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And this was true not only at the St. James 's Theatre but throughout " Theatreland , " the entertainment district in the West End of metropolitan London . We hear a parodic echo of plays like The Second Mrs Tanqueray when Jack Worthing ( played by Alexander ) , in the final act of The Importance of Being Earnest , says of Miss Prism ( who he mistakenly believes to be his long-lost and unmarried mother ) , " who has the right to cast a stone against one who has suffered ? The Cornell Brown Penn United Kingdom Centre is another invaluable resource . " Four months later , the U.S. Department of Health and Human Services wrote to Merck President Raymond Gilmartin and told him the promotional campaign was misleading.The claim that Vioxx " has a ' favorable cardiovascular profile ' is simply incomprehensible , " said the letter from Thomas W. Abrams , director of the Department 's Division of Drug Marketing , Advertising and Communication , which monitors pharmaceutical advertising.Last year , after Vioxx was pulled off the market , senior FDA epidemiologist David Graham published a treatise in Lancet that said " 88,000 to 140,000 excess cases of serious coronary heart disease probably occurred in the USA over the market life of rofecoxib , " or Vioxx.When trials show that a new treatment " confers a greater risk of a serious adverse effect than a standard treatment , we must be much more careful about allowing its unrestrained use , " Graham wrote.Under cross-examination , Lucchesi — who was on the stand when the documents were presented on an overhead projector — read fine print at the bottom of the study that said the opinions were not necessarily those of the FDA.The documents swung the tenor of what started as a good day for Merck , with Lucchesi acknowledging he had misspoken on the stand earlier.He told jurors he had not reviewed a document attached to a 1997 e-mail message from a Merck scientist that he said on Friday showed Merck had tried to alter the design of an upcoming study by giving aspirin to patients on Vioxx to protect their hearts . At every point , we will examine how writers ' representations of London both build on prior representations and influence subsequent ones , studying , in effect , the evolutions - - and , perhaps , devolutions - - of London 's literary character over time . We can easily picture how he spends his time in London when he is not paying at-home calls to the Hon . To support you in your studies , we each hold regular office hours at the King 's Strand campus in central London . " Miss Sullivan , sit down and be quiet . Lanier also points to Merck 's medical manual , which says arrhythmia in some form occurs in more than 90 percent of heart attack patients.Under questioning from Merck lawyer David Kiernan , Wiener conceded that he ca n't say with reasonable medical probability that Ernst had a bona fide heart attack . Along the way we will see London assume the guises of moral allegory and inspirational muse , stable home and criminal den , refined cultural center and uproarious multicultural accident , victim of violence and promoter of pacifism . On Monday Lanier 's next expected witness was Dr. Isaac Wiener , a cardiologist and co-director of the Cardiac Arrhythmia Center at UCLA Medical Center in Los Angeles.Robert Ernst , a produce manager at a Wal-Mart near Fort Worth who ran marathons and worked as a personal trainer , took Vioxx for eight months to alleviate pain in his hands until he died in his sleep .