Retraction Watch

Tracking retractions as a window into the scientific process

Two groups mistakenly publish case reports on the same patient

with 4 comments

Journal of Clinical Pharmacy and Therapeutics

Talk about a popular patient: A woman who developed a case of internal bleeding while taking the anticoagulant Xarelto (rivaroxaban) was written up in not one — but two — case reports. The trouble was, both groups didn’t realize what the other was doing, so the more recent article is now being retracted from the Journal of Clinical Pharmacy and Therapeutics.

The authors, a trio of doctors at Sakarya University in Turkey, described the case of a 75 year-old woman who came to the emergency room for fatigue and stomach pain after taking rivaroxaban for three days. A scan revealed a rectus sheath hematoma.

However, the case had already been published a few months earlier in the Indian Journal of Pharmacology by a separate group of doctors from Sakarya, along with authors from Yenikent State Hospital and Vakfikebir State Hospital.

Here’s the notice for “Spontaneous rectus sheath haematoma associated with rivaroxaban treatment”:

The above article, published online on 10 November 2014 in Wiley Online Library (, has been retracted by agreement between the authors, the journal Editor in Chief, A. Li Wan Po, and John Wiley & Sons Ltd. The retraction has been agreed because, unknown to the authors, another group published a similar study based on the same material in the Indian Journal of Pharmacology: Kocayigit I, Can Y, Sahinkus S, et al. Spontaneous rectus sheath haematoma during rivaroxaban therapy. Indian Journal of Pharmacology. 2014;46(3):339–340. doi:10.4103/0253-7613.132193.

A few years ago, the same thing happened when two groups from the Kwandong University College of Medicine each published a case report on the same patient with a rare case of basal cell carcinoma.

We’ve reached out to first author A. Tas Tuna and the editor-in-chief Alain Li Wan Po. We’ll update with any reply.

Hat tip: Tansu Kucukoncu

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  • turtle of doom September 1, 2015 at 9:51 am

    This is funny, but surely annoying for the group whose honest work is now being retracted.

    Because I think that the scientific process should be documented, no paper should ever be retracted. Notices should be appended to the original paper – quite easily done nowadays with electronic publishing – which caution the readers. In this case, a notice could have mentioned the earlier study, and even pointed out differences between both texts.

    That way, mishaps like this and scientific misconduct could be properly cited.

  • A Nawn September 1, 2015 at 11:10 am

    It’s unfortunate. Being “scooped” happens often enough in the sciences, and is exacerbated by having many labs working in similar topics. Didn’t think it would happen in case reports too.

  • qqaaqq September 2, 2015 at 10:34 am

    being scooped is usually grounds for rejection based on “this isn’t novel”… and sometimes it’s grounds for journals publishing companion pieces. sometimes there is a correction stating that someone already did something similar.

    in this case, i don’t get why the retraction… a correction, sure. the original authors didn’t “own” the data of the patient any more than the later authors. and if, in fact, enough identifying information was contained in the papers to identify the subject… that’s kind of a problem of itself. case reports are essentially reviews of a case file: there is no limit on the number of people who can write a review on a given topic so why limit the number of people summarizing a patient’s chart and giving their $0.02?

    Taking this a step further… say I am a student and I hear that John wants to write up patient X. John and I both are competing for competitive specialty. We both write up patient X, but I’m quick and sloppy and submit to a pay for publication journal, toss them a grand, while John does it well and submits to a real journal. My paper is “published” in 3 days from the time I start drafting. His takes 3 months. Then he gets slapped with a retraction because I alert his editor to my preexisting “publication” of a case study on that patient. Hog wash.

    • AaronY September 4, 2015 at 11:42 am

      The purpose of the literature is not to benefit authors, it is to benefit the field. If another researcher or clinician was examining the issue involved and they found the two papers, they might come to the conclusion that this finding has occurred in multiple, independent patients, rather than just for a single patient, which may lead to different actions/conclusions. Removing the second paper is also important for making sure there are no redundant findings included in reviews or meta-analyses.

      The situation you describe at the end would be unfortunate, and I hope that it would be a rare occurrence. Of course, the second paper, written more carefully, might include information not in the first paper, in which case it would/should not be retracted. This situation doesn’t rule out publishing multiple case studies using the same subject, but rather only if they present the same data from that study.

      At the end of the day, the integrity of the literature is more important than any individual’s contribution.

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