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ANDERSON COOPER 360 DEGREES

Big Pharma's Big Payout; Showdown Between North and South Korea

Aired November 23, 2010 - 22:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


DR. SANJAY GUPTA, CNN ANCHOR: And thank you all as well for watching.

Tonight: Are your doctors pushing pills on you because the drug companies are paying them to do so? For the first time, we're seeing how much some of these doctors are really getting. And we will show you that. We will also hear from one doctor who says, hey, what's the big deal with doctors getting paid sometimes big bucks? We're "Keeping Them Honest."

Also tonight: the deadly showdown between North and South Korea, artillery fire, casualty, threats of escalation and thousands of American troops potentially in harm's way. What's the White House going to do? What happens next on the ground? We have got a live report from South Korea and the very latest from Washington as well.

And later: A toxic town that Erin Brockovich stood up for is back in the news, and Erin Brockovich is back in the town. You will see why people there are suffering again. It's a sequel that she says never had to happen.

We begin, though, as we do every night, "Keeping Them Honest." And tonight we're on the medical money trail, where some closely-kept secrets are finally coming to light. You know, it's a corner of medicine that until recently has operated almost entirely in the shadows.

So, let me start with asking a couple of questions. When your doctor prescribes a medication, how can you be sure that she or he isn't being paid by a drug company to promote that drug? And, if he was, would that make you think twice about taking it? Would it make you wonder if that drug, the one he or she was being paid to promote, was really the best drug to treat you?

You know, it's been said by many that a doctor's prescription pad is one of the most expensive instruments in medicine. After all, it's the prescriptions doctors write that decide the medications, the tests and other treatments that patients get.

I want to show you a number, an important one, now, $300 billion. That represents what pharmaceutical sales were in 2009, according to IMS. That's a company that tracks the industry. IMS says that's about 5 percent more, incidentally, than in 2008. Now, it's not news that drug companies spend a lot of money to advertise and market their products, but, "Keeping Them Honest," it turns out that some of the biggest drug companies are also paying a lot of money to doctors to talk about their drugs to other doctors. The drug companies and many doctors who give these talks call it education. And some say it can improve patient care by keeping doctors up to date on the latest research and treatments.

Critics call it marketing, pure and simple. Or, even worse than that, they call it bribery, an attempt to influence the prescriptions doctors write. Now, we should point out that these payments, they are perfectly legal. And, under federal law, drug companies aren't required to disclose these payments.

That's going to change starting in 2013 under the new health care law. In the meantime, some states do require disclosures. Just this week, in fact, Massachusetts made these payments that we're talking about public.

But there's also a database now that's getting a lot of attention. It was created by journalists at ProPublica. Now, it's an interesting database. It really focuses on these seven drug companies. They disclosed how much they pay doctors. All but two, according to ProPublica, were forced to make this information public as part of settlements in fraud cases.

Now, keep in mind, these seven companies are just a fraction of all the drug companies. Keep that in mind as you look at some of the numbers now. What they found specifically is that -- ProPublica found that $282 million were paid to more than 17,000 doctors in 2009 and 2010 -- $282 million.

Now, if you break that down a little bit, you find that, to any particular doctor, they could really vary quite widely, from $100, a small number, to more than $300,000 -- $300,000 to a single doctor.

Break it down even a bit more -- 384 doctors received greater than $100,000. And 43 of these doctors received more than $200,000.

Now, these payments, to say the least, they are controversial. The question is, are they really an effort to control your doctors' pens? And that's the real question here. Coming back to the pen, what's the influence here? Are the drug companies right in maintaining that they are simply improving patient care?

Now, in a minute, we're going to hear from a doctor who accepts and defends these payments.

But, first, I want to bring in Charles Ornstein, senior writer at ProPublica, and Angie Maher, who used to work as a drug sales rep for Ortho-McNeil Pharmaceutical. Now, it's not one of the seven drug companies that's part of the ProPublica database, though she was a whistle-blower in a lawsuit alleging improper marketing tactics. And that suit resulted in an $81 million settlement. She was awarded $3 million.

Thank you both for joining us.

CHARLES ORNSTEIN, SENIOR REPORTER, PROPUBLICA: Thank you.

ANGIE MAHER, FORMER DRUG SALES REP FOR ORTHO-MCNEIL PHARMACEUTICAL: Thank you for having us.

GUPTA: Angie, let me start with you.

You worked for years as a sales rep for drug companies. What were you paid to do specifically when it came to recruiting doctors to become speakers? And -- and do you think your pressure of the doctors in any way to prescribe -- were you pressuring them to prescribe your company's drug specifically?

MAHER: Yes. As a pharmaceutical rep, I was a paid marketing representative to change the prescribing pattern -- to change the prescribing habits of physicians to write my drug...

GUPTA: I see.

MAHER: ... that I was marketing vs. a competitive drug.

I was under direct -- direct pressures from the company that I worked for to sell a drug, whether it's indicated for that particular disease state or in other areas where the drug may have not been proven to be efficacious, for whatever company I was working for.

GUPTA: So -- so, you would -- knew -- you knew these drugs were not efficacious, or had no proof of that, and they were asking you to -- to push them anyway?

MAHER: Not only were sometimes the drugs not efficacious, but the studies that the companies had me using sometimes only had three to 10 patients for the drugs that I was selling to the physicians.

GUPTA: Now, why did you become a whistle-blower?

MAHER: Because the company I was working for, Johnson & Johnson, the Ortho-McNeil division, I had complained several times to my district manager, to the regional manager, to human resources.

And I had said many times that the drug that I was selling, doctors were telling me that the patients were complaining of side effects, that the -- the patients weren't doing well on the therapy. And the -- the studies that I was showing weren't credible. They were written by Pharm.Ds in our company.

They were -- we were paying physicians large amounts of money to have three patients in a study.

GUPTA: Right.

MAHER: We were spending $10,000 a month to have physicians do patient programs, to do speech...

GUPTA: Right. Right. MAHER: ... speaking education programs, and it just wasn't an efficacious drug for all the areas that the drug was being written for.

GUPTA: Well, let me dig a little bit deeper into that.

Charles, drug companies say they use doctors who are respected leaders in their fields when they choose speakers. That's something we heard as we were investigating this. But you wrote about this. You found out a number of the doctors on the drug companies' payrolls have some pretty questionable medical pasts.

Can you talk a little bit about what you found specifically?

ORNSTEIN: Sure.

And not just that, Sanjay. We also found that many doctors were not really experts in their fields. They hadn't written medical papers. They weren't on the faculty of academic medical centers. They weren't on the guideline writing committees for their specialities.

GUPTA: Hmm.

ORNSTEIN: They were not leaders in their professional societies.

But, beyond that, we found hundreds that actually had discipline against their licenses in the states in which they -- they worked for overprescribing...

GUPTA: What...

ORNSTEIN: ... patients' medications...

GUPTA: What...

ORNSTEIN: ... for sleeping with patients, for crimes.

GUPTA: For sleeping with patients as well? So, these patients (sic) were -- were sanctioned, maybe didn't even have hospital privileges anymore, and they were being paid, you're saying?

ORNSTEIN: Absolutely. Some lost hospital privileges. Some had settled multiple malpractice suits. But, also, some had lost their licenses in states or had been put on probation, very serious infractions.

GUPTA: Did you find that, Angie? I mean, how -- how did the drug companies you work for choose doctors to become speakers? What were they looking for?

MAHER: The companies, all four companies that I worked for, at the beginning of the year, they will give a list of the top prescribing 20 physicians in the territory. And, as A pharmaceutical marketing rep, it's my responsibility to pick three doctors. I have to find three doctors. And I get paid a bonus when I develop a doctor to be a key opinion leader or a thought leader. And I essentially say to a doctor, hey, our company has identified you to be a thought leader. Would you like to be a thought leader for our company?

The doctor will normally, almost every time, say yes. And -- and then the next step is that the doctor will have to find 10 patients to try the drug out. Some of the drugs that they're using are $1,600 a month to start the initial clinical trial...

(CROSSTALK)

GUPTA: Right.

MAHER: ... before they're allowed to speak on the drug. And then they start...

ORNSTEIN: And, Sanjay...

GUPTA: OK.

MAHER: ... being paid to speak on the drug.

GUPTA: Well, and I want to -- and I want to bring in Dr. Stossel in a second.

But, Charles, let me say something.

We reached out to all seven pharmaceutical companies in ProPublica's dollars for doctors database, and they did all get back to us tonight, saying they do support this practice as educational for doctors.

Their trade association, PhRMA, gave us a statement as well that reads in part this: "Information provided by expert physicians to their peers through company-sponsored sessions can provide some perspective. But, in the end, physicians make treatment decisions based on the best choice for each individual patient. Given the demands associated with maintaining a practice, peer-to-peer education sessions are an important resource to many physicians."

Charles, I know you've been investigating this quite a bit. Valid point here PhRMA is making?

ORNSTEIN: Absolutely. I mean, in some cases, these are very educational. And we don't dispute that.

I think the point is that this is intended to create a conversation between the public and their physicians. I mean, judges recuse themselves in cases in which they take money. Teachers are not allowed to get paid directly from textbook manufacturers.

GUPTA: Mm-hmm.

ORNSTEIN: And the reason this goes on is because we're concerned about undue influence.

So, doctors were able to take this money for a long time. It hasn't been disclosed to patients.

GUPTA: Right.

ORNSTEIN: Now it's starting to be, and these are conversations that patients should be having with their doctors.

GUPTA: And we talked about the fact, by 2013, that's going to be mandatory.

Angie and Charles, stick around for a second.

I want to bring in Dr. Tom Stossel now as well. He's a professor of medicine at Harvard Medical School. He's also director of the Translational Medicine Division at Brigham and Women's Hospital.

Thanks so much for joining us, Doctor.

DR. THOMAS STOSSEL, PROFESSOR OF MEDICINE, HARVARD MEDICAL SCHOOL: Thank you. Nice to meet you, Sanjay.

GUPTA: Thank you.

You have -- you've talked a bit about this practice. I know you have -- you have given speeches on it. You defend the practice by doctors and pharmaceutical companies. Why?

STOSSEL: Well, I have been in medicine for over 40 years. And it's incomparably better today than when I started out.

And the reason is because of the tools we have gotten from industry, and physicians working with industry, and physicians teaching other physicians how to use those tools. So, on balance, the value way exceeds the allegations of corruption. That's why I support it. That's the overarching fact.

GUPTA: Charles -- Charles, how...

STOSSEL: Now, I have to take you...

GUPTA: Go...

(CROSSTALK)

STOSSEL: ... to task -- can I -- can I go ahead?

GUPTA: Go ahead, Dr. Stossel, yes.

STOSSEL: ... take -- take you to task for sort of three things.

First of all, I think this is a legitimate topic for discussion, and we welcome criticism. But I would first say that the -- that the language that sort of alleges corruption is in the forefront. Now, this makes good press. I would say that, if -- if Angie is correct, and that people in her companies were -- were promoting the use of medications inappropriately, they should be taken out and shot. The question is, is it true?

And the -- the aura that it is true is created by these enormous settlements that we read about in the press. But a settlement isn't a conviction. And what the audience and patients need to know is, the reason the companies settle is that the prosecutors have the threat of what's called debarment, that the company can no longer do business with the government, no Medicaid, no Medicare. That's capital punishment, and companies have to settle.

And when individuals defend themselves in these suits, they win. So, it's not so clear that this is what it's cracked up to be. Now...

(CROSSTALK)

ORNSTEIN: Sanjay, I...

(CROSSTALK)

STOSSEL: ... the other allegation of corruption -- sorry.

(CROSSTALK)

GUPTA: Angie -- let me -- let me let Angie respond to that real, Dr. Stossel, since you -- you brought up something about her specifically.

Angie, go ahead.

MAHER: I'm not sure what I'm responding to?

GUPTA: Well, he talked about the fact that -- you know, he's saying if what you were doing was -- was essentially pushing drugs that did not have efficacy, that's illegal, and -- and that's a different issue, he's saying, vs. what happens more commonly.

Is -- is that true? I mean, do you think that this is a widespread practice?

MAHER: Oh, it's a -- it's a very widespread practice. But it's also a practice that it comes from both ends. It comes from the doctors demanding drugs to be promoted off-label, and doctors going out promoting the drug off-label to their peers because they're being paid by the pharmaceutical industry, which demands the pharmaceutical reps to invite the physicians to be promoting a drug off-label by the pharmaceutical companies making their reps promote it.

So, it's a cat-and-a-mouse type situation. Off-label marketing is never going to end. It happens right now. It's going to happen tomorrow. It happened 10 years ago.

GUPTA: Right.

MAHER: And it's going to happen 10 years from now. It's -- it's a process that...

ORNSTEIN: Sanjay, if I...

MAHER: ... doesn't end...

GUPTA: Wait.

(CROSSTALK)

MAHER: ... but it's something that has to.

GUPTA: Go ahead. Charles, go ahead.

ORNSTEIN: Sanjay, if I can interject, what I would just say is that, you know, there are arguments pro and con in terms of collaborating with industry. And I think both sides obviously make very legitimate points.

But what's left missing here is the consumer and the consumer's right to information and to have information that they can talk to their physicians about. And I think that the fact that this is coming to light, the fact that consumers can look up their physicians and ask questions, if they choose to, that's a good thing. I don't see how that's a bad thing at all.

GUPTA: Dr. Stossel, I mean, so what Charles is talking about is just transparency. So, both these things could be true. You could have the system you're describing, but also transparency.

As you know, Dr. Stossel, ProPublica has a database of doctors that have been paid by pharmaceutical companies.

Incidentally, when you type in my name, it comes back with a Dr. Sanjay Gupta who is a psychiatrist in New York who took a total of $173,000 from drug companies last year. It's -- it's not me. It's a different Sanjay Gupta. I'm a neurosurgeon based in Georgia.

When invited that Dr. Sanjay Gupta on the program tonight, but he did not answer our calls. There's about 400 Sanjay Guptas in the country, incidentally.

When we typed in your name, Dr. Stossel, it says Pfizer gave you $2,668 last year in cash or non-cash compensation. Have you received other payments from other drug companies as well not in the database?

STOSSEL: Not this year. Not this year, but, in the past, I have.

(CROSSTALK)

STOSSEL: And you've got -- I'm all for transparency. Transparency's fine, but we need to ask ourselves, what is it really for?

Let me go back to something you said about the prescription pad being the most expensive entity. That's really not true, because drug costs are a small percentage of total hospital costs -- I mean total medical costs.

And the fact is, and -- that every time a physician prescribes a procedure, prescribes -- has a visit from a patient, the patient pays. So, the entire interaction between physicians and patients is commercial. And, yet, we don't ask doctors to spend the 15 minutes they have with a patient talking about their -- their payments.

The fact is that the way this transparency is played out is, it's the press and tort lawyers and prosecutors use it for the prurient interests of the amounts of money. I think the vast amount of physicians get very small amounts of compensation from industry...

GUPTA: Right.

STOSSEL: ... and that what they need to learn is that it's OK, that they shouldn't -- when you call up and say, well, I see you got $2,500 from Pfizer, they don't weasel, they refuse to talk to you. They say, yes, that's true, because that was for value. I produced value.

If I wasn't producing value, I might be a reporter.

(LAUGHTER)

GUPTA: Well, look, you know, Dr. Stossel, fair shot there.

But I will tell you that there's a lot of doctors who received a lot of money, some of them over $300,000, as we talked about. And, as far as transparency goes, I agree with you. And I think that, in 2013, as we discussed, transparency is going to be the name of the game. It's going to be here as part of health care reform.

And this discussion is something that we're probably going to continue, I'm sure, between now and then.

Dr. Tom Stossel, Angie Maher...

STOSSEL: Can I just...

(CROSSTALK)

STOSSEL: Sorry.

GUPTA: I'm sorry. We have got to go.

Charles Ornstein, fascinating article. Thank you so much.

Let us know what you think as well. Join the live chat now under way at AC360.com.

Up next, 28,000 American troops are there facing a nuclear despot who is now lobbing artillery shells and threatening all-out war. We're live in South Korea, after a deadly skirmish between North and South and fear of more to come. What, if anything, can America do about it?

Stick around.

And news about the jawbone discovered in Aruba. Was it Natalee Holloway's? A lot of people want to know. Late details, that is coming up.

(COMMERCIAL BREAK)

GUPTA: The White House national security team is scrambling to handle a crisis on the ground where more than 30,000 Americans once died in a battle, the Korean Peninsula. Fifty-seven years after the end of the Korean War, there's still no peace treaty between North and South Korea.

And, today, for about an hour, a real shooting war broke out, the two sides exchanging artillery fire, the North shelling a tiny South Korean island, killing two, and forcing the island's evacuation, the South firing back, each side now on a hair trigger, exchanging very tough talk.

The administration weighing what to do next, President Obama huddling with his advisers in the Situation Room -- the other Situation Room -- and tonight talking on ABC's "World News."

(BEGIN VIDEO CLIP, "WORLD NEWS")

BARBARA WALTERS, ABC NEWS: Is an attack on South Korea an attack on the U.S.?

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: South Korea is our ally. It has been since the Korean War. And we strongly affirm our commitment to defend South Korea as part of that alliance.

WALTERS: Will we perhaps send warships, or -- or would you put U.S. troops on alert?

OBAMA: Well, I -- you know, I'm not going to speculate on military actions at this point. I want to consult with President Lee.

(END VIDEO CLIP)

GUPTA: President Obama tonight.

So, the question is, what can the United States and the world, in fact, do, and what happens next? We're going to talk about that shortly.

First, though, let's go to Stan Grant in South Korea with more on what happened when the guns started firing and what's happening right now -- Stan.

STAN GRANT, CNN CORRESPONDENT: Yes, Sanjay, you know, there have been flash points before in the past 50 years of tension between North and South Korea.

What makes this different is that civilians were directly in the firing line. Now, what happened here, South Korea was carrying out military exercises around Yeonpyeong Island. Now, North Korea saw that as an aggression against North Korea. They said to stop. When it didn't stop, they then began shelling the island.

You can see from some of the images the shells hitting the island. You see buildings on fire, plumes of smoke billowing into the air. Now, South Korea then responded. It sent fighter jets to the scene. It also responded with fire.

Now, of course, ordinary civilians caught in the crossfire here. Two marines were killed. Others -- others were -- were wounded.

Where we're standing right now, we're at the coast guard headquarters, where civilians have been evacuated. We actually got a chance to speak to a few of them. You're talking here about some very elderly people as well. One 86-year-old woman we spoke to said she's just glad to be alive.

Another man said that he heard the big bang. Then he saw houses on fire and he had to scramble to safety in a nearby school.

Now, Sanjay, a war of words also breaking out here between North and South Korea. North Korea is calling South Korea a puppet regime. It is warning of a merciless military confrontation. South Korea calling crucial meetings and saying that it will bring its military together and severely retaliate.

Now, we have seen words used as weapons before in the Korean Peninsula, but, as we saw yesterday, these weapons are now backed with real firepower -- Sanjay.

GUPTA: One of the questions, Stan, a lot of people asking is, you know, what -- what's going on specifically right now? North Korean dictator Kim Jong Il is often said to be in poor health and has put his son, Kim Jong-un, in line to succeed him.

I mean, do -- do you know, or -- or do we know, frankly, who is in charge right now of the North Korean government?

GRANT: This is really the prism of which you have to look at North Korea, a period of instability.

Its economy is being flattened by sanctions. As you say, Kim Jong Il has been unwell for some time. He has set a succession in place for his son, Kim Jong-un. But he's only 27 years old.

GUPTA: Right.

GRANT: And Kim Jong Il also appointing his brother-in-law, how is a hard-liner, to effectively be a mentor to Kim Jong-un.

And many in South Korea are saying is that this is an attempt by Kim Jong-un to toughen up, to show his leadership credentials, to draw a line in the sand. It's not just this attack. If you remember, earlier in the year, there was an attack on a South Korean ship, and 46 people died there. So, what we're seeing is a provocation, a buildup to an eventual transfer of power, and Kim Jong-un establishing his credentials. But, of course, this is a very, very risky game...

GUPTA: Right.

GRANT: ... a very high-stakes game, Sanjay.

GUPTA: And very volatile as well.

Stan, thanks. Thanks for that. Stick around as well, Stan, if you would.

I want to bring in Mike Chinoy now, former CNN senior Asia correspondent and currently a senior fellow at the U.S. China Institute at USC. He's also author of "Meltdown: The Inside Story of the North Korean Nuclear Crisis."

Mike, thanks for joining us.

You have covered these developments between North and South Korea for a long time now. And there seems to have been, you know, other outbursts from time to time. How concerning is this latest outburst of violence?

MIKE CHINOY, AUTHOR, "MELTDOWN: THE INSIDE STORY OF THE NORTH KOREAN NUCLEAR CRISIS": Well, I think this has the potential to be very worrying, because it does involve civilians, and it involves a level of confrontation between the North and the South that we haven't seen for a while.

There is a context to this, which is that relations between the North and South have been bad for a number of years. It's partly because of the internal dynamic in North Korea with the succession. It's also because, in South Korea, you have had a conservative government headed by President Lee Myung-Bak, who, since taking over in 2008, has pushed for a tougher line towards North Korea.

And that has angered the North Koreans. There's also another context, which is, for the last 18 months, the North Koreans have been sending signals that they would like to engage diplomatically with the United States.

GUPTA: Right.

CHINOY: And both the U.S. and South Korea have effectively rebuffed those overtures. And this is a kind of signal from the North Koreans, this is what we can do if you don't pay attention to us.

GUPTA: Let me take a step back for a second, because, obviously, these are all hypotheses. And there's a lot we still don't know about what happened.

I mean, do you have a sense, Mike, whether this was, for example, a local commander who launched this attack? Or -- or do you think that this came down from central government in Pyongyang? CHINOY: We don't really know. There are some reports that Kim Jong Il and his son were seen in that part of North Korea in the days beforehand, but there's no way to be sure. It's simply too opaque.

I think the real issue now is, there are tremendous pressures on the president of South Korea to hang tough, possibly to respond militarily, which he said he would do if there is another flare-up. And I think that the worry is that, if there's another kind of episode like this, it could spiral out of control.

The other problem is that this comes after a year-and-a-half in which the U.S. and South Korea have dealt with North Korea through sanctions and pressure and criticism, and not through negotiations. And it's clear that's not modified the North Koreans' behavior.

So, for the Obama administration, the problem is, is there any way to get back to talking to North Korea, which is politically very difficult? But, given that the military option is very dangerous and that sanctions don't work, it may be the only alternative that has any prospect of ratcheting down the tension in the months ahead.

GUPTA: If overall restraint seems like it's sort of a tepid response, and if -- and if you sort of start to sword-rattle a little bit, that may be provocative, and sanctions aren't working, you put all those things together, Mike, what does the international community do? What does the United States do, do you think, here?

CHINOY: Well, one thing that the Obama administration is clearly going to do is to really pressure China.

Beijing is North Korea's best friend. The Chinese leadership has been particularly chummy towards Kim Jong Il in recent months. And I think the U.S. is going to be saying to the North Koreans -- to the Chinese, your support for North Korea has kind of enabled them to behave this way.

But I don't think there's that much evidence that the Chinese are going to shift gears and work to pressure North Korea. Beijing's priority here...

GUPTA: Right.

CHINOY: ... is to keep the North Korean system from collapsing.

And, so, in the end, the problem for the U.S. is, if you get tough, it's risky. If you keep sanctions up, it doesn't work. But how do you get back to talks without being accused of being weak?

GUPTA: It's -- it's a fascinating discussion, and so much going on in the world, with the Middle East and Afghanistan. We will talk more about this.

Mike Chinoy, Stan Grant as well, be safe over there. Thanks so much.

Coming up: a toxic town still poisoned. And Erin Brockovich is asking some questions. Does that sound familiar? It's happening all over again. Thirteen years after a huge settlement, there are unsettling new questions about the same old problem. Get ready for "Erin Brockovich 2." That's ahead.

And a loaded ammo clip was found on a commercial airline. Get this. It was discovered after a crawling child kicked it to the floor -- some scary stuff. We're going to tell you how it got there -- next on 360.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: Coming up on "CNN Heroes," a AC 360 exclusive. Anderson will sit down with some of the Chilean miners to talk about their ordeal underground, including what was the worst moment out of those entire 69 days. But first, though, Susan Hendricks joins us with the "360 Bulletin" -- Susan.

SUSAN HENDRICKS, CNN CORRESPONDENT: Sanjay, part of a jawbone with a tooth attached to it found on a beach in Aruba is not Natalee Holloway's, is not. That announcement came today after the bone was found earlier this month.

In a statement, an attorney for Natalee's mother, Beth Holloway, said this, quote, "Beth accepts the forensic conclusions, is emotionally exhausted from the inexplicably long wait and deeply disappointed in the time and manner in which she learned of the results. Apparently, Aruban prosecutors were more sensitive to media concerns than the painful vigil of a mother."

All right. Here's something you do not want to find on a plane. A loaded gun clip was found on a Southwest Airlines flight today when it landed in Phoenix after a child crawled over the clip and knocked it to the floor. It turns out the clip belonged to a law enforcement officer from a previous flight who forgot it on that plane.

And the date is set for next year's royal wedding. Prince William will marry Kate Middleton April 29 at Westminster Abbey. Still a lot of details have to be ironed out. The guest list, security issues and, of course, her dress. The royal wedding could have the biggest TV audience in history.

GUPTA: It's amazing. I still remember Princess Diana. It's like a billion people all around the world watching that wedding. So they expect even more than that.

Susan, stick around for this. It's time for tonight's "Shot," a question I'm sure we've all pondered, one of the great mysteries of all time, really. How is Kim from "The Real Housewives of Atlanta" -- Anderson, I don't know how you do this -- how is she possibly going to build upon the musical success she found with her first single, "Tardy for the Party"?

Tonight, we have the answer. Here she is on Bravo's "Watch What Happens" live after show, debuting her new song. It's called "Google Me," in which she implores listeners to, well, I guess, Google her. Take a look.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE (singing): Google me. G-O-O-G-L-E me. Research me. You'll find me. Click them keys and Google me. G-O-O- G-L-E.

(END VIDEO CLIP)

GUPTA: What do you think, Susan? Next big hit? As big as "Tardy for the Party?"

HENDRICKS: I'm wondering. Well, I don't know. It's a tossup. But I'm wondering if it worked, if people are Googling her right now. I see people over there doing it.

GUPTA: People Google themselves all the time. So there you go. I wonder what Google thinks of this.

HENDRICKS: Good times.

GUPTA: Good luck, Kim, with that.

Up next, though, "Keeping Them Honest." Thirteen years later, Erin Brockovich's fight isn't over. The story became a hit movie. And now, all these years later, a toxic town is still poisoned. The company blamed is taking heat again. That's ahead.

And a CNN Heroes/AC 360 exclusive. Anderson talks with several of the rescued Chilean miners. What was it like for them the moment they saw the first rescue drill break? Their insight, in just a moment.

(COMMERCIAL BREAK)

GUPTA: "Keeping Them Honest" tonight, call it "Erin Brockovich 2," only it's not a sequel to the blockbuster movie that won Julia Roberts an Oscar; it's a sequel to the controversy over what a huge utility company is accused of doing to the health of a community in California.

And get this: it's the same company, the same community, and the same problem as the first time around. And Erin Brockovich herself? Thirteen years later she is once again asking, how could this happen?

Dan Simon reports.

(BEGIN VIDEOTAPE)

JULIA ROBERTS, ACTRESS: That is my work.

DAN SIMON, CNN CORRESPONDENT (voice-over): In the movie "Erin Brockovich" Julia Roberts played the tough and relentless paralegal who brought PG&E to its knees. One memorable scene? Brockovich fighting PG&E lawyers to compensate her clients, the residents of Hinckley, California. ROBERTS: I want you to think real hard about what your spying is worth, Mr. Walker. Or what you might expect someone to pay you for your uterus, Ms. Sanchez. Then you take out your calculator, and you multiply that number by 100. Anything less than that is a waste of our time.

TODD: PG&E eventually wrote checks totaling $333 million to more than 600 residents.

(on camera) So they come to you and they say $333 million and you were like...

BROCKOVICH: Holy (EXPLETIVE DELETED). I mean, you know, I mean, it's pretty cool. I was excited for these people.

TODD (voice-over): Thirteen years later, the excitement is now replaced with fear. Recent evidence indicates the same underground chemical plume that caused so much illness and heartbreak here is growing.

BROCKOVICH: And I'm thinking, somebody somewhere has been asleep at the wheel.

TODD (on camera): After an enormous settlement and the worldwide attention that came with a Hollywood film, people who live here thought their problems would have ended a long time ago. But it turns out those toxic chemicals have been spreading over time.

(voice-over) That's a finding by the state water control board. Brockovich putts the blame squarely on PG&E.

BROCKOVICH: This is a company that has great technology. They certainly have the money. You can't control this plume here in Hinckley, after everything that's happened? It makes no sense to me.

TODD: The plume is two miles long and nearly a mile wide. It's made up of hexavalent chromium, a chemical once used by PG&E in the '50s and '60s to prevent rust in the machinery at a nearby plant. It's the same chemical that seeped into the groundwater here and can cause life-threatening illnesses.

Roberta Walker received an undisclosed amount of money in the settlement for illnesses she blames on the contamination.

REBECCA WALKER, HINCKLEY RESIDENT: I've had several stomach surgeries. I've had a hysterectomy. I've had several lumps removed from my breasts. I've got asthma now.

TODD: So when Walker learned the hex chromium was not moving towards the very home she moved to to get away from the danger, she naturally thought...

WALKER: Oh, my God. It's like being struck by lightning twice. It's like, how can this possibly be happening to me again?

And E says great strides have been made in cleaning up the contamination. So how could this happen after the? A top company official agreed to meet with us at its San Francisco headquarters.

These people, they're concerned about their water. They're concerned about their way of life. Are those concerns justified?

UNIDENTIFIED MALE: The approach that we're taking with the residents in Hinckley is, we're committed to working with those individuals that live in Hinckley, either directly over the plume or in the adjacent vicinity to the plume.

WALKER: The utility denies it's been asleep at the wheel and says it's difficult to contain the chemical but also says it has a comprehensive plan to do so, including pumping in more than 100,000 gallons of water each day into the underground the plume to block the contaminants from advancing. It says water quality on or near the plume meets safety guidelines set by the state of California.

But with growing unrest, not to mention bad PR, the utility, as of last week, took the momentous step of offering to buy all the properties of those affected. We're told it could be as many as 100 homes.

UNIDENTIFIED MALE: You can look at residents in the eye and tell them that if they're near this plume or on the plume you'll buy their house?

GREG PRUETT, SNP: Yes. Really and truly, what really matters is what the residents think. So if the residents feel that you need to do more, if they have health concerns, then what we've got to do is we have to do more and we have to be committed to addressing those concerns.

SIMON: Whether that will be enough to stem rising anxiety remains to be seen.

(on camera) Do you see a second lawsuit here?

BROCKOVICH: That, I don't know yet. I -- I wish and I don't want to see lawsuits in this instance being a solution. It's going to do nobody any good to drag them through the mud again for five years. What I do want to see is a company take accountability for what they've done, come out here and make it right by these people.

SIMON (voice-over): PG&E promises it will. Brockovich and others will be watching.

Dan Simon, CNN, Hinckley, California.

(END VIDEOTAPE)

GUPTA: And as Dan mentioned, PG&E has sent letters to affected Hinckley residents offering to buy them out. But the California state water resources board says it doesn't matter who owns the property. The contamination still needs to be cleaned up.

This is a topic we've been interested in for a long time. We did a whole documentary looking at toxic towns all across America. Hinckley is not the only one. One of the most amazing things that really struck me and I think strikes a lot of people is how much we don't know about so many of the chemicals that we're surrounded with.

There is a toxic safe chemical act, and there's about 80,000 chemicals that we're surrounded with every day. But this will amaze you. Only about 200 of those chemicals have actually ever been tested, and only five have been restricted out of 80,000. There is so much we don't know. That is part of the problem.

Up next, the worst moments and the best for those Chilean miners and the men who rescued them. They tell Anderson in a CNN Heroes/AC 360 exclusive interview.

And later why Charlie Sheen landed on the RidicuList tonight. And get this: it's not for the drugs, the drinking, the womanizing or the anger management problems. No, it's for one single word that we don't think you'd ever imagine using in the same sentence with him. We'll explain.

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GUPTA: Just two nights from now right here on CNN, you can watch as we honor 38 of the bravest and most intrepid individuals the world has gotten to know. Thirty-three men trapped more than two months in a Chilean mine and the five who ventured into the damaged mine to pull them back above ground.

Last weekend they were all in Los Angeles for the taping of the CNN Heroes program. Some of them sat down with Anderson. So tonight, part two of the CNN Heroes/AC 360 exclusive.

(BEGIN VIDEOTAPE)

ANDERSON COOPER, CNN ANCHOR: what was the most difficult moment in all 69 days?

JUAN ILLANES, RESCUED MINER (through translator): I think it was the first days. Those were the hardest for me. It was the unknown. It wasn't clear whether the rescue was going to happen effectively in 20, 30 or 40 days.

COOPER: How about for you? What was the most -- what was the worst moment?

JIMMY SANCHEZ, RESCUED MINER (through translator): It was the first few days. Those first 17 days were the hardest for me.

UNIDENTIFIED MALE (through translator): Yes. At that moment, when we were all there, and there was for me, the worst day was the first day. I thought it was the end.

COOPER: You've worked in the mines a long time. You're the most experienced here. You really thought that was it, that you were going to die?

MARIO SEPULVEDA, RESCUED MINER (through translator): Yes. The worst day was the 16th day for me. We could hear the drilling probe. It was very close. It was desperate and match at the same time.

But when the probe did not find our shelter, that was the most critical time and desperate time for me.

COOPER: Were there moments of panic? Of just moments of -- I mean, you know, maybe you hear that people are searching for you, but were there moments of -- I think if I was there, there would be times I would just panic.

ILLANES (through translator): When we realized the situation we were in, there was great concern and worry. We knew we were trapped but there wasn't a massive panic. Never. The situation was there where we all could have panicked. But we all worked together. And Mario had great ideas. We kept communicating, and it kept us all calm.

COOPER: I've been in situations where I thought my life was in danger and I made many promises to myself about how I would change or what I would do differently. Did -- did you all in your minds think about things you would do differently in your life if you were able to get out? I haven't followed through on some of the promises I've made, so -- but I still have time, so....

UNIDENTIFIED MALE (through translator): We found ourselves inside that mine. All the mistakes I've made, I've made big mistakes in life. But when we left that mine, we left with a new mentality. The things we didn't do in life properly we can now redo.

SEPULVEDA (through translator): For 39 years my life has not treated me very well. And inside that mine, that was the moment when I found a lot of answers in my life.

COOPER: That moment when the first drill came through, what was that like?

SEPULVEDA (through translator): it was exciting. Very exciting. Hope, life, the desire to continue living. It was beautiful. Like a party. It was outrageous. It was like a carnival. It was as if Chile played Argentina in a soccer match and Chile won.

We had a note prepared, a letter ready to send up. Otherwise, we would have forgotten everything, because it was such an exciting situation. So that is why we wrote the note.

COOPER: Did you write it out before the drill came? Did you know the drill was coming?

UNIDENTIFIED MALE: Translator: yes. The minute we heard them drilling. The minute it started. I wrote, we are OK in the shelter. The 33 of us.

(END VIDEOTAPE)

GUPTA: Amazing to hear so many of those stories. And we've got an important reminder, as well. You can follow those amazing stories. "CNN Heroes: An All-Star Tribute," airs this Thursday, Thanksgiving night at 8 Eastern, 5 Pacific right here on CNN.

And did Afghan President Hamid Karzai get tricked by a fake Taliban leader? He gives us take on the primary.

Plus actor Charlie Sheen's latest move that putts him on our RidicuList.

(COMMERCIAL BREAK)

GUPTA: A lot more happening tonight, and Susan Hendricks joining us again with a "360 News & Business Bulletin" -- Susan.

HENDRICKS: Sanjay, there is new research in the fight against HIV. A new study found that a combination of two widely-used anti- retroviral drugs taken daily reduced the risk of HIV transmission in men and transgendered women having sex with men. Their risk fell by 44 percent. Those who took the combination pill for most of an entire year reduced their risk by almost 73 percent.

The president of Afghanistan was fooled by a fake Taliban leader. That's according to NATO officials quoted in "The New York Times," but President Hamid Karzai calls it, quote, "foreign propaganda" and says he never met the man in question. Karzai claims the man hasn't even been to Afghanistan.

Stocks took a hit on Wall Street today with the deadly showdown between North and South Korea in the news and the Federal Reserve lowering its economic outlook. The Dow shrank 142 points and the NASDAQ sank 37 while the S&P fell 17 points.

And check this out. Man's best friend is smarter than cats. That's according to Oxford University who say dogs are more intelligent, because their friendly character helped them develop bigger brains. Cats like to go it alone so don't have to think as much. A writer at the same publication, though, says the truth about cats and dogs is that each is smart in its own way.

GUPTA: Don't need an Oxford university study to tell me that. I already knew dogs were smarter than cats, didn't you?

HENDRICKS: Come on. We want to see a shot out to both of them.

GUPTA: Right. Lot of enemies out there. Staff dogs, by the way, all the dogs you just saw, dogs of staff, including Sean Yeats (ph), who's in my year.

HENDRICKS: Where are the cats?

GUPTA: Where are the cats? Maybe that will be the next time. They get a new study.

But now on to the RidicuList and the newest member of it, Charlie Sheen. Best known lately for allegedly going on a rampage in the L.A. Suite at the New York Plaza Hotel, but porn star Capri Anderson, while on vacation with his daughters and his ex-wife, Denise Richards. That's not why he's on the RidicuList. He gets the honor tonight because yesterday he filed suit against Ms. Anderson, contending in part that she tried, quote, "to embarrass him in attempt to damage his career by going to the media with her false tale."

Now, it's not for us to say who did what to whom in that plaza suite or what laws, if any, were broken or any of that stuff. But embarrass Charlie Sheen? Embarrass Charlie Sheen? A porn star/alleged escort embarrassing Charlie Sheen? Three words. Cannot be done. Take a look.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Mr. Sheen, I'd like to place before you a document that has been marked as government's exhibit number 239. What do you recognize?

CHARLIE SHEEN, ACTOR: A personal check of mine.

UNIDENTIFIED MALE: What was that personal check for?

SHEEN: The check was written for sexual services.

UNIDENTIFIED MALE: And what is the amount of that check?

SHEEN: $1,500.

(END VIDEO CLIP)

SHEEN: Charlie Sheen. That was 15 years ago, testifying in the 1995 Hollywood madam trial. Remember her? A $1,500 check, and a lot more like them, admitting he paid nearly 50 grand for services rendered. Personal checks to hookers.

Embarrass Charlie Sheen? Do a Google search on the words "Charlie Sheen" and "hooker" and you're going to get nearly 6.5 million hits. He's been married three times, divorced twice and in divorce proceedings right now. He's accidentally shot a former fiance, accidentally shot her, checked in and out of rehab, fallen off the wagon countless times.

And on all that, believe it or not, was neither here nor there, except to his family, except for this. We think someone who's both so apparently unembarrassable and so utterly pre-embarrassed cannot claim that someone, anyone, tried to embarrass him.

That is unless, of course, he wants to land on the "360" RidicuList.

Got more serious stuff at the top of the hour. Big pharma shelling out big bucks to doctors. We'll show you how much money is changing hands. Critics call it bribery, but drug makers say it's education that improves patient care. We're "Keeping Them Honest."

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