Hutch witness sheds tears over patients

After two days of stoic and at times technical testimony, Dr. John Pesando started to cry.

He was recalling efforts by some members of the Fred Hutchinson Cancer Research Center's review board to curb a controversial medical experiment in which patients were dying.

They wanted the Hutch to suspend the experiment, but the Hutch's director, Dr. Robert Day, would agree only to stop enrolling patients likely to survive with conventional treatment, Pesando said. Years later, Pesando would learn that three more patients with good odds of survival were enrolled and died despite the assurances by Day and others.

"These were ethical men. We trusted them," Pesando said. "When they told us they were going to do something, we assumed that they had done it."

Pesando is a key witness in the trial of a lawsuit against the Hutch brought by the spouses of five patients who died in an experiment called Protocol 126. Pesando testified that patients were not told the experiment's true risks before enrolling and did not know that three doctors owned shares in a company whose antibodies were being tested.

In cross-examination, the Hutch's lawyer, George Mernick, raised questions about Pesando's credibility, showing that Pesando voted to approve Protocol 126.

Pesando said he voted once against it and at other times abstained, but the records falsely reflected unanimous votes. Pesando knew of no one else who raised questions about the truthfulness of the records.

Pesando also testified that he omitted information from his own records to hide the fact that he discouraged patients from enrolling in Protocol 126. Pesando said he was worried he'd lose his job.

One of Pesando's patients enrolled in the experiment.

E. Donnall Thomas, a pioneer in bone-marrow transplants and one of the doctors in Protocol 126, fired Pesando in early 1987. Pesando suspects the Hutch made it hard for him to find new jobs.

"It must have presented a delicious opportunity to get back at them," Mernick said, referring to Pesando's testimony.

Pesando testified that a review board in January 1981 voted against the protocol because there hadn't been enough animal studies yet; there were concerns that the experiment would lead to graft failures; and there were complaints that major risks weren't mentioned in consent forms.

"If they were in the consent form, I think as a patient, I would be very hesitant at this point to sign the consent," one review-board member said, according to records read by Pesando.

The experiment eventually was approved. But Pesando said by the end of January 1984 it was apparent that at least two patients in Protocol 126 had died of graft failure and two others were having problems engrafting. It was then that Day agreed not to enroll patients with a good prognosis.

However, Paul Mahler, an anthropology professor, was later enrolled. Though he had a good chance of being cured, Mahler died.

Pesando said patients came to the Hutch unaware they would be assigned to this experiment.

"They did not come there to be guinea pigs. They came there to be cured," he said.