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This decision significantly affects the progress of our case . Technology affects both internal and external communications , and we can use it to link us within our organizations , and to our publics . Jurors do n't have to pinpoint Vioxx as the sole cause to give an affirmative answer.If one or more garners a " yes , " jurors proceed to the remaining three questions involving financial damages . She said that was consistent with Merck 's belief that the older painkiller decreased blood clots _ which can cause heart attacks _ and that Vioxx lacked that effect on patients.Santanello also testified that before Vioxx went on the market , Merck tested it in 54 clinical trials involving 10,000 patients , comparing its effects to those of other anti-inflammatory drugs and sugar pills.Those trials _ which Lanier alleges were designed to produce statistically insignificant results _ showed no differences in adverse affects to users of Vioxx and the other pills , Santanello said.Merck in 2002 added warnings about cardiovascular risks to Vioxx 's label after two years of wrangling with the FDA . Merck argues that excess weight and other cardiac risk factors , not Vioxx , caused Humeston 's heart attack.Merck removed Vioxx from the market a year ago after studies linked it to higher incidences of heart attacks and strokes.But in May 2001 , Merck issued a news release with the headline : " Merck Confirms Favorable Cardiovascular Safety Profile of Vioxx . Technology also affects how we market our institutions . You should be able to read at a rate of at least 30 pages per hour when you are reading fiction ; you should budget more time for bulkpack readings as critical prose tends to be quite dense . You should be able to read at a rate of at least 30 pages per hour when you are reading fiction ; you should budget more time for secondary readings as critical prose tends to be quite dense . Historical Museum Commission , in Harrisburg , warned the group to consider the role of politics and how it affects cultural resources . " 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 .