Bernard Madoff's brother is sentenced to 10 years in prison

NEW YORK — The brother of imprisoned financier Bernard Madoff was sentenced to 10 years in prison for crimes committed in the shadow of his notorious sibling by a judge who said she disbelieved his claims that he did not know about the epic fraud.

Peter Madoff, 67, agreed to serve the maximum sentence allowable to the charges of conspiracy and falsifying the books and records of an investment advisor that he pleaded guilty to in June.

U.S. District Judge Laura Taylor Swain urged him to tell the truth even after he reports to prison Feb. 6 about what he knows about the multi-decade fraud that cost thousands of investors their original $20 billion investment.

The judge said Peter Madoff was "frankly not believable" when he said at his plea that he learned about the fraud only when his brother revealed it to him just before he surrendered to authorities.

Peter Madoff spoke only briefly Thursday before he was sentenced, saying: "I am deeply ashamed of my conduct and have tried to atone by pleading guilty and have agreed to forfeit all of my present and future assets."

He added: "I am profoundly sorry that my failures let many people down, including my loved ones."

Two investors spoke during the proceeding, which ended in less than an hour.

Investor Michael T. De Vita, 62, also demanded that the truth be forced out.

"I believe it to be physically impossible for a single person to carry out such a gargantuan task all by himself," he said.

De Vita said investors "have waited four years for others to accept responsibility for this massive crime. We are still waiting for that today."

"All of this was preventable if only one person was willing to do the right thing and stop this in its tracks years ago. Peter Madoff could have been that person," he said.

The sentencing comes four years and a week after Bernard Madoff first revealed the fraud, which occurred over several decades as the former Nasdaq chairman built a reputation for delivering unparalleled investment results, even in bad times. The revelation came only days after the business sent out statements that made investors think their investments had grown to a total of more than $65 billion.

Peter Madoff said at his plea that he had no idea his brother was running a massive Ponzi scheme, paying off longtime investors at times with money from newer investors.

"My family was torn apart as a result of my brother's atrocious conduct," he said. "I was reviled by strangers as well as friends who assumed that I knew about the Ponzi scheme."

But he conceded that he followed his brother's instructions and helped him decide which favored friends, clients and family members would receive the $300 million that remained in the company's accounts. The checks were never sent.

Peter Madoff, who joined his brother's firm after graduating from Fordham Law School in 1970, has been free on $5-million bail after he agreed to surrender all his assets.

Before the sentencing, his lawyer, John Wing, said in a memorandum that Peter Madoff will "almost certainly live out his remaining days as a jobless pariah, in or out of prison." He called him a victim of his loyalty to his brother, saying he had been mistreated by the sibling who was eight years older and was viewed as "the prince" by his mother.

As part of a forfeiture agreement, Madoff's wife, Marion, and daughter Shana must forfeit nearly all of their assets. The government said those assets and assets that will be forfeited by other family members include several homes, a Ferrari and more than $10 million in cash and securities. It said his wife will be left with $771,733. Besides the Madoff brothers, no other family members have been arrested.

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Obama makes gun control top priority

WASHINGTON — President Obama committed himself to placing gun control at the top of his second-term agenda, redoubling his intention to tackle the problem of gun violence in spite of daunting political obstacles that have frustrated similar efforts for years.

Appearing before reporters in the White House briefing room Wednesday, Obama sought to erase any doubts that he is prepared to stake his prestige on combating what he called an "epidemic of gun violence." Although he spoke in the aftermath of the massacre last Friday at a Connecticut elementary school, he placed the issue in a broader context, specifically mentioning people killed since then in the "lesser-known tragedies that visit small towns and big cities all across America every day."

As a first step, Obama gave Vice President Joe Biden the task of coming up with specific proposals before the end of next month. Working with Cabinet members and outside organizations, Biden is to come up with ideas that probably will include actions Obama can take administratively to bypass potential clashes with Congress.

The working group is expected to examine not only proposals for gun control measures, but also steps to improve services for the mentally ill and to push back against violence in popular culture.

Obama promised that he would detail "very specific" initiatives early next year, including in his State of the Union address, and sought to rebut the idea that Biden's group would be another ineffective Washington commission.

Biden has long experience with the politics of gun control from his service as the head of the Senate Judiciary Committee during the 1980s and 1990s. But neither his familiarity with the issue nor Obama's determination to press forward changes the extremely difficult nature of the fight that lies ahead for them.

In many respects, the climate for congressional action is less favorable than it was in 1994, when President Clinton's exhaustive personal lobbying campaign for a ban on assault-style weapons managed to prevail in a House of Representatives that Democrats controlled by two votes.

Despite an uptick in the aftermath of the latest tragedy, public support for stricter gun control laws remains significantly lower today than in the 1990s, according to polls.

"The politics are absolutely gruesome," said Paul Begala, a former Clinton advisor who worked to reelect Obama in 2012. "In many areas, the country is moving left, certainly in terms of gay rights, and on issues like marijuana. But from the time I was working with President Clinton, we've moved significantly to the right on gun control."

Patrick J. Griffin, a Clinton White House aide who was at the center of the fight over the 1994 crime bill, called it "probably tougher than healthcare" to get through Congress.

A handful of pro-gun-rights Democrats have stepped forward this week to suggest the need for tougher gun laws or at least a need for what Sen. Joe Manchin III of West Virginia called "a conversation on everything."

Republicans, however, have largely remained silent, making the Republican-controlled House of Representatives a particular stumbling block.

Asked whether GOP lawmakers would soon speak out in favor of tighter laws, Republican strategist Whit Ayres said no, "because they don't believe that more gun laws are likely to stop gun violence committed by mentally ill people."

Obama alluded to the daunting legislative math he faces by noting that many House Republicans represent districts that GOP presidential nominee Mitt Romney won last month. Indeed, a majority of the new House — 219 representatives out of 435 — will be Republicans from districts that Obama failed to carry, noted David Wasserman of the Cook Political Report.

In his remarks, Obama pledged to push ahead regardless of that political arithmetic. "The fact that this problem is complex can no longer be an excuse for doing nothing," he said.

He called on the new Congress to vote "in a timely manner" on banning the sale of assault-style weapons and high-capacity ammunition clips and on a requirement for background checks before all gun purchases. Those proposals, which Sen. Dianne Feinstein (D-Calif.) and others plan to introduce as early as next month, have repeatedly been blocked in Congress by the gun lobby and its allies.

The president also said the Senate should confirm a permanent director of the Bureau of Alcohol, Tobacco, Firearms and Explosives, a position that has been filled on an interim basis over the last six years because of opposition from gun rights forces.

Obama did not preview how he might try to prod reluctant lawmakers, but employing the memory of the Sandy Hook Elementary School shooting victims will probably be one technique.

Progress could be made "if those of us who were sent here to serve the public trust can summon even one tiny iota of the courage those teachers, that principal, in Newtown summoned on Friday," he said.

At one point, a reporter suggested that the president had essentially been absent from the gun control fight over the last four years, through repeated episodes of mass gun violence.

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Claire Danes and Hugh Dancy welcome a baby boy

NEW YORK (AP) — Claire Danes and Hugh Dancy's "Homeland" just got bigger.

Danes' rep confirms the couple welcomed a baby boy named Cyrus Michael Christopher.

People.com first reported Monday's birth.

It's the first child for 33-year old Danes and 37-year-old Dancy. They were married in 2009.

There's no word yet whether the new mom will attend the Golden Globe Awards on Jan. 13. She's nominated for Best Performance by an Actress in a Television Series for her work on Showtime's "Homeland."

Up next, Dancy stars in NBC's "Hannibal," an adaptation of Thomas Harris' novel "Red Dragon."

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F.D.A. and States Meet About Regulation of Drug Compounders

Mary Calvert/Reuters

Margaret Hamburg, the F.D.A. commissioner, testified on the meningitis outbreak before Congress in November. She addressed the need for greater federal oversight of large compounding pharmacies, which mix batches of drugs on their own, often for much lower prices than major manufacturers charge.

SILVER SPRING, Md. – The Food and Drug Administration conferred with public health officials from 50 states on Wednesday about how best to strengthen rules governing compounding pharmacies in the wake of a national meningitis outbreak caused by a tainted pain medication produced by a Massachusetts pharmacy.

It was the first public discussion of what should be done about the practice of compounding, or tailor-making medicine for individual patients, since the F.D.A. commissioner, Dr. Margaret Hamburg, testified in Congress last month about the need for greater federal oversight of large compounding pharmacies. So far, 620 people in 19 states have been sickened in the outbreak, and 39 of them have died.

Pharmacies fall primarily under state law, and the F.D.A. convened the meeting to get specifics from states on gaps in the regulatory net and how the states see the federal role. Some states said they would prefer to see the F.D.A. handle large-scale compounders like the New England Compounding Center, or N.E.C.C., the Massachusetts pharmacy that was the source of the outbreak.

“The consensus in our group was that there is a role for the F.D.A. to be involved in facilities like N.E.C.C.,” said Cody Wiberg, the executive director of the Minnesota Board of Pharmacy. “If you’re talking about compounding, most states have the authority and resources to handle that. If you’re talking about nontraditional compounding,” he said, referring to large-scale enterprises like N.E.C.C., “fewer states may have the resources to do that.”

Large-scale compounding has expanded drastically since the early 1990s, driven by changes in the health care system, including the rise of hospital outsourcing.

“It is very clear that the health care system has evolved and the role of the compounding pharmacies has really shifted,” Dr. Hamburg said in a telephone interview on Tuesday. She said the laws had not kept pace.

“We need legislation that reflects the current environment and the known gaps in our state and federal oversight systems,” Dr. Hamburg said.

Under current law, compounders are not required to give the F.D.A. access to their books, and about half of all the court orders the agency obtained over the past decade were for pharmacy compounders, although compounders are only a small part of the agency’s regulatory responsibilities.

The F.D.A.'s critics argue that the agency already has all the legal authority it needs to police compounders. They say that many compounders have been operating as major manufacturers, shipping to states across the country, and that the F.D.A. should be using its jurisdiction over manufacturers to regulate those companies’ activities.

“There should be one uniform federal standard that is enforced by one agency – the F.D.A.,” said Michael Carome, deputy director of Public Citizen’s Health Research Group, a nonprofit consumer organization, who has been a critic of the agency’s approach. “They have been lax in enforcing that standard.”

But Dr. Hamburg contends that the distinction is not so simple. Lumping large compounders in with manufacturers would mean they would have to file new drug applications for every product they make, a costly and time-consuming process that is not always necessary for the products they make, like IV feeding tube bags, for example. Dr. Hamburg has proposed creating a new federal oversight category for large-scale compounders, separate from manufacturers.

“What concerns me is the idea that we could assert full authority over some of these facilities as though they were manufacturers, as though there were an on-off, black-white option,” Dr. Hamburg said. “That is a heavy-handed way to regulate a set of activities that can make a huge positive difference in providing necessary health care to people.”

The central problem, state representatives said, is how to define large-scale compounding. Should companies be measured by how much they produce, whether they ship across state lines, the types of products they produce, or some combination of those factors?

“It’s easy to stand at a distance and ask why can’t there be a bright line?” said Jay Campbell, executive director of the North Carolina Board of Pharmacy. “Let’s not let the perfect get in the way of the good. We won’t be able to make a distinction that is razor sharp.”

Large-scale compounders play an important role in the health care supply chain when they produce high-quality products, F.D.A. officials say. They fill gaps during shortages and supply hospitals with products that can be made more safely and cost-effectively in bulk than in individual hospitals.

Officials said they wanted to make sure the products made by such suppliers were safe, but were also concerned about disrupting that supply.

Carmen Catizone, head of the National Association of Boards of Pharmacy, said that states were not equipped to regulate the large-scale compounders and that the F.D.A. needed to find a middle path for regulating them.

“Either hospitals are not going to like the solution, or the manufacturers aren’t going to like the fact that these guys get a shorter path,” he said. “But something’s got to give.”

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Federal regulators take steps to strengthen kids' online privacy [Google+ Hangout]

Columnist David Lazarus talks with Mark Blafkin, spokesman for the Assn. of Competitive Technology, an organization of app developers, and Alan Simpson of Common Sense Media, an advocacy group for parents.

By Jessica Guynn

December 19, 2012, 2:45 p.m.

SAN FRANCISCO -- Federal regulators have taken the first major step in nearly 15 years to strengthen the protection of kids’ online privacy.

The Federal Trade Commission said Wednesday that it has given parents greater control over the information that online services collect from kids 12 and under.

The changes don't go as far as originally proposed after heavy lobbying from the technology and media industry that said the changes would hamper economic growth, stifle innovation and limit the scope and number of online games and educational programs for kids.

Live video chat at 3 p.m.

The FTC began a review of the Children’s Online Privacy Protection Act in 2010. It said the law needed to catch up with the advances in technology and the explosion of mobile devices.

“The Commission takes seriously its mandate to protect children’s online privacy in this ever-changing technological landscape,” FTC Chairman Jon Leibowitz said in a statement. “I am confident that the amendments to the COPPA Rule strike the right balance between protecting innovation that will provide rich and engaging content for children, and ensuring that parents are informed and involved in their children’s online activities.”

Among the steps it has taken, the FTC has made it clear that a child’s location, photographs and videos cannot be collected without a parent’s permission. It also closed a loophole that allowed mobile apps and websites to permit third parties to collect personal information from kids without notifying or obtaining the consent of parents.

It also extended kids’ privacy rules to cover IP addresses, mobile device IDs and other means of identifying a user, requiring services to take “reasonable steps” to release kids’ information only to companies that can keep it “secure and confidential.”

Privacy watchdogs issued statements of support for the rule changes.

 “We are at a critical moment in the growth of the children’s digital marketplace as social networks, mobile phones and gaming platforms become an increasingly powerful presence in the lives of young people,” said Kathryn Montgomery, professor of communications  at American University. “The new rules should help ensure that companies targeting children throughout the rapidly expanding digital media landscape will be required to engage in fair marketing and data collection practices.”

Join us for a live video chat at 3 p.m. on the issue with consumer columnist David Lazarus and Mark Blafkin, a spokesman for ACT, an organization representing app developers, and Alan Simpson, vice president of policy at Common Sense Media, an advocacy group representing families.

ALSO:

FTC investigates mobile apps makers on children's privacy

Giant social network Facebook may give access to children under 13

Parents want more online privacy protections for kids, privacy groups say

Follow me on Twitter @jguynn

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Two more funerals in Newtown; NRA responds to school massacre

NEWTOWN, Conn. -- Two more of the children killed by a gunman who invaded a Connecticut elementary school were buried on Tuesday as officials released new details of the deadly spree that has reshaped the debate over gun control.

The National Rifle Assn., which has been under pressure to comment on the Newtown shootings, broke its silence and issued a statement saying it was ready to offer its plans at a Friday news conference.

“We were shocked, saddened and heartbroken by the news of the horrific and senseless murders in Newtown,” said the pro-gun rights lobbying group, which has repeatedly fought gun-control legislation on the national, state and local levels. “The NRA is prepared to offer meaningful contributions to help make sure this never happens again.”

PHOTOS: Mourning after the massacre

Both funerals were held at St. Rose of Lima Catholic Church, which has been one of the centers for consoling the bereaved and for memorial services that began Friday evening, hours after Adam Lanza opened fire inside Sandy Hook Elementary School.

Primarily using a Bushmaster AR-15-style rifle, Lanza killed 20 children and six adults in the school before turning a handgun on himself, authorities said. The rampage began Friday morning when Lanza killed his mother, Nancy, in the home they shared.

Dr. H. Wayne Carver, the state’s chief medical examiner, told reporters on Tuesday that Nancy Lanza was shot four times in the head with a .22-caliber rifle. She was most likely asleep when she was killed, Carver said, according to the Hartford Courant.

After shooting his mother, Adam Lanza took her car and several of her guns and went to the school, where he forcibly entered and opened fire. The Bushmaster and two handguns were later recovered from the building and a shotgun was found in the car, officials said.

Sandy Hook Elementary remains closed, most likely for months, as investigators continue their work seeking to understand why Lanza did what he did. The hundreds of students at the school are being relocated to a school in nearby Monroe, Conn.

In the rain and cold Tuesday, other Newtown students returned to their schools where teachers were prepared to help them cope with the massacre. Campuses also had a sizable police presence to reassure parents.

One Newtown school, Head O'Meadow Elementary, was locked down Tuesday due to an unspecified threat. The principal told parents to keep their children home, according to a letter from the principal published by WFSB-TV. Police have said they will deal harshly with hoaxes and threats, including two directed over the weekend at St. Rose.

The first funeral Tuesday morning was for James Mattioli, 6. In what has become an ongoing sight, mourners kept their heads down and walked quickly into the building, and refused to comment. The families have repeatedly asked for privacy for their grief, a position backed by local police.

James' funeral was the first of eight to be held at the church. By noon, flowers for the second service, for Jessica Rekos, also 6, had begun to arrive.

James has been described by family members as a budding “numbers guy.” Jessica was a horse enthusiast who wanted cowgirl boots for Christmas, relatives told reporters.

A wake was scheduled Tuesday night for slain teacher Victoria Soto. Police were to be part of an honor guard for Soto, who died trying to protect her students by getting them into a closet and putting her body between the gunman and her charges.

The shootings have reopened the debate on gun-control laws, specifically whether to renew the expired national ban on assault weapons. President Obama has asked his staff to come up with proposals, though no time frame for action has been given. Even staunch pro-gun rights lawmakers have also called for reopening discussion on some bans.

ALSO:

'Puppies for Rent' business in Utah sparks criticism

L.A. girls pay tribute in visit, but Newtown is a day of hearses

'No, no, no': Harrowing 911 call, then 4 dead near Longmont, Colo.

Susman reported from Newtown, Conn., and Muskal from Los Angeles.

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Google Music adds free iTunes-like song-matching feature

Title Post: Google Music adds free iTunes-like song-matching feature
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NY appeals court takes up Cameron Douglas case

NEW YORK (AP) — The Douglas name — first with patriarch Kirk and later with son Michael — has always meant gold for Hollywood. But drama for the third generation of the Douglas family has occurred mostly off-screen, where Cameron Douglas has battled drug addiction and legal troubles.

In papers submitted for appeals court arguments Wednesday, prosecutors and a lawyer for Cameron Douglas have retold in greater detail than before how a man who seemed to have so many advantages in life could land in prison for a decade on a drug conviction.

The dispute is over Manhattan Judge Richard M. Berman's decision to double Douglas' five-year prison term after he committed several new drug infractions, including convincing a lawyer-turned-love interest to sneak drugs into prison for him in her bra on three or four occasions.

Berman said he had not "ever encountered a defendant who has so recklessly and wantonly and flagrantly and criminally acted in as destructive and (as) manipulative a fashion as Cameron Douglas has."

In his brief, Douglas' lawyer Paul Shechtman called the additional sentence "shockingly long," saying it "may be the harshest sentence ever imposed on a federal prisoner for a drug possession offense."

Douglas, 34, was originally accused of distributing and conspiring to distribute more than 4.5 kilograms of methamphetamine and 20 kilograms of cocaine from August 2006 until his July 28, 2009, arrest at a Manhattan hotel. At the time, he was so visibly high on heroin that he was taken first to a hospital before he was brought to court, and it was later learned he had been shooting heroin five to six times a day for five years, Shechtman noted.

He was released from custody on the condition that he remain under "house arrest" with a private security guard at his mother's apartment, Shechtman said. Within days, he persuaded his girlfriend, Kelly Sott, to smuggle heroin to him, hidden in an electric toothbrush. Once discovered, his bail was revoked and he was incarcerated. Sott pleaded guilty to a misdemeanor in a plea deal and was sentenced to the seven months she had already served.

Still, Douglas gained leniency from what otherwise could have been a mandatory 10-year prison sentence by cooperating with the government, contacting his suppliers by telephone and text messages as law enforcement agents watched. As a result, two drug suppliers were arrested and convicted. Douglas testified at the trial of one supplier.

Douglas was sentenced to five years in prison for a Jan. 27, 2010, guilty plea to narcotics distribution charges even before his cooperation was completed.

At sentencing, Berman noted that the Douglas family had staged interventions for Douglas that he had refused and that two decades of drug addiction treatment had been unsuccessful. He said it appeared incarceration had produced the longest period of sobriety for Douglas since he was 13.

However, it was learned afterward that even prior to the April 20, 2010, sentencing, Douglas had persuaded one of his attorneys — a 33-year-old associate at a law firm with whom lawyers said he also had a romantic relationship — to smuggle Xanax pills to him in prison. Shechtman said she "apparently became enamored of Cameron during frequent visits."

He admitted that he had shared the 30 Xanax pills with other inmates and that he had also smoked cigarettes, gambled, snorted substances and committed other infractions while in prison.

Shortly after testifying at the Oct. 3, 2011, trial of a drug supplier, prison staff caught Douglas with the opioid dependence medication Suboxone and a white powdery substance believed to be heroin. The prison punished him with disciplinary segregation for 11 months and canceled nearly three months of his good conduct time.

On Oct. 20, 2011, Douglas again pleaded guilty to drug possession, agreeing in a plea deal that the sentencing range should be an additional 12 to 18 months in prison. Prosecutors say that within a week of the plea, the government learned from a cooperating defendant in another case that Douglas had misled the government about how he obtained heroin while in prison.

Douglas had claimed he got it in a television room or at a church service or that he obtained the heroin by chance, picking it up off the floor after another inmate dropped it, the government said. But prosecutors say the cooperator revealed he had brought Douglas the drugs directly to his cell.

In court papers, Shechtman blamed Cameron Douglas' long history of substance abuse and growing up with little parental support.

"While still a young teenager, he drank heavily and began selling drugs after his father sharply limited snorting cocaine," he said. "He used illegal drugs to self-medicate — to ward off depression and panic attacks."

He began using intravenous cocaine at age 20 and then started using heroin so that by age 25, "his life revolved around heroin," Shechtman said.

His friends were fellow users, who gravitated to him because of his access to family money, which supported their habits, the lawyer said. His drug habit led him to be fired from a movie in which he had a minor role in 2006.

"Exasperated, his father gave him an ultimatum: enter a drug rehabilitation program or have his access to family money sharply limited. Cameron declined to enter treatment; his father carried out his threat; and Cameron turned to drug dealing to support his habit," Shechtman wrote.

Shechtman argued that the judge had gone too far with Cameron Douglas, punishing an addict for something beyond his control.

"While we recognize that many of the words that the district court used to describe Cameron's conduct — 'reckless,' 'manipulative,' 'destructive,' — were apt, the simple truth is that Cameron Douglas is a heroin addict who has yet to shake his habit," he said.

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Attackers in Pakistan Kill Anti-Polio Workers

Rizwan Tabassum/Agence France-Presse — Getty Images

A Pakistani mother mourned her daughter, who was killed on Tuesday in an attack on health workers participating in a drive to eradicate polio from Pakistan.

ISLAMABAD, Pakistan — Gunmen shot dead five female health workers who were immunizing children against polio on Tuesday, causing the Pakistani government to suspend vaccinations in two cities and dealing a fresh setback to an eradication campaign dogged by Taliban resistance in a country that is one of the disease’s last global strongholds.

“It is a blow, no doubt,” said Shahnaz Wazir Ali, an adviser on polio to Prime Minister Raja Pervez Ashraf. “Never before have female health workers been targeted like this in Pakistan. Clearly there will have to be more and better arrangements for security.”

No group claimed responsibility for the attacks, but most suspicion focused on the Pakistani Taliban, which has previously blocked polio vaccinators and complained that the United States is using the program as a cover for espionage.

The killings were a serious reversal for the multibillion-dollar global polio immunization effort, which over the past quarter century has reduced the number of endemic countries from 120 to just three: Pakistan, Afghanistan and Nigeria.

Nonetheless, United Nations officials insisted that the drive would be revived after a period for investigation and regrouping, as it had been after previous attacks on vaccinators here, in Afghanistan and elsewhere.

Pakistan has made solid gains against polio, with 56 new recorded cases of the diseases in 2012, compared with 192 at the same point last year, according to the government. Worldwide, cases of death and paralysis from polio have been reduced to less than 1,000 last year, from 350,000 worldwide in 1988.

But the campaign here has been deeply shaken by Taliban threats and intimidation, though several officials said Tuesday that they had never seen such a focused and deadly attack before.

Insurgents have long been suspicious of polio vaccinators, seeing them as potential spies. But that greatly intensified after the C.I.A. used a vaccination team headed by a local doctor, Shakil Afridi, to visit Osama bin Laden’s compound in Abbottabad, reportedly in an attempt to obtain DNA proof that the Bin Laden family was there before an American commando raid attacked it in May 2011.

In North Waziristan, one prominent warlord has banned polio vaccinations until the United States ceases drone strikes in the area.

Most new infections in Pakistan occur in the tribal belt and adjoining Khyber-Pakhtunkhwa Province — some of the most remote areas of the country, and also those with the strongest militant presence. People fleeing fighting in those areas have also spread the disease to Karachi, the country’s largest city, where the disease has been making a worrisome comeback in recent years.

After Tuesday’s attacks, witnesses described violence that was both disciplined and well coordinated. Five attacks occurred within an hour in different Karachi neighborhoods. In several cases, the killers traveled in pairs on motorcycle, opening fire on female health workers as they administered polio drops or moved between houses in crowded neighborhoods.

Of the five victims, three were teenagers, and some had been shot in the head, a senior government official said. Two male health workers were also wounded by gunfire; early reports incorrectly stated that one of them had died, the official said.

In Peshawar, the capital of Khyber-Pakhtunkhwa Province, gunmen opened fire on two sisters participating in the polio vaccination program, killing one of them. It was unclear whether that shooting was directly linked to the Karachi attacks.

In remote parts of the northwest, the Taliban threat is exacerbated by the government’s crumbling writ. In Bannu, on the edge of the tribal belt, one polio worker, Noor Khan, said he quit work on Tuesday once news of the attacks in Karachi and Peshawar filtered in. “We were told to stop immediately,” he said by phone.

Still, the Pakistani government has engaged considerable political and financial capital in fighting polio. President Asif Ali Zardari and his daughter Aseefa have been at the forefront of immunization drives. With the help of international donors, including the Bill and Melinda Gates Foundation, they have mounted a huge vaccination campaign aimed at up to 35 million children younger than 5, usually in three-day bursts that can involve 225,000 health workers.

The plan seeks to have every child in Pakistan immunized at least four times per year, although in the hardest-hit areas one child could be reached as many as 12 times in a year.

Declan Walsh reported from Islamabad, and Donald G. McNeil Jr. from New York. Salman Masood contributed reporting from Islamabad, and Zia ur-Rehman from Karachi, Pakistan.

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Amgen pleads guilty to improper marketing of anemia drug Aranesp

Biotech giant Amgen Inc. pleaded guilty in federal court to improper marketing of its anemia drug Aranesp and has agreed to pay $762 million in criminal fines and civil settlements to resolve complaints from company whistle-blowers.

Federal prosecutors in New York said the Thousand Oaks company was "pursuing profits at the risk of patient safety" by encouraging doctors to use its popular anemia drug for unapproved uses to boost sales and to take market share from a rival drug maker.

Although doctors can prescribe medications for off-label uses, drug companies are banned from promoting use among certain patients or at doses that aren't approved by the U.S. Food and Drug Administration.

Quiz: Test your healthcare knowledge

"Biotech and pharmaceutical companies, like Amgen, do critically important work," said Marshall Miller, acting U.S. attorney in Brooklyn, N.Y., for this case. "That work can extend and enhance the lives of Americans or it can place those lives at risk in the pursuit of profits."

Amgen declined to comment about its plea and the settlement reached Tuesday while it awaits final approval from a federal judge Wednesday. The company had disclosed last year that it had reached a preliminary settlement of these cases and it took a charge of $780 million to cover the expected costs.

Aranesp was one of Amgen's best sellers for the last decade and contributed to Amgen's rapid rise in the drug industry. Aranesp is approved for treating patients suffering from anemia caused by chemotherapy and renal failure.

The drug posted revenue of $2.3 billion last year, but sales have steadily declined amid safety warnings and increased scrutiny of its costs to Medicare.

Amgen agreed Tuesday to pay a $150-million criminal penalty and $612 million to resolve 11 related whistle-blower complaints. Ten of the complaints remain under seal until the court accepts the settlement.

One of the key whistle-blower complaints that led to the settlement involved a former Aranesp product manager, Kassie Westmoreland, who worked at Amgen from 2002 to 2005. She filed suit against Amgen under seal in 2006, alleging that Amgen gave "liquid kickbacks" to doctors, among other inducements.

Her suit charged that Amgen overfilled vials of Aranesp to supply doctors with extra medicine at no charge. She alleged the company then encouraged doctors to bill Medicare and private insurers for this surplus amount, reaping them extra profit. Amgen pursued this strategy to take business away from Procrit, a popular anemia drug sold by Johnson & Johnson, according to the suit.

The Westmoreland case cited internal spreadsheets used by Amgen sales representatives to allegedly show doctors how much more money they could make from the overfills.

"Amgen provided extra product in the Aranesp vials as a liquid kickback that doctors could then cash in with federal and state governments through Medicare and Medicaid reimbursements," said Charles Kester, a Calabasas attorney who represents Westmoreland along with law firms in Boston and Washington, D.C. "Amgen is being held to account in a serious way for its choices to market this drug unlawfully."

Westmoreland is still pursuing separate claims against Amgen for retaliation and wrongful termination. She stands to receive some portion of the Amgen settlement under federallawfor whistle-blowers.

Amgen's shares fell 21 cents to $89.29 in trading Tuesday.

The company's case adds to a string of major settlements the federal government has secured from pharmaceutical giants. In July, GlaxoSmithKline agreed to plead guilty to federal charges and pay $3 billion in the largest healthcare-fraud settlement in U.S. history.

However, some critics say the government's enforcement efforts don't go far enough because the company executives involved typically avoid significant penalties or jail time.

Miller said there wasn't sufficient evidence in this case to charge any individuals at Amgen, but he said company executives and directors have been put on notice about the importance of complying with the law.

"I don't think Amgen is viewing this as the cost of doing business," the prosecutor said. "Amgen leadership must make sure this doesn't happen again."

chad.terhune@latimes.com

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