Lethal Remedy (11 page)

"Jandra Pharmaceuticals, how may I direct your call?" The voice was cheery, but the inflection told Sara that this was a message the woman repeated a hundred times a day.

"This is a doctor in Dallas, calling about one of your new drugs. Is there someone there who can give me some details about Jandramycin?"

There was a moment's silence. "I'm sorry. I don't believe we have a drug by that name. Are you sure?"

Sara shrugged to relieve the tension that had become a permanent fixture in her shoulder muscles. "I'm sure. Jandra Pharmaceuticals, Jandramycin. Think about it." She decided on a different tack. "Who's your public relations manager?"

"That would be Mr. Olson, but he's on vacation."

Sara waited, but apparently that was as much help as she was going to get. "Okay, your director of research?"

"That would be Dr. Wolfe. Would you like me to ring him?" "Please."

If she says, "Have a good day," I'll scream.
Just before the telltale buzz of a phone ringing, Sara heard "Have a good—" and gritted her teeth. It apparently wasn't going to take much to get on her nerves today. But if she wanted to coax any information out of this Wolfe guy, she'd better be on her best behavior.

"Bob Wolfe." The voice was a deep baritone, the accent definitely East Coast.

"Mr. Wolfe, this is—"

"Dr. Wolfe. I'm a Pharm D."

"I'm terribly sorry. Yes, the operator did give me your title. I apologize."

"No problem. Who's this?"

"This is Dr. Sara Miles. I'm on the internal medicine faculty of the Southwestern Medical Center in Dallas. I have a question about Jandramycin."

This time the pause was long enough that Sara thought she'd been disconnected. Finally, Wolfe said, "If you're at Southwestern, I'd suggest you talk with our principal investigator, Dr. Ingersoll. He's on the faculty there, too. Would you like his number?"

I've got his number. I know more about him than you ever will, you self-important—"
I know Dr. Ingersoll, and one of my patients is in his study. That's why I'm calling. She's developed what I believe is a late complication from Jandramycin, but Jack . . . Dr. Ingersoll won't accept that possibility. I need to know if there's anything in the basic research that would suggest an association with—"

"Stop. I don't want to hear about this. Dr. Ingersoll is in charge of the project, and if he doesn't think your patient's problem is related to Jandramycin, the matter's closed."

"You mean—"

"Listen, Dr. Miles, if that's really your name. How do I know you're not from one of our rival companies, sniffing around for dirt so you can sabotage our new drug application? What you're asking for is proprietary information. And you're not going to get it."

There was a loud click.
Why that self-important, self-centered, pompous—
Sara took a deep breath and blew it out slowly through pursed lips.
Who says Lamaze training can't be useful except in labor?
The phone in her hand came to life, and she heard a familiar female voice. "Jandra Pharmaceuticals. How may I direct your call?"

"I think I was disconnected."

"To whom were you speaking? I'll be glad to ring them back."

"Never mind. This time, would you ring your CEO or COO or whoever's in charge there?"

"That would be Dr. Patel. I'll ring his office. Please hold." This time Sara said it before the operator could get it out. "Thanks. And have a nice day."

Rip Pearson knew this was one of the most-feared situations faced by health care professionals, and he worked hard to keep his voice low and his manner calm. "John, this isn't the end of the world. I've seen this scenario dozens of times, and the odds are so overwhelmingly against your getting infected in any way—"

"I know, I know." John Ramsey squirmed on the edge of the treatment table. "But it makes me so angry that someone, a health care professional, could dispose of a needle and syringe in such an unsafe manner. Besides, it's not even one of the safety units they're supposed to use, the ones you can recap with one hand after using them."

"What makes you think it was one of the staffthat did this? You said yourself this wasn't one of the safety syringes we use here. If it were, we wouldn't be having this conversation. This was most likely a patient, probably a drug user. They had the syringe in their purse or their pocket and saw a chance to get rid of it. The cap came offwhen they dumped it, and it sat there just waiting to bite you."

"Okay. I'll stop fuming over something I can't change. Now what do I do?"

"Have you had hepatitis immunizations?"

"Aren't we going to talk about HIV exposure?"

Rip made a calming gesture. "We'll get to that, but your chances of getting HIV from a needle stick like this are less than 1 percent. What we worry about most is hepatitis, especially Hep B. Have you been immunized?"

"Yeah, the full series."

"Tetanus?"

"Current on that, too."

"There's the possibility of bacterial infection at the wound site, but we don't usually give prophylactic antibiotics for that. We'll just watch."

John leaned forward a bit. "And last, but certainly not least?"

"As I said, HIV isn't much of a risk. As you know, we can't do any kind of meaningful test on the needle or syringe, and we can't HIV test the person who used them last. I'd call this a class 2 or 3 exposure. We'll draw a baseline blood test and retest you periodically. You'll need to be on the standard twodrug regimen for at least a month. The odds are overwhelming that you'll be fine."

John didn't seem to relax despite the reassurance. That would probably take a while. He struggled with what was probably meant to be a smile. "Thanks for coming over so quickly, Rip. I appreciate it."

"Glad to do it. I'm sorry that Dr. Ingersoll wasn't available. We generally like for a senior faculty member to take care of situations like this that involve our staff."

"Actually, I'm glad it's you. I trust you. I'm not sure I can say the same about Jack Ingersoll."

He'd wondered how long it would take for questions to arise. Nothing is perfect, certainly not in medicine. He'd heard it all his life. "When something's too good to be true, it isn't." There wasn't a drug in the world that worked all the time with no potential for side effects. Penicillin had been a fantastic leap forward after Fleming made the accidental discovery in 1928. But now 2 percent of the people in the U.S. were allergic to this wonder drug, risking reactions that ranged from an uncomfortable rash to a violent death. Aspirin had been in use for over one hundred years, providing relief of mild to moderate pain. But over 5 percent of the population couldn't take it because of sensitivity or ill effects that ranged from minor to fatal. Nothing, however benign it might appear, was perfect. The same was true for Jandramycin.

What he'd told the board of Darlington was true—sort of. Jandramycin had problems, and when they came out, Jandra Pharmaceuticals would go in the tank. But he'd known all along it wouldn't be necessary for him to leak the information. The questions would be asked, and someone would eventually ferret out the truth. Of course, if that didn't happen, he was still sitting pretty on the inside of a multi-billion-dollar enterprise with four million untraceable dollars. If it did, that amount swelled to ten million. Not just a golden parachute—more like platinum or diamond. Enough to let him live for the rest of his life in comfort in a place he'd already picked out.

For now, all he had to do was sit back and let matters take their course. And he was prepared to do just that.

John couldn't hear the ring of his cell phone over the buzz of conversation and clatter of trays in the medical center's food court, but the vibration finally caught his attention. "Dr. Ramsey."

"This is Mark. What's up?"

John Ramsey picked up his venti mocha in his free hand and said, "Let me move outside. I can't hear myself think in here." He walked quickly into the hallway and from there outside into the courtyard. He settled onto an unoccupied bench in a quiet corner. "Better. Can you hear me okay?"

"Loud and clear," Mark said.

John brought him up to date, feeling the lump in his throat grow larger as he worked through the details. His malpractice insurance was no longer in force. It was unlikely that the medical school would protect him from any suit. "And now I've been served with the papers. Can I get you to look at them? Maybe I can buy you dinner tonight?"

"Um, well—" Mark's hesitation told John all he needed to know.

"That's okay. Obviously you have something planned for tonight."

"Actually, I have a meeting at the medical center at five, but I don't know how long it's going to last. Why don't I call you after that?"

John finished his coffee and tossed the cup in a nearby waste container. "That's fine." He rose and began to move slowly back toward the entrance. "What kind of a meeting do you have, if you don't mind my asking?"

"It's about—" John could almost see the gears turning in Mark's head. "You know, you might want to be there as well. Here's the deal."