Irvin took Vioxx for back pain, but never saw a doctor about it. Instead, the resident of St. Augustine, Florida, called his son-in-law, an emergency-room physician who lived in another city. He hadn't been able to keep down the first two painkillers prescribed by Dr Richard Schirmer. After he tried a sample given to him by an acquaintance, he asked Schirmer for Vioxx.
Schirmer testified that if the label had included a warning about heart attack risk, he wouldn't have prescribed Vioxx for his father-in-law.
Much of the evidence put on by Plunkett's attorneys focused on whether Merck should have added a warning to the label after it learned in early 2000 that patients taking Vioxx in a drug test called VIGOR had five times as many heart attacks as those on naproxen, another painkiller.
In his closing argument, Birchfield noted epidemiologist Wayne Ray's testimony that the drug probably was to blame for 54 percent of all heart attacks among people who suffered them while taking Vioxx. In Irvin's case, he said, that meant a 54 percent chance that the drug was among reasons for the heart attack.
Merck learned of the VIGOR study results in 2000. Had it stopped selling Vioxx or put a warning label on the drug then, he said, Irvin's son-in-law, an emergency room physician, would not have prescribed Vioxx for Irvin in April 2001.
"Did they rein in their massive marketing campaign? ... No. They pushed on wide open," he said. And he quoted the comment of Dr Eric Topol, a cardiologist subpoenaed for videotaped testimony while at the Cleveland Clinic.
"He said that was human experimentation," Birchfield continued. "Merck was playing Russian roulette for money with Dickie Irvin."
Merck attorney Phil Beck countered that no physician testified that Vioxx caused Irvin's death.
"In fact, no doctor testified that Vioxx was even a small factor in Mr Irvin's heart attack and death," he said.
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