Outraged patients around the world who suffered heart attacks or strokes while taking the anti-inflammatory drug Vioxx are lining up to sue its embattled U.S. manufacturer Merck, exponentially increasing the company`s potential liability. Last Friday, a Texas jury found that Merck was liable in the death of Robert Ernst, saying the drug maker had not released information about the heart risks. The panel awarded his widow $253.4 million. If other pending Vioxx lawsuits also go against Merck, the litigation could collectively become the biggest medical product liability action in history, exceeding in scope and economic impact the thousands of lawsuits associated with silicon breast implants in the 1990s, which drove their American manufacturer, Dow Corning, into bankruptcy. While there are an estimated 4,000 lawsuits waiting in the United States, there are potentially many more around the world, especially in Europe, where the expensive drug, used to treat arthritis, was wildly popular. Lawyers are busily collecting data on thousands of cases, trying to assess whether they should attempt to sue Merck in the United States, where rewards are likely to be higher, or in their home countries, where there are likely to be fewer legal hurdles. Christine Peckham, 52, of Lancashire, England, who had two strokes in 2001 while on Vioxx, has already filed court papers in New Jersey. “Merck has to be made accountable, since they knew about this problem at least seven months before I had my first stroke,“ said Peckham, who is now legally blind and uses a wheelchair. “I can`t work again, and there`s no reason why British taxpayers should cover my costs.“ It is difficult to tally the exact numbers of suits being filed outside the United States, although lawyers in Italy, France, Britain and Australia are working on cases. In each of those countries, the number of people who took the drug was in the hundreds of thousands. Richard Meeran, special council for Slater Gordon in Australia, said his firm had at least 100 strong cases against Merck, all people who had suffered or died of a heart attack after taking Vioxx for more than 18 months. But he worried that huge verdicts in the United States might mean that clients abroad would not have time to stake their claim. “Our main concern is that Merck will run out of money, given the number of claimants and the size of the U.S. award,“ he said. “We`re not overly concerned about the merits of the cases, since we think it is clear that the company behaved unacceptably.“ Lawyers in other countries echoed the concern: After Dow-Corning declared bankruptcy in 1995, European women with silicon implants, which were associated with leakage and autoimmune diseases, received less money than Americans under a compensation plan established by a U.S. court. “From past experience, there is a chance that foreign claimants might be treated less favorably,“ said Sapna Malik, a partner at Leigh Day, a London law firm that is preparing to file a lawsuits on behalf of hundreds of British Vioxx users. Malik, who represented clients in class-action suits against Dow Corning, has yet to decide whether to pursue the claims in Britain or the United States. While industry analysts have estimated that the lawsuits might cost Merck tens of billions of dollars, the company declined to discuss liability. “The American legal system and jury system is very different than those in other countries,“ Merck said. “There will be other Vioxx cases in the U.S. and elsewhere, and we will defend out position wherever these cases occur.“ Vioxx, a chemical in the cox-2 family of medicines, was widely used to treat pain from arthritis and related diseases from 1999 until Merck voluntarily withdrew the drug in 2004, after a study showed a link between long-term use of the drug and heart attack or stroke. But earlier studies, including at least one in March 2000, had suggested a risk. Plaintiffs` lawyers contend that the company minimized and misrepresented earlier scientific data to aid sales. An estimated 20 million people took Vioxx, which was the subject of an aggressive promotional campaign by Merck. In the United States, Merck spent $500 million advertising directly to patients between 2000 and 2004. Such advertising is prohibited in Europe. Although it is related to simple anti-inflammatory medicines like Motrin, patients often preferred Vioxx and other cox-2 medicines, because they produce fewer gastrointestinal side effects, like ulcers, and could be administered for longer periods and at higher doses. Other cox-2 medicines have been withdrawn from the market or carry warming labels about cardiac risks. In Italy, cox-2 medicines accounted for almost 25 percent of all anti-inflammatory and arthritis medicines prescribed in 2004, just four years after they were introduced, according to Dr. Pietro Folino-Gallo, who runs the Euro-Med-Star project, which tracks prescription drug use in Europe. In Denmark, their use increased by 275 percent in the same four-year period, Folino-Gallo said. In many countries, Vioxx, sold under a wide variety of names, was the market leader. Codacons, an Italian consumer protection group, is looking into bringing a lawsuit on behalf of Italians who took Vioxx. In France, Classaction.fr, a Paris-based group of lawyers, is considering a similar action on behalf of French patients. Before Peckham, the British woman who suffered two strokes while on Vioxx, was first prescribed the drug in 1999, she had struggled to get moving every morning, limited by arthritis. “Vioxx worked for my pain,“ she said. But on September 13, 2001, she developed “the mother of all headaches“ and discovered that the left side of her body was numb and her left face droopy. Unaware of any potential link to Vioxx, she continued to use the drug after that stroke, suffering a second one that left her legally blind three months later. Still, she stayed on Vioxx, said Russell Spargo, of Liverpool`s MSB Solicitors, the law firm representing her. “I knew nothing until September, 2004, when Merck withdrew Vioxx and my GP called to tell me to stop taking it immediately,“ she said.
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