A year ago, an academic society recommended nine papers be retracted. Journals have retracted only two.

Last year, an academic society recommended that journals retract nine papers by a researcher in Japan who collaborated with a notorious fraudster. Only two have been retracted.

The researcher is Yuhji Saitoh of Yachiyo Medical Center and Tokyo Women’s Medical University, who co-authored many papers with Yoshitaka Fujii, an anethesiologist who holds the dubious distinction of having retracted more papers than any other. Already, Saitoh has retracted 39 papers, many of which were co-authored by Fujii. But it turns out Saitoh was not an entirely innocent bystander: After receiving allegations of misconduct, the Japanese Society of Anesthesiologists (JSA) investigated approximately 40 publications by Saitoh.  

The JSA investigation into Saitoh’s work was prompted, at least in part, by a 2016 analysis (that we covered) from two anesthesiologists— John Carlisle and John Loadsman—who examined dozens of Saitoh’s papers, 23 of which he didn’t write with Fujii. Carlisle and Loadsman identified several potential concerns with Saitoh’s work, including that it was unlikely the sampling had been conducted randomly.

According to the report, released last September, a committee “identified ten publications with clear ethics violations, one of which has already been retracted.” Only two of the nine papers have been retracted — a 2004 paper in Anesthesia, and a 2010 paper in the Journal of Anesthesia.

Although it may seem like a straightforward task to retract a paper deemed to be flawed, we’ve chronicled many delays — for notorious fraudsters such as Fujii and Joachim Boldt, who occupy the #1 and #2 positions on our leaderboard, journals have taken years to retract some of their work. Even direct requests for retractions — such as from universities that conducted investigations — can take years for journals to process.

The seven Saitoh papers that remain part of the academic record are:

• “Delayed recovery of vecuronium neuromuscular block in diabetic patients during sevoflurane anesthesia,” Canadian Journal of Anesthesia, published in 2005, has been cited 11 times, according to Clarivate Analytics’ Web of Science.
• “Neuromuscular blockade can be assessed accelerographically over the vastus medialis muscle in patients positioned prone,” Canadian Journal of Anesthesia, published in 2003, has been cited seven times.
• “Train-of-four and double burst stimulation fade at the great toe and thumb,” Canadian Journal of Anesthesia, published in 1997, has been cited 14 times.
• “Recovery of post-tetanic and train-of-four responses at the first dorsal interosseous and adductor pollicis muscles in patients receiving vecuronium,” Canadian Journal of Anesthesia, published in 1996, has been cited seven times.
• “Monitoring of neuromuscular block after administration of vecuronium in patients with diabetes mellitus,” British Journal of Anaesthesia, published in 2003, has been cited 16 times.
• “Recoveries of post-tetanic twitch and train-of-four responses after administration of vecuronium with different inhalation anaesthetics and neuroleptanaesthesia,” British Journal of Anaesthesia, published in 1993, has been cited 41 times.
• “Reversal of vecuronium with neostigmine: a comparison between male and female patients,” Fukushima Journal of Medical Science, published 2009, has not yet been indexed.

The number of citations for each paper does not appear to have changed substantially since one year ago, when the JSA released its report.

Fujii is not a co-author on any of the nine papers it recommended for retraction. As we reported, when the investigation began, Saitoh resigned from the JSA, which permanently banned him.

We contacted the editors of the Canadian Journal of Anesthesia and British Journal of Anaesthesia to learn about the reasons for the delay. CJA editor-in-chief Hilary Grocott told us:

Still working on it.

Grocott added:

As we have a very small staff that handles many hundreds of submissions per year, often things such as the processes involved in handling retractions, despite their importance, take longer than we’d ideally like.  Admittedly, our efforts must first focus on optimizing the quality of the material we publish, in part to pre-emptively avoid future retractions, but also to optimally serve our authors and peer reviewers with timely processing of their new manuscripts.

When we contacted BJA editor Hugh Hemmings, we heard back from Steve Shafer, a professor at Stanford who was asked to coordinate the retractions because he’s handled the process multiple times as the editor of Anesthesia & Analgesia, which has retracted many of Fujii’s papers.

The delay, said Shafer, is because due process takes “a ton of time to handle,” especially for working editors who try to fit in journal duties around surgeries and research and other responsibilities. “We do try to exercise an abundance of caution when pulling something from the literature,” said Shafer, a member of the board of directors of our parent non-profit organization.

In this case, Shafer had to wade through through the original Saitoh papers, the analysis by Carlisle and Loadsman, the JSA analysis, and an extensive response Saitoh after he was asked to provide evidence to support his findings. In the letter, Saitoh defended the papers individually, and claimed that at the time he wrote them, there were no ethics committees at his institutions. (Shafer has investigated, and found that wasn’t true.) Saitoh also said a computer virus had wiped out some of his data, and he had destroyed some to protect the confidentiality of the patients who had participated in his studies.

Saitoh’s letter concludes:

I collected data and wrote manuscript sincerely.

According to Shafer, official retraction of the papers is now “in the works.”

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