'I know. I was with her just before I came here. She was grateful for your visit. Whatever you said had a markedly reassuring effect.'
Kate smiled inwardly, remembering the girlish exchange she and Ellen had had regarding the Omnicenter director's uncommon good looks and marital status. 'Maybe I could rent him for a night, ' Ellen had said, 'just to parade past Sandy a time or two.'
Zimmermann tapped his fingertips together. 'The lab reports show very little change.'
'I know, ' Kate said. 'If anything, they're worse. Unless there are several days in a row of improvement, or at least stability, I don't think her hematologist will send her home.' She felt a heaviness in her chest as her mind replayed the gruesome scene on Ashburton Five during Beverly Vitale's last minutes. Ellen's counts were not yet down to critical levels, but there were so many unknowns. A sudden, precipitous fall seemed quite possible. The stream of thoughts flowed into the question of whether with Ian Toole's findings, Kate herself should have some clotting measurements done. She discarded the notion almost as quickly as she recognized it. 'I hope as you do that there will be improvement, ' Zimmermann said. He paused and then scanned the menu.
'What will it be for you?' he asked finally. 'I'm not too hungry. How about an antipasto, some garlic bread… and a side order of peace of mind?'
Zimmermann's blue-gray eyes, still fixed on the leather-enclosed menu, narrowed a fraction. 'That bad?'
Kate chewed at her lower lip and nodded, suddenly very glad she had gone the route of calling him. If, as seemed possible, a confrontation with Redding Pharmaceuticals was to happen, it would be good to have an ally with Bill Zimmermann's composure and assuredness, especially considering the fragility of her own self-confidence. 'In that case, perhaps I had best eat light also.' Zimmermann called the waitress over with a microscopic nod and ordered identical meals. 'I want to thank you for coming out on such a grisly night, ' Kate began. 'There have been some new developments in my efforts to |! make sense out of the three bleeding cases, and I wanted to share them with you.'
'Oh? ' Zimmermann's expression grew more attentive. 'You know I've had sample after sample of medications from the Omnicenter analyzed at the State Toxicology Lab.'
'Yes, of course. But I thought the results had all been unremarkable.'
'They were… until late Friday afternoon. One of the vitamin samples I had analyzed contained a painkiller called anthranilic acid. The basic chemical structure of the drug is contained in several commerical products-By mid, from Sampson Pharmaceuticals, and Levonide, from Freeman-Gannett, to name two. However, the form contaminating the vitamins is something new-at least in this country. Ian Toole at the state lab is going to check the European manuals and call me tomorrow.'
'Is he sure of the results?'
'He seemed to be. I don't know the man personally, but he has a reputation for thoroughness.'
'What do you think happened?'
'Contamination.' Kate shrugged that there was no other explanation that made any sense. 'Either at Redding Pharmaceuticals or perhaps at one of the suppliers of the vitamin components, although I would suspect that a company as large as Redding can do all the manufacturing themselves.'
'Yes. I agree. Do you think this anthranilic acid has caused the bleeding disorders in our three women?'
'Bleeding and ovarian disorders, ' Kate added, 'at least ovarian in two of the women. We don't know about Ellen. The answer to your question is I don't know and I certainly hope not.'
'Why?'
'Because, Bill, the vitamins that were finally positive for something were mine. Ones you prescribed for me.'
Zimmermann paled. The waitress arrived with their antipasto, but he did not so much as glance up at her. 'Jesus, ' he said softly. It was the first time Kate had ever heard him use invective of any kind. 'Are you sure this Toole couldn't have made a mistake? You said yourself there were any number of samples that were negative.'
'Anything's possible, ' she said. 'I suppose Ian Toole and his spectrophotometer are no more exempt from error than… Redding Pharmaceuticals.'
'Do you have more of a sample? Can we have the findings rechecked at another lab?'
Kate shook her head. 'It was an old prescription. There were only half a dozen left. I think he used them all.'
Zimmermann tried picking at his meal but quickly gave up. 'I don't mean to sound doubtful about what you are saying, Kate. But you see what's at stake here, don't you?'
'Of course I do. And I understand your skepticism. If I were in your position and the Omnicenter were my baby, I'd want to be sure, too. But Bill, the situation is desperate. Two women have died. My friend is lying up there bleeding, and I have been unknowingly taking a medication that was never prescribed for me. Someone in or around Redding's generic drug department has made an error, and I think we should file a report with the FDA as quickly as possible. I spoke to the head pharmacist at Metro about how one goes about reporting problems with a drug.'
'Did you mention the Omnicenter specifically? ' Zimmermann asked. 'I may be nervous and frightened about all this, Bill, but I'm neither dumb nor insensitive. No. Everything I asked him was hypothe ical.'
'Thank you.'
'Nonsense. Grandstand plays aren't my style.' She smiled. 'Despite what the papers and all those angry Red Sox fans think. Any decisions concerning the Omnicenter we make together.' Kate nibbled on the edge of a piece of garlic bread and suddenly realized that for the first time since returning home to Jared's note, she had an appetite. Perhaps, after the incredible frustrations of the week past, she was feeling the effects of finally doing something. She passed the basket across to Zimmermann. 'Here, ' she offered, 'have a piece of this before it gets cold.'
Zimmermann accepted the offering, but deep concern continued to darken his face. 'What did the pharmacist tell you?'
'There's an agency called the U. S. Pharmacopia, independent of both the FDA and the drug industry, but in close touch with both. They run a drug-problem reporting program. Fill out a form and send it to them, and they send a copy to the FDA and to the company involved.'
'Do you know what happens then?'
'Not really. I assume an investigator from the FDA is assigned to look into matters.'
'And the great bureaucratic dragon rears its ugly head.'
'What?'
'Have you had many dealings with the FDA? Speed and efficiency are hardly their most important products. No one's fault, really.
The FDA has some pretty sharp people-only not nearly enough of them.'
'What else can we do? ' Absently, Kate rolled a black olive off its lettuce hillock and ate it along with several thin strips of prosciutto.
'I need help. As it is, I'm spending every spare moment in the library.
I've even asked the National Institutes of Health library to run a computer cross on blood and ovarian disorders. They should be sending me a bibliography tomorrow. I've sent our slides to four other pathologists to see if anyone can make a connection. The FDA seems like the only remaining move.'
'The FDA may be a necessary move, but it is hardly our only one. First of all I want to speak with Carl Horner and our pharmacist and see to it that the use of any Redding products by our facility will be suspended until we have some answers.'
'Excellent. Will you have to bring in extra pharmacists?'
'Yes, but we've had contingency plans in place in case of some kind of computer failure since… well, since even before I took over as director. We'll manage as long as necessary.'
'Let's hope it won't be too long, ' Kate said, again thinking of Beverly Vitale's lifeless, blood-smeared face. 'If we go right to the FDA it might be.'
'Pardon?'
'Kate, I think our first move should be to contact Redding Pharmaceuticals directly. I think the company deserves that kind of consideration for the way they've stood up for orphan drugs and for all the other things they've done to help the medical community and society as a whole. Besides, in any contest between the bureaucratic dragon and private industry, my money is on industry every time. I think it's only fair to the Omnicenter and our
