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 ANTE-MORTEM OBSERVATIONS

ANTE-MORTEM OBSERVATIONS

"Observations for Drug Effects" records are attached as exhibits #70 & 71. These records were completed on a weekly basis for the first four weeks, every two weeks through week 12, and every 4 weeks thereafter.  Each record lists the animals in a specific housing group, and entries are made for the following parameters: appearance and awareness, rales, eyes, motor activity sensory loss, urine/feces, appetite/thirst, and tissue masses/lesions.  There is also a space for notes, and masses are routinely described on the reverse side of the sheet.  The top of the sheet has blocks for entering the date of observations, number of weeks on treatment, and signature or initials of the person making the observations.  It was noted that many of the observation records were not signed or initiated.  Following is a tabulation of the numbers of records in which the person making the observations is not identified.

 HOUSING
 GROUP             NO. OF RECORDS NOT SIGNED OR INITIALED

  A                6        (wks 80, 92, 84, 88, 93, 94)
  B                6        (wks 80, 84, 88, 92, 93, 96)
  C                5        (wks 80, 84, 88, 92, 96)
  D                7        (wks 79, 80, 84, 88, 92, 94, 96)
  E                6        (wks 76, 80, 84, 88, 92, 96)
  F                9        (wks 76, 77, 80, 81, 84, 88, 92, 93, 96)
  G                5        (wks 80, 84, 88, 92, 96)
  H               11       (wks 1,  68, 76, 80, 81, 83, 84, 88, 92, 95, 96)
  J                 6        (wks 76, 80, 84, 88, 92, 96)
  K                8        (wks 71, 76, 80, 84, 88, 92, 93, 96)
  L                 5        (wks 76, 80, 84, 92, 96)
  M                5        (wks 76, 80, 84, 92, 96)
       TOTAL      79 records not signed or initialed

In addition to the lack of signatures, it was noted that many of the records were not originals, but appeared to be xerox copies of the originals.  Surprisingly, some of the xerox copies had "original" initials.  It was obvious that the initials had been placed on these sheets sometime after the sheets had been filled out, and after they had been copied.

Some examples of discrepancies of this type are as follows:

1.)  In housing group A, 26 of the 39 observation records were xerox copies with original initials.

2.)  In housing group B, 27 of the 43 observation records were xerox copies with original initials.

3.)  The record for week 76 of housing group A was a xerox copy but the date, initials, an week are all original.

4.)  For week 96 of housing group K, both an original and xerox copy of the observation record are present.  The xerox copy has original initials and a "B" entered in the "tissue masses and lesions" column.  There is also an entry in the "notes" column for rat #K25CF.  The original record also has a "B" entered in the "notes" column.  All of the above entries had obviously been made sometime after their original record had been completed and the xerox copy made.

5.)  A record dated 4-27-73 for housing group M does not have the date entered.  The observations were made for this animal on sheets covering weeks 92, 96, 100 and 104, indicating that the animal was dead.  The record for week 108, however, shows that the animal is alive, with motor activity, appetite, and thirst. The record for week 112 again shows that the animal is dead.

In addition to the discrepancy noted above, there is also an obvious error in the dating of these records; the observation sheet for week 92 is dated June 13, l973, and the observation sheet for week 88 is dated July 16, l973.

Ante-mortem observations were also made on other types of records.  A volume entitled "Tissue Masses and Deaths" (exhibit #65) has a record of the date that each animal died during the study.  The deaths are recorded in two different ways in this volume.  One record has a chronological list of deaths, and another record has a list of deaths organized by housing group.  This volume also has a "palpation Record", which describes each tissue mass, and lists the date that it was initially detected.

It was noted that many of the animals in the sequential record of deaths were listed out of sequence.  Following is a tabulation of the animals that were out of sequence.

(* indicates animal is listed out of sequence)

ANIMAL NO.

DATE FOUND DEAD

NO. OF DAYS ON TREATMENT

E6HN

8-12-73

640

E24HM

8-16-73

640

G10LM

*8-14-73

638

L11CM

5-6-73

535

C17CM

*5-4-73

542

A14MM

5-21-73

560

A24HM

10-15-73

707

C14HM

*10-27-73

718

E22CM

10-19-73

707

E29LM

10-25-73

714

A4CM

10-26-73

718

E26CM

11-15-73

735

C12LM

*11-14-73

736

L20CM

11-19-73

732

A11CM

11-25-73

748

A18CM

*11-18-73

741

J19MM

12-10-73

754

F25HF

6-10-73

576

D21CF

*6-9-73

577

H6CF

6-17-73

579

M12CF

*6-16-73

575

F18CF

7-22-73

615

H22LF

*8-20-73

641

D25MF

7-25-73

623

G2LM

10-5-73

689

G7CM

*6-14-73

567

The log of animal deaths in the "tissue masses and deaths" book was considered the primary data.  Animals were allegedly recorded in this book as they died.  When the above discrepancies were pointed out to Searle personnel, we were told by Tony Martinez on 4-28-77 that this log was compiled from the body and feeder weight data.  When it was pointed out that the exact date of death could not be determined from the body and feeder weight data, or from the observation records, we were told that the primary record of animal deaths was the log organized by Housing Group in the "Tissue Masses and Deaths" book.  We were told that the chronological log of animal deaths was made by transferring the data from the log organized by housing group, and therefore the animals being recorded out of sequence was not significant.

We then pointed out that the chronological record of deaths also contained the date fixed "in toto" and the date autopsied, neither of which were found on the log organized by housing group.  If the data was transferred from one record to the other, we wondered where the "date fixed in toto" and "date autopsied" came from.  We posed this question to Searle personnel and we were finally told on 4-29-77 that the "fixed in toto" and "date autopsied" columns on the chronological record of deaths was considered to be primary data, although it was prepared simultaneously with the pathology sheets, which contained the same data.

Another source of ante-mortem data was the ophthalmoscopic examination record.  Dr. Youkilis performed the eye examinations at periodic intervals and recorded his findings on the ophthalmoscopic record sheets.  These eye exam sheets were eventually attached to the pathology records, and the results of the eye exam was incorporated into the Clinical History of the animal on the pathology sheet.

During our review of the pathology records we noted that there were no eye exam sheets for 15 animals, all of which had been included in the individual Ophthalmoscopic Findings in the submission to FDA (Vol. 1, table 1, pages 122-133).  All of these missing eye exam sheets were for animals that had died during the study.  On 6-30-77 we interviewed Donna Helms, who told us that she would make an attempt to find the missing records.  We advised her that Dr. R. Stejskal had told us on 6-29-77 that not all of the eye exam sheets were attached to the pathology records, and that there may be another file of eye exam sheets somewhere.

On 7-1-77 Donna Helms reported that she had found the missing eye exam sheets in the K-1 File Room in K-Building.  After reviewing these records we found that a few discrepancies still existed.  They are as follows:

1.)  It appears that animal J3CM on page 125, Vol. l of the submission to FDA is in error.  We could find no records to substantiate the listed corneal scar and haziness for this animals.  Also, the observation records indicate that J3CM died at week 78.  It appears that the correct animal on page 125 should be J2CM and not J3CM.

2.)  We found eye exam sheets for H26MF and J29CM, yet the findings were not reported in the submission to FDA.

3.)  There seems to be a discrepancy between G16CM and G12CM. The pathology sheets for both of these animals report the identical ophthalmoscopic finding, yet there is no eye exam sheet for G12CM, and only the finding for G16CM was reported in the submission to FDA (Vol. 1, p. 125).

During our data review, we found an internal memo from Dr. Youkilis to K.S. Rao, dated 4-28-74.  The text of this memo is as follows: "

MEMO DELETED BY FDA CENSORS IN ORDER TO PROTECT CONTENTS FROM PUBLIC SCRUTINY

A copy of the above memo is included in exhibit #72.  Dr. Rao and Dr. Youkilis are no longer employed by Searle.

When an animal spilled an excessive amount of food, this was noted on the observation records by means of an asterisk in the "appetite/thirst" column.  The asterisk was also used to denote food spillage on the Teletype sheets for body/feeder weight data.  The amount of food spillage was not quantitatively determined by the technicians assigned to observe, feed and weigh the animals, but we were told that they made an effort to return spilled food to the food cups whenever possible.  WE were also told that food consumption data for those erats marked with an asterisk on the body/feeder weight sheets was not used in Searle's statistical analysis of the data.

The "palpation record" in the "Tissue Masses and Deaths" volume shows that tissue masses were sometimes excised from the animals.  The record indicates that a tissue mass measuring 1.5x1.0cm was excised from animal B31HF on 2-10-72.  The record also shows that a "skin incision over mass" was performed on animals C22LM and G25LM on Feb. 10, 1972.