Macchiarini case: seven researchers are guilty of scientific misconduct, rules Karolinska’s president

Seven researchers, including the now disgraced surgeon Paolo Macchiarini, are guilty of scientific misconduct, the president of the Karolinska Institute in Sweden has ruled.

Ole Petter Ottersen, who took office in 2017 with a mission to clean up the institute after a scandal over bioengineered implants damaged its reputation, asked for six articles to be retracted, including two published in the Lancet.

More controversially, he included in his list one of Macchiarini’s co-workers, Karl-Henrik Grinnemo, who had alerted the institute to defects in the articles as long ago as 2014. Whistleblowing after the event, said Ottersen, could not exculpate a researcher from criticism if he was a coauthor of the relevant article.

He said, “It is KI’s [the Karolinska Institute’s] firm opinion that a whistleblower who has participated in in a scientific study and also as author of a scientific article . . . cannot be freed from blame or absolved from responsibility.”

In this case, however, the moral responsibility is blurred by the initial response made to the whistleblowers by those then responsible for the institute. The whistleblowers’ concerns were dismissed and Macchiarini cleared in an investigation in 2015, which is now recognised as flawed.

Grinnemo told the website Retraction Watch: “KI and its leadership has throughout all these years tried to harass me and my whistleblowing colleagues. We have been very critical of the way KI has handled the Macchiarini case and it is ridiculous that KI should have the final word in this case, they are so biased.

“Me and my colleagues have done fantastic work to uncover the Macchiarini scandal, while KI has always tried to stop us.”

The case relates to a series of operations in which Macchiarini, regarded as a leading surgeon when he was recruited by the institute, inserted a replacement oesophagus made of a polymer material and seeded with stem cells to replace diseased organs in some patients. The results were published and followed up with reports that the patients were doing well, which was untrue. After it also emerged that Macchiarini had misrepresented his curriculum vitae, his contract with the institute was terminated.

Ottersen said that the whistleblowers should be commended for their actions but that this did not constitute a defence. The latest investigation covered 43 authors of six articles that appeared in the Lancet (two articles) Biomaterials (2), Biomedical Material Research (1), and Thoracic Surgery Clinics (1).

An earlier investigation of the same articles by the Swedish Central Ethical Review Board found all of the authors responsible for scientific misconduct. The latest decision by the Karolinska Institute, made on a case-by-case basis, disagrees. It says that 31 of the authors are “blameworthy” but not guilty of scientific misconduct, while five are acquitted.

The remaining seven, who are found guilty of scientific misconduct, are named as Macchiarini, Grinnemo, Philipp Jungebluth, Jan Erik Juto, Alexander Seifalian, Tomas Gudbjartsson, and Katarina Le Blanc.

Seifalian worked at University College London and made an artificial trachea in 2011 at Macchiarini’s request, for an operation on a man from Eritrea. Despite claims that the operation had been a complete success the patient died. In 2016 Seifalian was dismissed by University College London for reasons the college said were unrelated to the transplant programme. He claimed that he was made a scapegoat.1

Grinnemo raised concerns after he and colleagues saw that Macchiarini’s patients were not, as claimed, doing well. Macchiarini’s response was to accuse him of stealing data for a grant application, which resulted in an investigation by the institute’s management that found Grinnemo guilty of “carelessness.” The application was for artificial heart valves, not tracheas, an area where Macchiarini had no expertise, Grinnemo said.

He said that, after the verdict, his grants dried up. “No one wanted to collaborate with me. We were doing good research, but it didn’t matter,” he told Retraction Watch last year.2 The carelessness verdict was reversed after a change of vice chancellor at Karolinska and a review by the Central Ethical Review Board.