oversee projects involving human test subjects. They can be outgrowths of a university, hospital or even the pharmaceutical company itself.

When the Institute of Medicine of the National Academies warned in 2002 that conflicts of interest within the clinical testing industry were creating serious problems, overstretched review boards bore part of the blame. Add conflicts of interest to the equation, and cracks in the foundation of human medical testing start to appear.

While Hayes suggests that new investigatory pressures are creating an "overly cautious" pharmaceutical industry, he is willing to entertain the possibility there are still some bad apples in the biological barrel.

"I can be a little bit of a cynic in this life and say, you know, as much as you try to create a perfect system, there maywhat had happened, he didn't get very far.

"They were nice," Sellers says, "but there wasn't much information. As I recall, they just pretty much had the posture that what had happened didn't seem to have anything to do with the trial itself. And that he just had an apparent heart attack."

Slowly, things began to return to normal. New drug trials were begun.

FDA investigators showed up five months later and wrote up the death but did not shut down the clinic. Apparently, neither did they alert the review board or drug companies that used the clinic. And Fabre wasn't exactly trumpeting the fact he was under investigation.

In 2004, the Western Institutional Review Board, based in Olympia, Washington, approved two new studies for Fabre, according to Angela Brown, president of