Nature Communications retracts Macchiarini’s 2014 paper.

Retraction Watch

Tracking retractions as a window into the scientific process

Reading about embattled trachea surgeon Paolo Macchiarini? Here’s what you need to know

with 18 comments

Paolo Macchiarini

Paolo Macchiarini

The media has been abuzz in the last few weeks with developments in the ongoing story about “super surgeon” Paolo Macchiarini. We’ve been covering the allegations against him for years (and invited him to publish a guest post on our site). Below, we present a timeline of recent events, to keep you abreast of what we know so far.

Macchiarini was famous long before accusations of misconduct arose, once-heralded for creating tracheas from cadavers and patients’ own stem cells. However, the glow of his success was diminished somewhat after some Karolinska Institutet (KI) surgeons filed a complaint in 2014 — alleging, for instance, Macchiarini had downplayed the risks of the procedure and not obtained proper consent. In response, KI issued an external review by Bengt Gerdin of Uppsala University.

Here’s what’s happened since:

April 12, 2015: KI’s Ethics Council clears Macchiarini of a number of accusations leveled against him by Pierre Delaere at KU Leuven in Belgium, who had suggested the surgeon had engaged in scientific misconduct, including fabricating data. This is one of two ongoing KI investigations into his work.

May 27, 2015: KI releases an English translation of the report of Gerdin’s investigation, which found examples of misconduct in seven of Macchiarini’s published papers. KI gives the co-authors of his articles time to respond to the finding, after which it will make its final ruling.

June 22, 2015: Swedish Research Council freezes grant payments to the KI center run by Macchiarini.

June 26, 2015: Macchiarini calls Gerdin’s misconduct investigation “a potentially disastrous miscarriage of justice.”

June 29, 2015: Ola Hermanson, Macchiarini’s co-author on his 2011 Lancet paper, says the misconduct investigation contains “serious flaws and formal errors.”

August 28, 2015: After reviewing the evidence gathered during Gerdin’s investigation, KI’s Vice Chancellor Anders Hamsten rules that Macchiarini acted in some cases “without due care,” but that his behavior “does not qualify as scientific misconduct.”

October 9, 2015: We publish a guest post by Macchiarini, in which he criticizes us for including de-identified medical information about some of his patients in a post, and covering allegations before they have been thoroughly investigated.

January 5, 2016: Vanity Fair publishes a story about how Macchiarini romanced an NBC producer while she was working on a story about him, and in the process raises the allegation he lied on his CV when applying to the KI position.

January 13, 2016: Swedish Television airs a series of documentaries about Macchiarini and his work, alleging, in part, that he operated on patients in Russia whose conditions were not life-threatening enough to warrant such a risky procedure.

January 28, 2016: KI announces it may reopen its misconduct investigation into Macchiarini following the allegations revealed by SVT.

February 4, 2016: KI announces it will not extend Macchiarini’s contract, and he will “phase out” his research from now until November 30.

February 5, 2016: KI says it will issue a new external investigation of Macchiarini, examining questions about his recruitment and the handling of previous allegations of misconduct.

That same day, four whistleblowers release a statement arguing they had provided evidence of misconduct long before the SVT documentary series aired.

February 6, 2016: The secretary general of the Nobel Assembly — the body responsible for choosing the Nobel Prizes — resigns after saying “he may be involved” in KI’s investigation of Macchiarini.

February 9, 2016: KI confirms that Macchiarini’s CV did, in fact, contain inaccuracies when he applied for his adjunct position in 2010.

February 11, 2016: The Royal Swedish Academy of Science asks for a new investigation, and for changes to a 2011 Lancet paper, Science reports:

The Academy find it deeply unfortunate that the well-publicised report about the first operation with an artificial trachea, published in The Lancet in 2011, remains unchanged on the journal’s website. The Academy demands that a supplement is added to the journal, accounting for the further events, the complications and the patient’s death.

February 12, 2016: SVT releases additional short films comparing one patient’s medical record to what is reported in Macchiarini’s articles.

February 13, 2016: Hamsten resigns, citing criticism of the investigation.

February 23, 2016: The Royal Swedish Academy of Sciences voices its concerns about Macchiarini’s 2011 Lancet paper, claiming it severely misrepresents the state of the patient who received the transplant, who experienced severe complications and eventually died.

March 15, 2016: A KI spokesperson confirms that a new ethics council will be appointed, but the new members have yet to be determined.

March 23, 2016: KI dismisses Macchiarini, effective immediately.

April 1, 2016: The Lancet issues an expression of concern for Macchiarini’s 2011 paper, and removes three more authors, upon their request.

August 31, 2016: A report headed by the chairperson of the Swedish National Council on Medical Ethics (and commissioned by the Karolinska University Hospital) found the environment contributed to Macchiarini’s problems. According to Nature News, Macchiarini’s work environment:

provided a “culture of silence”, a lack of respect for rules and “group thinking”.

September 6, 2016: The results of another external inquiry into KI’s handling of the Macchiarini case criticized the institution:

including that Macchiarini’s recruitment in 2010 and the extension of his contract in 2013 were pushed through improperly. The report also found that KI cannot be completely absolved of responsibility for the synthetic trachea transplantations performed at Karolinska University Hospital.

September 9, 2016: Science reports that Sweden’s Central Ethical Review Board has found Paolo Macchiarini guilty of misconduct in a 2014 paper.

October 14, 2016: Nature Communications issues an expression of concern for the 2014 paper flagged by the Central Ethical Review Board.

December 9, 2016: Macchiarini issues an erratum for “Laryngeal transplantation in minipigs: vascular, myologic and functional outcomes” in European Archives of Oto-Rhino Laryngology, noting:

Although suitable permissions were obtained, the first publication and the permission granted by the publisher of the first publication were inadvertently not acknowledged for Figs. 2e and 4. The complete permission details are given below.

December 20, 2016: KI declares Macchiarini and three co-authors committed misconduct in the 2014 Nature Communications paper, which it asks to retract.

March 21, 2017: Nature Communications retracts Macchiarini’s 2014 paper. Macchiarini forwarded us his communications with the journal, in which he says KI lost some of his data, and he stands by the conclusions.

Note: The timeline will be updated as new events occur in this ongoing case.