Making a guess based on experience, Lord believed the second to be true. Either way, how did he know? One reason-Yaminer had done his fake reporting in a hurry and been careless. What had caught Lord's eye to begin was a close similarity between the handwriting on patient report forms on different dates. Usually such entries varied, and not only the handwriting, but the writing instrument. Even if a doctor used the same ball-point pen every day, it seldom performed with exact consistency. That in itself was not conclusive. Yaminer could have made earlier notes, then transformed them patiently into neater, finished reports. But for a busy doctor it was unlikely. Which prompted Lord to look for more. He found it. Among tests performed on patients receiving experimental drugs was one to measure urine pH-acidity or alkalinity. For an average person the result would be expressed in the range 5 to 8. But each measurement, on separate days, was an "independent event" and usually varied, meaning that a reading of 4 on Tuesday did not make likely another 4 in the same person on Wednesday. Expressed a different way: over five successive days, the likelihood of pH measurements being identical was only one in four. Long odds. Yet, repeatedly, Dr. Yammer's reports on patients showed identical pH readings day after day. Highly unlikely, even with one individual. Impossible in the case of fifteen patients-the number reviewed by Lord from the Yammer study. To be absolutely sure, Lord selected fifteen other patient names and made a similar review of blood studies. Again identical figures repeated with unnatural frequency. There was no need to go further. Any medical investigator would accept the pattern already uncovered as evidence of falsification in this instance, criminal fraud. With silent, seething anger, Lord cursed Dr. Yammer. The overall report presented by Yaminer made Hexin W look extremely good. But it was unnecessary. The drug would have looked good anyway, as was demonstrated by every other report which Lord had read. Lord knew what he ought to do. He should immediately inform the FDA, laying everything before them. After which Dr. Yammer would be officially investigated and almost certainly prosecuted. It had happened to other doctors before, and some had gone to prison. If Yaminer was found guilty he could go there too and also, perhaps, lose his license to practice medicine. But there was something else which Lord knew. If the FDA became involved, with Yaminer's work thrown out, all of it would have to be done again. And allowing for new arrangements that would have to be made, it would take a year and would delay Hexin W's introduction by the same amount of time. Again Lord cursed Yaminer for his stupidity and the dilemma now created. What to do? If it had happened in connection with a drug about which there were doubts, Lord told himself, he wouldn't have hesitated. He would have thrown Yammer to the FDA wolves and offered to give evidence at Yaminer's trial. But there wasn't any doubt about Hexin W. With or without the false report, it was going to be a beneficial, successful medication. So why not let the fake study go in with the other genuine ones? It was a safe bet that no one at FDA would notice; the sheer volume of an NDA made that unlikely. And if Yaminer's papers were looked over by an FDA examiner, there was no reason to suppose the deception would be seen. Not everyone was as quick to notice things as Vincent Lord. Lord would have preferred to omit the study altogether, but knew he couldn't. Yaminer's name was listed in other material already sent to FDA. He also hated the idea of letting Yaminer get away with what he had done, but there seemed no other way. So... all right. Let it go. Lord initialed the Yaminer study and placed it on a pile of others previously reviewed. He would make sure though, Lord vowed, that the bastard never worked for Felding-Roth again. There was a departmental file for Yaminer. Lord found it and stuffed his own rough work sheets in, the pages he had used to figure out the fakery. If he ever needed them, he would know exactly where they were.
Lord's assessment of the situation proved to be correct. The NDA was submitted and, in a satisfyingly short time, approved. Only one thing briefly troubled Vincent Lord, making him nervous. In FDA's National Center for Drugs and Biologies at Washington, D.C.-formerly the Bureau of Drugs-Dr. Gideon Mace was now a deputy director. Compared with earlier days, Mace was a changed and better person, a strict tee-totaler, at last with a good marriage, and respected at his work. His bad experience at the Senate hearing appeared to have done him no harm. In fact, soon afterward he had been promoted. Word reached Lord that Mace, while not directly involved with the Hexin W application, had taken an interest in it, as apparently he did with anything coming into the agency from Felding-Roth. Almost certainly, Mace still bore the company a grudge and hoped one day to get even But nothing happened as a result of Mace's interest, and when FDA approval to market Hexin W was given, Lord's nervousness evaporated.
As with Peptide 7, it was decided that the developmental name of Hexin W would he its product name also. "It comes easily off the tongue and will look good on packaging," Celia declared when it was time for the matter to be decided. Bill Ingram agreed, adding, "Let's hope it brings us the same kind of luck we had before.”
Whether luck helped or not, Hexin W was an immediate success. Physicians, including some in prestigious teaching hospitals, hailed it as an important medical advance which opened up new therapies for treating seriously ill patients. Medical journals praised both the drug and Vincent Lord. Many doctors in private practice began prescribing Hexin W, including Andrew, who reported to Celia, "It looks as if you have a live one there. It's as much a breakthrough, I think, as Lotromycin in its time.”
As more and more doctors discussed the drug with each other, and patients expressed gratitude for the relief it brought them, Hexin W's use expanded and sales zoomed. Other pharmaceutical companies, some of which had been wary at first, began using Hexin W under license, incorporating it in their own products to improve their safety. A few drugs that had been developed years before but were never marketed because of high toxicity were brought down from the shelf and subjected to experiments with Hexin W added. One such was an anti-arthritic drug named Arthrigo. The patent owner was Exeter & Stowe Laboratories of Cleveland, whose president, Alexander W. Stowe, was well known to Celia. A former research chemist, Stowe and a partner had formed their company a decade earlier. Since then, while the firm remained small, it had achieved a merited reputation for high-quality prescription products. After a licensing deal was negotiated, Stowe came personally to Felding-Roth headquarters. In his fifties, he was a genial figure who wore rumpled suits, had shaggy hair, and looked absentminded, which he wasn't. During a meeting with Celia and Vincent Lord he told them, "Our company has FDA permission to use a combination of Arthrigo and Hexin W experimentally. Since both drugs have anti-arthritic properties, we've high hopes for the outcome. Of course, we'll keep you informed as results come in.”
That was six months after Hexin W's introduction. A few weeks later, Celia and Andrew gave a Saturday evening party at their Morristown house in honor of Vincent Lord. Lisa and Bruce came home for the occasion. It was high time, Celia reasoned, that she did something personal for Lord, if only to make clear her recognition of his outstanding contribution to the company and to signal that any antagonism between them was now over, or should be. The party was a success, Lord more relaxed and happy than Celia had ever seen him. His thin, scholarly face became flushed with pleasure as compliments were heaped upon him. He smiled continuously and mingled easily with the guests who included Felding-Roth executives, prominent citizens of Morristown, others who had come especially from New York, and Martin Peat-Smith whom Celia had asked to fly from Britain for the occasion. The last gesture especially pleased Lord, as did Martin's toast, proposed at Celia's request. "The life of a research scientist," Martin declared while the other guests fell silent, "offers challenges and excitement. But also there are wearying years of failure, long hours of despair, and often loneliness. Only someone who has known those black occasions can understand what Vincent endured during his quest for Hexin W. Yet, his genius and dedication rose above them, leading to this celebration in which I humbly join, saluting-with you-a major scientific achievement of our time.”