Phillip Margolin: The Associate

“No, it’s true,” Daniel insisted. “Many of the women who claim that Insufort caused their child’s birth defect probably didn’t take the pill as prescribed. Maybe they took it occasionally or irregularly or only a few times and their glucose rose to dangerous levels.” “So we’re blaming the victim.” “Look, Kate, most women give birth to healthy babies, but some women give birth to babies who have problems.

Sometimes we know why. Some anticonvulsant drugs cause cleft palate.

Babies of older mothers are more prone to have birth defects. Maternal infections can also cause them. Then there’s alcohol, tobacco, and drugs. But the causes of most birth defects are medical mysteries. The difficulty is that Americans have been taught that there is an answer to every problem.” Daniel leaned forward and looked at Kate.

“Americans can’t accept the fact that shit happens. You get cancer, so you blame overhead power lines; you run someone over, so you blame your car. Are you familiar with the Bendictin cases?” Kate shook her head. “ ‘Morning sickness’ is a problem for many pregnant women. For most it’s unpleasant, but it can be deadly. You’ve heard of Charlotte Bronte?” “The author ofJane Eyre.” Daniel nodded. “Hyperemesis gravida-‘morning sickness’-killed her. In 1956, the FDA approved Bendictin, which was developed by Merrill Pharmaceuticals as a therapy for women with severe morning sickness. In 1979, theNational Enquirer announced that Bendictin was the cause of thousands of defects in infants. “The best way to determine if there is a cause-and-effect relationship between a drug and a problem is to conduct an epidemiological study. If a control group that hasn’t taken the product has as many, or more, problems as the group that’s taken the drug, you can conclude that there’s probably not a casual connection between the drug and the problem. All of the epidemiological studies of Bendictin concluded that there was no statistical difference in the incidence of births of babies with defects in the two groups. That didn’t stop lawyers from convincing women to sue.” “The plaintiffs’ attorneys must have had some evidence of a causal connection between the drug and the defects.” “They used experts who altered the results of studies or conducted studies without proper controls or inaccurately reported doses. The plaintiffs lost almost every case because they couldn’t show that Bendictin was to blame for any defects, but it cost Merrill Pharmaceuticals a hundred million dollars to defend all of the cases. In the end, a perfectly safe product was taken off the market because of all the bad publicity and other drug companies were scared to produce a drug that would help women counteract morning sickness. In 1990, theJournal of the American Medical Association reported a twofold increase in hospitalizations caused by severe nausea and vomiting in pregnancy since the disappearance of Bendictin. So who suffered? Only the innocent.” “Did all of the Insufort studies show that it’s safe?” Kate asked. “All but one,” Daniel answered hesitantly. Kate cocked her head to one side and watched Daniel carefully as she waited for him to continue. “I’m in trouble because I missed a letter from Dr. Sergey Kaidanov when I reviewed some discovery that was turned over to Aaron Flynn. The letter discusses a primate study involving Insufort.” “And?” A vision of Patrick Cummings flashed through Daniel’s mind. “The study showed a high incidence of birth defects in rhesus monkeys that had been given the drug during pregnancy,” he answered quietly. “Did Geller tell you about this study before the deposition?” “No. Geller’s chief medical adviser swears that he’s never heard of it.” “I see.” Kate sounded skeptical. “The Kaidanov letter doesn’t make sense, Kate. The percentage of defects was very high, in the forty-percent range. It’s so out of line with the other study results that there’s got to be something wrong.” “Maybe there’s something wrong with Geller’s other studies.” “No, I’ve never seen any evidence in any study of a link between Insufort and birth defects.” “Maybe you’ve never seen any evidence because Geller is hiding it. Remember the asbestos cases? The asbestos industry covered up studies that showed increased cancer in animals. It wasn’t until a lawsuit was brought that it came out that they’d known about the problem for decades. The lead-paint industry continued to defend its product even though lead poisoning was one of the most common health problems in children under six and there was scientific documentation of the dangers of lead poisoning as early as 1897. And let’s not forget the tobacco industry.” “Jesus, Kate, whose side are you on? Geller is our client.” “Our client is in the drug business to make a buck and it wouldn’t surprise me if Geller covered up the Kaidanov study if the results are as devastating as you say they are. Do you think Geller markets Insufort to help women?

Companies whose executives are men make a lot of these defective products that are used by women. There’s Thalidomide, DES-the synthetic estrogen that was supposed to prevent miscarriages and caused vaginal cancer-and the Dalkon Shield.” “Plaintiffs’ attorneys play on this sympathy for women to gouge money out of corporations with frivolous lawsuits so they can rake in millions,” Daniel answered angrily. “They don’t care about their clients or whether they really have a case. The Bendictin lawyers were hoping that jurors would be so appalled by the birth defects they saw that they’d forget that there was no evidence that Bendictin caused them. The breast implant cases used sympathy for women to sway public opinion even though there’s no evidence of a connection between defects in silicone gel implants and connective tissue diseases like systemic lupus erythematosus and rheumatoid arthritis.” Kate looked fed up. “I have a good friend who’s sterile because she used the Dalkon Shield. I worked on her lawsuit and I learned a lot about the way corporate America works. By the time the public discovers that a product is defective, the company has made so much money it can afford to buy off the victims. Tobacco is so flush it can make multibillion-dollar settlements and still keep trucking. “And don’t come down so hard on plaintiffs’ attorneys. They can make millions when they win a case, but they don’t make a penny if they lose.” “You think Aaron Flynn is a humanitarian?” Daniel asked, but his heart was not completely in tune with his words. As he spoke them he remembered Flynn ruffling Patrick Cummings’s hair. “Who else is going to represent the poor?” Kate asked. “ ’Cause it sure ain’t Reed, Briggs. If lawyers like Flynn didn’t take cases for a contingent fee no one but the rich could afford to sue. And they risk their own money on expenses, which they don’t recover if they don’t win. A good, decent lawyer can lose everything if he doesn’t prevail. The lawyer who sued when my friend became sterile did it to pressure the company into taking a dangerous device off of the market. He cared about Jill.

If Insufort is disfiguring children the only way to make Geller stop marketing it is to expose the problem, and one of the best ways to do that is in the courts.” Daniel expelled the breath he’d been holding.

“You’re right. Sorry. I’m just scared that I’m gonna lose my job because I missed that damn letter. And I’m certain there’s something wrong with Kaidanov’s study. It doesn’t make sense that he could get those results with Insufort. That’s why I was trying to find him. You know he hasn’t been at work for a while?” Kate nodded. “When I went to Kaidanov’s house I didn’t plan on going in, but I saw that the house had been searched and I thought he might be hurt or worse. And I did find something that might help.” Daniel pulled his handkerchief out of his pocket and laid the hard drive on the table. Kate stared at it.