Slashdot Mirror


Dr. Frances Kelsey, Who Saved American Babies From Thalidomide, Dies At 101

circletimessquare writes: Plenty of regulations are bad (some because big business corrupts them) but the simple truth is modern society cannot function without effective government regulation. It keeps are food safe, our rivers clean, and our economy healthy. Passing away at age 101 Friday was a woman who personified this lesson. In 1960 the F.D.A. tasked Dr. Frances Kelsey with evaluating a drug used in Europe for treating morning sickness. She noticed something troubling, and asked the manufacturer William S. Merrell Co. for more data. "Thus began a fateful test of wills. Merrell responded. Dr. Kelsey wanted more. Merrell complained to Dr. Kelsey's bosses, calling her a petty bureaucrat. She persisted. On it went. But by late 1961, the terrible evidence was pouring in. The drug — better known by its generic name, thalidomide — was causing thousands of babies in Europe, Britain, Canada and the Middle East to be born with flipperlike arms and legs and other defects." Without Dr. Kelsey's scientific and regulatory persistence in the face of mindless greed, thousands of Americans would have suffered a horrible fate.

20 of 278 comments (clear)

  1. But but but.. by Daemonik · · Score: 5, Funny

    Corporations can regulate themselves! We can totally trust them not to put greed ahead of public safety! Really, they've learned their lessons and besides, we have all the regulation the market needs with civil lawsuits! Just let us reform a few tort laws and cut a few useless regulations holding back all the awesome good things we want to bring to people and we'll all be living in a utopia!

    1. Re:But but but.. by serviscope_minor · · Score: 5, Funny

      Yeah those babies should have voted with their wallets and not bought thalidomide in the first place. After enough consumers suffered hideous deformities, word would have got around and the company would have stopped being profitable. The free market would work as it should.

      --
      SJW n. One who posts facts.
    2. Re:But but but.. by cbhacking · · Score: 4, Informative

      It's interesting how, in the days before the FDE, DEA, and all that, companies marketed all kinds of shit to people. Heroin was Bayer's brand name for their "non-addictive" (total lie, obviously) morphine alternative and *cough suppressant*. Some of their marketing of it targeted kids; hey parents, your little girl can't sleep because she's got a cold? Well, give her some heroin, that'll solve everything!

      Of course, none of these companies ever seem to have suffered any problems in the market as a result of the horrible effects of the stuff they sold, or the lying ways they marketed it. Bayer, of course.is still around, as is the company that brought Thalidomaide to the market (and at the time they were pretty small and new, without much ability to weather a major failing in the market). At least when it comes to pharmaceuticals, the market has shown absolutely no ability to regulate itself.

      --
      There's no place I could be, since I've found Serenity...
    3. Re:But but but.. by Opportunist · · Score: 5, Interesting

      I'm not implying it, I'm saying it. When I look at the US and then at most of (socialist) Europe, I can't really say with a straight face that I think our "socialist" ways are bad.

      The key is moderation. Unfettered capitalism is as devastating as a rigidly planned economy.

      --
      We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
    4. Re:But but but.. by Opportunist · · Score: 3

      You might notice the side note "if they deserve the name". The US government is pretty much a whore for sale to the highest bidder, not a government.

      --
      We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
    5. Re:But but but.. by weilawei · · Score: 5, Funny

      Uh, maybe I'm missing something, but you two seem to be violently agreeing.

    6. Re:But but but.. by Daemonik · · Score: 4, Insightful

      Yet you know with certainty that the doctors prescribed a real medication with actual effects and not just colored water that the doctor makes in the back of his office. You know, with certainty that the bottle Wal-Mart sells you (and really, if you have money wtf are you shopping at Wal-Mart?) will be the actual medicine and that they haven't been mixing water in to increase their profits, or buying counterfeit drugs to again increase their profits.

      The reason you know these things is because the government enforces regulations protecting you from such dishonest practices. The government enforces regulations that save your life and your children's lives from corporate greed every day, and because you don't see that you get to pretend like they aren't necessary, but you are simply deluded.

      Also, you may have money but you certainly aren't very bright if you think googling WebMD is a valid replacement for a medical degree.

    7. Re:But but but.. by swb · · Score: 4, Insightful

      From what I've read, I don't think the "non-addictive" nature of heroin was really a Bayer greed conspiracy as much as a byproduct of poorly understood nature of opiate dependence.

      Ironically, opiates saved countless lives from people suffering from intestinal illness where diarrhea would have killed them from dehydration. Considering the state of medical science at the turn of the century and the lack of alternative medications available, the opiates were miracle drugs. You have to wonder how many potentially life saving surgeries (like amputations or excisions of infection) wouldn't have happened without opiate pain relief or how many recoveries wouldn't have happened without opiate pain relief.

      A lot of mass opiate addiction (to the extent that it existed at all) wasn't injected morphine, but smoking opium. For those with an opium habit, a small maintenance dose of a stronger opiate like heroin that allowed them to not spend hours in an opium den may have actually seemed like a cure to them, much as contemporary medicine might consider opiate maintenance with methadone or buprenorphine a therapy for heroin addiction.

      You also have to wonder for some of the old use cases where it seems totally wrong now (like providing it to teething children) if perhaps the nature of its use didn't actually result in, say, toddlers getting addicted. Opiate tinctures were still manufactured medicines that cost money in an era where disposable income was small and geographic access to doctors or pharmacies to obtain it was limited. It's not hard to imagine that it may have been used sparingly due to cost, supply limitations or even medical advice from doctors who were aware of its habit forming potential, resulting in actual use not that different than a bottle of 20 vicodin provided after a wisdom tooth extraction today.

      I had terrible ear infection problems as a child in the early1970s, getting drainage tubes in my ears more than once (which was a real hospital stay back then) and our pediatrician gave us a bottle of demerol to treat the pain from the ear infection something I doubt would even be considered today.

    8. Re:But but but.. by amiga3D · · Score: 5, Interesting

      The real thing that should have happened is everyone involved should have been tried and executed. That would be a better deterrent than some supposed market force that doesn't really work since all these assholes have golden parachutes. Every single person behind covering up the continuing damage, not the initial mistake but the coverup once it was clear what was happening is a hideous monster and should be permanently removed from society. The real reason people keep doing this evil shit is that it pays and society should make it unmistakably clear that we wont tolerate it.

    9. Re: But but but.. by avatar+avatar · · Score: 4, Insightful

      And how would these parents have proven that the drug was to blame? Who would've forced the company to provide samples or hand over data? Would a coalition of parents have pooled their money to employ scientists and rent lab time for the task? I wouldn't care to guess how many millions more would have to suffer deformity to inspire that kind of collective action, but the scenario doesn't exactly make for a free market paradise.

    10. Re: But but but.. by drinkypoo · · Score: 3, Insightful

      The courts. It's called "Discovery." Requests for Production generally have to be complied with.

      Oh, the "requests" which "have to be complied with" or they will be backed up with VIOLENCE. STATIST!!! Seriously, everything about libertarians and similar is hilarious. I would be soooo embarrassed to admit I ever considered myself to be one if I didn't know that wisdom comes with age, if at all.

      --
      "You're right," Fisheye says. "I should have set it on 'whip' or 'chop.'"
    11. Re:But but but.. by squiggleslash · · Score: 3, Interesting

      I would say RFA completely invalidates your point. Governments did act relatively quickly and didn't try to shield the producers.

      By comparison, the free-market+lawsuits route was used for asbestos, tobacco, and leaded gasoline. In all three cases, eventually the government had to step in, after decades of inaction and of legal routes going nowhere and making little or no difference.

      If something is shown to be harmful, the government has a right to step in. We shouldn't have to wait for lawsuits - which can take decades, which address only specific issues, which can cost less to the manufacturers than ending the businesses that cause the problems, which can fail for reasons entirely unrelated to the harm causes to the victims - to somehow shut down the worst offenders.

      --
      You are not alone. This is not normal. None of this is normal.
    12. Re:But but but.. by JustOK · · Score: 4, Funny

      they get an eh

      --
      rewriting history since 2109
  2. Re:Leftist pretzel-think at its finest by weilawei · · Score: 4, Informative

    Herald the guy

    Dr. Frances Kelsey was a woman.

  3. Re:Leftist pretzel-think at its finest by _KiTA_ · · Score: 4, Informative

    Herald the guy who saved babies from being killed as a hero, while simultaneously saying its no big deal that planned parenthood is trafficking baby parts after they rip them out of its mother's womb.

    You're a fucking moron, and so is anyone else stupid enough to believe that hoax.

    http://littlegreenfootballs.co...
    http://littlegreenfootballs.co...
    http://littlegreenfootballs.co...
    http://littlegreenfootballs.co...

    And no, I can't say that any nicer. Anyone who believes planned parenthood is selling baby parts or that they're "ripping them out" is a fucking idiot who needs to have their brain taken away by social services.

  4. For the Euros, and especially the Germans by Opportunist · · Score: 4, Informative

    In case you wonder what the fuss is about, you might know that drug by the name it had over here: Contergan.

    --
    We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
  5. Walter White explains it by mark_reh · · Score: 3, Interesting
  6. This is a great look at incentives for bureaucrats by trout007 · · Score: 4, Insightful

    This is why bureaucracy is so dangerous. You are declared a hero if you stop something bad and are declared a failure if you let something bad happen. But if something is beneficial it doesn't matter if you let it go to market or not. The millions that suffer and die because of delays to get products to market are invisible. No stories are written about them and you are never blamed.

    With those incentives it's easy to see why the bureaucrat must delay things as long as possible.

    Take the OP quote of how the government ensures a healthy economy. We all know that's a complete joke. After 2008 what was needed was for the poorly run companies to go bankrupt and be bought by the well run companies. But that is risky from a bureaucratuv position. The status quo is preferable. So instead you take money from the well run companies and you give it to the poorly run ones as a bailout and everything is fixed right? Well right up until the house of cards falls again.

    --
    I love Jesus, except for his foreign policy.
  7. Not exactly the actual story... by tlambert · · Score: 4, Informative

    Not exactly the actual story... here's the real deal:

    http://blog.seattlepi.com/stev...

    SKF declined to market the drug in the U.S..

    Grunenthal signed a distribution agreement with the William S. Merrell Company.

    Merrell started human trials in the U.S. in Feb 1959, and expanded it to include pregnant women in May 1959.

    Merrell submitted an NDA (New Drug Application) in Sep 1960 under the drug name Kevadon.

    Merell began the "Kevadon Hospital Program" and ramped up distribution.

    Mostly Dr. Kelsey demanded testing on pregnant animals; while that was happening, news broke on the effects in July 1961.

    The NDA was withdrawn on March 8, 1962.

    All in all, 2.5M doses were distributed to 20,000 patients in the U.S.. The FDA did not have the teeth to prevent this, and Dr. Kelsey merely prevented approval, not distribution.

    There were actually a lot of victims of the drug in the U.S., and the FDA didn't (couldn't) prevent it.

  8. Chirality: important. Doing (R)Thalidomide justice by TheRealHocusLocus · · Score: 5, Informative

    Chirality of Enantiomers is usually not, but may be important in the consideration of new drugs. And if chirality is an issue, then a benign molecule may be broken apart by the liver and (possibly) recombined back into the same substance, but in a wrong, harmful way. We now "know" this. We did not know this then.

    TA portrays Thalidomide as a simple case of 'superior' FDA gate-keeping in the United States that prevented a harmful drug from reaching the market, a drug company dismissing (with hubris implied) what turned out to be serious danger. And this is true --- Dr. Kelsey was basing her judgement on a just a few reports of adverse effects, a numbing condition in arms and legs which indicated nerve damage. And Kelsey's projection that what ever caused this symptom might also impair development of the fetus was prescient and brilliant. It's a win.

    As to why the medical community maintained the myth that drugs would not pass through the placental barrier when alcohol clearly did, that's a clearly a what-the-fuck.

    To be fair however, there was an aspect to Thalidomide that confounded everyone at the time, and may even have confounded Dr. Kelsey herself had she been a chemist at the pharmaceutical company she fought. Trials on humans had indicated Thalidomide to be effective and safe, and the manufactured batches distributed in Europe were chemically indistinguishable from those that had yielded early successful trials.

    To dispense with the jargon of chemistry in favor of the delightful aphorism of Richard Feynman, "Nature is screwy," so-called organic molecules can have left and right handed "threads". He introduces handed-ness or chirality, in his his lecture on symmetry in physical laws as he describes a simple experiment where sugar is dissolved in water... (astoundingly, almost precisely!) only abut half of it is taken in by bacteria. And yet, though the bacteria cannot digest the remaining "wrong-handed sugar", chemical tests of composition would reveal that it is the same. And the half that remains is clearly different somehow, and that difference can be seen when light is passed through it with a polarizing filter. This optical property of chemistry was observed by Louis Pasteur in 1812, but not until the tragedy of Thalidomide did we realize that chirality matters.

    As described in this nice succinct PDF, (+)(R)-thalidomide was safe by itself, the enantiomer responsible for the beneficial sedative effect, but (-)(S)-thalidomide inhibits new blood vessel growth. Perhaps early batches used for testing had disproportionate amounts of (R) --- or something else happened. Perhaps I'll be down-modded if I suggest any reason that does not distill down to greed and malfeasance. But what is certain is that the tragedy brought chirality out of the realm of scientific curiosity to become a crucial part of drug development.

    For a time it was thought that a more refined manufacturing process which created (R) to the exclusion of (S) may have rendered Thalidomide "safe". And it would have, except that normal liver function involves breakdown and recombination of such molecules in equal amounts. Just like that dissolved left-handed and right-handed sugar.

    Today the chirality of new drugs is carefully considered and (R) and (S) enantiomers are tested separately. While Dr. Kelsey made a good judgement call, at the time she could not know precisely why it was a good call.

    The actual mechanism by which (-)(S)-thalidomide impairs the fetus has only recently been discovered.

    --
    <blink>down the rabbit hole</blink>