Doctor Says Vioxx Caused Man’s Death
ANGLETON, Texas – A doctor told jurors Friday in the nation’s first Vioxx-related civil trial that he believes the drug caused a 59-year-old Texas man to die of an arrhythmia brought on by a heart attack in 2001.
“His taking of Vioxx caused and/or contributed to his heart attack,” Dr. David Egilman said in a direct challenge to Vioxx maker Merck & Co.’s assertion that Vioxx has no relation to arrhythmias, or irregular heartbeats.
Carol Ernst, the widow of the man who died, is the plaintiff in the first of more than 4,200 state and federal lawsuits across the country to go before a jury.
Merck’s lawyers tried to keep Egilman from testifying to his expert opinion that Vioxx caused Robert Ernst’s death after the Wal-Mart produce manager took the drug for eight months to alleviate pain in his hands. The company voluntarily pulled Vioxx from the market in September when a study showed it could double risk of heart attack or stroke if taken for 18 months or longer, but the company argues that heart attack and arrhythmia aren’t interchangeable.
Ernst’s autopsy said he died of an arrhythmia, or irregular heartbeart, secondary to blockage in two major arteries.
Carol Ernst’s lawyer, Mark Lanier, contends that Robert Ernst died too fast for his heart to show damage, but Merck’s own medical manual says arrhythmias are associated with 90 percent of heart attacks. On Monday, a cardiologist is slated to testify, Lanier said.
State District Judge Ben Hardin allowed Egilman to testify about his belief that Vioxx caused Ernst’s death. The judge has yet to reconsider a Merck request to present a June 2001 opinion from a district court in Colorado that Egilman was “not objective, reliable or credible” as an expert witness in a beryllium case.
Egilman, a public health professor at Brown University, has been an expert for Lanier in other lawsuits involving asbestos.
He also testified he resisted prescribing Vioxx at his former family practice clinic in Braintree, Mass., because he disputed Merck’s assertion that the painkiller was safe years before the drug was pulled.
Egilman said Merck sales representatives repeatedly encouraged him to prescribe Vioxx after the drug went on the market in 1999, but he resisted those efforts. He said six-month results of a yearlong study of Vioxx competitor Celebrex published in 2001 said the drug prevented ulcers, but the unpublished full-year results showed the opposite. Both drugs were developed to relieve pain without causing stomach bleeds, which could be side effects of other pain relievers like aspirin.
“That clued me in that all these drugs may have had problems, so I didn’t want to use any of them,” Egilman said.
However, he said he sometimes gave Merck-provided samples of Vioxx to poor, uninsured patients who couldn’t afford the expensive prescription. He sold the clinic in 2002.
Egilman also accused Merck of violating his and his patients’ privacy by trying “to secretly find out what I prescribed.” Lanier has alleged the company did that to target doctors deemed in need of a push to prescribe Vioxx.
Merck lawyer David Kiernan said it was “completely and totally and absolutely false” that Merck secretly gathered information on patients and that the statement had “poisoned” jurors.
Pharmaceutical companies can track prescriptions, but not individual patient information, which is protected by privacy laws. Hardin advised jurors to disregard Egilman’s accusation
Controversy over the drug, taken by 20 million people before it was pulled, started when a 2000 study found that some Vioxx users suffered five times as many heart attacks as people who used the older pain reliever naproxen.
At the time, Merck attributed the difference to naproxen’s cardioprotective qualities rather than a defect in Vioxx, and got a rebuke from the Food and Drug Administration for lacking scientific evidence to back up that assertion.
After two years of wrangling with the FDA, in 2002 Merck added warnings about cardiovascular risks to Vioxx’s label.