as to how the president could make the claim that the actions of the University did not "in any way" contribute to the death of Mr. Markingson.
Even a small sampling of the events that occurred makes this claim very difficult to back up. The fact that the General Counsel at the University of Minnesota did an investigation means exactly nothing. He is the University's mouthpiece and the results of his supposed investigation were never made public.
So why is the University of Minnesota so afraid of an unbiased, outside, investigation? If it is true that the U has done nothing wrong, why not do it? The fact that a large number of people both inside and outside the University have asked that this be done is of no consequence? Many of these people are alums, faculty, and citizens of the state of Minnesota.
Send in the wackos...
In March, a writer from "Scientific American" contacted the school for a piece she was doing about the Markingson case
"I became more and more appalled at errors and breaches in normal research conduct," writer Dr. Judy Stone, MD, said.
The university's senior director of communications sent out an internal message that read in part, "I looked her up and can't tell if she's a wacko or not…. I get nervous about anyone who would pay any attention to Carl."
"I was shocked that the university response to my inquiry was that I'm a wacko," Stone said.
Stone spent 24 years conducting clinical trials and even wrote a book about it. She said she started her reporting on Markingson with no interest on one side or the other, and she has never met Elliott.
"They won't talk to me and have told other faculty also not to talk to me," she said.
And for a supposed senior director of communications at the U to make the statement:
"I looked her up and can't tell if she's a wacko or not..."
is both outrageous and incompetent. It takes a simple Google search to discover that not only does Dr. Stone have experience in clinical trials, she has also written a highly regarded book on that topic that is rated at 4.8/5 stars on Amazon. I will not further embarrass the director of communications by quoting from the many laudatory reviews of this well regarded book on clinical trials.
So the other pernicious and disturbing aspect of this case is the implication that anyone who would pay attention to Carl Elliot is a wacko. This is outrageous.
So 3,413 people who signed a petition for an independent investigation of the matter are wackos? Including practicing psychiatrists, medical ethicists, medical journal editors, U of M alumni, and citizens of the state?
A link to the institutional affiliations of the 170 scholars may be found here. The qualifications of some of the petitioners may be found here. To dismiss the opinion of these people because they "pay attention to Carl" beggars belief.
As the highly regarded psychiatrist and psychoanalyst Dr. Mickey Nardo put it:
...the care [Markingson] got didn’t approximate his best shot – not even a good shot. He spent 6 months languishing in a halfway house on a weak-sister medication that was having, at best, a sub-optimal effect. And he succumbed to a violent psychotic suicide in plain view, a testimony to the inadequacy of the treatment. Such things can happen in the best of circumstances, but this was the nowhere close to the best of circumstances – a patient under care who was neglected.
...neither burnout or understaffing appear to be the case here. This is something else that shouldn’t ever be in the mix – corporate greed. And in this case, it filtered down to the people doing the clinical trial itself and resulted in negligence in medical care, failing to engage the case at hand. It is a scandal that deserves full investigation and exposure, at a minimum – and maybe its days in court.
What EXACTLY is it going to take for my university to step forward, take responsibility, and see that things like this don't happen again?
I am not #umnproud. I am #umn ashamed, sorry to say.
William B. Gleason
University of Minnesota faculty and alum
[It isn't the wackos that are the problem here, it's the clowns.]
(AP Photo/The Star Tribune, Renee Jones Schneider)
For some background on this matter please see my earlier post on the petition to Governor Dayton calling for an independent investigation of the suicide of Dan Markingson.
Since that time more than 2500 people have signed the petition including citizens of Minnesota, and students, faculty, and alumni of the University of MInnesota.
Also among the signers are three former editors of the highly regarded New England Journal of Medicine; the editor of the Lancet - a highly respected British medical journal, a former editor of the British Medical Journal and the former health and disability commissioner of New Zealand as well as more than 200 experts in medical ethics and related disciplines. Others include a medical historian with expertise in the Guatemala syphilis studies, which resulted in an apology by President Obama in 2010, and one with expertise in the infamous Tuskegee experiments.
In his recent opinion piece on the Star-Tribune, Dean Friedman hypothesizes that "The University of Minnesota research case is not a scandal."
The first thing that pops up on the web for a definition of scandal is:
scandal (noun): An action or event regarded as morally or legally wrong and causing general public outratge.
synonyms: disgrace, shame
Based on the signatures, qualification, and comments of those calling for an independent investigation, I'd say that this situation qualifies eminently as a scandal.
The fact that the Dean starts his piece with this semantic argument indicates how weak his case really is.
But there is more...
Dr. Friedman states:
"The story may be familiar to some readers. For years, Elliot has focused his energy on this single issue. Yet as Elliot clamors for more examination, he seems to feel no responsibility to accurately report what has already been done."
a) Dr. Elliot has contributed greatly to our understanding of what I will delicately call the academic-medical-pharmaceutical complex using the Markingson case as well as many others to make major contributions to the medical ethics field. To belittle his efforts is unworthy of a medical school dean.
b) "accurately report what has already been done" This statement is almost laughable. Dr. Elliot has published copious documentation in this case on ScribD, as well as on his website. All we have gotten from the university is the same boilerplate denials. The tactic is simply to deny and stall and then to claim: "well that happened a long time ago."
In Dr. Friedman's own words:
"Nine years later, it is time to stop blaming our university and our researchers."
What really galls me is the following statement by Dean Friedman:
"Judge the university not on unfounded accusations, but on careful examination of the facts surrounding this case, and on the scale of the groundbreaking advancements taking place across our campuses every day."
I've already indicated who has carefully examined the facts (Elliot) and who is in denial of them (Dean Friedman) but this final argument that we should just forget about the Markingson scandal because of the "groundbreaking advancements taking place across our campuses every day" is preposterous.
Because advances are made we should ignore the plight of mistreated clinical trials patients. They are just so much broken crockery to sweep away?
And what is even worse about this argument - Dan Markingson did not die on the altar of "groundbreaking advancements" but in the service of a pharma sponsored trial of a drug (Seroquel) that can only be described as a marketing study.
For more information, gentle readers might want to consult the artlcle by the Strib's Maura Lerner and Janet Moore. There they will learn that in 2009, documents revealed in litigation against AstraZeneca illustrated that Dr. Charles Schulz, head of the U of M's psychiatry department and a highly paid Astra Zeneca consultant had inaccurately represented the benefits of Seroquel in both research presentations and press releases. The groundbreaking work of Dr. Schulz actually established that Seroquel was no more effective than older, existing drugs such as Haldol (haloperidol).
Someone seems to have forgotten about first, do no harm and other ethical matters, Dr. Friedman.
It is critical for the University of MInnesota to regain its good name and to take steps to see that something like this never happens again.
To defend the behavior of the University in the Markingson case is a fool's errand.
Added Later: Response from Chris Coughlan-Smith:
Hi, Professor Gleason. I can assure there is no effort to suppress discussion on this community. We have a policy in place on the approval of discussions, filtering commercial and promotional items to the correct area and deleting only profane and offensive material.
An error appears to have been made over the weekend and our policy has been reiterated with all who moderate the discussions.
I've personally approved Mr. McNabb's comments in the past and will continue to do so. I wish one of you would have asked someone in this office for a clarification. Thank you.
Chris, group founder and owner
Image Credit: Wikimedia Commons
Recently I learned of yet another attempt to stifle criticism at the University of Minnesota. It is sad, indeed, that the administration and the alumni association are engaging in the tactics of censorship and intimidation.
I sincerely hope that the next president will not tolerate this kind of activity at our university.
From my friend and fellow alum, Michael McNabb:
The University of Minnesota Alumni Association has a LinkedIn web site for posts submitted by alumni. I have sent several single sentence posts with links to essays in The Periodic Table, such as:
See the attached My Activity section of the UMAA site.
On April 30 the UMAA site blocked the submission of a single sentence post [Administration seeks to stifle criticism of research] with links to these posts:
When I scrolled down to the end of the My Activity section I saw the following question:
Are you sure that you want to permanently remove, block and delete all contributions from this member?
Then I checked the main section of the UMAA site and saw that my previous posts had been deleted.
The mission statement of the Alumni Association states that it is "dedicated to connecting alumni, students and friends in lifelong support of the University of Minnesota and each other."
It appears that the Alumni Association considers the current administration and the University to be one and the same for it excludes any perspective that challenges a course of action undertaken by the administration. (It is far easier to exclude than to allow alumni to hear different perspectives and to engage in an exchange of ideas.)
A "guiding principle" of the Alumni Association is that it "represents the independent voice of the alumni." See the UMAA site above. By excluding different perspectives of alumni the Alumni Association acts as the representative of the administration to silence the independent voices of those alumni.
Part of mausoleum of canon Guilain Lucas (1628)
Photo credit: Wikimedia Commons
Dr. Mulcahy's original letter appeared in the Minnesota Daily. I'd encourage interested readers to read it as well as my own comments at the end of the article. With the permission of Mary Weiss, I here reprint her letter. It should receive widespread attention in the community. Steps should be taken, including an independent investigation, to assure that such incidents do not occur in the future. To argue that what happened is not illegal is a far cry from the Hippocratic Oath: First do no harm.
I am Mary Weiss, mother of Dan Markingson, who died while in a University of Minnesota clinical drug study.
In a Feb. 24 letter to the editor published in the Minnesota Daily, “The Markingson case deserves better from the Daily,” R. Timothy Mulcahy, vice president for research at the University, states, among other things, that the University did not profit from the study in which Dan died.
So, this study was revenue neutral? Does the University not profit from their clinical drug research? Who would possibly believe this?
Mulcahy states non-University psychiatrists found no wrongdoing. Of course they found no wrongdoing: These psychiatrists were paid to find no wrongdoing by virtue of the fact that they were “expert witnesses” for the University. Other medial professionals have since disagreed with this
Dr. Harrison G. Pope, Jr., professor of psychiatry at Harvard Medical School, said about the study, “There is virtually no evidence that this vulnerable, severely psychotic and mentally incompetent patient was capable of understanding the study to which he was consenting.”
Or take the statement of James I. Hudson, also a professor of psychiatry at Harvard, who summed up his professional opinion of the doctor who conducted the study, saying, “Dr. [Stephen] Olson’s errors, omissions, improper acts and failures were to a reasonable degree of medical certainty, a substantial contributing factor and a proximate cause of Mr. Markingson’s death.”
Dr. Keith A. Horton, licensed psychiatrist in the state of Minnesota, said in his expert testimony, “It is my opinion that this case represents a violation of biomedical standards upon which there is a widespread consensus for informed consent and human subjects’ protection.”
Mulcahy states also in his article, “The University is steadfast in its commitment to the protection of all research subjects.”
If this had been the case, “Dan’s Law” — which was passed unanimously in both the Minnesota House and Senate in 2009 — would have been entirely unnecessary.
This law now prevents anyone on a stay of civil commitment from entering a psychiatric clinical drug study and also prohibits any doctor from putting his or her own patients into his or her own clinical drug study.
Also, Mulcahy states that “proper care was provided” to Dan. I don’t think many people would consider it “proper care” when on April 9, 2004, Easter Sunday — less than a month before he died — Dan was psychotic, and I, his distraught mother, left voice messages for Olson and also Jeanne Kenney, the study’s coordinator.
I said, “Do we have to wait for him to kill himself or someone else before anyone does anything?” thinking for sure someone would call me back in the morning and re-hospitalize Dan.
Unbelievably, no one responded — though Kenney did write my message verbatim in her study file. Evidently, the outcome of the study was more important than making a patient well or keeping him alive.
Also, Mulcahy states that no laws were violated by the University. In fact, the University was given immunity by a Hennepin County judge who cited the Minnesota law which states “[Minnesota] and its employees are not liable for … a loss caused by the performance or failure to perform a discretionary duty.”
Horton also said, “It is my opinion that no university or medical center should tolerate or condone the improper, coercive, unethical practices documented in the case of Dan Markingson. Correction measures should be instituted to prevent future injuries to vulnerable patients.”
But no correction measures have been taken. And the University still tolerates and condones improper, coercive, unethical practices.
What is it going to take for them to change? I really don’t know. Hopefully not the death of another parent’s precious child.