The jury also saw a "Dear Doctor" letter from 2001, in which Merck told physcians that in the largest trial ever of more than 4000 Vioxx patients, only 0.5% or 20 patients, suffered cardiovascular events, when in fact, the jury learned, 14.6% or 590 patients experienced cardiovascular problems.
The jury also learned that in April 2001, Dr Brent Wallace, the doctor who prescribed the Vioxx to Mr Ernst, had received the "Dear Doctor" letter with the grossly understated statistics.
Mr Lanier also presented documents to the jury to show that Merck sales reps had at one time earned a $2,000 bonus if one of their doctor-clients prescribed Vioxx to their patients more than 55% of the time, and also earned another $2,000 if the rate went higher than 61%
To demonstrate how Merck used intimidation tactics to silence medical researchers who spoke out about the risks associated with Vioxx, Mr Lanier presented the jury with a copy of a January 2001, letter from Stanford Medical School professor, Dr James Fries, written to then Merck CEO, Ray Gilmartin, that described how Merck researcher, Dr Louis Sherwood, called Dr Fries to try and get him to make another Stanford professor stop making negative comments about Vioxx during college lectures.
According to Dr Fries in the letter, Dr Sherwood warned that if the professor did not stop, he would "flame out" and "there would be consequences for myself and Stanford."
After listening to all the evidence, the panel of five women and seven men ruled that Merck failed to warn doctors of the dangers of Vioxx, that the drug was improperly designed, and that Merck's negligence caused Mr Ernst's death.
Upon learning of the verdict, Texas Attorney General, Greg Abbott, who has sued Merck on behalf of the state's Medicaid program, told reporters that the verdict "validates why my office brought suit against this company in the first place."
"The jury concluded," Mr Abbott, stated, "that the untimely death of Mr. Robert Ernst was the direct result of his taking Vioxx."
"The verdict also shows why Texas deserves to get its money back from Merck; the company purposely peddled a drug on the open market that it knew could harm people," he said.
"Merck compounded this problem by giving false information to the state's Medicaid program about the drug's safety," Mr Abbott in Consumer Affairs.com, August 19, 2005.
The jurors told the Wall Street Journal at the time, that it took them less than one hour to dismiss the claim that Vioxx was not responsible for Mr Ernst's death and that they were outraged by what they saw as Merck's cover-up of the risks associated with Vioxx.
A factor that largely swayed the jury was Merck's failure to add a warning for patients on the Vioxx label, even after the company began warning doctors that the drug could be linked to CVs. Juror, David Webb said during an interview on Good Morning America on August 20, 2005, "$229 million was the amount of money that Merck would gain if they put off changing the label."
On the August 19, 2005, edition of CNN's Newsnight, juror Rhonda Wade echoed Mr Webb. "Our award," she said, "was based on the fact that once they figured out they had no choice but to make the label change, they chose to stall it in order to make as much as $229 million."
"Looking through their evidence," she stated, "time after time, you could see where they knew about the CV events and how important it was and they didn't do anything about it."
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