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Pharmalot/NJ Star Ledger: "Anna Nicole Smith And...Peter Rost?"

By Ed Silverman

March 26, 2007

Anna Nicole Smith And...Peter Rost?

An unllikely pair, but there's speculation a connection exists.

First, let's take Peter Rost. He's the notorious former Pfizer exec who filed a whistleblower lawsuit against the drugmaker, alleging unlawful, off-label promotion of Genotropin, a human growth hormone treatment that he was responsible for marketing.

Now, poor Anna. The medical examiner's report, which was released today, indicates several prescription drugs, including human growth hormone, were ingested. Although the cause of death was overdose from methadone and antidepressants, her case may highlight HGH abuse.

As Rost notes on his own blog, HGH is prescribed for dwarfism and other growth deficiences, not the weight issues that plagued Anna Nicole. As Jim Edwards at BrandWeekNRX points out, this sordid publicity may work in Rost's favor. A federal appeals court is about to decide whether to let his lawsuit, which was denied last year a federal court judge, to proceed.

Hmm. Let's see. A corporate whistleblower. A drugmaker charged with nefarious behavior. A federal prosecutor. And an over-the-top dead celebrity and Playboy Playmate who looked like Marilyn Monroe. Sounds like a movie. Rost has said he wants to make a movie. Here's the script. Any guesses on who will play Hank McKinnell?

Peter Rost's blog;

Associated Press story about accidental overdose;

Medical examiner's report;

Hat tip to Jim Edwards at BrandWeek.

Posted by Ed Silverman

Brandweek: "Could Anna Nicole Smith's Death Boost Peter Rost's Case Against Pfizer?"

BrandweekNRX

By Jim Edwards

Could Anna Nicole Smith's Death Boost Peter Rost's Case Against Pfizer?

I can't believe I am typing these words, but ... Given that the coroner today said that human growth hormone was found in Anna Nicole Smith's body, could that assist former Pfizer vp Peter Rost in his jihad against Pfizer?

For those of you late to class: Rost sued Pfizer when the company failed to respond to his complaints that Genotropin, the brand Pfizer acquired in the Pharmacia merger, was being marketed off-label to healthy people for vanity purposes.

A Massachussetts judge kicked Rost's whistleblower suit out of court, and the feds officially declined to show an active interest. But Rost recently appealed the judge's decision on the grounds that in order to show he has a case he would have to file confidential patient data in court—which, in a classic Catch 22, is against the law.

The feds perked up again when they saw Rost's appeal, and asked for time to file their own brief. Rost suspects that the DOJ suspects that if the ruling stands it will knock out any other pharma whistleblower case that relies on patient data. The feds likely don't want that because it would make it virtually impossible to bring a whistleblower case without violating patient data privacy.

Anyway, to bring this full circle—given that Smith was using HGH, that almost certainly means she was abusing it, says Rost (it's indicated for dwarfism and various GH deficiencies, not weight problems).

And given that her death has now highlighted the prevalence of HGH abuse (check it out on Google here), could this be the extra fact that tips the appeals court to overturn the decision and allow Rost's suit to proceed?

You can't make this stuff up. Perhaps this is the ending Rost needs for his alleged movie?

Anna Nicole Smith Autopsy: Abused Growth Hormone!

The coroner's autopsy report (Full autopsy report -- PDF (contains graphic content)), shows that nine prescription drugs (not including metabolites of those drugs) were found in Anna Nicole's body.

A statement by the medical examiner also indicates that Anna Nicole Smith appears to have abused Human Growth Hormone, together with Vitamin B12. HGH is often abused by bodybuilders to increase muscle mass, and is also illegally prescribed together with B12 and other vitamins and hormones, in an attempt to stop aging. The Guardian came to the same conclusion, and wrote that Anna Nicole "had recently taken longevity medications, vitamin B12 and growth hormone."

In fact, the autopsy report states that "chronic repeated injections of various medications in buttocks" had resulted in "fibrosis with fat necrosis of dermal and subcutaneous tissues, bilateral gluteal regions and anterior right thigh." So Anna Nicole had injected herself so many times that the fat cells died in both buttocks and on the front of her right thigh . . .

Drug that killed Smith:
Chloral Hydrate (Noctec). This drug is used as a sleeping agent, and most of the time only prescribed if the person can not take benzodiazepines.

Other drugs contributing to death:
1. Diphenhydramine (Bendaryl), used to control allergic reactions.
2. Clonazepam (Klonopin), a benzodiazepine used to treat anxiety and panic attacks.
3. Diazepam (Valium), a benzodiazepine used to treat anxiety and alcohol withdrawal.
a. Nordiazepam (metabolite). Diazepam is metabolized to nordiazepam which is an active metabolite.
b. Temazepam (metabolite). This is a minor active metabolite of diazepam.
c. Oxazepam (metabolite?). This agent was not described as metabolite in report, but it should be noted that diazepam breaks down into oxazepam.
4. Lorazepam, a benzodiazepine used to treat anxiety.

Additional drugs not contributing to death:
8. Atropine, used to temporarily increase heart rate or as an antidote for inadvertent overdose of cholinergic drugs. Likely to have been used during resucitation attempt.
7. Topiramate (Topamaz), used to stop migraines.
8. Ciprofloxacin (Cipro), used to treat a variety of bacterial infections.
9. Acetaminophen (Tylenol), used to control mild to moderate pain and to reduce fever.

(Watch police chief's conclusions on investigation )

During the course of the autopsy, filed under Smith's given name of Vickie Lynn Marshall, doctors found evidence that Smith had an abscess in her left buttock that had been perforated by a needle, probably when she took injections of either the growth hormone or vitamin B-12, the medical examiner explained. The perforation allowed bacteria to get into Smith's blood, which caused a high fever in the days before her death.

America: A country with the right priorites.