The longtime doctor for a Granite City woman testified Wednesday that had he known what he does now, he wouldn’t have prescribed the painkiller Vioxx because he believes it was a contributing factor in his patient’s fatal heart attack.

The testimony came during the second week of a highly watched trial in Madison County that pits the husband of Patricia Schwaller against pharmaceutical giant Merck, the maker of Vioxx. Schwaller, who struggled with a host of heart risks severe obesity, hypertension, high cholesterol, borderline diabetes and more took the drug for 20 months before her sudden death in 2003.

Dr. Tibor Kopjas, who now practices in Maryville, said he put Schwaller on the drug because he feared her joint pain would keep her inactive, making it more difficult for her to lose weight. He said he had no fears of heart risks and only began to believe Vioxx was dangerous after Merck voluntarily pulled it from the market in 2004.

The company’s decision to halt Vioxx use came in the midst of a study that appeared to show a sharp increase in the risk of heart attack, compared with a placebo. When asked whether he would have prescribed Vioxx today, Kopjas responded, “I would not have.”

Merck attorney Dan Ball questioned Kopjas on Schwaller’s long-standing health problems and reviewed the drug’s warning label. The corporation contends that it adequately warned doctors and the public of potential heart risks of Vioxx.

More than 27,000 pending lawsuits allege that Merck ignored and even actively hid the drug’s risks. Juries have decided only 13 cases thus far, and Merck has won more than half.

Kopjas is a key witness in Schwaller’s case because he was her doctor for years. He admitted that he had heard public debate in 2002 over the drug’s effects on the heart but said he was unaware of early worries by Merck scientists that Vioxx could affect clotting as well as plaque buildup in arteries.

Those concerns, documents show, were apparent even before the drug was approved by the Food and Drug Administration in 1999. Merck scientists have said they eventually were satisfied that the drug posed no substantial heart risks.

Merck contends that it was Schwaller’s own medical history not the drug that caused her death. To counter, Schwaller’s attorney, Larry Wright, at multiple points tried to reiterate Kopjas’ claim that he wouldn’t have given Schwaller the drug if he had known better, because he believed it killed her.

Earlier in the day, defense attorneys presented the video deposition of Dr. Edward Scolnick, president of Merck Research Laboratories during Vioxx’s development. The testimony aimed to dispel the plaintiff’s claims that the corporation knew about the drug’s risks but hid them.

Scolnick said he initially had been worried but eventually was satisfied as more and more clinical trials came in. He said scientists also were continually watching for evidence that Vioxx was dangerous for the heart.



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