THE RESEARCH RECESSION: 12 years of Anesthesiology progress in question

Over the past 12 years, anesthesiologist Scott Reuben revolutionized the way physicians provide pain relief to patients undergoing orthopedic surgery for everything from torn ligaments to worn-out hips. (Brendan Borrell, Scientific American)

Rueben’s drug studies were responsible for convincing orthopedic surgeons to move away from the first generation of non-steroid anti-inflammatory drugs to a new method, known as COX2 inhibitors. He claimed that these new drugs, made popular under the names Vioxx, Celebrex, and Bextra, in combination with anticonvulsants could be effective in decreasing postoperative pain and reduce the use of addictive pain killers, such as morphine, after surgery. What seemed to be a break through, Reuben’s findings were hailed as a great step forward in redesigning anesthesiology.

12 years later however, the profession is in a state of crisis after an investigation by the Baystate Medical Center revealed that at least 21 of Reuben’s papers were entirely made up, faking the beneficial results and in some cases, masking possible dangers. The investigation found that the data in these 21 studies had been partially doctored, and in some cases, entirely fabricated by Dr. Rueben.

Although this most recent investigation has brought the wall tumbling down for Dr. Rueben, signs of cracks had leaks had begun to rear their ugly head over the past five years. In the early part of the decade, orthopedic surgeons began to distrust Rueben’s COX2 inhibitors, when animal testing found that the drugs might actually hinder bone healing. Soon there after, in 2004, Vioxx and Bextra, and Celebrex were pulled from the market because of their link to an increased risk of heart attacks and strokes. All the mean time, Dr. Rueben continued to present positive “findings” for the use of these COX2 inhibitors in his research.

So, even with the public at risk, what motivated Dr. Rueben continue his campaign for these drugs? Simple. Money. It was discovered during the course of the Baystate investigation that Dr. Rueben’s research was entirely funded by Pfizer; the maker of both Celebrex, and the anticonvulsants lauded by Dr. Rueben’s study to be used in conjunction with the COX2 inhibitors. Baystate however could not find any records of the payments, suggesting that the payments were made not to Dr. Rueben’s research group, but instead directly to Dr. Rueben.

Although we may think of doctor’s as always having the best intentions, one must always remember the power of money. Pharmaceutical corporations are some of the richest and most powerful companies in the world, and they need doctors on their side. It is much easier today for these drug companies to pay off a doctor to get the results they need rather than go back to the drawing table and leave behind an unsuccessful product. Because of this, remember to always remain informed when consulting with your doctor about possible medication options. An informed patient is always the safest patient.

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