Big Pharma, FDA and Preemption: Who should be held liable?

The Supreme Court Case, Wyeth v. Levine  (06-1249), the Supreme Court Justices are sharply divided over whether FDA regulations of labeling can prevent consumers from suing. Wyeth and the FDA presented the case before the Supreme Court involving Diana Levine, an amputee, whose bodily injury resulted from the use of the drug, Phenergan.

The debate among Supreme Court Justices is in the matter of whether consumers have the right to sue drug companies when the FDA has approved a drug for use. The strength of the argument presented by Levine's lawyers is that Wyeth is attempting to use FDA labeling to deny her a Consumer’s right to hold a Pharma company liable.

This is not the first case of involving a Pharma company being sued for harmful and deadly side effects of their drugs. A few notable instances include, Glaxo for their drugs Paxil and Avandia, Purdue Pharma for Oxycontin, Merck & Co. for Vioxx. In some cases, deficient research led to serious risks that was overlooked. In others, misleading advertising that omitted possible risks was the basis of these lawsuits.

The issue of FDA labeling as insurance to preempt lawsuits by consumers is an important aspect of the Wyeth v. Levine case. The issue of preemption is supported by the current Bush Administration in its attempts to reduce lawsuits by consumers against drug companies. Pharmaceutical companies argue that stiffer regulations and standards inhibit their research of newer, more effective drugs.

In the Levine case, Wyeth's argument reduces the lawsuit to a simple case of medical malpractice. Surprisingly, the FDA stands with Wyeth in the argument. The Federal Agency that is supposed to be on the side of Consumers, feels that once the FDA approved the drug for use, extraordinary risks that may appear as a result of use at some later point should not be a consideration for lawsuits against drug companies that have received FDA approval and are labeled as such. This begs the question: Who should be liable and held accountable if the FDA and the pharmaceutical maker fails to catch something in trials or overlooks a deadly side effects, because of the rush to get a drug on the market?

Another valid point of the argument by Levine’s lawyers is that Wyeth did not advise physicians or consumers of the danger of using the "push" method of injection of Phenergan. It is safe to say, that maybe more people would have had second thoughts about using this drug, if they would have known about the additional dangers. Moreover, in another case, Pfizer's anti-nausea drug, Vistrol, caused gangrene when injected into the arteries and Wyeth should therefore have requested an FDA to change the label warning of this on their Phenergan label.

The State of Vermont awarded Levine $6.8 million. In preemption arguments, federal law supersedes state law. Justices Scalia, Alito and Roberts argued in favor of Wyeth while Bader-Ginsberg argued in favor of Levine.

It would be simple to view Wyeth's position as one of preemption vs. adequacy of disclosure. Ultimately, the Supreme Court must address the potential for future lawsuits of this nature. They must also address the issue of what happens if the drug company gives the FDA false or misleading information about a drug that later proves to be harmful to consumers. Consumer advocates everywhere are following this case closely. Let’s see if the Supreme Court can do the right thing and tell Wyeth and the FDA that they do not get a free pass in this case. They are responsible for the safety of drugs that are put on the market, even if the FDA gives the drug a stamp of approval.

Jacob Goldstein, Writer and Blogger for the WSJ Health Blog, shares a few insightful comments from Diana Levine in his blog post "Wyeth v. Levine: The Mother of All Preemption Cases". He also includes a nice candid photo of the woman who Wyeth is going after for fighting for her rights to hold them accountable for taking their migraine drug that caused her to have her arm amputated. All eyes are on the Supreme Court regarding the decision of this case.  Let's see if they can get it right and hold the Pharmaceutical companies liable for unreported risks and dangers associated with their drugs.
 

Trial by Jury and Personal Injury

One of our favorite Bloggers, Blawgletter wrote a post about Tort Reform and the rights of trial by jury. Although his post is re: a securities fraud case against University of Phoenix, it also rings true that jury trials are important for personal injury cases. Without them, who would be held accountable? Ted Frank at Points of Law.com, chimed into the jury trial discussion by adding "trials remain a risky business for both plaintiffs and defendants", in a recent post. 

Pointsoflaw.com, provided an excellent summation of the Vioxx litigation in their  vioxx roundup yesterday. They cited several cases pending trials and gave updates on Merck. All eyes are on Merck. Let's see if their proposed vioxx settlement of $4.85 billion will make the jury trials go away. In a newswire release, Merck indicated that there are 50,000 Vioxx claimants. 

Only time will tell how this saga will end. Stay tuned...

Civil Justice Prosecutor's response to defense attorney on plaintiff rights

Bexis ( co-author of drug and device law blog)

I am sorry this response took so long. (Click here to see response from Bexis).  My life just does not have enough fun things like responding to your great blog post. 

First things first: For those of you not following my intellectually astute commenter, Shay’s Rebellion was the post-revolutionary (1787 or so) clash between the farmer and merchants in the New England states.  It was the first test of our new Democratic Republic and the system passed muster with high marks.  The point of this was to note, that we cannot rely on the government to save us from corporate profiteering at human expense.  I only wish I were such an extremist.  Extremists get loads of press and people are naturally drawn to them.  But, let's put the whole anarchist thing to bed.  Nothing could be further from the truth.   I love our system of Government.  I think government serves a legitimate purpose.  I am just a natural Republican.  When possible, I believe government should be smaller rather then bigger.  I would prefer to see government not intervene when not necessary.  This is especially true of the federal government.  In a contest between the federal government and the state government on who should be passing legislation, I would prefer to leave most things in the hands of the states.  I am, however, (tell Mark Hermann I used however properly again) not an extremist.  I realize the federal government has a legitimate role and a great responsibility to protect the national public from dangerous products.  This is a typical Republican position.  It is not the anarchist position.

What I do NOT believe is that the FDA has the ability to insure that the public is safe from dangerous drugs.  I do not believe that by passing the lowest threshold of government oversight that any company should be released of their responsibility to the end user of their products.  I do not believe that the government can be trusted or expected to guarantee product safety.  This holds true for our prescription drugs, our food supply and our water.  Government is the first line of defense.  It is not the exclusive remedy when a corporation harms its customer(s).

You say that 90% of products are not sued because of a defect.  I don't believe this, but let's pretend it's true.  What about the 10% of defects that you admit cause death, dismemberment or other injuries?  What about those people?  Why should they be prohibited from suing the business that harmed them because the dangerous product was Ok’d by some minimum wage government inspector?  Why, as a taxpayer, do I have to bear the burden of the injured person's medical bills because the business that caused the injury is off the proverbial hook?  Why should I, as a taxpayer, have to bear the burden of the injured person’s unemployment compensation when they can't return to work because of this injury?  Do you think the injured person is going to feel like the American Justice System did the right thing when they are told that there is no case because the FDA or some other government agency simply failed to catch a dangerous defect?  Is it fair that the injured person will have no legal remedy against the offending company?  Of course, all of the above is patently unfair and anti-American.  We are not Russia.  We hold people and businesses accountable for the harm they do, to individuals and to society.  To create an exception for drug companies or any other business is simply wrong.

You also state that I make this statement with 100% self interest in mind. You say, "trial lawyers do this for money." Well, I tip my hat to you. You caught them. Hundreds, even thousands of lawyers are actually working to make money. I am curious. What do you work for? I am betting that you can come up with all sorts of self-laudatory ideas about how you are principled and only do this out of the true desire to help the human race. But I am also pretty sure; in fact, I am 100% convinced, that you actually want to be paid. Not paid in good will and kind thoughts but paid in MONEY. In fact, I am betting that every person who reads this blog (all 6 of them) will agree that they work for money. I will also bet you make more money than the average personal injury lawyer. Typically, Plaintiff lawyers (excluding the few scumbags in the profession) who represent good people that have been seriously wronged, sleep well at night, knowing they are doing a really good thing for their client and for society.

The beauty of the entire system is that trial lawyers are forced to invest huge sums of money and huge amounts of time in their cases. They work on a contingency fee basis. If they don't win then they are not paid. You may assert that the poor drug companies settle all those cases, but it isn't true. Last year we heard about a very long and expensive Vioxx case that was lost by a Plaintiff lawyer in New Jersey, the land of drug case trials. The fact is that the average person could NEVER afford to fight against a drug company. The drug company can pay their (like you guys) trial lawyers $500 per hour for 10 lawyers to work all day and all night every day of the week. The average person cannot afford to hire a lawyer for $150 per hour, 3 hours per week. Without the contingency fee arrangement, the average Joe would never get justice.

Your most curious position was that government is simply more efficient than private industry at regulating the behavior of business. This is a counter-intuitive statement. Most people have the general feeling that government is inefficient and that if any business ran like government runs they would be bankrupt in a week. However, I will only address your rationale as to why business likes government oversight better then being held accountable by Plaintiff lawyers. Business prefers government oversight instead of personal responsibility because business knows that government simply cannot keep up. Government has limited resources. Those resources are politically distributed. In other words: if you have the right friends in the right places, like George W. Bush in the White House, then government regulatory agencies can lose their funding, lose their staffing and lose their ability to keep up with any industry George W. Bush decides to protect. Business has the money, the staff and the political lobbyists to subvert the good work of the government. I don't trust business without the balance of personal injury lawsuits.

Finally, on a personal note, to call plaintiff lawyers parasites at the same time as defending and protecting greedy corporations who put even nominal profits above human health and wellbeing is a twist of reality that only the most self loathing trial lawyers can try to rationalize to make them sleep better at night. The public is certainly suspicious and bright enough to see through frivolous cases. Plaintiff's lawyers are not Svengali's who hypnotize juries into giving money without reason. I would hope your ego is strong enough to agree that the defense bar attorneys are equal in talent to the Plaintiff's bar. If not, well then maybe you are right, the real problem is that business just needs better attorneys and since they don't seem to find them big business is hoping Uncle Sam will save them from the big bad Plaintiff's attorney.

Have a great day.

Brian F. LaBovick
Civil Justice Prosecutor

House Gives U.S. FDA More Power to Police Drug Safety

This week, The House of Representatives approved legislation that gives the FDA more power to police the safety of prescription drugs, sending the measure to the Senate for final approval.

What if the the Food and Drug Administration required drugmakers to study the safety of their products after they go on the market? Would that be so terrible? Would it be a bad thing for regulators to order warnings added to prescribing information? If these measures can help save lives and prevent more illnesses, I think not.

This new legislation may be able to prevent future repeats of what happened with Vioxx, the Merck & Co. painkiller, allegedly linked to heart attacks and strokes, and Avandia, GlaxoSmithKline Plc's diabetes pill linked in some studies to a risk of heart attacks.

I hope that  Representative Henry Waxman, a California Democrat, is correct in his assessment that the legislation ``provides FDA with critical tools the agency has been desperately lacking in its efforts to protect the American public from unsafe drugs". Now let's see if the Senate agrees.

Click here to read more on this new FDA legislation from Bloomberg News.


VIOXX Product Liability Trial starts in Florida: Kozic v. Merck

Merck  continues to fight against Vioxx Plaintiffs. This week the much anticipated VIOXX® product liability trial started in the Circuit Court of Hillsborough County, Florida. Merck plans to use evidence to show that VIOXX did not cause the heart attack of Refik Kozic.

In Kozic v. Merck & Co., Inc., Mr. Kozic claims that he used VIOXX for approximately nine weeks before suffering his heart attack in April 2001 at age 50.

Merck will handle this case and go on to their additional 27,000 Vioxx cases.  Their legal strategy take each and every case to trial.  Experts though three years ago it would cost Merck approximately $30 billion. However, to this date they have not paid anyone claiming they had a heart attack due to taking Vioxx.  The only thing that Merck has been paying over the years are legal bills to defend themselves against all the individual Vioxx claims. According to Ken Frazier, the company's lead counsel early on, Merck vowed to fight the cases one at a time, in an article on Cnn.com.  I agree  with Bryan Liang, Professor of health law studies at the California Western School of Law in San Diego, that it was "brilliant strategy to tell the world, they were going to fight every case." It definitely, places Merck in the stronger position.

Now on the other side of the argument, Byron G. Stier,  Associate Professor of Law
Southwestern Law School, and a leading Editor for the Mass Tort Litigation Blog, disagrees with Professor Liang's assessment of the Merck strategy. He candidly weighs in giving two strong arguments.  Professor Stier said: First, "the strategy of holding off settlement is only working for Merck because Merck is winning the individual cases."  Second, "the strategy of holding off settlement is only working for Merck because Merck is winning the individual cases."  Both professors make valid arguments, however, they lead to additional questions:  "Why is Merck so successful with their Vioxx cases?  What makes this drug bullet proof in the courtroom on appeal?  Is Ken Frazier and his legal team, that much better than all of the brilliant trial lawyers they are going up against in Court?

Time will tell if Merck and Vioxx will continue on lucky streak in these trials or if their luck runs out

Click here to read more on Vioxx litigation updates from Merck or Vioxx article from Cnn.com 

Merck's Vioxx is making headlines after a new study from NEJM

Merck's former billion dollar baby, Vioxx, arthritis Medicine, is still making headlines, despite having been pulled off the market for several years.  A recent 2,434-patient study, published on Wednesday in the New England Journal of Medicine, finds that increased heart risk begins much earlier than after 18 months of use, as previously indicated by the drug maker. Of course, Merck is denying the relevancy of this study. According to Merck, the study is not conclusive.

There are over 27,000 lawsuits against Merck from people who claim to have been harmed by the drug. I wonder if this new study will impact these lawsuits or not.   A few months ago, a jury awarded a man $47.5 million verdict  against Merck for Vioxx, finding it responsible for his heart attack.  The replacement for Vioxx, ARCOXIA, was not approved by the  Food and Drug Administration's (FDA) Arthritis Advisory Committee. They voted against recommending approval  of ARCOXIA® (etoricoxib) for the symptomatic treatment of osteoarthritis in the United States.  ARCOXIA has been under review by the FDA as an investigational selective COX-2 inhibitor since the New Drug Application (NDA) was submitted in December 2003 and is currently available in 63 countries. On a more positive note, Merck's stock is doing great.The stock closed at $53.38, this is an increase over prior trading. There must be promising new drugs in the pipeline that are keeping everyone optimistic and hopeful.

Time will tell. Let's see if if the former billion dollar baby, Vioxx,  will continue to make headlines.

 Click here to read more on Vioxx from Reuters or the New York Times.

The Private Law Firm, LaBovick & LaBovick, Civil Justice Prosecutors, is a Plaintiff’s firm. The firm focuses on fighting for personal injury victim’s rights in Florida and on qui tam (whistleblower claims) nationwide.  Visit our firm website at www.LaBovick.com for more injury information

Wisconsin Lawyer seeks new Vioxx trial

A Wisconsin Attorney requested Madison County Circuit Judge Daniel Stack to give his client a new trial, alleging the judge did not weigh all evidence when granting a directed verdict for Merck on one count of defective design during the county's first Vioxx trial.

At trial, lawyers for the Plaintiff alleged that Vioxx was defectively designed, inadequately tested, dangerous to human health, and lacked proper warnings, which subjected users to risks of heart attacks, strokes and other illnesses.

Merck argued that the Plaintiff''s preexisting risk factors -- a family history of heart disease, morbid obesity, diabetes, high blood pressure and sedentary lifestyle -- were responsible for her tragic unfortunate, sudden cardiac death

The trial ended in favor of Merck on March 27 after a seven-woman, five-man jury rejected the Plaintiff's claim that his wife's sudden heart attack at age 52 was caused by taking Vioxx.

Click Here to read more about this request for a new Vioxx trial in the Madison Record.