In the Houston Chronicle, People's Pharmacy columnists Joe Graedon and Teresa Graedon remember a drug scandal from 1970 that mirrors today's Avandia troubles almost exactly. Orinase, a popular diabetes drug was found to be increasing the very heart trouble it was designed (and marketed) to prevent.

Orinase's active ingredient is tolbutamide, a substance that stimulates the pancreas to produce insulin. According to the Graedons, the heart damage being caused by Orinase-takers was first revealed by the University Group Diabetes Program in 1970 following an extensive analysis of diabetes care in the US. Like the Avandia controversy, experts also debated the results of the University Group's conclusions on Orinase, yet it was more or less eventually accepted as fact that drugs belonging to the class sulfonylureas, including tolbutamide, do indeed increase the likelihood of heart problems. I say "more or less" because many authorities still hedge their bets. Example? The health site Drugs.com copies info on Orinase provided by Thomson Healthcare/Micromedix. According to that source, sulfonylureas, have been "reported, but not proven in all studies, to increase the risk of death from heart and blood vessel disease." [My emphasis.] This, thirty-seven years after the release of the study demonstrating such risk!

Orinase is still prescribed in certain situations. Is Avandia destined to end up sidelined, yet still on the market, like Orinase? Seems to be headed that way. In the meantime, the unfortunate reality is that new drugs will continue to be rushed to market and serious side effects discovered (or made public) only after they have been prescribed to thousands of people. The fact is, today's high-tech (and high-priced!) wonder drugs all come with a dose of risk.

I coach a girls' softball team. Whenever they take the field, I often bark out, "Ready positions!" Dust gently rises and settles as they spread their feet, bend their knees and open their gloves in anticipation. But dust from the recent Avandia scare is not settling, and within this cloud of confusion stand injury lawyers in ready position to snag the first clients.

As I researched the news on Avandia the past few weeks, my peripheral vision couldn't miss the on-screen Internet banners soliciting clients. When Glaxo's PR machine ran full-page newspaper ads assuring us Avandia is as safe as other type 2 diabetes medications, Houston lawyer Bill Bass ran an ad in the Houston Chronicle targeting Avandia-prescribed type 2 diabetics with heart problems interested in litigation.

As in softball, the Avandia plaintiffs bar team of lawyers play different positions. Houston lawyer Mark Lanier, known for winning the first case against the painkiller Vioxx, explained "chicken catcher" lawyers are adept at advertising and attracting good clients, while "chicken plucker" lawyers do not often advertise, but do take cases to trial. There is a switch-hitter position for the lawyers able to attract good clients, broker most off to the trial lawyers, then keep a few cases for themselves to try and settle after the first wave of litigation establishes a settlement value.

A typical "chicken catcher" takes 25 to 40 percent reaped by the trial lawyer. Recent television ads by Houston lawyer Adam Pulaski generated nearly 10 percent of their firm's 10,000 forecasted calls in the first few days, but many inquiries will not end up candidates for court. Lawyer buzz frames Avandia may be a hard case to win.

For Avandia takers possibly hurt by the drug, I hope you are okay. If you do decide to fly the coop and get caught, may you be sold at market to a seasoned "plucker". Read more in this Houston Chronicle story.