Avandia case study: 'He knew it was the drug straight away'

http://www.guardian.co.uk/business/2013/jan/29/avandia-case-study-gsk-pharmaceuticals

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If Sheila Abernethy looks out of her house and down to the bottom of her road in Wallasey, Merseyside, she can see what used to be a rubbish tip. Thanks to her husband, Thomas, it is now a landscaped hill. The retired policeman spent time and energy on good works, including refurbishing an old school for courses to help the unemployed, she says, and her voice breaks. "He didn't deserve to have this happen to him."

Mr Abernethy had type 2 diabetes even before he retired in 1989. It was under control for most of two decades, but when metformin, the standard drug, stopped working so well in 2006, he was put on Avandia. Three months later he was switched to Avandamet, a combination of metformin and Avandia. The drug, his wife believes, caused his death from heart failure after three long years of miserable and debilitating illness, when he was unable to lie down and had to spend his days and nights on oxygen in a chair.

"I feel angry because he was a good man," she said. "He'd done a lot for the community. He was so happy and cheerful – he always had a smile on his face. The nurses loved him. He made everybody laugh no matter what pain he was in."

Within weeks of starting on Avandia, she and her daughter noticed how swollen his ankles had become. "Before he started that tablet, you could put two fingers around his ankle," she said.

In March 2007, when they were heading to the doctor's because he felt so bad, he collapsed in the hallway. She sent for an ambulance. He could not breathe. He had all the signs of heart failure. An echo scan in May showed he had a right-sided ventricular heart failure, which was not treatable. "They said there was nothing they could do," said his wife. In July 2007, a family member saw the newspaper headlines. Avandia had been linked to heart failure in the US. "I got the paper and read it and knew it was the tablet he was on. He said I'm not taking it any more – make me an appointment with the doctor."

But it was too late, the damage had been done. By Christmas, his wife said he was carrying two stone of fluid. "He couldn't even stand up. He had a chair at the side of his bed and he slept and ate in the chair for three years."

In August 2009, Mr Abernethy died, aged 71, convinced that Avandia had caused his death. "My husband knew it was the drug straight away. He said nothing can become of this while I'm alive, but if anything comes of it when I'm not here, you have got to do something about it," said his wife.

But taking action against a pharmaceutical company is not an easy task in the UK. In the US, there is always big money at stake. If a case goes to court, a company knows it could face not only paying compensation for the pain and suffering of the person who was harmed or their bereaved relatives, but it could also face hefty fines for misconduct. Payouts can hit millions of dollars. The stakes are very high and drug companies may choose to settle out of court rather than take that risk.

That certainly appears to be the case with GlaxoSmithKline, makers of Avandia. The company has never admitted liability and maintains it acted responsibly – while at the same time suggesting its business practices are not what they were then.

The first cases against Merck over the painkiller Vioxx, which was found to increase fatal heart attacks and strokes dramatically, resulted in major damages paid out by the company. A jury in Texas awarded $235m (£149m) to a woman whose husband died after taking the drug – although some of the award was later overturned. Merck won 11 of the 16 first group actions, but decided it was wiser to settle other claims without admitting fault. There are still hundreds of UK claimants who have no compensation eight years after problems with Vioxx became public.

Mrs Abernethy says she does not care about money and that her husband's legacy is his charitable work. But he wanted her to pursue the company and so, even though she says she cannot move on until it is settled, she has instructed Manchester-based Express solicitors. It is worth it, she said, "as long as it stops somebody else going through what I and my family have been through".