There are a few new developments in the case of Anil Potti, the former Duke oncologist who resigned amidst an investigation into clinical trials he was running — and has been forced to retract seven papers, at last count.
Over the weekend, The Cancer Letter, which has been out front on this case, noted that the North Carolina Medical Board reprimanded Potti late last month. A reprimand carries no sanctions, but is entered into a physician’s public record. According to the consent decree:
Whereas, Duke Medical Center has investigated Dr. Potti’s curriculum vitae and Duke Medical Center biographical sketch concerns and concluded that, while there were some inaccuracies on the biographical sketch and curriculum vitae, they were largely the result of carelessness and honest errors with no clear intention to mislead;
The decree also notes that
Duke Medical Center is currently in the process of conducting a medical research misconduct inquiry related to Dr. Potti’s oncology research work; and
Whereas, Dr. Potti’s conduct as described herein constitutes unprofessional conduct within the meaning of N.C. Gen. Stat. § 90-14 (a) (6)
The state board reserved the right to call Potti back for testimony at any time, as new information surfaces, and the document makes it clear that Potti agreed to all of the terms.
While we we poking around the state medical board site, however, we found records (click on the “Malpractice” tab) indicating that Potti — or his insurance company — has recently paid out for 11 incidents of alleged malpractice. The payments — which are “malpractice judgments and awards that occurred within the last seven years and…Settlements of $75,000 or more that occurred on or after May 1, 2008,” according to the medical board — were made between September 6th and 26th of this year. They concern incidents between November 2007 and July 2009, which is when the trials in question were taking place.
Even at $75,000 each, which is the lowest possible amount that would be listed, that would be $825,000.
Two separate suits have recently been filed against Potti and Duke, on September 7 of this year. One involved eight plaintiffs and another involved one. The first payment listed on the state medical board site predated that filing, and the others are within a matter of weeks of it, so it appears likely these are older suits. We’ve contacted the plaintiffs’ attorneys in the August suits to find out if he knows anything about these cases, and will update with anything we hear back.
In the meantime, we doubt any of this information will show up in the daily stream of press releases that Potti has sent out on his behalf. Today’s, for example, is titled “Anil Potti Has Won Multiple Accolades For His Contribution In The Field Of Lung Cancer” and notes that he “loves watching movies.”
Update, 5:30 p.m. Eastern, 12/5/11: Thomas Henson, who is representing eight plaintiffs in suits against Potti and Duke, sent us the following comment by email:
…I am aware that before the lawsuit was filed, there were persons who elected not to pursue litigation.
Hat tip: Zachary Tracer
What exactly is the standard in North Carolina for “carlessness” or “honest error”? ‘I wish it were true so I wrote it down?’
Only a reprimand? A mere slap on the wrists!
Shame on the North Carolina Medical Board.
I suspect — only a suspicion. mind you — that the North Carolina Board made the right call. Three reasons.
First. the core areas of concern to the Board are likely the usual things: delicensing the grossly incompetent and impaired, punishing conflicts of interest, and protecting physicians from unlicensed competition, for the most part. Dr. Potti’s sins lie in other areas. Personally, I get worried when professional organizations start punishing licensees because the licensee has broken some other societal norm.
Second, professional boards have limited funding and sometimes depend on volunteer professional staff. If the misbehavior of a licensee is being adequately addressed by another agency, or by private litigation, parallel action by the Board may be a waste of public money. It also raises the possibility of seemingly inconsistent findings due to differing legal standards: e.g. incompetence and malpractice are two very different things.
Finally, those Boards — for very good reasons — really hate being used and manipulated by lawyers or other agencies for purposes unrelated to professional discipline. If nothing else, it tends to turn their relatively summary, informal procedures into a technical legal mess they’re not equipped to deal with.
Well said!
This is an interesting story, and an interesting blog. I enjoyed the time I spent here this morning.
Here is a reference to a recent, systematic study of retractions published in the medical literature. Wondering if this is on your radar?
Curr Med Res Opin. 2011 Jun;27(6):1175-82. Epub 2011 Apr 7.
Lack of involvement of medical writers and the pharmaceutical industry in publications retracted for misconduct: a systematic, controlled, retrospective study.
Woolley KL, Lew RA, Stretton S, Ely JA, Bramich NJ, Keys JR, Monk JA, Woolley MJ.
Thanks for the comment. We reported on that paper in April: http://www.retractionwatch.com/2011/04/15/want-to-avoid-a-retraction-hire-a-medical-writer-say-medical-writers/
For a collection of our posts on studies of retractions, see our “studies about retractions” category: http://www.retractionwatch.com/category/studies-about-retractions/
Dr Potti’s reprimand from NC Medical Board should be viewed in relation to the wide variance in standards from state to state: some states are aggressive and others are passive to the point of doing nothing (in my personal experience.) California, for example, has a highly aggressive board and will investigate + punish frequently. Other states, not so much (see my veryvery short web log on conradseitz.wordpress.)
Whether the Medical Board should punish Potti for nonclinical malfeasance is an issue that can be debated. However, the fact that Potti’s lawyers have paid out at least 11 settlements on malpractice charges recently cannot be ignored by an active Board. Malpractice is basically clinical, even if the charge is a technicality such as lack of informed consent.
Potti is displaying a pathology that suggests he is not in touch with reality, at least on the issue of his credibility; I think that leaves his ability to practice medicine open to question. Unfortunately, even aggressive medical boards steer clear of judging a physician’s mental status unless he/she is clearly psychotic AND disruptive.
Being paranoid or pathologically narcissistic is OK (not that I’m suggesting Potti is either.)
We also don’t know the results of IoM’s investigation into Duke yet. On the other hand, we may never know.
Toby – have you been following this case???
Yes, if not in real detail. Maybe more to the point, I’ve represented health care providers, insurers, and, once, a patient in cases involving professional discipline proceedings or agency investigations running in parallel with litigation. Too long a story for this space. The bottom line is that the situation gets gamed, and neither forum does what it’s supposed to do. The result may (or may not) be that Potti gets what he deserves in a general sense, but the system has always been distorted to achieve its result. I place a much higher value on the legitimacy and integrity of the system than on the result in any particular case. Not everyone agrees, but that’s where my attitude comes from.
Dear Conrad,
I think his sole pathology is merely a complete lack of morality, which is typical of sociopaths. In fact such individuals are really dangerous anywhere and society still hasnt found ways of dealing with them. But I stand by the belief that until some way of correcting these reckless people is found, they should be kept away from any capable position and always under strict surveillance. I would vote for expulsion and isolation.
A sociopath? A bit much, don’t you think?
Certainly not. A small research on the topic will reveal that people without any sense of morality, thus no shame or remorse, make up for 10-30% of human populations of all social segments. Usually that stand for over 50% of criminalitym and only a very small portion (about 1%) are truly physically violent.
They are considered a big recurrent problem because of their numbers and the fact that they cannot be corrected with punishment; “never learn”. Recurrent fraudsters and politicians usually are their favored specialities as they are not too afraid of being caught and exposed.
These are called sociopaths or psychopaths.
Hey, leave him alone. He is a “A Certified Oncologist And Dedicated Humanitarian”. Or so he said on Twitter yesterday. His Twitter feed makes up for in narcissism what it lacks in coherence.
Duke University attorneys have sent a letter of objection to the NC Medical Board. Quoting from the news report (http://www.heraldsun.com/view/full_story/16835284/article-Duke-challenges-Potti-reprimand-wording?instance=search_results ) “In a letter to the board from the University General Counsel’s Office, Duke said the organization’s conclusion that the university had found inaccuracies on Potti’s biographical sketch and curriculum vitae to be “largely the result of carelessness and honest errors with no clear intention to mislead” was simply “inaccurate” itself.”
how can we rid ourselves of this fraud?