1 NO. 90-CI-6033 JEFFERSON CIRCUIT COURT DIVISION ONE (1) 2 3 JOYCE FENTRESS, ET AL. PLAINTIFFS 4 5 VS. DEPOSITION FOR PLAINTIFFS 6 7 SHEA COMMUNICATIONS, ET AL. DEFENDANTS 8 * * * * * * * * * * 9 10 DEPONENT: TOM PIANKO 11 DATE: SEPTEMBER 22, 1993 12 13 * * * * * * * * * * 14 15 16 REPORTER: KATHY NOLD 17 18 KENTUCKIANA REPORTERS SUITE 260 19 730 WEST MAIN STREET LOUISVILLE, KENTUCKY 40202 20 (502) 589-2273 Page 1 1 * * * * * * * * * * 2 3 UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF INDIANA 4 INDIANAPOLIS DIVISION 5 IN RE ELI LILLY AND COMPANY ) Prozac Products Liability ) MDL Docket No. 907 6 Litigation ) 7 * * * * * * * * * * 8 NO. 91-02496-A 9 JACKIE LYNN BIFFLE, ET AL ) IN THE DISTRICT ) COURT OF 10 V. ) DALLAS COUNTY, TEXAS ) 11 ELI LILLY & COMPANY AND ) 14TH JUDICIAL DISTA PRODUCTS COMPANY ) DISTRICT 12 * * * * * * * * * * 13 NO. 92-14775-E 14 RICHARD HAROLD CROSSETT, JR., ) IN THE 15 CHAD H. CROSSETT, AMY MICHELLE ) DISTRICT CROSSETT AND KRISTEN ANN CROSSETT, ) COURT OF 16 INDIVIDUALLY AND AS SURVIVORS OF ) AND ON BEHALF OF THE ESTATE OF ) 17 JOCQUETTA ANN CROSSETT, DECEASED ) ) 18 V. ) DALLAS COUNTY, ) TEXAS 19 ELI LILLY & COMPANY, DISTA ) PRODUCTS COMPANY, TEXAS ) 20 PSYCHIATRIC COMPANY, INC. ) D/B/A/ HCA WILLOW PARK ) 101ST JUDICIAL 21 HOSPITAL, JAMES K. WITSCHY, M.D., ) DISTRICT AND DOUG BELLAMY, ED.D. ) Page 2 1 * * * * * * * * * * 2 NO. A-921,405-C 3 MARIA GUADALUPE REVES ) IN THE 4 INDIVIDUALLY AND AS NEXT ) DISTRICT COURT FRIEND OF GRANT JULIAN REVES ) OF 5 A MINOR CHILD, AND ON BEHALF ) OF THE ESTATE OF CHRISTIAN ) 6 MARIE REVES, DECEASED ) ) ORANGE COUNTY, 7 V. ) TEXAS ) 8 ELI LILLY & COMPANY, DISTA ) PRODUCTS COMPANY, RAVIKUMAR ) 9 KANNEGANTI, M.D., HOSPITAL ) CORPORATION OF AMERICA, A ) 10 TENNESSEE CORPORATION, HEALTH ) SERVICES ACQUISITION CORP., ) 11 A DELAWARE CORPORATION, ) HCA PSYCHIATRIC COMPANY, A ) 12 DELAWARE CORPORATION, TEXAS ) PSYCHIATRIC CO., INC.. A/K/A ) 13 AND/OR D/B/A HCA BEAUMONT ) NEUROLOGICAL HOSPITAL, AND HCA ) 14 HEALTH SERVICES OF TEXAS, INC. ) 128TH JUDICIAL A/K/A AND/OR BEAUMONT ) DISTRICT 15 NEUROLOGICAL HOSPITAL ) 16 * * * * * * * * * * Page 3 1 IN THE UNITED STATES DISTRICT COURT 2 FOR THE WESTERN DISTRICT OF TEXAS SAN ANTONIO DIVISION 3 ELIZABETH T. SANCHEZ, ) 4 INDIVIDUALLY AND AS THE ) SURVIVING SPOUSE, MARGARET R. ) 5 SANCHEZ, INDIVIDUALLY AND NEXT ) OF FRIEND OF DEBRA JEAN ) 6 SANCHEZ, VERONICA MARIE ) SANCHEZ, EDWARDO ESTEBAN ) 7 SANCHEZ, AND MICHAEL ANTHONY ) SANCHEZ, CHILDREN; AND ALL ON ) 8 BEHALF OF THE ESTATE OF ) EDWARDO SANCHEZ ) 9 ) V. ) CIVIL ACTION NO. 10 ) SA93CA367 ELI LILLY AND COMPANY AND ) 11 DISTA PRODUCTS COMPANY ) 12 * * * * * * * * * * 13 IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF TEXAS 14 HOUSTON DIVISION 15 MARIA SANCHEZ, INDIVIDUALLY ) AND AS NEXT FRIEND OF DEBORAH ) 16 SANCHEZ, VERONICA SANCHEZ, ) EDDIE SANCHEZ, AND MICHAEL ) 17 SANCHEZ, AND ON BEHALF OF THE ) ESTATE OF EDUARDO SANCHEZ ) 18 ) V. ) CIVIL ACTION NO. 19 ) H-93-1469 ELI LILLY AND COMPANY AND ) 20 DISTA PRODUCTS COMPANY, A ) DIVISION OF ELI LILLY AND ) 21 COMPANY ) Page 4 1 * * * * * * * * * * 2 STATE OF NEW YORK 3 SUPREME COURT COUNTY OF JEFFERSON 4 _____________________________________________ 5 STEPHANIE CAPONE, AS EXECUTOR OF THE ESTATE OF JOSEPH J. CAPONE, JR., AND 6 STEPHANIE CAPONE, INDIVIDUALL, NOTICE TO TAKE 7 PLAINTIFF, DEPOSITION UPON ORAL EXAMINATION 8 VS. INDEX NO. 93-251 9 ELI LILLY AND COMPANY, DISTA PRODUCTS 10 COMPANY, A DIVISION OF ELI LILLY AND COMPANY, FLOYD BAJJALY, M.D, 11 DEFENDANTS. 12 _____________________________________________ 13 * * * * * * * * * * 14 SUPREME COURT OF TEH STATE OF NEW YORK COUNTY OF ORANGE 15 --------------------------------------X BRUCE R. MALEN AS EXECUTOR OF THE : INDEX NO. 16 ESTATE OF BARBARA E. MALEN, AND OF : 4119/92 BRUCE R. MALEN, INDIVIDUALLY, : 17 : HON. PETER PLAINTIFF : PATSALOS, 18 : J.S.C. -against- : 19 : ELI LILLY & COMPANY, DISTA PRODUCTS : 20 COMPANY, A DIVISION OF ELI LILLY & : COMPANY, BARRY SINGER AND UNITED : 21 HOSPITAL, : : 22 DEFENDANTS. : --------------------------------------X 23 * * * * * * * * * * Page 5 1 ---------------------------------X 2 VALARIE J. FRIEDMAN AND DAVID : SUPERIOR COURT FRIEDMAN, HER HUSBAND, : OF NEW JERSEY 3 : LAW DIVISION: PLAINTIFF, : MIDDLESEX COUNTY 4 : DOCKET NO. : L-3191-91 5 VS. : : 6 ELI LILLY & COMPANY; DISTA : PRODUCTS INC, A DIVISION OF : 7 ELI LILLY & COMPANY; LISS : PHARMACY; MADISON PHARMACY AND : 8 JOHN DOES NOS. 1-25 (UNKNOWN : ENTITIES), : 9 : DEFENDANTS. : 10 ---------------------------------X 11 * * * * * * * * * * 12 SUPREME COURT OF THE STAET OF NEW YORK COUNTY OF SUFFOLK 13 -------------------------------------x 14 RHOMDA L. HALA and JOSEPH L. HALA, : 15 Plaintiffs, : Index No. 14869/90 16 - against - : 17 ELI LILLY & COMPANY and DISTA : PRODUCTS COMPANY, a DIVISION OF 18 ELI LILLY & COMPANY : 19 Defendants. : -------------------------------------x 20 21 * * * * * * * * * * Page 6 1 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS 2 COUNTY DEPARTMENT, LAW DIVISION 3 PATRICIA BRACH, ) ) 4 Plaintiff ) ) 5 v. )No. 92 L 13369 ) 6 ELI LILLY AND COMPANY, a foreign ) corporation; ALAN N. MILLER, M.D., ) 7 WILLIAM BRUINSMA, Psy.D., and ) CONDELL MEMORIAL HOSPITAL, ) 8 ) Defendants. ) 9 * * * * * * * * * * 10 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS 11 COUNTY DEPARTMENT - LAW DIVISION 12 RENATO DI SILVESTRO, Individually ) and as Special Administrator of ) 13 the Estate of JOHN DI SILVESTRO, ) Deceased, ) 14 ) Plaintiff, ) 15 ) v. ) No. 91 L 7881 16 ) ROBERT L. NELSON, et al., ) 17 ) Defendants, ) 18 ) GEORGE MELNICK, M.D. and PETER ) 19 FINK, M.D. ) ) 20 Respondents in Discovery.) 21 * * * * * * * * * * Page 7 1 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS 2 COUNTY DEPARTMENT, LAW DIVISION 3 JOAN M. GRYER, ) ) 4 Plaintiff, ) ) 5 v. ) No. 92 L 7387 ) 6 ELI LILLY AND COMPANY, et al., ) ) 7 Defendants. ) 8 * * * * * * * * * * 9 IN THE CIRCUIT COURT OF COOK COUNTY, ILLINOIS 10 COUNTY DEPARTMENT, LAW DIVISION 11 JENNIFER HAMMERLI, as Plenary ) Guardian of the Estate of RAY B. ) 12 HAMMERLI, a disabled person, ) ) 13 Plaintiff, ) ) 14 v. ) No. 92 L 2365 ) 15 ELI LILLY AND COMPANY, THE ) UPJOHN COMPANY, DICKIE KAY, M.D., ) 16 (former Respondent in Discovery), ) and RICHARD CZECHOWICZ (former ) 17 Respondent in Discovery), ) ) 18 Defendants. ) 19 * * * * * * * * * * Page 8 1 IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT 2 CHAMPAIGN COUNTY, ILLINOIS 3 LINDA GARDNER, Individually and ) as Special Administrator of ) 4 the Estate of SHANE GARDNER, ) deceased, ) 5 ) Plaintiff, ) 6 ) v. ) No. 91 L 1066 7 ) ELI LILLY AND COMPANY, a foreign ) 8 corporation, ) ) 9 Defendant. ) 10 * * * * * * * * * * 11 IN THE NINETEENTH JUDICIAL CIRCUIT COURT 12 LAKE COUNTY, ILLINOIS 13 JAMES E. SHEPPARD, Special ) Administrator of the Estate of ) 14 KENNETH K. SHEPPARD, Deceased, ) ) 15 Plaintiff ) ) 16 v. ) No. 93 L 124 ) 17 GOOD SHEPHERD HOSPITAL, a ) corporation, DR. STEWART SEGAL, ) 18 DR. SANFORD SHERMAN, DR. BRUCE ) CARLSON, DR. R. BERGLUND, and ELI ) 19 LILLY & COMPANY, a corporation, ) ) 20 Defendants. ) 21 * * * * * * * * * * Page 9 1 SUPERIOR COURT OF THE STATE OF CALIFORNIA 2 FOR THE COUNTY OF LOS ANGELES 3 DR. MARIUS SAINES, etc., et al., ) Case No: 4 ) SC 008331 Plaintiffs, ) 5 ) vs. ) 6 ) ELI LILLY & COMPANY, a corporation; ) 7 DISTA PRODUCTS COMPANY, a division ) of Eli Lilly & Company; and DOBS 1- ) 8 100, inclusive, ) ) 9 Defendants. ) ____________________________________) 10 11 * * * * * * * * * * Page 10 1 THE DEPOSITION OF TOM PIANKO, TAKEN AT THE 2 OFFICE OF BAKER & DANIELS, 300 NORTH MERIDIAN 3 STREET, SUITE 2700, INDIANAPOLIS, INDIANA 46204, 4 ON SEPTEMBER 22, 1993; SAID DEPOSITION TAKEN 5 PURSUANT TO NOTICE IN ACCORDANCE WITH THE RULES 6 OF CIVIL PROCEDURE. 7 * * * * * * * * * * 8 A P P E A R A N C E S 9 10 NANCY ZETTLER COUNSEL FOR GROUP A PLAINTIFFS 11 LEONARD M. RING AND ASSOCIATES, P.C. 111 WEST WASHINGTON AVENUE, SUITE 1333 12 CHICAGO, ILLINOIS 60602 13 LAWRENCE J. MYERS COUNSEL FOR ELI LILLY AND COMPANY 14 FREEMAN & HAWKINS 4000 ONE PEACHTREE CENTER 15 303 PEACHTREE STREET, N.E. ATLANTA, GEORGIA 30308-3243 16 CURTIS G. OLTMANS 17 ELI LILLY AND COMPANY LILLY CORPORATE CENTER 18 INDIANAPOLIS, INDIANA 46285 19 DALE A. DIAMOND COUNSEL FOR GOOD SHEPHERD HOSPITAL 20 CASSIDAY SCHADE & GLOOR 333 WEST WACKER DRIVE 21 CHICAGO, ILLINOIS 60606-1289 22 WILLIAM A. ROGERS COUNSEL FOR DEFENDANTS CZECHOWICZ, FINK, BRUINSMA 23 CLAUSEN MILLER GORMAN CAFFREY & WITOUS 10 SOUTH LASALLE 24 CHICAGO, ILLINOIS 60603 Page 11 1 PAUL J. CLEMENTI COUNSEL FOR DR. DICKIE KAY 2 HINSHAW & CULBERTSON 222 NORTH LA SALLE STREET, SUITE 300 3 CHICAGO, ILLINOIS 60601-1081 4 KATHERINE L. LAWS COUNSEL FOR DRS. WITSCHY AND KANNEGANTI 5 BAILEY AND WILLIAMS 3500 NCNB PLAZA 6 901 MAIN STREET DALLAS, TEXAS 75202-3714 7 JOHN F. PRESCOTT, JR. 8 COUNSEL FOR ST. ELIZABETH HOSPITAL ICE MILLER DONADIO & RYAN 9 ONE AMERICAN SQUARE INDIANAPOLIS, INDIANA 46282-0002 Page 12 1 I N D E X 2 3 DEPOSITION OF TOM PIANKO 4 5 DIRECT EXAMINATION BY MS. ZETTLER 15 6 CERTIFIED QUESTION 101 7 CERTIFIED QUESTION 155 8 CERTIFICATE 238 9 ERRATA 239 10 EXHIBITS 11 PLAINTIFFS' EXHIBIT NO. 1 88 PLAINTIFFS' EXHIBIT NO. 2 96 12 PLAINTIFFS' EXHIBIT NO. 3 104 PLAINTIFFS' EXHIBIT NO. 4 119 13 PLAINTIFFS' EXHIBIT NO. 5 129 PLAINTIFFS' EXHIBIT NO. 6 141 14 PLAINTIFFS' EXHIBIT NO. 7 144 PLAINTIFFS' EXHIBIT NO. 8 149 15 PLAINTIFFS' EXHIBIT NO. 9 150 PLAINTIFFS' EXHIBIT NO. 10 151 16 PLAINTIFFS' EXHIBIT NO. 11 155 PLAINTIFFS' EXHIBIT NO. 12 160 17 PLAINTIFFS' EXHIBIT NO. 13 164 PLAINTIFFS' EXHIBIT NO. 14 168 18 PLAINTIFFS' EXHIBIT NO. 15 170 PLAINTIFFS' EXHIBIT NO. 16 172 19 PLAINTIFFS' EXHIBIT NO. 17 178 PLAINTIFFS' EXHIBIT NO. 18 181 20 PLAINTIFFS' EXHIBIT NO. 19 181 PLAINTIFFS' EXHIBIT NO. 20 184 21 PLAINTIFFS' EXHIBIT NO. 21 190 PLAINTIFFS' EXHIBIT NO. 22 192 22 PLAINTIFFS' EXHIBIT NO. 23 201 PLAINTIFFS' EXHIBIT NO. 24 205 23 PLAINTIFFS' EXHIBIT NO. 25 210 PLAINTIFFS' EXHIBIT NO. 26 212 24 PLAINTIFFS' EXHIBIT NO. 27 217 PLAINTIFFS' EXHIBIT NO. 28 224 Page 13 1 PLAINTIFFS' EXHIBIT NO. 29 226 PLAINTIFFS' EXHIBIT NO. 30 230 2 PLAINTIFFS' EXHIBIT NO. 31 231 PLAINTIFFS' EXHIBIT NO. 32 232 3 PLAINTIFFS' EXHIBIT NO. 33 234 PLAINTIFFS' EXHIBIT NO. 34 236 Page 14 1 COMES TOM PIANKO, CALLED BY THE 2 PLAINTIFF, AND AFTER FIRST BEING DULY SWORN, WAS 3 DEPOSED AND TESTIFIED AS FOLLOWS: 4 DIRECT EXAMINATION 5 BY MS. ZETTLER: 6 Q. Good morning, Mr. Pianko. 7 A. Good morning. 8 MS. ZETTLER: Are we going to have the 9 same agreements, objections, et cetera, that we 10 did before? 11 MR. MYERS: Yes. 12 MS. LAWS: Same agreements we've always 13 had? 14 MS. ZETTLER: Yes. 15 Q. Have you ever given a 16 deposition before? 17 A. No, I haven't. 18 Q. Let me give you some ground 19 rules just to make it easier on Kathy here. 20 First of all, you have to answer out loud, you 21 can't shake your head or go uh-huh because she 22 can't -- she can take down an uh-huh, but you 23 never know what it is later on. If you have any 24 questions, you don't understand my question or Page 15 1 you don't hear me for some reason, which is 2 unlikely because I'm pretty loud, let me know and 3 I'll restate the question until you understand 4 it. Is that fair? 5 A. Yes. 6 Q. If you answer the question, 7 we'll assume that you answered it as asked, okay? 8 A. Yes. 9 Q. If you want to take a break at 10 any time, we take fairly frequent breaks, 11 probably not more than an hour, besides lunch, so 12 if in the meantime if you need to take a break, 13 let us know and we'll take a break, okay? 14 A. Okay. 15 Q. Why don't you give me your date 16 of birth. 17 A. 12-19-60. 18 Q. And your Social Security 19 number? 20 A. XXXXXXXXXXX. 21 Q. And your current address? 22 A. XXXXXXXXXXXXXXXXXXXXXXXXXXXXX. 23 Q. Okay. 24 A. XXXXXXXXXXXXXXXXXXX. Page 16 1 Q. XXXXXXXXXXXXXXXXXXXXXXXXXXX 2 XXXXXXXXXXXX? 3 A. XXXXXXXX. 4 Q. XXXXXXXXXXXXXXXXXXXXXXXXXXXXX? 5 A. XXXXXXXXXXXXXXXX. 6 Q. Are you still with Lilly? 7 A. Yes, I am. 8 Q. Are you married? 9 A. Yes. 10 Q. Do you have any kids? 11 A. Two. 12 Q. What are their names and ages? 13 A. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. 14 Q. Why did you move to XXXXXXXXX? 15 A. A job transfer. 16 Q. What position do you hold now? 17 A. Managed care coordinator. 18 Q. Managed care -- 19 A. Care coordinator, correct. 20 Q. Could you generally give us 21 your educational background starting with high 22 school, graduating high school? 23 A. Graduated high school from 24 Miskayuna High School, which is in upstate New Page 17 1 York, in 1978. 2 Q. Could you spell that? 3 A. M-I-S-K-A-Y-U-N-A. I went to 4 Cornell University, graduated from Cornell in 5 1982, then went to business school at the 6 University of Rochester, and graduated from the 7 University of Rochester in 1984. 8 Q. And you got your BMA at the 9 University of Rochester? 10 A. I got an MBA at the University 11 of Rochester, I received my BS degree in 12 immunology and physiology from Cornell 13 University. 14 Q. I'm sorry, when did you get 15 your MBA, what year? 16 A. 1984. 17 Q. Any other graduate or 18 postgraduate work? 19 A. No. 20 Q. When did you start at Lilly? 21 A. 1984. 22 Q. Right after you got your MBA? 23 A. Correct. 24 Q. Prior to -- and have you worked Page 18 1 for Lilly continuously since '84? 2 A. Yes, I have. 3 Q. Another rule, you have to let 4 me finish my question and I'll do my best to let 5 you finish your answer because she can't take us 6 both down talking at once. 7 A. Okay. 8 Q. Prior to 1984, did you -- did 9 you work? 10 A. No. Generally speaking, just 11 part-time jobs. 12 Q. Anything related to the 13 pharmacy industry? 14 A. No. 15 Q. Okay. What was the first 16 position that you held with Lilly? 17 A. Sales representative. 18 Q. And how long were you a sales 19 rep? 20 A. Until 1989. 21 Q. Would that also be known as 22 detail man? 23 A. Yes. 24 Q. And after being a detail man, Page 19 1 what did you do? 2 A. I came inside here, which we 3 call an inside rotation, to Indianapolis as a 4 medical information administrator. 5 MR. ROGERS: What was that? 6 THE WITNESS: Medical information 7 administrator. 8 Q. How long were you a medical 9 information administrator? 10 A. Approximately fourteen months. 11 Q. Do you remember when in 1989 12 you became a medical information administrator at 13 Lilly? 14 A. It was in early 1989, in 15 January, February, I believe. 16 Q. Okay. So to approximately the 17 middle of 1990 you were a medical information 18 administrator? 19 A. Correct. 20 Q. What did you do next? 21 A. I was a new product planning 22 associate. 23 Q. And how long were you a new 24 product planning associate? Page 20 1 A. About fifteen months. 2 Q. So to about the end of 1991? 3 A. Yes. 4 Q. What did you do after that? 5 A. Axid market research analyst. 6 Q. Axid market research? 7 A. An axid market research 8 analyst. 9 Q. How long were you an axid 10 market research analyst? 11 A. Up until three months ago. 12 Q. Beginning of July? 13 A. Yes. 14 Q. That's when you became a 15 managed care coordinator? 16 A. Correct. 17 Q. Let's start with your position 18 as a detail man in 1984. How is it that you got 19 that job? 20 A. I got that job by applying with 21 a regional personnel representative in Los 22 Angeles, and then following interviews to obtain 23 the job. 24 Q. Who was the regional personnel -- Page 21 1 what did you say was the last part? 2 A. Representative. To tell you 3 the truth, I don't remember his name. 4 Q. Did you seek him out or did he 5 seek you out? 6 A. I sought him out. 7 Q. How is it that you were aware 8 that Lilly was looking for detail men, detail 9 people? 10 A. It was a cold call. 11 Q. Were you assigned a specific 12 region? 13 A. Yes. 14 Q. What region was that? 15 A. Las Vegas, Nevada. 16 Q. Anywhere else? 17 A. Southern Utah. 18 Q. Anywhere else? 19 A. No. 20 Q. Was that your region the entire 21 time you were a detail man? 22 A. Yes. 23 Q. Can you give us an idea 24 generally what detail men do? Page 22 1 A. Generally we provide product 2 information about our products to the physician, 3 and also offer product samples. 4 Q. And when you say provide 5 product information to the physician, what form 6 or forms does that information take, pamphlets, 7 letters, things like that? 8 A. Generally speaking, we provide 9 information off a promotional brochure, product 10 information brochure. 11 Q. Who develops that brochure? 12 A. In-house. 13 Q. In-house at Lilly? 14 A. Here in Indianapolis, right. 15 Q. Did you detail any specific 16 type of drug or did you detail drugs across the 17 board? 18 A. Specific types of drugs. 19 Q. What types of drugs? 20 A. Antibiotics, non-steroidal 21 anti-inflammatories. 22 Q. Any others? 23 A. Eventually anti-depressants. 24 Q. When did you start detailing Page 23 1 anti-depressants? 2 A. Early 1988. 3 Q. Did you detail Fluoxetine? 4 A. I did. 5 Q. Did you detail any other 6 anti-depressants? 7 A. No. 8 Q. Did you start detailing 9 Fluoxetine shortly after it was approved by the 10 FDA? 11 A. I can't recall when the exact 12 approval date was to the time we launched Prozac, 13 but -- I don't know what the time span was 14 between the approval and the event promotion. 15 Q. But your beginning of detailing 16 of Fluoxetine coincided with the launch of the 17 drug generally? 18 A. Correct. 19 Q. Who did you detail Fluoxetine 20 to, what types of doctors? 21 A. Psychiatrists. 22 Q. Okay. 23 A. Eventually primary care 24 physicians. Page 24 1 Q. Internists, GP's, things of 2 that nature? 3 A. Correct. 4 Q. Was there any training, 5 additional training, that you went through in 6 preparation for detailing Fluoxetine? 7 A. Extensive training. 8 Q. Where did that training take 9 place? 10 A. Initially at home with learning 11 modules, and then a launch meeting, we called a 12 launch meeting, where we would spend actually a 13 couple of days -- I don't recall exactly the 14 content, but a couple of days on every aspect of 15 Fluoxetine. 16 Q. Can you give me a general idea 17 of how long the launch meeting lasted, total? 18 A. I think it was two days, as 19 best I can recall. 20 Q. So when you say a couple of 21 days on every aspect, you didn't mean a couple of 22 days on each individual aspect, you meant a 23 couple of days total? 24 A. Correct. Page 25 1 Q. Describe for me what learning 2 modules were? 3 A. They are a set of four or five 4 booklets, each dealing with a particular aspect. 5 One would be a basic depression disease 6 information, another might be on side effects, 7 another one might be on the actual compounds, the 8 pharmacokinetic properties of Fluoxetine, another 9 one might be on competitive products. That's 10 generally it. 11 Q. So these were all individual 12 books? 13 A. Yes, with a post-test 14 afterwards. 15 Q. Like a quiz to see how well you 16 learned the information in the booklet? 17 A. Yes. 18 Q. Were you graded on those quizs? 19 In other words, did you have to pass the quizs to 20 be able to detail the Fluoxetine? 21 A. Yes. 22 Q. Written or? 23 A. Written. 24 Q. Do you know if there were any Page 26 1 oral tests? 2 A. No, I don't believe so. 3 Q. Did you have any problems 4 passing the quizs? 5 A. Absolutely not. 6 Q. When you said there were home 7 learning modules, did you take the quizs at home 8 also and turn in your answers? 9 A. I think there are two phases to 10 this. Yes, you took the quiz at home and you 11 turned it in, but there's also, I believe, as 12 best as I can remember, a quiz administered at 13 the launch meeting, too. 14 Q. So the quizs at home were 15 essentially open book quizs? 16 A. Yes. 17 Q. Do you specifically remember 18 there being a quiz at the launch meeting? 19 A. I remember there was some kind 20 of question. I can't be really specific about 21 it, I can't exactly remember. 22 Q. Were you given any written 23 manuals or texts or pamphlets at the launch 24 meeting besides the learning modules that you Page 27 1 talked about earlier? 2 A. We have -- we had an 3 introductory product information pamphlet, it was 4 twenty pages or, you know, more or less, in 5 length, that pretty much summarized the package 6 insert, from its indications, depression, to 7 adverse events that you should be aware of, the 8 physician should be aware of, to dosing. And 9 that pamphlet, we pretty much spent the whole two 10 days learning each and every page of -- details 11 on each and every page. 12 Q. When you say the details, you 13 mean the details of the -- 14 A. Details of the drug, the 15 disease. Every little statement on that 16 promotional product information piece, we had to 17 learn. 18 Q. You don't mean how to detail 19 each piece, in other words how to communicate 20 each piece of information to the doctors? I just 21 want to make sure that when you say detail, you 22 mean it in the common meaning as opposed to the 23 detail person meaning. 24 A. The actual specific product Page 28 1 information knowledge, the statement knowledge. 2 Q. How many people were at this 3 launch meeting? 4 A. The entire DISTA sales force 5 organization, I want to say nine hundred sales 6 representatives, maybe it was eight hundred, I 7 can't really recall the exact number. 8 Q. Where was the meeting held? 9 A. Dallas, Texas. 10 Q. Who conducted the meeting? 11 A. Internal Lilly organization, 12 the sales organization, and the medical 13 organization, too. 14 Q. Prior to using these learning 15 modules and going to this launch meeting, did you 16 have any experience with treating, detailing or 17 otherwise the disease of depression? 18 A. No. 19 Q. Did you take any basic 20 psychology or psychiatry courses in undergrad? 21 A. Yes. 22 Q. What courses did you take? 23 A. Psych 101. 24 Q. You said earlier eventually you Page 29 1 started detailing it to primary care physicians. 2 Do you remember approximately when that started? 3 A. Four months post-launch to 4 psychiatrists, approximately. 5 Q. Did you have to go through 6 additional training to be able to detail to 7 primary care physicians? 8 A. No. 9 Q. Were you given any additional 10 materials? 11 A. No. 12 Q. As part of your job as detail 13 man, did you participate in any seminars for 14 primary care physicians or psychiatrists? 15 A. I don't believe so, but what do 16 you mean by seminars? 17 Q. Where seminars are put on 18 either directly or indirectly by Lilly regarding 19 either anti-depressants or depression to educate 20 or inform various groups of doctors about the 21 disease or the drugs. 22 A. No. 23 Q. Tell me the differences between 24 the DISTA sales force and the internal Lilly Page 30 1 sales force? 2 MR. MYERS: Let me just object to the 3 form. What do you mean by internal Lilly sales 4 force? 5 MS. ZETTLER: Well, testimony has been -- 6 we've gotten testimony in the past that there are 7 two separate sales divisions, one in DISTA and 8 one that is basically a part of Lilly, 9 independednt of DISTA, and I'm just trying to get 10 a better understanding of what that difference 11 is. 12 A. There's no internal versus 13 external. There basically is a label that they 14 place on a sales force, and it's all Lilly, and 15 you have a different basket of products, usually 16 two or three products. 17 Q. Give me the different labels. 18 A. DISTA and Lilly. 19 Q. Is there a select product 20 representative, things of that nature? 21 A. Yes. Lilly Select is what it's 22 called. 23 Q. And is that part of DISTA? 24 A. No. Page 31 1 Q. What is -- is there a specific 2 title for the DISTA sales force or is it just the 3 DISTA sales force? 4 A. Yes, DISTA Products Division. 5 Q. Did both of these groups detail 6 Prozac or Fluoxetine? 7 A. I think Select Products did, 8 and DISTA, definitely. 9 Q. Are there any other sales 10 groups within the Lilly organization besides 11 these two? 12 A. Lilly Hospital. 13 Q. Any others? 14 A. I think that's it. 15 Q. Did Lilly Hospital detail 16 Fluoxetine? 17 A. I can't recall whether they did 18 or didn't, I don't believe so. 19 Q. Did you -- were you responsible 20 for detailing to hospitals within your region? 21 A. No. 22 Q. Which group are you in, the 23 DISTA group or Lilly? 24 A. DISTA Products. Page 32 1 Q. So when you say that there were 2 about eight hundred to nine hundred detail men or 3 detail people as of the launch meeting, you're 4 talking about DISTA sales force or others? 5 A. I may not have the numbers 6 right, that's why -- it may have been six 7 hundred. I think we have a total of fifteen 8 hundred reps and, you know, between the different 9 divisions, Lilly Select, Lilly and DISTA. So it 10 may have -- I think there are eight hundred, but 11 I tell you I really don't know. 12 Q. When you say Lilly Select, 13 Lilly and DISTA, you mean Lilly Hospital? You 14 said -- 15 A. Actually there's four 16 divisions, the Lilly Hospital is usually totally 17 separate from the Lilly retail. 18 Q. So go through the four 19 divisions for me again. 20 A. Lilly Hospital, Lilly, Lilly 21 Select and DISTA Products. 22 Q. What's the difference between -- 23 is the title for Lilly just Lilly? 24 A. Yes. Page 33 1 Q. What's the difference between 2 Lilly and Lilly Select? 3 A. Just the label, just a 4 different name, different division, and often we 5 have different products. 6 Q. Do you know if both Lilly 7 detail men detailed Fluoxetine in addition to 8 Lilly Select products? 9 A. I don't believe so. 10 Q. The entire time you were a 11 detail man, did you work in DISTA Products? 12 A. Yes. 13 Q. You didn't work in any of these 14 other divisions? 15 A. No. 16 Q. When you were a detail man did 17 the issue of suicidality come up? 18 MR. MYERS: With respect to Fluoxetine? 19 MS. ZETTLER: Right. 20 A. I believe the issue of 21 suicidality came up towards the tail end of my 22 stint in DISTA Products, as I was right in 23 transition, moving. 24 Q. Tell me what you knew about Page 34 1 that issue at that time. You said the issue of 2 suicidality and the use of Fluoxetine. 3 A. At that time we knew and we 4 were aware and were well schooled that at any 5 time you're treating a patient with depression, 6 there's always a possibility for suicide because 7 it's such a very devastating disease, and that we 8 warn the physicians in our promotional piece that 9 when administering any product, as well as 10 Fluoxetine, that you need to be very, very aware 11 that patients are prone to suicide. And that is 12 about all I knew as far as suicide when I was a 13 detail rep. 14 Q. Okay. And that issue came up 15 towards the end of when you were a detail man? 16 A. No, that issue -- actually that 17 knowledge was something that we learned from the 18 learning modules to the very beginning launch 19 through that whole promotional brochure. 20 Q. When did the launch meeting 21 take place? 22 A. It was February, 1988. That's 23 one date I do know. 24 Q. So back in February of 1988, Page 35 1 you knew or you were told that people suffering 2 from depression were more prone to suicide? 3 A. Yes. 4 Q. How were you told to 5 incorporate that into your detailing of 6 Fluoxetine? 7 A. As best as I can recall, that 8 product information promotional brochure, it was 9 a comprehensive product information brochure, we 10 went through every -- sat down with the 11 physician, and the, quote, detail lasted from 12 fifteen minutes to a half hour going through each 13 and every point. And we did that with rigor. 14 And in there, in that promotional piece, as best 15 as I can recall, is a mention about safety and 16 suicidality associated with the administration of 17 anti-depressants and/or depression. 18 Q. Give me an idea what a typical 19 detail would encompass on Fluoxetine? 20 A. Generally speaking, we talked 21 about the disease, the nine symptoms of 22 depression, the importance of treating depression 23 and Fluoxetine's position as one of the 24 physician's choices as a treatment of depression. Page 36 1 Q. And it was promoted by Lilly as 2 a drug of first choice, wasn't it? 3 A. I don't believe so. 4 Q. What was it promoted as? 5 A. It was promoted as an 6 alternative to tricyclic anti-depressants. I 7 don't believe we ever promoted it as a drug of 8 first choice that I'm aware of, not during my 9 time. 10 Q. Now did you talk about these 11 things each time you made a detail call regarding 12 Fluoxetine, I mean for the same doctor? Let's 13 say you go to see Doctor A and you do your 14 initial spiel and then you go back to see him in 15 a few months or whatever. 16 A. No, we didn't go through 17 comprehensive. As the learning curve progressed, 18 you know, we talked about various different parts 19 of that promotional brochure, but we didn't go 20 through the whole thing all over again. It may 21 be two or three times out before we start not 22 going through the whole thing. 23 Q. How often would you detail an 24 individual doctor on Fluoxetine? Page 37 1 A. Approximately nine -- seven to 2 nine times a year. 3 Q. And your main function when you 4 would visit a doctor is to try to sell him the 5 product or to get him to prescribe the product; 6 correct? 7 A. No. 8 Q. What was your main function? 9 A. My main function was to supply 10 product information and allow the physician to 11 make the most informed choice. 12 Q. Information provided by Lilly, 13 though, you gave the doctors information that was 14 written and created by Lilly; correct? 15 A. No, not correct. 16 Q. Who created the information, 17 who wrote the information? 18 A. Various sources. 19 Q. Such as? 20 A. We have approved reprints that 21 come from professors from institutions on a 22 particular subject matter, be it depression, be 23 it tricyclics, be it pharmacokinetics, be it 24 receptor analysis. We were the conduits for Page 38 1 providing information on all aspects of 2 depression as well as Fluoxetine as well as 3 tricyclics. 4 Q. Do you have any knowledge as to 5 who you had written the articles that you're 6 referring to? 7 A. I can't recall back then, I 8 can't recall. 9 Q. Do you know if generally those 10 articles were written by people affiliated in 11 some way with Eli Lilly? 12 A. I can't recall, but I can 13 recall that they were very much independent 14 physicians, independent institutions. 15 Q. When you say they were very 16 much independent physicians and institutions, 17 what do you mean? 18 A. Well, as far as I know, again, 19 they were peer review journals that these 20 articles were written in many of them, and as a 21 result, because of the peer review process has, 22 as best as I understand it, they are peer review. 23 And as a result, hopefully we had a lot of the 24 potential biases that can occur. Page 39 1 Q. Potential biases that can occur 2 in what? 3 A. Any biases that you may be 4 inferring. 5 Q. That I may be inferring or 6 anybody generally? 7 A. Anybody generally. 8 Q. Did you ever do any research 9 into the connection between an author of a given 10 article and Eli Lilly? 11 A. No. 12 Q. Why not? 13 A. Again, I -- you know, being 14 from Cornell and going through a science program 15 and understanding peer review journals, provide 16 sources of, you know, generally speaking, on bias 17 information, I felt confident that if it was in a 18 peer review journal, it was a fairly unbiased 19 piece of information. 20 Q. So if it appeared in a journal, 21 it's unbiased? 22 A. No. 23 MR. MYERS: That's not what he said. 24 A. Peer review. Page 40 1 Q. What's a peer review journal? 2 A. From my knowledge, there's a 3 board, an editorial board that's set up to review 4 each and every article, what the contents are, to 5 make sure that it's under scientific standards 6 and it's upheld in all different scientific 7 standards, be it double-blind process, be it 8 totally independent analysis, and conclusions. 9 Q. So a journal such as JAMA would 10 be a peer review? 11 A. Correct. 12 Q. New England Journal of 13 Medicine? 14 A. Correct. 15 Q. Did you ever talk to the 16 editorial staff of a peer review journal with 17 regards to articles to be published or submitted 18 for publication by Lilly regarding Fluoxetine? 19 A. No. 20 Q. Do you know if that's done as a 21 matter of course within the industry, when people 22 from the manufacturer are contacted or contact a 23 journal? 24 A. I have no idea. Page 41 1 Q. Do you have any idea of what 2 the publication process of this approval, 3 submission approval process is of peer review 4 journals? 5 MR. MYERS: Other than what he just 6 told you a few minutes ago? 7 MS. ZETTLER: Right. 8 Q. The actual process that it goes 9 through. 10 A. No. 11 Q. Did you have any say as to what 12 articles you were to provide physicians -- 13 A. No. 14 Q. -- regarding Fluoxetine. Let 15 me finish my question. Who would make that 16 decision? 17 A. To the best of my knowledge, 18 the clinical physician assigned to Fluoxetine, 19 whatever product we have. 20 Q. Who were the clinical research 21 physicians that were assigned to Fluoxetine while 22 you were a detail man? 23 A. The only one that I really 24 recall was Doctor Charles Beasley. Page 42 1 Q. Have you ever spoken with 2 Doctor Beasley? 3 A. Yes, I have. 4 Q. Did you speak with Doctor 5 Beasley while you were a detail man? 6 A. I listened to him speak several 7 times at various meetings on Fluoxetine. 8 Q. What kinds of things would he 9 speak on, what kinds of topics? 10 A. Basically depression and 11 Fluoxetine. Again, broadly-based product 12 information, because he was the expert, medical 13 expert. 14 Q. Do you know what his 15 qualifications are? 16 A. M.D. with, I believe, a 17 residency in psychiatry, he's a psychiatrist. 18 Q. Do you know if he's Board 19 certified? 20 A. I do not. 21 Q. Why do you say he's an expert 22 on depression? 23 A. Because many individuals in the 24 community, physician community, even the Page 43 1 physicians I called on, had heard of Doctor 2 Charles Beasley and looked up to him as a 3 respectful individual who knows a lot about 4 depression and products. 5 Q. Did they tell you how they 6 became aware of Doctor Beasley? 7 A. One through, I guess, the 8 American Psychiatry Association meeting, that's 9 the best that I can remember. 10 Q. It wouldn't be through the 11 product information put out by Lilly, would it? 12 A. I don't believe that was ever 13 referred to that way. 14 Q. Lilly sponsors programs at 15 various association meetings and seminars, do 16 they not? 17 A. Can you repeat that question? 18 Q. Sure. For instance the APA 19 meetings, Lilly will sponsor programs that are 20 presented at meetings, various meetings. 21 A. Correct. 22 Q. And a number of those programs, 23 at least with regards to Fluoxetine, have to do 24 with various aspects of Fluoxetine and Page 44 1 depression; correct? 2 A. What Lilly will do is provide 3 funds to have a speaker talk on usually a topic 4 of their choice as long as it's within -- it's 5 depression. That's kind of the best, you know, 6 the only guidelines we'll support a speaker to 7 come in and talk about depression. And it could 8 be on products, but it's kind of whatever their 9 expertise is that they usually speak to the 10 psychiatry community or primary care physician 11 community. 12 Q. Does Lilly have any say as to 13 what the subtopic under depression would be? 14 A. Not to my knowledge. 15 Q. Why not? 16 A. Again, I think what's generally 17 accepted is what we expect is we just provide 18 funds to help the physician in terms of being 19 there presently and supplying the information to 20 the psychiatrist. So we really have no say, to 21 my knowledge, of what is the topic, other than 22 it's on depression. 23 Q. I'm sorry, I didn't mean to 24 interrupt you. Page 45 1 A. Other than it's on depression. 2 Q. When you say we provide funds, 3 provide funds to who, the doctors that 4 participate? 5 A. To tell you the truth, I don't 6 know. 7 Q. Who would know that? 8 A. Someone within our marketing 9 organization. 10 MR. MYERS: Not me. 11 MS. ZETTLER: Oh, Larry, you probably 12 do too know. 13 A. I really don't know, I don't 14 know who exactly is the person and what they do 15 exactly to dictate what goes on there. 16 Q. Is there a division or 17 department within the marketing division that 18 handles symposia such as lectures, things of that 19 nature? 20 A. There is a definite 21 administrative component of Lilly that deals in 22 symposia. And they -- you know, I don't think 23 that they are -- I just know that there's a 24 department within Lilly that handles symposiums. Page 46 1 Q. Do you remember the names of 2 any people that work in that department? 3 A. I really don't. 4 Q. Have you ever worked in that 5 department? 6 A. I have not. 7 Q. Have you ever worked in 8 conjunction with that department? 9 A. I have not. 10 Q. Tell me a little more about 11 what else happens in a typical detail on 12 Fluoxetine or at least what happened when you 13 were a detail person. In other words, did you 14 talk about the drug's pricing, dosages, things of 15 that nature? 16 A. Yes. 17 Q. What did you tell them about 18 pricing? 19 A. Generally speaking, if they 20 asked a price we would provide pricings from 21 local pharmacies on a DOT, day of therapy cost. 22 Q. Where would you get that 23 information? 24 A. From the local pharmacists. Page 47 1 Q. Local pharmacist doesn't 2 determine what price the Prozac is, though, does 3 it? 4 A. Often they do. Because all, 5 you know, all pharmacists, you'll find a 6 different price on every product usually with 7 every different pharmacy. 8 Q. Was there a suggested retail 9 price on Fluoxetine? 10 A. Yes. 11 Q. What was the suggested retail 12 price? 13 A. A dollar fourteen -- I don't 14 know, it's somewhere in a dollar, a little over a 15 dollar range. 16 Q. Per pill? 17 A. I think it was -- yes, per 18 pill, per twenty milligram. 19 Q. Who came up with that suggested 20 retail price? 21 A. Internal marketing. 22 Q. At Lilly? 23 A. At Lilly. 24 Q. You said that another part of Page 48 1 your job as detail man was to provide doctors 2 with samples of the drug? 3 A. Correct. 4 Q. Did you do that with 5 Fluoxetine? 6 A. Correct. 7 Q. How would you do that, would it 8 be something that would be done upon the doctor's 9 request or would you offer them the samples up 10 front? 11 A. We would offer. 12 Q. And did you have a procedure or 13 procedure by which you would give them or was it 14 a matter of just carrying around a bunch of 15 samples and giving them to them if they were 16 interested or did you have a procedure in the 17 book? 18 A. There was a very strict 19 procedure. 20 Q. What was the procedure, explain 21 it to me? 22 A. The procedure was that usually 23 we would be limited to the amount that we would 24 be able to give the physician, or at least a Page 49 1 general guideline, let's put it that way. That 2 we would, in front of the doctor, record, via 3 pencil, on a computer form the amount of the 4 sample and have the physician sign, we would date 5 it and then have the physician sign a release and 6 hand them the receipt that they received the 7 samples. 8 Q. Do you remember what the limit 9 was on the samples that you would give out on 10 Fluoxetine? 11 A. Usually one box. 12 Q. How many pills would be in one 13 box? 14 A. There was a seven-day supply. 15 So at once a day, seven pills. 16 Q. Seven pills in a box? 17 A. I think -- no, I don't believe 18 there's seven pills, there may have been seven 19 pills in a box, I really don't remember back then 20 exactly the amount of the box, but I know it was 21 a seven-day supply that we gave. 22 Q. Why so few? 23 A. It's a good question, I think 24 just limited resources. Page 50 1 Q. Did the number of samples that 2 you gave out or the number of pills and the 3 samples that you gave out change at all during 4 the time you were a detail man? 5 A. They may have increased 6 somewhat. I know that it appeared that samples 7 were a little bit more in plentiful supply. 8 Q. Did you ever detail liquid 9 Prozac? 10 A. No. 11 MS. ZETTLER: Can we take a quick 12 break? 13 MR. MYERS: Sure. 14 (A SHORT RECESS WAS TAKEN.) 15 Q. How were you paid as a detail 16 man? I don't want to know what your specific 17 income was, but was it salary, was it commission? 18 A. Salary plus contingent 19 compensation. 20 Q. What's contingent compensation? 21 A. It is an annual corporate-wide 22 compensation based on total corporate 23 performance. 24 Q. Like profit sharing? Page 51 1 A. Yes, I guess you would say -- 2 yes, it's profit sharing in a sense. 3 Q. Would your contingent 4 compensation depend upon the amount of, say, 5 Fluoxetine that was prescribed by doctors within 6 your region? 7 A. To a very, very, very small 8 amount. 9 Q. Okay. What do you mean by 10 that? 11 A. Because contingent 12 compensation, as I understand it, as a detail 13 rep, is based on how well our devices are 14 selling, how well everything else is going, how 15 well international sales are going, how well any -- 16 how well our costs are. It's based on the whole 17 corporate part, so I think I played a very, very, 18 very minor role in how much CC, very, very minor. 19 Q. Were you ever given any 20 information as to how much Fluoxetine was being 21 prescribed by doctors in your region? In other 22 words, would somebody come to you and say Mister 23 Pianko, the doctors in your region prescribed so 24 much Fluoxetine in the first quarter of 1988, for Page 52 1 instance? 2 A. No. 3 Q. Were you ever given any type of 4 information like that? 5 A. We had quota. 6 Q. Okay. Explain the quota system 7 to me. 8 A. For every product in our 9 portfolio we were set a quota, and we were not 10 judged usually on individual product specific 11 quotas, it was how is your whole territory doing 12 relative to quota. 13 Q. Relative to quota with regards 14 to your entire portfolio? 15 A. Uh-huh. 16 MR. MYERS: Yes? 17 A. Yes. 18 Q. How often were you asked or how 19 often were you told how well your territory was 20 doing compared to quota? 21 A. Three times to four times a 22 year. 23 Q. Who set the quota? 24 A. Internal Lilly. Page 53 1 Q. Who internally at Lilly? 2 A. I have no idea. 3 Q. Who reported your quota 4 performance to you? 5 A. My district manager. 6 Q. Who was that, with regards to 7 when you were detailing Fluoxetine? 8 A. Al Diggs. 9 Q. Could you spell the last name? 10 A. D-I-G-G-S. 11 Q. Was he your district manager 12 the entire time you were detailing Fluoxetine? 13 A. Yes. 14 Q. Did he ever tell you that your 15 quota with regards to Fluoxetine was below par? 16 A. No. 17 Q. Did he ever tell you that you 18 were exceeding your quota with regards to 19 Fluoxetine? 20 A. Probably. 21 Q. Why do you say that? 22 A. Because I don't think I was 23 ever below quota on Fluoxetine. 24 Q. When you say quota, quota of Page 54 1 what, with regards to Fluoxetine? In other 2 words, earlier you testified that your job was 3 not to sell Fluoxetine, yet you had a quota that 4 you had to meet or at least was a goal that was 5 set for you. So when you say you had to meet the 6 quota, quota of what, prescriptions, sales? 7 A. Dollars. 8 Q. What was the quota that was set 9 for Fluoxetine in 1988? 10 A. I have no idea. 11 Q. In general? 12 A. I honestly have no idea, it was 13 not -- the quota was not a big deal. 14 Q. Do you remember the quota at 15 any time throughout the time you detailed 16 Fluoxetine? 17 A. I do not. 18 Q. Who would have that 19 information? 20 A. Internal Lilly marketing. 21 Q. Were you ever, throughout your 22 employment at Lilly, responsible in whole or in 23 part for setting the quota for Fluoxetine? 24 A. No. Page 55 1 Q. How were you made aware of the 2 quota for Fluoxetine, was that something that you 3 received in writing or was that something you 4 were told verbally? 5 A. Writing. 6 Q. Did the quota change from time 7 to time to the best of your recollection? 8 A. Year to year. 9 Q. Increased? 10 A. Yes. 11 Q. What other things would you 12 discuss with the doctors at the various detailing 13 sessions? 14 A. Keflex antibiotics, lower 15 respiratory tract infections. 16 Q. You wouldn't detail those drugs 17 to psychiatrists, would you? 18 A. No. 19 Q. I'm talking about specifically 20 with regards to Fluoxetine. What other things 21 would you talk about with the doctors in the 22 Fluoxetine details or at least the Fluoxetine 23 portion of your detail? 24 MR. MYERS: Other than what you've Page 56 1 talked about already? 2 A. What I've already covered. 3 Q. Did you ever offer a doctor any 4 other incentives to prescribe Fluoxetine other 5 than samples? 6 A. No. I would like to correct 7 one last -- 8 Q. Sure. 9 A. It was not necessarily an 10 incentive, the samples, and I don't want that to 11 be interpreted that the samples were an incentive 12 for him to prescribe it, it was mainly to supply 13 the patients. 14 Q. But you only gave him enough 15 for one patient to take the drug for seven days? 16 A. I don't want to say that 17 absolute. Those were general guidelines, and I 18 recall being able to give one box to a physician. 19 Q. Were samples given to doctors 20 that were based on the numbers of Fluoxetine 21 prescriptions that he or she wrote? 22 A. No. 23 Q. Okay. Let's talk about your 24 inside rotation, which I believe started in Page 57 1 January and February of 1989; correct? 2 A. Correct. 3 Q. What's an inside rotation? 4 A. I probably didn't explain or 5 title that right. It generally brought inside to 6 do various different jobs as an associate. 7 Q. Before I forget, earlier you 8 testified that it's your recollection that 9 towards the end of your stint as a detail man, 10 the issue of suicidality and Fluoxetine came up. 11 Was that something that was different than what 12 you are taught initially about suicidality and 13 depression and anti-depressants? 14 A. I cannot remember, I cannot 15 remember. 16 Q. Do you remember it becoming a 17 specific issue towards the end of your stint as a 18 detail man? 19 A. I cannot. 20 Q. Is there anything that would 21 refresh your recollection? 22 A. No. 23 Q. These inside rotations, is that 24 something that each detail man is given an Page 58 1 opportunity to do? 2 A. No. 3 Q. How is it that you became 4 involved in the inside rotation? 5 A. Promotability. 6 Q. What do you mean when you say 7 promotability? 8 A. Upward plans, additional 9 responsibilities. 10 Q. Is this a promotion that you 11 sought out or was it something that was offered 12 to you? 13 A. I sought out. 14 Q. Who did you talk to about going 15 inside? 16 A. My district manager. 17 Q. Al Diggs? 18 A. Correct. 19 Q. Why did you want to change from 20 a detail man? 21 A. Additional responsibilities and 22 challenges. 23 Q. Where were you living when you 24 were a detail man? Page 59 1 A. Las Vegas, Nevada. 2 Q. And did this promotion entail a 3 move to Indianapolis? 4 A. Correct. 5 Q. When did you move to 6 Indianapolis? 7 A. Somewhere during that same 8 period of time, early 1989. 9 Q. Besides medical information 10 administrator, what other jobs did you do during 11 your inside rotation? 12 A. New product planning, axid 13 market research analyst. 14 Q. Okay. So all of the positions 15 that you held from the beginning of 1989 until 16 July of this year when you moved to manager care 17 coordinator, resulted as a part of your inside 18 rotation? 19 A. Correct. 20 Q. Tell me about your 21 responsibilities as medical information 22 administrator? 23 A. Basically I was an 24 administrator of information. Page 60 1 Q. What does that mean? 2 A. It means that we would help 3 facilitate the distribution of medical 4 information. 5 Q. Distribution of medical 6 information to who? 7 A. To physicians, medical 8 community, pharmacists. 9 Q. Outside Lilly? 10 A. Outside Lilly. 11 Q. Did you work on distributing 12 medical information or any information to other 13 Lilly employees? 14 A. Yes. 15 Q. What employees? 16 A. Sales representatives and 17 internal marketing and -- yes, that's it. 18 Q. When you say helped to 19 facilitate the distribution of medical 20 information, what did you do to help facilitate? 21 A. If a request for additional 22 medical information came in from a medical 23 professional or if the medical information was 24 requested by a physician through a sales Page 61 1 representative, and the sales representative 2 asked us to answer that question for that 3 physician, we would look at the question, look at 4 what it was, and try as best as possible to match 5 what kind of information we have to answer that 6 question. 7 Q. Okay. Were you finished? 8 A. Well, all this is then given to 9 the clinical physician, where he or she will look 10 at that to make sure the question is answered 11 with the right information and that it was 12 interpreted right, and then would sign a letter 13 and send it out to the medical professional. 14 Q. Did you have responsibilities 15 in drafting the letter responding to the 16 questions? 17 A. My only responsibility would be 18 to be a -- putting it together. In other words, 19 I would work with the clinical physician, he 20 would say I would like this information here, 21 this information here, so I would kind of cut and 22 paste and put it together and then bring it back 23 to him and say yes, that's the right letter, 24 that's the right information, and sign off on it, Page 62 1 and then it would go out. 2 Q. Have you ever heard the word 3 template? 4 A. Yes. 5 Q. What's a template? 6 A. Basically it depends on what 7 we're referring to, but if we stick with a 8 document? 9 Q. Right. 10 A. Then it's a -- it's a template 11 or form that is often asked that you can use 12 pretty much the same template for that -- for 13 multiple -- similar questions. 14 Q. So it's a prewritten paragraph 15 or document that's used almost in a form 16 letter-type means? 17 A. Yes. 18 Q. And your job was to construct 19 the letter based on various templates that were 20 available? 21 A. Construct? 22 Q. Draft. 23 A. An answer? 24 Q. Right. Page 63 1 A. Yes. 2 Q. Who wrote those prewritten 3 paragraphs or documents? 4 A. Charles Beasley. Charles 5 Beasley basically was the writer, was the author. 6 Q. Would Doctor Beasley generally 7 decide which templates would be used in which 8 response, things of that nature? 9 A. He would have the final say. 10 Q. He signed the majority of 11 letters that you sent in response, right? 12 A. Yes. 13 Q. Would you say that he signed 14 all the letters that you sent out? 15 A. Him or another clinical 16 physician, whoever had responsibility for that 17 day to review it all. 18 Q. What other clinical physicians 19 did you work with while you were a medical 20 information administrator? 21 A. John Heiligenstein. 22 Q. Anybody else? 23 A. Jamie Street. 24 Q. When were the templates Page 64 1 written, was that something that was done prior 2 to your becoming a medical information 3 administrator or was that something that was done 4 on an ongoing basis? 5 A. It was evolving, yes, ongoing. 6 Q. Was it a matter of when an 7 issue came up regarding Fluoxetine, then a new 8 issue would come up where a new template would be 9 written, something along those lines? 10 A. Yes. If a question came up 11 that was new information or if there was new 12 information available in the literature, then a 13 letter would be drafted. 14 Q. Say, for instance, a doctor 15 asks a detail person about a specific side effect 16 of or possible side effect of Fluoxetine, and 17 it's not a side effect that has been asked about 18 previously, would a new template be then written 19 to respond to that question? 20 A. Yes and no. 21 Q. Okay. What do you mean yes and 22 no? 23 A. If it was a question, again, 24 that was answered on a more frequent basis, then Page 65 1 that might become a template. 2 Q. Okay. So if it's something 3 that was like a shot in the dark, one time thing, 4 it wouldn't necessarily become a template, but if 5 you started getting more requests along the same 6 lines, then the template would be created? 7 A. Correct. 8 Q. Did you have any responsibility 9 for writing letters or documents that would be 10 given to prescribing physicians, pharmacists, 11 customers in general, other than in response to 12 questions? 13 MR. MYERS: Before he answers, let me 14 object to the form to the extent that you're 15 equating physicians and pharmacists with 16 customers. I don't think there's any testimony 17 that they're one and the same. 18 Q. Let's just talk about the 19 intermediary people at this point, not the actual 20 ingesting patient, but people who would be 21 prescribing the drug, for instance a doctor or 22 somebody who may be filling those prescriptions, 23 okay. So when I say a customer, at this point, I 24 just mean somebody along those lines instead of Page 66 1 an actual patient who's taking the drug, okay? 2 A. Okay. 3 MR. MYERS: Do you mean intermediary in 4 its legal sense as sometimes it is used? 5 MS. ZETTLER: No, Larry, I mean 6 intermediary as a middle person. 7 MR. MYERS: Thank you. 8 MS. ZETTLER: We have to get real 9 technical sometimes. 10 Q. Let me ask it this way: Is it 11 your understanding that periodically Lilly would 12 provide doctors and pharmacists, hospitals, et 13 cetera, with new information on the drug as it 14 comes up? 15 A. Yes. 16 Q. Did you have any responsibility 17 in writing or creating that information or those 18 documents that were given to doctors, 19 pharmacists, hospitals, et cetera? 20 A. Yes. 21 Q. Can you tell me what your 22 responsibility along those lines were? 23 A. As I described before, I was 24 sort of the cut and paste, if you want to say Page 67 1 that, but I was the person who put the documents 2 together. 3 Q. What kind of documents, give me 4 an idea of the types of documents you worked on, 5 along those lines? 6 A. The templates, the individual 7 custom letters, the Dear Doctor letters and Dear 8 Pharmacist letters. 9 Q. How about prescribing pamphlet, 10 information pamphlets? 11 A. No. 12 Q. What's a custom letter? 13 A. A letter that's not a template 14 on medical information. 15 Q. Is that something that's 16 generally sent out across the board or is that 17 something that's done in response to a specific 18 question? 19 A. In response to a specific 20 question. 21 Q. What we were talking about 22 earlier types of things? 23 A. Yes. 24 Q. How about Dear Doctor letters, Page 68 1 what are Dear Doctor letters? 2 A. Well, if a piece of new 3 information that comes out that is deemed 4 appropriate to give -- bring immediate attention 5 to, and needs to be communicated to a doctor, 6 immediately or in another way other than sales 7 representative or the media or anything like 8 that, it's communicated by letter to a physician 9 and to a pharmacist. 10 Q. Are those things that are sent 11 directly to the pharmacist or physician or is 12 that something that's given to them through the 13 detail men? 14 A. Sent directly to. 15 Q. Can you give me an example of 16 some of the subjects of Dear Doctor letters that 17 you were involved with? 18 MR. MYERS: With respect to Fluoxetine? 19 MS. ZETTLER: Right. 20 Q. Unless I specify otherwise, I'm 21 just asking you questions about Fluoxetine, okay? 22 A. Okay. Let's see. The only one 23 I can recollect is the issue on suicidality. 24 Q. And you worked on that Dear Page 69 1 Doctor letter? 2 A. Yes, I did. 3 Q. What did you do on that with 4 regards to that letter? 5 A. Basically gathered up the 6 statements from our clinical physicians and put 7 it in a letter form. 8 Q. When you say clinical 9 physicians, do you mean in-house research 10 physicians? 11 A. Yes, I did. 12 Q. What do you mean when you say 13 gathered statements from the clinical physicians? 14 A. Gathered information, whatever 15 was wanted -- whatever was needed to be 16 communicated from our clinical physicians to the 17 doctors. Again, I would be the conduit or the 18 administrator of that information and put it 19 together in a letter and bring it to the clinical 20 physician and say is this what you wanted 21 communicated. 22 Q. So the subject matter, the 23 topics that were discussed in the letter, were 24 topics that were given to you by the physicians, Page 70 1 they were not topics or matters that were written 2 by you, per se? 3 A. Correct. 4 Q. And your job was basically to 5 put it into readable form? 6 A. Yes. 7 Q. Did you use any preexisting 8 templates? 9 MR. MYERS: For that letter? 10 MS. ZETTLER: Yes. 11 A. No. 12 Q. Were any portions of that 13 letter subsequently used as templates for any 14 other letters? 15 A. I can't be sure. 16 Q. Which doctors gave you 17 information that was subsequently incorporated in 18 the suicidality Dear Doctor letter? 19 A. Doctor Charles Beasley. 20 Q. Anybody else? 21 A. I don't think so. 22 Q. Do you know where he got his 23 information from, the information that he gave 24 you? Page 71 1 A. No, I don't, other than 2 analysis that they had conducted, the medical 3 group, on data and also data from journals. 4 Q. When you say the analysis that 5 the medical group conducted, are you talking 6 about the reanalysis of existing clinical trial 7 information? 8 A. Yes. 9 Q. Did you ever have any 10 responsibility in writing, researching, putting 11 together reports that were sent to the FDA? 12 A. I don't know if anything of 13 mine was ever sent to the FDA. 14 Q. You were never asked 15 specifically to, say, work on a project like -- 16 such as a safety update or anything of that 17 nature? 18 A. No. 19 Q. Something you may have written 20 may have been incorporated at some point and sent 21 to the FDA, but you're not sure? 22 A. I have no knowledge on that. 23 Q. When you say that statements 24 were given to you by Doctor Beasley to be Page 72 1 incorporated in the suicidality Dear Doctor 2 letter, did he write paragraphs of information or 3 sections of information and it was your job to 4 put those sections into a readable form or did 5 you actually -- 6 A. Right. 7 MR. MYERS: Let her finish. 8 Q. Or did you actually write 9 paragraphs? In other words, incorporate 10 statistics that he gave you, things of that 11 nature. 12 A. No, it was the form. 13 Q. So he would actually write the 14 paragraphs or sections and you would just 15 organize them, so to speak? 16 A. Yes. 17 Q. And that was pretty much how it 18 was done in the custom letter responses, too? 19 A. (Witness moves head up and 20 down.). 21 Q. You have to say yes. 22 A. Yes. 23 Q. Okay. It's human nature to do 24 that, but Larry and I will keep reminding you, Page 73 1 don't worry. 2 A. I know you will. 3 Q. Besides the Dear Doctor 4 suicidality letter, do you remember working on 5 any other Dear Doctor letters? 6 A. I can't recall. 7 Q. Okay. Do you have any 8 recollection of whether or not a Dear Doctor 9 letter was written on the change of information 10 on MAO inhibitors from, I believe it was, the 11 warning section, the contraindication section? 12 A. Yes, yes, that was one. I knew 13 there was something else, but I forgot it was a 14 Dear Doctor letter. 15 Q. How about violent/aggressive 16 behavior, did you do any -- work on any Dear 17 Doctor letters on violent/aggressive behavior? 18 A. I may have, but I'll tell you 19 the truth, I don't remember. 20 Q. Are you aware of whether or not 21 such a letter was sent out? 22 A. I don't know if it was sent out 23 as a Dear Doctor letter, but certainly there was 24 a medical information letter on that issue sent Page 74 1 out, but I can't recall if there was a Dear 2 Doctor letter. 3 Q. What's the difference between a 4 Dear Doctor letter and a medical information 5 letter? 6 A. Medical information letter is 7 information that's requested by a physician. A 8 Dear Doctor letter is a broad distribution, 9 regardless of whether the information is 10 requested by a physician, to the whole medical 11 community. 12 Q. Do you recall working on 13 medical information letters regarding 14 violent/aggressive behavior? 15 A. Yes, I do. 16 Q. Was that something that was 17 requested fairly frequently or was that something 18 that was rare? 19 A. I believe it was rare. 20 Q. Do you have any idea how many 21 times you worked on responses to questions 22 regarding violent/aggressive behavior? 23 A. Rarely. 24 Q. Can you give me an idea what Page 75 1 rarely is, a ballpark figure, about how many 2 times? 3 A. My only qualification is that 4 it was very, very infrequent as relative to other 5 questions that are asked. 6 Q. Such as is relative to 7 suicidality questions? 8 MR. MYERS: His question was it was 9 requested less frequently. 10 MS. ZETTLER: Right. 11 A. Yes, it was requested less 12 frequently than suicidality. 13 Q. In fact at one point requests 14 regarding suicidality was the number one request 15 that was transmitted to Lilly about Fluoxetine, 16 wasn't it? 17 MR. MYERS: Let me -- for purposes of 18 the medical information letter or are you talking 19 now as a general question? 20 MS. ZETTLER: For purposes of the 21 medical information letters. 22 A. I think, as I recall, best as I 23 can, that suicidality was one of the most 24 frequently requested letters of information. I Page 76 1 don't recall whether it was one or two or -- you 2 could say in the top five. 3 Q. Why was the suicidality Dear 4 Doctor letter written and sent out? 5 A. Because of a need for -- a need 6 by the medical community for information on that 7 subject. 8 Q. Who determined that there was a 9 need in the medical community for information on 10 that subject? 11 A. I can't answer that, 12 specifically who decided that there was a need. 13 The only thing -- I can't even speculate. 14 Q. Was that letter written in 15 response to a large number of requests for 16 information by doctors? 17 A. I can't say yes to that. 18 Q. Tell us when was that letter 19 written? 20 A. Sometime, I believe, as best I 21 can, in early 1989. 22 Q. You started as a medical 23 information administrator in early 1989. Do you 24 recall if that was one of the first projects you Page 77 1 worked on? 2 A. It's hard to say. It was 3 sometime in that first half of 1989 that that 4 letter, as I recall, was written, and I don't 5 know whether it was one of the first projects 6 because I had a multitude of projects, but I know 7 it was within that period of time. 8 Q. Within the first half the 1989? 9 A. Yes. 10 Q. How many doctors was that 11 letter sent to? 12 A. Which letter? 13 Q. The suicidality Dear Doctor 14 letter. 15 A. Every physician in the United 16 States. 17 Q. Every single doctor in the 18 United States? 19 A. Every single doctor that I'm 20 aware of that was on the AMA mailing list as well 21 as the osteopath list, every physician. 22 Q. Regardless of their area of 23 practice? 24 A. Regardless of their area of Page 78 1 practice. 2 Q. So you would send it to 3 cardiovascular surgeons? 4 A. (Witness moves head up and 5 down.). 6 Q. Pediatrics? 7 A. As best that I know, yes. 8 Q. Podiatrists? 9 A. Yes. 10 Q. Was information generally about 11 Prozac sent to all those doctors? 12 A. I can't answer that, I don't 13 know. 14 Q. When you were a detail man, 15 what types of doctors would you detail generally? 16 A. Specialists, psychiatrists and 17 primary care physicians. 18 Q. What kinds of specialists? 19 A. Psychiatrists. 20 Q. But I'm not talking just 21 Fluoxetine. You said that you also detailed 22 antibiotics; correct? 23 A. Infectious disease consultants. 24 Q. Would you detail cardiovascular Page 79 1 people? 2 A. No. 3 Q. Would you detail orthopedic 4 doctors? 5 A. Yes. 6 Q. Would you detail heart 7 surgeons? 8 A. No. 9 Q. What other types of doctors 10 besides orthopedic doctors would you detail 11 generally? 12 MR. MYERS: He told you he detailed 13 doctors other than orthopedists. 14 MS. ZETTLER: Well, if he says that 15 he's already told me. 16 A. The only one that I can recall 17 is EMT's, which are ear, nose and throat. 18 Q. Would you detail Fluoxetine to 19 an EMT? 20 A. No. 21 Q. Would you detail them to 22 orthopedists, orthopedic doctors? 23 A. I don't believe so, unless if 24 the information is requested. Page 80 1 Q. Do you recall ever having a 2 doctor, orthopedic surgeon or orthopod, ask you 3 about Fluoxetine? 4 A. Yes. 5 Q. Was that fairly common? 6 A. No. 7 Q. On how many occasions did that 8 happen to the best of your recollection? 9 A. Rarely. 10 Q. When was the MAO inhibitor and 11 reaction Dear Doctor letter written to the best 12 of your recollection? 13 A. This is really stretching it, 14 mid-'89 to maybe the third quarter of 1989, and 15 again, I can't even be sure. I could be totally 16 wrong on that. 17 Q. Was that letter written in 18 conjunction with a package insert change? 19 A. Yes. 20 Q. Was the suicidality Dear Doctor 21 letter written in conjunction with the package 22 insert change? 23 A. I can't remember specifically. 24 I can remember that there was a package insert Page 81 1 change, and I don't remember whether this was 2 associated with the Dear Doctor letter or not. 3 Q. Was another Dear Doctor letter 4 written specifically in conjunction with the 5 package insert change to your knowledge? 6 MR. MYERS: Package insert change? 7 MS. ZETTLER: On suicidality. 8 A. I can only remember one letter. 9 Q. Was this suicidality Dear 10 Doctor letter written in response to Martin 11 Teicher's article on increased suicidality and 12 the use of Fluoxetine? 13 A. I can't say that that was the 14 primary reasoning behind the Dear Doctor letter. 15 Q. Are you aware of any other 16 reasons? 17 A. The package insert change may 18 have been one. And media and -- I think it was a 19 number of factors as to why that was sent out. 20 Q. Was the suicidality Dear Doctor 21 letter written after Doctor Teicher's article 22 came out or before? 23 A. After. 24 Q. When you were a medical Page 82 1 information administrator, was it part of your 2 responsibility to keep a file on articles 3 published in medical journals or articles 4 published generally? 5 A. Yes. 6 Q. Why were you charged with doing 7 that? 8 A. Because I was administrator of 9 that information. 10 Q. Okay. And how would you become 11 aware of journal articles, for instance? 12 A. Literature searches and Charles 13 Beasley. 14 Q. Okay. When you say literature 15 searches, are you talking like Med-line type 16 searches, things of that nature? 17 A. Correct, yes. 18 Q. Any other searches besides 19 Med-line? 20 A. No. 21 Q. Did you have any responsibility 22 with regards to the publication of articles 23 resulting from Lilly clinical trials on 24 Fluoxetine? Page 83 1 A. No responsibility other than I 2 was a keeper of articles. 3 Q. To your knowledge, is there a 4 list of articles that were published as a result 5 of clinical trials sponsored in whole or in part 6 by Lilly? 7 A. Yes. 8 Q. Who has that list? 9 A. I don't know who has that list 10 other than in -- you can find that list in a 11 comprehensive monograph. 12 Q. What do you mean when you say 13 comprehensive monograph? 14 A. Comprehensive product monograph 15 for Fluoxetine has a bibliography of all -- of 16 most, I can't say all, articles written on 17 Fluoxetine. And Charles Beasley would also be 18 the source. 19 Q. Were you also charged with 20 keeping track of articles that were not 21 published, in other words articles that were 22 written either by Lilly employees or somebody 23 connected with Lilly that were not published? 24 MR. MYERS: It can't be an article if Page 84 1 it's not published. You mean manuscripts of 2 proposed articles? 3 MS. ZETTLER: Yes, manuscripts. 4 A. Okay. I can't say I had the 5 responsibility of that. No, I had no 6 responsibility for that. 7 Q. Did you keep a file? 8 A. Of? 9 Q. Of non-published manuscripts. 10 A. I can say that something -- a 11 manuscript may have crossed my desk and may have 12 been filed, but I can't say that I specifically 13 kept that. I can't exclude it either, but it was 14 not my responsibility to hold those manuscripts 15 for any purpose. 16 Q. Okay. Who was your supervisor 17 when you were a medical information 18 administrator? 19 A. Earlene Ashbrook. 20 Q. Was she your supervisor the 21 entire time you were a medical information 22 administrator? 23 A. Yes. 24 Q. Were you involved at all with Page 85 1 writing letters to Lilly sales reps? 2 A. Yes. 3 Q. What types of letters did you 4 write to Lilly sales reps? 5 A. Anything that involved medical 6 information. 7 Q. Was that done on a regular 8 basis or was that something that was done as it 9 came up? 10 A. It came up on a regular basis. 11 Q. Okay. But was there like a 12 quarterly newsletter that went out to sales reps 13 or quarterly letters? 14 A. No. 15 Q. What were your responsibilities 16 with regards to writing those letters? 17 A. Really similar to the medical 18 information letters, I was the one who brought it 19 together. 20 Q. Okay. So again, you would take 21 information from, say, Charles Beasley and put it 22 in an organized form to be sent out to the sales 23 reps? 24 A. Yes. Page 86 1 Q. Did you work with anybody else 2 on those letters? 3 A. Depending on the subject 4 matter, I would work with possibly a marketing 5 associate in conjunction with legal, and a 6 physician. 7 Q. You said depending on the 8 subject matter? 9 A. Right. 10 Q. Give me an idea of subject 11 matters that you would work on with marketing, 12 legal and physicians? 13 A. Competitive product review 14 would be something that would be more 15 specifically oriented towards a marketing 16 associate. I mean primarily when it gets into 17 that kind of thing, that's when we work with a 18 marketing person. 19 Q. Okay. When you say competitive 20 products, you mean other anti-depressants in this 21 case? 22 A. Correct. 23 Q. How about the legal department, 24 how would they figure into this picture? Page 87 1 A. Any communication to sales 2 representatives, to physicians, had to be 3 reviewed and approved by our legal department. 4 Q. For what purpose? 5 A. To make sure that it falls 6 within the legal parameters of information. 7 Q. Is the legal department 8 involved in the suicidality Dear Doctor letter? 9 A. Correct. 10 Q. Do you remember what their 11 function was with regards to that, did they 12 review drafts, things of that nature? 13 A. They reviewed drafts. 14 Q. To your knowledge, did they 15 make any changes in the letter before it was sent 16 out? 17 A. If they made changes, I can't 18 recall what exactly the changes were. 19 (PLAINTIFFS' EXHIBIT NO. 1 WAS 20 MARKED FOR IDENTIFICATION AND 21 RECEIVED IN EVIDENCE.) 22 Q. Have you had a chance to review 23 Exhibit 1? 24 A. Yes. Page 88 1 Q. Do you recognize this document? 2 A. Vaguely. 3 Q. Can you tell me what it is? 4 A. I believe this is a letter 5 tracking document. 6 Q. What's letter tracking? 7 A. Well, the only significance to 8 my responsibility of this document is not 9 necessarily the details here, but of the days 10 lapsed between when you received the request and 11 when the request was answered or the date mailed. 12 Q. Okay. So, for instance, if 13 you're talking about the first letter here, it 14 says date received, I believe it's September 6, 15 1989, and the response was mailed on September 16 14, 1989, there was an eight-day lapse between 17 the two? 18 A. Right. 19 Q. Up at the top, it said, under 20 the title, medical correspondence received, it 21 says date received, date mailed, days lapsed, 22 letter number, et cetera. Do you see that? 23 A. Yes. 24 Q. And medical requestor is Page 89 1 circled. Who is a medical requestor, is that the 2 doctor or would that be the detail person? 3 A. I have no idea. Unless I saw 4 the names there, I would have no idea. 5 Q. And that name is blacked out, 6 the names are blacked out, correct, they're 7 masked? 8 A. Correct. 9 Q. How about under area, is that a 10 geographical area or is that an area of practice? 11 A. I don't know. 12 Q. Again, these words are masked? 13 A. Correct. 14 Q. Over towards the right-hand 15 side of the document, it says MIA initials. 16 Would that be medical information administrator? 17 A. Correct. 18 Q. So if you had responsibility 19 for writing a response to a request, then your 20 initials would be listed there? 21 A. That's correct. 22 Q. Is there any way of following 23 from this document what the subject matter of the 24 request was, the original request? Page 90 1 A. Yes. 2 Q. How can I tell? 3 A. There's a code underneath date. 4 Q. The date received over on the 5 left-hand side? 6 A. That's correct. 7 Q. Okay. For instance, the second 8 letter down, it says PZ slash eighty-seven? 9 A. That's correct. 10 Q. PZ stands for Prozac? 11 A. Yes. 12 Q. What does eighty-seven stand 13 for? 14 A. A letter number, usually a 15 template number. 16 Q. Do you recall what template 17 eighty-seven was? 18 A. I do not. 19 Q. Is there a listing or was there 20 a listing when you were medical information 21 administrator of what the various template 22 numbers or code numbers related to? 23 A. Yes, there is. 24 Q. Did you have a copy of that in Page 91 1 your file? 2 A. I don't know if it's in a file, 3 but it was -- it definitely was a book that was 4 sitting on top of a shelf in a desk that listed 5 the letter and what the contents of the letter 6 was, with a code. 7 Q. What else did that book contain 8 besides the code? 9 A. The actual letter. 10 Q. The form letters? 11 A. Uh-huh, yes. 12 Q. Anything else in that book? 13 A. No. 14 Q. Were you ever asked to turn 15 over your Fluoxetine related documents to Lilly 16 in the legal department? 17 A. Yes. 18 Q. When is the first time that you 19 were asked to do that? 20 A. I don't recall. 21 Q. Do you know if it was before or 22 after the suicidality Dear Doctor letter was 23 written? 24 A. I don't remember. Page 92 1 Q. Do you recall whether or not 2 you were asked to turn over Fluoxetine related 3 documents to the legal department while you were 4 still a detail person? 5 A. No. 6 Q. No, you don't remember or no, 7 you weren't? 8 A. No, I did not get a notice to 9 turn over my Fluoxetine -- to the best of my 10 knowledge, I don't remember getting any kind of 11 notification while I was a detail rep to turn 12 over Fluoxetine documents. 13 Q. Okay. You looked like you were 14 still thinking about it for a second. 15 A. There may have. Like I said, 16 I'm not sure, I'm not sure, I don't recall doing 17 that. 18 Q. Would there be anything that 19 could refresh your recollection on that? 20 A. The only thing would be a 21 specific date on the material in my name that 22 showed I did that. 23 Q. Do you recall at some point 24 getting some sort of notice from the legal Page 93 1 department that they wanted you to turn over your 2 Fluoxetine related documents? 3 A. Yes. 4 Q. Do you remember if that was in 5 writing or if that was verbal? 6 A. Both. 7 Q. When you say it was both, the 8 verbal communications, was that a matter of 9 somebody just -- 10 A. Management. 11 Q. Somebody above you telling you 12 that legal wanted you to turn over documents? 13 A. Someone above us specifically 14 coming down and making sure that all the 15 documents were sent to legal. 16 Q. To the best of your 17 recollection, was there ever a meeting on that 18 subject? 19 A. No. 20 Q. Are you still working on Prozac 21 today? 22 A. No. 23 Q. Were you working on Prozac 24 prior to leaving -- right up to leaving in July Page 94 1 of 1993? 2 A. No. 3 Q. When did you stop working on 4 Prozac? 5 A. When I assumed my new 6 responsibility as new product planning associate. 7 Q. And that was mid-1990? 8 A. Yes. 9 Q. So as of mid-1990, you have not 10 had any responsibilities related to Fluoxetine? 11 A. Correct. 12 Q. When I say Fluoxetine, I mean 13 for any indicated use such as like Lovan or 14 bulimia? 15 A. No. 16 Q. Without giving me anything 17 specific, what types of products are you working 18 with now? 19 A. Well, I'm in contractual sales. 20 So to some extent, the whole portfolio of 21 products I represent in managed care 22 institutions. So you could say that I'm somewhat 23 associated with Prozac, but I don't get in any 24 kind of product detail or anything. We're not Page 95 1 schooled on individual products, we're basically 2 into contractual sales with major buyers within 3 that institution. 4 Q. Like hospitals? 5 A. No, like HMO's. 6 Q. Explain what you mean by 7 contractual sales. 8 A. Basically, in order to be 9 placed on a formulary, because most 10 pharmaceutical products are, quote, considered 11 commodities, you need to have a contract signed 12 in place with an HMO to have your product on that 13 formulary. 14 Q. So in other words, for HMO 15 doctors to be able to prescribe your medication, 16 you have to have a contract with the HMO? 17 A. Generally speaking, yes. 18 (PLAINTIFFS' EXHIBIT NO. 2 WAS 19 MARKED FOR IDENTIFICATION AND 20 RECEIVED IN EVIDENCE.) 21 Q. Have you had a chance to look 22 at Exhibit 2? 23 A. Yes, I have. 24 Q. Do you recognize this document? Page 96 1 A. No, I don't. 2 Q. Do you have any idea why it was 3 in your file? 4 A. No, I don't. 5 Q. The document appears to be a 6 memo from a Stan Bialkowski to Charles Beasley, 7 John Heiligenstein, Mary Huff, Dan Masica, Doug 8 Tillman and a CC to Earlene Ashbrook; correct? 9 A. Correct. 10 Q. And the subject matter of the 11 memo is medical letters sent to Kentucky during 12 September to December of 1989; correct? 13 A. Correct. 14 Q. Give me an idea of how the 15 various requests and responsibilities were kept 16 track of. I believe you testified with regards 17 to Exhibit 1 that there was a computer data base 18 in which all of the letters were compiled; 19 correct? 20 A. Correct. 21 Q. What other types of information 22 were kept in that data base with regards to 23 letters that were sent and requests that were 24 received? Page 97 1 A. I don't know. 2 Q. To your knowledge, would I be 3 able to find out from that data base whether or 4 not a specific doctor ever made a request? 5 A. I believe so. 6 Q. Do you have any idea why people 7 Mister Bialkowski, B-I-A-L-K-O-W-S-K-I, wrote 8 this memo re medical letters sent to Kentucky 9 during September through December of 1989? 10 A. No. 11 Q. Are you familiar with the Joe 12 Wesbecker incident down in Louisville? 13 A. I've heard of it. 14 Q. Have you ever had any 15 responsibilities with regards to that occurrence? 16 When I say that, I mean like writing letters, 17 constructing Dear Doctor letters, things of that 18 nature? 19 A. I can't remember, recall or 20 think that anything specifically associated with 21 the case you mentioned that I had to do something 22 in response to. 23 Q. What do you know about the 24 Joseph Wesbecker incident? Page 98 1 A. Not much other than it was a 2 very unfortunate situation and individuals were 3 hurt. 4 Q. When you say it was a very 5 unfortunate situation, what do you mean? 6 A. Anybody -- when anything like 7 that happens, I think it's an unfortunate 8 situation. 9 Q. What's your understanding of 10 what happened? 11 A. That someone killed people, 12 that's all I know. 13 Q. Okay. Where did you come to 14 that understanding, of that knowledge? 15 A. Through the media. 16 Q. Anybody here discuss that 17 subject with anybody at Lilly? 18 A. Not specifically. I really 19 forgot all about it, and it was mentioned to me 20 yesterday during -- and I was reminded about what 21 it was. So I had forgotten all details or 22 anything about it. 23 Q. You said it was mentioned to 24 you yesterday. Who mentioned it to you Page 99 1 yesterday? 2 A. Counsel. 3 Q. Have you talked about that with 4 anybody else at Lilly? 5 A. No. 6 Q. What did you do in preparation 7 for the deposition? 8 A. Basically went through my 9 history and what my job responsibilities were, 10 and -- really, that's it. And they said the 11 reason you're here is -- 12 MR. MYERS: Don't go into what you were 13 told. 14 THE WITNESS: Okay. 15 Q. What did you tell them about 16 your history? 17 MR. MYERS: Don't answer that. 18 MS. ZETTLER: I think he waived it, 19 Larry. 20 MR. MYERS: He hasn't waived it. 21 Q. Are you going to follow your 22 counsel's instruction? 23 MR. MYERS: He's instructed not to 24 answer your question about the subject of Page 100 1 anything he discussed with counsel yesterday. 2 MS. ZETTLER: He just said he talked 3 about his history. 4 MR. MYERS: He's not going to answer. 5 Q. Are you following your 6 counsel's instruction? 7 A. Yes, I am. 8 MS. ZETTLER: Certify it. 9 (QUESTION CERTIFIED.) 10 Q. Besides counsel, have you 11 talked to anybody else at Lilly regarding your 12 deposition? 13 A. No, I have not. 14 Q. Have you looked at any 15 documents in preparation for your deposition? 16 A. No, I have not. 17 Q. Were you asked to look at 18 documents? 19 A. No, I have not. 20 Q. Have you talked to anybody 21 outside of Lilly regarding the deposition? 22 A. No, I have not. 23 Q. Have you talked to your wife 24 about the deposition? Page 101 1 A. Only that I'm going to a 2 deposition in Indianapolis. 3 Q. When did you get here? 4 A. Yesterday. 5 Q. Prior to yesterday, did you 6 meet with anybody from Eli Lilly with regards to 7 this case or any other Prozac case? 8 A. I did not, I have not. 9 Q. How long did you meet with 10 counsel yesterday? 11 A. I think three hours. 12 Q. Who did you meet with? 13 A. Mary Huff and Steve Lore. 14 Q. Anybody else? 15 A. No. 16 MS. ZETTLER: Let's take another quick 17 break. 18 (A SHORT RECESS WAS TAKEN.) 19 Q. Mister Pianko, did you keep 20 drafts of the Dear Doctor suicidality letter in 21 your files? 22 A. I don't remember, I may have. 23 Q. If you kept such drafts, would 24 you have turned them over to the legal Page 102 1 department? 2 A. Yes. 3 Q. When were you first told that 4 you would be giving a deposition in this case? 5 A. Approximately two months ago. 6 Q. And was that before or after 7 you moved to Colorado? 8 A. After. 9 Q. Were you given an option as to 10 when you could come and give your deposition? 11 A. The way it was requested is if 12 you're going to be in Indianapolis in the near 13 future, please let us know because we need to set 14 aside a day so you could give a deposition. 15 Q. Are you here for purposes other 16 than the deposition today? 17 A. The only purpose is for the 18 deposition. 19 Q. Were you here anytime between 20 two months ago and today for any reason? 21 A. I don't think so. 22 Q. How often do you come to 23 Indianapolis? 24 A. Approximately three times a Page 103 1 year. 2 Q. So for a specific reason? 3 A. Usually a meeting, a managed 4 care meeting. 5 Q. Were you involved in the 6 managed care prior to your current position? 7 A. No. 8 Q. If you weren't planning on 9 being here for any other reason, how is it that 10 you ended up here today? 11 MR. MYERS: He said he came for the 12 deposition. 13 MS. ZETTLER: Right. 14 Q. You testified a couple of 15 seconds ago that you were asked -- 16 A. Mary Huff urged and requested 17 that I be here today. 18 Q. When did she make that request? 19 A. A month ago, maybe, three weeks 20 ago. 21 (PLAINTIFFS' EXHIBIT NO. 3 WAS 22 MARKED FOR IDENTIFICATION AND 23 RECEIVED IN EVIDENCE.) 24 Q. Okay. Have you had a chance to Page 104 1 look at Exhibit No. 3? 2 A. Yes, I have. 3 Q. Do you recognize this document? 4 A. Yes, I do. 5 Q. Can you tell me what it is? 6 A. It's a medical information 7 letter sent to a physician upon request. 8 Q. Okay. This actually appears to 9 be a draft of the letter, doesn't it? 10 A. Yes, it does. 11 Q. Is this your handwriting on the 12 first page of the exhibit? 13 A. It looks like it. 14 Q. Okay. 15 A. Not all of it, though. 16 Q. Which is your handwriting and 17 which is not your handwriting? 18 A. I can't legibly make any 19 assessment of this, but this looks like my 20 handwriting on page one under malaise and sleep 21 disorder. 22 Q. How about the notes to the left 23 of that, looks like a paragraph sign, due to the 24 something, it's got a little note in the Page 105 1 left-hand margin? 2 A. It does not look like my 3 handwriting. 4 Q. Do you recognize that 5 handwriting? 6 A. I do not. 7 Q. Would you recognize Charles 8 Beasley's handwriting if you saw it? 9 A. I can't be sure. 10 Q. How about the second page of 11 the exhibit, is that your handwriting? 12 A. That's my handwriting. 13 Q. That's on page Pz 482 1564, 14 correct? 15 A. That's correct. 16 Q. How about the following page, 17 1565? 18 A. That's correct. 19 Q. That's your handwriting? 20 A. That's correct. 21 Q. How about the following page, 22 1566? 23 A. Yes, that's my writing. 24 Q. And how about the last page of Page 106 1 the exhibit, 1568? 2 A. That is not my writing. 3 Q. Do you know whose writing that 4 is? 5 A. Probably Charles Beasley's. 6 Q. Why do you say that? 7 A. Because he's really the only 8 one that would be writing this other than myself. 9 Q. Only one who would be writing 10 the graph on the test events? 11 A. Correct. That I know of, that 12 I can recall. That may not be Charles Beasley's, 13 but that's my guess. The other possibility of 14 that is a clinical research CRA. 15 Q. Clinical research 16 administrator? 17 A. Yes. 18 Q. Did you work with any clinical 19 research administrators in particular? 20 A. Jeff Powell. 21 Q. So the possibility is just 22 Doctor Beasley or Jeff Powell with regards to the 23 last page of the exhibit? 24 A. The best that I can guess, yes. Page 107 1 Q. On the first page of the 2 exhibit, in the bottom of the page, it says EE 3 number two. What does that stand for? 4 A. See -- the S is not -- it's see 5 number two. So I believe there's a number two 6 here, and the paragraph that should have been 7 inserted there. 8 Q. Okay. Number two comes -- 9 shows up in the third page of the exhibit, 1560? 10 A. Correct. 11 Q. So I take it you're replacing 12 this paragraph at the bottom of the first page of 13 the exhibit with number two? 14 A. Correct. 15 Q. Who would make decisions such 16 as that, to replace that paragraph with paragraph 17 number two? 18 A. Charles Beasley. 19 Q. Do you know why Doctor Beasley 20 wanted to take that paragraph out of his letter? 21 A. No, I don't. 22 Q. On the first page of the 23 exhibit it says Dear Doctor blank, your request 24 for information regarding the incidence of, Page 108 1 quote, depletion, unquote, like syndrome. Is 2 this an example of a situation where templates 3 had not been established for a particular adverse 4 event? 5 MR. MYERS: Is your question is this 6 letter an example of that? 7 MS. ZETTLER: Right. 8 A. Yes. 9 Q. So if there had been other 10 subsequent requests for depletion-like syndrome, 11 templates would have been developed? 12 A. This may serve as a form of a 13 template for which to answer a question similar 14 to that. 15 Q. If you look at the fourth page 16 of the exhibit, at the bottom of the page, it's 17 Pz 482 1566. 18 A. Uh-huh, yes. 19 Q. It says at the bottom, 20 contained in previous letter. The paragraph that 21 starts, currently there is no information 22 available as to the neurochemical basis of 23 adverse events listed above for the management of 24 this type patient; correct? Page 109 1 A. I'm sorry, what is the 2 question? 3 Q. That's what it says? 4 A. Yes, correct. 5 Q. Is this your handwriting on the 6 left, it says contained in previous letter? 7 A. I can't be sure. 8 Q. Are you familiar with this 9 paragraph? 10 A. I'm not familiar with that, the 11 paragraph itself, no. 12 Q. Do you know where it came from? 13 A. No, I can't remember. 14 Q. Would you look on the next 15 page, at the bottom of the page, the last 16 paragraph. It starts out the same, currently 17 there is no information available as to the 18 neurochemical basis of the adverse events listed 19 above for the management of this type of patient, 20 period. However in clinical trials or controlled 21 studies, depressed patients taking twenty, forty 22 or sixty milligrams fixed doses of Prozac, a 23 higher incidence of some adverse events were 24 observed with higher dosages of Prozac; correct? Page 110 1 A. I'm lost, I'm sorry. 2 Q. At the bottom of the page, it 3 says 1567. 4 A. Yes. 5 Q. It looks like it's another form 6 of the paragraph that's at the bottom of the page 7 just previous to that. 8 A. Correct. 9 Q. Does that refresh your 10 recollection as to where that paragraph came 11 from? 12 MR. MYERS: Which paragraph, the one on 13 the previous page? 14 MS. ZETTLER: Right. I mean 15 essentially they're the same with some additional 16 information at the end of this paragraph on page 17 1567; correct? 18 MR. MYERS: Wait a minute, what's the 19 question, is the question where did it come from 20 or is it the same? 21 Q. Right now my question is the 22 two paragraphs are essentially the same except 23 there's a little bit more information on the 24 second one; correct? Page 111 1 A. That's correct. 2 Q. Okay. Does the second -- does 3 the paragraph at the bottom of page 1567, Pz 482 4 1567, refresh your recollection as to where the 5 paragraph is written out on the page previous, Pz 6 482 1566, came from? 7 A. I can understand now why that 8 says contained in previous letter, that it's this 9 letter that that's referring to. 10 Q. Okay. So the letter that's on 11 Pz 482 1567 is the letter that's the previous 12 letter? 13 A. I can't be sure that that's, 14 quote, the previous letter, only that you 15 referred to that similar sentence and I'm 16 agreeing that that similar sentence is contained 17 in there and it says previous letter, but I don't 18 know if that's the previous letter. 19 Q. Okay. On page Pz 482 1567, 20 those paragraphs -- are these paragraphs listed 21 in here, written in here, are these templates for 22 the most part? 23 A. Yes, that is a template. 24 Q. What are TESS events, T-E-S-S Page 112 1 events? 2 A. I don't recall what TESS stands 3 for. 4 Q. Does treatment emergent signs 5 and symptoms ring a bell? 6 A. I agree with the treatment 7 emergent, and probably symptoms, but I don't 8 think I know, remember, exactly what that title 9 represents. 10 Q. Do you recall an issue 11 regarding the use of Fluoxetine in a condition 12 know as tardive dyskinesia coming up? 13 A. Yes, I do. 14 Q. How did that issue first arise? 15 A. I don't know. 16 Q. Were you charged with drafting 17 medical information letters in response to 18 questions on tardive dyskinesia? 19 A. Yes. 20 Q. And, again, you did that in 21 conjunction with Doctor Beasley? 22 A. Absolutely. 23 Q. Have you ever heard of the 24 ELECT dictionary? Page 113 1 A. Yes. 2 Q. Can you tell me what that is? 3 A. The way I would summarize it, 4 it's a standardized way in which you would group 5 various adverse events under one terminology. 6 Because there's so many different ways that 7 adverse events are described, that it allows for 8 the -- a standard way of communicating those 9 adverse events and understanding them. 10 Q. Do you know if the ELECT 11 dictionary was something that was developed by 12 Eli Lilly? 13 A. I don't believe it was, but I 14 can't answer it. 15 Q. Who do you think it was 16 developed by? 17 A. I have no idea, some governing 18 body. 19 Q. Are you familiar with the 20 condition of extrapyramidal syndrome? 21 A. I have heard of the terminology 22 and I think I know what it is. 23 Q. Okay. What is your 24 understanding of what it is? Page 114 1 A. It's involuntary movements. 2 Q. When you would draft these 3 medical information letters, were you relying 4 solely on Doctor Beasley or somebody like him for 5 the information that was included in the letters? 6 A. I was relying primarily on 7 Doctor Beasley or Doctor Street or Doctor 8 Heiligenstein for that information. 9 Q. Did you work with anybody 10 besides Doctor Beasley on the tardive dyskinesia 11 response letters? 12 A. I can't recall, it's possible. 13 Q. If there were -- 14 A. That would be another 15 physician. 16 Q. That would be Doctor Street or 17 Doctor Heiligenstein? 18 A. Maybe Jim Kotsanos might be 19 another medical physician I worked with. 20 Q. Have you ever -- 21 A. One other name, David Wheadon. 22 Q. Would the doctor who was 23 working with you on the drafting the letter be 24 the doctor who would eventually sign the letter Page 115 1 and send it out to the doctor, or in other words 2 would -- if Beasley was working with you on a 3 particular letter, would he be the doctor who 4 would eventually sign the letter? 5 A. He would -- the physician who 6 is responsible -- the physician responsible for 7 really writing the letter and approving its 8 contents would approve the letter as it is. 9 Then, depending on which physician was on, quote, 10 duty for reviewing the information requests and 11 letters, if it was John Heiligenstein, John would 12 look at the request for information, would take 13 the letter that Doctor Beasley had potentially 14 written and approved, and would look and make 15 sure that it answered, then would sign his name 16 to that letter. 17 Q. Was there some sort of routine 18 by which the doctors would -- like, for instance, 19 Doctor Heiligenstein would have that 20 responsibility one week, and the next week Doctor 21 Beasley would, or was that a matter of Doctor 22 Heiligenstein filling in if Doctor Beasley 23 happened to not be there that day. 24 A. My best recollection is that Page 116 1 Charles Beasley had primary responsibility for 2 signing off on those letters, and that if Doctor 3 Beasley was away or was consumed by other 4 matters, that John or Jamie would fill in that 5 responsibility. 6 Q. Signing off on the letters? 7 A. Right. 8 Q. How often would that happen, 9 where somebody would fill in for Doctor Beasley? 10 A. I don't know. 11 Q. Would Doctor Beasley sign off 12 on a letter that was drafted by Doctor 13 Heiligenstein or Doctor Street? 14 A. Yes. 15 Q. How often would that happen? 16 A. I don't know. 17 Q. Was that another situation 18 where Doctor Heiligenstein would, say, have 19 primary responsibility for responding to a 20 certain question, and he just wasn't available 21 for some reason that day and Doctor Beasley would 22 fill in for him, or was it a matter of Doctor 23 Beasley being charged with signing off on all the 24 letters, information letters, that went out Page 117 1 unless he was unavailable? 2 A. I don't remember how that was 3 specifically structured or organized within that 4 department. 5 Q. Do you remember generally 6 working with somebody like Doctor Heiligenstein 7 to construct or draft a letter and having Doctor 8 Beasley sign off on it even if Doctor 9 Heiligenstein was available? 10 A. I can't recall any particular 11 instance like that. 12 Q. How about generally? 13 A. Well, Doctor Heiligenstein 14 specializes in child psychiatry, and if there was 15 something -- some kind of issue request for 16 information on child psychiatry, Doctor 17 Heiligenstein would be the specialist, so 18 everyone would refer to him for the information 19 and possibly draft a letter. Now I can't 20 remember any specific letter being drafted by 21 him, but it's possible that that's happened. And 22 as a result, if this letter of information 23 answers a specific question, then if we get 24 another request on that same subject, and Page 118 1 theoretically, if Doctor Heiligenstein is out, 2 then one of the responsible physicians might sign 3 off on that letter. 4 Q. Okay. 5 (PLAINTIFFS' EXHIBIT NO. 4 WAS 6 MARKED FOR IDENTIFICATION AND 7 RECEIVED IN EVIDENCE.) 8 Q. Have you had a chance to look 9 at Exhibit 4? 10 A. Yes, I have. 11 Q. Do you recognize this document? 12 A. I don't recognize the specific 13 document, I recognize the format and general 14 content of the document. 15 Q. Okay. This isn't a typical 16 medical information letter, is it? 17 MR. MYERS: Typical in comparison to 18 what? 19 Q. In comparison to the majority 20 of the other types of letters that were sent out. 21 A. I think this may be a typical 22 letter. 23 Q. Okay. Let me ask you this: At 24 the beginning of the letter it says the purpose Page 119 1 of this letter is to complete your initial 2 request with follow-up information on the 3 association of tardive dyskinesia with Prozac 4 therapy; correct? 5 A. Correct. 6 Q. Would this type of letter be 7 sent out in response to just a single request by 8 a doctor? 9 A. No. 10 Q. So this was a letter that was 11 written in response to an additional request for 12 information on that subject by this doctor? 13 A. I believe, as I look at this 14 now, that we always want to supply as complete of 15 information as we possibly can, and if a question 16 comes up that we need to do additional research 17 on, this is a typical follow-up letter to supply 18 additional information if it's available to us. 19 Q. Second paragraph of the letter 20 says: As you may have noted, there were 21 eighty-three reports of extrapyramidal syndrome. 22 In these eighty-three reports, the reporter of 23 the event used the term, quote, tardive 24 dyskinesia seven times, period. Where would -- Page 120 1 how would the doctor have noted that the reporter 2 used the term tardive dyskinesia seven times 3 within that group of eighty-three people where 4 reports of extrapyramidal syndrome was made? 5 MR. MYERS: Let me object to the form 6 to the extent that you're asking him to speculate 7 how a physician, someone other than him, would 8 know, or what a reporter, someone other than him 9 or the physician, how they would note something. 10 Q. Let me ask you this: Was it 11 Lilly's policy to report what the initial 12 reporters said about a particular adverse event? 13 A. I'm not sure, I don't 14 understand that, can you repeat that? 15 Q. Sure. Let's look at the last 16 two pages of Exhibit No. 4, okay. Have you seen 17 one of these documents before, international 18 event report? Not the specific one, but 19 generally the form. 20 A. I've seen an adverse event 21 report similar to that. 22 Q. Have you ever seen this 23 particular event report before? 24 A. This one in particular? Page 121 1 Q. Yes. 2 A. I can't recall remembering it. 3 Q. Do you have any idea why this 4 was in your file? 5 A. Generally speaking, this was 6 probably -- the only thing I can remember is the 7 doctor probably had an adverse event and asked 8 for additional questions on that adverse event. 9 The physician who had a patient experience that 10 adverse event, this is probably the report of the 11 adverse event that was filed. 12 Q. Okay. 13 A. So in order to respond to some 14 of those questions, that just because by address 15 and -- that's why that might be attached to that. 16 Q. Okay. So this adverse event 17 form probably related -- or at least in your 18 experience related to this doctor's patients? 19 A. Probably. 20 Q. Was it Lilly's policy to send 21 copies of 1639s or international event report 22 forms to doctors in general regarding a specific 23 adverse event? 24 A. I don't know the procedure that Page 122 1 the drug epidemiology unit does in terms of 2 sending this. I would not make the assumption 3 and I don't recall any case where I have sent a 4 letter out with -- did you say 1639, this 5 document, with that letter. It may have been in 6 the file merely for address and background 7 information on the request. So I can't make the 8 assumption or I wouldn't make the assumption that 9 this was sent out with this letter. 10 Q. Okay. So just to make sure I 11 understand, you don't recall an incident where 12 you sent out a medical information letter in 13 response it a question by a physician where you 14 attached 1639 international event reports or 15 anything of that nature to that letter? 16 A. No. 17 Q. No, you don't recall? 18 A. No, I can even recall I did 19 not. 20 Q. Ever? 21 A. I can't recall. 22 Q. To the best of your -- 23 A. To the best of my knowledge, I 24 can't ever recall sending out a 1639 or Page 123 1 instructing. Now, an exception is Doctor Beasley 2 has control over this and Doctor Beasley may have 3 sent that out attached with the letter. 4 Q. Have you ever seen a case where 5 that happened? 6 A. I've never seen a case. 7 Q. Going back to this letter, the 8 second paragraph states: As you may have noted, 9 there were eighty-three reports of extrapyramidal 10 syndrome. In these eighty-three reports, the 11 reporter of the event used the term tardive 12 dyskinesia seven times. Was it typical for you 13 or somebody working with you such as Doctor 14 Beasley to report what the initial reporter's 15 narrative was on an adverse event report? 16 A. This basically is a letter that 17 I believe goes with a list of adverse events out 18 of one thousand two hundred and seventy-three 19 patients. Doctor Beasley makes a clinical 20 judgment on what events are EPS, that's attached 21 there, so Doctor Charles Beasley will say that 22 there are eighty-three because EPS is a broad 23 classification of many different things, and what 24 this is referring to is probably tardive Page 124 1 dyskinesia in that thing, and it says seven 2 times. And that's all that is referring to. 3 Q. What is EPS? 4 A. Extrapyramidal syndrome. 5 Q. Okay. 6 A. So my is assumption there is a 7 table attached listing all the reports that were 8 reported, that there are various different 9 terminology -- or different classifications of 10 symptoms that fall under EPS symptoms, 11 eighty-three of them. 12 Q. Okay. 13 A. And that tardive dyskinesia, 14 there is seven reports of it, and that's what 15 this letter was referring to, there are seven 16 reports of, quote, tardive dyskinesia. But being 17 as comprehensive as I know Doctor Beasley is, he 18 says let's include them all so they can fully 19 know, but let's refer to a letter that there were 20 seven specific terms, because we take -- as I 21 understand, exactly what the doctor says, and 22 that's how that is referred to. 23 Q. Okay. Is it your understanding 24 that there's a policy at Lilly that certain event Page 125 1 terms will be -- certain events will be mapped to 2 certain terms in the ELECT dictionary? 3 A. Yes. 4 Q. Is it your understanding that 5 with regards to tardive dyskinesia it was mapped 6 to EPS? 7 A. I don't know. 8 Q. Okay. Do you have an 9 understanding of the process that an adverse 10 event report goes through before it's entered 11 into the DEN system? 12 A. No. 13 Q. Are you aware that an adverse 14 event may come into Lilly -- a report of an 15 adverse event may come into Lilly through a 16 physician? In other words a physician calls up 17 and says I have a patient who experienced such 18 and such while on your drug? 19 A. Yes. 20 Q. And that doctor gives a 21 narrative report of what happened to his patient; 22 correct? 23 A. Correct. 24 Q. And from that narrative report Page 126 1 an event term is assigned from the ELECT 2 dictionary by somebody at Lilly; correct? 3 A. I believe so. 4 Q. The second paragraph of Exhibit 5 4 says: As you may have noted, there were 6 eighty-three reports of extrapyramidal -- of EPS, 7 okay. Of these eighty-three reports, the 8 reporter of the event used the term tardive 9 dyskinesia seven times. Does that imply that 10 Doctor Beasley was saying within the eighty-three 11 reports of EPS that tardive dyskinesia was 12 reported seven times in the narrative given to 13 Lilly by the initial reporter? 14 MR. MYERS: Well, before he answers, 15 let me object to the form because I believe, 16 Nancy, it gets into him speculating as to what 17 Doctor Beasley was implying by making such a 18 statement. He told you about two questions ago 19 what he understood the question to mean, but now 20 you're getting into what Doctor Beasley meant by 21 making a statement and it's speculative. 22 MS. ZETTLER: Well, I'm not saying -- 23 MR. MYERS: If you know, answer it, if 24 you don't know, tell her that. Page 127 1 A. I don't know what Doctor 2 Beasley speculated, I can only go back to what I 3 understand that paragraph to represent, that 4 again -- that probably under tardive dyskinesia, 5 there's seven events listed, and that's what this 6 paragraph was referring to out of all the 7 different types of other symptoms that would fall 8 under a broad classification of EPS. 9 Q. Do you remember any of the 10 other symptoms that fell under the EPS 11 classification? 12 A. I can't recall. 13 Q. Do you know who decided to map 14 those various events to EPS? 15 A. The people in, I believe -- I 16 don't know, it's the drug epidemiology unit and 17 how they work through their system that maps 18 these things. 19 Q. Were you ever -- did you ever 20 have an understanding of how various depression 21 related events mapped, in other words like 22 suicide attempt, depression, suicidal ideation, 23 were you ever made aware of how they were to be 24 mapped? Page 128 1 A. No, there's no -- 2 Q. In your position as a medical 3 information administrator, were you considered a 4 part of the marketing division or the medical 5 division? 6 A. The medical, I reported through 7 medical. 8 Q. Were you ever involved in the 9 marketing department? 10 A. No, I was not involved. 11 MS. ZETTLER: Do you want to take a 12 lunch break? 13 MR. MYERS: Sure, that would be fine. 14 One o'clock? 15 MS. ZETTLER: Yes. 16 (A LUNCH BREAK WAS TAKEN.) 17 (PLAINTIFFS' EXHIBIT NO. 5 WAS 18 MARKED FOR IDENTIFICATION AND 19 RECEIVED IN EVIDENCE.) 20 Q. Have you had a chance to review 21 Exhibit 5? 22 A. Yes, I have. 23 Q. Is this your handwriting? 24 A. Yes, it is. Page 129 1 Q. Do you recognize the document? 2 A. Yes, I do. 3 Q. Could you tell me what this is? 4 A. I believe that -- I don't know 5 the specific event, other than I think we 6 received an adverse event about a murder/suicide, 7 and I don't even recall if it was something that 8 we -- a phone call received or whether it 9 appeared on the news. It may have been in a 10 media event, and then we got word of it and, so, 11 that's why I think this memo resulted from. 12 Q. Okay. What was your role in 13 this meeting? 14 A. That's a good question. 15 Communicator of information. 16 Q. Okay. Under outcome at number 17 two, it says formulate response from medical, 18 Charles Beasley and Tom Pianko. Does that 19 refresh your recollection specifically what your 20 role was? 21 A. Yes, that's one of my roles 22 there, yes. 23 Q. When it says formulate response 24 from medical, what does that mean, what do you Page 130 1 mean there? 2 A. Well, a response to the event. 3 In other words, gathering all the medical 4 information that we have available to us and 5 respond to questions. 6 Q. Questions from whom? 7 A. Questions from the medical 8 community. 9 Q. Outside of Lilly? 10 A. Outside of Lilly. 11 Q. What about media questions? 12 A. And also media questions. 13 Q. Anybody else? 14 A. Really, that's what this would 15 imply. 16 Q. Okay. Are all three pages 17 related to the same issue, all three pages of 18 Exhibit 5? 19 A. Yes. 20 Q. On the second page of the 21 exhibit, it says Friday, 9:00 o'clock meeting? 22 A. Uh-huh. 23 Q. Can you read what it says 24 underneath that? Page 131 1 A. No. 2 Q. Looks like late p.m., something 3 4:00 p.m.? 4 A. I think it's -- yes, maybe says 5 late p.m., I don't know. 6 Q. Under that it says Doctor 7 Beasley event has occurred. What do you mean by 8 that? 9 A. I don't remember. 10 Q. Was this second page written 11 after the meeting that was on Friday, 4-27-90? 12 A. I don't recall. 13 Q. Under that it says Monday, 9:30 14 a.m., share with Prozac staff. 15 A. Yes. 16 Q. What does that mean? 17 A. I believe during that time, I 18 shared with the marketing people an adverse event 19 that was reported or occurred, and that's what 20 that means. 21 Q. Okay. And under that, it says 22 further details are pending, I was asked why were 23 we not informed Friday. Who asked you that? 24 A. I don't remember the specific Page 132 1 person, but I would say marketing asked me that. 2 Q. Who is Bob Petersen? 3 A. He was Prozac marketing plans 4 manager at that time. 5 Q. Is he still with Lilly? 6 A. I don't know. 7 Q. You said he was Prozac 8 marketing plans manager at that time. Was there 9 a time subsequent to this memo where he was no 10 longer Prozac marketing plans manager? 11 A. Post this memo? 12 Q. Right. 13 A. Yes, he was transferred 14 overseas. 15 Q. Do you remember when he was 16 transferred overseas? 17 A. I do not. 18 Q. Do you remember -- do you have 19 any idea how long after this memo? 20 A. I really don't, no. 21 Q. Do you know why he was 22 transferred overseas? 23 A. Promotion. 24 Q. Where overseas was he Page 133 1 transferred to? 2 A. I don't recall. To the best of 3 my knowledge it was Germany. 4 Q. The second and third page of 5 Exhibit 5, what is that, it looks like a time 6 line of some sort? 7 A. I'm sorry, what? 8 Q. The second two pages of Exhibit 9 5. 10 A. Yes. 11 Q. Looks like it's a time line of 12 sorts. Can you tell me what it is, why they 13 wrote it out like that? 14 A. It's a list of events and times 15 that occurred. 16 Q. Why did you write it out like 17 this, why did you list the times and events? 18 A. I wrote it out because I had -- 19 I believe I was documenting the event to explain 20 exactly where I fit into this thing, because if 21 you read at 4:30 -- let's see. If you read at 22 4:15, marketing wanted me to report and let them 23 know of this adverse event, and medical, who I 24 reported to, who was totally separate from Page 134 1 marketing, did not want them to report it, so I 2 was documenting in CYA. 3 Q. CYA? 4 A. Covering my most -- 5 Q. So you mean CYM? 6 A. Yes. 7 Q. Okay. Under 4:30, it says 8 talking with Dan M and David. Who is Dan M? 9 A. Dan Masica. 10 Q. Who is David? 11 A. David Wheadon. 12 Q. And it appears from what you 13 wrote at 4:30 that Dan wasn't real happy that you -- 14 or, I'm sorry, David wasn't real happy that you 15 had talked to marketing about the adverse event; 16 is that true? 17 A. I don't know if that's true. I 18 think David, in his mind, had clear, you know, 19 specific reasoning as to why I should not share 20 that information with them, and he clearly 21 spelled it out, what my role was. 22 Q. What was your understanding of 23 Doctor Wheadon's reasoning for not wanting 24 marketing to know about the adverse event, at Page 135 1 least at this time? 2 A. Because they wanted to assess 3 fully all the facts of the case. 4 Q. Do you have any specific 5 recollection as to what case this was? 6 A. No, I really do not, I have no 7 recollection. I think it was a media, something 8 that was reported through the media, that's the 9 only thing I can think of. 10 Q. Why is it that you went to 11 marketing and reported the adverse event? 12 A. I can't remember at the time 13 other than that they would be interested in that 14 information. 15 Q. Was it your practice to go to 16 marketing and report adverse events that came to 17 your attention? 18 A. Not -- I think, as a general 19 rule, I was a liaison between marketing and 20 medical. And in that role, that's why I 21 communicated that. 22 Q. Okay. Under the 4:30 notation, 23 you quote Doctor Wheadon as saying: While you 24 are in medical, you are a medical information Page 136 1 associate, not a marketing information associate. 2 What did he mean by that? 3 MR. MYERS: Let me object to the form 4 as to what Doctor Wheadon meant, that's 5 speculation. 6 Q. What is your understanding of 7 what Doctor Wheadon meant by that? 8 MR. MYERS: Same objection. If you 9 know, tell her. 10 A. All I can say is he didn't want 11 me to tell marketing prematurely of information 12 that they received in medical. 13 Q. Were you ever a marketing 14 information associate? 15 A. No, that's just a terminology 16 that he made up. 17 Q. What else was done in response 18 to this adverse event report? 19 A. I can't recall, I think what is 20 listed here is the best documentation of that. 21 Q. Did you formulate any 22 correspondence or any document in response to 23 this adverse event? 24 A. I can't remember if I Page 137 1 specifically wrote a document to respond to this 2 event. Again, my best recollection is from this 3 document. 4 Q. On the first page it says 5 outcome formulate response from medical, Charles 6 Beasley and Tom Pianko. Do you remember, based 7 on that, whether or not you formulated a 8 response? 9 A. Again, that was something that 10 was planned, and I don't remember specifically 11 what the outcome, whether we went forward with 12 the response and what it produces in particular 13 to that, this note and this event. 14 Q. Okay. The second two pages, 15 this time line that you wrote out in the second 16 two pages of this exhibit, covering yourself, is 17 this document what you did at these various 18 periods of time? 19 A. Let me read thoroughly. 20 Q. Sure. 21 A. I would say yes, this fairly 22 closely represents my role and my actions in 23 surrounding this event. 24 Q. Okay. Under 12:00 p.m. it says Page 138 1 write up an action plan and results for meeting 2 delivered to Bob Petersen. Did you actually 3 write up an action plan? 4 A. That's why I say closely, 5 because I can't recall an absolute action plan 6 that was written up. 7 Q. It says results of meeting, 8 actually planning results of meeting delivered to 9 Bob Petersen. 10 A. I think this might be this 11 document, to be honest with you, I mean I really 12 do not recall a specific action plan on this 13 other than what we see here. As a matter of 14 fact, this is probably the memo, and it may have 15 been cut off, but Rick Prine and Bob Petersen 16 were probably listed on this. 17 Q. You're talking about the first 18 page of Exhibit 5? 19 A. Yes. 20 Q. That is what? 21 A. That is what is referred to at 22 12:00 p.m. 23 Q. And this is what you may have 24 delivered to Mister Petersen? Page 139 1 A. Correct. 2 Q. Under 4:15 you write: Doctor 3 Beasley indicates to me I may have made a mistake 4 by telling marketing about this adverse event. 5 We still don't know if the patient was on Prozac. 6 It states you must keep this info confidential, I 7 respond with apology and state I did not know 8 this procedure. What procedure are you talking 9 about? 10 A. The procedure referenced about 11 telling marketing prematurely about an adverse 12 event until they have all the facts. 13 Q. Okay. You go on to say I 14 indicate to him in the past Stan and Laura would 15 communicate this information to marketing. What 16 do you mean by that? 17 A. That a medical information 18 administrator -- administrators serves as a 19 conduit or a liaison between medical and 20 marketing, and so any pertinent issues, we would 21 be a communication vehicle. 22 Q. Who is Stan? 23 A. He's a medical information 24 administrator. Page 140 1 Q. What is his last name? 2 A. Bialkowski. 3 Q. And how about Laura, who is 4 Laura? 5 A. Laura Caleorla, she was also a 6 medical information administrator. 7 Q. How do you spell Caleorla? 8 A. C-A-L-E-O-R-L-A. 9 Q. Have you ever heard the name 10 Laura Fludzinski? 11 A. Yes. 12 Q. Do you know who Laura 13 Fludzinski is? 14 A. Yes. 15 Q. Who is she? 16 A. She, I believe, as I can best 17 recall, was the clinical investigation 18 coordinator for Fluoxetine clinical trials, as 19 best I can summarize, I don't remember. 20 Q. How about Leslie Chipless? 21 A. No, I don't recall that name. 22 (PLAINTIFFS' EXHIBIT NO. 6 WAS 23 MARKED FOR IDENTIFICATION AND 24 RECEIVED IN EVIDENCE.) Page 141 1 Q. Have you had a chance to review 2 Exhibit 6? 3 A. Yes. 4 Q. Is this your handwriting? 5 A. No. 6 Q. Do you recognize it? 7 A. I do not. 8 Q. Have you seen this document 9 before? 10 A. No, I have not. 11 Q. Do you have any idea why it was 12 produced as being part of your file? 13 A. I do not. 14 Q. Are you familiar with the 15 subject matter of the document? 16 MR. MYERS: I'm sorry? 17 Q. The subject matter, are you 18 familiar with it? 19 A. I'm familiar with the subject 20 matter. 21 Q. Could you tell us generally 22 what this document is talking about? 23 MR. MYERS: Let me object to the form, 24 he says he's never seen it before. Page 142 1 MS. ZETTLER: He also said he's 2 familiar with the subject matter. 3 MR. MYERS: Well, he can confirm what's 4 in it, but I object to the form, asking him to 5 summarize what's in a document that he did not 6 write and he's never seen. 7 MS. ZETTLER: He can take his time and 8 read it. 9 A. I'll read it to you verbatim, 10 but to be honest with you, it's Prozac suicide 11 event term, suicide attempt, for means other than 12 OD. 13 Q. I don't want you to read it. 14 A. I know, but I really honestly 15 have never seen this document before. 16 Q. But you are familiar with the 17 subject matter, are you not? 18 A. Yes. 19 Q. The subject matter is event 20 terms assigned to various suicidality related 21 events; correct? 22 A. I can't answer that. 23 Q. Why not? 24 A. Because I really don't Page 143 1 understand exactly what this letter is and what 2 it is saying. Event term, suicide attempt for 3 means other than OD, for SA use -- I don't know 4 what SA use, so I can't make a judgment what this 5 really means and what you're asking because I 6 really don't know. 7 Q. Okay. Is it your understanding 8 that it was Lilly's policy to map adverse events 9 related to suicidal thought to depression, to the 10 event term depression? 11 MR. MYERS: Before he answers, let me 12 object to the form because it assumes a policy 13 which may or may not be consistent with what's in 14 the respective dictionary. So I think the 15 question is based on a faulty assumption. 16 A. I'm not aware of that policy. 17 Q. Are you aware of any policy 18 with regards to the mapping of suicide or 19 violent/aggressive behavior adverse events to 20 certain event terms at Lilly? 21 A. No, I'm not aware of a policy. 22 (PLAINTIFFS' EXHIBIT NO. 7 WAS 23 MARKED FOR IDENTIFICATION AND 24 RECEIVED IN EVIDENCE.) Page 144 1 Q. Have you had a chance to look 2 at Exhibit 7? 3 A. Yes, I have. 4 Q. Do you recognize the first page 5 of Exhibit 7? 6 A. I do not. 7 Q. Okay. You are carbon copied on 8 that memo, are you not? 9 A. That's correct. 10 Q. Are you familiar with the 11 subject matter of the memo? 12 A. Yes, I am. 13 Q. Tell me what Prozac and 14 suicidality strategy is. 15 A. I have no idea what Charles 16 Beasley was referring to. 17 Q. You said you were familiar with 18 the subject matter of the memo; correct? 19 A. Yes, I am. 20 Q. Can you tell me what this memo 21 is dealing with? 22 A. I believe Charles Beasley was 23 writing and communicating that suicidality has 24 been noted in the literature with other Page 145 1 anti-depressants prior to Teicher's reports. 2 Q. Have you ever talked to Doctor 3 Teicher? 4 A. No, I have not. 5 Q. Have you ever talked to Doctor 6 Beasley or anybody else at Lilly regarding Doctor 7 Teicher or his articles? 8 A. Probably. 9 Q. Do you remember any 10 conversations with Doctor Beasley? 11 A. Not specific conversations, no. 12 Q. How about generally? 13 A. Generally, I'm sure we 14 discussed Teicher's reports. 15 Q. Was it part of your 16 responsibilities as a medical information 17 administrator to research or look into other 18 anti-depressants and their side effects? 19 A. Sure, I assisted in doing 20 literature searches and gathering references for 21 any subject matter that Doctor Beasley wanted me 22 to look at. 23 Q. Was it a matter of Doctor 24 Beasley asking you to do a literature search on a Page 146 1 particular matter or did you undertake to do 2 those types of searches on your own without being 3 asked? 4 A. It depended on the situation, I 5 think. 6 Q. Okay. Can you give me an 7 example where you did your own independent 8 research? 9 A. I can't -- you know, it could 10 be something, a question that came up, be a 11 doctor that he wanted or she wanted a literature 12 search done and I would go and do that without at 13 least initially consulting with Charles Beasley, 14 but then again, all that stuff was referred back 15 to Charles Beasley, I was just the person who 16 initiated gathering that stuff and brought it to 17 Doctor Beasley. 18 Q. The second page of Exhibit No. 19 7, the second and third page, it says literature 20 review? 21 A. Uh-huh. 22 Q. Can you tell me what this is? 23 A. I don't know, I didn't write it 24 or have any part of that. Page 147 1 Q. Who did? 2 A. I don't know who LCS is or AKJ. 3 Q. Have you ever done a similar 4 literature review? 5 A. Probably. 6 MR. MYERS: Hold on. Of the type 7 referred to in this document? 8 MS. ZETTLER: Right. 9 A. I've done literature reviews, 10 yes. 11 Q. In what circumstances would you 12 do a literature review? 13 A. Any time an article, be it a 14 competitive anti-depressant or our own 15 anti-depressant, was in an article published, I 16 would do -- if it was interesting, I would do a 17 literature review on it. 18 Q. Is this a form that was used at 19 Lilly to put together literature review or is 20 this something that this person made up on their 21 own? 22 A. I believe it was what they made 23 up on their own. 24 Q. Do you recognize this Page 148 1 literature review? 2 A. I do not. 3 Q. Do you have any idea why it was 4 in your file or produced as being in your file? 5 A. I do not. 6 Q. Do you know if the article this 7 person is talking about is an article published 8 by Lilly or not? 9 A. I don't know. 10 Q. Do you recognize any of the 11 authors? 12 A. I do not. 13 (PLAINTIFFS' EXHIBIT NO. 8 WAS 14 MARKED FOR IDENTIFICATION AND 15 RECEIVED IN EVIDENCE.) 16 Q. Have you had a chance to review 17 Exhibit 8? 18 A. Yes. 19 Q. Do you recognize this document? 20 A. I do not. 21 Q. Why am I not surprised. Have 22 you ever helped write documents such as this? 23 A. I have not. 24 Q. Do you have any idea why this Page 149 1 would have been produced to us as part of your 2 file? 3 A. I do not. There's a lot of 4 papers in all my files, and they accumulate over 5 time, and that is the only reason that a lot of 6 these documents ended up in my files. 7 Q. That's assuming they actually 8 came from your files, Mister Pianko. Have you 9 ever seen this document before? 10 A. I have not. 11 Q. Are you familiar with Lilly's 12 drug experience network? 13 A. I'm not familiar with it, no. 14 (PLAINTIFFS' EXHIBIT NO. 9 WAS 15 MARKED FOR IDENTIFICATION AND 16 RECEIVED IN EVIDENCE.) 17 Q. Have you had a chance to review 18 Exhibit 9? 19 A. Yes, I have. 20 Q. Do you recognize this document? 21 A. I do not. 22 MS. ZETTLER: So we have gone from not 23 giving us documents to giving us too many 24 documents, is that what the story is now, Larry? Page 150 1 MR. MYERS: Is that a question or a 2 statement? 3 MS. ZETTLER: It's a statement, 4 comment, editorialism. 5 Q. At the bottom of this page, 6 first page of Exhibit 9, it says several 7 suggestions may be helpful in presenting this 8 information to physicians. Is this a document 9 that was written to be sent to sales 10 representatives to your knowledge? 11 A. I do not know. 12 Q. Do you have any idea why this 13 would have been included in your file, Mister 14 Pianko? 15 A. Just the same reason as before, 16 there's lots of transition and people don't clear 17 out files and they just accumulate. 18 Q. When you say lots of 19 transition, what do you mean? 20 A. I was in the job for fourteen 21 months, my predecessor was probably in for a 22 similar period of time, and so someone is not in 23 that job, in that desk, in that office for years 24 upon years upon years, and when you rotate, the Page 151 1 person assumes that office and those files, and 2 unless you've got a lot of time to go through 3 them all and throw things out, you just 4 accumulate these and they end up in your files, 5 and then that's it. 6 Q. Who was your predecessor? 7 MR. MYERS: To the MIA job? 8 MS. ZETTLER: Yes, let's start with the 9 MIA job. 10 A. Stan Bialkowski. 11 Q. Where is Mister Bialkowski now? 12 A. I believe he's somewhere in the 13 southeast. 14 Q. Is he still working for Lilly? 15 A. I think so. 16 Q. Do you know what he's doing for 17 Lilly now? 18 A. I think he's a district 19 manager. 20 Q. District manager of what? 21 A. District sales manager. 22 Q. Who was your predecessor as a 23 detail rep in the region that you worked? 24 A. I don't know. Page 152 1 Q. Who was your predecessor in 2 your job as axid market research analyst? 3 A. Brian Brucell. 4 Q. In your job as axid market 5 research analyst, did you do any work in regards 6 to Fluoxetine? 7 A. No, I did not. 8 Q. Who was your predecessor in 9 managed care coordinator position? 10 A. It's a newly created position. 11 Q. Who was your predecessor when 12 you became a new product planning associate? 13 A. I can picture the face, but I 14 don't remember the name. 15 Q. Would documents such as Exhibit 16 9, Exhibit 8 and Exhibit 7 be -- I'm sorry, 17 Exhibit 8 and Exhibit 9 be documents that would 18 have been used in your position as new product 19 planning associate? 20 A. No, they are not. 21 (PLAINTIFFS' EXHIBIT NO. 10 WAS 22 MARKED FOR IDENTIFICATION AND 23 RECEIVED IN EVIDENCE.) 24 Q. I can tell by the look on your Page 153 1 face what the answer to this question is going to 2 be, Mister Pianko, but I'm going to ask it 3 anyway. Do you recognize this document? 4 A. I do not. 5 Q. Do you have any idea other than 6 the possibility that it may have been passed 7 along by your predecessor as to why this would 8 have been produced? 9 A. That's correct, it's probably 10 been passed along. 11 Q. You don't know that, do you? 12 A. I do not know that, I've never 13 seen it so I can't even -- 14 Q. It's really speculation on your 15 part that it was in your files when you came? 16 MR. MYERS: That's not what he said. 17 Don't answer that, she's just arguing with you 18 now. 19 MS. ZETTLER: I'm not arguing with him. 20 MR. MYERS: He's not going to answer 21 that question. 22 Q. It's really speculation, isn't 23 it? 24 MR. MYERS: Don't answer that. Page 154 1 MS. ZETTLER: Certify it. 2 (QUESTION CERTIFIED.) 3 (PLAINTIFFS' EXHIBIT NO. 11 WAS 4 MARKED FOR IDENTIFICATION AND 5 RECEIVED IN EVIDENCE.) 6 Q. Have you had a chance to review 7 Exhibit 11? 8 A. Yes, I have. 9 Q. Do you recognize Exhibit 11? 10 A. Yes, I do. 11 Q. Again, this appears to be 12 various drafts of medical information letters 13 regarding questions about tardive dyskinesia; is 14 that true? 15 A. Correct. 16 Q. This first page of Exhibit 11, 17 can you tell me what that is specifically, is 18 this the letter that was eventually used, the 19 draft that was eventually used in response to 20 tardive dyskinesia questions? 21 A. I don't know if eventually used 22 is the word, but this is a copy of a medical 23 information letter in response to a question on 24 tardive dyskinesia -- let me make sure that's Page 155 1 correct. The association of tardive dyskinesia 2 with Prozac, that's a copy of a letter to a 3 specific doctor. 4 Q. Okay. What I'm trying to get a 5 handle on is whether in cases such as tardive 6 dyskinesia, or other of the more common requests, 7 things like that, did there come a time when 8 there was a form letter in effect used where it 9 would just be filled out for that person, that 10 individual doctor, and sent out or did you 11 reconstruct a letter every single time you had a 12 request? 13 MR. MYERS: Are you assuming tardive 14 dyskinesia is a common request? 15 MS. ZETTLER: No, Larry, I'm just 16 trying to get an idea of what the procedure is. 17 Q. Let's use nausea, okay. Would 18 you agree that was a fairly common adverse event 19 reported with regards to Fluoxetine? 20 A. Yes. 21 Q. And in that situation with 22 nausea, was there a time where it got to the 23 point where you had a certain number of requests 24 where you just wrote out a specific form letter Page 156 1 that you used across the board? 2 A. Yes. 3 Q. Did that happen with tardive 4 dyskinesia? 5 A. Yes, but it was probably a very 6 infrequent request. 7 Q. Okay. But there came a time, 8 at least to the best of your recollection, where 9 a form letter, so to speak, with regards to 10 tardive dyskinesia was used? 11 A. Yes. 12 Q. How about suicidal ideation or 13 suicidality? 14 A. Yes. 15 Q. How about violent/aggressive 16 behavior? 17 A. Yes. 18 Q. Hostility? 19 A. I don't think so. I think it 20 may have been violent/aggressive behavior, I 21 don't recall. 22 Q. Okay. Violent/aggressive 23 behavior and hostility may have been one and the 24 same? Page 157 1 A. I can't answer that, I don't 2 know. 3 Q. But at least with regards to 4 tardive dyskinesia, suicidal ideation and 5 violent/aggressive behavior, there came a time 6 when a form letter was used in response to each 7 of those types of requests? 8 MR. MYERS: When you say form letter, 9 are you talking something different than a 10 template or whatever we were talking about 11 earlier? 12 MS. ZETTLER: No. What I'm trying to 13 find out is if it got to the point where they 14 would just use the same letter, so to speak, in 15 response, attaching the same information, that 16 kind of stuff. 17 A. I want to say yes, but I'll 18 qualify that. It takes two letters to get a form 19 letter, okay. We'll have a form letter if 20 there's a second request, because what we do is 21 because the information is at hand, as long as 22 it's up-to-date, we'll base the second request on 23 that letter, so you can call a letter that's only 24 requested two times a form letter. Page 158 1 Q. Okay. So when you say a second 2 request, you mean a second request from another 3 doctor, not two requests from the same doctor? 4 A. Exactly. 5 Q. So as long as a letter is 6 drafted, such as the letter that's on the first 7 page of Exhibit No. 11, this letter may be used 8 over and over again in response to requests by 9 other doctors regarding tardive dyskinesia? 10 A. Only in the context that it 11 answers the question that the doctor is asking. 12 Q. Okay. So if they're asking 13 about the association of tardive dyskinesia with 14 Prozac therapy, this is the letter that would be 15 sent? 16 A. I cannot answer that that is 17 the letter that would be sent. 18 Q. Can you tell me from looking at 19 this letter what question this letter is 20 answering? And I mean Exhibit No. 11. 21 A. The only thing I can say is 22 tardive dyskinesia came up as a request by a 23 physician, and this answers that part of the 24 question, but I can't tell you that this is the Page 159 1 only letter that's been sent out or if it's 2 comprehensive. 3 Q. Did you have more than one form 4 letter, for lack of a better phrase, for adverse 5 event, in other words did you have more than one 6 form letter that was used with regards to 7 suicidal ideation? 8 A. No, not more than one form 9 letter. 10 MR. MYERS: Are you through, are you 11 done with your answer? 12 A. But a form letter can be 13 modified to go into further detail. 14 (PLAINTIFFS' EXHIBIT NO. 12 WAS 15 MARKED FOR IDENTIFICATION AND 16 RECEIVED IN EVIDENCE.) 17 Q. Have you had a chance to review 18 Exhibit 12? 19 A. Yes, I have. 20 Q. Do you recognize this exhibit? 21 A. I do. 22 Q. Can you tell me what the first 23 two pages of Exhibit 12 are? 24 A. It's a medical information Page 160 1 letter responding to an initial request to 2 follow-up on the association of tardive 3 dyskinesia with Prozac therapy. 4 Q. Okay. This letter was written 5 in response to a subsequent request? 6 A. I can't recall whether -- what 7 the specifics behind this letter are. I don't 8 recall this exact letter, I can only tell you 9 that a letter of this nature is familiar to me. 10 Q. Is this a form letter, too? 11 A. It does not appear so. 12 Q. Can you you go back top Exhibit 13 4, please? Is Exhibit 4 a draft of Exhibit 12, 14 the first two pages of Exhibit 12? 15 A. I don't know if it's a specific 16 draft, they look very, very similar in content. 17 Q. The third page of Exhibit No. 18 12 looks like a narrative starting with Prozac, 19 ESP, tardive dyskinesia. Can you tell me what 20 that is? 21 A. Actually, this may be a form 22 letter now that I look at it. I would have to 23 say that the content may have developed -- I 24 believe, this evolved, the process, as more Page 161 1 information became available. Then we always 2 wanted to make sure that every following 3 physician that requested that information have 4 that complete information. So if research was 5 done or information became more available, then 6 subsequent letters would include that information 7 on that subject. That's my best recollection, 8 and that's why initially when I looked at it it 9 was different than the other one, and that may be 10 a form letter. 11 Q. So the second, third and fourth 12 pages of Exhibit No. 12 could be what turned out 13 to be a form letter on ESP -- EPS, I'm sorry, 14 tardive dyskinesia? 15 MR. MYERS: The second page is a 16 continuation of the first,. 17 Q. I'm sorry, the third page, 18 third, fourth and fifth page of the exhibit. 19 A. Yes. 20 Q. What about the page, looks 21 like, I guess, the sixth page, it's Pz 482 1178. 22 A. Yes, that is a form attachment. 23 Q. Same with the next page, 1179? 24 A. Yes, it's a form attachment. Page 162 1 Q. In fact, these two tables, 2 similar tables, were attached to just about every 3 medical information letter; correct? 4 A. Surrounding an adverse event. 5 Q. Okay. 6 A. Not these specific tables. 7 Q. Right, similar tables. 8 A. Tables that -- 9 Q. A table from treatment emergent 10 adverse events, incidents in placebo controlled 11 clinical trials, and a table on spontaneous 12 reports of adverse events. 13 A. Right. 14 Q. And again, this information 15 that's contained in these tables was given to you 16 by Doctor Beasley or another clinical research 17 physician? 18 A. Correct. 19 Q. How about the last three pages 20 of this exhibit, is that your handwriting? 21 A. It is not. 22 Q. Do you recognize it? 23 A. It appears to be Charles 24 Beasley's. Page 163 1 (PLAINTIFFS' EXHIBIT NO. 13 WAS 2 MARKED FOR IDENTIFICATION AND 3 RECEIVED IN EVIDENCE.) 4 Q. Have you had a chance to review 5 Exhibit 13? 6 A. Yes, I have. 7 Q. Are you familiar with these 8 letters that make up Exhibit 13? 9 A. What do you mean by familiar 10 with these letters? 11 Q. Do you recognize them? 12 A. I don't recognize the specific 13 ones, but they're just typical letters that I 14 recognize that come in the form of this form, so 15 I don't know again what you mean by do you 16 recognize. 17 Q. Okay. Do you recognize the 18 form? I mean, obviously since the names were 19 blacked out as to who the letter went to, you're 20 not going to be able to recognize the letter. 21 A. As long as that's clear. I 22 mean I don't recognize the specific letters, but 23 generally speaking, I recognize the content of 24 them. Page 164 1 Q. The first letter states: Your 2 request for information regarding the incidents 3 of aggressive behavior associated with Prozac; 4 correct? 5 A. Yes. 6 Q. And on the third page of the 7 exhibit, Pz 480 1262, it says your request for 8 information regarding the incidence of violent 9 behavior associated with Prozac. 10 A. That's correct. 11 Q. Now these are essentially the 12 same letters, aren't they, as far as form and 13 substance, other than that first paragraph? 14 A. It appears so. 15 Q. Does this indicate to you that 16 the person was asking in the first letter, the 17 person was asking about information on aggressive 18 behavior or related to aggressive behavior 19 associated with Prozac, and the second one was 20 asking about violent behavior? 21 A. That's correct. 22 Q. So really what's been 23 incorporated here is the verb that's used by the 24 requestor, as far as the actual request? Page 165 1 MR. MYERS: At the beginning of the 2 letter? 3 MS. ZETTLER: Right. 4 A. I can't comment specifically on 5 these letters, but generally all the time we try 6 to respond to individual requests and by how the 7 terminology is expressed by the requestor. 8 Q. Up at the top there's a code in 9 the top left-hand corner, it looks like. Can you 10 tell me what that is up there? 11 A. I don't know. 12 Q. How about the second letter, it 13 looks like it's clearer. 14 A. I don't know, I'm not familiar 15 with the codes. Often we would send these to the 16 word processing unit and they would code them. 17 Q. Who was in charge of keeping 18 track of the letters that were sent out? 19 A. I don't know. 20 Q. Go back to Exhibit Number 1. 21 It says letter number in the upper left-hand 22 corner, the column titles. 23 A. Yes. 24 Q. The number in the upper Page 166 1 left-hand corner in Exhibit 13, would that be the 2 corresponding letter number to your knowledge? 3 A. I can only -- I don't know, I 4 really don't, I have no knowledge of that at all. 5 Q. If you were going to look at 6 Exhibit No. 1, and wanted to see a specific 7 letter, how would you pull up -- how would you be 8 able to find the letter by the letter number 9 listed in Exhibit 1? In other words, what would 10 you look at to be able to find a copy of that 11 letter? 12 A. Ask our word processing people 13 to track a letter down. 14 Q. So you would call them up and 15 say I want to see letter number eight nine zero 16 one one two two eight? 17 A. No, it's more I want to see the 18 letter by Doctor whoever, or something like that. 19 I can't even say I've ever requested a letter. 20 But it would be the word processing unit if that 21 request came out to track the letter down. 22 Q. So you would say I want to see 23 a letter by Doctor Beasley to Doctor Smith? 24 A. You could probably request it Page 167 1 that way and get it. 2 Q. Now I don't understand what you 3 mean when you say you wouldn't call it, you would 4 ask them, I want to see a letter by Doctor so and 5 so. 6 A. They would be able to track -- 7 our word processing, I assume, would be able to 8 track by physician what letters have been sent to 9 him. 10 Q. You mean the initial requestor? 11 A. Right. 12 Q. By physician, okay. The date 13 in the upper left-hand corner of Exhibit 13, 14 would that be the date that the letter was 15 received to your knowledge? 16 MR. MYERS: Which letter? 17 MS. ZETTLER: The original request. 18 A. I don't know. 19 Q. Okay. 20 (PLAINTIFFS' EXHIBIT NO. 14 WAS 21 MARKED FOR IDENTIFICATION AND 22 RECEIVED IN EVIDENCE.) 23 Q. Have you had a chance to review 24 Exhibit 14? Page 168 1 A. Yes, I have. 2 Q. Are you familiar with the 3 exhibit? 4 A. Yes. 5 Q. Okay. Up in the left-hand 6 corner of the first page we see that code again, 7 Pz slash twenty-one. Would that indicate that 8 this is letter number twenty-one? 9 A. Form letter number twenty-one. 10 Q. Okay. What's fifty-five twenty 11 letter mean? 12 A. It's a fifty-five twenty IBM 13 real ancient, historic, fifty-five twenty word 14 processor. 15 Q. Okay. Then it says Prozac 16 hospitalized patients; correct? 17 A. Yes. 18 Q. Is that the general title of 19 the form letter? 20 A. I believe so. 21 Q. What's the S zero zero, S zero 22 one, S zero two, are those codes to incorporate, 23 like, letters and names and things like that? 24 A. It appears so. Page 169 1 Q. Next to that paragraph that 2 says one, two, three, four, five, what does that 3 mean, do you know? 4 A. I don't know. 5 Q. Next couple of pages it talks 6 about Prozac depression accompanying anxiety. Is 7 this a form letter also? 8 A. Yes. 9 Q. In fact, after that it looks 10 like an actual -- looks likes it's more in a 11 letter format, right, the same thing? 12 A. Correct. 13 Q. And this indicates in the upper 14 left-hand corner of Pz 710 328 that this form 15 letter is letter twelve; correct? 16 A. That's correct. 17 Q. Okay. 18 MR. MYERS: Can we take a break? 19 MS. ZETTLER: Sure. 20 (A SHORT RECESS WAS TAKEN.) 21 (PLAINTIFFS' EXHIBIT NO. 15 WAS 22 MARKED FOR IDENTIFICATION AND 23 RECEIVED IN EVIDENCE.) 24 Q. Okay. Have you had a chance to Page 170 1 review Exhibit 15? 2 A. Yes, I have. 3 Q. Is that your handwriting at the 4 top? 5 A. I don't believe so. 6 Q. Do you recognize that 7 handwriting? 8 A. No, I don't. 9 Q. Have you ever worked with Dr. 10 Leigh Thompson? 11 A. No, I have not. 12 Q. Do you recognize this letter? 13 A. I recognize parts of the 14 letter, but I do not recognize the letter itself. 15 Q. When you say you recognize 16 parts of the letter, what do you mean? 17 A. Some of the contents I 18 recognize because some of them came out of our 19 medical letter. 20 Q. Okay. So part of the medical 21 letter templates were used in this letter? 22 A. Yes. 23 Q. Can you tell me which ones? 24 A. I believe the ones indicated by Page 171 1 the writing. 2 Q. Okay. To the right it says 3 four, five, six, and then -- on the first page. 4 A. Yes. But again, I can't be 5 sure. 6 Q. How about on the third page of 7 the exhibit where it says eating disorders? 8 A. Yes. 9 Q. Those are from the medical 10 letter or are those from other form letters 11 relating to eating disorders? 12 A. They may be from other form 13 letters on eating disorders, but I don't know 14 without looking at the actual letter. 15 Q. Did you have any way of telling 16 from this exhibit who drafted this letter? 17 A. No. 18 (PLAINTIFFS' EXHIBIT NO. 16 WAS 19 MARKED FOR IDENTIFICATION AND 20 RECEIVED IN EVIDENCE.) 21 Q. Have you had a chance to review 22 Exhibit 16? 23 A. Yes, I have. 24 Q. Do you recognize this exhibit? Page 172 1 A. Yes, I do. 2 Q. Can you tell me what the 3 exhibit is? 4 A. The exhibit reports on the 5 number of requests -- requested medical 6 information letters. 7 Q. And when you say the number of 8 requests, you mean by topic? 9 A. By topic. 10 Q. Was it part of your 11 responsibility as medical information 12 administrator to keep track of the numbers of 13 requests by physicians regarding various topics? 14 A. Yes, it was. 15 Q. Why? 16 A. I don't know why the specific 17 reason. I had responsibility, but I assumed it, 18 we assumed it. 19 Q. When did you start keeping 20 track of the numbers of various requests? 21 A. I don't recall. 22 Q. Was it before or after the 23 Teicher article was published? 24 A. I believe it was before. I Page 173 1 think this was -- it was something I assumed, and 2 was just generally -- that kept track of 3 different types of requested information. 4 Q. When a doctor would write in 5 and request information about a suicidal 6 ideation, would that generally be a response to 7 treatment of a specific patient to the best of 8 your recollection? 9 A. Can you repeat that one? 10 Q. Sure. When a doctor would 11 write in and request information about suicidal 12 ideation, for instance, would they say I have a 13 patient who has experienced suicidal ideation 14 while being treated with Prozac, I would like to 15 know what the incidence is or something along 16 those lines? 17 A. To the best of my knowledge, 18 generally not. 19 Q. What were the requests, what 20 form did they typically take? 21 A. Typically they would take the 22 media and patients concerns because they hear in 23 the media the physician telling that to the sales 24 representative, and requesting additional Page 174 1 information on that topic, and that's how the 2 majority were generated. 3 Q. Okay. Were the majority of 4 requests for information transferred to you 5 through the detail people? 6 A. I can't answer whether the 7 majority, but certainly a significant amount were 8 generated. Probably the majority were generated 9 by physician requests to the sales 10 representatives, and the sales rep then forwarded 11 that request to us to respond. 12 Q. When you were a detail man, was 13 it part of your responsibility to ask the 14 physicians whether or not any of their patients 15 had experienced adverse events while on Lilly 16 drugs, in general? 17 A. It's always our responsibility 18 to report any -- in terms of any conversation, if 19 an adverse event ever came up on our 20 pharmaceuticals it was an absolute responsibility 21 that we report that adverse event. 22 Q. My question is: Was it part of 23 your responsibility to initiate discussions 24 regarding adverse events, in other words ask them Page 175 1 have any of your patients experienced adverse 2 events while being on one of our drugs? 3 A. Generally speaking, we explain 4 to a physician that, you know, we are responsible 5 for reporting any adverse events, and if they do 6 have any adverse events on our drugs, we want 7 either you to report it to this number or we will 8 report it to them. 9 Q. And you initiated that? 10 A. At times we initiated that. 11 Q. And would you do that on every 12 detail? 13 A. No. 14 Q. What percentage of details 15 would you do that? 16 MR. OLTMAN: As to him or as to any 17 sales representative? 18 MS. ZETTLER: As to him. 19 THE WITNESS: To me? 20 MS. ZETTLER: I would appreciate it if 21 we can keep it down to one lawyer representing 22 the witness at a time. 23 MR. MYERS: Well, we didn't do that 24 last week with you and Paul Smith alternatively Page 176 1 asked questions. Mr. Oltman is just helping me 2 and I need all the help I can get. 3 A. On a given day, a small 4 percentage. I don't know the exact percentage, 5 but, you know, we are responsible to make sure 6 that the physician understood that we report any 7 type of adverse events on DISTA or Lilly drugs. 8 Q. What about with regards to 9 Fluoxetine? 10 A. Fluoxetine as well as Keflex or 11 any drug. 12 Q. Was there ever a time in your 13 experience with Fluoxetine at Lilly where Lilly 14 told the detail men to specifically inquire of 15 physicians whether or not any of their patients 16 had experienced adverse events on the drug? 17 A. I can't recall that directive. 18 Q. Are you aware of any Dear 19 Doctor letters that were sent out by Lilly to 20 physicians eliciting any information they had 21 about adverse events that their patients on 22 Fluoxetine had experienced? 23 A. No, I'm not aware. 24 Q. How often would you report the Page 177 1 numbers of requests by physicians as set out in 2 Exhibit 16? 3 A. Once a month. 4 Q. And you don't recall when you 5 started doing that? 6 A. As I stated before, I inherited 7 that report, so I don't recall because I have no 8 knowledge or exposure when that process was set 9 up, but it was prior to my arrival. 10 Q. In medical? 11 A. In medical information, as the 12 medical information administrator. 13 Q. Did you do this on other drugs 14 that you worked on at Lilly? 15 A. Yes, we did. 16 Q. On a monthly basis? 17 A. On a monthly basis. 18 (PLAINTIFFS' EXHIBIT NO. 17 WAS 19 MARKED FOR IDENTIFICATION AND 20 RECEIVED IN EVIDENCE.) 21 Q. Have you had a chance to review 22 Exhibit 17? 23 A. Yes, I have. 24 Q. Do you recognize this exhibit? Page 178 1 A. Yes, I do. 2 Q. Who is Allen Lampe? 3 A. Sales representative. 4 Q. And what is just a field 5 letter? 6 A. It is a common letter on which 7 sales representatives communicate. 8 Q. Communicate with whom? 9 A. Internal. 10 Q. Is this field letter 11 specifically used to transfer requests from 12 physicians? 13 A. It is often used. 14 Q. When you draft a response to a 15 physician request, do you open a file or keep a 16 file on that response in it? What I'm trying to 17 find out is if you had a file with, say, the 18 initial letter request or something along the 19 lines of Exhibit 17 with the initial request in 20 it, and the follow-up letter, if any, that was 21 written? 22 A. I didn't do that on a regular 23 basis. Occasionally what I would do -- the only 24 reason I would keep a letter is that if, again, a Page 179 1 similar question was asked on that subject I 2 would have the basis then to write another 3 letter. 4 Q. What would happen to the 5 initial request letter? 6 A. The initial request letters are 7 filed with, I believe, our word processing unit. 8 Q. And what about the responses? 9 A. And I think they're filed with 10 the response. 11 Q. Okay. In data processing? 12 A. In data processing. 13 MR. MYERS: You said word processing, 14 and you said data -- 15 A. Word processing. 16 MR. MYERS: I don't know if it's 17 different or not. 18 Q. In your position as a medical 19 information administrator, were you charged with 20 keeping track of studies that were in process, 21 clinical investigations? 22 A. I was not. 23 Q. Were you in charge of keeping 24 track of publications resulting from clinical Page 180 1 trials? 2 A. I was not. 3 (PLAINTIFFS' EXHIBIT NO. 18 WAS 4 MARKED FOR IDENTIFICATION AND 5 RECEIVED IN EVIDENCE.) 6 Q. Have you had a chance to review 7 Exhibit 18? 8 A. Yes, I have. 9 Q. Is this your handwriting? 10 A. No, it is not. 11 Q. Do you recognize this document? 12 A. No, I don't. 13 Q. Do you recognize the 14 handwriting? 15 A. No, I don't. 16 Q. To your knowledge, did anybody 17 in the medical information administration 18 department have any responsibility for keeping 19 track of pending or completed Prozac clinical 20 trials? 21 A. No. To the best of my 22 knowledge, no. 23 (PLAINTIFFS' EXHIBIT NO. 19 WAS 24 MARKED FOR IDENTIFICATION AND Page 181 1 RECEIVED IN EVIDENCE.) 2 Q. Have you had a chance to review 3 Exhibit 19? 4 A. Yes, I have. 5 Q. Do you recognize this exhibit? 6 A. I have seen it. 7 Q. Okay. Can you tell me what it 8 is? 9 A. It looks like a comprehensive 10 collection of articles written and published, 11 although it looks like there's also -- it's 12 clinical trials, too, that are in process that 13 involve Fluoxetine. 14 Q. Okay. 15 A. And depression -- no, I think 16 it's just Fluoxetine. 17 Q. Okay. Did you have any 18 responsibility in compiling this exhibit? 19 A. No, I did not. 20 Q. And I'm sorry, you said you 21 have seen this before? 22 A. Yes, I have seen it. 23 Q. In what context? 24 A. As an information resource for Page 182 1 me to -- especially ones that have been 2 completed, so that when gathering data for 3 medical responses, we can refer back to the 4 clinical trials. 5 Q. Okay. Do you have any 6 knowledge as to how study codes or numbers are 7 assigned to various studies? 8 A. No, I do not. 9 Q. So you wouldn't know, like on 10 the second page of Exhibit 19, at the very 11 bottom, there's a study that starts E zero 12 twenty-six. Do you know what the E stands for? 13 A. I do not. 14 Q. Are you familiar with a pilot 15 with what a pilot study is? 16 A. A pilot study, as I interpret a 17 pilot study, is to find some means to investigate 18 possible hypothesis. So it's sort of a pilot 19 study. 20 Q. What do you mean when you say a 21 possible hypothesis? 22 A. Like is Fluoxetine effective in 23 obsessive compulsive disorder. You may want to 24 do a pilot study or a small study to see if Page 183 1 there's any type of effect before you go into a 2 larger scale study. 3 Q. Okay. Are you aware of any 4 pilot studies that were done related to the issue 5 of Fluoxetine and suicidality? 6 A. No, I'm not. 7 Q. Are you familiar with what a 8 rechallenge study is? 9 A. No, I'm not. 10 Q. How about a surveillance study? 11 A. I'm not. 12 Q. Are you aware of any studies 13 that have been or in the process -- or are in the 14 process of being conducted related in any way to 15 the use of Fluoxetine and suicidality? 16 A. No, I'm not. 17 Q. How about the use of Fluoxetine 18 in violent/aggressive behavior? 19 A. I am not. 20 (PLAINTIFFS' EXHIBIT NO. 20 WAS 21 MARKED FOR IDENTIFICATION AND 22 RECEIVED IN EVIDENCE.) 23 Q. Have you had a chance to review 24 Exhibit 20? Page 184 1 A. Yes, I have. 2 Q. Have you seen this exhibit 3 before? 4 A. No, I have not. 5 Q. Did you have any responsibility 6 with regards to marketing plans for Fluoxetine? 7 A. No. 8 Q. Do you know if your predecessor 9 in medical information administration had 10 responsibilities with regards to marketing of 11 Fluoxetine? 12 A. I do not know. 13 Q. Are you familiar with any of 14 the statements made in this exhibit? 15 MR. MYERS: Let me object to the form. 16 It's a pretty lengthy exhibit and it's got a lot 17 of, quote, unquote, statements. 18 MS. ZETTLER: He can take his time. 19 MR. MYERS: All right, take your time 20 and look at all of it. 21 A. The only thing that I'm 22 familiar with, and in fact I didn't even read it 23 right because the title to it -- I thought was 24 reuptake, and I thought that's what we were Page 185 1 promoting, but obviously that must be some kind 2 of competitive response and some scenario that -- 3 so generally speaking, I don't recognize anything 4 in here. 5 Q. Turn to about the eighth page 6 back in that exhibit, Pz 476 1166. When you were 7 a detail man, did you receive information similar 8 to this form of information that is represented 9 starting with that page 476 1166, in other words 10 where goals were set out, objectives, things of 11 that nature? 12 A. No, I did not. 13 Q. Would you turn back to that 14 sertraline page -- I'm sorry, turn to page 476 15 1173. Are you familiar with any of those 16 gentlemen that are listed on that page? 17 A. Yes, I am. 18 Q. Can you tell me who they are? 19 A. Charlie Perry was Prozac 20 marketing plans manager, and Bob MacNeil is 21 manpower planning. Those are the two individuals 22 I know. 23 Q. What's manpower planning? 24 A. General sales force numbers, Page 186 1 allocations. 2 Q. Have you ever heard of Gary 3 Lightfoot? 4 A. I've heard his name. 5 Q. Do you know if he's employed or 6 was employed at Eli Lilly? 7 A. Yes, he was employed with Eli 8 Lilly. 9 Q. What about Bob Dempsey? 10 A. He was employed at Eli Lilly 11 again, and I've heard his name, but I'm not 12 familiar with him. 13 Q. How about Bob Graham? 14 A. Same. 15 Q. Is it your understanding that 16 these gentlemen all work for Pfizer now? 17 A. I have no idea. I don't think -- 18 I know Bob MacNeil doesn't work for Pfizer now, 19 and Charlie Perry doesn't work for Pfizer, 20 they're still employed by Eli Lilly and Company. 21 Q. Do you know what they mean here 22 when they say sertraline product managers, the 23 list of these gentlemen's names? 24 A. I don't know. Page 187 1 Q. Other than Mister Perry and 2 Mister Petersen that I think you testified to 3 earlier, who else was in the marketing department 4 at Lilly when you were there? 5 MR. MYERS: In the entire marketing 6 department? 7 MR. OLTMAN: On any product? 8 MS. ZETTLER: On Fluoxetine. 9 A. On Fluoxetine? 10 MR. MYERS: That's awfully broad, but 11 go ahead and give it your best shot. 12 A. Rick Prine, Bob Petersen, 13 Charlie Perry and -- I'm just kind of 14 brainstorming. 15 Q. Sure. 16 A. Those were the managers that 17 were there when I was there. 18 Q. Okay. Who did these gentlemen 19 report to? 20 A. Gary Tauscher. 21 Q. Anybody else? 22 A. No, not that I know of. 23 Q. Who did Mister Tauscher report 24 to? Page 188 1 A. I don't know. 2 Q. And is it your testimony that 3 to your knowledge Mister Perry is still marketing 4 plans manager? 5 A. To the best of my knowledge, he 6 is not marketing plans manager. 7 Q. Do you know where he is now? 8 A. In the southeast. 9 Q. Is he still working for Lilly? 10 A. Yes, as far as I know. 11 Q. How about Mr. Prine, is he 12 still in the marketing department? 13 A. He is not. 14 Q. Do you know where he is? 15 A. In Indianapolis here. 16 Q. But he's not in marketing? 17 A. No. 18 Q. Is he still working for Lilly? 19 A. Yes, he's still working for 20 Lilly. 21 Q. Do you know what department 22 he's in? 23 A. I think sales. 24 Q. I believe you said Bob Petersen Page 189 1 is no longer in the country; correct? 2 A. That's correct. 3 (PLAINTIFFS' EXHIBIT NO. 21 WAS 4 MARKED FOR IDENTIFICATION AND 5 RECEIVED IN EVIDENCE.) 6 Q. Have you had a chance to review 7 Exhibit 21? 8 A. Yes, I have. 9 Q. Do you recognize it? 10 A. I do not. 11 Q. On the third page of Exhibit 12 21, Pz 485 2190, is that your handwriting? 13 A. It is not. 14 Q. Do you recognize the 15 handwriting? 16 A. I do not. 17 Q. In your responsibility as a 18 detail person, did you ever have any involvement 19 with symposiums for general practitioners? 20 A. I did not have, there was no 21 association with any symposium. 22 Q. How about as medical 23 information administrator? 24 A. Nor as a medical information Page 190 1 administrator. 2 Q. Again, do you have any idea why 3 this would have been produced to us as part of 4 your file? 5 A. As part of the same reason, we 6 have files and files of data that the bodies 7 move, the offices stay there, the data 8 accumulates and no one throws it out. 9 Q. So is it your testimony that 10 somebody from marketing was using the office 11 space that you used and your files stayed there? 12 A. No. We get so much information 13 as medical information administrator that you 14 have to keep really in touch with everything 15 that's associated with the product. And a lot of 16 information, be it whether it's relevant to your 17 job or not, is put in the mail, placed on there, 18 and then people -- and especially myself, I 19 didn't do this, but I file it under Prozac, and 20 it just grows. 21 Q. Do you have any idea why you 22 would have or in what way you would have used 23 this document in your job as medical information 24 administrator? Page 191 1 A. This would be of no use. 2 (PLAINTIFFS' EXHIBIT NO. 22 WAS 3 MARKED FOR IDENTIFICATION AND 4 RECEIVED IN EVIDENCE.) 5 Q. Have you had a chance to review 6 Exhibit 22? 7 A. Yes, I have. 8 Q. Do you recognize this document? 9 A. I recognize both documents in 10 there. 11 Q. Tell me where the two 12 documents, where there are two documents? 13 A. The first document referring to 14 sales representative verbatim is a different 15 document and was not generated by myself. 16 Q. Okay. Is it generated by your 17 department? 18 A. Probably. 19 MR. MYERS: When you say his 20 department, which department are you talking 21 about? 22 MS. ZETTLER: Medical information 23 administration. 24 A. The verbatims were derived from Page 192 1 Doctor Charles Beasley in our department. The 2 initials on there are via the marketing 3 department for a marketing letter out to the 4 sales representatives. 5 Q. Whose initials are those? 6 A. I really don't know, I can't 7 recall whose initials those are, but they're not 8 me. 9 Q. How do you know they're 10 marketing department -- 11 A. Because I know this is 12 something that they need. They'll take the 13 verbatims that Doctor Beasley develops and crafts 14 and works with Doctor Beasley, and then they send 15 them out in a marketing letter. 16 Q. What department is -- what 17 department were you in, is that medical division? 18 A. Yes, it was medical division. 19 Q. Is there a subgroup that you're 20 involved in or were involved in? 21 A. Regulatory affairs, I believe, 22 is our subgroup, but I can't recall. But it was 23 a part of the medical division. 24 Q. Okay. How many medical Page 193 1 information administrators did you work with 2 while you were in that area? 3 A. That I worked with or -- 4 Q. Well, how many medical 5 information administrators were working on 6 Fluoxetine during the period of time you worked 7 on it? 8 A. Myself, I was the primary MIA, 9 and then there was another individual that worked 10 sort of part-time on Fluoxetine. 11 Who was that? 12 A. Laura Calerola. 13 Q. Anybody else? 14 A. And Terry Moore. 15 Q. Anybody else? 16 A. No. 17 Q. Who is Judy Skaggs? 18 A. Someone in marketing word 19 processing. 20 Q. Okay. So the verbatims at the 21 beginning of Exhibit 22, the first two pages, are 22 separate from the suicide data analysis letter 23 that starts on the -- 24 A. Well, I shouldn't say it's Page 194 1 separate, they're just two different documents. 2 I would assume -- I'm not even going to assume, 3 the excerpts or the important verbatims were 4 generated by Doctor Charles Beasley and possibly 5 by some of the medical letters, and provided to 6 marketing so that the marketing department could 7 communicate to the sales representatives. The 8 second document is a full written letter on the 9 subject of that, to the sales representatives. 10 Q. Okay. And the second document 11 starts with Pz 280 1210? 12 A. Correct. 13 Q. What are verbatims, what is a 14 verbatim? 15 A. That's a good question. And I 16 really can't answer other than they're responses 17 to questions asked, they're canned responses to 18 questions asked concerning -- 19 Q. Questions asked sales reps? 20 A. Yes. 21 Q. Did you receive such verbatims 22 when you were detailing Fluoxetine? 23 A. Not this verbatim, but we 24 received verbatims from various product groups. Page 195 1 Q. What types of verbatims did you 2 receive regarding Fluoxetine when you were a 3 detail man? 4 A. I really don't remember. 5 Q. Were they sent to you in 6 written form like this? 7 MR. MYERS: As opposed to what kind of 8 form? 9 Q. Were they sent to you in 10 written form? 11 A. I vaguely recall receiving some 12 verbatims in written form, but it was not a 13 letter. I can't answer that because I don't 14 think we did. 15 Q. Okay. You don't think you 16 received verbatims? 17 A. Well, I don't think it was in 18 written form. You asked me if it was in written 19 form and I don't remember distinctly any 20 particular instance or product or category in 21 which we received a written verbatim. But I do 22 remember receiving verbatims, and often they're 23 on our information brochure, those are kind of 24 considered verbatims, too. Because we are Page 196 1 supposed to, and we do, detail off these, and 2 they're saying verbatim. 3 Q. When you were a detail man, did 4 you keep a file of all the documents that were 5 provided to you by Lilly? 6 A. No. 7 Q. Why not? 8 A. I can't answer. 9 Q. If you were to detail off the 10 information packets, why didn't you maintain 11 them? 12 A. We did detail off the current 13 promotional piece, but often, if something is 14 outdated, you're instructed to -- for instance if 15 there's an update in the package insert, you 16 can't be going around with the old package 17 insert, you have to destroy that and go around 18 with the new package insert. So whatever current 19 we had -- whatever was current information we 20 had. 21 Q. What did you do with the 22 documents that you had in your possession when 23 you went from being a detail man to working as 24 the medical information administrator? Page 197 1 A. Garbage. 2 Q. The second document, starting 3 at Pz 280 4390, is that a form letter? 4 A. Repeat that number again, 5 please? 6 Q. Sure. The second document in 7 this exhibit, the one that starts on page 8 thirteen ninety -- actually the substance of it 9 starts with the next page. 10 A. Yes, that's a form letter. 11 Q. Did you do form letters to send 12 to the sales representatives as well as to 13 doctors who requested information? 14 A. This is a form letter to the 15 sales representatives, based off the medical 16 letter. 17 Q. When you say the medical 18 letter, do you mean the medical letter on 19 suicidality? 20 A. The medical information letter 21 on suicidality. 22 Q. Did you receive letters like 23 this when you were a detail man? 24 A. On this subject? Page 198 1 Q. Yes, this type of letter. 2 A. Sure, we received letters on 3 all of our products like this. 4 Q. Okay. Would you keep these 5 types of letters? 6 A. Some I do, some I don't, but, 7 you know, I generally didn't have a specific 8 rule. If it was important information, I felt it 9 was important, I kept it. 10 Q. Okay. Were you involved in 11 drafting this form letter to the representatives? 12 A. Yes, I was. 13 Q. And there's another copy, a 14 second draft, so to speak, of the letter, 15 starting at page thirteen ninety-six. And 16 there's some revisions made. Did you make those 17 revisions? 18 A. I did not, that's Charles 19 Beasley's writing. 20 Q. And again, this letter was put 21 together like the medical response letters? 22 A. Correct. 23 Q. Doctor Beasley provided you 24 with the information and you put it in a coherent Page 199 1 form? 2 A. Correct. 3 Q. Not that Doctor Beasley is 4 incoherent. 5 A. No. 6 Q. After you drafted the letter, 7 then he would review it and make changes? 8 A. Absolutely. 9 Q. Did he make a lot of changes? 10 A. I can't recall. 11 Q. Do you know if Doctor Beasley 12 ever practiced psychiatry in the private sector? 13 MR. MYERS: If he was ever in the 14 private practice of psychiatry? 15 MS. ZETTLER: Right. 16 Q. Did he ever practice as a 17 psychiatrist? 18 A. Yes, he was. 19 Q. When? 20 A. I don't know, but I know he 21 was. 22 Q. Do you know how long he had a 23 private practice? 24 A. I do not. Page 200 1 Q. Do you know if he was ever 2 associated with any hospitals? 3 A. I do not. 4 Q. Do you know what area of the 5 country he's from? 6 A. I believe Ohio, but again, by 7 all means, I don't know exactly. Ohio and Doctor 8 Beasley, somehow I recall associated, but I could 9 be totally wrong. 10 Q. Cleveland? 11 A. There you go, Cleveland. 12 (DISCUSSION OFF THE RECORD.) 13 (PLAINTIFFS' EXHIBIT NO. 23 WAS 14 MARKED FOR IDENTIFICATION AND 15 RECEIVED IN EVIDENCE.) 16 Q. Have you had a chance to review 17 Exhibit 23? 18 A. Yes, I have. 19 Q. Do you recognize this? 20 A. I do. 21 Q. You do, okay. Can you tell me 22 what it is? 23 A. It was a proposal by a company 24 to provide patient information that I believe Page 201 1 never went forward, and again was filed. 2 Q. And the company is PIA Press? 3 A. Yes. 4 Q. Was this a proposal that they 5 made in response to a solicitation by Lilly? 6 A. I don't have any idea, I can't 7 answer that. 8 Q. Do you know why it was -- why 9 it didn't go forward? 10 A. I don't have any idea why it 11 did not go forward. Again, maybe it went forward 12 after I left, I just -- I don't know, I know by 13 the title this was a proposal. 14 Q. What was your involvement in 15 this project, if any? 16 A. None, I just received the 17 document. 18 Q. Do you know where they got the 19 information that's contained in the pamphlet? 20 A. I do not, I have no part of it. 21 MR. MYERS: They being PIA? 22 MS. ZETTLER: Right. 23 Q. Do you know if Lilly ever did 24 produce a pamphlet for use by consumers? Page 202 1 A. I believe there's a patient 2 information brochure on depression, and we 3 sponsor it, I'm not sure if it talks about Prozac 4 or not. 5 Q. Did you have any involvement in 6 creation of that pamphlet? 7 A. No, I did not. 8 Q. Did you ever have any contact 9 with anyone from the National Institute of Mental 10 Health? 11 A. No, I have not. 12 Q. Are you familiar with the Many 13 Faces of Depression campaign? 14 A. I know I'm aware of it. 15 Q. Did you have any involvement in 16 that? 17 A. I did not. 18 Q. Was that something that was 19 developed at Lilly? 20 A. I can't answer, I don't know 21 where that came from. 22 Q. How is it that you're aware of 23 it? 24 A. Again, often pieces will end up Page 203 1 on my desk or that I'll see in passing, and I'll 2 see it, but I don't -- so that's how I become 3 aware of it. And that rings a bell, Many Faces 4 of Depression, that's why I'm aware of it. 5 Q. What department at Lilly would 6 work on such a promotion, if they did? 7 A. Marketing plans. 8 Q. Marketing plans. That would be 9 Mr. Prine, Mister Petersen, Mister Perry? 10 A. Yes, Perry. 11 Q. Did you ever work with Burrs 12 and Marsteler, anybody from Burrs and Marsteler? 13 A. No, I don't know who they are. 14 MS. ZETTLER: Let's take another break. 15 (A SHORT RECESS WAS TAKEN.) 16 Q. Mister Pianko, did you have any 17 responsibility of drafting letters to Lilly 18 employees instructing them on patient relations? 19 A. No. 20 Q. Did you have contact with 21 anybody at the FDA? 22 A. No. 23 Q. Were you responsible for 24 drafting any press releases or things of that Page 204 1 nature? 2 A. No not -- occasionally they'll 3 take an excerpt out of the medical letter because 4 it's, you know, been medically approved, legally 5 approved, and represents the facts as interpreted 6 by our medical department, and incorporate that, 7 and I may have some part of that and then it 8 would end up in a public release statement. But 9 I've never -- I don't draft the public media 10 response. 11 Q. Did you have anything to do 12 with drafting package insert language? 13 A. No. 14 (PLAINTIFFS' EXHIBIT NO. 24 WAS 15 MARKED FOR IDENTIFICATION AND 16 RECEIVED IN EVIDENCE.) 17 Q. Have you had a chance to review 18 Exhibit 24? 19 A. Yes. 20 Q. Do you recognize this exhibit? 21 A. No, I don't. 22 Q. Did Mister Bialkowski leave 23 when you came on board? 24 A. Yes. Page 205 1 Q. Where did he go when you 2 assumed his responsibilities? 3 A. I don't remember where he went. 4 He now is a district manager. 5 Q. This letter appears on DISTA 6 letterhead to DISTA sales representatives 7 regarding records of Fluoxetine induced 8 akathisia, right? 9 A. Correct. 10 Q. And it's dated November 17, 11 1989? 12 A. That's right. 13 Q. And you were working as a 14 medical information administrator at this time, 15 right? 16 A. Let me try to get my dates 17 straight. No, I was not, I don't believe so. 18 Q. So your testimony earlier that 19 you started as a medical information 20 administrator in January or February of 1989 was 21 not correct? 22 A. I apologize. Let me try and 23 think of when I started again. No, that's 24 correct. Page 206 1 Q. Does this exhibit at the top 2 indicate -- it has Mister Bialkowski's name on 3 it; correct? 4 A. Yes, it does. 5 Q. And there's a note, handwritten 6 note, written at the top that says: Stan, extra 7 copy. I replaced originally in your manila 8 folder; correct? 9 A. Correct. 10 Q. So this indicates that Mister 11 Bialkowski was given a copy of this -- at least 12 the first page of this exhibit at some point; 13 correct? 14 A. Let me think a little bit about 15 the dates, when I arrived there. I apologize, I 16 really am having a hard time remembering when I 17 arrived at my job. You know, I stand corrected, 18 I must have started this job in early 1990, and I 19 was in transition during this period of time, 20 during the Fall, because we go through a switch 21 process so that they kind of give your stamp of 22 approval to come back. So I was in transition, I 23 started the job in early 1990, I apologize. 24 Q. Did you start as a medical Page 207 1 information administrator before or after Doctor 2 Teicher's article was published? 3 A. After. 4 Q. Have you seen any letter 5 similar to the one comprising Exhibit No. 24, at 6 least the first page? 7 MR. MYERS: Has he seen on other 8 subjects? 9 MS. ZETTLER: No, this subject. 10 A. On akathesis? 11 Q. Right. 12 A. I know that I processed medical 13 letters addressing that issue. 14 Q. Okay. To your knowledge, is 15 the letter that -- the first two pages of Exhibit 16 24, is that a form letter? 17 A. I don't know. 18 Q. Are you aware that there are 19 two different forms of the akathisia letter, 20 akathisia shortened and akathisia? 21 MR. MYERS: Let me object to the form 22 only if there is another form, could you direct 23 him to it, if in fact you're looking at it, and I 24 don't know that you are. Page 208 1 MS. ZETTLER: I don't know if I am 2 either, Larry. 3 Q. I have one that's labeled, if 4 you look at Pz 477 2223. It says document name, 5 akathisia shortened. 6 MR. MYERS: Is the question is he aware 7 of it or is that what is says? 8 Q. Let me ask it this way: To 9 your knowledge, are there two forms of an 10 akathisia letter, this akathisia letter? 11 A. I don't know. 12 Q. Was there two forms? 13 A. This looks like drafts to the 14 background, and by coding they probably -- there 15 was a second draft, they just didn't say draft 16 two. Someone in word processing may have labeled 17 that shortened, I don't know. 18 Q. Were there two forms of the 19 akathisia letter that you worked with in response 20 to medical information requests? 21 A. I don't know, I don't recall 22 two forms. 23 Q. Have you ever heard of a 24 company called FOI Services, Incorporated? Page 209 1 A. FOI. 2 Q. FOI. 3 A. No. 4 (PLAINTIFFS' EXHIBIT NO. 25 WAS 5 MARKED FOR IDENTIFICATION AND 6 RECEIVED IN EVIDENCE.) 7 Q. Have you had a chance to look 8 at Exhibit 25? 9 A. Yes, I have. 10 Q. Do you recognize this exhibit? 11 A. I recognize forms of the 12 exhibit, I don't recognize the specific exhibit. 13 Q. Okay. What do you mean when 14 you say you recognize forms of the exhibit? 15 A. I do know that there's freedom 16 of information, and that's what that stands for. 17 So when you said before are you familiar with FOI 18 Services, no, then I see the memo. I didn't know 19 there was a company that did that, but there must 20 be, and I know that you can get freedom of 21 information, and that's what I recognize, this 22 freedom of information document. 23 Q. Have you ever made a Freedom Of 24 Information Act request? Page 210 1 A. No, I have never. 2 Q. Has anybody in your division 3 made Freedom Of Information Act requests, as far 4 as you know? 5 MR. MYERS: In the medical division? 6 MS. ZETTLER: Sure. 7 A. I can't speculate knowing, I 8 don't know if they have or not. 9 Q. How do you know that -- how did 10 you come to the knowledge that you could make 11 Freedom Of Information Act? 12 A. Because I believe -- I've seen 13 some of these documents before in their freedom 14 of information requests, so apparently someone is 15 requesting them, but I can't be specific to know 16 that it's my division or what division is 17 requesting the freedom of information. 18 Q. Have you ever worked with 19 anybody from FOI Services? 20 A. No, I have not. 21 Q. Have you ever been charged with 22 responsibility of getting FDA documents related 23 to drugs other than drugs produced by Lilly? 24 MR. MYERS: When you say FDA documents, Page 211 1 do you mean documents from the FDA? 2 MS. ZETTLER: Right. 3 A. No. 4 (PLAINTIFFS' EXHIBIT NO. 26 WAS 5 MARKED FOR IDENTIFICATION AND 6 RECEIVED IN EVIDENCE.) 7 Q. Have you had a chance to review 8 Exhibit 26? 9 A. Yes, I have. 10 Q. Do you recognize that exhibit? 11 A. Yes, I do. 12 Q. Are you familiar with Doctor 13 Jonathan Cole? 14 A. I have heard of him. 15 Q. Have you ever spoken to Doctor 16 Cole? 17 A. I have not. 18 Q. Second paragraph of the first 19 page of Exhibit 26 says: On January 26th, Doctor 20 blank, one of the co-authors of the paper, an 21 investigator for Lilly, contacted our medical 22 department. Is the blank in that instance Doctor 23 Cole? 24 A. I have no idea. Page 212 1 Q. It lists three co-authors, it 2 lists three authors of the Marty Teicher article 3 at the top, doesn't it, Teicher, Glod, G-L-O-D, 4 and Cole; correct? 5 A. Yes. 6 Q. Do you know of any other 7 co-authors of the Teicher article? 8 A. I do not. 9 Q. And Doctor Glod, at least from 10 the name, appears to be a woman, does it not? 11 A. Carol Glod? 12 Q. Uh-huh. 13 A. Carol is, I believe, a woman's 14 name. 15 Q. Second sentence in the second 16 paragraph says: Doctor blank noted that he 17 submitted one of the case histories. He also 18 stated both he and Doctor Teicher reviewed this 19 intense suicidal preoccupation as a, quote, rare 20 event, unquote; correct? 21 MR. MYERS: Are you asking him if 22 that's what it says? 23 MS. ZETTLER: Yes. 24 A. Yes, that's what it says. Page 213 1 Q. Does that indicate to you in 2 any way whether or not the blank, Doctor blank, 3 who was an investigator for Lilly, was Doctor 4 Cole or Doctor Glod? 5 A. I have no idea. 6 Q. Is the first page of Exhibit 26 7 a letter to sales representatives? 8 A. I don't believe so. 9 Q. Who was that letter meant for? 10 A. It's really an internal public 11 relations document. 12 Q. Who would it go to? 13 A. Basically it's really for just 14 public relations use, however we get copies of 15 what they're saying. 16 Q. What who's saying? 17 A. Public relations. 18 Q. Is public relations different 19 than marketing? 20 A. Yes. 21 Q. Okay. Who is -- did the public 22 relations department have a manager while you 23 were working as a medical information 24 administrator? Page 214 1 A. Ed West. 2 Q. How about the page following 3 the second page, it says number two statement. 4 Would that be something that your -- that you 5 would -- you or somebody like you would produce 6 or is that something that would be produced in 7 public relations? 8 A. This is something that Charles 9 Beasley would consult with and maybe use some of 10 the documents that Doctor Beasley and I created, 11 and take and use them also for public relations, 12 through Doctor Beasley. 13 Q. Okay. Are you familiar with 14 some of the language on the second page of 15 Exhibit 26, does that look familiar to you? 16 A. Yes. 17 Q. Which language looks familiar 18 to you? 19 A. Prozac is indicated for the 20 treatment of depression, and is widely accepted 21 as a safe and effective therapy in the use and 22 according to its label. 23 Q. Anything else? 24 A. Second paragraph, two looks Page 215 1 familiar. 2 Q. Anything else? 3 A. The third paragraph looks 4 familiar, and the fourth paragraph looks 5 familiar. 6 Q. Would the second, third or 7 fourth paragraphs be templates, used for the 8 medical letter, suicide letter? 9 A. I can't really comment whether 10 that's a template used for the medical letter or 11 not, I would have to compare, I don't remember. 12 Q. How about the third and fourth 13 page, what is that? 14 A. My understanding is this is how 15 public relations responds to questions. 16 Q. And again, this is for internal 17 use? 18 A. Public relations' use. 19 Q. Were these questions and 20 answers used by the Lilly sales representatives? 21 A. No. 22 Q. How about the fifth page of the 23 exhibit, Pz 712 1952? 24 MR. MYERS: What about it? Page 216 1 Q. What is that? 2 A. Similar format of verbage that 3 was used by our public relations department. 4 Q. Second page after that, 1953, 5 is that something that Doctor Beasley would have 6 contributed to also? 7 A. I don't know. Anything that 8 has to do with clinical aspects of Prozac and 9 position statements, I know that Doctor Beasley 10 has probably contributed to that. 11 Q. Any other stand-by statements 12 and question and answers reflected in this 13 exhibit that's also created by public relations? 14 A. Yes, this whole document is a 15 public relations generated document. 16 Q. This last page, it says label 17 was inadvertently omitted. Do you know what that 18 means? 19 A. I do not know what that means. 20 (PLAINTIFFS' EXHIBIT NO. 27 WAS 21 MARKED FOR IDENTIFICATION AND 22 RECEIVED IN EVIDENCE.) 23 Q. Have you had a chance to review 24 Exhibit 27? Page 217 1 A. Yes. 2 Q. Do you recognize this exhibit? 3 A. Yes, I do. 4 Q. First page appears to be an 5 E-Mail from Gary Tauscher to you dated March 7, 6 1991; correct? 7 A. Correct. 8 Q. And the subject matter of the 9 E-Mail is a study conducted by Sandoz or 10 responses by Sandoz comparing Pamelor versus 11 Prozac; correct? 12 A. That's correct. 13 Q. The study allegedly referenced 14 emergence of suicidality on Prozac versus 15 Pamelor; correct? 16 A. Supposedly the statement -- it 17 says supposedly the study includes references to 18 the emergence of suicidality on Prozac versus 19 Pamelor. 20 Q. And one of the investigators on 21 the Sandoz Prozac/Pamelor study was Doctor Fabre; 22 correct, Doctor Louis Fabre? 23 MR. MYERS: Are you referencing a 24 specific page? Page 218 1 MS. ZETTLER: He can look at the second 2 page, I think it will tell him. 3 A. In a minute I'll try and find 4 it in here and see if that's the case. 5 Q. Take your time. 6 A. It makes reference to Doctor 7 Fabre. I don't believe from this note, this 8 memo, that Doctor Fabre was -- I just don't know, 9 I just know that Doctor Fabre is quoted in there. 10 Q. Okay. Look at the second or 11 the last full paragraph on the second page of the 12 exhibit. 13 A. Okay. 14 Q. Have you read it? 15 A. Yes. 16 Q. Okay. Does that indicate to 17 you that whether or not Doctor Fabre was an 18 investigator on the Sandoz study? 19 A. It appears so. 20 Q. In fact, so that we know, so 21 that there's no confusion, why don't you turn to 22 page 532, Pz 1017 532, about halfway down the 23 page after the CPR report. 24 A. Okay. Page 219 1 Q. Does that satisfy you that 2 Doctor Fabre -- 3 A. Yes, it does. 4 Q. So he was involved as a 5 clinical investigator in the Sandoz study? 6 MR. MYERS: Of his independent 7 knowledge or according to this? 8 MS. ZETTLER: According to this. 9 A. According to this, it would 10 suggest that, yes. 11 Q. Above that, March 12th, there's 12 an E-Mail, it looks like, from Brooks Bradley to 13 Gary Tauscher; is that correct? 14 A. That's correct. 15 Q. Dated March 12, 1991? 16 A. Correct. 17 Q. And it says: Gary, I have 18 received your request for additional information 19 from Doctor Fabre via Tom Pianko. Did you ever 20 contact Doctor Fabre with regards to this study? 21 A. No, I did not. 22 Q. Why not? 23 A. Because I just had no need to. 24 Q. Did you ever speak to Mister Page 220 1 Bradley about whether or not he talked to Doctor 2 Fabre? 3 A. I did not, the only thing I did 4 was forward this message to Brooks Bradley. 5 Q. Is it your understanding that 6 Doctor Fabre conducted a Fluoxetine trial on 7 behalf of Lilly? 8 A. I don't remember if he 9 conducted a Fluoxetine trial on behalf of Lilly, 10 I don't recall that fact. 11 Q. Okay. Do you know whether or 12 not he conducted a Fluoxetine trial besides the 13 Sandoz trial? 14 A. I don't know. I know he's an 15 author on one of the articles, that's all I know. 16 I know he's an author on a Fluoxetine article. 17 Q. Okay. To your knowledge, does 18 Lilly use clinical investigators on more than one 19 drug, clinical trials on more than one drug? 20 A. Can you repeat that? 21 Q. Sure. Let me ask you this: 22 Say Doctor Fabre did conduct a clinical trial on 23 Fluoxetine, okay? 24 A. Uh-huh, yes. Page 221 1 Q. And Lilly was investigating or 2 studying another anti-depressant for market 3 besides Fluoxetine, aside from Fluoxetine. Do 4 you know if it was Lilly's policy to use clinical 5 investigators, for instance, like Doctor Fabre 6 and use him again on another drug? 7 A. I have no idea. 8 Q. Have you ever heard of Scrip, 9 S-C-R-I-P? 10 A. Yes. 11 Q. Can you tell me what that is? 12 A. That is a pharmaceutical 13 industry newsletter. 14 Q. Does that come out on hard copy 15 form or is this something that's published 16 periodically? 17 A. It's published in hard copy and 18 also you can get it through electronic data base 19 searches. 20 Q. So if you did like a Med-line 21 search, you could get it? 22 A. Yes. 23 Q. Is it part of your 24 responsibility to keep up with Scrip's items on Page 222 1 Fluoxetine? 2 A. Any information, regardless of 3 its source, I try to keep up on. 4 Q. Okay. Did you do regular 5 searches as a matter of course, like monthly 6 document searches or information searches? 7 A. They're regular in a sense that 8 I was always doing searches on any topic, various 9 topics. So there was no need to set a schedule 10 up for regular -- I was always doing literature 11 searches. 12 Q. What about Fluoxetine searches 13 generally, just in case something new was 14 published? 15 A. Oh, yes. What we do, we get a 16 data base hit list reported to us, so nothing 17 escapes us, we hope, as best we possibly can. 18 It's as good as the data base can pick those 19 things up. 20 Q. You said the data base hit 21 list? 22 A. Well, it reviews the literature 23 on a regular basis. I don't initiate it, it's 24 done automatically. Page 223 1 Q. Is this done through the 2 company, is it a service that's provided? 3 A. I think it's internal. 4 Q. Is there somebody who's charged 5 with doing that or is it something that's built 6 into the computer itself? 7 A. I think it's built into the 8 computer itself. 9 Q. Do you know the name of that 10 program or service? 11 A. I don't. But there is a name, 12 but I don't know the name, I can't recall it. 13 Q. Who is Stephen Bandak, 14 B-A-N-D-A-K? 15 A. I do not know. 16 (PLAINTIFFS' EXHIBIT NO. 28 WAS 17 MARKED FOR IDENTIFICATION AND 18 RECEIVED IN EVIDENCE.) 19 Q. Have you had a chance to review 20 Exhibit 28? 21 A. Yes, I have. 22 Q. Do you recognize this exhibit? 23 A. I do not. 24 Q. You do not. You notice that Page 224 1 your name is on the first page at the top of the 2 list, don't you? 3 A. Yes, I do. 4 Q. Who is Gordon? 5 A. I think he's a clinical 6 physician. 7 Q. Do you know what document it's 8 referring to where it says fix correspondence, 9 redrafting, merging all comments right by your 10 name? 11 A. I don't know what that would be 12 referring to. 13 Q. On the second page, again at 14 the top, it says strategic area, physician 15 correspondence, lead person, Gordon, Potvin, 16 Pianko, next steps, then redrafting merging all 17 comments. 18 A. Again, that may refer to the 19 medical letter, but I don't know because I 20 haven't ever -- I don't believe I've ever seen 21 this document. And that may be just a medical 22 letter which I have responsibility for getting 23 together. 24 Q. When you say the medical Page 225 1 letter, you mean the suicidality letter? 2 A. A medical letter. If that's 3 what this is referring to, let's see. Most 4 likely. 5 Q. Okay. Would it be a Dear 6 Doctor suicidality letter? 7 A. I don't know if it's a Dear 8 Doctor suicidality letter or the medical 9 information letter. 10 Q. The letter that would have been 11 sent in response to requests for information on 12 suicidality? 13 A. Yes. 14 (PLAINTIFFS' EXHIBIT NO. 29 WAS 15 MARKED FOR IDENTIFICATION AND 16 RECEIVED IN EVIDENCE.) 17 Q. Have you had a chance to look 18 at Exhibit 29? 19 A. Yes, I have. 20 Q. Do you recognize this exhibit? 21 A. Yes, I do. 22 Q. Can you tell me what that is? 23 A. Apparently different options in 24 sending out the medical letter listed. Page 226 1 Q. When you say the medical 2 letter, what do you mean? 3 A. Dear Doctor letter. 4 Q. The Dear Doctor suicidality 5 letter? 6 A. Actually this is a letter to 7 the sales representatives, marketing letter to 8 the sales representatives. 9 Q. Marketing letter related to 10 suicidality? 11 A. Well, it's a term. It's a 12 letter related to suicidality to our sales 13 representatives. 14 Q. On the first page of the 15 exhibit, it has marketing letter alternatives and 16 it lists four, I believe, alternatives; correct? 17 A. Yes. 18 Q. Can you explain the 19 alternatives to us? Like, in other words, number 20 one, it says summary of data, slash, use of a 21 detail piece, slash, initiate discussion. What 22 does summary of data mean? 23 A. As best as I can recall, this 24 was something I put together that looked at all Page 227 1 the different alternatives on how to -- what you 2 should include in the letter to the sales 3 representatives. Should we just summarize the 4 data, use a detail piece and initiate discussion, 5 should we -- and there's all different 6 interpretations of that summary of the data, no 7 detail piece, do not initiate discussion. Take 8 the medical letter contents, include that, use a 9 detail piece and initiate discussion, or four, 10 medical letter contents included, no detail 11 piece, and do not initiate discussion. 12 Q. Okay. So let's -- under number 13 one, it says summary of data. You mean summary 14 of data related to suicidality? 15 A. Yes. 16 Q. And use of a detail piece, what 17 do you mean by that, what's a detail piece in 18 this situation? 19 A. An information brochure. 20 Q. To give to the doctors or to 21 give to the sales reps? 22 A. Supply to sales reps so that 23 they can use it in their physician discussion. 24 Q. Okay. Is that the brochure you Page 228 1 were talking about earlier telling you how to 2 detail? 3 A. Correct. 4 Q. And that brochure would have 5 contained verbatims, things of that nature? 6 A. Yes. 7 Q. Okay. Then initiate 8 discussion, what do you mean by that, initiate 9 discussion between the sales rep and the doctor? 10 A. Correct. 11 Q. And then under option three it 12 says, medical letter contents included. You mean 13 included in the letter to the sales reps? 14 A. Correct. 15 Q. How would that differ from the 16 summary of data? 17 A. Basically going into more 18 detail. 19 Q. The letter would go into more 20 detail, the medical letter? 21 A. The medical letter contents 22 would go into more detail. 23 Q. The other two, use of a detail 24 piece, initiate discussion, are the same as above Page 229 1 in number one? 2 A. Correct. 3 Q. Then following those first two 4 pages are just examples of what you meant by the 5 above? 6 A. Yes, these were drafts. 7 (PLAINTIFFS' EXHIBIT NO. 30 WAS 8 MARKED FOR IDENTIFICATION AND 9 RECEIVED IN EVIDENCE.) 10 Q. Have you had a chance to review 11 Exhibit 30? 12 A. Yes, I have. 13 Q. Do you recognize that document? 14 A. Yes, I do. 15 Q. Can you tell me what that is? 16 A. It's a document responding to 17 questions asked of me. 18 Q. Who is R. E. Williams? 19 A. Ron Williams. 20 Q. Who is Mister Williams? 21 A. He's vice-president of sales. 22 Q. Okay. And he's asked you, 23 looks like, three questions here, or at least 24 you're responding to three questions? Page 230 1 A. Correct. 2 Q. Where did you get the 3 information in answer to question number one 4 regarding the incidence of suicide in the United 5 States? 6 A. Charles Beasley. 7 Q. How about number two? 8 A. Charles Beasley. 9 Q. How about the answer to number 10 three? 11 A. Charles Beasley. 12 Q. Why did Mister Williams want 13 this information, if you know? 14 A. I believe it was just out of 15 curiosity. 16 (PLAINTIFFS' EXHIBIT NO. 31 WAS 17 MARKED FOR IDENTIFICATION AND 18 RECEIVED IN EVIDENCE.) 19 Q. Have you had a chance to look 20 at Exhibit 31? 21 A. Yes, I have. 22 Q. Do you recognize this document? 23 A. I do not. 24 Q. Do you recognize the subject Page 231 1 matter of the document, is that familiar to you? 2 A. That's about Prozac and, you 3 know, when it was approved. So in that context, 4 you know, I'm familiar with that, but the details 5 I'm not familiar with at all. 6 Q. Okay. Were you ever involved 7 in drafting a chronology of dates, significant 8 dates, with regards to Prozac? 9 A. Not that I can recall. 10 Q. Do you know if Doctor Beasley 11 was ever involved in the task? 12 A. I have -- I don't know. 13 Q. Were you ever involved in 14 drafting a list of package insert changes for 15 Prozac? 16 A. I may have been. 17 (PLAINTIFFS' EXHIBIT NO. 32 WAS 18 MARKED FOR IDENTIFICATION AND 19 RECEIVED IN EVIDENCE.) 20 Q. Have you had a chance to look 21 at Exhibit 32? 22 A. Yes, I have. 23 Q. Do you recognize this? 24 A. Vaguely. Page 232 1 Q. Did you have any 2 responsibilities in drafting this document? 3 A. No, I did not have any 4 responsibility in drafting it. 5 Q. How is it that you recognize 6 it? 7 A. I have seen this come across my 8 desk. Often, if someone asks me when was the 9 package insert changed for this, I would then ask 10 regulatory affairs, and this, I believe, is a 11 document from regulatory affairs. So that's why 12 I'm familiar with it. 13 Q. Why would you ask regulatory 14 affairs for this document? 15 A. Because they're the ones that -- 16 they're part of the package insert regulations, 17 so they would keep this as -- they would track 18 such a thing. 19 Q. Right, but why would you want 20 to see such a document? 21 A. If the question was asked to me 22 as to when or something, a package insert is 23 changed, that's why, that's how I would. Again, 24 I would be a conduit to that, that would pass Page 233 1 through my desk. 2 Q. So, for instance, if somebody 3 asked you when hyperprolinemia was added to the 4 package insert, you would ask -- 5 A. I would ask someone in 6 regulatory affairs, or if I had this document 7 filed somewhere, I could go in and look and tell 8 them the date it was. 9 Q. Okay. 10 (PLAINTIFFS' EXHIBIT NO. 33 WAS 11 MARKED FOR IDENTIFICATION AND 12 RECEIVED IN EVIDENCE.) 13 Q. Have you had a chance to look 14 at Exhibit 33? 15 A. Yes, I have. 16 Q. Do you recognize it? 17 A. I do. 18 Q. Can you tell me what it is? 19 A. It's a letter to sales 20 representatives that indicate that the package 21 insert is changed providing the previous section 22 out of the package insert with the revised 23 section. 24 Q. Did you draft this letter? Page 234 1 A. Yes, I did. 2 Q. Is this a form letter? 3 A. It was sent to every sales 4 representative, DISTA sale representative. 5 Q. And if you look at the fifth 6 page of the exhibit, 712 1439, Pz 712 1439. Do 7 you recognize that? 8 A. Yes, I do. 9 Q. This is a draft of the letter 10 informing DISTA sales representatives that the 11 package insert changed to add suicidal ideation 12 and violent behavior; correct? 13 A. This indicates a change in the 14 package insert, including pancreitis, suicidal 15 ideation and violent behaviors, and is to inform 16 the sales representatives -- is one of the ways 17 in which to inform the sales representatives of 18 the change in the package insert. 19 Q. And at least it appears from 20 this letter that at this time that it was 21 intended for another side-by-side comparison of 22 the changes to be attached; correct, like the MAO 23 inhibitor letter? 24 A. Correct. Page 235 1 Q. Is it your understanding that a 2 letter informing the sales representative of 3 package insert changes with regards to suicidal 4 ideation, pancreitis and violent behavior was 5 sent out? 6 A. Yes. 7 Q. And were there side-by-side 8 comparisons of the package insert attached? 9 A. I can't answer in absolute on 10 that. 11 Q. And the date looks like on this 12 letter is -- the draft at least, is May 24, 1990 -- 13 I'm sorry, the date of the revision is May 24, 14 1990. 15 MR. MYERS: Which page? 16 MS. ZETTLER: 712 1439. 17 A. That's what it says here, yes. 18 (PLAINTIFFS' EXHIBIT NO. 34 WAS 19 MARKED FOR IDENTIFICATION AND 20 RECEIVED IN EVIDENCE.) 21 Q. Have you had a chance to review 22 Exhibit 34? 23 A. Yes, I have. 24 Q. Do you recognize this exhibit? Page 236 1 A. Yes, I do. 2 Q. Tell me what it is? 3 A. It's a summary of 4 anti-depressant package inserts and their 5 reference to suicidality. 6 Q. And did you compile this? 7 A. I do not remember if I did. 8 Q. What was the purpose for 9 compiling all the package insert language related 10 to suicidality and other drugs? 11 A. I don't know. 12 Q. Is this something that was to 13 be sent to Lilly sales representatives? 14 A. Oh, I don't believe so. 15 Q. Was this something that was 16 done in preparation for changing the Prozac 17 package insert? 18 A. I do not remember. 19 MS. ZETTLER: Let's take a quick break. 20 (A SHORT RECESS WAS TAKEN.) 21 MS. ZETTLER: No further questions. 22 MR. MYERS: No questions. 23 MR. OLTMAN: No questions. 24 (THE WITNESS WAS EXCUSED.) Page 237 1 COMMONWEALTH OF KENTUCKY ) 2 : ss COUNTY OF JEFFERSON ) 3 4 I, MARY KATHLEEN NOLD, A NOTARY PUBLIC IN 5 AND FOR THE STATE OF KENTUCKY AT LARGE, DO HEREBY 6 CERTIFY THAT THE FOREGOING TESTIMONY OF 7 TOM PIANKO 8 WAS TAKEN BEFORE ME AT THE TIME AND PLACE AS 9 STATED IN THE CAPTION; THAT THE WITNESS WAS FIRST 10 DULY SWORN TO TELL THE TRUTH, THE WHOLE TRUTH, 11 AND NOTHING BUT THE TRUTH; THAT THE SAID 12 PROCEEDINGS WERE TAKEN DOWN BY ME IN STENOGRAPHIC 13 NOTES AND AFTERWARDS TRANSCRIBED UNDER MY 14 DIRECTION; THAT IT IS A TRUE, COMPLETE AND 15 CORRECT TRANSCRIPT OF THE SAID PROCEEDINGS SO 16 HAD; THAT THE APPEARANCES WERE AS STATED IN THE 17 CAPTION. 18 WITNESS MY SIGNATURE THIS THE 4TH DAY OF 19 OCTOBER, 1993. 20 MY COMMISSION EXPIRES MARCH 10, 1994. 21 22 23 _________________________ MARY KATHLEEN NOLD 24 COURT REPORTER AND NOTARY PUBLIC STATE OF KENTUCKY AT LARGE Page 238 1 2 3 E R R A T A S H E E T 4 5 COMMONWEALTH OF KENTUCKY ) : SS 6 COUNTY OF JEFFERSON ) 7 8 I, TOM PIANKO, THE UNDERSIGNED 9 DEPONENT, HAVE THIS DATE READ THE FOREGOING PAGES 10 OF MY DEPOSITION AND WITH THE CHANGES NOTED 11 BELOW, IF ANY, THESE PAGES CONSTITUTE A TRUE AND 12 ACCURATE TRANSCRIPTION OF MY DEPOSITION GIVEN ON 13 THE SEPTEMBER 22, 1993 AT THE TIME AND PLACE 14 STATED THEREIN. 15 PAGE NO. LINE NO. CHANGE REASON Page 239 1 PAGE NO. LINE NO. CHANGE REASON 2 3 4 5 6 7 8 _____________________________ 9 TOM PIANKO 10 SWORN TO AND SUBSCRIBED BEFORE ME THIS 11 _____ DAY OF __________, 1992. 12 _____________________________ NOTARY PUBLIC, STATE OF 13 KENTUCKY AT LARGE Page 240 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Page 241 1 COMMONWEALTH.....................................185 2 PLAINTIFFS' EXHIBIT NO. 1.........................61 3 PLAINTIFFS' EXHIBIT NO. 2.........................67 4 PLAINTIFFS' EXHIBIT NO. 3.........................74 5 PLAINTIFFS' EXHIBIT NO. 4.........................86 6 PLAINTIFFS' EXHIBIT NO. 5.........................94 7 PLAINTIFFS' EXHIBIT NO. 6........................104 8 PLAINTIFFS' EXHIBIT NO. 7 .......................107 9 PLAINTIFFS' EXHIBIT NO. 8........................110 10 PLAINTIFFS' EXHIBIT NO. 9........................111 11 PLAINTIFFS' EXHIBIT NO. 10.......................114 12 PLAINTIFFS' EXHIBIT NO. 11.......................115 13 PLAINTIFFS' EXHIBIT NO. 12.......................119 14 PLAINTIFFS' EXHIBIT NO. 13.......................122 15 PLAINTIFFS' EXHIBIT NO. 14.......................127 16 PLAINTIFFS' EXHIBIT NO. 15.......................128 17 PLAINTIFFS' EXHIBIT NO. 16.......................130 18 PLAINTIFFS' EXHIBIT NO. 17.......................135 19 PLAINTIFFS' EXHIBIT NO. 18.......................137 20 PLAINTIFFS' EXHIBIT NO. 19 ......................137 21 PLAINTIFFS' EXHIBIT NO. 20.......................140 22 PLAINTIFFS' EXHIBIT NO. 21.......................144 23 PLAINTIFFS' EXHIBIT NO. 22.......................146 24 PLAINTIFFS' EXHIBIT NO. 23.......................153 Page 242 1 PLAINTIFFS' EXHIBIT NO. 24.......................157 2 PLAINTIFFS' EXHIBIT NO. 25.......................161 3 PLAINTIFFS' EXHIBIT NO. 26.......................162 4 PLAINTIFFS' EXHIBIT NO. 27.......................167 5 PLAINTIFFS' EXHIBIT NO. 28.......................173 6 PLAINTIFFS' EXHIBIT NO. 29.......................174 7 PLAINTIFFS' EXHIBIT NO. 30.......................177 8 PLAINTIFFS' EXHIBIT NO. 31.......................178 9 PLAINTIFFS' EXHIBIT NO. 32.......................179 10 PLAINTIFFS' EXHIBIT NO. 33.......................181 11 PLAINTIFFS' EXHIBIT NO. 34.......................183 12 13 14 15 16 17 18 19 20 Page 243 1 DIRECT EXAMINATIONBY MS. ZETTLER:..................1 2 COMMONWEALTH.....................................185 3 PLAINTIFFS' EXHIBIT NO. 1.........................61 4 PLAINTIFFS' EXHIBIT NO. 2.........................67 5 PLAINTIFFS' EXHIBIT NO. 3.........................74 6 PLAINTIFFS' EXHIBIT NO. 4.........................86 7 PLAINTIFFS' EXHIBIT NO. 5.........................94 8 PLAINTIFFS' EXHIBIT NO. 6........................104 9 PLAINTIFFS' EXHIBIT NO. 7 .......................107 10 PLAINTIFFS' EXHIBIT NO. 8........................110 11 PLAINTIFFS' EXHIBIT NO. 9........................111 12 PLAINTIFFS' EXHIBIT NO. 10.......................114 13 PLAINTIFFS' EXHIBIT NO. 11.......................115 14 PLAINTIFFS' EXHIBIT NO. 12.......................119 15 PLAINTIFFS' EXHIBIT NO. 13.......................122 16 PLAINTIFFS' EXHIBIT NO. 14.......................127 17 PLAINTIFFS' EXHIBIT NO. 15.......................128 18 PLAINTIFFS' EXHIBIT NO. 16.......................130 19 PLAINTIFFS' EXHIBIT NO. 17.......................135 20 PLAINTIFFS' EXHIBIT NO. 18.......................137 21 PLAINTIFFS' EXHIBIT NO. 19 ......................137 22 PLAINTIFFS' EXHIBIT NO. 20.......................140 23 PLAINTIFFS' EXHIBIT NO. 21.......................144 24 PLAINTIFFS' EXHIBIT NO. 22.......................146 Page 244 1 PLAINTIFFS' EXHIBIT NO. 23.......................153 2 PLAINTIFFS' EXHIBIT NO. 24.......................157 3 PLAINTIFFS' EXHIBIT NO. 25.......................161 4 PLAINTIFFS' EXHIBIT NO. 26.......................162 5 PLAINTIFFS' EXHIBIT NO. 27.......................167 6 PLAINTIFFS' EXHIBIT NO. 28.......................173 7 PLAINTIFFS' EXHIBIT NO. 29.......................174 8 PLAINTIFFS' EXHIBIT NO. 30.......................177 9 PLAINTIFFS' EXHIBIT NO. 31.......................178 10 PLAINTIFFS' EXHIBIT NO. 32.......................179 11 PLAINTIFFS' EXHIBIT NO. 33.......................181 12 PLAINTIFFS' EXHIBIT NO. 34.......................183 13 14 15 16 17 18 19 20 21 22 23 24 Page 245 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Page 246 1 DIRECT EXAMINATIONBY MS. ZETTLER:.................14 2 COMMONWEALTH.....................................237 3 (QUESTION CERTIFIED.)............................100 4 (QUESTION CERTIFIED.)............................154 5 PLAINTIFFS' EXHIBIT NO. 1.........................87 6 PLAINTIFFS' EXHIBIT NO. 2.........................95 7 PLAINTIFFS' EXHIBIT NO. 3........................103 8 PLAINTIFFS' EXHIBIT NO. 4........................118 9 PLAINTIFFS' EXHIBIT NO. 5........................128 10 PLAINTIFFS' EXHIBIT NO. 6........................140 11 PLAINTIFFS' EXHIBIT NO. 7 .......................143 12 PLAINTIFFS' EXHIBIT NO. 8........................148 13 PLAINTIFFS' EXHIBIT NO. 9........................149 14 PLAINTIFFS' EXHIBIT NO. 10.......................152 15 PLAINTIFFS' EXHIBIT NO. 11.......................154 16 PLAINTIFFS' EXHIBIT NO. 12.......................159 17 PLAINTIFFS' EXHIBIT NO. 13.......................163 18 PLAINTIFFS' EXHIBIT NO. 14.......................167 19 PLAINTIFFS' EXHIBIT NO. 15.......................169 20 PLAINTIFFS' EXHIBIT NO. 16.......................171 21 PLAINTIFFS' EXHIBIT NO. 17.......................177 22 PLAINTIFFS' EXHIBIT NO. 18.......................180 23 PLAINTIFFS' EXHIBIT NO. 19 ......................180 24 PLAINTIFFS' EXHIBIT NO. 20.......................183 Page 247 1 PLAINTIFFS' EXHIBIT NO. 21.......................189 2 PLAINTIFFS' EXHIBIT NO. 22.......................191 3 PLAINTIFFS' EXHIBIT NO. 23.......................200 4 PLAINTIFFS' EXHIBIT NO. 24.......................204 5 PLAINTIFFS' EXHIBIT NO. 25.......................209 6 PLAINTIFFS' EXHIBIT NO. 26.......................211 7 PLAINTIFFS' EXHIBIT NO. 27.......................216 8 PLAINTIFFS' EXHIBIT NO. 28.......................223 9 PLAINTIFFS' EXHIBIT NO. 29.......................225 10 PLAINTIFFS' EXHIBIT NO. 30.......................229 11 PLAINTIFFS' EXHIBIT NO. 31.......................230 12 PLAINTIFFS' EXHIBIT NO. 32.......................231 13 PLAINTIFFS' EXHIBIT NO. 33.......................233 14 PLAINTIFFS' EXHIBIT NO. 34.......................235 15 16 17 18 19 Page 248