Merck launched the painkiller Vioxx (rofecoxib) in 1999 despite internal data suggesting elevated cardiovascular risk. The VIGOR trial (2000) showed a five-fold increase in heart attacks versus naproxen; Merck downplayed the finding for four years. APPROVe (2004) confirmed the risk and Merck withdrew Vioxx globally. The FDA estimated 27,000 to 55,000 excess cardiovascular deaths during the drug's five years on the market. Merck settled MDL 1657 for $4.85 billion in 2007. Internal emails show executives debating how to "handle" the cardiovascular signal. This is a confirmed corporate concealment, not a disputed claim.