BOSTON, Aug. 17, 2010— -- "Craigslist Killer" Phillip Markoff created a ghoulish shrine to his former fiancee before he died, spreading out photos of her on the small table in his cell and scrawling her name in his own blood over his cell door where guards would not easily see it, ABC News has learned.
The details of Markoff's death are emerging as Boston officials have begun an investigation into how Markoff, who twice before tried to kill himself, managed to commit suicide while awaiting trial for murder.
Markoff, 24, killed himself on Sunday, the anniversary of what would have been his wedding day. When he was arrested in April 2009 he was engaged to marry fellow medical student Megan McAllister.
In the days immediately after his arrest, McAllister staunchly defended Markoff's innocence, but a few days later went to the jail where he was held and broke off their engagement. Markoff's first attempted suicide occurred shortly after when he tried to slash his wrists with a serrated spoon.
The murder suspect took elaborate steps to make sure he died, but he also made final homage to McAllister. Photos of McAllister covered the small table in Markoff's cell. As previously reported, Markoff had written "Megan" and "pocket" in his blood on the wall. ABC News has learned that it was written above his doorway where he could see it, but correction officers could not easily see it.
Suffolk County District Daniel Conley confirmed the words above Markoff's cell door at a news conference today, but could not explain Markoff's use of the word "pocket."
"We're still studying that," Conley said.
McAllister could not be reached for comment, and has not issued a statement since her former boyfriend died.
Markoff's suicide and gruesome farewell to McAllister could affect his former fiancee, one expert said.
"It really depends on whether they can be successfully manipulated into taking responsibility for someone else's behavior," forensic psychiatrist Dr. Park Dietz of Newport Beach, Calif., told ABC News. "It depends on how vulnerable to manipulation she is."
"I think many people would say thank God I got away and never give it another thought, while others would get dragged into it," Dietz said.
Phillip Markoff Was Determined to Die
Markoff's grisly suicide preparations included scraping a prison issue pen and a piece of metal into what Conley called a "primitive scalpel." Sources told ABC News the metal came from a metal plate Markoff pried off of an electrical outlet.
He used the make-shift blade to slash major arteries in his ankles, legs and neck, including the carotid artery in his neck, Conley said. Clear plastic bags that are available to inmates were used to catch the pooling blood.
He swallowed toilet paper to ensure that he could not be revived, used gauze to tighten another plastic bag over his head, and then pulled the covers over him from head to toe.
The investigation is still trying to determine whether Markoff also took any drugs that may have contributed to his death.
By mid-morning on Sunday, a deputy sheriff "sensed something was wrong because the covers were over his head," a source to ABC News. "He went in. Called his name and pulled back the covers and found him."
Boston City Councilor Steve Murphy has ordered an investigation into what went wrong at Nashua Street jail. Today he told ABC News, "Obviously there are serious deficiencies in the management of that operation."
Markoff was awaiting trial for the murder of Julissa Brisman, a woman he found on Craigslist offering sensual massage. Markoff was charged with robbing two other women offering similar services on Craigslist.
Conley said that Markoff's death "should not obscure the brutality of his crimes," and said the suicide was "the ultimate indication" of his guilt.
The prosecutor said the suicide was unfair to the Brisman family.
"The Brisman family has been deprived of a judgment rendered" as well as the chance "to tell the court and Mr. Markoff of the immense pain he inflicted on them."
Conley said that Markoff's death obviously ended plans for a trial, but said he would present the evidence publicly.
ABC News' Kim Carollo contributed to this report