Building on that, J&J reached out to Omnicare, a company that provided pharmaceutical services in nursing homes. The two companies cut a deal so that Omnicare doctors would prescribe Risperdal, and the profits would be shared with Omnicare. (Yes, that’s called a kickback.)

Even though Risperdal wasn’t approved for the elderly, J&J formed a sales force, called ElderCare, with 136 people to market it to seniors. The F.D.A. protested and noted that there were “an excess number of deaths” among the elderly who took the drug.

J&J seems to have shrugged. It was making vast sums, and the F.D.A. didn’t have teeth.

At the same time, J&J was also expanding into another forbidden market: children. The company began peddling the drug to pediatricians, so that by 2000, more than one-fifth of Risperdal was going to children and adolescents.

In 2003, the company had a “back to school” marketing campaign for Risperdal, and a manager discussed including “lollipops and small toys” in sample packages, Brill says.

All this was great for business, and by 2004 Risperdal was a $3-billion-a-year drug.

One challenge was that a J&J study had found that Risperdal led 5.5 percent of boys to develop large breasts, a condition known as gynecomastia. J&J covered this up, Brill says, quoting internal documents.

I asked J&J and Gorsky for comment. In particular, I wanted to understand why an executive who presided for years over conduct that the company conceded was criminal had been elevated to chief executive.

Gorsky declined to comment, and a company spokesman, Ernie Knewitz, didn’t really want to have that conversation. Knewitz did say the company “vehemently” disagrees with Brill’s take, denies a cover-up and considers Risperdal a useful drug with real benefits.