Press Box

Blood Money?

The Los Angeles Times’ flawed masterpiece about corruption at NIH.

Tainted tour de force

Not many newspaper stories can boast that they were five years in the making, and fewer still can claim that they were worth the wait. But David Willman’s meticulously researched 11,700-word feature, “Stealth Merger: Drug Companies and Government Medical Research,” in the Sunday, Dec. 7, Los Angeles Times is that brilliant exception.

The Times began chewing on a story in 1998 about the appalling—but perfectly legal—financial ties between some National Institutes of Health scientists and the pharmaceutical companies with which the NIH collaborates on experimental drugs. Willman draws on countless interviews, thousands of pages of NIH financial-disclosure reports, memos, e-mails, company reports, and SEC and FDA filings, as well as state and federal legal actions to document how highly paid NIH senior scientists have earned hundreds of thousands of dollars in fees and stock options from drug companies in recent years. One researcher, Dr. Ronald N. Germain, “has collected more than $1.4 million in company consulting fees in the last 11 years, plus stock options,” the Times reports.

What’s more, the freelancing that’s perfectly legal today at NIH was unthinkable two decades ago, and new financial disclosure rules make it almost impossible to scrutinize the outside work done by NIH scientists. (See this Willman sidebar.) The medical ethicists interviewed by the Times ask, quite logically: Are these NIH scientists working for the NIH, whose mission is medical knowledge, or the pharmaceutical companies, whose primary goal is profit? Can these double-dippers be trusted not to design, execute, and interpret their studies to the benefit their benefactors? Will they sell out their patients’ safety to advance the drug companies’ interests?

Willman’s brilliant muckrakings are sure to prompt the beheadings of an NIH director or two. And the rhetorical pageantry of a congressional investigation about conflict of interest at NIH can not be far away. Here’s my “but” clause: Willman undercuts his considerable accomplishment with an opening (and a conclusion) that is as sensational as anything you’d read in an “if it bleeds, it leads” tabloid. In staccato fashion, Willman describes the 1999 death of “Subject No. 4” at the NIH research clinic as if it’s a contemporary version of the Tuskegee Experiment. He writes:

The cause of [Subject No. 4’s] death was clear: a complication from an experimental treatment for kidney inflammation using a drug made by a German company, Schering AG.Among the first to be notified was Dr. Stephen I. Katz, the senior NIH official whose institute conducted the study.Unbeknown to the participants, Katz also was a paid consultant to Schering AG.Katz and his institute staff could have responded to the death by stopping the study immediately. They also could have moved swiftly to warn doctors outside the NIH who were prescribing the drug for similar disorders. Either step might have threatened the market potential for Schering AG’s drug. They did neither.

Willman doesn’t come out and say that Dr. Katz killed Subject No. 4 or deliberately put other kidney patients at dire risk because a drug manufacturer gave him money. He doesn’t have to. As newspaper attorneys advise reporters every day, no plaintiff will ever defeat you in libel court if you make sure to write your copy in such a way that the reader arrives at the damaging assessment on his own instead of from your precise words.

Did Dr. Katz knowingly and deliberately place kidney patients in danger for financial gain? The story doesn’t say so explicitly, but the context of the early paragraphs surely encourages readers to think in that direction. You have to read 2,600 words beyond the lede before you’re offered Katz’s self-defense: “Katz said that he did not know at the time that Schering AG was the maker of the drug his institute was testing.” In another thousand words or so, Katz elaborates that when he signed an official NIH “recusal,” vowing not to work on any NIH project involving his benefactor Schering AG, he did so not knowing that Berlex Laboratories, the maker of the experimental kidney drug, was owned by Schering.

Now, Katz might be artfully covering his tracks with selective recollection, and I might be cutting him too much slack, but there’s not even an unsmoking gun connecting the Schering money and Subject No. 4’s tragic death. In fact, Willman notes just 50 words from the story’s end that an internal review absolved the institute from responsibility for the death and that Katz is not mentioned in the wrongful-death lawsuit against the government filed by Subject No. 4’s husband.

Reading and rereading the last thousand words of Willman’s story, I get the feeling that he wants us to believe that a compromised Katz and NIH did something wrong—perhaps committed some sin of silence or scientific suppression or cover-up—by not more vocally and aggressively publicizing the dangers of the experimental drug. But because Willman doesn’t actually express that sentiment, choosing instead to furtively prod the reader in that direction with his presentation, he taints his investigative tour de force. Readers expect much, much more from stories that were five years in the making.


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