The Trial (12 page)

39

Ryan and Sara were in their bedroom on the second floor of the house when it happened. An explosion rocked them from sleep. Ryan rushed to their window and found his Corvette in flames. He glanced to the street to see a large, dark vehicle pull away. The lights were out, but it looked like a Lincoln. Ryan called 911 and then ran downstairs, followed closely by Sara. He stepped out the front door, sized up the flames, and knew he could do nothing but wait for the fire department. Other neighbors started coming out of their houses, wondering what had happened. Ryan had no explanation. Then a neighbor pointed to his front window. The glass was broken. Ryan studied it and then went into the house, where he found a note tied to a rock. A crude way to send a message, he thought. The note read
Get with the Exxacia program or this will be just the beginning.

After the firemen and police left, Ryan went to the phone and dialed Boatwright’s home number. Boatwright glanced at the caller ID as he picked up his phone. “Sinclair, why are you calling me in the middle of the night?”

“Boatwright, you son of a bitch!” Ryan yelled into the phone. “My car was just bombed in my driveway, and the bastards left a note about Exxacia. Other than my team, you’re the only one who knows my opinion. You’ve cut a deal with Kingsbury, haven’t you?”

“I, I don’t know what you’re talking about,” Boatwright stuttered. “Have you been drinking?”

“How much is Kingsbury paying you to get his drug approved?”

“You’re mad, Sinclair, stark raving mad,” Boatwright replied, finally mustering the strength to yell back at his accuser.

“Hear me out, Boatwright. I didn’t tell the police my suspicions before, but I’ll be on the phone with them first thing in the morning. It’s got to be you or Kingsbury, probably Kingsbury since you wouldn’t have the guts to do something like this, but that doesn’t mean you didn’t know it was coming.”

Before Boatwright could reply, Ryan hung up.

*   *   *

Boatwright listened to the dial tone for a few seconds as he considered what to do. Then he retrieved his cell phone and stepped out into the backyard, where he called Kingsbury. After he relayed the conversation, he continued, “I didn’t have anything to do with the bombing, and I don’t even want to know if you did, but—”

“Boatwright, I can assure you I had nothing to do with it either,” Kingsbury interrupted. “The cops can sniff around all they want and they’ll never tie me to it. Trust me on that. Good night, Roger.”

“Wait, wait, Alfred, one more thing. That wire transfer. Is it secure? I mean, can anyone ever find out about it?”

“Perfectly secure, Roger. You can relax. I’ll see you at the committee hearing.”

*   *   *

Sara poured Ryan coffee and sat beside him at the kitchen table. “Ryan, quit the FDA. We don’t need this in our lives, and we don’t need the money. Look at me. I’m pregnant with our first child. Little Max needs a father,” she pleaded as her eyes filled with tears.

Ryan stirred his coffee as he thought. “I’m not a hero, Sara, but I’m not a quitter either. You know that. I still intend to derail this drug. It’s going to kill people. I’m just not sure how or when. Meantime, I want you to move in with my dad and mom.”

Sara took both of Ryan’s hands in hers and looked into his eyes. “Let it go for now. Pick another day for your fight. Boatwright is going to push it through committee anyway. Maybe you ought to go to Senator Grassley. He’s on the Senate drug oversight committee. Once you’ve gone public and have Grassley behind you, Kingsbury will back off.”

“I’ll think about it. There’ll be a way,” Ryan said. Then he kissed his wife and led her to bed.

40

In San Marcos, Luke’s phone rang. “Mr. Vaughan? I mean Luke. This is Brad. Can I drop by for a few minutes this morning?”

“Sure, Brad. Come on over. I’ll put on another pot of coffee.”

Ten minutes later Luke saw Brad climb out of his pickup, dressed in a T-shirt, jeans, and boots, and stride up the sidewalk. Luke met him at the top of the steps.

“Morning, Brad. What brings you over? You get a speeding ticket?”

“No, sir. Got my last one four years ago. Can we go into your office?”

Luke nodded, noting Brad’s solemn manner, and opened the door. When they were seated at the coffee table by the fireplace, Luke tried again. “Brad, I can tell you’ve got some problem. Spill it.”

“Sir, it’s not about me. It’s Samantha. She’s started going to bed around eight, and even after twelve hours’ sleep, she’s sleeping through her first class. I’m worried about her.”

Luke squeezed his hands together as he thought. “Now that you mention it, lately, when she comes over here to work, she’s not as efficient as she was. In fact, she’s almost listless. She claims she’s just been up studying.”

“I’m sure that’s true, sir, but I think there’s something else going on. I’ve tried to get her to talk, and she just says she’s got some bug and she’ll get over it. Only it’s been going on for three or four weeks.”

Luke frowned. “Thanks, Brad. I’ll talk to her this afternoon. I appreciate your concern.”

41

Dr. Kingsbury and two of his associates were already in the conference room when Dr. Boatwright entered. “Good morning, Dr. Boatwright. Beautiful morning, isn’t it? These are my colleagues Dr. Allen and Dr. Escamilla. They did some of the research on Exxacia.”

“Good morning, Dr. Kingsbury,” Boatwright said. “May I have a word in private?”

Kingsbury nodded and followed Boatwright into an adjoining room. Boatwright shut the door. His hands were shaking. He had also developed a nervous twitch in his right eye. He didn’t appear to have slept in days. “Alfred, judging from what happened at Sinclair’s house, it appears the price of poker is going up.”

A look of horror came across Kingsbury’s face. “Surely you don’t still think I had anything to do with that. I was at home with Suzanne. No one else thinks I’m a suspect. Why should you? Maybe you’re the one who did it, Roger.”

“Look, Alfred, I’m desperate. I’m on the Internet every night. I’ve called people all over the world, trying to find something to help Joanne. Finally I’ve located a scientist in Austria who has come up with an experimental treatment for ALS. It’s a two-year program that is going to run well into seven figures.” He paused, then blurted, “I need five million dollars. You get me the money. I’ll get your drug approved. If not, it won’t get past this committee today.”

Kingsbury sized up the situation. He wasn’t sure that Boatwright wasn’t mentally unbalanced at this point. Still, the committee was assembling just outside the door. It was now or never. He would deal with Boatwright another day. “All right, Roger. We’ve got a deal. Payment to be made once the drug is approved and on the market.”

When Kingsbury and Boatwright reentered the conference room, the committee members were starting to drift in from the hall. Kingsbury had studied them on the Internet and knew enough about their backgrounds to comment about each of them or their institution or compliment them on something about their work. Drs. Allen and Escamilla handed each member a packet of journal articles on Exxacia, now showing the lead author of each as a prominent member of the infectious disease community. Each article also had a label, indicating in what distinguished journal they might expect to see it published in the next few months. No one mentioned that the articles had been written by scientists on the Ceventa payroll.

When eight of the eleven members were present, Dr. Salazar, the chairman, asked them to take their seats. The last person to enter the room was Ryan Sinclair, who chose to sit by himself along the wall. As he looked around, he saw the empty chairs at the oval table and studied the members in attendance. He concluded that no one in the room was seriously opposed to approval. Whatever he said was going to fall on deaf ears, particularly since Boatwright would be advocating strongly for the drug—and somewhere in the back of his mind he saw his burning Corvette and the note. As much as he hated to do so, he decided this was not the day to draw a line in the sand.

“Ladies and gentlemen,” Dr. Salazar began, “we last met on this drug a little over a year ago and took Dr. Boatwright’s recommendation to request a large clinical trial. Ceventa agreed to it. You received the summary results last week, and Dr. Kingsbury has been kind enough to join us. Dr. Kingsbury?”

Kingsbury stood at his place. “Thank you, Dr. Salazar. I’m pleased to advise that the clinical trial, one of the largest ever conducted by a pharmaceutical company, has proved just what we anticipated. Exxacia has a remarkable impact on sinusitis, bronchitis, pneumonia, and tonsillitis. It holds distinct promise for a number of other bacterial infections, but we are not seeking approval for those at this time.”

“If I may interrupt, Dr. Kingsbury,” Dr. Rogers from Palo Alto said, “I’ve studied your data very carefully. I can go along with your recommendations on the three respiratory illnesses, but I’ll have to see more trials before I can approve Exxacia for tonsillitis.”

Several other committee members nodded in agreement.

“Dr. Kingsbury,” Dr. Sebastian from Chicago asked, “what about the issues we raised at our last meeting about Exxacia causing problems with the liver and heart?”

Dr. Kingsbury smiled. “I’m glad you asked. There were a few isolated events, but nothing more than with any other antibiotic, right, Dr. Boatwright?”

Boatwright, now calm and professional after taking a Prozac, stood beside Kingsbury and chimed in. “He’s correct, Dr. Sebastian. CDER is prepared to give Exxacia its highest recommendation, and if this committee agrees, an approval letter will go out immediately.”

“I might also add,” Dr. Kingsbury continued, “your notebooks contain postmarket results from a number of countries in Europe and South America.” He neglected to mention that they had omitted such results from a number of other countries where the reports of adverse events were considerably higher.

“I see Dr. Sinclair sitting over there.” Dr. Craig nodded in Ryan’s direction. “I understand he was the review officer in charge of this drug. Do you have anything to add, Dr. Sinclair?”

Ryan remained seated and folded his arms. “No, sir. Dr. Boatwright is in charge of this meeting. I’m just here as an observer.”

“Just a minute, Dr. Sinclair. You’ve lived with this drug for over a year and you’re telling us you have nothing to say. I find that hard to accept.”

“Sorry, Dr. Craig, but Dr. Boatwright is speaking for CDER and the agency.”

Dr. Craig was puzzled about Ryan’s refusal to comment but said nothing further.

“Well, then, Dr. Kingsbury,” Dr. Salazar said, “if you and your assistants will leave the room along with Dr. Boatwright and Dr. Sinclair, the committee will go into executive session.”

The next morning Roger Boatwright posted a letter on the FDA Web site approving Exxacia for sinusitis, bronchitis, and pneumonia. Then he e-mailed Kingsbury and told him he would continue to push for approval for tonsillitis, but that approval would have to wait for another day.

42

Samantha pedaled from her last class to the house. She had to stop three times to get her breath and was sweating when she got home. She entered the front door and heard Luke on the phone talking to a client, so she went into her office and started opening the mail. Luke ended his call, crossed the hall, and took a seat.

“How was school today, Sam?”

“About the same, Dad. I may make a B in French, though.”

“Don’t worry about it. I know you’re pushing yourself. Brad dropped by this morning.”

“Brad? Why?”

“He’s worried about you, Sam. He says that you’ve been sleeping through classes.”

“Brad ought to be minding his own business,” Samantha said.

“Sam, he’s concerned. He’s just trying to do what’s best for you. Is he right?”

Tears filled Samantha’s eyes. “Yes, sir. Dad, I don’t know what’s going on. I’m sleeping all the time. I’m not eating much either because I’m too nauseated.”

“Sam, I don’t quite know how to ask this but directly. Are you pregnant?”

“Dad, of course not. Brad and I aren’t even sexually active.”

Luke nodded his head and looked at his daughter as he thought. “Your face is looking sweaty.”

“Yeah, I just rode home, and it’s pretty warm out there today.”

Luke stepped around the desk and looked more carefully at his daughter. “Sam, I want you to come out in the front yard so I can get a better look at you.”

“Why, Dad? What if the neighbors see us?”

“Just for a minute. Come on.”

Reluctantly, Sam followed Luke down the steps and into the sunlight. Luke took her hands and turned them over so that the underside of her forearms caught the sun.

“Sam, your skin is yellow. Look up at me. I want to see your eyes.” She did as he asked. “The whites are yellowish. How long has that been going on?”

“I don’t know, Dad. A few days, I guess.”

“Okay, come back in the house. I’ve got another question.”

When they were seated in Luke’s office, he asked, “Sam, I may be getting too personal. Forgive me. When you go to the bathroom, what color is your urine?”

“It’s pretty dark.” Sam sighed as she slumped in her chair again.

“I’m taking you to see Clyde Hartman in the morning. He’s the best internist in town, maybe one of the best in this part of the country. And you’re spending the night here, not back at your apartment.”

“Dad, I’ve got homework to do and classes tomorrow.”

“Sam, this is more important. Stay here a minute while I call Clyde. Then you can go up for a nap.”

Cocoa had been listening intently to the conversation. While Luke turned to the phone, she went over to Samantha, whined quietly, and lay down at her feet.

“Yes, ma’am. This is Luke Vaughan. Is Dr. Hartman around?”

Clyde Hartman picked up the phone. “Afternoon, Luke. As far as I know, I’m not getting sued for malpractice. So what can I do for you?”

“Clyde, Sam’s jaundiced. I don’t know if it’s her liver or something else. Can you see her tomorrow?”

“You bet. Don’t worry about an appointment. Just come on over. I’ll work her in.”

Luke thanked the doctor and told Samantha to take a nap. Sam and Cocoa climbed the stairs. It was the next morning before she woke.