HOUSTON — Only two days into the Vioxx trial, jurors were hearing testimony on a key question in the case.
What caused the blood clot that killed 53-year-old Richard "Dicky" Irvin of St. Augustine, Fla.?
Irvin died in May 2001 when the clot suddenly obstructed the flow of blood from his heart. He had been taking Vioxx for a little less than a month.
Irvin's case represents Vioxx's first federal trial. The drug's manufacturer, Merck, faces some 7,000 Vioxx-related lawsuits in federal and state courts. The Whitehouse, N.J.-based company withdrew Vioxx from market in September 2004 after a long-term study showed the drug doubled risk of heart attack or stroke if taken for 18 months or longer.
The first witness on Wednesday was Dr. Colin M. Bloor, professor emeritus for pathology at the University of California, San Diego. He was hired by the plaintiff to review Irvin's autopsy and the slides of his heart and arteries.
Bloor said Irvin developed the clot because he was taking Vioxx. Many researchers believe that Vioxx causes blood clots.
But, blood clots and heart attacks are common occurrences in the general population. Merck claims Irvin's clot had a more common origin: The clot formed when plaque, or a fatty deposit in the wall of an artery, ruptured with no help from Vioxx. But Bloor told the plaintiff's lawyer Paul Sizemore there was no evidence the plaque ruptured and that, if that had happened, the blood clot would have been attached to the artery wall or the fatty deposit. The clot wasn't connected to the walls or plaque.
In a pointed cross-examination, defense lawyer Phil Beck tried to shake Bloor's certainty that Vioxx, not pre-existing plaque, was to blame for Irvin's fatal blood clot.
"Am I correct, Doctor, that there are different types of plaque, some more prone to rupture than others?'' Bloor said, "Yes."
Beck asked, "Would you agree that Mr. Irvin had a more unstable kind of plaque?'' Bloor agreed.
Then Bloor insisted he hadn't seen any signs of a rupture on slides of four cross-sections of Irvin's affected artery.
"You looked at four sections (of the artery). If someone wanted to, they could take thousands of these slices, right?'' Beck asked.
Beck continued, "You're aware that every other pathologist who's looked at these slides disagrees with you?''
"Yes,'' said Bloor.
Then Beck said, "If all these pathologists agree there was a plaque rupture, then the cause of death was plaque rupture, not Vioxx."
"That is not my opinion,'' Bloor maintained.
In coming days, the jury will have to form its own opinion on the cause of the Irvin's blood clot.
Later in the day, two of Irvin's four children testified that their father worked long days at a physically demanding job, as manager of a seafood shop that supplies restaurants.
Richard Eugene Irvin III now holds his father's job. He said "Dicky" Irvin worked from seven in the morning to nine or 10 at night. He said Irvin helped to unload the catch from boats that docked behind the seafood shop, carrying boxes that weighed 50 to 100 pounds.
The lawsuit, filed by Dicky Irvin's widow, is the third liability case against Vioxx to go to trial. The last two were in state court. The plaintiff prevailed in one; Merck in the other.