John Lescroart - The Suspect

"And Caryn knew about others?"

"Of course. She's the inventor. She wanted to see the earliest drafts. Which evidently they tried to keep from her too. And pretty successfully."

"Who did?"

"Furth. The money people. And of course Bill Blair. Our CEO? Once we pulled through the first round of clinical trials, they were all gung ho for full production, but Caryn had gotten some calls from docs she knew that had had problems. She even had a couple of her own patients show some disturbing signs. And it worried her."

Some of these details rang with a distant familiarity in Stuart's mind. He was sure that Caryn had mentioned some of this to him back when she was first starting to test her new socket, her concerns about every aspect of the product. But he hadn't paid very close attention.

Caryn was all about problems and their solutions. She was the original girl who cried wolf-everything was a crisis, a problem, a challenge. Their daughter wouldn't eat dinner one night and Caryn would harangue his ear off about how Kym was borderline anorexic or bulimic. If a patient had a rough night's sleep after surgery-and almost all of them did-Caryn would worry it to death. Until finally Stuart, feeling it was out of self-defense, just finally shut her off. He couldn't listen to any more "what ifs." She'd talk and talk, one critical topic-money, the state of health care, polymer chemistry, her patients, Kymberly-flowing seamlessly into the next, and each one fraught with danger, possible failure, alternatives to consider. Exhausting. Constant and exhausting.

Until he was left nodding, pitching in with the occasional "Uh-huh."

But now, sitting here with Kelley, he realized that many of the things that engrossed Caryn might in fact have been damned interesting, even compelling. Certainly, the details surrounding the Dry-den Socket were fascinating-and incredibly important-to him right now at this moment. But back when it had been a part of Caryn's daily existence he had been tuned out, deaf to the songs that gave meaning to his wife's life.

It had not all been her shutting him out, at least not at the beginning. He'd been equally complicit, perhaps more so, in the dissolution of their intimacy. The thought hit him, suddenly and unexpectedly, in a wave of regret and loss and brought him up short, his hand suddenly at his forehead as though pressing away a migraine.

"Stuart? Are you all right?"

He nodded at her. "I'm sorry. My mind just went out. Where were we?"

"Clotting," Kelley said. "Hypercoagulability." "Sure," Stuart said, "I was going to say that." "You're teasing, but it's a real thing. It's what Caryn was trying to fix."

"Could a layperson understand it if he wanted to explain it to his lawyer, for example?"

"I think so. You know that the basic problem Caryn set for herself was to find a plastic for the cup-side of the hip that didn't degrade, right?"

"Generally, yes."

"Okay, so she knows polymer chemistry inside out. She discovers this one particular type of high-density polyethylene-"

"Whoa, Kelley. We're dumbing it down, okay?"

An impatient pout, then Kelley continued. "High-density polyethylene is dumbed down, I'm afraid. You don't want to hear the technical name. Bottom line is she found a plastic that worked in animal trials. As you know."

"What wasn't working before?" Stuart asked.

"The basic problem? Some people, Caryn included, believed that the industry standard plastic was the proximate cause of even the one percent of blood clots. And even worse, over time the plastic elutes a chemical-"

"It does what?"

"Elutes. Produces. A chemical that dramatically increases coagulation in some people. It's called 'small particle disease'-there's a layman's term for you-and it's often fatal."

"And that's what Caryn was trying to avoid?"

"Right. She thought, or hoped anyway, that she could drastically reduce that one percent clotting number, maybe down to one in a thousand cases, or less. So I think it's important to understand that even if Mr. Furth was correct on the fatality number he gave you, and he's not, the Dryden Socket at one percent failure was no improvement over what we've been doing for years. And in fact, Caryn was most of the way to convinced that it was worse."

"How much worse?"

Kelley bit at her lower lip and took in a deep breath. "Maybe a lot. Maybe as much as five percent. Those are the preliminary figures from studies that aren't completed yet. Five in a hundred deaths."

"From the same thing? Small particle disease?"

"No. In fact, we've done several coagulation cascades and this is kind of the opposite, where we're seeing the creation of multinucle-ated giant cells which, essentially, become osteoclasts that eat bone."

"Eat bone? Not good, I'm guessing."

"It is bad. It's going to be much worse, though, if PII goes into full production."

"But if they know this, why would they go ahead with it? I mean, they've got to realize that they're looking at lawsuits forever. They'd be killing themselves."

"Not if they could get the problem fixed soon enough. They could take orders, start some cash flow going, have the delay later in the process rather than sooner. Caryn was already working on it, narrowing down some other options…"

"Another plastic?"

"Right. And pretty sure she was on the right track. She told me she thought we had a good chance to solve the problem in two years, maybe less. But it's a time and money game with PII. They're evidently strapped pretty badly right now, and if there's more delay before the FDA gives them a green light…"

"I know about that. At least I know that Caryn put up a lot of short-term money…" Stuart, struck with another insight, drummed his hands on the steering wheel. "Which would mean that at the time she did the mezzanine loan, she must have believed PII was going into production pretty soon, right? And was okay with it."

"But she wasn't okay with it. I know she wasn't." A silence settled in the cab. Finally Kelley said, "Look. She thought the money she gave them was to buy time for her research. That was her clear understanding. Except then she found out they weren't reporting the negative studies and planned to go ahead anyway."

"And when did she find that out?"

"I'm not sure exactly, but recently. Certainly by last week. She was down here, I think it was on Wednesday, and had evidently just gotten word from Mr. Furth that the FDA was days or weeks away from approval, and she was having a fit about it. She went into Mr. Blair's office and he told her that the deaths had occurred after the study was completed and therefore they shouldn't technically affect the FDA's ruling, which was going to send PII stock through the roof. And meanwhile she should just keep up her work on the next generation."

"How did she respond to that?"

"How do you think? She told him it was unconscionable and that

if he went ahead, she was going to go to the newspapers. It was her name on the socket, and she wasn't going to allow it to hurt people." "So what did Blair do?"

"He backed down a little, evidently. At least that's what Caryn told me when she came back out to the lab. They were all going to have another meeting this week and see if they could all come to some decision that made everybody happy. But she wasn't too optimistic."

"And the meeting was supposed to be this week?"

"Probably today," Kelley said. "She usually came down here to work on Wednesdays. Except of course now there won't be-" She stopped abruptly as her eyes teared up. For a few seconds she fought the urge to cry. At last, swallowing, gathering her strength, she went on. "So you see why I felt I had to talk to you?"

Assistant District Attorney Gerry Abrams showed up uninvited at Devin Juhle's desk in Homicide at a little after four, when Juhle had just gotten himself arranged to write up an incredibly depressing witness interview he'd had with a despondent mother in a case he was following up on after he'd left Stuart Gorman's house. Abrams breezed by the lockers across from him, knocking on the top of one of them to announce his arrival. When Juhle looked up, he started right in, the soul of enthusiastic good cheer. "I must say you look a bit peaked, my good man. I've been thinking about Gorman, and I predict it'll cheer you right up."