The Door Revolves: Tufts Medical School Dean Goes Back to Merck

A little news item <a href="http://www.nj.com/business/index.ssf/2009/12/new_jersey_drug_maker_lures_tu.html">in the Newark Star-Ledger</a>:<br /><blockquote><em>Merck announced the appointment of Michael Rosenblatt as executive vice president and chief medical officer</em>.<br /><br />The appointment, which was announced this morning by the company, is effective immediately.<br /><br />Rosenblatt will be responsible for bringing greater focus to Merck’s global medical activities as well as shaping innovative medical strategies. He will report directly to CEO Richard Clark.<br /><br />Rosenblatt has served as <em>dean of Tufts University Medical School since 2003</em>.<br /><br />Earlier, he was <em>senior vice president for research at Merck Sharp & Dohme Research Laboratories</em>, where he co-led the worldwide development team for Fosamax, Merck’s treatment for osteoporosis.<br /></blockquote><br />A quick Google tour revealed that while he was Dean, Dr Rosenblatt also served as a <a href="http://www.millenniapartners.com/OurTeam/TeamView.asp?TeamMemberID=63">Scientific Advisor</a> to Boston Millenia Partners, a venture capital firm; a Founder and then <a href="http://www.nuvios.com/founders.htm">Scientific Advisor</a> to Nuvios, which now is known as <a href="http://radiuspharm.com/sab.htm">Radius Pharmaceuticals</a>;  an <a href="http://www.puretechventures.com/content/team.asp?mainPage=team&subPage=advisors">Advisor</a> to Puretech Ventures, which <a href="http://www.puretechventures.com/content/strategy.asp?mainPage=about&subPage=strategy">specializes</a>"in company creation and early-stage investment in novel therapeutics, medical devices, diagnostics, and research technologies"; and a <a href="http://www.shire.com/shire/CorporateInformation/directors.jsp?tn=1&m1=3">Director</a> of <a href="http://www.shire.com/shire/CorporateInformation/index.jsp?tn=1&m1=29">Shire</a>, "one of the world’s leading specialty biopharmaceutical companies."<br /><br />This is a reminder how fuzzy the line has become between medical academics and health care corporations.  Here is an example of someone who alternated his main employment between leadership posts in academic medicine and in the pharmaceutical industry, but while in academia maintained a string of part time commitments to a further variety of biotechnology and pharmaceutical companies, and related venture capital firms.  Given all these positions and financial relationships, who knows where his main allegiance was?  <br /><br />I would hope that the Dean of  a medical school would be the primary steward of the academic and clinical missions.  But what kind of stewardship can one expect from someone who came from one lucrative position in the pharmaceutical industry, and was to go back to an even higher level position, and who worked for several biotechnology/ pharmaceutical firms, and venture capital firms on the side?<br /><br />Hat-tip to <a href="http://shearlingsplowed.blogspot.com/2009/12/new-merck-names-new-chief-medical.html">Shearlings Got Plowed blog</a>.

The Door Revolves: Tufts Medical School Dean Goes Back to Merck

A little news item in the Newark Star-Ledger:Merck announced the appointment of Michael Rosenblatt as executive vice president and chief medical officer.The appointment, which was announced this morni…

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Was a Private Equity Takeover of Bausch and Lomb Meant to Conceal Its Legal Settlements of Cases of Eye Infections?

This week, the Associated Press <a href="http://www.google.com/hostednews/ap/article/ALeqM5jz3TMuH6bomvVkjjZcYoABBjQYGgD98HAO4G1">reported</a> on yet another way health care corporations may keep information that reflects poorly on their products out of public view. The story involved fungal eye infections that particularly afflicted users of a specific contact lens cleaning solution:<br /><blockquote><br /><em>More than 700 lens wearers in the United States and Asia say they were exposed to a potentially blinding infection known as Fusarium keratitis while using ReNu with MoistureLoc, a new-formula multipurpose solution for cleaning, storing and moistening soft contact lenses</em>.<br /><br />Sometimes, the damage was irreparable. Seven people in Florida, Maryland, New York, Oregon, Tennessee and West Virginia had to have an eye removed. At least 60 more Americans needed vision-saving corneal transplants.<br /><br /><em>The U.S. Centers for Disease Control and Prevention confirmed 180 cases in 35 states from June 2005 through September 2006</em>, when the agency's dedicated surveillance stopped, according to Dr. Benjamin Park, a CDC epidemiologist. CDC continued to hear of sporadic, unconfirmed cases in the months after MoistureLoc was withdrawn, Park said.<br /><br />'Surveillance usually captures the tip of the iceberg and sometimes it captures a larger tip than other times,' Park said in an interview.<br /><br />Among out-of-court settlements reached in May was a potential bellwether case brought by Andrea Martin, a Broadway actress and comedienne whose eye was scarred. In Colorado, a corneal transplant ended a race-car driver's career. In Baltimore, a chimney-sweep business owner who lost an eye got hooked on painkillers.<br /><br />Leading eye doctors and government scientists concluded that <em>MoistureLoc, launched in 2004 with novel disinfectant and moisturizing ingredients, was the only lens solution that contributed to the outbreak</em>. Yet the mechanics of how it caused the problem are still not fully clear.<br /></blockquote><br /><br />AP alleged that Bausch and Lomb kept the cases out of public view by using a previously unknown (at least to me) strategy:<br /><blockquote><br /><em>Contact lens maker Bausch & Lomb Inc. had an overriding reason for going private in 2007: It wanted to handle a devastating recall of its flagship lens cleaner, its chief executive said, 'without a lot of outside distraction.'<br /></em><br />Over the past year, <em>away from the glare of public scrutiny</em>, the optical products company has quietly settled nearly 600 fungal-infection lawsuits — with dozens more individual claims yet to be resolved. The cost so far: Upward of $250 million.<br /><br />With some fungal lawsuits still unresolved, the prospect of Bausch & Lomb's health care nightmare being aired in court has not entirely faded — which heartens some lawyers and doctors.<br /><br /><em><strong>'The truth has been very carefully buried,</strong> and it appears to have been buried going back to the beginnings of the outbreak,'</em> said Dr. Arthur Epstein, who was chairman of the American Optometric Association's contact lens and cornea section during the highly publicized crisis.<br /><br />'All settlements were predicated on silence about the clinical findings and blame and so forth. My hope was that what actually happened would become part of public record in a courtroom. That way, we'd be able to learn from it and move on and make sure it never happened again.'<br /><br />When Bausch & Lomb was acquired by private equity firm Warburg Pincus for $3.67 billion in October 2007, <em>Chief Executive Ronald Zarrella said the deal would allow the company 'to pursue the growth path we were on ... without a lot of outside distraction.'</em>Zarrella retired last year.<br /><br />'hey can do all this out of the public eye — guys like me aren't sitting there scrutinizing the financial impact of every single settlement,'said analyst Jeff Johnson of Robert W. Baird & Co. in Milwaukee. 'you can completely focus on your brand and on doing what's right by the patient.'</blockquote><br /><br />So, if I understand this correctly, after Warburg Pincus took the company private, it was no longer required to file certain reports with the US Securities and Exchange Commission (SEC), including reports that would have had to acknowledge the multiple settlements the company made of cases alleging adverse effects of its contact lens solution. What is striking is the allegation by the AP that "taking the company" private was a strategy meant to conceal the settlements of these cases, (rather than a strategy implemented to fulfill other aims, which had the side effect of diminishing reporting of these cases' results.)<br /><br />Again, I am hardly an expert, but relatively opaque private equity firms like Warburg Pincus seem to have become increasingly influential in the US economy, and to have an increasing role in health care. In 2007, we had <a href="http://hcrenewal.blogspot.com/2007/09/web-of-deception-ensnares-us-nursing.html">posted</a> how private equity firms running nursing homes, including Warburg Pincus, seemed to contribute to the opacity of their operations. More recently, we <a href="http://hcrenewal.blogspot.com/2009/04/hedge-fund-u.html">posted</a> about how leaders of private equity, and of other kinds of firms in the finance arena, seem to also increasingly be leaders to which medical schools report.<br /><br />One final note... A quick tour through the Warburg Pincus website reveals how involved the firm is in health care. The firm <a href="http://www.warburgpincus.com/industries/healthcare/Default.aspx">claimed</a> that as a "direct equity investor in healthcare for more than 30 years, Warburg Pincus has invested more than $4 billion in approximately 120 healthcare companies." Furthermore, the firm seems quite intertwined with the leadership of academic medicine. It has a Life Sciences Advisory Board, of which three of four members are current leaders in academic medicine. The most prominent, Dr Michael Rosenblatt, Dean of the Tufts University School of Medicine, did not disclose this relationship in several versions of his biography published on the university web-site. (See the Tufts administration version <a href="http://provost.tufts.edu/1174149600661/Provost-Page-prov2w_1174149601058.html">here</a>, and the Tufts Medical Center version <a href="http://www.tuftsmedicalcenter.org/OurServices/EndocrinologyandDiabetes/MichaelRosenblattMD">here</a>.)<br /><br />Oh, what a tangled web we have weaved in health care, a web that continually frustrates transparency and makes it hard to figure out who was responsible for what when things go wrong.

Was a Private Equity Takeover of Bausch and Lomb Meant to Conceal Its Legal Settlements of Cases of Eye Infections?

This week, the Associated Press reported on yet another way health care corporations may keep information that reflects poorly on their products out of public view. The story involved fungal eye infec…

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The Political Incorrectness of Discussing Conflicts of Interest in Medical Academia

<a href="http://www.boston.com/news/local/massachusetts/articles/2009/03/26/ethics_event_spawns_a_tussle_at_tufts/">From today's Boston Globe</a>,<br /><blockquote><br />Tufts University has withdrawn an invitation for a top aide to US Senator Charles E. Grassley to give the keynote speech at a conference on conflicts of interest in medicine and research, leading one conference organizer to pull out and question the university's commitment to academic freedom.<br /><br />The University-wide Committee on Ethics rescinded the invitation on March 13, according to e-mails obtained by the Globe. The messages said top Tufts officials refused to allow other administrators to be panelists at the meeting if Grassley's aide spoke, saying it was inappropriate to do so while Grassley is investigating ties between a Tufts professor and the drug industry.<br /><br />The senator, a Republican from Iowa, sent a letter on Feb. 17 to the president of Tufts, Lawrence S. Bacow, requesting detailed information on the relationship between a 'Dr. Boucher' and the pharmaceutical industry, including the amount and dates of all industry payments between January 2006 and December 2008. Dr. Helen Boucher is an infectious diseases specialist at the Tufts medical school.<br /><br />Spokeswoman Christine Fennelly first said in an e-mail that when Grassley declined the invitation, 'it was decided to refocus the symposium on a smaller scale, where the panelists would be faculty from Tufts University and affiliated faculty from Tufts Medical Center.'<br /><br />Later, when told that Krimsky's e-mails explicitly said the speaking offer was rescinded, she said the invitation to Grassley's aide had been withdrawn. 'Indeed . . . the administration felt it prudent to not engage someone from the Senator's office while we respond to the Senator's inquiry,' she wrote.<br /></blockquote><br /><br />One only has to browse the FIRE (Foundation for Individual Rights in Education) <a href="http://www.thefire.org/">web-site </a>to see the sad state of free speech and academic freedom in American universities. Most of the cases they discuss seem to involve barriers to presenting politically incorrect viewpoints on campus. FIRE has presented several cases involving dis-invitation of speakers with such views.<br /><br />On the other hand, on Health Care Renewal we have discussed our share of cases involving free speech and academic freedom in academic medicine. Most of these cases seem to involve barriers to presenting research results that turn out unfavorable to vested financial interests, particularly interests served by the promotion of particular health care products, like drugs or devices, or services.<br /><br />This case appears to be something of a hybrid. Like a number of cases discussed on the FIRE web-site, it involves the dis-invitation of a campus speaker whose viewpoint might not fit with that of the powers that be on campus. However, instead of causing offense because of his political positions, Mr Thacker seemed to cause offense because he has been involved in investigating conflicts of interest affecting medical academics. Thus, it seems that discussing such conflicts of interest has become politically incorrect. This seems to be a fairly blatant instantiation of the <a href="http://hcrenewal.blogspot.com/2007/08/bling-bling-poltical-correctness-and.html">anechoic effect</a>.<br /><br />See also <a href="http://carlatpsychiatry.blogspot.com/2009/03/tufts-blows-it.html">comments</a> by Dr Daniel Carlat on the Carlat Psychiatry Blog.<br /><br />ADDENDUM (31 March, 2009) - also see <a href="http://scienceblogs.com/effectmeasure/2009/03/more_on_conflicts_of_interest.php#more">comments</a> on the Effect Measure Blog.

The Political Incorrectness of Discussing Conflicts of Interest in Medical Academia

From today's Boston Globe,Tufts University has withdrawn an invitation for a top aide to US Senator Charles E. Grassley to give the keynote speech at a conference on conflicts of interest in medicine …

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