I included Andy/Amanda as Madison-related too... Andy received the bleeding ulcer since he was essentially punishing himself as a result of keeping the pregnancy from Ephram. He was physically and emotionally breaking down during this time period all due to guilt... guilt he shouldn't have had since he tried to stop Ephram and Madison but they wouldn't listen to him. Andy's stomach was being eaten away due to the guilt and he was making terrible decisions as well to punish himself further by dating Amanda. Without Madison/Madisongate, the bleeding ulcer and Andy/Amanda never would have happened.

In addition, Ephram/Amy and Ephram/Andy wouldn't have broken up temporarily, Delia wouldn't have been hurt and disappointed, the Ephram band lie never would have happened, Amy's heart wouldn't have broken into a million pieces. It all leads back to Madison.