Hardy 11 - Suspect, The (23 page)

He'd been sure it was a woman's voice on the answering machine when he'd been packing, so it must have been Gina. Which meant there may have been a development. He considered it for a few seconds, and decided it probably wouldn't be profitable to talk to her in person, plus he was all argued out with his daughter, so he called his own home number to get the message Gina must have left.

But it wasn't Gina.

"Hello, this is Kelley Gray Rusnak from PII calling for Stuart. Stuart, I don't know if you remember me, but I was Caryn's lab assistant down here. You and I met a couple of times. I see what they're saying in the papers about you and Caryn, but you know I've read all your books and I just don't believe you're the kind of person who could hurt someone, especially Caryn. And I don't know, maybe you're already in jail, but I haven't heard that on the news yet and I probably would have, so I thought I'd try to reach you at your home number. I think maybe there's something you should know about that's been going on here, that Caryn was kind of worried about..."

19

The PII corporate offices and laboratories
were located in the industrial flats, pocked by low-rise development, near the San Francisco airport. Kelley Rusnak seemed relieved to hear back from Stuart, but didn't want to talk about it on the telephone. Stuart convinced her to take some time off and meet him in half an hour at the Hungry Hunter, a steak house just off the freeway in San Bruno, perhaps ten minutes from where she worked.

The cab of the truck had cooled to mere lava, but Stuart barely noticed. Kicking himself for not having answered the phone in his house, when Kelley's information, whatever it was, might have done him some good in his discussions with Fred Furth or even Juhle, he was obviously speeding as he flew past a Palo Alto city police car waiting at the front of a line at a red light on El Camino. Slamming on his brakes, then jamming down a couple of gears, his eyes were glued to the rearview as the cop turned in behind him and lit up his red flashers.

A murder suspect driving a vehicle with a stolen license plate, carrying a loaded gun in the cab, Stuart put on his blinker and began to pull over. But the patrol car swung left around him. As it passed, the officer in the passenger seat wagged a finger at Stuart, but evidently they'd gotten a call to some event that trumped his traffic stop. Raising his own hand, acknowledging the warning with a wary smile, Stuart continued on the El Camino for another block before turning off the main thoroughfare into a side street—any side street. With his stomach churning and his head gone light with the close call, he wound his way through a neighborhood of mostly brand-new mansions, to the freeway entrance.

He was at the Hungry Hunter parking lot fifteen minutes later. It was past lunchtime now, and still an hour or more before happy hour was to begin, so there was no problem with parking. Stuart was rolling up his driver's side window when a knock on the other window almost made him jump. When he'd gotten Kelley’s message, and even when he'd talked to her and set up this meeting, he hadn't been completely sure which of Caryn's lab colleagues Kelley was. But now, reaching over and unlocking the door, he recognized her right away.

She was an inch on either side of five feet tall, probably in her mid-thirties, with shoulder-length black hair and a faintly cherubic face, unadorned by makeup of any kind, even lipstick. "Do you mind if we just talk out here in your cab?" Although she'd already climbed in and closed the door behind her. Turning to face him, she let out an anxious breath, tried a mostly unsuccessful smile and said, "Hi."

"Hi. How are you doing?"

"I'm a little nervous, to tell you the truth."

"What about? Coming to see me?"

"Not just that, but that, too, yes. Driving over here, I even thought somebody might have been following me. They passed by and went on the freeway, but still. . ."

"Why would somebody be following you?"

"No reason, really. And they probably weren't. But things have been so weird lately, and then with Caryn . . . I'm so sorry about her. She was really . . . really special. I still can't believe it."

"I'm having some troubles with that myself." Stuart turned and looked around behind them, out over the parking lot. "Well, Kelley, we seem to be the only ones out here. If you want, we could go someplace else, or just drive. Whatever you want."

She shook her head. "No. I'm sure this is all right. I'm just being paranoid." A quick smile. "Which of course doesn't mean that they're not after me."

"Who would be after you?"

"Well... I guess whoever might have been after Caryn."

"We're talking concerns about the Dryden Socket, right?"

She nodded.

Stuart took a beat, then rolled his window down again and rested his hands on the bottom of the steering wheel. "Just before I called you, I was visiting with Frederick Furth down in Palo Alto," he said. "You know him?"

"By name, sure. He was Caryn's go-to guy for the money stuff."

"Right. He told me that Caryn was just having some last-minute jitters, that's all. It was nothing serious. You don't agree with that?"

"Not even a little bit. That's just not true. She was going to try to stop them from going into full production if she could. At least that's what she told me last week."

"But why, Kelley? Furth told me about the problems that didn't make it into the clinical studies, okay, but—"

"Those weren't 'problems,' Stuart. They were deaths."

"Right. Furth acknowledged that. He wasn't trying to hide anything that I could see. He said you're always going to get a certain percentage of deaths in any major surgeries like these from various complications. Post-op clots. That kind of thing."

"Right. A certain percentage. Did he happen to tell you what that percentage was?"

"He said about one in a hundred. Which is what's coming back from these clinical trials. I think he said they've had six deaths in six hundred surgeries, something like that, which is right in the pocket for this kind of surgery in general."

She was looking at him in disbelief. "He told you one in a hundred? He's off by a factor of five."

"How could that be? I mean, all this stuff is published, isn't it? It's public record."

"Right. And so far—so far—it's true they've had those six confirmed deaths that have been in the first published studies, the ones that came in just a little too late. I suppose you've heard about that since that's what all the fuss has been about. The late reports. Except what Mr. Furth left out is that these aren't the only studies reporting fatalities. They're just the only ones that have been vetted and published so far."

"And Caryn knew about others?"

"Of course. She's the inventor. She wanted to see the earliest drafts. Which evidently they tried to keep from her too. And pretty successfully."

"Who did?"

"Furth. The money people. And of course Bill Blair. Our CEO? Once we pulled through the first round of clinical trials, they were all gung ho for full production, but Caryn had gotten some calls from docs she knew that had had problems. She even had a couple of her own patients show some disturbing signs. And it worried her."

Some of these details rang with a distant familiarity in Stuart's mind. He was sure that Caryn had mentioned some of this to him back when she was first starting to test her new socket, her concerns about every aspect of the product. But he hadn't paid very close attention.

Caryn was all about problems and their solutions. She was the original girl who cried wolf—everything was a crisis, a problem, a challenge. Their daughter wouldn't eat dinner one night and Caryn would harangue his ear off about how Kym was borderline anorexic or bulimic. If a patient had a rough night's sleep after surgery—and almost all of them did—Caryn would worry it to death. Until finally Stuart, feeling it was out of self-defense, just finally shut her off. He couldn't listen to any more "what ifs." She'd talk and talk, one critical topic—money, the state of health care, polymer chemistry, her patients, Kymberly—flowing seamlessly into the next, and each one fraught with danger, possible failure, alternatives to consider.

Exhausting. Constant and exhausting.

Until he was left nodding, pitching in with the occasional "Uh-huh."

But now, sitting here with Kelley, he realized that many of the things that engrossed Caryn might in fact have been damned interesting, even compelling. Certainly, the details surrounding the Dryden Socket were fascinating—and incredibly important—to him right now at this moment. But back when it had been a part of Caryn's daily existence he had been tuned out, deaf to the songs that gave meaning to his wife's life.

It had not all been her shutting him out, at least not at the beginning. He'd been equally complicit, perhaps more so, in the dissolution of their intimacy. The thought hit him, suddenly and unexpectedly, in a wave of regret and loss and brought him up short, his hand suddenly at his forehead as though pressing away a migraine.

"Stuart? Are you all right?"

He nodded at her. "I'm sorry. My mind just went out. Where were we?"

"Clotting," Kelley said. "Hypercoagulability."

"Sure," Stuart said, "I was going to say that."

"You're teasing, but it's a real thing. It's what Caryn was trying to fix."

"Could a layperson understand it if he wanted to explain it to his lawyer, for example?"

"I think so. You know that the basic problem Caryn set for herself was to find a plastic for the cup-side of the hip that didn't degrade, right?"

"Generally, yes."

"Okay, so she knows polymer chemistry inside out. She discovers this one particular type of high-density polyethylene—"

"Whoa, Kelley. We're dumbing it down, okay?"

An impatient pout, then Kelley continued. "High-density polyethylene
is
dumbed down, I'm afraid. You don't want to hear the technical name. Bottom line is she found a plastic that worked in animal trials. As you know."

"What wasn't working before?" Stuart asked.

"The basic problem? Some people, Caryn included, believed that the industry standard plastic was the proximate cause of even the one percent of blood clots. And even worse, over time the plastic elutes a chemical—"

"It does what?"

"Elutes. Produces. A chemical that dramatically increases coagulation in some people. It's called 'small particle disease'—there's a layman's term for you—and it's often fatal."

"And that's what Caryn was trying to avoid?"

"Right. She thought, or hoped anyway, that she could drastically reduce that one percent clotting number, maybe down to one in a thousand cases, or less. So I think it's important to understand that even if Mr. Furth was correct on the fatality number he gave you, and he's not, the Dryden Socket at one percent failure was no improvement over what we've been doing for years. And in fact, Caryn was most of the way to convinced that it was worse."

"How much worse?"

Kelley bit at her lower lip and took in a deep breath. "Maybe a lot. Maybe as much as five percent. Those are the preliminary figures from studies that aren't completed yet. Five in a hundred deaths."

"From the same thing? Small particle disease?"

"No. In fact, we've done several coagulation cascades and this is kind of the opposite, where we're seeing the creation of multinucleated giant cells which, essentially, become osteoclasts that eat bone."

"Eat bone? Not good, I'm guessing."

"It is bad. It's going to be much worse, though, if PII goes into full production."

"But if they know this, why would they go ahead with it? I mean, they've got to realize that they're looking at lawsuits forever. They'd be killing themselves."

"Not if they could get the problem fixed soon enough. They could take orders, start some cash flow going, have the delay later in the process rather than sooner. Caryn was already working on it, narrowing down some other options ..."

"Another plastic?"

"Right. And pretty sure she was on the right track. She told me she thought we had a good chance to solve the problem in two years, maybe less. But it's a time and money game with PII. They're evidently strapped pretty badly right now, and if there's more delay before the FDA gives them a green light. . ."

"I know about that. At least I know that Caryn put up a lot of short-term money ..." Stuart, struck with another insight, drummed his hands on the steering wheel. "Which would mean that at the time she did the mezzanine loan, she must have believed PII was going into production pretty soon, right? And was okay with it."

"But she wasn't okay with it. I know she wasn't." A silence settled in the cab. Finally Kelley said, "Look. She thought the money she gave them was to buy time for her research. That was her clear understanding. Except then she found out they weren't reporting the negative studies and planned to go ahead anyway."

"And when did she find that out?"

"I'm not sure exactly, but recently. Certainly by last week. She was down here, I think it was on Wednesday, and had evidently just gotten word from Mr. Furth that the FDA was days or weeks away from approval, and she was having a fit about it. She went into Mr. Blair's office and he told her that the deaths had occurred after the study was completed and therefore they shouldn't technically affect the FDA's ruling, which was going to send PII stock through the roof. And meanwhile she should just keep up her work on the next generation."