Update on the Vioxx trial

“In other testimony, both sides played portions of a videotaped deposition of Dr. Brent Wallace, Mr. Ernst’s doctor. Under defense questioning, Dr. Wallace said that many Americans die every year from arrhythmias, or irregular heartbeats, caused by coronary artery disease.

Mr. Ernst’s death certificate lists an arrhythmia as his cause of death. Lawyers for Merck say that Vioxx has never been shown to cause arrhythmias, and so Vioxx cannot have caused Mr. Ernst’s death.

But W. Mark Lanier , a lawyer for Mr. Ernst’s family, has told the jury that a blood clot caused by Vioxx led to the arrhythmia that killed Mr. Ernst. Even though the autopsy showed no evidence of a blood clot, several witnesses for plaintiffs, including Dr. Maria M. Araneta, the coroner who conducted the autopsy, have backed Mr. Lanier’s theory and said that it was more likely than not that Vioxx caused Mr. Ernst’s death.”

Couple of points. I wasn’t aware that Vioxx had a marked associated with blood clots. If anything, it should lead to more bleeding.

As for Vioxx causing the arrhythmia – it’s possible, but I don’t know how a physician can say it was “more likely than not”. If one looks at the causes for sudden cardiac death, you can see there are a myriad of causes: 65 to 70 percent, coronary artery disease; 10 percent, other structural heart disease; 5 to 10 percent, in the abscence of structural heart disease; 15 to 35 percent, non-cardiac in origin.

Again, although Vioxx certainly may have played a role, it is impossible to be certain.