More than three years after a diet supplement sickened 72 people, most in Hawaii, civil and criminal cases against the makers of OxyELITE Pro rage on.
The latest development: A relatively unknown, international medical journal is slamming the Queen's Medical Center and the state Department of Health over how they handled the Hawaii patients. And the article is providing ammunition for OxyELITE's makers.
Two people who took the supplement died, three had to have liver transplants and about 50 more were hospitalized with liver failure or other issues between April and October 2013.
Many continue to have serious complications from the diet drug.
Kona resident Kenneth Waikiki, then 22, is still having medical issues and will have to take anti-rejection drugs for the rest of his life.
Pearl City resident Lance Taniguchi was close to needing a transplant, but his liver recovered on its own -- eventually.
"It's functioning now, so I'm glad to be alive now," he said.
But his medical problems continue.
Liver failure ended his nine-year career with the Navy, and he still suffers from fatigue.
"A lot has happened, a lot of my work life has changed," Taniguchi said. "I had to get medically separated from the military."
Both men are part of civil suits against USPLABS, but the makers of the supplement also face criminal cases.
Last year, a federal grand jury in Dallas, where USPLABS is based, indicted the top executives for conspiracy to commit wire fraud. The allegations: That the company imported numerous shipments of substances using fake documents so that components of their product could sneak in from China.
In 2014, the New England Journal of Medicine reported that the U.S. Centers for Disease Control and Prevention confirmed what astute Honolulu Dr. Linda Wong had suspected -- that OxyELITE Pro was responsible for the Hawaii cluster of liver problems.
In a new strategy aimed at fighting the allegations against them, USPLABS is citing different research, published in a Latin American journal, that claims Hawaii patients were misdiagnosed and didn't get the appropriate care.
The researcher slams the Queen's Medical Center, Wong, and the state Department of Health.
The journal article's author, a German doctor, claims news conferences to warn others taking the supplement put a bias against OxyELITE Pro and that health officials failed to find other possible factors.
The researcher claims one patient's liver failure may actually have been caused by an overdose of acetaminophen, the active ingredient in Tylenol.
And another patient, an overdose of ibuprofen.
He writes that other patients suffered from gall stones, and blames one man's pig hunting, saying eating wild hog in Hawaii contributed to his liver illness.
The article also says the cluster of Hawaii cases is "best explained by various liver diseases rather ... than one dietary supplement" despite the fact that all the patients were taking OxyELITE Pro.
Attorney Rick Fried is not involved in the case but has reviewed the details and said the DOH responded properly to prevent further illness.
"There are medical journals that will take publications without peer reviewing it. In other words, having other doctors look at it and vet them for accuracy and that's apparently what the defense has come up with here," Fried said.
Fried said criminal cases that are intertwined with civil ones always drag on, which puts a heavy burden on patients and their families.
The criminal trial for the makers of the product is set for January 2018; the civil cases could take another year after that.
The Queen's Medical Center, state Department of Health, and attorneys for the patients all declined to comment, citing the ongoing legal battles.