Schulz Deposition
Schulz Deposition
Schulz Deposition
1 I N D E X
2 PAGE
3 Examination:
4 By Dr. Barden 5
5
Exhibits REFERRED TO
6
A -
Curriculum Vitae-Dr. Charles S. Schulz-2/17/04 25
7 B -
Curriculum Vitae-Dr. Charles S. Schulz-12/12/06 26
C -
July 2006 Department of Psychiatry Audit Report 56
8 D -
5/10/07 New York Times Article 60
E -
6/3/07 New York Times Article 61
9 F -
4/6-7/06 CME Schizophrenia Treatment Lecture 91
G -
8/3/05 AstraZeneca Results Update-David Brennan 108
10 H -
10/3/06 Washington Post Article 115
I -
9/22/05 New England Journal of Medicine Article 124
11 J -
9/06 University of Minnesota IRB Documents 127
K -
8/6/02 IRB Letter to Ophthalmology 175
12 L -
Financial Records of CAFE Study 201
M -
10/22/03 AstraZeneca Letter to Olson 204
13 N -
10/17/05 Listing and Check 207
O -
12/11 and 12/19/03 Theodore I Records 210
14 P -
Agenda for CAFE Web-Cast Meeting w/ Attachments 212
Q -
Remittance Papers and Attachments 226
15 R -
E-Mails and Other Correspondence 236
S -
Coordinator Call Minutes and Attachments 243
16 T -
CAFE Coordinator Teleconference Agenda and
Attachments 247
17 U - 11/7/03 Pallett E-Mail to Kenney with
Attachment 258
18
19 Requests made on pages 12 and 32.
20
21
22
23
24
25
4
1 P R O C E E D I N G S
2 DR. BARDEN: Well, I guess we'll go around
3 and introduce ourselves. My name is Dr. Chris Barden,
4 and I'm here on behalf of plaintiff Mary Weiss.
5 MS. PEARSON: I'm Gale Pearson here on
6 behalf of plaintiff Mary Weiss.
7 MR. RANDALL: Stephen Randall on behalf of
8 plaintiff Mary Weiss.
9 MS. WEISS: Mary Weiss, Dan Markingson's
10 mother.
11 MR. GROSS: Chuck Gross on behalf of the
12 University of Minnesota.
13 MS. AHMANN: Bridget Ahmann on behalf of
14 AstraZeneca.
15 MS. NELSON: Angela Nelson on behalf of
16 Dr. Schulz, Dr. Olson, and the University of Minnesota
17 Physicians.
18 MR. HUTCHINSON: David Hutchinson for the
19 University of Minnesota.
20 MS. FLYNN: Ruth Flynn, University of
21 Minnesota Physicians.
22 MR. ALSOP: David Alsop on behalf of
23 Dr. Schulz and Dr. Olson.
24 THE WITNESS: My name is Dr. Charles Schulz.
25 I'm head of the psychiatry at the University of
5
1 Minnesota.
2 DR. BARDEN: Would you like to swear the
3 witness.
4 CHARLES SCHULZ, M.D.,
5 having been duly sworn, was examined and
6 testified as follows:
7 EXAMINATION
8 BY DR. BARDEN:
9 Q Good morning, Dr. Schulz.
10 A Good morning.
11 Q Have you ever been deposed before?
12 A Yes, I have.
13 Q How many times?
14 A I can't recollect for sure. I would say maybe ten times.
15 Q Have you ever been sued before?
16 A Yes, I have.
17 Q How many times?
18 A I recollect four times in my career.
19 Q And can you tell me the dates of those suits?
20 A I can give you an approximation of those --
21 Q Great.
22 A Of those suits.
23 Q That's fair.
24 A I was part of a suit brought around 1982 while I was on
25 the faculty at the Medical College of Virginia, and I was
6
1 as expert witness.
2 Q Do you have access to those? You do have a list of
3 those?
4 A I don't have a list of those, but if it were something
5 that you need, I would work with Mr. Alsop and we could
6 track down the attorneys I worked with and get those
7 cases.
8 Q Great, thank you, that would be --
9 A I mean, I'd certainly do my best.
10 Q That would be very helpful. Thank you. So you've only
11 testified -- let me ask you this: Have you ever
12 testified for the plaintiff in a malpractice case?
13 A I'm trying to think. I do not believe I've testified for
14 a plaintiff in a malpractice case.
15 Q Have you ever testified for the defendant in a
16 malpractice case?
17 A Yes, I have.
18 Q And you could -- you would be able to find out when and
19 where that was?
20 A That was about 25 years ago. So I would do my best, is
21 all I can say.
22 Q Have you testified as an expert witness in the last ten
23 years?
24 A I have testified as an expert witness I believe in one
25 case since I've been here in Minnesota in the last eight
13
1 hour.
2 Then I drafted a letter of response to
3 Mrs. Weiss. I gave the draft of the letter to Dr. Olson
4 so he could review it, make sure we were all on the same
5 page, and he knew what I was going to be sending back to
6 her, and I mailed the letter back to Mrs. Weiss. And I
7 did not have an opportunity to talk with Dr. Olson about
8 the case after that time.
9 Q How many letters did you receive from Mrs. Weiss?
10 A Well, I have one, and I realize there is some -- that
11 Mrs. Weiss has indicated there were more letters, but I
12 received a letter, I think in April.
13 MR. HUTCHINSON: Could I interrupt? Is it
14 Weiss or Weiss? It's Weiss, isn't it?
15 DR. BARDEN: It's Weiss.
16 MR. HUTCHINSON: It's Mrs. Weiss.
17 THE WITNESS: I apologize, Mrs. Weiss.
18 BY DR. BARDEN:
19 Q So to the best of your knowledge, you only remember
20 receiving one letter?
21 A That's correct, to the best of my knowledge, right.
22 Q And how many letters did Dr. Olson receive, do you know?
23 A I don't know.
24 Q During your hour-long discussion with Dr. Olson about
25 this case after Dan's death, what did you discuss in that
18
1 one-hour meeting?
2 MR. ALSOP: That's a misstatement. This
3 hour-long meeting was before his death. It's the meeting
4 about the letter.
5 DR. BARDEN: But it was the meeting. Thank
6 you.
7 THE WITNESS: Well, I don't have the letters
8 available, but it was, I would say mid-April.
9 BY DR. BARDEN:
10 Q Was there documentation made of this meeting?
11 A Other than the draft of the letter that I mailed back to
12 Mrs. Weiss in response to her letter, describing what my
13 thoughts were and my attempt to address her points, that
14 was the only documentation made.
15 Q Okay, so you had a one-hour meeting with Dr. Olson.
16 A And --
17 Q And with Ms. Kenney.
18 A Uh-huh.
19 Q About patient care of Dan Markingson, but there was no
20 documentation made of this meeting, other than this
21 letter. Is that your testimony?
22 A Well, the person was in a research study and --
23 MR. ALSOP: Well, Doctor, the question is,
24 are there any other documentation you're aware of or not.
25 Do you know?
19
1 A No.
2 Q You don't.
3 A I don't.
4 Q Can you point to me any peer review journal articles or
5 references that would indicate that Dr. Olson's behavior
6 was acceptable, that is, being the only treating
7 physician, the only treating psychiatrist, the PI, and
8 the study physician for Dan?
9 MR. ALSOP: It's vague and ambiguous, but go
10 ahead.
11 THE WITNESS: No. Yeah, I'm not aware of a
12 peer review article that discusses that.
13 BY DR. BARDEN:
14 Q Are you aware of any publications of any kind that would,
15 that discuss that?
16 A No.
17 Q Have you yourself performed those multiple functions with
18 your patients that you've treated?
19 MR. ALSOP: That's irrelevant, but go ahead.
20 THE WITNESS: Well, I have not been the
21 principal investigator of a study for quite some time,
22 maybe one or two studies, but in the past, maybe ten, 12,
23 15 years ago, I've been principal investigator of a study
24 and the person who also was the only doctor for a patient
25 in the study.
21
1 BY DR. BARDEN:
2 Q Okay, so it's been -- so in the last 15 years, you have
3 not served those multiple roles with any of the patients
4 you've seen?
5 A No, just --
6 MR. ALSOP: That's a misstatement of his
7 testimony, it's argumentative, but go ahead, Doctor, you
8 can answer.
9 THE WITNESS: I just want to think a second
10 to make sure I'm reviewing in my mind the studies where
11 I've been principal investigator. I would like to say,
12 within the last eight years, I have always involved other
13 doctors in the studies, either as the rating psychiatrist
14 or somebody that would be available.
15 BY DR. BARDEN:
16 Q So for the last eight years, you've involved others.
17 A Correct.
18 Q How many patients have you treated in the last eight
19 years?
20 A Well, my major duty is administrative in the
21 Department of Psychiatry as the department head. What I
22 do clinically is each year, either for two to four weeks,
23 I will work as the attending psychiatrist on one of our
24 inpatient services, and I --
25 Q That's for two to four weeks per year?
22
1 A That's correct.
2 Q Okay.
3 A And so I will go over to our ward, meet the resident med
4 student. We will see anywhere from eight to ten
5 patients. It provides an opportunity for teaching,
6 supervision, and discussion, but I'm the attending
7 physician for those patients during that week I'm the
8 attending.
9 Q Just for two to four weeks a year.
10 A Right.
11 Q So for the rest of the year, you're not really seeing
12 patients?
13 A Well, I'm sorry, I hadn't finished.
14 Q Okay.
15 A But I appreciate that. So I also see people in the
16 outpatient clinic, and I have maybe six or seven patients
17 I work with regularly on an outpatient basis, and I'm
18 trying to think how to quantify this. Spend anywhere
19 from two to four hours a week in the outpatient clinic,
20 sometimes more, sometimes less.
21 Q So the number of hours over the course of a year per week
22 that you spend in patient care is quite minimal.
23 A Well, I've -- compared to what? I think compared to
24 other people at the University, that's a pretty good
25 clinical load for a department chair, and I think for a
23
1 fiduciary duty?
2 A Well, I can't say whether I've heard it or not. I was
3 just hoping you could provide some further definition so
4 I could do my best to answer the question.
5 Q As the chairman of psychiatry at the University of
6 Minnesota Medical School, as you sit there now, what is
7 your understanding, and I'm not asking you for any legal
8 term at all, I'm asking you for the rights used in
9 medicine, what is your understanding as you sit there now
10 of the term a physician's fiduciary duty to patients?
11 MR. ALSOP: Object as vague and ambiguous.
12 Again, go ahead, Doctor, if you can answer.
13 THE WITNESS: You know, I would only be
14 speculating in trying to answer your question. I just --
15 I don't know.
16 BY DR. BARDEN:
17 Q Do you think it's important for a chairman of a
18 department at the University of Minnesota Medical School
19 to be knowledgeable about the rights of medical patients?
20 A Yes, I do.
21 Q Do you think it's appropriate for the chairman of a
22 department at the University of Minnesota Medical School
23 to be aware of basic terminology in biomedical ethics?
24 MR. ALSOP: Object as vague. Go ahead.
25 THE WITNESS: Could you restate the
34
1 A Sounds fine.
2 Q But there are terms and concepts that are used in
3 medicine that are also used in law, correct?
4 MR. HUTCHINSON: Objection, lack of
5 foundational.
6 MR. ALSOP: I'll join.
7 THE WITNESS: I would guess so.
8 BY DR. BARDEN:
9 Q Let me give you an example. Informed consent, that's a
10 term that's used in medicine, isn't it?
11 A Yes, it is.
12 Q It's also used in law. But if I ask you for your opinion
13 or for information you know about a term informed
14 consent, I just want to clarify, I'm only asking you for
15 your medical knowledge. I'm not going to ask you how
16 it's used in the legal world. Is that okay?
17 A That's fine.
18 Q But as a licensed physician in the State of Minnesota,
19 you are required to know some legal things, aren't you?
20 MR. ALSOP: Object to foundation.
21 BY DR. BARDEN:
22 Q Such as the rights of patients with regard to informed
23 consent. Is that right?
24 MR. HUTCHINSON: That sounds like are you
25 asking him if he's required to know the legal rights, and
36
1 A I don't know.
2 Q Have you reviewed the case records?
3 A No.
4 Q When you had your one-hour meeting with Dr. Olson and
5 Jean Kenney, you never looked at any of the records?
6 A No. I just met with them.
7 Q Did Dr. Olson ever inform you that he never obtained such
8 a document from Dan Markingson?
9 A No, he didn't.
10 Q Did Dr. Olson inform you in that hour meeting that Dan
11 Markingson was under a threat or stay of commitment when
12 he signed the informed consent form for the CAFE study?
13 A Well, you've used two terms there, one was threat of
14 commitment, the other is a stay of commitment, and so
15 maybe you could clarify which you'd want to talk about.
16 Q Are you aware of any difference between the threat of
17 commitment and the stay of commitment?
18 A I'm aware of what a stay of commitment is in Minnesota,
19 and I'm not aware there is a term in Minnesota threat of
20 commitment.
21 Q Okay. What's your understanding of a stay of commitment?
22 A My understanding of it is, is that a person can, in a
23 hypothetical example, I'm working with a patient on a
24 ward, the person would be able to leave the hospital and
25 be on a stay of commitment, and if things did not go in a
39
1 BY DR. BARDEN:
2 Q Well, that's what happened in this case. So, yeah, I'm
3 asking you --
4 A So you're asking a specific question.
5 MR. HUTCHINSON: Object to that as a
6 misstatement of the evidence and argumentative, and
7 object to the preface.
8 MR. ALSOP: I would join in those
9 objections.
10 BY DR. BARDEN:
11 Q The record speaks for itself. Let's do it generally
12 first. Have you had a psychiatrist --
13 A We're talking hypothetically, now.
14 Q Let's start with a hypothetical, yeah.
15 A Okay.
16 Q Psychiatrist is instructing a court that a person is not
17 competent to make decisions for themselves with regard to
18 finances, travel, freedom, etc., but at the same time,
19 they're keeping the person in a research study in which
20 they have to be able to give consent. Would you have
21 trouble, have any concerns, if you saw that behavior in a
22 psychiatrist under your supervision?
23 MR. ALSOP: Object as vague and ambiguous.
24 Go ahead, Doctor.
25 MR. HUTCHINSON: Object on grounds of lack
42
1 of foundation.
2 MS. AHMANN: Join.
3 THE WITNESS: You know, my best answer is I
4 would want to know more. I think in the, my
5 understanding, in the State of Minnesota, a committed
6 person still, if felt to understand a research study, may
7 participate in a research study.
8 So I do understand your question, and it
9 would cause me concern if I were to learn about the
10 scenario you described, but then there would be other
11 circumstances or I'd want to know more about the story of
12 how the person could stay in the study and be a committed
13 patient.
14 BY DR. BARDEN:
15 Q Are there special rules and principles at the
16 University of Minnesota with regard to research subjects
17 who are decisionally impaired?
18 MR. ALSOP: Object on the basis of
19 foundation. Go ahead.
20 MR. HUTCHINSON: Join.
21 BY DR. BARDEN:
22 Q Well, let me deal with your lawyer's objection. Do you
23 know what the term decisionally impaired means?
24 A Yes, because I also collaborate with people who work in
25 research with, clinical research with people with mild
43
1 every ward, and that the staff on the ward, any staff,
2 can write a complaint of concern about any physician's
3 activities, and then that is sent to the administration
4 of the hospital; and then that, after it's reviewed by
5 the administrative staff, may be referred back to the
6 unit to be discussed between medical director and person
7 who was complained about, or if it was an issue of a
8 difference of opinion about a treatment approach between
9 say a staff nurse and a patient, that it would be
10 discussed on the unit. Or, in rare cases, it would be
11 referred to a University of Minnesota Medical Center
12 quality committee.
13 BY DR. BARDEN:
14 Q Was this system in place during the time Dan was treated?
15 A Yes.
16 Q Have you -- let me go back to the rogue psychiatrist
17 question first. Have you had trouble in the past at the
18 University of Minnesota Psychiatry Department with
19 someone considered rogue psychiatrists?
20 MR. ALSOP: Same objection, it's irrelevant,
21 but go ahead.
22 MR. HUTCHINSON: Objection, lack of
23 foundation.
24 MS. AHMANN: Join.
25 THE WITNESS: I've been at the University of
48
1 A Yes, I was.
2 Q Now, we were talking about Dr. Abuzzahab, correct?
3 A Yes.
4 Q And Dr. Garfinkel, and you'd mentioned they'd had some
5 difficulties, correct?
6 A That's correct.
7 Q Yeah. Didn't Dr. Garfinkel, in fact, wasn't he convicted
8 of multiple felonies?
9 A I don't know.
10 Q I show you what we're going to mark as Exhibit No. D. I
11 do have copies of this.
12 MS. PEARSON: Dave, there is copies for you.
13 MR. ALSOP: Yeah, I'm passing it out.
14 (Schulz Deposition Exhibit D marked for
15 identification.)
16 BY DR. BARDEN:
17 Q This is a New York Times article dated June 3, 2007. The
18 title is "After Sanctions, Doctors Get Drug Company Pay."
19 Have you read this, Dr. Schulz?
20 A Uh-huh.
21 Q It begins by saying, "A decade ago the Minnesota Board of
22 Medical Practice accused Dr. --"
23 A I'm sorry, where are you reading from?
24 Q From the very first sentence.
25 A Mine says, "When Anya" is my first sentence.
61
1 BY DR. BARDEN:
2 Q The report of the state board of medical licensing that
3 suspended Dr. Abuzzahab's license. Have you read that
4 report?
5 A No. Oh, but, and the date of that was? You asked me if
6 I read the report. When was that?
7 Q Correct. And I get to ask the questions, fortunately.
8 MR. HUTCHINSON: Well, the first line says
9 ten years ago. A decade ago.
10 DR. BARDEN: Yes, that is correct.
11 MR. HUTCHINSON: Which would be 1997.
12 That's how I understand it.
13 DR. BARDEN: I believe that is the date.
14 BY DR. BARDEN:
15 Q It says further down, "Dr. Abuzzahab failed to appreciate
16 the risks of taking Patient No. 46 off Clozaril, failed
17 to respond appropriately to the patient's rapid
18 deterioration and virtually ignored this patient's
19 suicidality." Do you see that?
20 A Yes, I do.
21 Q That's remarkably similar to the accusations against
22 Dr. Olson in this case, right? Isn't that correct?
23 MR. ALSOP: Object as argumentative, a
24 misstatement.
25
64
1 BY DR. BARDEN:
2 Q He failed to respond appropriately to the patient's
3 deterioration and virtually ignored the patient's
4 suicidality. Aren't those the allegations in this --
5 MR. ALSOP: Object as argumentative.
6 MR. HUTCHINSON: I'll join.
7 MR. ALSOP: If you know, Doctor, go ahead.
8 THE WITNESS: Just to be clear, the
9 question, you're asking me about the allegations against
10 Dr. Olson, compared to these findings by the board ten
11 years ago.
12 BY DR. BARDEN:
13 Q Right. We're in the early process --
14 A Uh-huh.
15 Q -- of this legal litigation with regard to Dr. Olson's
16 conduct, correct?
17 A Right, right.
18 Q Yeah, but you've read Dr. Hudson and Dr. Pope's opinions,
19 right?
20 A Uh-huh.
21 Q Isn't this true, that --
22 A What I said is I read their opinions as it related to me.
23 I did not read their opinions as it related to Dr. Olson.
24 Q But in their, in their opinions which related to you,
25 they certainly clearly stated that it was their opinion
65
1 BY DR. BARDEN:
2 Q I'm talking from all sources.
3 MR. ALSOP: It's irrelevant and vague, but
4 go ahead, Doctor. It's also lacking in foundation.
5 THE WITNESS: I can only make an estimate.
6 I believe that some years, from all sources, or putting
7 together work for different companies, some years -- I
8 want to make one more qualification. If I am asked to
9 give a lecture for a drug company, I will receive money
10 for the honorarium to give the talk, and then I will
11 receive money for my expenses to fly to the site and stay
12 in a hotel, eat dinner.
13 BY DR. BARDEN:
14 Q I'm interested in all of that, all of those files, all
15 totalled.
16 A I can't estimate all of that, but I would say that some
17 years I have made $20,000 and some years I may have made
18 $50,000 or $60,000, for professional services and
19 expenses.
20 Q So over a five-year period, you'd estimate that of, what,
21 a quarter million dollars, more, less?
22 A It has to be less, if some years are 20,000 and other
23 years are higher. Maybe 150,000, 180,000 dollars, in
24 total.
25 Q And that's from all drug companies from all sources, and
67
1 BY DR. BARDEN:
2 Q Looking for the dollar amount from any drug company, any
3 time, any kind of funding of any type sourcing from any
4 pharmaceutical company and ending up at you, and let's
5 start from 1999 through 2004, looking for a dollar
6 amount. And we don't really, we don't need to estimate
7 this eventually, because you do file income taxes. Is
8 that correct, Doctor?
9 A That's correct.
10 Q And you do report this as income, correct?
11 A Uh-huh.
12 Q And so, for example, if you're reimbursed for a trip to
13 Hawaii for a week, you do report that travel ticket as
14 income, do you not?
15 A I'm not -- the question was sort of long. I'm not quite
16 understanding the question.
17 Q Okay. If you receive a ticket to Hawaii from a drug
18 company to do a talk, you do report that to the IRS as
19 income, correct?
20 A I haven't been to Hawaii, but wherever I might get the
21 talk, if the company sent me a check for my honoraria and
22 for the expenses, yes, I would report that.
23 Q What if they just gave you a plane ticket, do they ever
24 do that, send --
25 A Sometimes they do.
69
1 Pay?"
2 A Okay. Which one is that, D or E?
3 MS. PEARSON: E.
4 BY DR. BARDEN:
5 Q E, E as in Edgar. Look at page 2 of 5 at the bottom
6 there. It says, "records most likely understate the
7 extent of the problem because they are incomplete. And
8 the Minnesota Board of Medical Practice disciplines --"
9 A I'm sorry. Where are you reading?
10 Q I'm sorry. Right here (indicating). We can just --
11 A Okay.
12 Q "The Minnesota Board of Medical Practice disciplines a
13 smaller share of the state's doctors than almost any
14 other medical board in the country, according to rankings
15 by Public Citizen." Were you aware of that?
16 MS. AHMANN: I'm going to object to vague.
17 I'm not sure what you're asking him. You read a couple
18 of sentences; they're different.
19 BY DR. BARDEN:
20 Q Okay. Are you aware of the fact that Minnesota
21 disciplines a smaller percentage of the state's doctors
22 than any other state?
23 MR. HUTCHINSON: According to that advocacy
24 group.
25 MR. ALSOP: Object on the basis of
73
1 BY DR. BARDEN:
2 Q The question was very simple. Do you think this shows a
3 pattern? Is there a pattern of lax management with
4 regard to protecting patients' rights at the
5 Department of Psychiatry, as demonstrated by the
6 Garfinkel, Abuzzahab, 71 percent of physicians not
7 knowing how to file complaints, and this case?
8 A I'm sorry, I just want to make sure I understand your
9 last statement. Seventy-one percent of who?
10 Q Do you recall we looked at the audit?
11 A Yeah, I do. Why don't we look at it again for a second
12 just to make sure.
13 Q It's page 11.
14 A I think we were looking at page 11.
15 MR. HUTCHINSON: Just while he's doing that,
16 just so the record is clear, I do object to the question
17 on the ground it lacks foundation, calls for speculation,
18 conjecture, and is irrelevant.
19 MR. ALSOP: I'll join in those objections.
20 THE WITNESS: Again, talking about the third
21 part of this, this audit, which is not addressing at all
22 the earlier process for clinical work on our wards, it
23 was concerning to me, and we have held a number of staff
24 meetings to further make sure that our staff understands
25 about these, and I do not think that there is, in the
80
1 BY DR. BARDEN:
2 Q "In Minnesota, psychiatrists collected more money from
3 drug makers from 2000 to 2005 than doctors in any other
4 specialty." Do you know why that might be, as the
5 chairman of psychiatry, why would psychiatrists receive
6 more money from drug makers than any other specialty?
7 MS. AHMANN: Object to lack of foundation.
8 MR. ALSOP: I'll join.
9 MR. HUTCHINSON: Same.
10 THE WITNESS: Without seeing that primary
11 data, I don't know if I can agree to that, so then I
12 can't speculate as to why that might be the case.
13 BY DR. BARDEN:
14 Q Okay. Well, for the purposes of this question, I'd like
15 you to tell me if there is any reason why psychiatrists
16 would receive more drug money than any other specialty.
17 MS. AHMANN: Same objection.
18 MR. ALSOP: Same objection.
19 THE WITNESS: No, I can't.
20 BY DR. BARDEN:
21 Q Once again, we're looking at page 2 of 7, Exhibit D,
22 "Dr. Stephen H. Hyman, the provost of
23 Harvard University." You've heard of Harvard University?
24 A Yes, I have.
25 Q Do you think being the provost of Harvard University is a
88
1 BY DR. BARDEN:
2 Q Okay. Are there any drug companies for which you have
3 received money other than the ones you've disclosed on
4 this page?
5 MR. ALSOP: It's vague as to time. Go
6 ahead.
7 DR. BARDEN: I think that's a very good
8 objection.
9 MR. ALSOP: Well, thank you.
10 BY DR. BARDEN:
11 Q During the time that Mr. Markingson was treated at the
12 Department of Psychiatry and was a subject in the CAFE
13 study on which you were a coinvestigator, were you
14 receiving funding from any drug company other than the
15 ones that are listed on this page?
16 MS. AHMANN: I'm going to object of lack of
17 foundation, it's assuming that these he was receiving at
18 the time, but, state my objection.
19 MR. HUTCHINSON: I'm not sure where we are
20 here.
21 MR. ALSOP: I'm not sure there is a
22 question.
23 DR. BARDEN: There is a question pending.
24 BY DR. BARDEN:
25 Q Are there any other companies than the ones listed there
96
1 for which you were -- see, they make objections and then
2 you answer the question.
3 A No, I understand. Just you were looking around, I didn't
4 know. So let me be clear that the forms that are filled
5 out that lead to these statements are for the 12 months
6 preceding the conference. So this would describe the
7 period of April 2005 to 2006, and my recollection would
8 be that this is similar to my activities in 2004.
9 Q Okay, so there are no companies other than the ones
10 listed, to the best of your knowledge.
11 A I can't say for sure.
12 Q Okay.
13 DR. BARDEN: I'm going to have the witness
14 identify this, and then we'll decide if we're going to
15 make it an exhibit or not.
16 BY DR. BARDEN:
17 Q Can you identify this document for us?
18 MR. HUTCHINSON: This is Exhibit G?
19 DR. BARDEN: It might be.
20 MR. HUTCHINSON: Oh.
21 THE WITNESS: I don't recognize this.
22 BY DR. BARDEN:
23 Q Okay. On the front it says AstraZeneca results update,
24 David Brennan. Do you know a David Brennan?
25 A I believe he works for AstraZeneca and I think -- let me
97
1 question?
2 MR. ALSOP: You answered the question,
3 Doctor. He can make his objection.
4 BY DR. BARDEN:
5 Q This means that these companies provided financial
6 support for this conference, correct?
7 A Correct.
8 Q Thank you. Now, are you aware of any restrictions on
9 companies marketing off-label uses for their drugs, for
10 their medication?
11 A Yes, I am.
12 Q Okay, but it's okay for them to finance a conference at
13 which you, a physician, speak about or endorse off-label
14 uses, correct?
15 MS. AHMANN: I'm going to object, lack of
16 foundation, misstatement. He talked about investigative
17 uses as well.
18 MR. ALSOP: You can answer, Doctor.
19 DR. BARDEN: Uh-huh.
20 THE WITNESS: What, you'd like me to answer?
21 MR. ALSOP: Yes, go ahead.
22 BY DR. BARDEN:
23 Q But you as a physician can speak out and endorse or
24 support off-label use of medications, correct?
25 A Not really, and why don't I just take a minute to address
103
1 BY DR. BARDEN:
2 Q So let me just go ahead and show you these two slides,
3 which are on page 17 of what's been marked as Exhibit G.
4 DR. BARDEN: Actually, we haven't marked it.
5 (Schulz Deposition Exhibit G marked for
6 identification.)
7 BY DR. BARDEN:
8 Q Okay. Dr. Schulz, do you see where it says, "Seroquel
9 Continues to Drive the Global Atypical Market?" Do you
10 see that?
11 A Yeah, I see the type and the slide.
12 MR. HUTCHINSON: I'm missing the page
13 number, I'm sorry.
14 MR. ALSOP: Seventeen.
15 DR. BARDEN: Seventeen.
16 BY DR. BARDEN:
17 Q And it says, "Global Atypical Market $14 billion." Would
18 that fit with what you understand the global atypical
19 drug market to be, $14 billion.
20 MS. AHMANN: Object, lack of foundation.
21 THE WITNESS: I don't know.
22 MR. HUTCHINSON: Same.
23 THE WITNESS: I don't have any idea.
24 BY DR. BARDEN:
25 Q You don't have any idea at all?
110
1 the hospital costs for those patients went way down, and
2 so the net cost to a system was the same or improved.
3 BY DR. BARDEN:
4 Q And have more recent studies found those earlier research
5 studies to be in error?
6 A I haven't read any recently.
7 Q Have you read any recent studies indicating that the
8 new -- well, let me back up a minute.
9 How much more expensive are the atypicals
10 than the older antipsychotics?
11 MR. HUTCHINSON: What year are we talking
12 about now?
13 MR. ALSOP: Currently?
14 BY DR. BARDEN:
15 Q During the time that Mr. Markingson was treated in the
16 CAFE study on which you were a coinvestigator.
17 MR. ALSOP: Object on the basis of
18 foundation, but go ahead, Doctor.
19 THE WITNESS: Well, I think the best way I
20 can answer that is that I'm aware that the medicine that
21 was used a lot through the late '70s and '80s,
22 haloperidol, is a generic medication and is
23 particularly -- is inexpensive. I have heard in
24 conversation, but I'm not sure I've seen on paper, that a
25 person being managed with haloperidol, expense might be
114
1 exaggerated?'"
2 A I don't agree with that statement.
3 Q Is there a pattern in these? You don't agree with the
4 past president of the APA; you don't agree with Steve
5 Hyman, the head of NIH; you don't agree with
6 Professor Pope, who is the only psychiatrist in the world
7 to be in the half of one percent most cited in psychiatry
8 and neuroscience; you don't agree with Dr. Hudson; you
9 don't agree with a lot of these people. Do you feel like
10 your opinions on these issues are unusual?
11 MR. HUTCHINSON: Object to that as
12 argumentative.
13 MR. ALSOP: I'll join.
14 MS. AHMANN: Join.
15 MR. HUTCHINSON: Irrelevant, lacking in
16 foundation, misleading, misstatement of the evidence, and
17 inappropriate.
18 MR. ALSOP: It's vague also. But go ahead,
19 Doctor, if you can answer that question, go ahead.
20 THE WITNESS: My response to your question
21 is that the people you've mentioned, I all know. I know
22 them all. I know Steve, I know Steve Sharfstein. And I
23 think they're good doctors and good psychiatrists. You
24 pointed out a sentence or two of some things that they've
25 commented on, and I have not agreed with those
120
1 BY DR. BARDEN:
2 Q I'm sorry?
3 A So I guess you're meaning if --
4 Q If the market --
5 A Well, you mean worldwide.
6 Q Yeah.
7 A If the world changed.
8 Q I think that's fair.
9 A I think that if the world changed, that there would be a
10 big impact on the pharmaceutical companies that make
11 atypical antipsychotics.
12 DR. BARDEN: I think let's go off the record
13 now.
14 (Lunch recess taken at 12:20 p.m.)
15 * * * *
16 (Proceedings continued at 1:10 p.m.)
17 DR. BARDEN: We're back on the record?
18 Great.
19 BY DR. BARDEN:
20 Q Good afternoon.
21 A Good afternoon.
22 DR. BARDEN: Does everyone have a copy of
23 this? It's the UM IRB, starts 2811, Bates stamped 2811.
24 MR. ALSOP: Yeah, I'll mark it, get it for
25 her.
128
1 September 2006.
2 Q Uh-huh. Is it your understanding that this is any change
3 from previous?
4 A I think that there were changes. I can't tell you all of
5 them with this delegation of responsibility.
6 Q But it's always been the case that PIs are responsible
7 for the treatment of human subjects, correct? That
8 certainly hasn't changed, has it?
9 A Well, I wouldn't think so, but I, just in taking a look
10 at what you're directing me to, this document of 2006,
11 and saying hasn't this been the way it's always been, I
12 can't say for sure.
13 Q Can you, as a psychiatrist who has done research, can you
14 point to me any particular time period in the last 30
15 years where principal investigators were not the persons
16 responsible for the treatment of human subjects?
17 MR. ALSOP: Object to multiple question and
18 vague. Go ahead.
19 THE WITNESS: My understanding of what the
20 IRB asks the principal investigator to do is to be
21 overall in charge of the conduct of the study, and that
22 includes the science and the informed consent or the
23 safety of the people who are in the study.
24 BY DR. BARDEN:
25 Q Okay, and that would have been Dr. Olson in the study
131
1 afternoon?
2 Q Correct.
3 A No.
4 Q Have you had any classes or training in the duties of a
5 coinvestigator on a drug trial study?
6 A As I discussed earlier, the University of Minnesota has a
7 responsible conduct research class, not specific to
8 coinvestigators, but the conduct of research, and I took
9 that course and was certified.
10 Q Okay. Did Dr. Olson ever come to you and say that he had
11 written to a court that Dan Markingson lacked capacity to
12 make informed judgments, but that he had signed him in as
13 a subject in the study? Did Dr. Olson ever comment,
14 present that issue to you?
15 MR. HUTCHINSON: This is repetitive.
16 MR. ALSOP: Objection, repetitious, but go
17 ahead one more time.
18 THE WITNESS: I don't recall any
19 conversations like that.
20 BY DR. BARDEN:
21 Q Did Dr. Olson ever come to you discussing potential
22 coercive effects on court orders of any of your subjects?
23 MR. ALSOP: Objection, repetitious.
24 THE WITNESS: No, he did not.
25
133
1 BY DR. BARDEN:
2 Q Do you have any special policies or procedures at the
3 University of Minnesota for patients, for research
4 subjects who have been coercively influenced by court
5 orders?
6 MR. ALSOP: Object as argumentative,
7 misstating the facts, and foundation, but go ahead.
8 MR. HUTCHINSON: Join.
9 THE WITNESS: My understanding is that a
10 patient who is committed still retains the ability to
11 consent for certain issues. In other words, a patient
12 may be committed to our hospital, and still voluntarily
13 consent to receive a medication treatment, as an example.
14 BY DR. BARDEN:
15 Q Patients receiving neuroleptics supposed to sign a form?
16 A Our hospital does have a policy that, there is a sheet
17 that they are supposed to sign that describes the side
18 effects of medications so that they understand it.
19 Q Is there any special form to be signed for the use of
20 neuroleptics, other than what you've discussed so far?
21 A That's what I thought I just described.
22 Q Did Dr. Olson ever inform you that he did not have Dan
23 sign that when he used neuroleptics on him in the
24 hospital?
25 MR. ALSOP: Object as repetitious. Go
134
1 ahead.
2 MR. HUTCHINSON: Same.
3 MR. ALSOP: Go ahead, you can answer.
4 THE WITNESS: I understand what happens, is
5 unfortunately --
6 MR. ALSOP: You hear me.
7 THE WITNESS: Yeah. What was the question
8 again?
9 BY DR. BARDEN:
10 Q Did Dr. Olson ever inform you that he treated Dan
11 Markingson with neuroleptics in the hospital without
12 having him sign such a form?
13 A No, he did not ever tell me that.
14 Q Would you have concerns, if he had in fact done that?
15 A I would want to know more about it, yes.
16 Q Would those kinds of violations of procedures be
17 something you would report, or would you discuss it
18 personally with Dr. Olson?
19 MR. ALSOP: Object to the form of the
20 question as plural, and misstating the facts, and it's
21 duplicative, but go ahead.
22 MR. HUTCHINSON: I'll join. Lacking
23 foundation.
24 DR. BARDEN: Okay. I think that's fair.
25
135
1 BY DR. BARDEN:
2 Q It happened one time. He put him on neuroleptics, but
3 never got the form signed. Would that be something you
4 would report or discuss with him personally?
5 MR. HUTCHINSON: Well, counsel, are you
6 asking him to assume this witness became aware of that?
7 Because I thought he said he didn't, Dr. Olson didn't
8 tell him that. That's where I'm a little lost.
9 DR. BARDEN: Okay, and I'm having trouble
10 with your speaking objections, again, which you're
11 actually coaching the witness, which are highly improper.
12 If you have -- the proper objection for that is lacks
13 foundation, calls for facts not in evidence, and that is
14 all that you get to say. You don't get to coach the
15 witness on what he said or what his memory was or whether
16 reported. That's not appropriate. Let's stick to the
17 legal objections. Okay?
18 MR. HUTCHINSON: Maybe you intend to ask
19 misleading questions, but I thought the question --
20 DR. BARDEN: Then you get to bring that up
21 with the court. You can state it states facts not in
22 evidence, you can say misleading, but you can't give a
23 speech that informs the witness what your theory of the
24 question is. That's highly inappropriate. Thank you.
25 MR. HUTCHINSON: Read -- you're going to
136
1 Q During the time Dan Markingson was in the CAFE study and
2 being treated at Fairview.
3 A Well, as we discussed this morning, there are forms, and
4 there were forms, paper forms, on the unit during the
5 time of late 2003 and 2004, and if a staff member, nurse,
6 social worker, psychiatric tech, had a concern that
7 something had not gone correctly, they would fill that
8 form out and turn it in to the hospital administration,
9 Fairview Behavior Services. They would examine it, and
10 they would either direct the complaint back to the unit
11 and have the medical director of the unit meet with the
12 person who brought the complaint or person that brought
13 the complaint, the head nurse, and if the complaint was
14 about a psychiatrist, meet with them and solve the
15 problem.
16 Q So that was the system in place --
17 A Correct.
18 Q -- but the audit we discussed indicated that a very
19 significant percentage of the people working on those
20 units didn't feel like they'd be protected from
21 retaliation, if they complained, correct?
22 MR. ALSOP: That's argumentative and a
23 misstatement of the facts in his prior testimony in this
24 case when you asked him about those issues.
25 MR. HUTCHINSON: Same, and lack of
139
1 foundation.
2 MR. ALSOP: Go ahead, Doctor.
3 THE WITNESS: So the process I just
4 described to you is a University of Minnesota
5 Medical Center process for work on our wards. The audit
6 that we discussed earlier was a questionnaire of the
7 secretaries, the grant accountants, and the academic
8 faculty within our faculty area, and did not address at
9 all the scenario you described regarding the ability of
10 people working on the wards to make a complaint to the
11 hospital about what was going on.
12 So, therefore, none of the people on the
13 wards were the object of this audit.
14 BY DR. BARDEN:
15 Q Has there been a survey audit done on those hospital
16 wards?
17 A I don't know.
18 Q Do you have any reason to believe it would be any
19 different or maybe even much worse than it was in an
20 academic setting?
21 MR. ALSOP: Object, argumentative.
22 DR. BARDEN: I'm sorry. Let me rephrase
23 that.
24 BY DR. BARDEN:
25 Q What, if anything, information do you have indicating
140
1 BY DR. BARDEN:
2 Q What is in place when you have a medical chart and
3 documents to a court saying this patient believes that
4 his family members are lizards, for example, or he's in a
5 Satanic cult, I mean, that he's grossly psychotic, and
6 they use the phrase lacks capacity, and they say that he
7 should be petitioned to a court for commitment and they
8 say that he's grossly psychotic, and then he's signed
9 into a research study on his own signature? Was there a
10 system in place during this timeframe, that is, December
11 of 2003, was there a system in place that would have
12 caught that error; and, if so, what was the system?
13 MR. ALSOP: Assumes facts not in evidence as
14 to the last comments, it's multiple and argumentative,
15 but go ahead.
16 MS. AHMANN: Join.
17 MR. HUTCHINSON: Same, and lacks foundation.
18 THE WITNESS: So the investigator, Dr. Olson
19 in this case, needs to pass the responsible conduct to
20 research course we've discussed. The people helping
21 Dr. Olson, the project coordinators or research
22 assistants, have courses in certifications they need to
23 pass on the same material. In addition to that,
24 Dr. Lieberman, who we discussed earlier, the head of the
25 CATIE study published in the New England Journal of
144
1 BY DR. BARDEN:
2 Q Then on the next page, which is page UM IRB 2800, at the
3 very bottom, last sentence it says, "Under no
4 circumstances may subjects be forced or coerced to
5 participate." Do you agree with that?
6 A Yes, I do.
7 Q But you don't agree that a court stay of commitment,
8 which threatens to put someone in the state mental
9 hospital if they don't comply with a directive to enter a
10 treatment study, you don't think that's coercive, right?
11 MR. ALSOP: It's repetitious, asked and
12 answered at least three times. Go ahead.
13 MR. HUTCHINSON: Join, and lack of
14 foundation.
15 MS. AHMANN: Join.
16 THE WITNESS: I believe the patient had a
17 choice of either being in the study or continuing
18 treatment at another hospital.
19 BY DR. BARDEN:
20 Q Did you ever read the court order in this case?
21 A No.
22 Q So what's the foundation for your belief that he had a
23 choice, if you haven't read the court order?
24 A Let me back up. My belief is based on working on the
25 wards and the use of the stay of commitment procedure on
155
1 those wards.
2 Q Okay. How many other patients do you have or have you
3 had in your studies who was, A, court-ordered to follow
4 the treatment recommendations of their treater; and B,
5 had a treater that recommended the CAFE study only? How
6 many patients have you seen like that, had a court order
7 to follow the recommendations of the treatment team, the
8 treatment team said you're going into CAFE?
9 A I'm not aware of any other patients in the CAFE study
10 that that happened to.
11 Q Look at -- continuing on what's been marked as Exhibit J,
12 if you look at the bottom right, there are some little
13 handwritten page numbers. If you go to page 6, I'm
14 sorry, 7 of that, the top right it says page 701, the
15 Bates number for this is UM IRB 2793. Do you see under E
16 where it says, "Does the consent form: Disclose
17 alternative procedures which may be advantageous to the
18 subject?"
19 A Yes, I do.
20 Q Okay. Have you read the consent form in this case?
21 A No, I haven't.
22 Q It discloses no alternative procedures whatsoever, does
23 it, Doctor?
24 MR. ALSOP: Lacking in foundation. He's
25 told you he hasn't seen the form.
156
1 BY DR. BARDEN:
2 Q Have you ever seen the CAFE study informed consent form?
3 A No, I haven't.
4 Q So as a coinvestigator of this study and as someone who
5 is listed as ten percent, as a ten percent
6 coinvestigator, you never saw the informed consent form
7 for this study, correct?
8 MR. ALSOP: Have you heard the last three
9 answers when he says he hasn't seen it? Are you
10 confused? You don't have to answer that question. Don't
11 answer that question.
12 BY DR. BARDEN:
13 Q You didn't think you had a duty to look at the informed
14 consent form?
15 MR. ALSOP: It's argumentative. Go ahead,
16 you can answer that question.
17 THE WITNESS: No.
18 BY DR. BARDEN:
19 Q Have you, in your other studies, have you used informed
20 consent forms which disclosed no alternative treatments?
21 MR. ALSOP: Object as vague and ambiguous.
22 THE WITNESS: Seeing that you're asking me
23 about what I do, I would say that when I'm participating
24 in clinical research, if a person who is currently a
25 patient is referred, we say that you can participate in
157
1 the IRB.
2 MR. ALSOP: Vague as to forms, but go ahead.
3 BY DR. BARDEN:
4 Q Have you ever seen a form at the University of Minnesota
5 that disclosed that they had a financial incentive to
6 keep the subject in the study for a year, a full year?
7 A Let me say, it's a lot easier for you to answer if you
8 ask me a question, rather than ask other questions, etc.
9 So kind of stay on the tack, it's a lot easier for me.
10 Q Have you seen, since you've been at the University of
11 Minnesota since '99, have you ever seen an informed
12 consent form that disclosed when a company was paying by
13 the visit?
14 A No.
15 Q That is, they had a financial incentive to keep in the
16 study week after week?
17 MR. ALSOP: Now it's argumentative, assumes
18 fact not in evidence.
19 MS. AHMANN: Join.
20 MR. HUTCHINSON: Join.
21 MR. ALSOP: Go ahead.
22 THE WITNESS: Could you repeat your first
23 question?
24 MR. ALSOP: He said no to the first part of
25 question your question, and then you added something.
169
1 BY DR. BARDEN:
2 Q Have you ever seen an informed consent form at the
3 University of Minnesota that disclosed a financial
4 conflict of interest, in that the investigator or the
5 study or the university was paid by the visit?
6 A I think I just said no.
7 Q Okay.
8 A Haven't seen that.
9 Q Have you seen one where the speaking fees and honorariums
10 and consulting fees of the PI were disclosed in the
11 informed consent form?
12 A No. If I could take a break now, biological break now,
13 it would be helpful.
14 DR. BARDEN: Absolutely.
15 THE WITNESS: Thank you.
16 (Brief recess taken.)
17 BY DR. BARDEN:
18 Q Doctor, we're still on what's been marked as Exhibit J.
19 If you look at the bottom right corner, handwritten
20 number 11. Do you see that? That's 8.
21 A Okay.
22 Q There you go.
23 A Thank you.
24 Q If you look at the top third of the page, it says -- page
25 number UM IRB 2789. You see where it says, "Finder's
170
1 BY DR. BARDEN:
2 Q Okay. Have you ever received financial or other
3 incentives of food or gifts or anything else for
4 recruiting subjects?
5 A No.
6 Q And you've already testified, just to make sure the
7 record is clear, you're not aware, you are not aware that
8 this was going on in the CAFE study, correct?
9 MS. AHMANN: Object to lack of foundation.
10 THE WITNESS: Correct.
11 DR. BARDEN: Okay.
12 THE WITNESS: I don't know one way or the
13 other.
14 BY DR. BARDEN:
15 Q Next page, Bates No. UM IRB 2790, middle of the top,
16 "When the research involves adults unable to consent, the
17 IRB reviews and evaluates the proposed plan for
18 permission of legally authorized representative, using
19 the primary reviewers review sheet as a guide to
20 discussion." Is that your understanding of the policy of
21 the University of Minnesota IRB?
22 A Yes, it is.
23 Q But you're not aware of any subject in the CAFE study who
24 went through this procedure for adults unable to consent,
25 correct?
172
1 A That's correct.
2 Q Next let's look at page 14, bottom right, 14,
3 UM IRB 2704. See at the bottom there it says, "When some
4 or all of the subjects, such as children --
5 A I'm sorry, where --
6 Q -- prisoners --" right here (indicating).
7 A Where are we looking, when?
8 Q "When some or all the subjects, such as children,
9 prisoners, pregnant women, handicapped, or mentally
10 disabled persons, or economically or educationally
11 disadvantaged persons, are likely to be vulnerable to
12 coercion or undue influence, or for subjects found at
13 international sites, additional safeguards have been
14 included in the study and in the IRB review process, to
15 protect the rights and welfare of these subjects." Is
16 that your understanding of the University policy?
17 A Yes, it is.
18 Q Are you aware of any special safeguards that were
19 included in the CAFE study for Dan because he was listed
20 by his treating psychiatrist as lacking capacity?
21 A No.
22 Q Are you aware of any additional safeguards used for Dan
23 because he was under court order, that is, a stayed
24 commitment, to follow the treatment recommendations of
25 his physician, who is also the PI in the CAFE study? Are
173
1 A No.
2 Q Okay. Page 19 on the bottom right. This is UM IRB 1316.
3 Very top of the page, "Subjects who are not able to give
4 informed consent may enroll in the research only if they
5 have a guardian who demonstrates the capacity and
6 willingness to consent for the subject. The subject will
7 then need to assent to participation." Is that your
8 understanding, that's the policy at University of
9 Minnesota?
10 A I'm sorry, I've gotten behind you. Could you point to
11 what you were reading?
12 Q Just the top part there (indicating).
13 MR. ALSOP: Would you read the first two
14 sentences you read?
15 BY DR. BARDEN:
16 Q Right at the top. "Subjects who are not able to give
17 informed consent may enroll in the research only if they
18 have a guardian who demonstrates the capacity and
19 willingness to consent for the subject. The subject will
20 then need to assent to participation." Is that your
21 understanding of your policy?
22 A Yes.
23 Q Okay.
24 DR. BARDEN: Let's mark this as Exhibit K.
25 MR. ALSOP: Which one is it, so I know what
175
1 Q Yeah.
2 A -- on the floor for me.
3 Q We'll get back to it. As coinvestigator of the CAFE
4 study, are you aware of the date the CAFE study issued
5 its reconsent amendment?
6 A Let me answer that. So my earlier question had to do
7 with when you said the consent amendments of being
8 issued, etc. So your question to me is, so I understand,
9 that the overall principal investigators of the CAFE
10 study took a month longer to get the consent amendment
11 sent out to the sites? Is that what your question is?
12 Q What my question is, is I'm showing you the date of the
13 consent amendment for the CAFE study.
14 A Okay.
15 MR. ALSOP: No, it's the CATIE study, sir.
16 BY DR. BARDEN:
17 Q The CATIE study, April 5, 2004. Do you see that?
18 A Yes, I do.
19 Q My question to you is a very specific one, and it
20 requires a yes or no, first of all. Were you aware that
21 the CAFE study also issued a consent amendment warning
22 subjects about this increased risk of diabetes and
23 hypoglycemia? Hyperglycemia.
24 A Not specifically, I wasn't aware that that had been
25 issued.
182
1 Q Okay. Did anyone ever come to you and say, you know,
2 we're way behind the CATIE study in issuing this warning,
3 we better get it out to the CAFE subjects? Did anyone
4 approach you and say anything like that?
5 A No.
6 Q If you had found out that the CAFE study warning to
7 subjects was significantly later, by as much as a month
8 after the CATIE subjects were warned, would that trouble
9 you, as a physician interested in the well-being of the
10 CAFE subjects?
11 MR. ALSOP: Object as irrelevant,
12 misstatement of the facts, and argumentative. Go ahead.
13 THE WITNESS: My answer is, I would want to
14 better understand what had happened. And any time there
15 is a change in the consent form, it is concerning, and I
16 would want to learn more about what happened.
17 BY DR. BARDEN:
18 Q Uh-huh. Did anyone ever come to you and say, you know,
19 Dan Markingson never had the opportunity to reconsent for
20 the study based on these new risks and dangers, because
21 they didn't issue the warning until a month after CATIE
22 and after Dan was dead?
23 MR. GROSS: Objection, misstates the
24 evidence.
25
183
1 BY DR. BARDEN:
2 Q Did anyone ever come and state that to you?
3 A No, they did not.
4 MR. GROSS: Objection, misstates evidence.
5 MR. ALSOP: It's irrelevant. Go ahead.
6 THE WITNESS: I've already answered it.
7 MR. ALSOP: Yeah, that's fine.
8 BY DR. BARDEN:
9 Q Let's look at the next page, page 4. It's an e-mail. On
10 the top it says March 15, 2004. Do you see that? Then
11 down below it says, "Dear CAFE Investigators and Study
12 Coordinators. Recently the FDA issued a new warning
13 about the risks of hyperglycemia and diabetes in patients
14 taking atypical antipsychotic agents, including the CAFE
15 study medications." Do you see where it says that?
16 A Yes, I do.
17 Q So they were on notice as of this March 15, 2004,
18 correct?
19 MR. ALSOP: Object on the basis of
20 foundation, but go ahead.
21 THE WITNESS: Okay. Again, the question
22 is -- I'm sorry. I get distracted with the multiple
23 conversation.
24 BY DR. BARDEN:
25 Q The CAFE investigators, that would include you, correct,
184
1 A No.
2 Q Well, it says that amount $16,362, and then it says,
3 "Independent Review Board Fees." What's that for, do you
4 know?
5 A My understanding is that's the IRB fee.
6 Q Okay, so the IRB was paid by AstraZeneca.
7 MS. AHMANN: Objection, lack of foundation.
8 THE WITNESS: By Quintiles.
9 MR. GROSS: Same objection.
10 BY DR. BARDEN:
11 Q Have you ever seen any statements under oath by an IRB
12 official saying they're not paid by drug companies or
13 outside companies?
14 A No.
15 Q Interesting. Okay. Now let's go to page 8, bottom right
16 corner, 8, UM CAFE 3191, the bottom of the page,
17 "Recruitment Efforts?"
18 A Where are --
19 Q This is an e-mail to Jeannie Kenney. Have you seen that
20 name before?
21 A Yes, I have.
22 Q Who is Jeannie Kenney? What does she do?
23 A Jeannie Kenney was a project coordinator and social
24 worker in the Department of Psychiatry.
25 Q Was she paid for her work on the CAFE study?
187
1 A Yes.
2 MR. ALSOP: Is that a statement or question?
3 Go ahead.
4 DR. BARDEN: He answered it.
5 BY DR. BARDEN:
6 Q Now, let's look at page 14, at the bottom right, of
7 what's been marked as Exhibit --
8 A Just look here.
9 Q You see here's an e-mail from Amy VandenEynden at
10 Quintiles to Jeannie Kenney. Do you see that?
11 A Yes, I do.
12 Q And it says, "It sounds like you have a good amount of
13 leads/potentials. Hopefully your hard work will start to
14 pay off soon!" Exclamation point. "The specialty
15 inpatient unit sounds like it will help out a lot with
16 recruitment!!" Exclamation point, exclamation point.
17 Did you set up that specialty inpatient unit to make it
18 particularly easy to recruit psychotic patients?
19 MR. ALSOP: It's a multiple question, it's
20 vague, but go ahead.
21 THE WITNESS: I talked with the
22 administration at University of Minnesota Medical Center
23 to indicate to them that I thought having a unit that
24 specialized in the care of people with serious
25 psychiatric illness would improve the quality of care to
195
1 Exhibit M.
2 (Schulz Deposition Exhibit M marked for
3 identification.)
4 BY DR. BARDEN:
5 Q It's a letter on AstraZeneca letterhead, correct?
6 A Yes.
7 Q It looks like it's to Stephen Olson, M.D.?
8 A Yes.
9 Q The University of Minnesota Department of Psychiatry.
10 Signed by Savinder --
11 A Can you go back just for a second?
12 Q Uh-huh.
13 A It's interesting, as you're pointing this out to me, that
14 it's addressed to Dr. Olson, who is the principal
15 investigator, but the letter was sent to the Office of
16 Sponsored Projects Administration.
17 Q Okay.
18 A So it would not have gone immediately to him. It would
19 have gone over to --
20 Q Sure.
21 A -- what we call SPA.
22 Q But it's signed by you, you recognize Dr. Olson's
23 signature there, correct?
24 A Correct.
25 Q Yeah.
206
1 A No.
2 Q Okay, and then you see a visit ID was visit 19. Do you
3 see that?
4 A Yes, I do.
5 Q Do you see the date was May 8, 2004?
6 A I do see that.
7 Q And do you see the payment was made for $1,446 on that
8 day for that visit?
9 A For that line, I saw, yeah.
10 Q For that visit?
11 A Uh-huh.
12 Q Yeah. Does that date ring a bell to you? Are you
13 familiar with any of the dates in this study?
14 A No.
15 Q Yeah. Dan Markingson was deceased on that day.
16 A Okay. Sorry.
17 Q So he really didn't have a visit 19.
18 A Okay.
19 Q But apparently Dr. Olson fell for it.
20 MR. GROSS: Objection, lack of foundation.
21 MR. ALSOP: It's argumentative, misstates --
22 MS. AHMANN: Can I just, I'm going to lodge
23 my objection, and she keeps telling me she doesn't hear
24 me, but the reason is, can you just pause when people
25 start objecting so she can get the objections down?
209
1 Thanks.
2 BY DR. BARDEN:
3 Q All right. Do you have any explanation for this document
4 other than what we've discussed so far?
5 A No.
6 Q If Dr. Olson had billed for a date on which his patient
7 was deceased, would you have a trouble with that?
8 A Certainly.
9 DR. BARDEN: How are we coming on the
10 Xeroxing?
11 MR. ALSOP: I can go check, if you want me
12 to check.
13 DR. BARDEN: Yeah. Why don't we just
14 take --
15 MS. AHMANN: Use those ones you copied
16 before, or are those not --
17 DR. BARDEN: Oh, yes. Hopefully, well,
18 hopefully we'll get to that.
19 MS. AHMANN: Okay.
20 DR. BARDEN: You mean these, the last
21 packet?
22 MS. AHMANN: Yeah, that's fine.
23 MR. ALSOP: There is three or four things
24 here to be copied.
25 DR. BARDEN: Let's go ahead and do that.
210
1 This is Exhibit O.
2 MR. ALSOP: Which one is it?
3 DR. BARDEN: It's a new one.
4 MR. ALSOP: Do we have a copy of it here?
5 DR. BARDEN: I think you do, yeah. That's
6 it. There you go.
7 MR. GROSS: Is it the Theo I records?
8 (Schulz Deposition Exhibit O marked for
9 identification.)
10 BY DR. BARDEN:
11 Q Okay, Dr. Olson -- Dr. Schulz. Trying to understand how
12 this study worked. If you look on the back of these two
13 sheets, see where it says, "If medication is missed,
14 indicate one of the following orders." Do you see that?
15 A Okay. Where? Okay. Where, here (indicating)?
16 Q Right there (indicating).
17 A Okay.
18 Q The one dated 12-19-03, do you see that?
19 A I see there is a note there, 12-9 -- 12-19.
20 Q It says, "If medication is missed ... omit the dose
21 entirely." Do you see that?
22 A Uh-huh.
23 Q Okay, and then the other sheet is 12-11-03, and that
24 says, "If medication is missed ... add the missed dosage
25 to the next med time." Do you see that?
211
1 A Yes, I do.
2 Q Help me understand why, a week apart, that that would be
3 like that.
4 MR. ALSOP: Object on the basis of
5 foundation, but go ahead.
6 BY DR. BARDEN:
7 Q Why would the suggestion as to what to do if medication
8 is missed be different week-to-week like that?
9 MR. ALSOP: Foundation. If you know, go
10 ahead.
11 THE WITNESS: So thanks for giving me a few
12 minutes to take a look at this form, and I can really
13 only speculate that the difference in the two orders are
14 related to, in the first document, it looks as if the
15 patient is making a transition into the study; and so in
16 Dr. Olson's judgment, he felt that adding the missed dose
17 may be the best way to proceed.
18 On the second sheet, which is a week later,
19 it looks to me as if on the back he's discontinued the
20 Risperdal, which was his original clinical medicine, and
21 he's now on the CAFE-assigned medications. So for
22 whatever reasons that I won't speculate about, Dr. Olson
23 decided that he would change the order.
24 BY DR. BARDEN:
25 Q Okay. Let's go back to -- do we have this one?
212
1 referral sources."
2 Is that your understanding it's a common
3 practice to send thank you gifts for referral sources?
4 A No, it's not my understanding.
5 Q Have you ever done that in any of your studies?
6 A Yeah, I think I may have in the past. I have a
7 recollection of, during the mid-'90s, of visiting a
8 community mental health center and providing a luncheon
9 for them for collaborating with us.
10 Q How about mugs and other goodies?
11 A No, I don't think I've ever done that. I don't recall
12 ever doing that.
13 Q And you've never done the other for the last seven years.
14 Is that correct?
15 A That's correct.
16 Q Next page, page at the bottom right UM CAFE 0728, 8.
17 Study from the CAFE, Jody Robertson, project manager.
18 "Dear Study Coordinators & Principal Investigators.
19 Within this box are the CAFE goodies that we have been
20 discussing in our recent teleconferences. These are to
21 be used as small tokens of appreciation for any referring
22 clinicians. Within you will find: Individually wrapped
23 CAFE M & M packets, CAFE Post It Notes, informational
24 brochures on Schizophrenia from NAMI, CAFE pens. You may
25 request additional items listed above by sending ...
219
1 A No.
2 Q Okay. Next page, 9 at the bottom right, UM CAFE 0767,
3 from Jean Kenney. See right in the middle of the page,
4 September 3, 2002. "Hi Jody, I'm from Dr. Stephen
5 Olson's site at the University of Minnesota. I was not
6 notified of the CAFE Coordinator Teleconference. I
7 started here just as our site got up in June and we have
8 definitely been struggling to get patients. None of the
9 recruitment really started until after I got here and got
10 trained in so hopefully the work I've been putting in the
11 last few months will start to pay off." Have you ever
12 seen that e-mail before today?
13 A No, I haven't.
14 Q Next page, UM CAFE 0792. In the middle there, quoting
15 Jean Kenney. "Hello Dr. McEvoy. Subject DAD was
16 hospitalized --"
17 A It's pronounced McEvoy.
18 Q McEvoy. Thank you.
19 A You're welcome.
20 Q "Subject DAD was hospitalized 4/3/04 after rapid
21 decompensation. As this was a weekend, Dr. Olson was not
22 aware until Monday a.m. He was given 5 milligrams
23 Zyprexa on 4/3 and 4/4. It was discontinued on 4/5 by
24 Dr. Olson and he was restarted on CAFE meds which he was
25 initially refusing. An IM Geodon 20 milligrams PRN order
221
1 time, that the way our practice plan, our University was
2 set up, that if there was an untoward event or if there
3 was litigation regarding a research study, that the
4 defense of that would be done by the University. If a
5 person had an untoward event and litigation, and the
6 person was in the clinic and not involved in research,
7 that the defense would be done by University of
8 Minnesota Physicians. So I was informed of that at some
9 point probably in the summer of 2004, discussed that with
10 Dr. Olson. This part about since it is self-insured, I
11 didn't say anything to him about that.
12 Q Okay, and at that point, Dr. Olson had not told you that
13 he was the sole and only physician treating Dan
14 Markingson above and beyond the research study, correct?
15 A Correct, that's right.
16 Q Okay. On page 13 on the bottom right, UM CAFE 2356, to
17 Jennifer Frantz from Jean Kenney?
18 A Where?
19 Q Subject -- I'm sorry we're on right here (indicating).
20 See where it says to Jennifer Frantz?
21 A Yes.
22 Q Okay. At the bottom it says Jeannie Kenney. Subject,
23 this is in regarding subject 13. Do you see the 13 on
24 the end of that number?
25 A Yes, I do.
224
1 Q That's Dan.
2 A Uh-huh.
3 Q "I know this has been a nightmare for all of you...I
4 forwarded your e-mail to Ruth Flynn who is an attorney
5 working in our Risk office and have asked her to respond
6 about what we need to do with mom now that she has the
7 records. My instinct is that we need to tell her to stay
8 away, but Ruth will call you. Joellen Johnson, Patient
9 Relations." Have you seen this e-mail before today?
10 A No, I have not.
11 Q Okay, on page 19, on the bottom right. On the bottom
12 right, handwritten number 19. UM CAFE 2362. "Shirley
13 Qual, Esquire, Director of Compliance, Risk Management
14 and Regulatory Affairs. I spoke to Mr. Dunder after I
15 received --" well, this is from Steve, Steve Olson?
16 A Okay. I'm sorry. Where are we?
17 Q Right in the middle here (indicating).
18 A We're on Steve's note, not to Shirley.
19 Q Steve Olson's note, Associate Professor of Psychiatry.
20 "I spoke to Mr. Dunder after I received this message and
21 he indicates he is the appropriate person to act as a
22 buffer with MW. He needs to see all of the material that
23 MW is requesting, and as you told me later today, she has
24 only the clinical notes, not the 1000+ pages of the
25 resource source documents which I thought we had sent
225
1 A Okay.
2 Q On page 1, do you see where it says Quintiles, Inc., at
3 the top?
4 A Yes.
5 Q "Request for investigator payment, IRB reimbursement?"
6 A Yes, I do.
7 Q The amount is $1500.
8 A I see that.
9 Q And in the middle of the page, it says, "Sponsor:
10 AstraZeneca." Do you see that?
11 A Yes.
12 Q And "Investigator: Stephen Olson?"
13 A Yeah.
14 Q "Reason for payment: IRB REIMBURSEMENT." Is it your
15 understanding that IRB's responsible -- the reimbursement
16 is by IRB's for their work?
17 A I have seen payment to our IRB for other studies. No, so
18 this doesn't surprise me.
19 Q Next page, page 2, UM SPA 0236. "Principal
20 Investigator/Program Director, Stephen C. Olson." Do you
21 see that at the top?
22 A Yes, I do.
23 Q Looks like a grant, doesn't it? "Personal
24 justifications, Olson, principal investigator,
25 Dr. Olson-8% effort." Do you see that?
228
1 A Yes.
2 Q Okay. "Will supervise the personnel activities of the
3 CAFE project and take primary responsibility for assuring
4 the training and supervision of the staff." That's what
5 he did, right?
6 A Yes.
7 Q Okay. Then do you see your name down --
8 A Yes, yes I do.
9 Q "Schulz, Co-Investigator ... 10% effort." Quote, "Will
10 assist in the training and supervision of the staff.
11 Will work with the entire team to develop and implement
12 recruitment and follow-up care of patients in the
13 protocol." You did not do that, correct?
14 A That's correct.
15 Q Do you feel like when you agreed to do this, you had a
16 contract with the IRB and the paying agencies to do this
17 or not?
18 A Well, I didn't receive any money, so I didn't feel I had
19 a contract for payment, and my understanding was that I
20 was to be available to Dr. Olson for these activities.
21 Q But if IRB approved this and if the sponsor paid for it
22 based on the supposition that experienced Dr. Schulz
23 would be assisting and watching over Dr. Olson and
24 assisting in the training and supervision and recruitment
25 and follow-up care, and you in fact were not involved in
229
1 BY DR. BARDEN:
2 Q I'm asking you what it says in the document.
3 MR. ALSOP: You've read it two or three
4 times. You've asked him what it says two or three times.
5 One more time and we're not going to answer any
6 questions. One more time.
7 BY DR. BARDEN:
8 Q It does not say will assist when calls, does it?
9 MR. ALSOP: Objection, repetitious. The
10 document speaks for itself.
11 THE WITNESS: No.
12 BY DR. BARDEN:
13 Q Next page, "Departmental Internal Peer Review. Principal
14 Investigator: Stephen Olson. Co-Investigators: Charles
15 Schulz and John --" how do you say that?
16 A Vuchetich.
17 Q Vuchetich, okay. So do you see there is a faculty effort
18 certification, percent of effort, this is for Olson, is
19 eight percent, correct?
20 A Yes.
21 Q You see where it says percent of salary, eight percent?
22 A Yes. No. Let me see, percent --
23 Q S-a-l-a-r-y, correct?
24 A You're kind of looking at the whole page here. Do you
25 mean No. B?
232
1 Q Yes.
2 A 1(b).
3 Q Yeah. It says percent of salary, correct, eight percent?
4 A That's correct.
5 Q Thank you. Next page, 4 at the bottom. "Principal
6 Investigator: Stephen Olson, M.D." Do you see that?
7 A Yes, I do.
8 Q It says, "Breakdown of Payments, initial payment,
9 $16,362," correct?
10 A That's correct.
11 Q It says, "Upon receipt and approval of all regulatory
12 documents and this signed Clinical Study Agreement,
13 AstraZeneca shall forward a payment of $16,362 to the
14 representative noted below. This Initial Payment is a
15 refundable, advance payment for the first patient
16 enrolled and will be deducted from future Per Subject
17 Payments. If Institution does not enroll at least 1
18 Subject into the Study within 8 weeks of the date of its
19 receipt of the Study Drug, this Agreement may be
20 immediately terminated by AstraZeneca, and Institution
21 shall refund to AstraZeneca the $16,362 Initial Payment."
22 Did I read that correctly?
23 A Yes, you did.
24 Q And that's your understanding of the agreement you had,
25 correct, the CAFE study?
233
1 A Yes, it is.
2 MS. AHMANN: Objection --
3 BY DR. BARDEN:
4 Q Next, page 5 at the bottom right. We'll be looking at
5 pages 5 through, 5 through 14 as the AstraZeneca clinical
6 study agreement. Between -- if you see UM SPA 0076,
7 page 5 at the bottom right?
8 A Yes, I do see that.
9 Q At the top it says, "This CLINICAL STUDY AGREEMENT ...
10 dated as of the last date of the signatures below, is by
11 and among AstraZeneca Pharmaceuticals, LP, a Delaware
12 limited partnership with offices at 1800 Concord Pike,
13 Wilmington, Delaware ... ('AstraZeneca'), and The Regents
14 of the University of Minnesota, a Minnesota corporation
15 ('Institution') ... with Stephen Olson ... as ('Principal
16 Investigator')." Is that your understanding of the
17 parties to this agreement?
18 A Yes, it is.
19 Q Okay. On the next page, page 6 at the bottom,
20 UM SPA 0077. Right in the middle of the page, it says,
21 "Principal investigator --"
22 A Would you give me the letter?
23 Q Sorry. B, 5(b).
24 A Okay.
25 Q "Principal investigator shall obtain the informed consent
234
1 referrals."
2 Have you ever had study sweatshirts before?
3 A You know, I don't recall ever handing out study
4 sweatshirts, but I have heard about other studies in
5 which T-shirts about the study or something like that
6 have been given to patients.
7 Q Next page, page 2, to Amy from Jeannie Kenney. "Hi Amy.
8 Attached you'll find the most recent ICFs. The IRB
9 really got mixed up with approving the protocol change
10 and so it wasn't until actually just this last week that
11 we received final approval. They approved the consents
12 before approving the protocol. I now need to go back and
13 have everyone else sign new consents so they are
14 officially informed of the protocol change." Have you
15 seen this e-mail before today?
16 A No, I haven't.
17 Q Next page. Did you ever pay for private limousines for
18 patients to come in to be subjects in your study? Did
19 you ever pay for private limousines?
20 A We paid for, there was a car service that provided more
21 reliable pickup of some of our patients at agencies
22 around town, so I was aware of a car company. I didn't
23 know it was a limousine company.
24 Q Okay. Page, we're on page 3 here.
25 A Uh-huh.
239
1 A Yes.
2 Q It says, "CAFE Enrollment Kickoff. Dear Colleagues,
3 We've now worked together on the CAFE project for almost
4 two years. Our common goal is to complete the study
5 successfully and provide data that will answer critical
6 questions about the use of atypical antipsychotic drugs
7 in patients in their first psychotic episode. I thank
8 you for your superb efforts in making this trial possible
9 and successful to date. Although recruitment has
10 recently gone quite well, we still must consider the risk
11 for not meeting our target of 400 subjects. As of
12 Sunday, November 30th, 2003, we have enrolled 328
13 subjects out of our target 400. There are only 13 weeks
14 left to enroll subjects and there is no possibility of
15 further extending the enrollment period. We have been
16 averaging 20 new subjects a month for the past 6 months
17 now but we need to enroll about 25 per month for the
18 remainder of the trial. If each site can enroll 1
19 patient per month in the remaining 3 months then we will
20 meet our goal. I encourage you to make every effort to
21 enter patients into CAFE in this final stage of
22 enrollment. With a little extra effort, we will
23 succeed." Have you seen this letter before today?
24 A No, I have not.
25 Q Does this give us some idea of the kind of pressure,
242
1 Q Did you ever recruit any subjects for the CAFE study?
2 A I don't believe so.
3 Q Have you ever stressed to a potential subject that they
4 would receive perks for -- well, have you ever told any
5 referring physicians that as a perk, they would receive
6 high-quality care?
7 MR. ALSOP: Object as vague, but go ahead.
8 THE WITNESS: Over my career in clinical
9 research, I'm sure I've discussed with my colleagues that
10 my belief was that participation in some trials would
11 lead to an excellent evaluation, sustained attention,
12 perhaps some of the laboratory tests or imaging leading
13 to discovery of other illnesses that they hadn't been
14 screened for, and that it could be a useful thing for a
15 patient to participate in clinical research, so --
16 BY DR. BARDEN:
17 Q Sure.
18 A I've said that.
19 Q Sure. If the study is competently done, it can be quite
20 helpful, correct?
21 A Yes.
22 Q The study's incompetently done, it can be quite harmful,
23 correct?
24 MR. ALSOP: It's argumentative, vague and
25 ambiguous. Go ahead.
246
1 [it] to Marie asap." The question is, have you seen that
2 before today?
3 A No.
4 DR. BARDEN: Next let's look at this one.
5 It says CAFE on the top.
6 (Schulz Deposition Exhibit T marked for
7 identification.)
8 BY DR. BARDEN:
9 Q See at page No. 1 where it says, "Recruitment
10 information, new ideas [and] requests?" Do you see that?
11 We're on the same page?
12 A No. 2?
13 Q Yeah. My question, it says, "CAFE Coordinator
14 Teleconference." Did you ever participate in any of
15 these?
16 A I don't think so, no.
17 Q Next page, No. 2, these are the minutes of the
18 October 2003 meeting, you see that, handwritten notes?
19 A Uh-huh. Do you know whose notes these are?
20 Q I don't, unless it says it on here. It says, "CAFE
21 Teleconference: Coordinators. Last month: 27
22 enrolled ... October so far: 12 enrolled ... CAFE
23 web cast meeting October 29th."
24 This is during that time period, was it not,
25 when Dr. Lieberman had wrote that they felt like their
248
1 BY DR. BARDEN:
2 Q Okay. In the e-mails we've seen, were there not some
3 subject information, some information about people, their
4 parents said no?
5 A Oh, yes.
6 Q He was discontinued from the medication?
7 A Right.
8 Q Jean Kenney's e-mailing this off, and what was --
9 A Let me go back --
10 Q To the best of your knowledge, what kind of permission
11 did she have to do that?
12 MR. ALSOP: That's lacking in foundation --
13 BY DR. BARDEN:
14 Q That is, sending e-mails with containing the facts of
15 people's lives?
16 MR. ALSOP: It assumes facts not in
17 evidence, object to the form of the question,
18 speculative, and lacking in foundation. Go ahead.
19 THE WITNESS: So I described my
20 understanding of how things were proceeding on the
21 psychosis specialty unit, and that the, that
22 investigators would put a note in the front of the chart
23 for the attending psychiatrist to approach a patient, and
24 they could either refer or not refer. If they were
25 referred, then Jeannie could approach the patient and
251
1 BY DR. BARDEN:
2 Q That they're being quote, screened, unquote, "for
3 multiple studies including CAFE?"
4 MR. ALSOP: Same objection, it's foundation,
5 but go ahead if you know.
6 THE WITNESS: Okay. Well, I think this is
7 Dr. Perkins, who works at University of
8 North Carolina-Chapel Hill, giving her opinion, and I
9 told you what our process was, and it looks like it's a
10 little different than the one she's recommending.
11 BY DR. BARDEN:
12 Q Yeah, because this says if a potential patient is
13 identified by the screening, "the recruiter should notify
14 the study clinician who can [then] contact the patient
15 directly." That's not talking to the patient; that's
16 screening. Patient doesn't know.
17 A Yeah, I see that last sentence. I agree with you.
18 Q "Strategy 2-Hold educational seminars on Schizophrenia
19 and the CAFE study. Some suggestions for target groups
20 are the ER and walk-in clinic residents and attendings.
21 This is an opportunity to meet these people and establish
22 a rapport while educating them on CAFE. (Remember, that
23 AZ offers $100 [every] 3 months to support these events."
24 "Strategy 3-During these educational
25 meetings, emphasize the benefits of your site taking on
254
1 A No.
2 Q Were you aware that they were giving gifts to encourage
3 referrals?
4 MR. ALSOP: It's repetitious. Go ahead.
5 THE WITNESS: Well, I may not be
6 understanding this correctly, but my understanding of how
7 this was going is that Jeannie and Elizabeth, or Jeannie
8 and Elizabeth and Steve Olson, would go to a mental
9 health center or some other maybe community education
10 meeting, and they would set up a booth, and they might
11 have a bowl of chocolates or a pen with either
12 University of Minnesota and, it sounds like from here,
13 maybe the CAFE study, and that they would see that and
14 talk either with people in the community or others.
15 That's my understanding of what these materials were
16 about.
17 BY DR. BARDEN:
18 Q Let's go to page 7. "Dear CAFE Investigators, Despite
19 the fact we've made considerable progress in the period
20 since the CAFE investigators' meeting in January [of]
21 2002, for a variety of reasons we are behind schedule on
22 enrollment."
23 A Do you know when this was written?
24 Q I don't. It says January 2002, though. "For this reason
25 I am requesting --"
258
1 BY DR. BARDEN:
2 Q Looking at the front part here, again, this is from
3 Monica Pallett to Jeannie Kenney, November 7, 2003.
4 Again, this is about checking on the PANSS certification
5 of Dr. Olson. "He is not certified to rate the PANSS for
6 CAFE and if he is doing so should score all three of the
7 certification tapes ... Also, I just scored his PANSS
8 submission for tape 20 for CATIE ... and he scored it
9 quite low so [he] will need to rescore it."
10 Do they have people rescoring tapes as part
11 of research studies? If the people at the main office
12 think the score's too low, they just have them rescore
13 it? Is that research protocol?
14 MR. ALSOP: It's a misstatement of this
15 document, argumentative, lacking in foundation. Go
16 ahead.
17 MS. AHMANN: Join.
18 THE WITNESS: So I don't know anything
19 specific about this.
20 BY DR. BARDEN:
21 Q Have you ever seen this e-mail before today?
22 A No.
23 Q Would you think it would be appropriate for someone to
24 rescore a PANSS submission because a bureaucrat thinks
25 it's too low?
260
1 A That's correct.
2 Q Dr. Olson ever tell you that Dan Markingson kept a
3 detailed journal?
4 A No.
5 Q That it was right there in his room in the Theo House,
6 anybody could have looked at it any time or asked him
7 what was in it, but apparently no one ever did? Did
8 Dr. Olson ever tell you anything about this?
9 A No, he did not.
10 Q All right. Takes care of that one.
11 DR. BARDEN: How much time have I used so
12 far?
13 VIDEO TECHNICIAN: As far as the videotape
14 running?
15 DR. BARDEN: Yes.
16 VIDEO TECHNICIAN: We're about five
17 and-a-half hours, give or take five minutes.
18 DR. BARDEN: Okay, and you know what, we're
19 getting into a whole other one, so I promised you
20 5:00 o'clock. We'll come back and finish the other two
21 and-a-half hours, or whatever I have.
22 MR. ALSOP: I think one and-a-half.
23 DR. BARDEN: One and-a-half. Thanks.
24 MR. ALSOP: Go right ahead.
25 VIDEO TECHNICIAN: I can get the exact time
263
1 for you.
2 MR. ALSOP: Yeah, just give us a time so we
3 can put in the record.
4 DR. BARDEN: Thank you. We'll leave the
5 exhibits with the court reporter and you'll make copies,
6 correct, when you do this? And Doctor, we'll see you
7 next time, and you'll make your dinner.
8 MR. ALSOP: Do you want me to give the ones
9 you have not?
10 (Brief time off the record.)
11 MR. ALSOP: Mr. Barden, I'm just going to
12 put on the record that he confirmed it's five and-a-half
13 hours.
14 VIDEO TECHNICIAN: Give or take five
15 minutes.
16 MR. ALSOP: That's fine. So five and-a-half
17 hours.
18
19 (Deposition adjourned at 4:45 p.m.)
20 * * * *
21
22
23
24
25
264
1 STATE OF MINNESOTA )
)ss. CERTIFICATE
2 COUNTY OF WASHINGTON )
3 BE IT KNOWN that I, Janice L. Young, took the
foregoing deposition of CHARLES SCHULZ, M.D.;
4
That I was then and there a Notary Public in
5 and for the County of Washington and State of Minnesota;
6 That by virtue thereof, I was then and there
authorized to administer an oath;
7
That the witness, before testifying, was by me
8 first duly sworn to testify the truth, the whole truth
and nothing but the truth relative to said cause;
9
That the testimony of said witness was
10 recorded in stenotypy by me and was reduced to type-
writing under my direction;
11
That the foregoing deposition is a true
12 record of the testimony given by said witness;
13 That the cost of the original has been charged
to the party who noticed the deposition, and that all
14 parties who ordered copies have been charged at the
same rate for such copies;
15
That I am not related to any of the parties
16 hereto, nor an employee of any of them, nor
interested in the outcome of the action;
17
That I am not financially interested in the
18 action and have no contract with the parties,
attorneys, or persons with an interest in the action
19 that affects or has a substantial tendency to affect
my impartiality; and
20
That the reading and signing of the foregoing
21 deposition by said witness were waived.
22 WITNESS MY HAND AND SEAL this 30th day of
June, 2007.
23
24 ______________________________
Janice L. Young
25