A career cut short

Nix's lawsuit contends anti-inflammatory drugs to blame

Attorney Robert Couch doesn’t want to hear about bad luck, especially when leading medical experts offer the characterization. No, his client -- former Southern Mississippi star running back Derrick Nix -- is hooked up to a dialysis machine these days. His kidneys are shot. The kid is just weeks away from a scheduled kidney transplant.

This is a sad story about a good person. And Couch is itching to fight the big boys, to have his day in a Mississippi courtroom against pharmaceutical giants Pfizer and Merck. It’s his contention that Celebrex and Vioxx, popular prescription anti-inflammatory drugs that Nix took after suffering an ankle injury during the 2000 season, triggered focal segmental glomerulosclerosis -- a severe degenerative kidney disease.

“We believe that the facts are going to show, and the science will bear us out on this, that the only explanation for the problem suffered by Derrick was the use of this drug," said Couch. “Derrick was healthy before. There is no indication he had any kidney problems at all until he took this drug. The damage occurred more or less contemporaneous with his use."

In a lawsuit filed on behalf of Nix last month, the Hattiesburg attorney sought unspecified monetary damages, including loss of future earnings, against the pharmaceutical firms. If Nix had been healthy, said NFL draft guru Tony Pauline, he would have projected as a third- or fourth-round pick in last month’s NFL Draft.

The legal wrangling down in Mississippi, Couch predicts, probably won’t begin in earnest for another year. Already, the pharmaceutical firms have had the case moved to federal court, and Nix’s attorney is now preparing a motion to have it returned to state court.

But when the time comes, how strong a case can Couch make that the drugs brought down a top college running back?

Three independent medical experts contacted by SI.com believe Nix’s attorneys have a difficult road ahead, even though Mississippi state courts have a reputation for being friendly towards liability lawsuits. The kidney and pharmacology specialists, in fact, suggest that Nix may have been suffering from the illness before experiencing fluid retention and other symptoms after taking the anti-inflammatory drugs.

What most troubles the specialists, all of whom have served as expert witnesses at one time or another in similar cases, is the timing as described in the lawsuit. After suffering a high ankle sprain in a Sept. 30, 2000, game against Memphis, Nix took Celebrex for a week and then Vioxx. Six weeks later, according to the suit, Nix was diagnosed as suffering from membranous glomerulonephritis.

“That is awfully quick and it doesn’t happen that way," said Dr. Dominic Sica, chairman of clinical pharmacology and hypertension at Virginia Commonwealth University. “He only had two or three weeks of therapy. And if it does happen, it hasn’t picked up enough of a head of steam. I can pretty much tell you that he had this going on before he took the drugs. I think what happened is the fluid-retaining tendencies of Celebrex and Vioxx unmasked it."

At play here is the continuing mystery in the athletics community about the risks of anti-inflammatory drugs. NBA basketball stars Alonzo Mourning and Sean Elliott have both had their careers interrupted by serious kidney disease. The use of anti-inflammatory drugs has been mentioned as a possible factor, yet medical experts have been unable to make a definitive link.

“As far as I know, neither Celebrex or Vioxx have been linked to that lesion in the kidney [diagnosed in the case of Nix]," said Dr. William Henrich, chairman of the department of medicine at the University of Maryland. “That doesn’t mean it couldn’t be. It’s just not an easy putt to make between those two things.

“Here’s the problem for everybody. Kidney disease is often silent. Today you may be feel well, but tomorrow somebody could make this diagnosis. You’re going to have blood in your urine or you might have swelling. And sometimes an injury, like an ankle injury, may draw attention to swelling. So if this is the usual sort of thing, the Celebrex, while not helping anything I’m sure, is not related to membranous glomerulonephritis, if that is the right diagnosis. And what you have are two things that are true, but unrelated."

Couch said he’s prepared to bring witnesses and evidence to back his assertions at the appropriate time, but he pointed out that Nix had been tested “fairly extensively" at Southern Miss and none of the previous urine analyses revealed kidney problems.

It’s worth noting that Couch declined to name Southern Mississippi trainers or medical staff in the suit, though they provided the anti-inflammatory drugs and were responsible for monitoring Nix. An obvious conflict here is that Nix’s brother, Tyrone, is the defensive coordinator at Southern Miss.

Asked if that was a reason the university was left out of the suit, Couch cited attorney-client privilege in declining comment.

What medical experts also wonder is why Nix returned to the football field after his initial diagnosis in 2000. Just sitting out the 2001 season wasn’t enough, they contend. Forget about the terrific talent and the NFL dreams. Nix accepted a huge risk by playing last season -- as did Southern Miss and its coaching and medical staff.

As a doctor familiar with Nix's illness noted, dehydration itself is one of the major stresses on anyone with kidney disease. “And with two-a-days in the Mississippi summer you run the risk of getting dehydrated," the doctor said.

This only highlights the ethical dilemma when a college athlete faces a possible career-ending illness or injury. Is it the athlete, doctor or athletics staff who pulls the plug? And what about patient-physician confidentiality when the doctor is not affiliated with the university?

Maybe it's OK if a pro athlete makes the decision independently. But something doesn’t seem ethically right in leaving the choice to a student-athlete, even a good kid with NFL dreams.

Mike Fish is a senior writer for SI.com.

Comments? To e-mail Fish, click here.

 

Related information

Stories

Previous Mike Fish Columns

Multimedia

Visit Video Plus for the latest audio and video