The trial is almost over, and the jury has heard from many witnesses for both plaintiff, Wendy Dolin, and Defendant, GSK. GSK's last roll of the dice saw Anthony Rothschild (pictured above) take the stand. Up to 2009, and possibly to the present, Rothschild has taken money and related grants from the National Institute of Mental Health, Cyberonics, and Wyeth. He is a consultant for numerous pharmaceutical companies to include Pfizer, GlaxoSmithKline, Forest Laboratories, Eli Lilly, and Takeda.
First and foremost, Rothschild describes himself as an expert in psychological autopsies, a method, according to '
All About Forensic Psychology', that involves collecting all available information on the deceased via structured interviews of relatives, friends and healthcare personnel. Additionally, information is supposed to be collected from available health care records and related documents. We know Rothschild had access to Stewart Dolin's medical records and other documents but did he ever interview relatives or friends of Stewart Dolin? Did Rothschild ever interview Stewart's healthcare personnel? It appears he did not.
For a day and a half, under direct examination from defence attorneys, King & Spalding, Rothschild told the jury that Stewart Dolin's state of mind caused his death and Paxil had nothing to do with Stewart's death. Rothschild further claimed there is no relationship between SSRIs, akathisia, and suicide. He went on to state that, even if there was such a relationship, Stewart Dolin was not suffering from akathisia.
Rothschild told the jury that he treats patients with akathisia, 99% of whom were on neuroleptic and/or antipsychotic medications. When asked if akathisia was difficult to treat, Rothschild answered, "...akathisia is not that complicated to treat. You just give another medication, and you can wipe out the akathisia quickly." Rothschild went on to tell the jury that he had read Stewart Dolin's medical notes and that, in his opinion, Stewart had suicidal thinking on July 6th before starting Paxil.
Oddly, Rothschild also informed the jury that he, Rothschild, walked from the Reed Smith offices to the train station where Stewart Dolin's life ended. Why Rothschild claimed this is unclear, as there is no way Rothschild could ascertain what route Stewart Dolin took from his Reed Smith office to the train station. Rothschild also claimed that he reviewed Stewart Dolin's credit card details and that Stewart had purchased a train ticket. This, too, has not been verified, but Rothschild claimed such a purchase was made in an attempt to convince the jury that, somehow, buying a train ticket, supported Rothschild's opinion that Stewart was of sound mind and body and planned his death.
"If someone has, again, an irresistible impulse, you know, I actually have trouble working that bloody machine. I mean, if you had akathisia, why would you buy a ticket. I mean, you just jump over the thing and run down." He added, "It's just, to me, this was deliberate and planned. I mean, he had, he had to think, "I need the card to get, to buy the ticket, buy the ticket and get on the platform." It took some, you know, it was premeditated. He had planned this out ahead of time."
When asked about the witness who saw Stewart Dolin pacing before he jumped, Rothschild dismissed the restlessness, telling the jury, "A lot of people pace when they're waiting for a train."
I don't know what types of train platforms Rothschild frequents, but I've taken trains many times in my life and have never seen a person pacing the platform. I'd think it rather odd if I saw someone pacing up and down a train platform, and I would be concerned.
Rothschild then claimed he had read the police report in this case. He falsely claimed, under oath, that Michael LoVallo, a managing partner at the law firm where he and Stewart worked, told the police "that these problems at work may have been part of the reason Mr. Dolin committed suicide." However, as you will learn in cross-examination, further on down this post, LoVallo did not state this to the police.
A case for perjury, perhaps? We shall see.
Throughout King & Spalding's direct examination many visuals were used in a futile attempt to convince the jury that Stewart Dolin was frequently criticized by his work colleagues and that this criticism added to Stewart's work-related stress. However, the reality is that Stewart Dolin received excellent reviews from the vast majority of his colleagues and this was later highlighted when Rothschild was cross-examined (below). Rothschild conveniently omitted the excellent appraisals Stewart received from his colleagues.
Cross-examination by David Rapoport
Plaintiff attorney, David Rapoport started his cross-examination of Rothschild by asking about the supposed statement LoVallo made to the police. Rapoport asked Rothschild if it was a lie. Rothschild answered,
"No, it was not." However, the fact is, there was no such statement made to the police by Michael LoVallo. LoVallo does not believe that work stresses caused or contributed to cause Stewart Dolin's suicide, and Rothschild was forced to concede this fact whilst under cross-examination.
Next came the issue of Rothschild's cozy relationship with GlaxoSmithKline. In the Dolin case alone, Rothschild has been paid approximately $165,000 for his testimony. Rapoport pressed Rothschild further and asked him about previous cases where GSK has called him as an "expert" witness. When asked how many times GSK has hired him as a witness in Paxil death cases, Rothschild couldn't seem to count that high.
"Going back 15 years, I can't give you an exact number, but it's probably in the neighborhood of 20 or 30."
Thanks for that info, Mr. Rothschild. You've now informed the jury that Paxil has been implicated at least 20 to 30 times in drug-induced death cases. Did Rothschild receive poor coaching from his attorneys or did he finally decide to tell the whole truth, given that he had previously been caught lying? Of course, in each of the "20 or 30" cases where Rothschild has been paid by GSK for testimony, Rothschild has always claimed Paxil does not cause suicide.
Getting back to the issue of Stewart Dolin's train ticket, Rapoport showed Rothschild a Ventra card. The card is a pre-paid travel pass. Rothschild couldn't say for certain if Stewart used a Ventra card on the day of his death. Strange, because under direct examination Rothschild had claimed that a person with akathisia would not buy a ticket. He presumed that Stewart bought a ticket when in fact Stewart may not have had to buy a ticket at all.
Psychological autopsies
Under cross-examination, Rothschild was asked whether or not he was board certified to conduct psychological autopsies. He answered,
"There is no such thing."
It's a crying shame that GSK's expert doesn't know much about the profession in which he claims to be an expert. The Psychological Autopsy Certification Training (PACT) disputes Rothschild's claim. Since 2011, The American Association of Suicidology (AAS) has offered the
Psychological Autopsy Investigator Certification Program. I'm amused and aghast that GSK calls an "expert" who has no credentials in his field.
Visuals
During Rothschild direct examination by King & Spalding, many visuals were shown to the jury, visuals that lamely attempted to paint a bad picture of Stewart Dolin. Rapoport picked up on this. One such visual was a 2009 PGL evaluation where comments were left by Stewart's employees. Rothschild didn't tell the jury about the glowing appraisals Stewart Dolin received. He didn't mention that Stewart's colleagues described Stewart as
"honest, hardworking, and one who leads by example." He left out that Stewart
"Seems to be decisive and takes what he does very seriously and cares about the group, seems to be a good administrator." He forgot to tell the jury that
"Stew is honest and direct in his dealings with the C & S group." "Stew is approachable and willing to listen. He sincerely wants to do his best. He's able to balance different constituencies" and so on. There were many more compliments of Stewart Dolin that Rothschild left out.
Rapoport then showed how Rothschild, in a previous testimony, claimed there is no evidence that there's a higher rate of death by suicide in children and adolescents who take Paxil versus placebo.
Finally, Rapoport asked Rothschild the following:
"So you've treated thousands of patients, some of them have committed suicide and never once have you found that a drug contributed to suicide in the patients, have you?"
Rothschild answered
"No."
Rothschild was then asked further questions by King & Spalding on re-direct examination. It was basically them repeating themselves over and over until finally King & Spalding rested their defence.
David Healy returns to the stand.
In an unusual move, plaintiff's expert witness called Dr. David Healy back to the witness stand. Healy rebutted claims made by GSK's previous witnesses. GSK's "experts" previously criticized Healy's evidence, in particular, Healy's professional knowledge about akathisia.
Healy's evidence was, once again, damning to GSK.
Plaintiff's Exhibit 347
(Fig 1)
Of the 22 deaths that occurred during the Paxil clinical trials, many were violent. GSK's expert, Dr. Kraus, had previously testified that Paxil-related suicides were not violent. Healy was asked, "...of these 22 people who killed themselves while taking Paxil in GSK's clinical trials, how many of them were violent?" Healy answered, "16." He added, "There were a range of acts from hanging to gunshot wounds to throwing themselves in front of trains."
Healy was also asked if GSK accurately reported suicide events in their Paxil clinical trials?
He answered,
"No, they haven't." Furthermore, Healy told the jury,
"I have been able to analyze the data from one of GSK's major depressive disorder trials and, in particular, to look at the suicidal events that happened in that trial."
On the subject of akathisia, GSK's "expert" witness, Anthony Rothschild, had earlier told the jury that there was no scientific or peer-reviewed literature supporting an association between akathisia and suicide. Asked whether or not this was true, Healy told the jury this was not true and he further referenced a book about akathisia authored by Dr. Sachdev. Healy informed the jury that this text is viewed as an authoritative work in the field. Healy also stated that GSK's "expert," Anthony Rothschild, had written about akathisia. In Chapter 2 of Rothschild's book, he wrote,
"Akathisia, a syndrome marked by distinctly unpleasant symptoms of motor restlessness and anxiety may increase the risk of suicide."
What happened next was another twist in this case. More evidence, it appears, that GSK has been less than honest with the truth. In the Major Depressive Disorder (MDD) trials, GSK claimed 11 subjects attempted suicide. But Healy pointed out that this was incorrect, in reality, 12 people attempted suicide in GSK's MDD trials. When asked if GSK calculated this 12th suicide attempt in any of their analysis, Healy replied,
"Apparently not."
This means that the 6.7% increased risk of suicidal behavior among adults who consume Paxil,
"should be something more like 7.3," noted Healy.
The combined figure, as
reported earlier in this trial, is actually a staggering 8.9%.
After Healy's rebuttal, a defeated Todd Davis from King & Spalding asked the judge to strike the testimony of Healy. The Honorable Judge Hart replied,
"the motion to strike is denied."
Closing arguments from both plaintiff and defendant start next week.
