Merck also had a high-tech surveillance system in place in the medical community where doctors, many with financial ties to Merck, would contact the company whenever they heard criticism. A July 21, 2000, memo reads: "Communication from advocate regarding a program given by Dr. Singh... It was hyper-inflammatory."
A July 2000 document shows that Merck even knew about the cartoon he used in his lectures and reads: "Received reports that Dr. Singh showed a cartoon of a character hiding under a blanket and asked the audience to speculate about what it is that Merck is trying to hide."
Other documents show sales reps were gathering information as they made their rounds to doctors' offices and would use voicemail to relay the data to Merck's National Service Center. A July 26, 2000 memo reads: "NSC report that at nine meetings in the L.A. area over the last three days, Singh presented sessions that were very unfavorable to Vioxx."
Around this same time, Dr Singh made his concerns about Vioxx known to one of Merck's largest Vioxx buyers, the Department of Veterans Affairs. Reportedly it was at this point that Dr Sherwood elevated himself to the director of damage control and a detailed report began to compiled on Dr Singh's activities with nearly a dozen Merck executives involved.
An October 4, 2000 memo, by a senior regional executive states: "I have in excess of 80 e-mails pertaining to interactions with Dr. Singh from March 1999 to present. The following is my best recollection of what has happened. Because of the sensitive nature of the following, I strongly encourage you not to share with anyone unless they clearly have a need to know."
Less than a month later, Dr Sherwood called Dr Singh's boss at Stanford University, Dr James Fries.
"I don't usually receive phone calls on a Saturday at home from representatives of drug companies," Dr Fries said during an interview with National Public Radio, of a call he received from Dr Sherwood on October 28, 2000. "So it was definitely unusual," he said.
Dr Fries told NPR he received a call "stating that someone on my staff had been making wild and irresponsible public statements about the cardiovascular side effects of Vioxx."
According to Dr Fries, Dr Sherwood hinted there would be repercussions for Stanford if Dr Singh did not stop making negative statements about Vioxx and he was left with the impression that Merck's financial support to Stanford University was at risk.
Back at Merck, on November 17, 2000, apparently believing his efforts were successful, Dr Sherwood wrote an email to the marketing department that said: "Fries and I discussed getting Singh to stop making the outrageous comments he has in the past few months... I will keep the pressure on and get others at Stanford to help."
In another email, he specifically directed one Merck executive to pressure Dr Singh himself: "Tell Singh that we've told his boss about his Merck-bashing," he wrote. And tell him, "should it continue, further actions will be necessary (don't define it.)," he said.
However, after speaking to Dr Sherwood, Dr Fries told NPR he started making calls of his own and learned that Dr Sherwood had called 7 other institutions, including the University of Minnesota, the University of Texas Southwestern and a Harvard teaching hospital, where researchers had raised concerns about the safety of Vioxx.
After Dr Fries learned about those calls, he wrote a letter to Merck CEO, Raymond Gilmartin, and questioned the propriety of Dr Sherwood's calls in what Dr Fries referred to as, "a consistent pattern of intimidation of investigators by Merck."
The letter included the warning: "There is a line that you can't go across. ... It had gone over that line."
In response to questions from his boss, on January 23, 2001, Dr Sherwood wrote a memo saying there was no "orchestrated campaign or specific program" to deal with "problem individuals."
But then he went on to discuss how he only gets involved if other Merck department heads are unsuccessful in their attempts to "balance" critics. "I will only get involved when our representatives... regional medical directors, Merck research lab physicians... or key individuals in the therapeutic business group have felt frustrated by their inability to reach out or to 'balance' selected individuals," he wrote.
A July 2000 document shows that Merck even knew about the cartoon he used in his lectures and reads: "Received reports that Dr. Singh showed a cartoon of a character hiding under a blanket and asked the audience to speculate about what it is that Merck is trying to hide."
Other documents show sales reps were gathering information as they made their rounds to doctors' offices and would use voicemail to relay the data to Merck's National Service Center. A July 26, 2000 memo reads: "NSC report that at nine meetings in the L.A. area over the last three days, Singh presented sessions that were very unfavorable to Vioxx."
Around this same time, Dr Singh made his concerns about Vioxx known to one of Merck's largest Vioxx buyers, the Department of Veterans Affairs. Reportedly it was at this point that Dr Sherwood elevated himself to the director of damage control and a detailed report began to compiled on Dr Singh's activities with nearly a dozen Merck executives involved.
Less than a month later, Dr Sherwood called Dr Singh's boss at Stanford University, Dr James Fries.
"I don't usually receive phone calls on a Saturday at home from representatives of drug companies," Dr Fries said during an interview with National Public Radio, of a call he received from Dr Sherwood on October 28, 2000. "So it was definitely unusual," he said.
Dr Fries told NPR he received a call "stating that someone on my staff had been making wild and irresponsible public statements about the cardiovascular side effects of Vioxx."
According to Dr Fries, Dr Sherwood hinted there would be repercussions for Stanford if Dr Singh did not stop making negative statements about Vioxx and he was left with the impression that Merck's financial support to Stanford University was at risk.
Back at Merck, on November 17, 2000, apparently believing his efforts were successful, Dr Sherwood wrote an email to the marketing department that said: "Fries and I discussed getting Singh to stop making the outrageous comments he has in the past few months... I will keep the pressure on and get others at Stanford to help."
In another email, he specifically directed one Merck executive to pressure Dr Singh himself: "Tell Singh that we've told his boss about his Merck-bashing," he wrote. And tell him, "should it continue, further actions will be necessary (don't define it.)," he said.
However, after speaking to Dr Sherwood, Dr Fries told NPR he started making calls of his own and learned that Dr Sherwood had called 7 other institutions, including the University of Minnesota, the University of Texas Southwestern and a Harvard teaching hospital, where researchers had raised concerns about the safety of Vioxx.
After Dr Fries learned about those calls, he wrote a letter to Merck CEO, Raymond Gilmartin, and questioned the propriety of Dr Sherwood's calls in what Dr Fries referred to as, "a consistent pattern of intimidation of investigators by Merck."
The letter included the warning: "There is a line that you can't go across. ... It had gone over that line."
In response to questions from his boss, on January 23, 2001, Dr Sherwood wrote a memo saying there was no "orchestrated campaign or specific program" to deal with "problem individuals."
But then he went on to discuss how he only gets involved if other Merck department heads are unsuccessful in their attempts to "balance" critics. "I will only get involved when our representatives... regional medical directors, Merck research lab physicians... or key individuals in the therapeutic business group have felt frustrated by their inability to reach out or to 'balance' selected individuals," he wrote.
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