A Rogues Gallery

 

A Rogues Gallery

Lock, Stephen and Wells, Frank, editors. Fraud and Misconduct in Medical Research. London:
BMJ Publishing Group, 1993.

Here is a list of fraud cases in the biomedical sciences drawn up by the senior editor of the book.
The list is focused on the biomedical sciences and ignores the others. Some of the descriptions
are relatively long because this author considers them "classic." This listing is provided in the
text on pages 6-16 and is quoted in its entirety.

The Rogues Gallery approach, listing the villains, is sometimes a useful reference to have. The
ellipses may be interpreted to refer to pages in the text where these cases are discussed in this
book and gives the reader here a good idea of what is discussed in the text.

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Australia

1981 Michael Briggs, professor of endocrinology at Deakin University, Geeling, who forged data
on oral contraceptives...

1985 Ronald Wild, professor and dean of social science at La Trobe University, Victoria. His
fifth book contained large-scale plagiarisms from 10 different sources. He resigned after
difficulties with the initial inquiry.

1987 Ashoka Prasad, consultant psychiatrist at the Victoria Mental Health Institute, Melbourne,
fabricated data on 8000 patients with schizophrenia... Such was the concern about the possible
legal implications of publishing this conclusion - another theme that was subsequently, but
erroneously, to be used as an excuse for doing nothing - that the findings were released under the
privilege in the Victoria State Parliament.

1988 William McBride, director of Foundation 41 in Sydney, New South Wales, who forged data
on the action of hyoscine in fetal rabbits. An important case for not only does it concern a world
famous figure, who was powerful enough to raise a major threat to an important drug, Debendox,
but it also illustrates the difficulty of instigating an inquiry at a private foundation when such a
procedure is resisted by the head of the unit...

United Kingdom

1975 J. P. Sedgwick, A High Wycombe family doctor, who had agreed with a pharmaceutical
company to coordinate and take part in a trial of an antihypertensive drug. He returned 101
completed clinical trial forms many of which contained forged signatures of the seven other
participating doctors,s and results which showed that the active drug was having a uniform and
consistent effect that was appreciably different from the test results from other sources. Reported
by the company to the GMC, Dr. Sedgwick had his name removed from the medical register.

1977 Robert Gullis, biochemist at Birmingham University. Faked results in research done in both
the United Kingdom and Germany into messenger chemicals in the brain ... forming the basis of
his PhD thesis and 11 articles, all of which were retracted by the departments concerned.

1980 E. A. K. Alsabti, who was a major plagiarist. Though he worked largely in the United
States, he is included in the United Kingdom section since he probably also worked here at some
time (giving at least two addresses in the United Kingdom), while his misconduct was featured
prominently in three British journals (Nature, the Lancet and the British Medical Journal). An
Iraqi immunologist, Alsabti worked at various research centres in the United States in 1977-8,
and then qualified from the American University of the Caribbean in May 1980, going on to
practice at various medical centres until 1982 and privately until 1989. In September 1990 he was
reported to have been killed in a car crash in South Africa, but as of April 1991 no death
certificate had been forthcoming in response to inquiries.

In his earlier posts Alsabti had fallen foul of his superiors; the Temple University authorities
speaking of his "irresponsible and non-professional behavior," the microbiologist Professor E. F.
Wheelock at Jefferson Medicine College finding "very strong" evidence of fraud, and the M. D.
Anderson Hospital asking him to leave because a manuscript he had submitted for review was an
obvious plagiarism of Wheelock's work.

It was Wheelock who some months after this last episode was to bring changes of plagiarism into
the open - a case subsequently reinforced when Daniel Wierda, a postdoctoral student, found that
his article in the European Journal of Cancer had been published in an almost identical version in
the Japanese Journal of Medical Science and Biology under the names of Alsabti and two
fictitious coauthors. The European journal had refereed Wierda's paper to Dr. Jeffrey Gottlieb,
who had worked at the M. D. Anderson Hospital but had been dead for four years. Alsabti had
picked it up, made minor alterations, and submitted it to the Japanese journal, which had
published it before the bona fide article had appeared.

The article was formally retracted by the editor of the Japanese journal, while comments about
the case appeared in various scientific journals, one of which led to Alsabti's resignation from an
internal medical residency programme of the University of Virginia and subsequently from at
least two training programmes elsewhere. In all, it seems likely that Alsabti plagiarized some 60
articles, most of them in obscure journals.

1981 Michael Purves, reader in physiology at the University of Bristol, who faked data to show
that the uptake of radioactivity labelled 5-deoxyglucose (a marker for glucose itself) was greater
in the brain cells of active, awake sheep embryos than of sleeping ones. The findings were
presented at the 1981 International Congress of the Physiological Sciences, and published in its
proceedings. Nevertheless, colleagues could not replicate the work and a university investigation
was held. Purves resigned his post and retracted his findings in a letter to Nature.

1986 Art Conolly, medical student at Oxford, who plagiarized an anonymous British Medical
Journal editorial on the differential diagnoses of dementia and published it under his own name
in another journal. Both journals published statements about what had happened.

1986 V. A. Siddiqui, Durham psychiatrist who faked data in a trial of an antidepressant. Reported
by the pharmaceutical company to the Association of the British Pharmaceutical Industry (ABPI)
and thence to the GMC, which suspended his registration for six months...

1990 Sheo Kumar, Hornchurch family doctor who faked data in a trial of drugs used for
hypertension. He submitted to the pharmaceutical company record forms and related documents
that were misleading and failed to conduct the study trial in accordance with the study protocol.
Reported by the company to the ABPI and thence to the GMC, which found him guilty of serious
professional misconduct and admonished him.

1991 Lakshmi Pandit, Wimbledon family doctor who faked data in a trial of drugs used in
obstructive airways disease. Reported by the contract research organization to the ABPI, and
thence to the GMC, which removed his name from the medical register...

1991 R. B. Gonsai, London family doctor who faked data in a comparative trial of two inhalation
techniques. Reported by the contract research organization to the ABPI, and thence to the GMC,
which removed his name from the medical register...

1991 David Latta, Glasgow family doctor who faked data in a comparative trial of two
antihypertensive drugs. Reported by the pharmaceutical company to the ABPI, and thence to the
GMC, which removed his name from the medical register...

United States 1974 William Summerlin, immunologist at the Sloan- Kettering Institute, New
York, who faked transplantation results, darkening transplanted skin patches in white mice with a
black felt-tip pen,m and alleging that human corneas had been successfully transplanted into
rabbits. Sir Peter Medawar, who was present at the latter demonstration, has given a good and
amusing account of prevailing attitudes at the time, which led fellow scientists to keep quiet
about results they just did not believe. Admitting that he had been a moral coward on this
occasion, Medawar said that he believed that the whole demonstration was either a confidence
trick or a hoax. Subsequently Summerlin's boss, the celebrated immunologist Robert Good,
resigned from the directorship of the Institute.

1978 Marc Straus, head of a cancer research team at Boston University, working on a clinical
trial drug treatment in cancer, in which 15% of data were found to be false. Straus resigned, but
stated that, although data had been faked, he had not had any role in the faking.

1979 Vijay Soman, an assistant professor of medicine at the Yale School of Medicine, who
plagiarized parts of a manuscript sent in 1978 by the New England Journal of Medicine for peer
review to his boss, Philip Felig, who passed the job on to him. Subsequently Soman and Felig
published an article on the same topic, insulin binding in anorexia nervosa, in the American
Journal of Medicine. Accused of plagiarism and conflict of interest, Felig seemed to settle the
difficulties by stating that the work had been completed before they had received the paper for
review; but its author, Dr. Helena Wachslicht-Robard, a young researcher at the National
Institutes of Health (NIH), who during this episode was to switch to hospital practice. persisted in
her complaints - which in an inquiry by Dr. Jeffrey Flier, a Boston dibetologist, in February 1980
were shown to be justified. Not only had Soman copies her manuscript, but most of the data of
his own study had been faked. A subsequent investigation soon after found that, of 14 articles,
only two could be approved, and the data were either missing or fraudulent in the remaining 12
(10 of them with Felig as coauthor). All these articles were retracted by Felig.

The case is important as it features poor review and conflict of interest, as well as the hesitancy
in those early days of instigating a full and proper inquiry into an accusation made against a
senior figure, and only Wachslicht-Robard's persistence brought about the disclosures. It was
also a personal tragedy for Felig, who resigned a prestigious post at Columbia University, to
which he had been appointed while the episode was unfolding.

1980 Joseph Cort, physician who while working at Mount Sinai Hospital, New York, faked data
on vasopressin analogues that would stimulate the production of factor VIII without hypertensive
and diuretic side effects.

1980 John Long, pathologist at Massachusetts General Hospital, who faked data on four
allegedly separate cells lines derived from Hodgkin's disease tissue, only one of which was
human (though not Hodgkin's cells) and the remainder were derived from contamination by cells
from a northern Columbian brown-footed monkey. He resigned, and the work was retracted in
the Journal of the National Cancer Institute.

1981 Mark Spector, a Cornell University graduate student, who faked data on a theory or cancer
causation - in which a tumor virus infects a cell causing it to produce the viral src protein. This, a
kinase, then sets up a cascade of other cellular kinases, which finally results in phosphorylation
of the cell membrane ATP- ase. The result is a diminished activity of the ATP-ase
characteristically found in tumor cells but not in normal cells. Given the potential importance of
these findings, others tried rapidly to replicate them, but could not and it was then found that
Spector had used radioactive iodine to label his gels rather than radioactive phosphorus - thus
vitiating the findings. Not all of these were faked, however, but which were true remains
uncertain. Spector;s coauthors retracted the article in Cell in the same year as its publication.

1981 John Darsee, Harvard research worker in cardiology, who was seen to falsify data during a
laboratory study; his overall head of department, the distinguished cardiologist Eugene
Braunwald, decided that this was a single bizarre act and allowed him to continue to work under
close supervision, but terminated his NIH fellowship. Six months later, however, it became clear
that Darsee's data in a multicentre study of treatments to protect the ischemic myocardium were
different from those at the three other units taking part ... Harvard Medical School set up a
committee of investigation, as did the NIH and Emory University, where Darsee had last worked.
It emerged that Darsee had committed an extensive series of frauds, originating during his
undergraduate days at Notre Dame University, and continuing at Emory and Harvard. These
included non-existent patients or collaborators, and invented data, as in the multicentre trial.
There were also procedures and results that on reflection were virtually impossible: drawing
blood from the tail veins of 200 rats weekly for all of their 90- week lifespan, and obtaining
venous blood specimens in all 43 members of a family on two consecutive days after an
overnight fast twice a year as well as complete sets of 24-hour urine specimens (including a 2
year old child). In all, during his career Darsee published over 100 papers and abstracts, many of
them in prestigious journals and with distinguished coauthors; many of these had to be retracted.

Possibly, until recently, more ink has been shed on Darsee's case than on any other. In part this
was because it was the first major publicized case that was not an isolated blemish on the fact of
science (not mad - rather, bad); in part because it concerned prestigious institutions, coauthors,
and journals; in part because of the charismatic personality of one of the central figures; in part
because it started the whole debate about the rights and wrongs of authorship, data retention,
supervision of juniors, and the management of suspected cases of fraud; and finally, in part
because it shifted the whole climate of feeling of trust to thinking the unthinkable - the possibility
that things might not be as they seemed. These ramifications are able explored in Marcel
LaFollette's new book, and a particularly cogent account of why Darsee was trusted in the
conditions prevailing at the time is provided by his former mentor, Eugene Braunwald.

1983 William Aronow, a cardiologist at Long Beach, California, who after the Food AND Drug
Administration had found irregularities in five studies involving four different drugs between
1974 and 1978 - with "all discrepancies noted being on the side of favoring drug efficiency" -
agreed not to participate in further drug trials without FDA approval. Dr. Alan Lisook, chief of
the FDA's clinical investigation branch, stated that the agency had reached similar agreements in
seven other cases - while after an official procedure 50 researchers had been disqualified...

1985 Robert Slutsky, a resident in cardiological radiology at the University of California, San
Diego, who between 1978 and 1985 was the author or coauthor of 137 articles. The possibility of
fraud was raised by an astute referee who queried apparently identical statistical results for two
different sets of data of data in consecutive articles he had to read when Slutsky applied for
promotion. An inquiry found experiments and measurements that had never been done, incorrect
procedures, and reports of statistic analyses that had never been performed. A committee of
investigation was set up and, after interviewing coworkers, looking at lab notebooks, and reading
the articles, classified these as valid (77) questionable (48) or fraudulent (12). Some of these last
were retracted, and a few statements of the validity were also published.

This is yet another important case, illustrating several other features about medical misconduct.
Firstly, there was Slutsky;s high productivity - at one stage he was producing one paper every 10
days - which occasioned little but admiration from his colleagues. Secondly, several of the latter
were happy to accept "gift" authorship on papers reporting work with which they had had
nothing to do - and indeed couldn't have had, given that the work hadn't been done. Thirdly,
there was the way in which this junior worker had successfully managed to escape any
supervision of his research by his seniors. And, lastly, there was the curious behavior of several
journals, which either declined to insert any retraction or statement of validation (sometimes but
not always on legal grounds) or, if they did so tended to do this in such terms as to make the
retractions non-retrievable on electronic databases.

1986 Charles Glueck, professor of internal medicine at the University o.f Cincinnati, published in
1986 an article in Pediatrics concluding that a low cholesterol diet, supplemented with drug
treatment, lowered blood cholesterol concentrations in children but did not interfere with their
growth and development, or sexual maturation. A committee of inquiry found that he had
committed serious scientific misconduct by misrepresenting the study findings. It had not been a
prospective study, as stated, the data was internally inconsistent, and the charts of some of the
patients did not contain data to substantiate the findings cited. An NIH review concluded that,
given the diversity of opinion about the term prospective, this finding was not substantiated, but
the second and third findings were. The committee recommended that Glueck should be debarred
from receiving federal funds for two years and serving on any peer review or advisory committee
for five years. Glueck resigned from his post (moving immediately to become director of the
Cholesterol Center at the Jewish Hospital of Cincinnati), and the article was retracted.

1986 Claudio Milanese, an Italian immunological worker at Harvard's Dana-Farber Cancer
Institute, who, as coauthor of articles in Science and the Journal of Experimental Medicine,
reported that IL-4A, s lymphokine, induced interleukin-2 receptors. Failure to replicate the works
after Milanese had returned to Italy (Turin) led to an investigation and the finding that IL-4A did
not exist. The articles were retracted by Milanese;s colleagues and two unpublished manuscripts
were withdrawn.

1986 Theresa Imanishi-Kari, a Tufts University biologist who fabricated key data in transgenic
mice experiments. The work, published in Cell, showed that genetic changes could be triggered
by the transplanted genes, and had as coauthors five colleagues, including the Nobel Laureate,
David Baltimore. In response to suggests by Margot O'Toole, a postdoctoral worker, that some
of the work haver been done, an ad hoc committee of inquiry was convened by Tufts, which
concluded that there had been only scientific disagreement, and a review of the case by Herman
Eisen, professor at the Massachusetts Institute of Technology, found minor errors but no fraud.

From this point onwards there was a long chain of events, starting when a colleagues of
O'Toole's contract the well known "fraudbusters" Walter Stewart and Ned Feder of NIH (who
had had a prominent role in the Darsee story); after examining the 17 pages from Imanishi-Kari;s
notebooks, they said that they suspected misconduct. In May 1988 the Congressional Committee
on Energy and Commerce's Subcommittee on Oversight and Investigations, chaired by
Representative John Dingell, held its first hearing, focusing o this case, subsequently turning
over the notebook pages to the secret service. At its fourth hearing, in May 1990, the latter was to
show that the records and reported experiments were "j=not contemporaneous with respect to
time." In March 1991 a draft report of the Office of Scientific Integrity (OSI) found serious
scientific misconduct, whole two months later, Baltimore - who had previously defended the
article very vigorously and attacked Stewart, Feder, and Dingell's staff for unwarranted
meddling - accepted the findings and apologized for his failure to act rigorously in investigating
Margot O'Toole's doubts.Baltimore, who had initially made minor corrections to the article in
Cell, the retracted it. Again, the sequel was a personal tragedy for Baltimore, who resigned his
post as president of Rockefeller University, to which he had been appointed only 18 months
beforehand. Very recently, however, given that the U.S. Attorney has decided not to prosecute
Imanishi-Kari, Baltimore has apparently "unretracted" the article.

1987 Stephen Breuning, a psychologist at the University of Pittsburgh who faked data purporting
to show that in retarded children stimulant drugs were more effective and had fewer side effects
than the standard treatment with tranquilizers. This is said to have led to changes in therapeutic
policy, notably in the state of Connecticut. Breuning was dismissed and the case referred to the
U.S. Attorney's office; in the autumn of 1988, after pleading guilty to two charges of making
false statements on federal grant applications, he was sentenced to serve 60 days in a halfway
house, 250 hours of community service, and give years of probation. He was also required to
return to the university $11,352 (his salary from the grants) and to stay out of psychology for the
five-year period. Apparently, not all of the articles were fraudulent, but four were retracted. This
case is important as it is possible the first where there was demonstrably an actual or potential
serious implication for patients, and where criminal prosecution was instigated.

1987 C. David Bridges, an ophthalmologist at Baylor University who was alleged to have used in
an article of his own information in a paper sent to him for peer review by the Proceedings of the
National Academy of Sciences...

1987 Shervert Frazier, a professor psychiatry at Harvard Medical School and former director of
the National Institute of Mental Health, who resigned his professorship after admitting that he
had plagiarized large sections of four review articles published between 1960 and 1975. He was,
however, allowed to continue practicing on the staff of McLean Hospital which is operated by a
group that includes Harvard.

1988 Philip A. Berger, Stanford professor of psychiatry who was found guilty of "deviation from
accepted practices in the conduct and reporting of science." Some participants in a drug trial had
been identified as not taking drugs but were found in fact receiving medication, and some
allegedly normal controls were found to have been suffering from mild senile dementia. After
scrutiny of the investigation's report by the Office of Scientific Integrity Review, Berger was
debarred from Health and Human Services Scientific grants or contracts for three years.

This case is important as Stanford spread the blame among all the coauthors of the articles,
suggesting that every author is responsible for the data in these. And the university also issued an
official statement on its standards for promotions, reminding the faculty that the total number of
publications is not as important as quality, while "least publishable unit" or repetitive publication
would be detrimental to a candidate's record. The university also stated that it was drawing up a
set of guidelines for multidisciplinary research.

1988 Stephen Stahl, a Stanford psychiatrist who was a colleague of Berger's, was faulted in the
same inquiry for using inappropriate controls and inaccurately describing patients in two studies.
Like Berger, he was banned from serving on Public Health Services committees for five years,
and grant applications in which the two collaborated over the following five years were required
to include certification of the reliability from the institutions applying for them.

1989 Douglas Nelson, a physiologist at Northwestern University, Evanston, Illinois, who
"misrepresented the publications status of his papers in manuscripts and grant applications
submitted to NIH." He was excluded from sitting on NIH advisory panels and was required to
submit his federally funded research to supervision.

1989 Lonnie Mitchell, a psychologist of Coppin State University, Baltimore, Maryland, who had
used plagiarized material in a grant application. He was prevented from serving on Public Health
Services advisory committees for five years and required to provide "certification as to the
integrity, honesty, and reliability" of any Public Health Services application made in the
following five years.

1990 Arnold Rincover, associate professor of psychology, University of North Carolina at
Greensboro, was found by a university investigation to have committed plagiarism. He resigned.

1990 Martin Bak, research fellow in surgery at Harvard University Medical School was found by
a university investigation to have fabricated data for a draft manuscript and published abstracts.
He resigned and was banned from receiving federal grants and contracts for three years.

1990 David H. Van Thiel, professor of medicine, surgery, and psychiatry at the University of
Pittsburgh Medical School was found by a university investigation to have plagiarized review
articles in a book chapter he wrote. His tenure was revoked and he was barred from serving on
Public Health Services committees for three years.

1990 L. Cass Terry, professor of neurology at the University of Michigan, was found by a
university investigation to have plagiarized articles sent to him to review as well as using
plagiarized material in portions of his doctoral thesis, grant applications, and a book chapter. He
was banned from serving on Public Health Services committees for five years.

1991 Hiroaki Shimokawa, advanced research fellow in internal medicine at the University o.f
Iowa Medical School, was found by a university investigation to have altered data. He had
returned to Japan by the time of the investigations, but was banned from receiving federal
research and training support for three years.

1991 Paul P. Demedluk, adjunct professor of neurology at the University of California, San
Francisco, was found by a university investigation to have fabricated data in two published
articles and an unpublished paper and book chapter. He resigned and was banned from receiving
federal grants and contracts for three years.

1991 Herbert K. Naito, head of the Cleveland Clinic Foundation's section of lipids, nutrition, and
metabolic diseases, was found by a foundation committee to have committed plagiarism in three
articles. He was asked to resign and banned from serving on Public Health Services committees
for three years.

1991 George E. Egan, senior histology technician in the New York State Department of Public
Health's Wadsworth Center for Laboratories and Research, Albany, New York, confessed to
having altered experimental results by adding snake venom to tissue samples. He resigned and
was banned from receiving federal grants and contracts for three years.

1991 Rakesh Singhal, research associate in neuroscience at Tufts University Medical School, was
found by the a university investigation to have altered and fabricated data. He committed suicide.

1991 Russell P. Santo, assistant scientist in the division of neurosciences at Oregon Regional
Primate Center, Beaverton, Oregon, was found by a center investigation to have used the same
phonograph of cells to represent different sets of data he published s=articles. He resigned and
was banned from serving on Public Health Service committees for three years.

1992 Mitchell Rosner, aa graduate student in embryology at the NIH who faked data showing
that embryonic cell division requires Oct-3, a protein that switches on genes, and that the protein
may even regulate DNA replication in early development. The article in Cell was retracted by his
three coauthors in May 1992, and Rosner withdrew his candidacy for a doctorate at Georgetown
University Medical School.

Other Countries

1992 Isidro Ballart, a South American PhD student at the University of Zurich who faked data to
show that he had produced functioning measles viruses in cell cultures from cloned
complementary DNA. His coauthors retracted the article in EMBO Journal (1990) in 1991.

At the time of writing several other cases under investigation had received some publicity but
had not been included, and hence I have not included them here. (I have also not included any
case in which, though widely publicized, the findings remain equivocal.)