Cardiologist says Vioxx not responsible for man's death

By KRISTEN HAYS
The Associated Press

ANGLETON, Texas - A cardiologist testifying Friday ruled out Vioxx as the cause of a Texas man's death who took the once-popular painkiller for eight months, citing the lack of evidence of a heart attack or blood clot in the autopsy.

Dr. Craig Pratt, director of research at the Methodist DeBakey Heart Center in Houston, said the autopsy of 59-year-old Robert Ernst "speaks for itself," attributing his death to an irregular heartbeat caused by clogged arteries with no mention of a heart attack.

His testimony for Vioxx manufacturer Merck & Co. highlighted the crux of the dispute in the nation's first Vioxx-related lawsuit to go to trial: Whether Vioxx, which Merck pulled from the market last year after a study showed it doubled the risk of heart attack or stroke if taken for 18 months or longer, had anything to do with Ernst's death.

Jurors likely will begin deliberations next week, lawyers said Friday. Merck expects to rest its defense Monday or Tuesday, and closing arguments could begin by Wednesday.

Ernst's widow, Carol, claims Merck knew years before it pulled the drug in 2004 that Vioxx could be dangerous, but minimized those concerns in favor of profits. Her husband, a Wal-Mart produce manager who also ran marathons, died in his sleep after taking Vioxx for eight months to ease pain in his hands.

Pratt was Merck's second expert to counter claims that a Vioxx-induced heart attack triggered Ernst's fatal arrhythmia. Three plaintiff's experts have blamed Vioxx.

The coroner who performed Ernst's autopsy also testified that a heart attack brought on by a clot more than likely triggered the fatal arrhythmia. Dr. Maria Araneta said she didn't note those conditions in her report because the clot was probably dislodged by vigorous CPR and Ernst died too quickly for his heart to show damage. She didn't blame Vioxx for a clot or heart attack, noting she didn't know much about the drug in 2001.

Pratt said Friday Araneta's autopsy was valid, but her opinions about a clot and heart attack were not.

"I don't think this patient had a heart attack. I don't think this patient had a clot. I think it's clear this death was not due to Vioxx," he said.

However, Carol Ernst's lawyer, Mark Lanier, challenged Pratt's credibility.

Under questioning from Merck lawyer Gerry Lowry, Pratt told jurors his past work with Merck amounted to attending a meeting of experts a dozen years ago to offer opinions on a Merck drug for the heart. He said he had testified for both plaintiffs and pharmaceutical companies before, including a case involving cholesterol-lowering Baycol.

On cross-examination, Pratt acknowledged he serves on the board of scientific advisers for Swiss pharmaceutical company Actelion, which has an exclusive research alliance with Merck. He also said his Baycol testimony came in a case in which Lowry represented Baycol-maker Bayer Corp.

A plaintiff's expert who blamed Vioxx for Ernst's death, Dr. David Egilman, acknowledged under direct examination that he had repeatedly testified on behalf of plaintiffs represented by Lanier in asbestos cases.

Carol Ernst also claims that even though her husband had one artery blocked up to 75 percent, his blood flow sustained his heart in vigorous exercise, so Vioxx is responsible for killing him in his sleep.

Pratt testified it wasn't unusual for people with blocked arteries to die while at rest. He said some studies show up to 36 percent of people with clogged arteries can die in their sleep.

But when Lanier showed the cardiologist a 1997 study that placed the rate of such deaths at less than 15 percent - by a scientist Pratt had said he relied on - Pratt couldn't cite specific studies with the higher rates.

"There are thousands of papers," Pratt said.