Autism Omnibus: Vera Byers the, uh, expert

16 Jun

The Omnibus case needs to establish (at this time) two issuses: causation to Michelle Cedillo in particular and also general causation in that thiomersal and MMR in combination cause Michelle’s autism. So far the expert witnesses for the Plaintiffs have been less than stellar but on Day 4 you could almost hear the sound of a barrel bottom being scraped.

The establishment of witnesses as ‘expert’ is vital to each sides case. They have to establish to the Special Masters (which by the way is a great title – do they have long flowing robes and carry light sabres?) that _their_ experts are indeed that – experts. Bear that in mind as you read the rest of this.

The cross examination of Vera Byers was an exercise in the destruction of a persons expert credibility. No wonder the Petitoners team decided against putting Geier, Bradstreet, Haley et al on the stand. It would’ve been a massacre.

Q: You’re not certified in allergy and immunology, are you?
A: I’m board eligible. I have not taken the test.

Q: Is board eligible a phrase that’s recognized by the organization that certifies allergists and immunologists?
A: Yes, it is…

Q: You’ll see on your screen a letter from the American Board of Allergy and Immunology referencing your status with that organization. They note that the board neither recognizes, uses nor defines the term board eligible.
A Okay.
Q: So you’ve been essentially representing that that is a qualification that you have in terms of rendering an opinion about immunology?
A: Yes, I have.

Q: You mention in your resume that you’re the medical director of the four doctor team responsible for filing the Biologics License Application for Enbrel?
A: That is not exactly correct. I was a consultant medical director. There were I think either four or five physician members of the team.
Q: So that part is perhaps a misstatement on your curriculum vitae?

[NB: Here’s the wording of Byers CV: _1998 – 2000: Immunex Corp: Medical director on the team responsible for filing the BLA for for Enbrel in methotrexate resistant rheumatoid arthritis, and as initial therapy for rheumatoid arthritis._ The section this is in is entitled: Consulting Medical Director. Misleading and ambiguous in the extreme.]

Q: If we were to check the files at FDA to see whether your name appears at all on any of the documents submitted by Immunex for Enbrel, would your name appear?
A: I’m sorry. I don’t know.
Q: We checked at FDA. Your name doesn’t appear on any of the documents submitted by Immunex on the Biologics License Application

Q: You talked this morning about Nottingham University.
A: Yes.
Q: On your CV you say that you’re still a member of the faculty there. Is that true?
A: No. I think I dropped off.
Q: So your CV is inaccurate? You are not still on the faculty of Nottingham University?
A: That’s correct. It sounds like it’s an old CV.

[NB: This detail is also on Byers CV on her website]

Q: Your CV also lists you as a faculty member at University of California-San Francisco. Are you still a member of that faculty?
A: To my knowledge I am, unless this hearing has kicked me off.
Q: We checked with University of California-San 3 Francisco. What was your faculty role at University of California?
A: I’m on the adjunct series.
Q: What did you do there?
A: I did research in poison oak and ivy dermatitis, went on rounds with the docs.
Q: How long ago was that?
A: Let me see. Through from about 1974 through about 1981, and then I went back again in 1984 and was there episodically probably through about two years ago.
……
Q: Okay. About a decade ago for the dermatitis? About a decade ago for the dermatitis?
A: About, yes.
Q: Any other involvement at UCSF, at University of California-San Francisco?
A: Well, I use their library and I go to their parties…..

Amazing. Apparently affiliation with a major university can be claimed by using the library and going to parties.

Q: They in their response indicated that your participation was I believe at best gave very occasional lectures.
A: Oh, no. That’s not true. I don’t know why they said that. Maybe they just don’t know. Who did it come from? Oh, Bruce Wintroub? See, Bruce Wintroub is the head of dermatology, right? This was in biostatistics.
Q: You worked there in biostatistics?
A: No. I took the courses in biostatistics.
Q: You took courses?
A: Yes.

Seems mini-Geier isn’t the only person who likes to claim institutional affiliation from being a student.

Q: Now, in the last decade, about the last decade, you’ve only seen patients in consultation for litigation purposes, correct?
A: They’re not specifically for litigation purposes,…..
…..
Q:Do you recall testifying in a case in February of this year, a vaccine case?
A: Probably. Was that you?
Q: Yes, it was.
A: Hello.
Q: Welcome back. Now, do you recall what your answer was about whether you treated patients or whether you saw them in consultation for litigation purposes at that time?
A: I’m sorry. I don’t.
Q: Would it refresh your recollection then to know that you testified at that time that for approximately the last 10 years you had only seen 16 patients for litigation consultation purposes?

Ouch.

30 Responses to “Autism Omnibus: Vera Byers the, uh, expert”

  1. Ms. Clark June 16, 2007 at 05:53 #

    About this time in her testimoney as I recall, is where she starts getting kind of punchy, and she laughs too much.

    Where she said, “Was that you?” She was sort of laughing.

    Apparently, she had been in a courtroom with Mr. Matanowski and forgot about it… I don’t know if he had been asking her questions for that other trial.

    He told her something like, maybe you’d like to update your testimony in that other case, and she said something like,

    “Do you think we’ll win?” Which was also said in this out of place, comical kind of voice.

  2. Matt June 16, 2007 at 06:48 #

    It is amazing, but your blog entry doesn’t do justice to just how bad this testimony was. Even the A-champ people responding on their own blog are agast at how bad this woman was.

    She was worse than a mercury-mom EOHarm newbie up there–and it’s too bad that this isn’t stretching the truth much.

    You don’t even point out the part where she accuses the attorney of “making faces at me”. When one of the special masters tells her to look at them, she says, “she’s much more attractive, thank you”.

    Matt

  3. A Non June 16, 2007 at 10:08 #

    The other thing, that doesn’t really come out of the transcripts, or even the audio link, is the quality of the attorneys.

    For the DoJ, a relatively young, sharp-suited team, led by a guy who clearly aims to be going somewhere. For the petitioners, tired, crumple-clothed folk who would otherwise probably be hanging around emergency rooms waiting for someone who slipped over in Walmart.

    It’s the fast track v the dog track. And while the conspiracy theorists will doubtless suggest that this means the families didn’t get a level playing field, in fact it, again, evidences how cruelly they’ve been fooled by a gang of no-hopers and charlatans.

  4. Bartholomew Cubbins June 16, 2007 at 12:07 #

    Are you sure you didn’t get this from the Onion?

    I guess dignity isn’t a requirement for becoming an expert witness for the antivaxers.

    I believe that there are children out there, a very small fraction of the population, who have adverse reactions to medications including vaccines. This court appears to be designed to help out these people and I have to wonder about the quality of the witnesses and lawyers in a typical case. Hopefully this case is just abnormally poor because it’s been put together as a fishing expedition with broad and ill-defined implications instead of focusing on the case of a particular child.

  5. _Arthur June 16, 2007 at 12:55 #

    Kevin, please post the dialog where Dr. V. Byers categorically refuses to generalize her expert opinion to any other case than Michelle C.
    The reaction of the Special Master is enlightening.

    There’s also the moment where Vera is caught having added stuff to her presentation to make up for what Dr. Aposhian omitted. Byers herself knows very little about mercury toxicity.

  6. Joeymom June 16, 2007 at 13:03 #

    Wow, what a weirdo. I can tell you how adjuncting works in most of the world- you can claim affiliation only as long as you are teaching a course. Period. I have special permission from one instiution to present myself as affliliated there even when I am not teaching, because I teach there so often (so if I go someplace say, in the summer, I can still say “I teach at…”). My title is Adjunct Assistant Professor at some places, Adjunct Lecturer at others, and I have to know which is which when I put my CV together.

    You can pay a fee to use the library in semester you aren’t teaching.

    Going o parties doesn’t count for official affiliation. 😉 But you guys knew that.

  7. kristina June 16, 2007 at 14:18 #

    And then there’s her Shanghai connection via Hutchison MediPharma to take “classic Chinese herbs” (unspecified) and test them in clinical trials in the US (p. 868).

    Byers is not the only “autism expert” to note her “university affiliation” as an adjunct……..

  8. Matt June 16, 2007 at 14:20 #

    “There’s also the moment where Vera is caught having added stuff to her presentation to make up for what Dr. Aposhian omitted. Byers herself knows very little about mercury toxicity.”

    Then also, there’s the part where she goes on about Aposhian educating her on Mercury…then states that the lawyers told her not to talk to the other witnesses.

    Total inconsistency.

    Matt

  9. A Non June 16, 2007 at 14:35 #

    I guess you’ll all have noticed that, on Thursday and Friday, the day was cut short because the petitioners didn’t have enough witnesses to fill out the allotted time.

    I can tell you, it’s pretty damn frustrating to arrive at court only to be told that they’ve finished for the day.

    The plan was to go 9 till 6. Thursday was 9 till about 1. Friday was nine till about 2.30, with an hour taken for lunch and two breaks.

    With the defence fielding twice as many witnesses (on account of Wakefield, Bradstreet, Geier and so forth being liabilities to the cause), it looks like we’ll now have two solid weeks of senior people (most of them MDs) explaining the science and medicine.

    If I was a parent signed up to this thing, I would be watching it with a sense of growing despair.

  10. _Arthur June 16, 2007 at 17:31 #

    Matt, there may be no inconsistencies, they worked together to prepare the case, but their lawyers may have told them not to confer for the duration of the hearing.

    Nevertheless, having mercury toxicity explained to you, and being an expert in mercury toxicity are 2 very different propositions.
    She presented 14 slides on mercury toxicity, but she cannot vouch personally for their accuracy, and was unable to provide on the spot the reference where this all this science comes from.

    Next week, real experts will demolish the Petitioners fanciful construct. It is full of holes.

    Baby Michelle suffered from a high fever 1 week after the MMR vaccine. Can the fever be a coincidence ? Babies with fevers are not uncommon. Michelle’s mother was told (twice) at the time that there was a nasty baby flu going around then.
    Baby Michelle has all the clinical signs of Crohn’s disease, and is being treated from Crohn’s disease. The petitioners make no case that Crohns is related to autism, they rather think that she suffers from “autistic enterocolitis”, and that an unknown subset of utistic children suffer from gastro-intestinal troubles.
    One key “fact” of the Petitioners is that they discovered measles RNA in a biopsy sample of Baby Michelle’s gut, using PCR. The other team will show huge procedural errors in the PCR technique, and total lack of controls, making the observation a false positive, and destroying the petitioners’ whole house of cards. Besides, correct PCR technique failed to detect measles in blood samples.
    One doctor testified that, based on the presence of measles in baby Michelle’s gut, he speculates that the virus is likely to be also present in her brain, causing inflammation, impairment, autism.
    And the presence of measles in her gut tissues is attributed to a weakened immune system, itself attributed to heavy metals, likely to be due to the accumulation of thimerosal, persisting 7 months after the last thimerosal shot. Note to petitioners: if Baby Michelle immune system was weakened during 7 months (and is stell weakened now), wouldn’t her have caught a dozen flus during that time ?
    And I remember Dr. Aposhian mentionning the “baby haircut” study, insisting that if other studies failed to observe a difference between mercury in the hair of autistic and NT babies, was because they weren’t using a *reputable* lab …

    There are holes as far as the mind can see…
    I feel sorry for the parents. The petitioners didn’t chose a good test case, and didn’t chose good experts…

  11. VAB June 16, 2007 at 17:38 #

    Wow!

  12. daedalus2u June 16, 2007 at 19:36 #

    For the second fever she was given antibiotics and the fever went away. That is a sign of a bacterial infection, not a virus.

    Mercury is very easy to measure. At the levels in hair it is trivial.

    I would like to see results of mercury tests on her various fluids over time.

    Has cryptic mercury ever been observed in any organism? By “cryptic” I mean mercury that cannot be removed via chelation.

    I hope that when the poor boy who was killed by EDTA was autopsied that his brain mercury level was measured, just to show that it is normal.

  13. _Arthur June 16, 2007 at 19:53 #

    By cryptic mercury, you mean mercury that is not in the blood, nor the hair, nor urine, but in speculated hypothetic “plaques”, possibly situated in the brain. That cryptic mercury can (speculatively) be removed by chelation, with considerable doses of Lupron castrating agent.

  14. daedalus2u June 16, 2007 at 20:32 #

    Yes, that cryptic mercury. They might look for kryptonite too. There is just as much evidence for kryptonite poisoning as there is for mercury poisoning.

  15. Rich June 17, 2007 at 05:19 #

    I believe that in their ruling excluding Daubert as a standard for allowing testimony — on grounds that this is not a jury trial — the special masters nonetheless stated that they would apply Daubert post-testimony. So it would seem that the entire Byers testimony would likely be excluded altogether as the special masters consider their opinion.

    One also has to wonder if given that not one of the witnesses has much experience with AUTISM the special masters might also be skeptical about the plaintiff’s witnesses.

  16. Ms. Clark June 17, 2007 at 06:09 #

    The Diva blog now has some more of Dr. Byers problems and odd, if not bizarre, moments documented with page numbers and all.

    http://autismdiva.blogspot.com/2007/06/omnibus-hearing-byers.html

  17. Kev June 17, 2007 at 06:52 #

    Rich is absolutely right. Daubert _does_ apply, only not pre-trial. So no one can be excluded. I think the Special Masters did this to fend off potential accusations of ‘conspiracy’ from the anti-vaxxers.

  18. Matt June 17, 2007 at 14:43 #

    Kev,

    I hate to say it, but it appears in the case of Dr. Byer, the Dilbert Standard has been applied.

    Matt

  19. A Non June 17, 2007 at 15:06 #

    I notice that when asked by the shrewd special master Vowell, Dr Byers could not name any anti-inflammatory cytokines.

    Knowing your pro- and anti-inflammatory cytokines (or at least a dozen or so) is so central to immunology that I believe on these grounds alone Byers’s testimony could be struck.

    These people are a disgrace to themselves, and, more importantly, to the parents who placed trust in them.

  20. _Arthur June 18, 2007 at 17:10 #

    Dr. Kinsbourne testimony transcript is online now, at
    ftp://autism.uscfc.uscourts.gov/autism/index.html

    At cross-examination, Kinsbourne is convinced that the attenuated measles virus present in the MMR shot must have somehow infected baby Michelle ganglia, gut lining and brain, but he is utterly unable to present a model on how this has happened. (Speculation heaped upon speculation, I would say). IIRC, baby Michelle did not present any syptoms of a measles infection, except the non-specific high fever, then attributed to a flu.

    Dr. Fombonne and Dr. Cook are supposed to be the first of the Respondants expert witnesses, this week.

  21. A Non June 18, 2007 at 23:39 #

    Hilarity in court today as Ms Chin-Caplan for the petitioners tried to insinuate that Eric Fombonne had failed to delare his expert witness work. Oooh, conflict of interest…

    However, so propelled was she by her years of conspiracy theory, that she failed to check the papers before confronting him in front of the special masters.

    There they were in print, with his involvements set out in very unusual detail on his papers.

    And she moved swiftly on…

    A big contrast with Kinsbourne was that, Kinsbourne’s direct was much louder than his cross examination (as he wilted under questioning). Fombonne, however, was the other way around: he got louder under cross-examination as his years of frustration with these people led him to rather pummel his interrogator.

    But the best has yet to come.

  22. Ms. Clark June 18, 2007 at 23:58 #

    I didn’t get to hear all of what Fombonne said, I heard some of the direct examination up til lunch and I think I heard most of the cross, which was short… if I recall… and I heard some of the next Witness, Dr. Edwin Cook, whose credentials were about as impressive as Fombonne’s, maybe more so because this guy’s younger brother is autistic. At one point I was pretty sure he said something about autism being fascinating in part because he say some traits in himself. Though it doesn’t seem from the sound of what he was saying that he fit the Asperger’s kind of profile, maybe he’s BAP.

    I didn’t get to hear all of what Dr. Cook said as I had to hang up and get something done.

    At any rate, at one point Fombonne was answering a question in the cross and he began to do something like a stern lecture, and yes, his voice was louder than before. He was trying to clarify some point, it was like, “You should know this already, but here I am again explaining it, AGAIN.”

    They asked how much Fombonne had made as an expert witness in another case, he did not hesitate or waffle, he said, “$500 an hour.” Whoa, that’s a chunk-o-change, but I guess it’s the going rate. He said her made $60,000 (?? maybe he said 50-70 thousand…) off that case. He said how many months he had worked on it… anyway… tell your children to get PhD’s and become experts so that they can charge this kind of dough.

    They did try to trap Fombonne, from what I could see. One time Chin-Chaplin for the petitioners said, “In this published paper, did you declare your conflict of interest?” (LIke she had caught him at something). And he said, “Yes… see it there…”

    If they have the audio up already, I’ll have to listen to it again. Tomorrow they’ll have the transcript available.

    Fombonne will come back and speak as an epidemiologist. Today he spoke as a psychiatrist with experience in diagnosing autism and in working with autistic kids (though he also works with mentally ill children and teens).

  23. Ms. Clark June 19, 2007 at 00:03 #

    I don’t think MIchelle had any symptoms of measles. The word “rash” appears in the transcript once or twice, but it was not associated with the measles, it was a diaper rash or something, if I recall, not around the time of the vaccination at all.

    The big thing today was that MIchelle had symptoms of autism long before she was vaxed with the MMR. She was flapping her hands, and not making eye contact, flicking her fingers in front of her eyes, and she was very speech delayed and motor skills delayed. She didn’t sit up alone until she was 11 months old and was late learning to walk. Her she didn’t point or use age appropriate baby gestures. Fombonne said, if he had seen the video of her and didn’t know her, he’d have said she very much looks like an autistic child, but one with mental retardation, too.

  24. A Non June 19, 2007 at 08:27 #

    The video showed Michelle as a almost completely unengaged. Although only clips from the family video were shown, there was no challenge to Fombonne’s selection.

    These were the videos, you will recall, that the family fought to prevent from being shown to the respondents, but the masters overruled them.

    Not surprisingly, really. Michelle doesn’t speak, look up at anyone and giggle, gesticulate, or in any other way seek to involve anybody else in the video moments, which, of course, included things like an Xmas party and other special occasions.

    Still, the parents came out for the lunch break smiling and evidently sharing a joke of some kind.

    They seem to be quite sophisticated people – the mother especially.

  25. Ms. Clark June 19, 2007 at 09:00 #

    Special Master Hastings went out of his way to say to the parents that he didn’t think they were bad parents, and he elicited a comment of that kind from Fombonne who said it was common for parents with only one child to miss the signs of autism, since they tend to think that their child is fine. If they already have a normal child to compare the autistic child to, it tends to increase the odds of that child being diagnosed about 4 months earlier (than the singlton autistic child).

    But if the parents were trying to keep these videos from the respondents, then maybe they knew very well that Michelle wasn’t normal before the MMR, they knew that she didn’t start flapping only after the MMR, as the mom testified, because Michelle is on video flapping at 7 months, apparently. That she doesn’t respond to her name is plain from the audio portion alone, Mrs. Cedillo keeps saying Michelle’s name over and over and gets no response, apparently.

    also of interest is Michelle’s accelerated head growth to the point that her head measurement goes off the top of the chart some time in her first year. One of her docs was concerned and wanted to do an MRI of her head.

    Michelle’s parents looked really normal to me.

  26. _Arthur June 19, 2007 at 19:35 #

    But if the Petitioners and their legal councils (and their medical experts) were aware that baby Michelle had autism symptoms well before her MMR shot, that’s tantamount to fraud.
    I’m sure the Special Masters won’t penalize the parents, but if the whole of Petitioners case is based on fraud and misrepresentation…

  27. Phil June 19, 2007 at 23:13 #

    Arthur, I think the worst that can happen is that the Omnibus will be lost. I can’t think of a way the petitioners could be penalised, but the positive that comes out of it in general is that the proof will be on the legal record that the MMR had nothing to do with Michelle’s Autism, and this will be a precedent that will wreck most of the Omnibus cases.

    Penalty enough for the curebies I think.

  28. _Arthur June 20, 2007 at 01:46 #

    Phil, it is even a double whammy for the Chelators, because under their own “scientific” theory of autism, as presented for the Petitioners, it is the attenuated Measles virus that causes autism (by an inflammation of the brain, no less), and not the mercury.

    The thimerosal in other vaccines merely “suppress the immune system”, to allow measles infection to take place (and only that infection, somehow).

    So chelation (to remove the mercury, presumably), would not undo the damage from the brain inflammation.

    That’s the best speculative conjecture they could come up with, which was supposed to make all antivax happy, both the anti-MMR and the anti-thimerosal ones. They had a hard time to make it up look scientific, with only 1 data point, the alleged detected presence of measles in the gut.

    Now, expect the chelators to say that Krigsman&co. were completely wrong, it was the _mercury_ *in the brain* that creates Autism. They’ll have to create a brand new big tent.
    They’ll never admit they were wrong, tho.

  29. Phil June 20, 2007 at 11:27 #

    Of course not, Arthur. They are up a gum tree without a paddle. I mean the woman on the petitioners said on the very first day that there was 25 micrograms of thiomersal in vaccines. 25 MICROGRAMS! 25/1,000,000 of a gram for crying out loud! How can anyone take that seriously? That’s what gets me more than anything.

    I said on another thread here that the key to Michelle’s Autism is the sensory overload as a result of the flu she caught. Nothing whatsoever to do with the vaccines. Like most disabilities – Autism is pot luck. There’s no way of telling who could get it without the genetic proof – which is the only thing that can be confirmed by science. And even then, if the sensory overload doesn’t happen – no ASD.

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  1. Autism Omnibus - a disaster for the families « Action For Autism - June 20, 2007

    […] Cedillo family who stepped up to the mark for this historic hearing, this seems not to be the case. Left Brain/RightBrain and Autism Diva have written detailed discussions with extensive references to the transcripts of […]

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