The Macchiarini case: The external inquiry into Karolinska Institutet criticises KI on several counts
On Monday, 5 September, the external investigators presented the results of their inquiry into Karolinska Institutet’s handling of visiting professor Paolo Macchiarini. Their report criticises KI on several counts, 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.
The external investigation was conducted by Sten Heckscher, Ingrid Carlberg and Carl Gahmberg, and covers the initial correspondence between KI and Macchiarini in autumn 2009 through 4 February 2016. Matters under scrutiny include the recruitment of Macchiarini in 2010, the extensions of his contract in 2013 and 2015, the division of responsibilities between KI and Karolinska University Hospital regarding the controversial transplantations, and KI’s handling of the scientific misconduct allegations levelled against Macchiarini.
Their report concludes that Karolinska University Hospital bears responsibility for the transplantations of synthetic tracheae performed there. However, the investigators also found that Karolinska Institutet cannot be completely absolved of responsibility for these operations. For example, the university cited the transplantations as research successes in its evaluations of research funding utilization. Furthermore, individuals from KI took part in discussions preceding and following the operations. Consequently it was also KI’s responsibility to ensure that they were performed in accordance with relevant rules and regulations.
Moreover, Karolinska Institutet is accused of nonchalance in the application of the law, including the Freedom of the Press Act and the Administrative Procedure Act, an attitude that caused failings in Macchiarini’s recruitment and the extensions of his contract. The report also criticises the manner in which the allegations of scientific misconduct against Macchiarini were managed. For example, decisions were not justified in the way provided by the Administrative Procedure Act.
The investigators proceed to discuss how responsibility should be divided and how the consequences of failing to act upon this responsibility should be assessed. The report concludes with a discussion on structural issues that could have contributed to the mistakes made.
About the investigators
Sten Heckscher is a former president and justice of the Supreme Administrative Court of Sweden, cabinet minister, under-secretary of state and national police commissioner.
Ingrid Carlberg is an author and journalist, and honorary doctor of medicine at Uppsala University.
Carl Gahmberg is professor of biochemistry at Helsinki University.
Pia Cedermark, Justice of the Swedish Administrative Court of Appeal, served as secretary to the inquiry.