The Vioxx recall started off a firestorm, fueling Congressional hearings into the FDA's ability to track side effects and causing massive upheavals throughout the drug industry.
Some of the toughest reforms, like a proposal to create a separate FDA office that would track side effects and yank products from the market, have fallen by the wayside.
The FDA's ability to track drug side effects is "a joke, " says David Nathan, a diabetes drug expert at Harvard Medical School who reviewed Nissen's paper.