One step forward, two steps back Just 2 months ago (Daily Dose, 9/19), I wrote to you in tentative elation about the unprecedented August jury award in the first Vioxx lawsuit to make it to trial. To recap, I praised the jury for awarding the victim's next of kin an incredible quarter-billion dollars. Further, I declared that although I typically frown on obscenely large damage awards in lawsuits, in the case of killer Vioxx, I thought that no award would be too high… And that's exactly what the result of the second Vioxx trial is: No award. Call it a clean win for Merck. Over the course of a 7-week trial in New Jersey, their attorneys successfully lied - er, argued - that they believed the drug safe up until the moment they learned the results of the heart risk study that damned the medication in September 2004. As supporting evidence (of course), they cited the FDA's certification of Vioxx as safe on four separate occasions during the drug's life, according to an Associated Press report from 2 weeks ago. As a result, the jury awarded the plaintiff not a red cent. Upon learning the evidence, I can't say I entirely blame them, much as it pains me to say. First off, most of the damning evidence against Vioxx suggests that extended usage (periods of 18 months or longer) was a key factor in the drug's heart risk. Turns out the plaintiff, a 60-something man of questionable heart health to begin with, only took the drug for 2 months for knee pain. Also, the man didn't die, a fact which no doubt is of major solace to him and his family, but does little to impress a jury these days… What really burns me up about this is that this somewhat iffy New Jersey trial has made subsequent Vioxx lawsuits immeasurably more difficult for plaintiffs - even those in which liability is much more convincingly evident. How? Because it's precedent that makes for victories in court. Another decisive jury victory for a bona-fide victim, living or not, would have done Merck some serious damage in terms of forcing high-dollar out-of-court settlements of large numbers of the more than 7,000 Vioxx trials still pending on court dockets nationwide. Now, many of these suits will no doubt be abandoned, and those remaining will be a much greater uphill battle to prove liability in. If this happens, and Merck ends up being able to keep a large chunk of the more than $25 billion it profited on killer Vioxx, how will the drug industry learn the lesson it so desperately needs to: That it can't just kill people and get away with it? **************************************************** "Katrina cough" plagues returning victims Last month (Daily Dose, 10/28), I wrote to you about the alarming prevalence of building-killing mold in what's left of New Orleans in the wake of hurricane Katrina. According to some reports, the infestation is so severe that many office buildings (including some government hubs) and even hospitals may have to be shut down. At the very least, it seems likely that thousands of homes in the Big Easy will have to be bulldozed because of the creeping crud. And now, like clockwork, the mold-associated health problems I warned of are starting to rear their ugly heads. According to ABCNews, the LA Times, and other sources, reports from the field show that there are an alarming and unprecedented number of cases of upper respiratory infections like bronchitis and sinusitis (as much as 25% more than normal) - especially among those who are trying to restore their homes and go on with their lives. Of course, the CDC just started their surveys on the disease November 5th, and they claim that until they've compiled their data a month or more from that date, they'll know little, if anything, about the condition. Heck, by the time they've got it sorted out, New Orleans will probably be well on its way to being rebuilt. But of course, it doesn't take a government agency - or even a doctor like me - to say what's causing the media-hyped "Katrina cough." It's a combination of airborne irritants (like dust from dried mud) afloat as a result of demolition and construction projects, inhaled spores from mold infestations, and infections from breathing the air in buildings that are harboring both particulate matter and undiscovered spores. That's a no-brainer. The feds should save the money they're paying the CDC to study the condition for 6 months and conclude that we should all stock up on 99-cent Home Depot breath masks and put it toward sanitizing (or even reconstructing) contaminated buildings or medical facilities. If I know anything about wasteful federal spending, this cash could go a long way if re-allocated in this manner. Always coughing up the facts, William Campbell Douglass II, MD | 
