A plaintiff’s expert witness in Madison County’s Vioxx trial testified that he has billed nearly $140,000 for his services on Vioxx cases.

In the trial’s second week, Dr. Mark Furman of the University of Massachusetts Medical School told jurors he bills $400 per hour for reading medical records; $500 per hour when being deposed and $750 per hour when testifying in court.

The trial pits Frank Schwaller, whose 52-year-old wife Patricia Schwaller died after using Vioxx, against the drug’s maker Merck Pharmaceutical.

Throughout his career Furman said he has given expert testimony or provided depositions in a total of nine cases on behalf of plaintiffs.

Furman testified Tuesday that Patricia Schwaller’s biggest risk factor was that she took Vioxx, not the fact that she had other medical conditions.

“To a reasonable degree of medical certainty, Vioxx was a substantial and significant factor in her death,” Furman said during questioning from plaintiff’s attorney Andy Birchfield.

Furman also testified that before she started taking Vioxx, there was only a 1 percent chance Schwaller would have had a heart attack with the other risk factors she had.

Last week jurors were told that Schwaller had pre-existing risk factors, including a family history of heart disease, obesity, diabetes, high blood pressure and a sedentary lifestyle.

During cross examination, Merck attorney Dan Ball of Bryan Cave asked Furman why he did not consider Schwaller’s morbid obesity and diabetes when coming up with the 1 percent figure.

“It was an oversight,” Furman told Ball.

Ball also got Furman to admit that obesity can lead to sudden death.

Ball asked Furman if he still stuck with his deposition answers that Schwaller’s risk factors did not play a role in her death.

After he repeatedly dodged the question Ball asked Furman if he was trying to “wiggle out of them because they were ridiculous.”

Furman stuck by his answers.

On Wednesday, Schwaller’s primary care doctor, Tibor Kopjas, M.D. of Maryville testified for the first time ever in his career as a physician.

Both sides labeled him as the “busiest doctor in the metro-east.”

Kopjas testified that Schwaller was a pleasant person, was very truthful when talking to him and for the most part followed his directions and advice.

He said she did have problems with losing weight, and when she did lose it, had trouble maintaining.

Kopjas said he was “shocked” when he heard of Schwaller’s death.

He said he preferred Vioxx over the other cox-2 drug, Celebrex, because Vioxx was only needed to be taken once per day. He also testified that he was one of the doctors who would talk to other doctors on behalf of Merck in order to get other physicians to prescribe Vioxx.

He is currently promoting a diabetic drug Merck.

Kopjas said he believes Vioxx was a substantial factor in Schwaller’s death and said he would not have prescribed it had he known then what he knows now.

During cross examination, Kopjas said Vioxx was a remarkable drug and a highly effective medication.

Kopjas also admitted that he took Vioxx and once Merck took it off the market, he kept some samples and continued to take it.

He also told Ball that he had no problem with the way Merck salespeople conducted business with him.

Kopjas told Ball the reason he reached his conclusion that Vioxx caused Schwaller’s death was because Vioxx was taken off the market.

He also said that all medications have potential side effects and that finding a suitable pain reliever for Schwaller was “a real challenge.”

Kopjas testified that during Schwaller’s last office visit with him six weeks before her death, she weighed 280 pounds, which was a gain of 19 pounds since her last visit. Her blood pressure was 150/100 when first came into the exam room and before leaving that day it was 160/94.

Kopjas also said that her high cholesterol, hypertension, inactivity, diabetes, morbid obesity, age, stress and being in a post menopausal state also contributed to her death.

Earlier in the day Wednesday, jurors heard videotaped testimony from Edward Scolnick.

From 1982-2003, Scolnick served as president of Merck Research Laboratories; executive vice president for science and technology at Merck & Company, Inc.; executive director and vice president in the department of virus and cell biology and senior vice president for basic research at Merck Research Laboratories.

He testified that after the data from a study called VIGOR came in, he never considered taking Vioxx off the market.

He also testified that there was so much data that showed that Vioxx was a safe drug.

Scolnick also said that he “violently disagrees” that Merck put profits ahead of patients.

Scolnick also took Vioxx, but jurors will not get to hear that due to a sucessful motion in limine prior to the trial.

After Scolnick, plaintiff’s attorneys played a small portion of a video deposition of Merck’s Human Health president David Anstice.

In the video, Anstice revealed he did not have a medical degree.

“So the president of Human Health is a salesman,” the attorney on the video asked.

The attorney asking questions to Anstice, Mark Lanier of Texas, accused Merck of rushing Vioxx to the market because they were losing the patents on Pepcid, Mevacor, Prinivil and three other medications.

“You need replacement products to replace revenue,” Lanier said.

Lanier asked Anstice if Merck rushed Vioxx to the market so that executives like himself could still be paid millions of dollars and so the power bill could be paid.

Anstice responded by telling Lanier Vioxx was highly invested in because of the benefits it could provide to patients.

Lanier also accused Merck of giving doctors free dinners so they would write prescriptions. He also said that Merck employed the largest sales force in their history to promote Vioxx and gave more free samples to doctors than at any other time.

When Dr. Kopjas testified, he said that it was normal for “all” drug companies to take doctors to dinner and to give them free samples.

Merck executives are expected to testify on Thursday.

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