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Merck executive testifies in nation's first Vioxx trial

ANGLETON, Texas (AP) _ Merck & Co.'s top epidemiologist testified in the country's first Vioxx-related trial that an in-house training game for Vioxx sales representatives dubbed ``Dodge Ball'' wasn't about learning to dodge questions from doctors about the drug's safety.

Nancy Santanello, executive director and head of Merck's department of epidemiology, was the first witness to testify in the case that began with opening statements last week.

As Merck's corporate face among the company's team of lawyers she took some verbal punches Monday as plaintiff's lawyer Mark Lanier questioned the ethics of Merck's marketing and commitment to safe drugs.

Her testimony was to continue Tuesday.

In the case, the widow of a man who took the drug for about eight months before he died in his sleep alleges Vioxx caused his death and Merck knew the drug was dangerous years before voluntarily pulling it from the market in September.

Merck says the company acted responsibly, disclosed Vioxx research and voluntarily removed the drug from the market when a study showed it doubled the risk of heart attack if taken for a year and a half or more.

On Monday Lanier presented an internal memo laying out the ``Dodge Ball'' training and asked Santanello why trainees could only move on to the next round of the card game if they gave Merck-approved answers to possible doctors' questions about Vioxx safety or dodged such questions altogether.

``The point is, you never had to answer the question if you dodged it?'' Lanier asked.

``Basically you're trained to answer questions from physicians _ not to dodge questions,'' Santanello said, noting participants couldn't win if they dodged all the questions.

Lanier highlighted warning letters Merck received from the Food and Drug Administration about misrepresenting or downplaying Vioxx safety concerns in aggressive marketing that included glitzy television ads.

Merck added warnings about cardiovascular risks to Vioxx's label in 2002. About 20 million people took Vioxx before it was pulled from the market.

The trial centers on the May 2001 death of Robert Ernst, a 59-year-old produce manager at a Wal-Mart in Cleburne, near Fort Worth. Ernst also ran marathons and worked as a personal trainer. He died in his sleep next to his wife, Carol.

His autopsy report says he died of an arrhythmia, or irregular heartbeat, secondary to plaque buildup in two major arteries.

Whitehorse Station, N.J.-based Merck argues that no studies link Vioxx to arrhythmia, so the drug couldn't have caused Ernst's death. Lanier's legal team argues that arrhythmia is most often caused by heart attack, but Ernst died too fast for his heart to show damage.
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