278 1 STATE OF MINNESOTA DISTRICT COURT

2 COUNTY OF HENNEPIN FOURTH JUDICIAL DISTRICT Wrongful Death 3 -------------------------4 Court File No. Mary Weiss, on her own behalf 27CV07-1679 5 and as next of kin and trustee of the Estate of Dan Markingson, 6 deceased, Videotape Deposition 7 Plaintiff, Vol. 2 8 -vs-

9 Board of Regents for the University of Minnesota; Dr. Stephen Olson; 10 Dr. Charles Schulz; Institutional Review Board for the University of Minnesota; 11 Astrazeneca Pharmaceuticals, LP; Astrazeneca LP and Zeneca, Inc., 12 Defendants/Respondent 13 - - - - - - - - - - - - - - - Volume 2 pgs. 278 - 328 14 15 16 17 18 19 20 21 22 23 24 By MARTHA M. FIER, COURT REPORTER 12151 Gantry Lane Deposition of: STEPHEN OLSON, M.D. Taken at: Pearson, Randall & Schumacher 100 South Fifth Street Suite 1025 Minneapolis, Minnesota Date: January 18, 2008

Commencing at: 11:00 a.m.

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25

Apple Valley, Minnesota 55124 800-844-6420 * 952-431-1252

279 Deposition of STEPHEN OLSON, M.D., taken pursuant to Notice to Take Oral Deposition, under the 2 Rules of Civil Procedure, for the District Courts of Minnesota, at Pearson, Randall & Schumacher, 100 3 South Fifth Street, Suite 1025, Minneapolis, Minnesota, commencing at approximately 11:00 a.m., on 4 the 18th day of January, 2008, before Martha M. Fier, Notary Public, in and for the State of Minnesota. 5 - * 6 APPEARANCES: 7 R. CHRIS BARDEN, Esq., and GALE D. PEARSON, 8 Esq., of the law firm of Pearson, Randall & Schumacher, Fifth Street Towers, 100 South Fifth 9 Street, Suite 1025, Minneapolis, Minnesota 55402 appeared for and on behalf of Plaintiff. 10 DAVID P. ALSOP, Esq., and ANGELA M. NELSON, 11 Esq., of the law firm of Gislason & Hunter, 701 Xenia Avenue South, Suite 500, Minneapolis, Minnesota 55416 12 appeared for and on behalf of Defendants Olson and Schulz. 13 DAVID C. HUTCHINSON, Esq., and CHARLES A. 14 GROSS, Esq., of the law firm of Geraghty, O'Loughlin & Kenney, Alliance Bank Center, 55 East Fifth Street, 15 Suite 1100, St. Paul, Minnesota 55102 appeared for and on behalf of Defendant Board of Regents of the 16 University of Minnesota. 17 BRIDGET M. AHMANN, Esq., of the law firm of Faegre & Benson, 2200 Wells Fargo Center, 90 South 18 Seventh Street, Minneapolis, Minnesota 55402-3901 appeared for and on behalf of Defendants Astrazeneca 19 and Zeneca. 20 Also present, Ruth Flynn, Esq., Risk Management Operations Director, University of 21 Minnesota Physicians, 720 Washington Avenue SE, Minneapolis, Minnesota 55414. 22 - * 23
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24

Examination: By Dr. Barden ........... 281

25 Exhibit No. 35 - Amended Videotape Deposition Notice marked on page 301

280 1 VIDEOGRAPHER: We are now on the

2 video record. This is the deposition of Dr. Stephen 3 Olson being recorded Friday, January 18, 2008 in 4 Minneapolis, Minnesota. At this time, will the 5 attorneys please identify themselves for the record. 6 DR. BARDEN: My name is Dr. Chris

7 Barden. I'm here for the plaintiff Mary Weiss. 8 MS. PEARSON: I'm Gale Pearson here

9 for Plaintiff Mary Weiss. 10 MS. AHMANN: Bridget Ahmann appearing

11 on behalf of Astrazeneca. 12 MR. GROSS: Charles Gross on behalf

13 of the University of Minnesota. 14 MR. HUTCHINSON: David Hutchinson for

15 the University of Minnesota. 16 MS. NELSON: Angela Nelson on behalf

17 of Dr. Olson. 18 MR. ALSOP: Dave Alsop on behalf of

19 Dr. Olson. 20 VIDEOGRAPHER: The time is now 11:09

21 a.m. Will the court reporter please administer the

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22 oath. 23 24 25

281 1 2 3 4 5 STEPHEN OLSON, M.D. called as a witness, having been duly sworn, was examined and testified as follows: EXAMINATION

6 BY DR. BARDEN: 7 8 9 Q. A. Q. Good morning. Good morning. Were you aware of the recent study in the

10 New England Journal of Medicine regarding the 11 misreporting of antidepressant effectiveness data? 12 13 A. Q. Yes. What's your understanding of what that

14 study showed? 15 A. That the majority of studies showing

16 antidepressants to be superior to placebo ended up 17 published and the majority of studies that were 18 negative were not published. 19 Q. And by negative, you mean not superior to

20 placebo.

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21

A.

Right, or inferior to placebo, if there

22 were such. 23 Q. Okay. As a psychiatrist, did that trouble

24 you? 25 A. Yes.

282 1 2 Q. A. Why? Because it gives a distorted, inflated view

3 of the efficacy of antidepressants. 4 Q. And the research that the New England

5 Journal of Medicine was looking at extended back over 6 how many years? 7 A. By that, I don't know. That I don't know.

8 I have not seen the article itself. I've read a news 9 summary of it. 10 Q. Okay. Did the news summary inform you that

11 the misreported data goes back through the time 12 period that Dan was in the Cafe Study, that is those 13 years? 14 15 16 A. Q. A. Oh, certainly. Okay. So, I mean, this -I would assume it goes back to the '90s,

17 and I didn't know whether before that, but at least a 18 decade. 19 Q. So this was a longstanding pattern that

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20 they discovered. 21 22 A. Q. Yes. Uh-huh. Okay. Are you aware of similar patterns of

23 misreporting of data on the effectiveness of 24 psychiatric treatments? 25 A. I'm not aware of other review articles or

283 1 meta-analysis of the sort, but I assume that that 2 goes on across the board, uh-huh. 3 Q. Were you aware, for example, of Dr. Walter

4 Freeman's work? Have you ever heard that name? 5 6 7 8 9 10 A. Q. A. Q. A. Q. Walter Freeman? Yes. The lobotomist? Yes. Yes, uh-huh. Were you ever aware of any misreporting of

11 treatment effectiveness that Dr. Freeman did? 12 A. Well, I read Jack El-Hai's book about that,

13 but I don't remember specifically. That wouldn't 14 surprise me at all. Back in the 1950s I think it was 15 pretty clear that he had an inflated view of the 16 efficacy of psychosurgery. 17 18 Q. He was the master of the ice pick, correct? MR. ALSOP: I'm going to object as

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19 argumentative and vague, but go ahead. 20 THE WITNESS: He was one of the

21 primary developers of that procedure and was 22 certainly its leading spokesperson and proponent. 23 BY DR. BARDEN: 24 Q. And when you say "that procedure," could

25 you describe for the record what Dr. Freeman would

284 1 do? 2 A. He would anesthetize the patient by

3 administering electroshock, and while they were 4 unconscious, he'd put a metal instrument, similar to 5 an ice pick, in the canthus of the eye, tapped it 6 with a hammer to break through the back of the orbit 7 and then moved it in some back and forth fashion to 8 sever fibers in the frontal lobe. 9 Q. That surgery is no longer widely used, is

10 it? 11 A. I'm not aware that that surgery is done at

12 all. 13 Q. Are you aware of a psychiatrist named Dr.

14 Bennett Braun? 15 16 A. Q. No. Never heard of any misreporting of

17 treatment effectiveness for the treatment of

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18 so-called multiple personality disorders? 19 20 A. Q. Oh, certainly, but I don't know -You don't know the names of the people

21 involved in that. 22 23 A. Q. The names of the -The names of the MPD theorists and

24 researchers. 25 A. Oh, I would probably recognize some of

285 1 them, but not -- I can't recall, offhand, who was -2 yeah. No, I don't know. 3 Q. Were you aware of any controversies

4 regarding misreporting of treatment data having to do 5 with so-called MPDs? 6 A. Yes, the psychiatric literature was -- and

7 popular literature was -- there were reports of the 8 wide-spread incidents of multiple personality 9 disorder and the treatment, beneficial treatment 10 effects of hypnosis and other forms of therapy to 11 reintegrate personalties. And many, many patients 12 were involved in treatment like that that wasn't 13 really supported by, I think, objective clinical 14 trials. 15 Q. How about treatment known as reparenting?

16 Have you ever heard of that, reparenting? I guess

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17 Dr. Dean Baack (phonetic) may have been the most 18 famous phonetic, but -19 A. I don't know if that was the thing where

20 patients would be involved in some simulation of 21 birth and reborn in sort of a ritual ceremony. I'm 22 not sure if that's what you're referring to. I'm not 23 familiar with the term "reparenting." 24 Q. That's actually attachment therapy what

25 you're describing. But you're not aware of anything

286 1 known as reparenting therapy. 2 A. No, not to recall. If you described it to

3 me, I might recognize it. 4 Q. This is where the psychologist -- the

5 psychiatrist, actually, would cuddle the patient and 6 actually breast fed them, was reparenting them. 7 8 A. Q. No, I haven't heard of that. Okay. We talked about misreporting of

9 antidepression med research. Are you aware of any 10 controversies with regard to a 10-fold increase in 11 the diagnosis of bipolar illness in children? 12 13 A. Q. Yes. What's the nature of that particular

14 controversy, to the best of your knowledge? 15 A. That over the last decade, there's been

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16 first an increased awareness that bipolar disorder 17 could present in children, and then an increase in 18 attention and the literature and in clinical 19 practice. And so many more kids are diagnosed with 20 bipolar disorder now than were previously. And the 21 controversy is, is this really bipolar disorder or is 22 this just a more acceptable diagnosis for conduct 23 disorder and attention deficit and other behavior 24 problems? And concurrent with that is the 25 controversy about whether -- or whether and how much

287 1 of the treatment and diagnosis is promoted by the 2 pharmaceutical industry in order to create a, say a 3 new market for medications. 4 Q. The 10-fold increase is not just a

5 diagnosis of bipolar, it's also the use of very 6 serious antipsychotic medication typically given to 7 adults to younger and younger children, right? I 8 mean, that's part of the controversy. 9 10 form. 11 THE WITNESS: Could you repeat the MS. AHMANN: I'm going to object to

12 question, because -13 BY DR. BARDEN: 14 Q. Okay. It's not just a controversy about

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15 diagnosis, it's also a controversy about the use of 16 medications with children -17 18 19 A. Q. A. Yes. -- that are typically just used for adults. Well, I disagree with that, that -- these

20 are medications that are approved for the use in 21 adults, and the number of studies and the amount of 22 research to support their use in children is far 23 less. 24 Q. But a 10-fold increase over 10 years is

25 controversial in the use of these meds with children,

288 1 correct? 2 3 A. Q. Yes. Are you aware of a controversy in

4 psychiatry over the last decade or so -- and again, 5 these all cover the time period that Dan Markingson 6 was in the Cafe Study, right? 7 8 A. Q. Uh-huh. All of the controversies we've discussed so

9 far cover those years. 10 11 A. Q. Yes, uh-huh. Okay. Are you aware of a controversy with

12 regard to the widespread overuse of AD/HD medication 13 in children?

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14 15

A. Q.

Yes. And once again, this enormous percentage

16 increase in both the diagnosis and the use of 17 medicine for children having supposed AD/HD troubles, 18 right? 19 20 MS. AHMANN: Objection to form. THE WITNESS: I don't -- I don't know

21 that the diagnosis of AD/HD has increased 22 dramatically, but, I mean, I had, in my training 25 23 years ago, I was aware that stimulants were much more 24 widely used in the Untied States than in, say, 25 Britain. And one, you know, one of my instructors

289 1 indicated he thought that it was an easy way out for 2 clinicians, pediatricians to prescribe a stimulant 3 when, in fact, maybe a different educational plan or 4 some behavioral intervention might be appropriate. 5 So I think that's an ongoing concern

6 about the appropriate use. On the other hand, there 7 are studies that show that stimulants are extremely 8 effective. And so I think it's a controversy that 9 exists in many areas of psychiatry. There seems to 10 be an underutilization of treatment in certain cases 11 and an overutilization. And trying to train people 12 to administer treatment appropriately is the --

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13 should be the goal. 14 BY DR. BARDEN: 15 Q. Are you aware -- you mentioned the

16 difference, for example, the use of these medications 17 with children in Europe. Are you aware of the 18 differences in the percentages of the -- standard 19 percentage of children in the population taking 20 stimulants for so-called AD/HD in the United States 21 versus those in Europe? 22 A. I don't know the specific figures, but I've

23 heard some information about that, and I'm sure it's 24 much higher in the U.S. 25 Q. Much higher as in stunningly higher,

290 1 correct? 2 3 4 MS. AHMANN: Objection to form. THE WITNESS: It's higher. MR. ALSOP: It's vague and ambiguous

5 and argumentative. 6 BY DR. BARDEN: 7 Q. So this is another controversy that is out

8 there in terms of whether medication should be used 9 in the percentages and the amounts that it's being 10 used, correct? 11 A. Yes.

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12

Q.

All of these controversies, that is the

13 misreporting of depression medications that skews 14 results so that people think the meds are more 15 effective than they are, the controversy regarding 16 the enormous increase in use of medication for 17 bipolar illness in children, controversy regarding 18 the enormous increase in the use of stimulants in 19 children with AD/HD, all of these controversies have 20 to do with the question of whether drug companies are 21 influencing the field of psychiatry for their 22 enrichment; isn't that correct? 23 24 MS. AHMANN: Object to form. MR. ALSOP: Object, as a misstatement

25 of the evidence, as to form and argumentative. Go

291 1 ahead, Doctor. 2 THE WITNESS: I think that that's a

3 part of that. I don't think that it's the only 4 concern or explanation for those changes -- those 5 things you mentioned. 6 BY DR. BARDEN: 7 Q. Hum. To clarify, I mean, these are complex

8 issues, but that certainly is an issue, a theme that 9 goes throughout these various controversies, isn't 10 it?

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11 12 vague. 13 14 15

MR. ALSOP: Same objection. Also

MS. AHMANN: Join. MR. HUTCHINSON: Join. THE WITNESS: It could be.

16 BY DR. BARDEN: 17 Q. How about the controversy with regard to

18 misreporting of the treatment effectiveness of the 19 new antipsychotics, which are very expensive, versus 20 the old antipsychotics which are not very expensive? 21 Are you aware of any controversy regarding that? 22 A. Absolutely. I'm an investigator for the

23 Cady Study which investigated that issue. 24 25 Q. A. And what did the Cady Study find? That the newer antipsychotics were, if

292 1 better, only incrementally better than a first 2 generation antipsychotic if it was prescribed at a 3 very modest dosage for the treatment of 4 schizophrenia. 5 Q. And how much more expensive were the new

6 antipsychotics than the old ones? 7 A. They varied depending on the drug, but

8 probably roughly 10-fold. 9 Q. Ten-fold.

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10 11

A. Q.

Five to 10-fold. Five to 15-fold, maybe. And so are you aware of any legal actions

12 brought by states to recover the difference in money 13 expended for new antipsychotics versus old ones? 14 15 A. Q. No. Are you aware of any claims that tens of

16 billions of dollars have been wasted using the new 17 drugs versus the old ones in terms of Medicaid and 18 Medicare programs? 19 20 MS. AHMANN: Object to form. THE WITNESS: Am I aware of claims --

21 no, I'm not aware of any claims. 22 BY DR. BARDEN: 23 Q. You haven't seen any controversies with

24 regard to the fact that it took so long to do the 25 Cady Study that, in fact, for years states were

293 1 paying out these enormously increased expenses for 2 the newer drugs when they could have been using the 3 older, less expensive ones all along? Are you aware 4 of that particular controversy? 5 6 7 8 MS. AHMANN: Object to form. MR. ALSOP: I'll join. MR. HUTCHINSON: Join. THE WITNESS: No, I'm not aware of a

Olson depo 2.txt[5/9/2013 7:39:50 AM]

9 claim that this should have been evident from the 10 beginning. I disagree with that claim. I think that 11 there are advantages. The Cady Study isn't a 12 definitive study, and there are considerations that, 13 far beyond cost, that need to be taken into account. 14 But I'm -- I've heard of possible efforts of Medicaid 15 and pharmacy benefit managers to mandate the use of 16 older first generation antipsychotics over the newer 17 drugs currently, but not -18 BY DR. BARDEN: 19 20 21 Q. A. Q. But not previously. Yeah. Uh-huh. Have you ever heard of experiment

22 of nature? It's a standard phrase in the science 23 field, isn't it? 24 A. Yeah. I think it would be an event that

25 occurs through some random occurrence in nature that

294 1 provides an insight into -- it's like a mini 2 randomized trial. Two twins, one falls out of a tree 3 and hits his head, has a concussion, and you find out 4 15 years down the line that that kid develops 5 schizophrenia, let's say. 6 Q. Right. So we've been going through a list

7 of controversies with regard to the use of

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8 medications and whether research has skewed and 9 misreported to enrich drug companies. Isn't it, in 10 fact, the case that Dan Markingson's case is an 11 experiment of nature that exposes the fatal flaw in 12 the pill counting type methodology used in the Cafe 13 Study and, in fact, shows such studies to be yet 14 another example of the misreporting of scientific 15 information for the enrichment of drug companies? 16 17 A. No. MR. ALSOP: Object as argumentative,

18 multiple question and form. 19 20 MS. AHMANN: Join. MR. HUTCHINSON: Join. Lacking

21 foundation. 22 BY DR. BARDEN: 23 24 Q. A. When you were engaged in the Cafe Study -You want an answer or do you just want to

25 ask a question and have it objected to?

295 1 2 3 Q. A. Q. Go ahead. I'd like you to answer. No. Okay. When you were working on -- and I

4 thought you did that. Sorry. I was so sure you had. 5 I actually thought you'd answered. 6 When you were working on the Cafe Study,

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7 did you ever consider including a blood test on a 8 randomly selected sample of your subjects to ensure 9 that the subjects were actually taking the medication 10 that they were prescribed? 11 12 A. Q. No. Did you ever -- well, first of all, do you

13 know about the psychology department at the 14 University of Minnesota? 15 16 17 18 A. Q. A. Q. Yes. It's a fairly highly ranked department? Yes. Do you know how highly ranked? Do you have

19 any idea? 20 A. I would believe it's in the top 10, but I

21 don't know that for a fact. 22 Q. Okay. Did you ever consider consulting

23 with a psychological expert on methodology? 24 A. No, I wasn't involved in the design of the

25 Cafe Study.

296 1 Q. Did you ever report any concerns with the

2 so-called pill counting methodology, that it would be 3 highly unreliable with mental patients? 4 5 A. Q. No. Okay. When did you first find out that Dan

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6 Markingson had no Cafe medication study drugs in his 7 blood stream? 8 A. It would have been probably one to three

9 months after his death, the results of the autopsy, 10 and I can't recall if I heard them directly or if 11 they came via written report, but -12 Q. So it wasn't until his suicide, which I

13 guess could be construed as an experiment of nature 14 which led to an actual blood test, it wasn't until 15 that that you even knew that he wasn't taking the 16 medications in the Cafe Study. 17 MR. HUTCHINSON: Object as

18 argumentative, misstating the evidence. 19 20 MR. ALSOP: I'll join. Also form. MR. HUTCHINSON: Lacking in

21 foundation, relevance. 22 23 MS. AHMANN: Join in all. MR. ALSOP: Go ahead, Doctor, if you

24 can answer. 25 THE WITNESS: Well, it's a convoluted

297 1 question, but we had concerns about his compliance 2 earlier in the Cafe Study, and I still don't know the 3 sensitivity of the assay, I don't know the 4 reliability of whether it was from serum or vitreous

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5 fluid. So I don't know for a fact that he wasn't 6 taking his medication and that perhaps the specimen 7 was -- the assay isn't valid. So -8 BY DR. BARDEN: 9 Q. But the only evidence that we actually have

10 of his blood indicates that he was taking nothing, 11 correct? 12 A. He was taking not enough to be detected

13 with that test. 14 Q. Uh-huh. So then based upon the results of

15 that experiment of nature, what percentage of your 16 other subjects -17 MR. HUTCHINSON: Object to form as

18 argumentative. 19 BY DR. BARDEN: 20 21 22 Q. A. What percentage of -I -MR. ALSOP: Well, wait, wait, wait,

23 wait. He hasn't -- wait until he asks a question. 24 THE WITNESS: Okay.

25 BY DR. BARDEN:

298 1 Q. What percentage of your other subjects in

2 the Cafe Study were also not taking their medication? 3 MR. ALSOP: Object as irrelevant and

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4 speculative, but go ahead. 5 6 7 MS. AHMANN: Join. MR. HUTCHINSON: Lacking foundation. THE WITNESS: I disagree with your

8 statement that this was an experiment of nature, and 9 I don't know how many other of the subjects were 10 actually taking their medication, just as I don't 11 know how many of my patients are actually taking the 12 medication. 13 BY DR. BARDEN: 14 Q. Uh-huh. Why don't you consider this to be

15 an experiment of nature? What's your reasoning for 16 saying that? 17 A. Well, it didn't fit into what I considered

18 an experiment of nature as I defined it, an 19 occurrence that would give some insight, for example, 20 my example of twins, one has a head injury and one 21 doesn't. 22 Q. Yeah. Dan Markingson's death forced a

23 blood test showing that your pill counting 24 methodology is not reliable. Isn't that a classic 25 textbook experiment of nature?

299 1 MR. ALSOP: That is argumentative,

2 irrelevant. Object to form.

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3 4 5

THE WITNESS: I don't know. MS. AHMANN: Join. MR. HUTCHINSON: Join.

6 BY DR. BARDEN: 7 Q. So as someone who is responsible for the

8 lives of patients in this type of research, when you 9 found out that the blood test indicated that Dan 10 Markingson was not taking any medication, what steps 11 did you take to determine the reliability of the 12 blood test used in the autopsy? 13 MS. AHMANN: I'm going to object to

14 form, lack of foundation. 15 16 MR. HUTCHINSON: I'll join. THE WITNESS: I didn't -- I didn't

17 take any steps. 18 BY DR. BARDEN: 19 Q. Okay. And you're still using the so-called

20 pill counting methodology in research, isn't that 21 correct? 22 23 A. Q. In some of our studies, yes. And in those pill counting studies, you're

24 not taking random blood tests to ascertain whether 25 people really are taking the medication or not.

300 1 You're not doing that, are you?

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A.

Well, some studies do include pharmokinetic

3 studies and some may include assays that do measure 4 the blood levels, but they're not provided to the 5 investigator. That's part of the protocol. It's 6 just their genetic analyses and their other, maybe 7 other aspects that aren't -8 Q. So there are protocols that use blood

9 testing. 10 11 A. Q. Yes. So if someone had claimed that it would be

12 unethical to have a protocol with blood testing, 13 that's absurd, correct? 14 15 16 17 MS. AHMANN: I'll object to form. MR. ALSOP: I'll join. MR. HUTCHINSON: Join. THE WITNESS: No, I don't think it

18 would have been unethical. 19 BY DR. BARDEN: 20 21 22 Q. A. Q. Okay. It's not standard practice. Not -- well, isn't that the problem? Isn't

23 the standard practice in AD/HD research and bipolar 24 research and misreporting of antidepressant research 25 and in so-called pill counting methodology of the

301

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1 antipsychotic, it's the methodology to enrich the 2 drug companies by not finding negative results? 3 Isn't that the problem, Doctor? 4 5 A. No. MR. ALSOP: It's a multiple question,

6 vague and ambiguous and irrelevant. 7 8 9 10 11 12 MS. AHMANN: Join. (WHEREUPON, Deposition Exhibit No. 35 was marked for identification by the Reporter.) DR. BARDEN: How much do we have? VIDEOGRAPHER: Thirty-four minutes.

13 BY DR. BARDEN: 14 Q. This is Exhibit 35. Okay. Okay. For the

15 record, I'm handing Dr. Olson what's marked as 16 Exhibit No. 35. It's the amended videotape 17 deposition of Dr. Steven Olson. Do you recall 18 receiving that, Doctor? Have you ever seen that 19 before? 20 21 A. Q. Yes. Uh-huh. Okay. If you could just look on page 2

22 there. If we could look on it together. 23 24 A. Q. I'm looking at it. All right. See where it says I'm going to

25 take this deposition on Friday January 18th? That's

302
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1 today, correct? 2 3 A. Q. Uh-huh. Commencing at 11 a.m., and that's about

4 when we started, isn't it, 11 a.m.? 5 A. Yes. It says 2007, but I assume that's

6 a -7 Q. Okay. That's -- and to bring with you for

8 inspection and copying a complete copy of the medical 9 record file on plaintiff Dan Markingson from the 10 University of Minnesota. Is that what that says? 11 12 A. Q. Yes, uh-huh. Just a straight forward question, did you

13 bring any records with you today? 14 15 A. Q. No. Okay. Now, last time I had talked to you,

16 we discussed what you had done to prepare for the 17 deposition. Have you done anything since then to 18 prepare for part two of the deposition? 19 A. I reviewed the transcript of the previous

20 deposition in the last week or so. 21 Q. Okay. In the last week? The last day or

22 two, or week ago or when do you think you did that? 23 Again, I'll never ask you for any conversations with 24 your lawyers, but I can certainly ask you about -25 A. Within the past week.

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303 1 Q. Okay. How much money -- what's the total

2 amount of money that you've received from all drug 3 companies in the year 2007? 4 5 A. Q. I don't know. As you sit there now, as a tax paying

6 citizen -- I take it you pay taxes, do you not? 7 8 9 A. Q. I do. And you filed a tax return? MR. ALSOP: For 2007?

10 BY DR. BARDEN: 11 Q. Have you filed an estimated payment for

12 2007? On January 15th did you -- have you not been 13 filing estimated payments throughout the year or not? 14 15 A. Q. Yes. Okay. And based upon your knowledge of

16 your own personal finances, I'm asking you how much 17 money have you received from drug companies in fiscal 18 year 2007? 19 MR. ALSOP: Object, it's repetitious,

20 asked and answered and speculative. Go ahead, 21 Doctor. 22 DR. BARDEN: I'm just going to object

23 for the record to a lawyer who claims that a person 24 knowing their own financial status is "speculative." 25 BY DR. BARDEN:

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304 1 Q. And now we'll go on with your answer,

2 please. 3 4 A. Q. For all of 2007, probably $20,000. Okay. And how about for 2008, given that

5 we're just in the first month of that year? 6 7 8 9 A. Q. A. Q. Zero. Okay. And then how about in 2006? Probably around $20,000. Okay. Are you aware of any media reports

10 indicating that you have received quite a bit more 11 than that? 12 13 14 A. Q. A. Yes. And what is that media report? Well, that's a Web site, I believe St. Paul

15 Pioneer Press got that shows payments from several 16 drug companies, including $149,000 payment from 17 Astrazeneca in 2006. 18 Q. Uh-huh. And it's your claim that that's

19 not accurate. 20 A. No, my claim is that that's payment for a

21 research study that went through the University, as 22 all payments for research do. It's not a payment to 23 me. It's not income that's reportable on my personal 24 tax return.

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25

Q.

Okay. So this was a study that you brought

305 1 in -- these are funds that you brought in to the 2 University? 3 4 A. Q. Uh-huh. Okay. And it's your testimony that that

5 did not affect your salary at all. 6 MR. ALSOP: That's argumentative and

7 a misstatement of his testimony. 8 9 MS. AHMANN: Join. THE WITNESS: That's correct.

10 BY DR. BARDEN: 11 Q. So there's no increase in your salary if

12 you bring in millions of dollars of research, for 13 example. That's your understanding of how the system 14 works. 15 16 17 MS. AHMANN: Object to form. MR. ALSOP: I'll join. THE WITNESS: It's an irrelevant

18 question, because I don't bring in millions of 19 dollars of research. So -20 BY DR. BARDEN: 21 Q. Well, I'm interested in your understanding

22 of the process of how the academic research process 23 works, Dr. Olson. Is it your understanding that your

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24 personal salary is not related at all to the amount 25 of money you bring in in research?

306 1 MR. ALSOP: Object on the basis of

2 foundation. Go ahead. You can answer. 3 4 form. 5 6 MR. HUTCHINSON: Same. THE WITNESS: Basically, I'm paid a MS. AHMANN: I'm going to join as to

7 salary, and it is not affected by my research. If I 8 were to bring in millions of dollars of research, I 9 suspect that I should ask for a bigger raise than I 10 generally get. So that's my answer. 11 BY DR. BARDEN: 12 Q. So it's your belief that at your level of

13 research, that is, the kind of research you bring in, 14 that you believe there is no relationship between 15 your personal income and the amount of research money 16 you bring in to the University. Is that your 17 testimony under oath? 18 19 A. Q. Yes. Uh-huh. Okay. Has your personal income from the

20 University changed over the last five years? 21 22 A. Q. Yes. And has it gone up?

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23 24

A. Q.

Yes. What are those numbers beginning in, say,

25 let's start during the time Dan was in treatment, a

307 1 little before, starting with 2001? 2 MR. ALSOP: You don't have to answer

3 any questions about your income from the University 4 of Minnesota. It's privileged. He's not going to 5 answer those questions. 6 MR. HUTCHINSON: Join on grounds of

7 relevance. 8 DR. BARDEN: I understand that that's

9 your objection. I think that objection is obviously 10 wrong. This witness has just testified as to a very 11 unique and unusual belief that his personal income is 12 not related to the research money that he brings in, 13 and I think that his -- it's very likely that his 14 personal income data will show that that testimony is 15 not accurate. 16 So I think as part of

17 cross-examination, we're certainly entitled to those 18 data. If he wants to get a confidentiality order or 19 something of that effect, I'd be happy to go along 20 with that. I'm not interested in anyone else finding 21 out how much money he's made from the University over

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22 those years, but we certainly would like to 23 investigate whether there is a relationship between 24 him bringing in money and the personal income he 25 receives from the University, since that is typically

308 1 and commonly expected in every other university I'm 2 aware of on the planet Earth. So that would be our 3 argument. 4 If you want to block him from

5 answering that, it may necessitate a motion and us 6 reconvening again in the future, but that's up to 7 you. 8 MR. ALSOP: I disagree with

9 everything you said in its entirety. His personal 10 income, salary, is not relevant, it's privileged, and 11 he's not going to answer those questions. He's 12 answered questions about income from drug companies 13 and everything else, but to talk about his salary 14 with the University is absolutely irrelevant and 15 privileged and he's not going to answer those 16 questions. 17 DR. BARDEN: Okay. Can you please

18 cite for me the case law that you believe gives you 19 that so-called privilege? 20 MR. ALSOP: I'm not going to cite you

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21 any case law. That's my position. Proceed. 22 23 MR. HUTCHINSON: I'll join in that. DR. BARDEN: What is your legal basis

24 of privilege? I'm aware of attorney-client 25 privilege.

309 1 MR. ALSOP: I am done with my

2 objection, sir. Move on. Make your motion if you 3 think I'm wrong. 4 DR. BARDEN: I'm not done. I'm

5 certainly aware of the attorney-client privilege, I'm 6 certainly aware -7 8 attorney? 9 MR. ALSOP: No, no, no, no, no. Let THE WITNESS: Can I confer with my

10 him make his statement. 11 DR. BARDEN: I'm certainly aware of

12 the Fifth Amendment privilege. I'm not aware of the 13 income privilege. And if you could give me a good 14 faith legal citation on that or your good faith 15 statement on the record that you have seen such a 16 case that would justify such a privilege, I would be 17 happy to -- I would be happy to honor that. But if 18 it's just your personal opinion and you just don't 19 like the question, then I'm going to have to ask him

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20 to answer it. 21 MR. ALSOP: Well, he's not going to

22 answer the question. You can make your motion. It's 23 privileged. 24 25 DR. BARDEN: Okay. MR. HUTCHINSON: And I object on

310 1 grounds of relevance, materiality. It's designed to 2 get information to support a claim for punitive 3 damages that are clearly not allowed by statute, and 4 this is not reasonably calculated to lead to the 5 discovery of admissible evidence. It's harassment, 6 it's badgering and I object. 7 DR. BARDEN: Okay. And we would

8 argue for the record that it's just standard 9 cross-examination and it goes directly to the 10 testimony that he just offered under oath. 11 MR. HUTCHINSON: I've never heard

12 this type of cross-examination in 30 years. 13 14 MR. ALSOP: I have not either. MR. HUTCHINSON: It's not standard in

15 any case I've ever been in. 16 17 DR. BARDEN: And I've practiced in -MR. HUTCHINSON: Nor on the comments

18 by Plaintiff's lawyer about characterizing the answer

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19 or the objection. 20 DR. BARDEN: And once again, that's

21 not a legal objection, sir. 22 23 was? 24 DR. BARDEN: We're putting arguments MR. ALSOP: And yours was? And yours

25 on the record about a claim of privilege which is an

311 1 extremely unusual act for a lawyer. 2 MR. ALSOP: I disagree with you.

3 BY DR. BARDEN: 4 Q. Okay. So your lawyer has instructed you

5 not to answer. Are you going to follow those 6 instructions? 7 8 A. Q. Sure. Okay. Have you hired a personal attorney

9 in this matter? 10 11 A. Q. No. Did you ever sign a cross indemnification

12 agreement in this matter? 13 14 A. Q. I don't think so. You're not aware of any cross

15 indemnification agreement? 16 17 MS. AHMANN: Asked and answered. THE WITNESS: I don't know what that

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18 is, so I guess I don't. 19 BY DR. BARDEN: 20 Q. Are you aware of any cross indemnification

21 agreement having to do with any of the entities 22 participating in the Cafe Study? 23 24 A. Q. No. Have you ever -- did you read the contract

25 you entered into with regard to the Cafe Study?

312 1 MS. AHMANN: I'm going to object to

2 form and vague. 3 MR. ALSOP: I'll join. Go ahead.

4 BY DR. BARDEN: 5 Q. Let me back up. We'll make that clear for

6 the record. How many contracts did you sign with 7 regard to the Cafe Study? 8 9 10 11 12 A. Q. A. Q. A. I don't know. Do you have any idea at all? I would say one, and I may -What was that one? At the beginning of the study, the sponsor

13 and the university arrive at an agreement and they 14 usually, the principal investigator will sign that, 15 and I may have -- I'm sure I looked at the document 16 in a general sense, but I rely on the university's

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17 contract office to look at the details, and they're 18 usually the ones that clear any indemnification and 19 liability and confidentiality issues. So -20 Q. I just want to make this clear for the

21 record. As a licensed physician practicing in the 22 State of Minnesota, did you read the contract that 23 you signed for the Cafe Study? 24 25 A. Q. Yes. Okay. We talked to Dr. Schulz earlier and

313 1 he was discussing when he met with you and Ms. Kenney 2 to discuss Mary Weiss' letter. Do you recall such a 3 meeting? 4 5 A. Q. Her letter of March '04 to Dr. Schulz? The letter that was certified to Dr.

6 Schulz. He claims he only got one letter, so that's 7 the one we're talking about is the certified letter. 8 9 10 11 12 13 A. Q. A. Q. A. Q. Okay. Did you meet with Dr. -Yes. -- Schulz? Yes. How many times did you meet with Dr. Schulz

14 with regard to Dan Markingson's case? 15 A. I don't recall. I recall that meeting and

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16 subsequent discussions about the content of the 17 letter, he gave me a copy or a draft, and I made some 18 comments on it. Probably discussed it with him. 19 Q. Okay. And you discussed it with Ms.

20 Kenney, too? 21 22 A. Q. Oh, yes. Sure. So -- and then there were subsequent

23 discussions? How many? 24 A. I can't quantify discussions with Jean

25 Kenney. We were working together on a daily basis on

314 1 the study on -2 Q. I'm sorry. I should have clarified, then.

3 How many discussions with Dr. Schulz? 4 A. I don't -- I don't recall. I don't recall

5 any specific extended formal meetings. We may have 6 discussed briefly whether there was any, you know, 7 followup in the context of other meetings that I may 8 have had with him, but I don't recall any details. 9 Q. Did you ever inform -- do you recall

10 informing Dr. Schulz that during the time he was in 11 the Cafe Study, Dan Markingson was under a stay of 12 commitment order? 13 A. I don't recall specifically if we discussed

14 that.

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15

Q.

Do you recall ever discussing with Dr.

16 Schulz that Mary Weiss was concerned that Dan 17 Markingson might become violent? 18 A. Well, I think that was part of the

19 discussion in response to her letter. 20 Q. What did you discuss with Dr. Schulz with

21 regard to her concerns that Dan might become violent? 22 A. I can't recall any specific details of the

23 conversation, but the discussion was -- I'm sure it 24 evolved around the degree of concern that she had 25 balanced against the observations that we had made in

315 1 his visits at the university and the reports that we 2 were getting from everybody else that was seeing him. 3 4 5 Q. A. Q. Did Dr. -And that they didn't jibe. At anytime, did Dr. Schulz instruct you or

6 advise you to inform the IRB of Mary Weiss' 7 complaints? 8 9 A. Q. No. And you did not inform the IRB of Mary

10 Weiss' complaints, correct? 11 12 A. Q. No. Are you aware -- well, let me ask you this:

13 How many other studies are you participating in

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14 currently at the university? I'm just looking for 15 the number. 16 17 A. Q. Eight, roughly. Give or take. And how many have you participated in

18 totally since 2000, say 2000? Just looking for the 19 number. 20 21 A. Q. Twenty. And what's the total number of subjects in

22 all of those 20? And again, I'm just looking for a 23 ballpark figure. 24 MR. ALSOP: Object as speculative

25 lacking foundation. If you know, go ahead.

316 1 THE WITNESS: I wouldn't know. Some

2 of them I participated in were studies that I was a 3 co-investigator and so I'm not completely aware of 4 what -- the number of subjects that were, you know, 5 finally recruited. If you limit it to clinical 6 trials that I was the principal investigator for, 7 like the Cafe, my guess is somewhere around 100. 8 BY DR. BARDEN: 9 Q. But if you look at all of the 20, it would

10 be multiple hundreds of subjects. 11 A. Because some of the studies are something

12 like a questionnaire study or a --

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13 14

Q. A.

Sure. -- or a registry might have, you know, a

15 hundred people, but all we have is contact 16 information or -17 18 Q. A. Okay. -- I might have participated in a study

19 that recruited 150 people for brain imaging. 20 Q. Okay. So of the Cafe type study, you think

21 there would be somewhere around 100 subjects. 22 23 A. Q. Yeah. Were there any -- again, I'm not looking

24 for the names of any other patients. How many of 25 those other subjects were under a court order or a

317 1 stayed commitment during the time they were in the 2 research study? 3 A. I think there was -- I think there was at

4 least one. 5 Q. You think there was at least one. Okay.

6 And what year would that person have been court 7 ordered? 8 A. I don't know. Somewhere between 2004 and

9 2006. 10 Q. Was that during the time that Dan

11 Markingson was also under court order? Was it before

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12 that or after that? 13 14 15 16 A. Q. A. Q. I don't recall. Pardon? I don't recall. Okay. Was there a study -- was there a

17 subject other than Dan Markingson who you tried to -18 who you presented evidence to get them committed or 19 stayed for commitment twice? Anyone other than Dan 20 Markingson? 21 22 A. Q. I don't recall. Was that other subject, the one that was in

23 a stay of commitment, was that also in one of your 24 studies or was that in someone else's study? 25 A. No, that was in one of my studies.

318 1 Q. Did you also obtain an informed consent

2 from that subject or have Ms. Kenney do it, or did 3 someone else obtain the informed consent? 4 5 A. Q. I don't recall. Was the other person that was court

6 ordered, were they court ordered to comply with your 7 treatment team's recommendation for treatment? 8 A. I don't know what the -- I don't know what

9 the conditions were. 10 Q. For the other person that was court

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11 ordered, did you participate as a witness, that is, 12 someone who filed a witness statement with the court 13 to obtain the court order for that person? 14 15 16 left? 17 18 VIDEOGRAPHER: Fourteen minutes. (A brief recess took place.) A. Not that I recall. DR. BARDEN: How much time do I have

19 BY DR. BARDEN: 20 21 Q. Let me ask you a couple questions. DR. BARDEN: Tell you what, why don't

22 we go off the record for just a few minutes. I want 23 to look through my file. We have 14 minutes. 24 25 record. VIDEOGRAPHER: We are off the video

319 1 MR. ALSOP: We can stay off the

2 video, but for the record, if you want to ask Dr. 3 Olson what his percentage raises have been in the 4 last five or six years on a percentage basis, you can 5 do that. But he's not going to give numbers. 6 7 record. 8 DR. BARDEN: Okay. Dr. Olson's VIDEOGRAPHER: We're now on the video

9 attorney informed us that we can ask the percentage

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10 increases in salary over those years. It's still our 11 position that we're entitled to the actual dollar 12 numbers. 13 BY DR. BARDEN: 14 Q. But can you give us the percentage

15 increases from, say, 2002 to the present? 16 A. Once a year, the university salaries are

17 increased within a certain range and over that period 18 of time, my raises have been in the range of zero to 19 four percent. 20 Q. Okay. Zero to four percent. All right.

21 And the money you receive from drug companies, how 22 has that come up, or how did that change from 2002 23 through today, year by year? 24 A. I don't have figures for 2002. I had just

25 arrived at the university, so I probably had zero.

320 1 Q. Okay. 2003? Sorry. We're on a short

2 clock here. 2003? 3 4 5 6 A. Q. A. Q. I don't know specific figures. 2004? This is your income, correct? No. This is the revenue from studies. Oh, I'm sorry. Let me clarify. I'm

7 talking about all the money you've received from drug 8 companies personally. You mentioned 20,000.

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MR. ALSOP: Directly versus through

10 the studies. 11 BY DR. BARDEN: 12 13 14 15 16 Q. A. Q. A. Q. Directly to you from drug companies. It's roughly $20,000 a year. Every year, year in, year out since 2002? Yeah, probably. That's for speaking and that's for

17 consulting. What else is that for? 18 19 20 21 A. Q. A. Q. That's pretty much it, yeah. Okay. 20,000 a year. Uh-huh. Any other sources of income, other than

22 your 20,000 plus your university salary? 23 24 that? 25 MR. ALSOP: Well, I mean, if it's THE WITNESS: Do I have to answer

321 1 drug -- related to drug companies. If it's 2 investments you've made or something, you don't have 3 to answer that question. 4 THE WITNESS: No, it's not related to

5 drug companies. I consult for the Hennepin County 6 Mental Health Center and go see people in crisis and 7 get paid for that. Is that -- you want to know that?

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8 BY DR. BARDEN: 9 10 11 Q. A. Q. Anything else? Sure. That's fair. No. Okay. I'm going to ask you some quotes and

12 I would like to know if you agree or disagree with 13 these statements. "Knowledge of patient preferences 14 is essential to good clinical care, since the 15 patient's cooperation and satisfaction reflect the 16 degree to which medical intervention fulfills the 17 patient's choices, values and needs." Do you agree 18 with that? 19 20 A. Q. I agree with that in a general sense. Next, "Patient preferences are legally

21 significant, because the American legal system 22 considers the patient-physician relationship to be a 23 fiduciary relationship in which the fiduciary, such 24 as the physician, has an obligation to promote the 25 best interest of persons who have entrusted

322 1 themselves to the physician's care." Do you agree 2 with that? 3 MR. ALSOP: Object to as vague and

4 ambiguous, calls for a legal conclusion. Go ahead. 5 6 MS. AHMANN: Join. THE WITNESS: I don't know. I'd have

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7 to see that in context. I'm not sure if these are 8 rules or guidelines. I don't think -- I don't like 9 to characterize physician relationships as a purely 10 fiduciary one, certainly, so I disagree with that 11 part. 12 BY DR. BARDEN: 13 Q. You're licensed in the State of Minnesota,

14 correct? 15 16 A. Q. Yes, you know that. You are required by the State of Minnesota

17 to understand some legal rules and restrictions, 18 aren't you? 19 MR. ALSOP: Object on basis of

20 foundation, calls for a legal conclusion. Go ahead, 21 if you know. 22 THE WITNESS: I don't know what

23 medical license requires of me in terms of knowledge 24 of legal terms, no. 25 BY DR. BARDEN:

323 1 Q. Does your license require you to understand

2 informed consent, for example? 3 MR. ALSOP: Same objection,

4 foundation of what the state requires. 5 THE WITNESS: In a general sense,

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6 yes. 7 BY DR. BARDEN: 8 Q. Yes. That's a medical and a legal term,

9 isn't it? 10 11 A. Q. Yes. Yeah. Quote -- I'll ask you if you agree

12 or disagree with this. "Above all, fiduciaries must 13 avoid financial conflicts of interest that could 14 prejudice their client's interest." 15 MR. ALSOP: Same objection. Go

16 ahead, you can answer. 17 18 MS. AHMANN: Same. MR. HUTCHINSON: Join.

19 BY DR. BARDEN: 20 21 Q. A. Do you agree with that or not? Well, in a -- in a general sense, yes. I

22 think physicians have to be clear -23 24 25 Q. A. Q. Okay. -- and aware of the -Well, we're --

324 1 2 answer. 3 DR. BARDEN: These are yes or no MR. ALSOP: Let him finish his

4 questions.

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5 6

MR. ALSOP: No, they're not. DR. BARDEN: Our time will be

7 extended based on that. 8 9 MR. ALSOP: No, it won't. DR. BARDEN: He will not answer a

10 totally irrelevant question and take up our time. 11 12 question. 13 14 15 16 know. 17 MR. ALSOP: That's fine. DR. BARDEN: Just agree or disagree. MR. ALSOP: He maybe can't. THE WITNESS: Then I'll say I don't MR. ALSOP: He's answering a

18 BY DR. BARDEN: 19 Q. The next one is, "Informed consent is

20 defined as the willing acceptance of a medical 21 intervention by a patient after adequate disclosure 22 by the physician of the nature of the intervention, 23 its risks and benefits, as well as of alternatives 24 with their risks and benefits." Do you agree with 25 that?

325 1 2 MS. AHMANN: Same objections. THE WITNESS: In general, yes.

3 BY DR. BARDEN:

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Q.

"If patient preferences are ignored or

5 devalued, patients are likely to distrust and perhaps 6 disregard physician's recommendations." Do you agree 7 with that? 8 9 A. Q. No. "It is clearly unethical to do anything to

10 a patient that will not benefit and may even harm the 11 patient in order to benefit the physician or some 12 other party." Do you agree with that? 13 14 A. Q. In general, yes. "In order for patients to be allowed to

15 make reasonable choices, they must be provided with 16 adequate and truthful information. This includes 17 disclosure about a physician's financial incentives 18 that could influence the recommendations the 19 physician makes to the patient." Do you agree with 20 that? 21 A. In general. I don't think it's relevant to

22 this case, but -23 Q. What is your contract at the U? Is it year

24 by year or how many years is it? 25 A. It's year by year.

326 1 Q. It's year by year. And what are the bases

2 upon which you are evaluated and who does the

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3 evaluating? 4 A. The basis is on, I guess, meeting the goals

5 of the department, the specific tasks that I'm 6 assigned to do. That includes quality of care of 7 patients, my teaching of residents and medical 8 students, my participation in departmental university 9 activities, outreach to the community, as well as the 10 -- advancing the research in the department. So 11 multifactorial, like any job at this level, and 12 ultimately Dr. Schulz is the one who makes that 13 decision. And I would assume that he takes a number 14 of factors into account when he makes that decision 15 so whether it's going to be a one or a three percent 16 raise. 17 Q. So part of your evaluation in terms of

18 keeping your job is participating in and assisting 19 the University in its goal of doing research, 20 correct? 21 MR. ALSOP: It's a misstatement.

22 Object to form. Go ahead, you can answer. 23 THE WITNESS: Currently, yes, that

24 currently is part of my job expectation. 25 DR. BARDEN: How much time do I have

327 1 left?

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2 3

VIDEOGRAPHER: Six minutes. DR. BARDEN: I don't think I have

4 anything more at this time. Thank you. 5 6 7 8 9 MR. ALSOP: We'll read and sign. MR. HUTCHINSON: I have no questions. MR. ALSOP: No questions. MS. AHMANN: No questions. VIDEOGRAPHER: We are now off the

10 video record. The time is 12:11 p.m. 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

328

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1 STATE OF MINNESOTA

2 COUNTY OF BLUE EARTH) 3 BE IT KNOWN that, I took the foregoing deposition

4 of STEPHEN OLSON, M.D., pursuant to Notice; 5 That I was then and there a notary public in and

6 for the County of Blue Earth, State of Minnesota; 7 That said witness before testifying was duly

8 sworn to tell the truth, the whole truth, and nothing 9 but the truth relative to the cause specified in the 10 Notice; 11 That the witness did not waive the reading and

12 signing of said deposition; 13 That I am neither attorney nor counsel for, not

14 related to or employed by any of the parties to the 15 action in which this deposition is taken and, 16 further, that I am not a relative or employee of any 17 attorney or counsel employed by the parties hereto or 18 financially interested in the action; 19 That the testimony was taken down in stenotype by

20 me; then reduced to typewriting under my direction by 21 means of computer-aided transcription, and is a true 22 and correct transcript of my stenotype notes. 23 Witness my hand and seal this 25th day of ______________________ MARTHA M. FIER

24 January, 2008. 25

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