Scott Reuben

Scott S. Reuben (born 1958) is an American anesthesiologist who was Professor of Anesthesiology and Pain Medicine at Tufts University in Boston, Massachusetts and chief of acute pain at Baystate Medical Center in Springfield, Massachusetts from February 1991[1] until 2009 when he was sentenced to prison for healthcare fraud. Reuben was considered to be a prolific and influential researcher in pain management, and his purported findings altered the way millions of patients are treated for pain during and after orthopedic surgeries.[2] Reuben has now admitted that he never conducted any of the clinical trials on which his conclusions were based "in what may be considered the longest-running and widest-ranging cases of academic fraud."[3] Scientific American has called Reuben the medical equivalent of Bernie Madoff, the former NASDAQ chairman who was convicted of orchestrating a $65-billion Ponzi scheme.[2]

Scott S. Reuben
Born1958
OccupationAnesthesiologist
Criminal statusReleased in 2010
Conviction(s)Pleaded guilty February 24, 2010
Criminal chargeHealth care fraud
PenaltySix months in federal prison, three years' supervised release, $5,000 fine, forfeiture of $50,000, $360,000 restitution

Background

Reuben was educated at Columbia University.[4] He graduated from medical school at the State University of New York at Buffalo in 1985 and undertook his anesthesiology residency at Mount Sinai Medical Center in New York City.

Reuben fell under suspicion when Baystate conducted a routine audit in May 2008 which revealed that Reuben had not been given approval for two studies that he intended to present during the hospital's research week. On March 10, 2009 a Baystate spokeswoman announced that Reuben admitted to fabricating many of the data underlying his research. Reuben never conducted the clinical trials that he wrote about in 21 journal articles dating from at least 1996.[2][3] In some cases, he even invented the patients.[5] Although Reuben often co-wrote papers with other researchers, Baystate found that the other researchers did not know about or participate in Reuben's studies,[5] and their names were forged on documents.[2][4] The hospital asked the journals to retract the studies, which reported favorable results from painkillers including Pfizer Inc.'s Bextra, Celebrex and Lyrica and Merck & Co. Inc.'s Vioxx. His studies also claimed Wyeth's antidepressant Effexor could be used as a painkiller. Pfizer gave Reuben five research grants between 2002 and 2007. He was a paid member of the company's speakers bureau, giving talks about Pfizer drugs to colleagues.[6][7] Reuben also wrote to the Food and Drug Administration, urging the agency not to restrict the use of many of the painkillers he studied, citing his own data on their safety and effectiveness.[7]

"Doctors have been using (his) findings very widely," said Steven Shafer, editor of Anesthesia and Analgesia, a scientific journal that published ten articles identified as containing fraudulent data.[8] "His findings had a huge impact on the field."[6] He also described Reuben's actions as the biggest case of fraud in the history of anesthesiology.[5] Fellow editor Paul White believed that Reuben's fraudulent studies may have actually harmed patients due to the sale of "billions of dollars' worth of drugs" that caused slower recovery times.[2]

Reuben's work had actually come under scrutiny as early as 2007, when several anesthesiologists noticed his studies never showed negative results.[4] Greg Koski, former director of the Office for Human Research Protections, said the fraud was unusual because Reuben was able to carry it on for almost 13 years without being caught by the peer review process.[5]

All of Reuben's 21 fraudulent articles, as well as the article abstracts, are documented in the magazine Healthcare Ledger.

Tufts has since cut ties with Reuben,[7] and his Massachusetts medical license was permanently revoked after a period in which he voluntarily agreed not to practice.

Sentencing

On January 7, 2010 Reuben agreed to plead guilty to one count of health care fraud. Prosecutors alleged that Reuben obtained thousands of dollars in grants for research that he never performed.[9] He formally pleaded guilty on February 21, 2010 before Judge Michael Ponsor. On May 24, Ponsor sentenced him to six months in prison, followed by three years of supervised release. He was ordered to pay a $5,000 fine, forfeit $50,000 to the government and make $360,000 in restitution to pharmaceutical companies.[10][11] The plea deal effectively ended his career as a doctor; most states will not grant medical licenses to convicted felons.

On November 16, 2011 the U.S. Food and Drug Administration (FDA) issued an order permanently debarring Reuben from assisting in drug applications.[12]

Impact

A 2009 review of systematic review articles used in evidence-based medicine found that while some reviews were no longer valid when the Reuben studies were removed, the conclusions in the majority of them remained unchanged.[13] The review found that the key Reuben claims that needed to be re-examined were "the absence of detrimental effects of coxibs on bone healing after spine surgery, the beneficial long-term outcome after preemptive administration of coxibs including an allegedly decreased incidence of chronic pain after surgery, and the analgesic efficacy of ketorolac or clonidine when added to local anesthetics for intravenous regional anesthesia."[13]

In 2010 the editorial in Anaesthesia argued that,[14]

Reuben's fabricated data may have had impact beyond systematic review conclusions because they addressed topical questions for which anaesthetists, surgeons, and patients seek answers, such as the utility of multimodal anaesthesia, or whether non-steroidal anti-inflammatory drugs (NSAIDs) influence bone healing ... Millions of people have had NSAIDs after fractures, trauma or orthopaedic surgery without problems of bone healing. The plausibility of a sizeable negative effect of NSAIDs on bone healing has to be questioned.

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See also

References
  1. "Fraud Case Stuns Anesthesiologists Post-op Pain Expert Fabricated Years of Data", Anesthesiology News, 35 (4), April 2009, retrieved 27 December 2015
  2. "A Medical Madoff: Anesthesiologist Faked Data in 21 Studies", Scientific American, March 10, 2009, retrieved December 27, 2015
  3. Harris, Gardiner (March 11, 2009), "Doctor Admits Pain Studies Were Frauds, Hospital Says", The New York Times, retrieved December 27, 2015
  4. "Fraud Case Rocks Anesthesiology Community", Anesthesiology News, March 2009
  5. Doctor accused of faking studies; His work dealt with pain drugs, Boston Globe, March 11, 2009
  6. Mass. doctor accused of fabricating pain studies, Associated Press, March 11, 2009
  7. Top Pain Scientist Fabricated Data in Studies, Hospital Says, Wall Street Journal, March 11, 2009
  8. "Retraction Notice", Steven L. Shafer, Anesthesia and Analgesia, 20 February 2009
  9. Dr. Scott Reuben, former chief of acute pain at Baystate Medical Center in Springfield, pleads guilty to health-care fraud. The Republican, January 15, 2010
  10. Scott Reuben, a former Baystate doctor who faked research, sentenced to 6 months for health care fraud, The Republican, June 24, 2010
  11. Anesthesiologist sentenced on health care fraud charge Archived 2011-05-31 at the Wayback Machine. United States Attorney for the District of Massachusetts, June 24, 2010
  12. Scott S. Reuben: Debarment Order (FDA)
  13. Marret; et al. (Dec 2009). "lessons from the Reuben case". Anesthesiology. 111 (6): 1279–89. doi:10.1097/ALN.0b013e3181c14c3d. PMID 19934873.
  14. Editor (17 March 2010). "Fraud or flawed: adverse impact of fabricated or poor quality research". Anaesthesia. 65 (4): 327–330. doi:10.1111/j.1365-2044.2010.06295.x. PMID 20402871.CS1 maint: extra text: authors list (link)
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