Letters from

Peter Andréasson, Carl Elliott, Jeffrey Bub, and David Z Albert

To the Editors:

In the April 5 issue of The New York Review, you published an article entitled “Knifed with a Smile.” I would like to make a few comments regarding that text:

1. The text states that none of the whistleblowers recall receiving an apology from Karolinska Institutet (KI). That could very well be the case; however, it is an irrefutable fact that on December 20, 2016, KI published a public apology in one of the most widely distributed and read Op-Ed pages of all the Swedish dailies, Dagens Nyheter: “That the whistleblowers who raised the alarm about Paolo Macchiarini’s activities were not listened to is unacceptable, and here, in this article, KI publicly apologizes to the whistleblowers.” (Text in Swedish: “Att de visselblåsare som larmade om Paolo Macchiarinis verksamhet inte blev hörda är oacceptabelt och här ber KI offentligt visselblåsarna om ursäkt för det.”) This information was sent to Professor Elliott on October 31, 2017.

2. Furthermore, the article implies that KI is actively trying to forget or hide the Paolo Macchiarini case. This is simply not correct. There is an ongoing investigation of scientific misconduct regarding publications in which Paolo Macchiarini is named as the principal investigator. A decision by Karolinska Institutet’s vice-chancellor regarding that investigation will come later this spring. During the past two years, Karolinska Institutet has also implemented new and revised routines and guidelines and reinforced supervision as a direct consequence of this case—and there are more changes yet to come.

3. Finally, Karolinska Institutet has made a significant effort to create and maintain total transparency throughout the process and case regarding Paolo Macchiarini and his involvement with KI. This includes openly referring to and citing criticism against KI. Please take a look at our website for more details: ki.se/en/news/themacchiarini-case-timeline.

Peter Andréasson Chief Press Officer Karolinska Institutet Stockholm

Carl Elliott replies:

Peter Andréasson’s letter should give no one any confidence that the Karolinska Institute has learned from the Macchiarini scandal. It is true that Karin Dahlman-Wright, the pro-vice-chancellor of the Karolinska Institute, informed me of an article in Dagens Nyheter on December 20, 2016, which included a brief statement of apology to “the whistleblowers.” However, the supposed apology seemed almost laughably inadequate. It concerned a single finding of research misconduct by Macchiarini in an article published in Nature Communication, and the misconduct had concerned tissue engineering in rats. Yet by the time the article appeared, Macchiarini had been charged with manslaughter; the vicechancellor of the Karolinska Institute had resigned in disgrace; an external review had identified research misconduct in six published papers by Macchiarini; and at least five patients who had gotten synthetic trachea implants from Macchiarini were dead. In the article cited, Dahlman-Wright addressed only the single instance of research misconduct, not the suffering inflicted on patients. She did not apologize for the fact that the leaders of the Karolinska Institute and the Karolinska University Hospital had protected Macchiarini. She failed to mention that institutional leaders had reported the whistleblowers to the police and threatened to fire them. In fact, she did not even do the whistleblowers the courtesy of mentioning their names. Neither does Andréasson. For the record, the whistleblowers are Matthias Corbascio, Thomas Fux, KarlHenrik Grinnemo, and Oscar Simonson. When I followed up by e-mail to Dahlman-Wright, I questioned the effectiveness of an apology that the whistleblowers themselves did not consider sufficient. I also pointed out that they had been threatened with dismissal and reported to the police. In response, Dahlman-Wright referred me again to the article in Dagens Nyheter and said my questions about the threats should be directed to the Karolinska University Hospital. A spokesperson for the hospital replied that it had no plans to apologize. When I put the same questions to the newly appointed vice-chancellor, Ole Petter Ottersen, he declined to answer and referred me back to the statement by Dahlman-Wright.

For years officials at the Karolinska Institute insisted that the whistleblowers were wrong and that we should believe the administration instead. Many did, and the results were disastrous. Now Karolinska Institute officials are again insisting that the whistleblowers are wrong and that true reform is underway. Who should we believe this time?