On Tuesday a series of video depositions were aired to the jury. Sadly, I have no access to the videos and cannot directly report on them. Thankfully, GSK's lawyer, Todd Davis, has provided fabulous entertainment akin to a desperately sad clown. Yesterday Davis ineffectively cross-examined the plaintiff's next expert witness, Dr. Joseph Glenmullen.
Dr. Glenmullen is yet another thorn in the side of GSK. He has previously served as expert witness in many Paxil lawsuits, and, just like Dr. David Healy, is disliked by GSK and their King & Spalding attorneys. Both Glenmullen and Healy were subjected to GSK's pre-trial circus in which GSK filed motion after motion arguing that these renowned doctors should not give evidence at this trial. GSK's attempts were denied.
After yesterday, I can vividly see why GSK opposed Glenmullen as an expert. In short, Glenmullen ran circles around Davis. More on this further on down this blog post.
Glenmullen detailed Stewart Dolin's medical notes and told the jury the akathisia Stewart experienced occurred the last time he was prescribed Paxil. This was six days before Stewart's Paxil-induced death. During these six days, Stewart showed increased signs of agitation, just as he did when he was previously prescribed Zoloft years ago. In fact, when the Zoloft dose was increased, Stewart's adverse drug reaction (akathisia) worsened. When Stewart stopped taking Zoloft, his agitation subsided. Sadly for Stewart and his survivors, when he last took Paxil his adverse drug reaction ended in death. Akathisia, as Glenmullen stated yesterday, is "a drug-induced reaction, a compulsion to kill yourself." Glenmullen added that a death such as this is referred to "as a paroxetine-induced accident, not a suicide. It's paroxetine. It's the label that didn't warn that is the cause."
Regarding GSK's supposed adult suicide warning on the Paxil labeling, Glenmullen clearly nailed it. Referring to the 2010 Black Box warning displayed in court, Glenmullen told the jury how there was explicit language that short-term studies did not show an increase in the risk of suicidality with antidepressants compared to sugar pills in adults beyond age 24. He also pointed out the sentence, "Depression and certain other psychiatric disorders are themselves associated with increases in risk of suicide." He explained to the jury, "...What that tells me as a practicing psychiatrist is that if I'm treating a 57-year old patient and I put them on Paxil, Paxil couldn't make them worse. Paxil couldn't make them suicidal. It would be, and it says explicitly, their depression or other psychiatric condition."
Glenmullen further noted the black box warning is "really bad" because it implies the suicide warning is just for children, ergo a doctor treating an adult could not warn about a potential risk of suicide because the labeling suggests there is only a suicidality risk among children taking Paxil.
The jury was informed that the labeling was written in such a way so that doctors would not only NOT know about the adult suicide risk, doctors would actually increase the dose because they would assume worsening of depression and/or new disturbing behaviors had nothing to do with Paxil.
Glenmullen added, "And here's another dimension to it. If the patient gets worse and it might be the drug, what do you do? You take them off the drug to see. If they get worse and it couldn't be the drug but it's the depression, what do you do? You increase the drug, which is going to worsen the risk. So it's very dangerous. And that's why, in my opinion, it's really this lack of a warning that's responsible for his (Stewart Dolin's) death."
Glenmullen told the jury he is "100% certain" that "Mr. Dolin's was a "paroxetine-induced, Paxil-label-induced death."
Cross-examination by King & Spalding's Resident Clown
As per his norm, Davis repeatedly tried but failed to discredit the witness. He attempted to catch out Glenmullen with answers Glenmullen provided in various testimonies, including testimony that was more than 11 years ago!
A spectator in the court told me, "You should have seen the spectacle created by GSK when it came time to do their cross. They were so unorganized with their multiple binders that the jury started to laugh."
Davis also went down the route of asking Glenmullen how much he was paid to give expert opinions in previous Paxil litigation. Leaves me wondering how much Todd Davis has been paid to defend one of the most controversial drugs in history. Further, I wonder whether he and his law team view their thousands of "settlements"as victory.
In what world is it viewed as a success to place gagging orders on families of Paxil victims so that the truth about the dangerous product is hidden?
Thus far, Davis has done a fine job of entertaining both spectators and jurors alike. Today's Davis looks more like a sad clown than the smug clown who skipped into court three weeks ago. So, there you have it: King & Spalding attorneys seem to work well together if one considers their joint performance mere entertainment. Sad clown Davis and his jack-in-the-box sidekick, Andrew Bayman, will continue their lame cross-examination of Glenmullen today.