The Ontario Divisional Court has overturned a University Health Network decision that found, in the court’s words, that Toronto cancer researchers Dr. Sylvia Asa and Dr. Shereen Ezzat “falsified and fabricated images in a number of research articles,” the Star has learned.
In a decision released Friday, a three-judges panel did, however, uphold a separate UHN finding that the researchers committed research misconduct in the form of “material non-compliance” and in doing so, failed to comply with publication standards in scientific journals.
The court ordered that the sanction against both doctors be sent back to UHN for review and that the hospital pay $20,000 to cover their legal costs. After the decision, the hospital maintained that it never concluded that the doctors falsified and fabricated images.
“We agree with the Court that a finding of fabrication and falsification specifically against Drs. Asa and Ezzat — had it been made — should be set aside,” hospital spokeswoman Gillian Howard wrote in an email to the Toronto Star.
“But ... UHN never interpreted the Investigation Committee’s report as including such a finding.”
The judges dismissed this difference of opinion in the ruling by pointing out the hospital’s argument “ignores” the “clear wording” it used in its own written materials when the doctors appealed the investigation’s findings.
Nevertheless, Howard added the hospital welcomed the court’s clarification, adding UHN’s reconsideration of the sanction will be completed in the next few weeks.
An investigation continues into additional papers the researchers co-authored.
The Toronto clinicians — who are married — are published medical researchers in the early detection, diagnosis and treatment of hormone-producing tumours. Before resigning from her leadership position last spring, Asa had run Canada’s largest hospital diagnostic laboratory at UHN for 15 years.
The researchers’ fall from grace became public last summer after three academic journal articles they co-authored were retracted and an editor’s note cautioning readers of possible inaccuracies was placed on a fourth. The retractions were prompted by the findings of an UHN internal investigations committee who found the presence of “manipulated and/or fabricated data” in the form of several figures used in the papers.
In a joint statement forwarded to the Star from their lawyer, Asa and Ezzat said they were “pleased” with the court’s findings.
“Having dedicated years of our lives to research, allegations of falsification and fabrication of data strike at the very core of what we hold dear, and we feel vindicated that the court has exonerated us,” reads the statement.
“We are grateful that our justice system restored our integrity in this most serious matter and we look forward to continuing our work of conducting research to understand and treat human disease.”
Both researchers also emphasized that the scientific validity of their work “was never an issue at any level of the proceedings.”
Their lawyer, Brian Moher, described the decision as “a significant victory for those who want transparency and accountability in the way public health care is delivered, especially so for the people of Ontario who are afflicted with cancer.”
A branch of the Superior Court of Justice, the Divisional Court typically reviews government action in Ontario. The court considered its intervention in this case necessary due to the vested “public interest” in the researching and treating of cancer across the province.
By the time the Star reported on the retractions of their medical journal articles last summer, the researchers had already initiated legal proceedings. They had filed an application with Ontario Divisional Court to request a judicial review of UHN president and CEO Dr. Peter Pisters’ decision to dismiss their appeal and uphold the hospital’s investigative committee’s findings and sanctions imposed on them.
The finding of material non-compliance in particular was based on the committee’s concerns of “multiple irregularities” believed to have occurred in the doctors’ labs throughout a ten-year period.
The doctors’ subsequent punishment involved the suspension of the couple’s collaborative-research labs in March 2015. Forbidden from initiating new projects or applying for new funding, their cancer-researching careers have been effectively put on hold ever since.
Their request for judicial review was then granted in August. This “impartial” review, Moher explained last year, would determine “whether the hospital findings were correct and appropriately arrived at.”
The hearing itself took place in early December. Three judges examined elements the hospital’s panel consulted with during its investigation, including witness statements, email correspondence and UHN research policies before releasing its decision Friday.
Documents filed in court showed at least one of Asa and Ezzat’s co-authors claimed responsibility for modifying images with Photoshop in two papers that were investigated and subsequently retracted. The former lab employee noted that neither Asa or Ezzat were told the published images had been altered.