Surgical Hero or Delusional Man with a Knife?

Does anyone know who Paolo Macchiarini is?

Once considered a pioneer of regenerative medicine, Paolo fell from grace when it was discovered that he was using patients for experiments.

Deception At Its Best

Netflix has now dramatized the case of Paolo as a true crime series, “Bad Surgeon: Love Under the Knife.”

I found the Netflix series gripping and intriguing. It captures the essence of fraud and deception at an organizational level (my kind of series!).

It is well worth the watch.

It is puzzling how a person could fool such highly recognized organizations as the Swedish Karolinska University and the medical journal Lancet, to say the least. Still, it reflects just how deceptive and convincing this man was.

Paola was hailed as a brilliant thoracic surgeon. After several botched operations, leading to the eventual death of those patients, it came to light that he had no foundation to conduct the surgery he was doing.

In December 2018, Sweden reopened investigations into three previously closed cases, accusing him of acting inappropriately on these three people.

Things just went downhill from there.

In 2019, an Italian court sentenced him to 16 months in jail for falsifying documents and abusing his position.

In 2020, he was indicted for aggravated assault in connection with the three surgeries he was being investigated for. Two years later, he was found guilty of bodily harm, but only in one of the three cases.

In June 2023, the original decision was overturned, and he went to jail for 2.5 years for three counts of aggravated assault. He avoided manslaughter charges because of other complications with the patients at the time of their deaths.

When Love Gets in the Way

At the peak of his fame, he wooed an NBC News producer, Benita Alexander, who was reporting on his windpipe procedures for a 2014 special titled ‘A Leap of Faith.’

Unfortunately, he failed to tell her he was married when they met. He lied, saying that he was divorced. He swept her off her feet with a lavish lifestyle and a promise of more. They became engaged shortly after.

Subsequently, it would come to light that Paolo lied about his current marriage status and about a lavish wedding that was planned and would be officiated by Pope Francis.

In 2015, she called off their engagement after she began suspecting that the Swiss-born doctor had lied about their wedding, his career, and marital status.

Paola’s Claim to Fame

Paolo Macchiarini’s fall from grace was as rapid as his rise to fame.

Four co-workers’ misconduct reports at the Karolinska, his previous arrest in Italy for bribery, the social media outcry, and the evidence from his fiancé (the US newscaster) turned the world against him.

At least seven patients trusted Paolo and his revolutionary process of regenerating human windpipes by seeding plastic scaffolds with stem cells from the patient’s own bone marrow.

The Karolinska Institute was so desperate to hire Paolo and reap the fame and accolades that came with him that they ignored warnings from others that he already had accusations of scientific misconduct surrounding his work.

Paolo removed the patient’s trachea (windpipe) and implanted an artificial one coated with stem cells.

The surgeries were performed on compassionate grounds (all other possibilities had been exhausted, and effective in animal studies had been achieved).

Paolo was allowed to proceed despite warnings from other prominent Professors outside of Karolinska that the science and success of the tracheal implants were unfounded by any studies.

He and 24 co-authors tried to publish their findings on his first patient in the New England Journal of Medicine. However, his paper was rejected due to insufficient data, so he resubmitted it to The Lancet.

Tremors in His Success

One of the more junior researchers was seduced by Paolo’s charm. Invited to participate in Paolo’s ground-breaking surgery and research, Karl-Henrik Grinnemo’s life was about to change forever, but not in a good way.

Disgusted by the treatment that one of Paolo’s patients received and the prolonged agony that she was put through, Grinnemo and three other colleagues, all of whom were involved in her care, embarked on a pathway to get the radical surgery shutdown.

Over the next three years, they tried in vain to alert the Karolinska Institute to Paolo’s lies about his ethical approvals (which he did not have), his false data on which animal students were based, and his lies to the scientific world about the patient’s conditions.

It all fell on deaf ears.

Money Talks

Instead of getting concerned, the Karolinska investigations ignored the claims about Paolo, and focused on the four whistleblowers.

All they got was persecution and the deformation of their character at great personal cost to their careers.

With the promise of recruiting almost 100 patients into clinical studies to be performed at Karolinska and nearly $50 million for a new research center in Asia, it was too much for them to turn down. Instead, they tried to silence the whistleblowers.

Who knows how it would have ended without articles in the New York Times in 2014 and Vanity Fair in 2016?

The mind boggles thinking about the further damage and deaths that could have resulted.

Spring Cleaning at Karolinska

The unwanted press directed at Karolinska caused a cascade of resignations. The President, Dean of Research, an advisor to the President, and eventually the entire Board were all fired or resigned.

Unfortunately, the damage was done.

The whistleblowers received little reward for their efforts and are all still fighting for their careers and reputations. Unlike in the US, European whistleblowers do not get the same protection and compensation.

Where is Paolo now?

Now at age 66, it is over a decade since he performed his first operation.

A Swedish court sentenced Paolo Macchiarini to 2.5 years behind bars. Since December 2023, 11 of his research papers have been retracted, including four from The Lancet medical journal.

In 2016, he was fired from the Karolinska University for claims of scientific negligence and falsification of his CV.

He was conducting research and publishing results from baboon studies in Russia and still believed he was a success until the start of his two-and-a-half-year sentence in Sweden.

A Decided Lack of Ethics

It is a good reminder of how unethical behavior can be played out.

Three points stick out for me in this story:

i) The ethical dilemma of self-importance and how people can become so engrossed in their own self-importance and narcissistic behavior that they can destroy the lives of others and not even realize it.

Not only did Paolo Macchiarini lie and commit scientific fraud, causing the death of at least seven patients, but he also ruined the life of the person he supposedly loved and the lives of at least four of his co-workers.

ii) Seemingly, ethical organizations can hide the truth if given the wrong incentives. Prestigious and well-regarded organizations such as the Karolinska University and Institute can hide the deceptive behavior of their senior management for the sake of continued fame and money.

iii) It’s no wonder people do not speak up about unethical behavior when there is such a lack of protection and no reward for doing so. Unlike in the US, these whistleblowers received nothing in return for their efforts except a damaged career and ruined personal life.

Till next time,

Calvin