Both the heterozygous and homozygous FH were originally defined by the presence of the LDLR mutation. Through a decade of citation kiting, FH has transformed one of the best understood diseases into one of the least understood. Williams’ “clinical” diagnostic system came with a base rate advantage, and this advantage has not been carried forward as the leading screening strategy in the USA since his tragic death. Recent federal action exposed Aegerion’s strategy of avoiding precise definitions of the disease. Even the peer-reviewed diagnostic criteria have been engineered by way of fact-ectomies carried forward through the citation kiting, and through such, we can observe the art of redefining FCH, T2DM, METS, and the obese as “FH.” Although it had already been established that genetic identification of an LDLR mutation was the only unequivocal diagnosis, a truncated diagnostic procedure is proposed today, and genetic testing is discouraged. Now, Aegerion’s 10-K says that there is no consensus on diagnostic criteria. But what should we expect after nearly a decade of equivocating the definition and diagnostic procedure by way of citation kiting? Can I create the confusion, then use that confusion as my defense?