The Perry Mason Moment - Day Ten of the Autism Onmibus Trial

DIRECT EXAMINATION OF DR. NICHOLAS CHADWICK BY MS. PATTON – ATTORNEY FOR THE GOVERNMENT (RESPONDENTS)

Dr. Chadwick started working with Dr. Andrew Wakefield in his laboratory at the Royal Free Hospital in 1994 and when Dr. Wakefield started working with autistic patients in 1996.  He was present during gut biopsies for PCR testing and the drawing of cerebral spinal from autistic patients.  There were some fake positives, according to Dr. Chadwick, but these samples were otherwise negative for the measles virus RNA.

He was also responsible for sending RNA samples to the lab of Dr. Kawashima.  Dr. Kawashima got some positive results from samples in which they'd gotten negative results.  Dr. Chadwick was concerned about the possibility of contamination and also whether one of the chemicals used by the Kawashima lab, an antibody from Porton Down, had cross-reacted with bacterial proteins, rather than measles virus RNA.

Dr. Chadwick informed Dr. Wakefield of these concerns former to the publication of Dr. Wakefield's article in The Lancet.

CROSS-EXAMINATION OF DR. CHADWICK BY MS. CHIN-CAPLAN – ATTORNEY FOR THE PLAINTIFFS (PETITIONERS)

Dr. Chadwick appeared surprised to learn that Dr. Wakefield was not a witness in this trial.  He was also surprised to learn that the results from Dr. Kawashima's lab formed no part of this case.  When he was questioned why he was testifying in this hearing (he was apparently a late addition) he said it was because he'd been told it was about the safety of vaccines.

When informed that the test results for this case utilized a process called TaqMan PCR, he answered that he hadn't worked with that form of PCR replication during his time with Dr. Wakefield.  Additionally, he's had no interaction with the Unigenetics Lab of Dr. O'Leary which performed the TaqMan PCR and obtained the measles virus RNA from the intestinal tissue of Michelle Cedillo.

SPECIAL COMMENT

Dr. Chadwick was a disaster for the defense.

It wasn't necessarily because of anything he said, but that he was simply such an inappropriate witness for this case.  If Dr. Wakefield was a witness, then there might have been a reason for his testimony.  If he'd worked with the TaqMan PCR technology there might've been a reason.  If he'd had any dealings with the Unigenetics Lab of Dr. O'Leary there would've been a reason.  When the cross-examination was finished it was apparent there was no reason for Dr. Chadwick to be a witness.

Judges closely observe how each side puts on their case.  They're alert to vital questions raised in testimony, the tactics used by each side, and the credibility and usefulness of witnesses place on by counsel.

By putting on such an inappropriate witness, defense counsel probably hurt their credibility with the Special Masters.  In fairness, these things happen in a trial.  The witness you thought would be dynamite turns out to be a dud.  The thought which sounded so fantastic before trial is an embarrassment.  It happens and you simply need to go on.

But for applicant's counsel it was a rare opportunity to experience a Perry Mason Moment.

DIRECT EXAMINATION OF DR. JEFFREY BRENT BY MS. RENZI – ATTORNEY FOR THE GOVERNMENT (RESPONDENTS)

Dr. Brent is a full Clinical Professor of Pediatrics and Internal Medicine at the University of Colorado Health Sciences Center in Denver, Colorado, and has a single specialty practice which deals solely with issues related to medical toxicology.

He received his master's and Ph.D. in Biochemistry at Mount Sinai School of Medicine in New York, was a postdoctoral fellow at Columbia University, and attended medical school at the State University of New York in Buffalo.  He served as an intern at Harvard and completed his residency at the Emory University School of Medicine.

Dr. Brent won the Louis Roche award from the European Association of Poison Control Centers and Clinical Toxicologists for his contributions to the field.  He does peer review for the journal Clinical Toxicology as well as The New England Journal of Medicine and the Journal of the American Medical Association.  Dr. Brent has more than 200 published articles and has testified on behalf of pharmaceutical companies in toxic tort cases.

In his practice, Dr. Brent has treated public suffering from mercury toxicity.  In one case, a dentist had a rug which was contaminated from mercury fillings.  She vacuumed the rug which turned the mercury into a vaporous state which she then inhaled.  The dentist developed a neurological syndrome and was subsequently treated through chelation.  Dr. Brent has treated autistic children suffering from toxic exposures, normally from their trend to mouth items that may be toxic.

In his review of Michelle Cedillo's medical records and the supporting literature, Dr. Brent was confident that there was no connection between her autism and her thimerosal-containing vaccinations.  As for in-vitro studies showing thimerosal disrupting the proper functioning of nerve cells he observed that the in-vitro environment was "highly vulnerable" and may not accurately recreate what happens in the body.

According to Dr. Brent, the Goth and Agrawal studies showing effects on dendridic cells were not relevant because they used thimerosal, when it is known that thimerosal quickly converts into ethyl mercury in the body.  Michelle's last thimerosal containing shot was nine months before her MMR shot, more than enough time for the mercury to apparent her system.

A point of confusion according to Dr. Brent, was the difference between ethyl and methyl mercury.  Using alcohol as an analogy, he compared ethyl mercury to beer of wine, while methyl mercury was akin to wood alcohol, of which a small amount may maybe be fatal.

There was some discussion of the EPA and FDA "reference doses for mercury, along with the admission that on certain vaccination dates that level may maybe be exceeded.  But, Dr. Brent pointed out that a "reference" dose was not the threshold for toxicity.

In commenting on the Homes study of mercury retention in the first haircut of autistic children as compared to controls he confirmed that the mercury levels of the controls were exceptionally high, while the levels of the autistic patients were quicker to the normal range.

The Bradstreet and Geier study showing increased excretion of mercury in the urine of autistics relative to controls also came in for criticism.  Dr. Brent noted a large variance in their results, the complicating business of diet, questions about monitoring of compliance with chelation, and the fact that a baseline before treatment was not established.

Dr. Brent did not judge there was a genetically vulnerable subpopulation in regards to mercury and noted that no genetic evidence had been offered for that theory.

In discussing the disease of acrodynia (mercury toxicity as the result of mercury-laced teething powders from the 1890s to the 1950s when the disease disappeared) he said that later testing of these children showed the excretion of 200 to 2,500 micrograms of mercury per liter in their urine while the normal expected excretion is 1-2 micrograms. 

But, he did note that approximately 35% of the children diagnosed with acrodynia had no measurable mercury in their urine.

CROSS-EXAMINATION OF DR. BRENT BY MS. CHIN-CAPLAN – ATTORNEY FOR THE PLAINTIFFS (PETITIONERS)

Ms. Chin-Caplan spent the first part of her cross-examination banter out how much time Dr. Brent has for actual research, along with the fact that he has no research laboratory.

In his treatment of mercury cases, he discussed how he gets his patients (referral from additional medical professionals) and his testing protocols which include the obtaining of blood and urine mercury levels.

He was cross-examined on the FDA's ban of thimerosal on over the counter harvest and conceded that Thimerosal has never been tested for safety.  He also agrees that Thimerosal has not been taken out of all vaccines.

Dr. Brent acknowledged that methyl mercury caused problems in the cases of Minimata Bay, in Iraq with mercury treated grain, and that studies of populations in the Faroe and Seychelles Islands that ingested large amounts of seafood with mercury suffered from intellectual deficits.

Dr. Brent also admitted that there have been cases of ethyl mercury poisoning, examples of which were even controlled in his report.  He also agreed with the study that showed that the post-vaccination levels of mercury are higher in preterm infants, than persons who were full-term, and that further study was warranted.

He also agreed that there was no question that at a high enough dose mercury was a neurotoxin.  He also acknowledged that there was a long latency period between exposure and injury.  For example, in the case of the contaminated Iraqi grain, it took months for symptoms to appear in the unnatural individuals.

Dr. Brent admitted that his own report controlled examples of thimerosal poisoning, albeit with amounts lower than persons found in vaccines.

Five out of six infants died when an antibiotic with high amounts of thimerosal were agreed to them.  Curiously, the one who survived was also the youngest.  She was only six weeks ancient.  A two month follow-up claimed she was doing fine.  In the Fagan case, a thimerosal tincture was applied to the umbilical cord of newborn babies.  Ten out of thirteen of the children died.  A ten year follow-up of the remaining three survivors was able to locate only one.  The girl was described by her teachers as reckless, easily distracted, and not interested in schoolwork.

In the Zheng case in China, there was contamination due to rice treated with ethyl mercury.  Dr. Brent's report confirmed 40 out of 41 of the unnatural farmers recovered or improved, despite the high levels to which they were exposed.

But, Ms. Chin-Caplan presented Dr. Brent with evidence that only 27 of the unnatural farmers were treated with chelation, while 13 were not.  The treated group showed significant improvements, even recovery, while a two-month follow-up of the non-treated individuals showed small improvement in signs or symptoms.  Dr. Brent appeared confused by what he'd written in his own report.

Dr. Brent admitted that at high does mercury can exchange the immune system, even if he couldn't tell the level of that dose.

Ms. Chin-Caplan then went through a cross-examination which I found reasonably impressive.

Dr. Brent acknowledged that low levels of mercuric mercury lower the glutathione content of the cells.

He agreed that different members of the lymphoid cell population have different sensitivities to mercury, with the monocytes life the most sensitive.

He admitted that some thimerosal will turn into mercuric mercury.

He said it is possible that the lack of a toxic effect doesn't mean there might not be significant functional impairment of a cell.

He agreed that organic and inorganic mercury can exchange both the humoral and cell-mediated immune response of the body.

Dr. Brent acknowledged that the mechanism by which mercury causes immuno-suppression is unclear.

He conceded that there's a lot of data on genetically-altered rodents which demonstrate an unusual response to mercury.

He agreed that if a person has fewer monocytes, mercury may maybe become even more toxic.

He acknowledged that methyl mercury is 5 to 10 times more potent than mercuric mercury.

Dr. Brent confirmed that at apt levels most heavy metals will exchange the immune system.

It was at this point that Dr. Brent appeared to get rattled because of the effectiveness of Ms. Chin-Caplan's cross-examination.  He started to fight this line of questioning because of his confirmed belief that these questions were not relevant to the level of mercury controlled in vaccines.

He said that at this point it was only speculation that there was a sub-population more susceptible to mercury, with the exception of some preliminary findings of the CPOX4 gene present in 12 to 15 percent of the population.  When questioned what that earnings, he said that it is currently unclear.

When questioned by Ms. Chin-Caplan about the Adams tooth study, showing twice the amount of mercury in the baby teeth of autistic children vs. the teeth of normally-developing children his answer was that the difference may not be statistically significant.

He didn't really have much to say about the Burbacher study of primate brains exposed to mercury at levels comparable to the U.S. vaccination schedule.  He agreed that Burbacher found that ethyl mercury turned inorganic three times nearer than methyl mercury where it would be retained in the brain.  He also agreed that in its organic state, mercury will have a very, very slow rate of excretion.

He also agreed that vaccines are administered at a very vulnerable period of development, but claimed large epidemiological studies would show no correlation.

SPECIAL MASTER QUESTIONS FOR DR. BRENT

Special Master Vowell started by asking his understanding of the mercury efflux theory.  He responded by saying that the hypothesis suggests that there are certain public who because of their genetics will have distress getting rid of the mercury in their system.  But, he said he was unaware of any support for their thought.

Turning to acrodynia, Vowell questioned how the 1 in 500 number of afflicted children was arrived at.  He seemed to say the evidence was pretty excellent that of children who used the mercury teething powder, only about 1 in 500 would be afflicted with acrodynia.  He volunteered an explanation that the 1 in 500 who did come down with acrodynia probably had a very high dosage of the teething powder.

Vowell then questioned if he had any studies showing that there was a dose/response relationship in the acrodynia-afflicted children.  Bent answered he was unaware of any such study.

In comparing mercury to alcohol, Vowell then questioned if somebody may maybe develop a tolerance, like a heavy drinker who can drink more alcohol than a contemporary and not show any ill effects.  Brent answered that there was no such built-up tolerance for mercury.

In response to a question about an Iraqi farmer who ate wheat contaminated with methyl mercury, compared to a Chinese farmer who ate rice contaminated with ethyl mercury, Bent said their symptoms would probably be similar.  But, he held to his previously-confirmed contention that you would probably need more ethyl mercury to get the same hurt as methyl mercury.

In a discussion of injected mercury compared to mercury that was eaten, Dr. Brent said that the injected mercury would probably be slightly less toxic.

REDIRECT OF DR. BRENT BY MS.PATTON – ATTORNEY FOR GOVERNMENT (RESPONDENTS)

Her only point on redirect was that the toxicity of mercury is simply a question of the dose, not any additional factors.

FINAL THOUGHTS ON THIS DAY OF TESTIMONY

Ms. Chin-Caplan is doing an brilliant job. Her cross-examination of Dr. Chadwick was brilliant.   It left Dr. Chadwick as a discredited witness.

Dr. Brent was a tough witness.  He sounded credible and intelligent.  But, Ms. Chin-Caplan did an brilliant job of walking him through all of the known toxicity problems of mercury, along with showing how much is currently unknown.  It is a leap to go from the high levels of known mercury toxicity to the lower levels claimed to harm autistic children.  But with the example of acrodynia affecting only 1 in 500 children, it doesn't seem an unreasonable one to make.

I thought the questions of the Special Masters probably are the best road-map to how this case will turn out.  Therefore, Dr. Brent's aver that the children unnatural with acrodynia probably got a higher dosage was open to question, and the question was questioned.

When Dr. Brent said there was no study which supported his belief that the dosage was the main difference between the children who got acrodynia and persons who didn't, he left himself wide open.  The genetic explanation is just as plausible as the dosage explanation.

1 in 500 kids who used mercury teething powders got acrodynia.  The rate of autism in vaccinated children is 1 in 150.  We may not get a Perry Mason answer to this question, but we do have a lot of facts to build a picture.

Kent Heckenlively has worked as an attorney, television producer, and is now a beloved science teacher.

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