The New York Times, "At Vioxx Trial, a Discrepancy Appears to Undercut Merck's Defense"

          In a 2001 letter to doctors, Merck seriously understated the heart risks faced by patients taking its painkiller Vioxx, according to evidence presented Tuesday in the first Vioxx lawsuit to reach trial. In the letter, Merck reported that patients taking Vioxx in the largest clinical trial of the drug ever, only 0.5 percent had incurred "cardiovascular events," or heart and circulation problems. That would mean only about 20 patients among the more than 4,000 who took Vioxx during the study.
          But in fact, 14.6 percent of the Vioxx patients -- or 590 people -- had cardiovascular troubles while taking the drug, according to Merck's own report on the study to federal regulators. And 2.5 percent, or 101 people, had serious problems, like heart attacks. Merck sent the letter to thousands of doctors, including in April 2001 to Dr. Brent Wallace, who had prescribed Vioxx to Robert Ernst. Mr. Ernst, who was 59, died suddenly in May 2001 after taking Vioxx for eight months, and his family is suing Merck, claiming the drug caused his death.
          The gap between Merck's internal analysis of the study and its letter to physicians may undercut a crucial aspect of the company's defense: that Merck fully disclosed Vioxx's potential heart risks to doctors and patients during the five years the drug was on the market. Merck stopped selling Vioxx last September after a clinical study disclosed heart risks that the company said were its first conclusive evidence of the drug's safety problems.
          A jury of seven men and five women is hearing the case, Ernst v. Merck, in Brazoria County Courthouse in Angleton, a town of 18,000 about 45 miles south of Houston. The case has attracted national attention as the first of thousands of Vioxx-related lawsuits to reach trial. About 20 million people took Vioxx before Merck stopped selling the drug last fall, and some epidemiologists have estimated that the drug may have been linked to tens of thousands of heart attacks or strokes.