Madeline first appeared on-screen in April 2010 when her husband, Charles, was hospitalized after being attacked on the pier. He blamed F.B.I. Agent Rafe Hernandez and Madeline assured her husband Rafe would pay the crime. Later, Chad arrived to see his father and, when he questioned his father's suspicion that Rafe was the culprit, Charles harshly criticized his son, stating, among other insults, that he should have left him in boarding school. Madeline tried to soothe things over between them, but neither Charles nor Chad seemed calmed by her words.

A short time afterwards, Madeline met Gabi Hernandez, Rafe's sister and Chad's former girlfriend. She acted charmed by Gabi, but, as soon as they parted way, she criticized Chad's choice of love interests. In turn, Chad called his mother a snob, just like his father. Madeline didn't argue with her son as she was too preoccupied after seeing Kate Roberts-DiMera across the room at the Java Café, indicating that share a sordid past. Madeline wouldn't open when Chad asked her what was wrong, but she reiterated that he should stay away from the DiMera family after all they have done to their family in the past.

Weeks later, Madeline was upset when Chad informed her that he was going to the DiMera mansion for a study group. She demanded they changed locations citing how dangerous the DiMera family is. Chad reluctantly agreed. Afterwards, Madeline went to the mansion herself to confront Kate. She warned Kate to keep the DiMeras away from her family or else she would destroy her life with Stefano by divulging past misdeeds. Madeline left a shaken Kate behind.

Upon hearing about Madeline's threat from Kate, Stefano called her for a meeting. Madeline ignored his request, but they later ran into each other on the piers. Each one warned the other to stay away from their respective families.

The threats didn't work and Madeline, Kate, and Stefano continued to cross paths. Eventually, it was revealed that Madeline was once a high-priced call girl. Kate, once her close friend, had recruited her into that lifestyle as Madeline was desperate for money to pay for law school. Kate introduced her to her pimp, Stefano.

After some time of working together, the three of them parted ways when they were involved in the death of a congressman. The man, Congressman Andrews, had gotten violent with Madeline and Stefano intervened. Technically, it was "self"-defense, but given the circumstances, Stefano, Madeline, and Kate covered up the crime.

Years later, in 2010, Stefano knew Madeline had evidence against them. Kate agreed to impersonate her and break into Madeline's safety deposit box. In it she found a video tape incriminating all three of them in Congressman Andrews's death. The tape was destroyed and Stefano vowed to have nothing more to do with Madeline.

But Kate had looked through the rest of the box's contents and found a file which held yet another devastating secret. Kate, however, decided not to tell Stefano about it, unless Stefano flat-out asked her. Madeline was grateful to her old friend's silence.

Unfortunately, Chad found out about Madeline's call-girl past. He was furious with his mother and the two got into a heated argument on the pier. As Madeline tried to explain, Chad walked away. She followed him up the stairs, but, when he tried to get away from, she fell.

While barely clinging to life, Madeline told Chad that she lied for him – everything she did was for him. She was rushed to the hospital where she later died. As it turned out, Madeline suffered from hypertension as well as aneurysms and one in her brain had ruptured causing her death. Chad was a wreck with guilt and sadness, and it didn't help that Charles blamed him. Kate, however, knew she held Chad's future in her hands' by holding the key to Madeline's secret.