TRENTON, N.J. - Merck & Co.'s painkiller Vioxx contributed to an Idaho postal worker's heart attack, a jury in Atlantic City ruled Monday, reversing the verdict in the man's first trial and hitting Merck with a total of US$47.5 million in damages.

The jurors awarded the man and his wife $20 million in compensatory damages Monday morning, then late Monday hit Merck with $27.5 million in punitive damages.

The verdict in the case of Frederick (Mike) Humeston, who was granted a second trial in light of new evidence, means Merck has now won nine cases and lost five in the mushrooming litigation over its former blockbuster arthritis pill.

Humeston, 61, of Boise, Idaho, suffered a heart attack in September 2001, several months before Merck - under pressure from U.S. regulators - put a stronger warning about the cardiovascular risks of Vioxx on the drug's detailed package insert.

Humeston, a decorated veteran, had taken Vioxx intermittently for knee pain from a Vietnam War shrapnel wound.

The five-man, three-woman jury ruled on March 2 that Merck was negligent and did not provide adequate warning about those risks before Humeston's heart attack. That set the stage for a second phase of the trial, with the jury last week hearing evidence on whether Vioxx contributed to Humeston's heart attack, entitling him to damages.

The jurors awarded Humeston $18 million in compensatory damages and gave another $2 million to his wife, Mary.

The jury, which deliberated for about five hours over two days, also decided Humeston should be reimbursed for his out-of-pocket costs for Vioxx.

Then, after brief arguments over punitive damages, the jury deliberated briefly late Monday and decided to assess $27.5 million in punitive damages against Merck.

Hope Freiwald, a member of Merck's defence team, said the company would pursue all avenues of appeal.

Humeston lost his first trial against the pharmaceutical giant in 2005, but New Jersey Superior Court Judge Carol Higbee granted him a second trial because new evidence surfaced that short-term Vioxx use could also be risky; Humeston took the drug on and off for about two months. Merck insists Vioxx didn't increase cardiac risks until after 18 months of use, but many doctors say research disproves that.

"It's been a long battle. I'm just happy that justice finally prevailed," said Humeston's lawyer, Christopher Seeger.

Whitehouse Station, N.J.-based Merck pulled Vioxx from the market in September 2004 after its own research showed the drug doubled the risk of heart attack and stroke.

During the eight-week trial, Merck lawyers contended Humeston had several risk factors for heart disease, including being overweight and sedentary and having high blood pressure and cholesterol levels.

In the unusual, two-phase court proceeding in Atlantic City, jurors were initially asked to only consider Merck's conduct in marketing and disclosing risks of Vioxx.

Judge Higbee chose the two-phase arrangement to try to speed up Vioxx trials. She is overseeing all Vioxx lawsuits filed in New Jersey - more than half of the roughly 28,000 suits Merck faces. Merck has been fighting the suits one by one.

The jurors ruled on March 2 that Merck was negligent in the case of Humeston.

"We believe the result is not supported by the evidence in this case," Freiwald said late Monday. "We think the verdict in this case reflects the fact Merck didn't have a chance to tell the jury the entire story before the jury formed its conclusions."

Merck shares fell 32 cents to $44.29 in trading on the New York Stock Exchange.