On May 8, 2004, Dan Markingson killed himself while participating in a University of Minnesota Department of Psychiatry drug study. The violent nature of Markingson’s suicide — he slashed open his neck and abdomen with a box cutter — is cited by some as evidence of his continued psychotic condition despite having been in the university drug study for approximately five months, according to a report by Legislative Auditor James Nobles.1
The following are some of the key points in the auditor’s report:
- In 2003, Markingson was a 26-year-old aspiring screenwriter living in Los Angeles after having earned a BA in English from the University of Michigan. When his mother visited in July, she noticed disturbing changes in her son’s behavior. For example, Markingson had set up wooden posts around his bed to create an “astral field,” and he thought an alien had burned a spot on his carpet.
- While back in Minnesota on November 12, 2003, Markingson talked about participating in a satanic ritual in which he might be required to kill people, including his mother. In response, Markingson’s mother called police, who took him to Regions Medical Center in St. Paul. Medical staff determined that Markingson was mentally ill and posed a danger to himself or others. They placed Markingson under a 72-hour hold.
- Due to a lack of available beds, Markingson was transferred that same day to Fairview University Medical Center (FUMC) hospital and placed under the care of a psychiatrist, an associate professor at the University of Minnesota Department of Psychiatry.
- A judge put Markingson’s slated commitment to a state psychiatric facility on hold for six months on the condition that he agree to comply with FUMC’s treatment plan. Markingson’s treating physician at FUMC was also participating in a clinical drug study funded by AstraZeneca Inc., a pharmaceutical firm headquartered in London. The University of Minnesota was one of 26 sites in the U.S. and Canada conducting the three-year “CAFÉ” drug study. The study compared an AstraZeneca antipsychotic drug with two other similar drugs on individuals experiencing their first psychosis.
- The FDA had already approved the three drugs as “safe and effective” treatments for schizophrenia, so the study did not involve a new experimental treatment. The double-blind study randomly assigned one of the three medications to the patients. The study coordinator took Markingson’s psychiatric and medical history and obtained his informed consent to participate.
- Markingson was extremely vulnerable when recruited into the study, according to the report. He was mentally ill and faced commitment to a state psychiatric hospital if he did not cooperate with the FUMC treatment plan and the treatment team’s aftercare recommendations following discharge.
- Markingson’s mother, Mary Weiss, expressed strong concerns about her son’s participation in the drug study and continually warned that he was not improving. There is little evidence that the study team adequately followed up with her about her concerns, according to the report.
- His subsequent suicide occurred in the bathroom of a state-licensed group home for people with mental illness.
- In 2009, the Minnesota legislature passed a law restricting the enrollment into drug trials of persons under a stay of commitment.
- Nobles, J. Office of the Legislative Auditor, State of Minnesota. A Clinical Drug Study at the University of Minnesota Department of Psychiatry: The Dan Markingson Case. Special Review: March 19, 2015: http://bit.ly/1xjI5IB.