This excerpt of a deposition of Dr. Robert Kern discusses how much Zicam can reach the area of the nose that is responsible for your sense of smell.
The deposition of ROBERT C. KERN, M.D., taken before Jana E. Cox, Certified Shorthand Reporter, at 333 West Wacker Drive, Chicago, Illinois, commencing at 2:00 p.m. on the 23rd day of March, A.D., 2005.
A. Well, my understanding of it from the reading of it -- as I recall, I did that before I actually tried to knock out this patient's smell -- was that you put a prong with an atomizer. You try to get it up as high and as close to the olfactory cleft as possible and spray the 1 percent zinc sulfate onto the olfactory epithelium directly. That's what they were trying to do. And they had recruited these otolaryngologists that were trained and hopefully aren't going to injure the person when they were doing this.
But what I did -- and specifically was I used a long atomizer that for my recollections of looking at Peet Richter picture was very similar. I put that prong medial to the middle turbinate, sprayed it directly on the area, theoretically at least duplicating what they're doing. And probably sprayed more than 1/2 CC and -- because they apparently took great pains to only give 1/2 CC, 1/2 CC to one CC. I wasn't able to accomplish anything. So it makes me skeptical that they really -- because I needed to knock out the person's sense of smell completely. I couldn't wound it. I had to eliminate it. Because otherwise if there was any information getting through, it was going to give this person this foul superimposed flavor to food. So I have a feeling that they may have weakened the sense of smell perhaps, but I'd be skeptical that whatever they completely eliminated it, and I'd be extremely skeptical that they completely eliminated permanently unless the person had some other underlying problem.
MR. WENZEL: Now, let's mark this document that we've been referring to as Exhibit 1-2.
(Kern Deposition Exhibit No. 1-2 marked as requested.)
BY MR. WENZEL:
Q. When the substance comes out of the atomizer, is it in a mist form?
A. Yes.
Q. And 1 CC, how does that compare with the typical single dose of Zicam nasal gel spray?
A. Well, if you look later on in those sheets there, one of them goes through that.
Q. Does that -- The following page that says -- Let's -- All right. Can you show me where that is, Doctor.
A. That is the white sheet of paper with neat handwriting.
Q. All my sheets are white.
A. Oh, that's true. Yours are going to be a little different. It's the one with “zinc sulfate heptahydrate” in the corner.
Q. Got it. All right. What does that tell us about the dose of zinc gluconate -- I mean the Zicam dose?
A. Well, this is calculating using 1 percent solution of zinc sulfate heptahydrate and using a half - 500 microliters or 1/2 CC dose to the olfactory epithelium, how much zinc is going to be in that, how much zinc ion. And by these calculations here, 1.4 milligrams of zinc is what they were delivering at the time of the Toronto study to the olfactory epithelium.
Q. Okay. They were delivering 1 point how much zinc again?
A. It's the one that's underlined there. 1.4 milligrams per 1/2 CC. So that's what - Assuming it was all in there, that's, you know - Now, they talk about between 1/2 and 1 CC. So it could be double that, I suppose. I'm not sure exactly. It's not completely clear whether they -- whether they used one or two or whether it was a half for each side or what, but it's either that number or double that number.
Q. That's what they were using in the Toronto polio study; is that right?
A. Correct. The one that the subsequent claims of smell loss temporary and permanent that we discussed.
Q. Now, in Zicam what is the typical dose?
A. 120 microliters of the gel.
Q. Is it microliters, not milliliters?
A. No. 120 milliliters would be enormous.
Q. And how does --
A. That would be half a can or third of a can of Coke. That would be a lot.
Q. And how does 120 microliters compare with the amount that was used in the Toronto study?
A. Well, you can see also the number that's underlined at the bottom there.. 273 milligrams. So it's about five times less zinc was being delivered by 1 shot of zinc gluconate.
Q. Does the fact that the zinc gluconate in the Zicam product is in a gel form make any difference?
A. Yeah. I think it makes it less likely to get up to the olfactory epithelium.
Q. Why is that?
A. Because the gel will stick where it hits. So if hits anywhere along the way, the majority of it's going to stick. Whatever hits is going to stick. If
BY MR. WENZEL:
Q. All right. Now, the next page I have, the page that says up at the top “zinc sulfate heptahydrate”?
A. Yes.
Q. And what is it that you've done here on this page?
A. Well, this is the involved calculations for determining exactly how much zinc is in the two -- It is written out rather nicely here, but it's how much zinc. zinc ion is in 120 milligrams -- or I'm sorry -- 120 microliters of zinc gluconate or Zicam, which is in the lower right-hand corner. And then how much is in zinc sulfate heptahydrate 1 percent solution 1/2 a CC. So it's basically the amount of zinc. as I calculated, in the Toronto study versus how much is in zinc gluconate. That's where the ratio of 1.14 milligrams of zinc over, you know, 0.273 is about 5 to 1. That's where I came up with the number that five times as much zinc is being applied in the Toronto study. And even more when I tried to do it versus this here, which is the zinc -- Zicam down on the bottom.
