W. Mark Lanier, the lawyer, told jurors Wednesday that Merck's deceptive marketing to doctors and consumers had caused Robert Ernst to take Vioxx, a painkiller and arthritis drug, leading to his death at age 59 in May 2001.

Lanier asked the jury of seven men and five women to award Ernst's wife, Carol, $40 million in compensatory damages and many times that in punitive damages. Since this trial is the first Vioxx-related personal injury case to reach a jury, a large award is necessary to convince drug companies to disclose the risks of their medicines, Lanier said.

"Please don't let 'em off light," Lanier said in an impassioned speech to the jury at the end of almost six hours of closing arguments by both sides. "Let your voice be heard."

Link to Cause of Death Questioned

But lawyers for Merck implored the jury not to hold Merck responsible for Ernst's death, saying that Lanier had never proved that Vioxx caused Ernst's death on May 6, 2001. A coroner found the cause to be an arrhythmia, or irregular heartbeat, and no clinical trials have ever linked Vioxx to arrhythmias, said Gerry Lowry, a lawyer for Merck.

"They've got to establish a link between Ernst's cause of death and Vioxx, but there is no such link," Lowry said.

David Kiernan, another Merck lawyer, said that the company had repeatedly tested Vioxx for heart risks and shared its data with doctors and the US Food and Drug Administration. When a clinical trial in 2004 showed that Vioxx was riskier than a placebo, or sugar pill, Merck acted prudently and withdrew the drug from the market, Kiernan said.

The closing arguments came after both sides presented almost five weeks of testimony about Vioxx, a drug that Merck sold from 1999 to 2004 and that was taken by an estimated 20 million people.

Ernst's family is suing Merck in state district court in Brazoria County, Texas, alleging that Vioxx caused his death.

More than 4,000 other people have sued Merck, alleging that Vioxx caused them to suffer heart attacks and strokes. Analysts say that between 20,000 and 100,000 people or their families may eventually sue the company, and estimates of Merck's Vioxx-related liabilities have ranged from $4 billion to as much as $30 billion

Merck: 'Conscious Indifference'?

The jury was set to begin deliberating on Thursday. Under the instructions from Judge Ben Hardin, jurors must first determine three issues: whether Merck failed to warn doctors about Vioxx's dangers; whether Vioxx was a defective product and could have been designed differently, and whether Merck's negligence is responsible for Ernst's death.

Under Texas law only 10 of the 12 jurors must agree on the questions to reach a verdict. If the jury answers yes to any of the first three questions, it may award Carol Ernst compensatory damages for Robert Ernst's lost wages, as well as her pain and suffering and the loss of his companionship.

Because Robert Ernst worked at Wal-Mart at the time of his death, his lost wages are relatively trivial, but the jury can award as much money as it sees fit for Carol Ernst's mental anguish.

If the jury decides to award compensatory damages, it will then go on to decide whether Merck sold Vioxx despite knowing it had "an extreme degree of risk" and acted with "conscious indifference." In that case, the jury can award punitive damages. Under Texas law, those damages are capped at three times the amount of any compensatory damages the jury awards.

Lanier divided his presentation into two parts, a segment of almost two hours in the morning, and at the end of the day a closing rebuttal to Merck's argument. He repeatedly referred to documents and e-mail from scientists at Merck that showed them discussing Vioxx's potential heart risks as early as 1997, more than two years before the company began selling the drug.

Lanier also criticized Merck's marketing of Vioxx, saying that the company had trained its salespeople to avoid questions about Vioxx's potential heart risks.

Jury Urged to Look Past Marketing Practices

In their response, Kiernan and Lowry said that Lanier had repeatedly misrepresented evidence and failed to prove that Vioxx led to the arrhythmia that caused Robert Ernst's death. They urged the jury to look past Lanier's allegations about Merck's marketing practices and focus on whether Ernst suffered a heart attack, as Lanier has claimed.

"This case is about science," Lowry said. "It's not about an ad that ran one time in Puerto Rico." Criticizing Lanier for using cartoons in his presentation, she said, "This is a court of law, and it's not Saturday morning television, and it's not entertainment."

Kiernan then told the jury that Merck had good reasons to assume that Vioxx might not be more dangerous than other painkillers. He pointed out that in an April 2005 paper, the Food and Drug Administration appeared to back that position, finding that other painkillers might have heart risks similar to Vioxx's.

Lowry finished Merck's closing, again arguing that Lanier had failed to prove that Ernst had died from a heart attack or that Vioxx was in any way responsible for his arrhythmia. Her presentation appeared strong.

She told jurors that a verdict in favor of Merck would actually relieve Carol Ernst of any guilt over her husband's death. During her testimony, Carol Ernst had testified that she felt guilty because she recommended that her husband take Vioxx.

"You have a chance to do the right thing, and that is to release Ms. Ernst from that guilt," Lowry said.