“It is abundantly clear the F.D.A. has failed to keep Americans safe,” Senator Manchin said in a statement on Tuesday. “How many more Americans have to die before we see a culture change at the F.D.A.? If there was ever a time for a change in leadership at the F.D.A., an institution with such direct impact on the American people, it is now.”
Another senator, Richard Blumenthal, a Democrat from Connecticut, said he had “grave reservations” about Dr. Califf’s nomination. He had voted against him five years ago, too.
At the hearing, Senator Maggie Hassan, a New Hampshire Democrat, criticized the agency for failing to change opioid policies as the death toll soared for years. She called for an overhaul of opioid medication labeling. Senator Ben Ray Luján, a Democrat from New Mexico, expressed outrage about the 2013 approval of the medication Zohydro, which was authorized over the objection of an agency advisory committee.
“Something’s got to change,” Senator Luján said. “And I’m hoping, doctor, that you can be that person.”
The senators’ concerns drew a pledge from Dr. Califf that he would undertake a “comprehensive review” of the agency’s opioid policies if he were confirmed. He said he would look at options for addressing the crisis, including a change to the labeling of opioid medications. “If I’m confirmed, I’m going to take a very aggressive approach on this,” he said.
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The hearing concluded without a vote. The panel will take one at a later date, and that would be a precursor to a full vote in the Senate, which has not yet been set. Dr. Califf’s earlier stint as commissioner lasted nearly a year, until President Donald J. Trump was sworn into office.
Dr. Califf’s other experience at the agency as deputy commissioner for medical products and tobacco may help guide him as the agency considers how to proceed with new vaping products and whether to allow Juul to stay on the market. The F.D.A. recently authorized an electronic cigarette to be sold in the United States, a decision that weighed the benefits of helping some adults quit smoking against the risk of youth addiction. Dr. Califf described the level of youth vaping as an “alarming rate,” noting that the appointment of a new leader of the agency’s tobacco unit would be a key decision.