Court documents: USC doctor didn't 'agree with' FDA's Toradol warnings

In his deposition, Tibone said he didn't "agree with" FDA warnings about Toradol's cardiovascular risks. He did not provide supporting evidence for his position, admitting that before and during the period he gave the drug to Armstead and other USC players he: (a) conducted no research or surveys on Toradol's adverse effects; (b) read no peer-reviewed journal articles on the matter prior to Armstead's heart attack; (c) did not investigate the drug beyond talking to NFL trainers he knew and having a brief, informal conversation with a friend who is a cardiovascular surgeon.

Tibone also said that he doesn't prescribe Toradol to patients in his private practice, and that he personally had taken the drug once, to treat pain from a kidney stone.

By the beginning of March, Armstead's condition worsened. A MRI exam revealed that he had suffered an acute anterior apical myocardial infarction, more commonly known as a heart attack. Myocardial infarctions are specifically mentioned by the FDA as a possible risk of Toradol use, made likelier by repeated off-label use and combining the painkiller with other non-steroidal anti-inflammatories such as Ibuprofen and Naproxen, drugs that Tibone and USC training staff also had administered to Armstead during the season.

Tibone and USC argue they used Toradol properly because they were treating Armstead's acute pain resulting from a single injury. Whether or not the definition of "acute" pain includes an orthopedic injury lasting for months—a highly contested point in the lawsuit—the extended duration of Armstead's treatments seemingly disregarded FDA warnings, which impose a five-day limit on using the drug.

Moreover, the multiple Toradol shots approximately two hours apart alleged by Armstead and indicated by USC athletic records would exceed the FDA's recommended daily dose limit of no more than 60 milligrams, or one such injection.