Karolinska Institutet's handling of a number of issues related to Paulo Machhiarini's activities

Decision in short:

The surgeon Paolo Macchiarini was employed by Karolinska Institutet (KI) in 2010 as a guest professor in regenerative surgery. The position was combined with a role as senior
physician at Karolinska University Hospital. As such, Paolo Macchiarini conducted a number of transplantations using artificial tracheas. Afterwards, the transplantations have been severly criticised.

Paolo Macchiarini’s activities at Karolinska Institutet and Karolinska University Hospital have been reviewed in several different ways, including a preliminary enquiry by the public prosecution authorities concerning the operations conducted in Sweden. This enquiry was concluded in October 2017. KI's responsibility for the activities has been examined in a review that was presented in a special report.

The purpose of the Swedish Higher Education Authority’s (UKÄ) review has been to examine a number of issues falling under the purview of the Authority’s supervisory responsibility. UKÄ’s review was based largely on the report on Karolinska Institutet and an extensive complaint received by the Authority. UKÄ has also asked a number of questions to KI’s board where the Authority has found there to be outstanding issues that need to be clarified.

Serious criticism

UKÄ’s review has included looking at how Karolinska Institutet has handled the reporting of secondary employment, suspicions of research fraud and Paolo Macchiarini’s employments. UKÄ’s assessments in the decision lead the Authority, in short, to express serious criticism of KI. Overall, the investigation into the case gives the impression that Karolinska Institutet wanted to protect Paolo Macchiarini’s reputation as a researcher at all costs and retain him as an employee. The reasons for this assessment include KI:

  • neglecting to fully examine his secondary employment,
  • not investigating several suspicions against him regarding research fraud,
  • insufficiently conducting the investigations of research fraud that were actually initiated
    regarding him, and
  • extending one of his employment contracts in contradiction to the higher education institution’s appointments procedure.

These discovered shortcomings are so serious that UKÄ cannot be satisfied with this criticism. Therefore, in 2018 the Authority will follow up KI’s work with its plan to address these areas and, in particular areas, it will review policy documents and cases at KI, the latter through special random controls.