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with the mechanism of action of the drug, both with respect to its indications and its adverse effects; they must under- stand the mechanism of the injury caused by the drug, as well as co-morbid condi- tions to which the defense will point as alternate causes of the plaintiff ’s injury; they have to be able to engage well- credentialed defense experts who will, if history is any guide, concoct Byzantine defenses with only a tenuous basis in science and medicine. In the presentation of the science
case, the trial package committee sought to provide an introduction to these sorts of critical subject matters. There were two principal documents: the Backgrounder and the Compendium. The Science Backgrounder was a comprehensive
guide to the critical scientific issues in the case. For Vioxx, which belongs to the class of drugs which selectively inhibit the enzyme cyclooxygenase-2, this involved explanations of cyclooxygenase and selective inhibition of COX-2; the pro- posed mechanism of action for adverse reactions to the drug, and early hypothe- ses regarding potential risk; the manufac- turer’s clinical trials, with particular attention paid to the critical VIGOR study and its aftermath; important label changes; and issues surrounding the withdrawal of the drug. The Science Compendium was an
introduction to the core medical literature, and contained detailed abstracts of key articles. At the same time, an exhaustive collection of the relevant collection of
medical literature was provided, organized by topic and fully searchable. This enabled attorneys to access quickly a large body of literature to address specific points. • Case Presentation and Themes As discussed above, most MDLs ably
conduct discovery against the defen- dant. And most eventually make avail- able for plaintiffs at least some analysis of the documents in the case, usually in the form of what has come to be called a “theme grid.” But unfortunately, it is uncommon for plaintiffs’ leadership to provide a coherent general liability pres- entation that is actually ready for trial, in a genuine “plug and play” format, and this is a shame. Empowering lawyers around the country to push
See Tide, Page 36
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