At UC San Diego : Unraveling a Research Fraud Case

In a steel file cabinet in a storage room at the UC San Diego School of Medicine, an extraordinary case of research fraud unravels like a chilling detective story set in the laboratories of academic medicine.

It begins with the curriculum vitae of Dr. Robert A. Slutsky, Wunderkind and heir apparent to the dukedom of cardiac radiology. The resume on file lists hundreds of publications, grants, awards, appointments--a startling prolificacy for just seven years.

“Offer position on silver platter!” reads one supervisor’s recommendation. There are others: “Who could resist! . . . A true investigative spark plug. . . . Highest academic potential of any candidate I’ve seen to date.”

Then precipitously, the tale turns dark.

A professor, reviewing Slutsky’s work for appointment to full-time professorship, stumbles upon statistics that curiously are replicated in two different papers. Concerned, he confides his suspicions to the department head, who turns to Slutsky’s co-investigators for elucidation.

But neither the lab technician nor the research fellow knows of the work--supposedly dog experiments testing the ability of steroids to minimize the damage of heart attacks. The research fellow, listed as co-author on one paper, says he has never seen it before.

He says he doubts that the experiments were ever done.

Thus began the unraveling of what is believed to be one of most extensive academic fraud cases in recent history, a case that not only destroyed Slutsky’s academic career but embarrassed a university and scarred the careers of dozens of researchers.

15-Month Investigation

After a 15-month investigation, a University of California, San Diego, committee concluded last fall that 13 of Slutsky’s papers contained fraudulent information. It classified 55 as questionable--that is, the co-authors were unable to prove their validity--and 79 as valid.

Slutsky had fudged statistics, recycled data and inflated numbers of experimental animals, the committee charged. He had claimed to have done tests that were never done, and he added other researchers’ names to his papers--when they had done little or no work and sometimes without their knowledge, according to the committee.

But more than the mere transgressions of one ambitious researcher, the case illuminates the dark side of high-stakes scientific inquiry: The system had actually encouraged Slutsky.

“I think it’s quite clear in this situation that the system broke down,” said Dr. John Ross Jr., a UC San Diego professor of medicine, head of the division of cardiology and one of Slutsky’s early supervisors.

Slutsky’s seemingly implausible productivity was rewarded. In spite of some concerns about his work, his supervision remained lax. There were ominous signs, such as sloppiness, but associates did not look closely, out of reticence or even self-interest.

Ignored Practice

Full professors and underlings who stood to gain by their affiliation with Slutsky turned a blind eye to his practice of putting their names on his papers. Flattered by the “favor,” they inadvertently lent him credibility and helped camouflage his fraud.

“In terms of the apparent magnitude of misconduct, this is a very big case,” said Mary Miers of the National Institutes of Health in Washington, which had awarded Slutsky a large grant.

In the end, the UC San Diego committee exonerated Slutsky’s co-authors, finding that they did not deliberately participate in the fabrications. But committee members suggest privately that some of Slutsky’s peers and even full professors had been incautious or irresponsible.

Slutsky’s fabrications are unlikely to have affected patient care since his conclusions tended to confirm what was already known. But within the university and the field of radiology, the mention of Slutsky still hits a raw nerve.

Some former colleagues refused to talk about the case. Others talked for several hours straight. Some, fearing further association with Slutsky, spoke on the condition that their names would not be used.

The cliche about Bob Slutsky is “he didn’t have to do it.”

He was young and brilliant, with 10 ideas to everybody else’s one. Raised on Long Island, N.Y., he had graduated with honors from Tufts University in Massachusetts and had gone on to medical school at UCLA.

Slutsky arrived at UC San Diego in 1974 to serve a three-year residency, rotating through the sub-specialties in medicine and tending to patients on the hospital wards. Then he moved into research, going from research fellow to salaried physician to assistant clinical professor.

He earned a national reputation quickly in the late 1970s, finding an innovative way to study ventricular capacity in patients with heart disease. The technique involved using X-rays and other non-invasive methods of assessing heart function.

‘On the Cutting Edge’

“I thought he was probably on the cutting edge,” said Dr. Elliot Lasser, the radiology professor who later detected the fraud. “He was very bright and quickly keyed into new techniques.”

Recalled one former colleague, who said he was drawn to the university in part by Slutsky’s record: “He was clearly the most impressive person there. He was dynamic, a quick thinker, extremely hard working. He always had something going.”

Slutsky’s style was aggressive, and his work habits relentless. He would spend vacations in the labs and nights at home writing papers. Colleagues say they chose to attribute those traits to an energetic mind--and perhaps a touch of eccentricity.

But a few say they also thought that they saw signs of manic behavior. Some say Slutsky would erupt over seemingly insignificant events, such as a canceled meeting or a slight difference of opinion from a colleague.

Nevertheless, colleagues tended to view him as simply “the pleasant workaholic that we like to see, especially in academics”--as it was put by Dr. Paul Friedman, an associate dean and professor of radiology who played a pivotal role in UC San Diego’s investigation of Slutsky.

In 1983, Slutsky abruptly changed departments, moving from cardiology to radiology. Some say it was a natural move because he had experience in cardiac radiology. Others say he saw more opportunities for advancement in the field of radiology.

In any case, the switch forced Slutsky to serve another residency in another specialty. He now faced a double burden, attempting to keep up his research while carrying out a whole new set of clinical duties as a resident.

“I think that I probably gave him too much work to do,” conceded Dr. Robert Berk, then-chairman of the radiology department. “No matter what he was asked to do, he accepted it and seemed to do it. . . . He was overworked, and perhaps that led to the problem.”

But in retrospect, there were many ominous signs.

Slutsky was always extraordinarily prolific. Even when burdened with clinical obligations, he published research at a remarkable rate. At one point, he was producing a paper every 10 days--a pace researchers now say is impossible, even with co-authors.

Some of his papers were strikingly sloppy, colleagues say. Reviewing them later, the university found co-authors’ names misspelled and titles incorrect. In Slutsky’s bibliography, one investigating committee member found “major errors in a majority of citations.”

He also had a habit of taking home notebooks full of raw data, rather than copies--a practice Friedman said violates elementary rules of research. Others had difficulty getting lists of patients Slutsky had studied.

Economical Use of Funds

Slutsky had gained a reputation for economical use of research funds, getting a lot of experiments out of relatively few dogs and patients. He would make numerous different types of observations on the same animals, then write up his findings in separate papers.

Looking back, investigators say his supervisors should have been suspicious.

In his final papers, on the purported dog studies, they say Slutsky’s success rate was too high. Whereas younger fellows working under Slutsky acknowledged in their own papers that some dogs had died during surgery, Slutsky’s final papers acknowledged no such deaths.

“Animal stuff is difficult, particularly where you’re giving dogs heart attacks,” Friedman said. “Not all the animals survive. Nobody has ever started up with an experiment that involved 10 dogs and ended up with 10 dogs at the end. You just can’t do it.

“If you look at the number of animals that were done and the perfection of the experiments, they’re just totally unreasonable.”

Yet no one, apparently, confronted Slutsky.

Often, his supervision was quite lax. Because of his accomplishments, some experienced and respected professors who supervised him say they viewed him as an equal. His hybrid specialty placed him in an area of research in which he knew as much or more than his nominal bosses.

“Ultimately, you trust somebody,” said Dr. Joel Karliner, now a professor of medicine at the University of California, San Francisco, and formerly a supervisor of Slutsky at UC San Diego. “We’d all been trained in the same way. There was kind of an atmosphere of collegiality.”

But at least some colleagues now concede that they had doubts.

Used Name Without Consent

One was Dr. Martin Lewinter, a cardiologist now at the University of Vermont. Slutsky had put Lewinter’s name on a manuscript without his consent--a practice Lewinter said made him uncomfortable.

Lewinter acknowledged in an interview that “the most appropriate response would have been to have him remove my name” from the paper before it was published. But he admitted he never did that; he simply distanced himself from Slutsky.

The UC San Diego cardiology faculty had reservations, too. Despite Slutsky’s extraordinary productivity and growing reputation in the field, the division never offered him a position on the faculty.

“I, for one, felt that he was in too big of a hurry,” Dr. Ross, the division head, said when asked why. “It was always rather difficult to get him to hone in and complete an area that he had started.”

As an example, Ross cited Slutsky’s well-known work on calculating ventricular volume. He said he urged Slutsky to “go back and validate the method” but “he didn’t want to do that. He wanted to go do something else.”

Another warning sign that went unheeded came as early as 1981 when Slutsky was under consideration for his first radiology appointment. A professor at another institution wrote a letter of recommendation that UC San Diego officials now say should have raised concerns.

“Some of his research has been performed rapidly and has not been validated sufficiently prior to publication,” the professor wrote. “ . . . More importantly, he has tended to publish similar data in multiple manuscripts rather than combine the information in a single comprehensive article.”

But none of those people took their reservations further.

“Whistle-blowing is something that somebody has to make up their mind that they want to do, and it takes a person of considerable strength and conviction to blow a whistle,” said Dr. Richard Peters, chairman of the investigating committee. “And I think a lot of people were suspicious but weren’t enough involved that they went the next step.”

By March, 1985, Slutsky was up for appointment as associate professor of radiology and chief of cardiac radiology. If approved, at 36 he would have become an associate professor--bypassing the rank of assistant professor.

As part of the appointment process, Slutsky’s papers went to a senior professor for his review and recommendation. That task fell to Dr. Elliott Lasser, a former chairman and the department’s founder in 1968 who was neither a supervisor nor close associate of Slutsky.

One night in his La Jolla home, Lasser was poring over some of Slutsky’s papers, studying two articles based on separate studies with dogs. Suddenly, he noticed the same set of statistics in both papers, in spite of the significantly different numbers of dogs.

At first, Lasser wondered if it might be a mistake.

But when he took his findings to the department chairman, Berk noticed the same numbers in a third paper. And Slutsky’s co-authors and the lab technician knew nothing of the experiments and had not seen the papers.

Upon further investigation, Berk could find no one who had been involved with the experiments. Nor could he find any grant expense equal to what Slutsky would have needed to pay for the work.

With some dread, Berk and Lasser decided to confront Slutsky, who was in Boston on a three-month pediatric cardiology fellowship. Even en route, Berk clung to the hope that Slutsky would not be guilty of “such an ignominious thing.”

But the meetings at the Boston Sheraton did not go well.

At first, according to documents on file with the university, Slutsky argued that one of the three questionable manuscripts should not even have been considered: He claimed that he had never submitted it for publication and had asked his secretary to withdraw in from the file.

But when Berk and Lasser threatened to investigate, Slutsky admitted that the paper had been rejected for publication. He indicated that he had submitted it anyway to the department toward his promotion, writing “In Press” on the top to suggest that it would be published.

Slutsky said he had listed younger researchers as co-authors to “stimulate them.” As for funding, he claimed that he had taken money left over from small grants to pay for the experiments in question. He said the lab technicians on the experiments had since left UC San Diego and that he was not sure any of the data was still around.

Slutsky agreed to return immediately to San Diego to try to find the data he said would prove that the experiments took place. But once back in San Diego, he produced only a shopping bag of charts and other papers that committee members said related to different work.

On April 30, he wrote his letter of resignation to Berk.

“Now I have come to acutely realize that the time has come to enter the private practice of medicine and cardiology,” reads Slutsky’s carefully worded letter, devoid of any mention of the rising suspicions of fraud. “ . . . I am sure you can appreciate my reasons for entering the private sector.”

He disconnected his phone and vanished from San Diego.

And the university’s investigation began in earnest.

Papers Reviewed

Under guidelines drawn up four years earlier, a faculty committee set out to identify which papers were valid or invalid. They contacted 93 of Slutsky’s colleagues, interviewed supervisors, reread papers, recalculated statistics and pored over laboratory logs.

Slowly, they uncovered glaring discrepancies.

For example, they found that Slutsky’s manuscripts claimed that a total of 221 CT scans were done on dogs. But logs from the scanner indicated that was nearly twice as many scans as had ever been done in the history of the scanner, they said.

Similarly, there was no record of any use in the lab of radioactive thallium or triphenyltetrazolium, though Slutsky claimed to have used them in experiments. Nor was there any record of disposal of a large number of radioactive dogs.

In the case of one paper, the senior author told the committee that Slutsky had simply altered some facts and added a paragraph claiming to have done a statistical analysis that was never done. The addition did not alter the conclusions, but the paper contained fraudulent information, the committee said.

In other papers, co-investigators said Slutsky had claimed to have done procedures they said were never done--such as reading blood pressures at points in the subjects’ respiratory cycles and the use of various dyes to study dogs’ hearts.

The committee rejected the principle of “innocent until proven guilty” and asked that the co-authors prove the work valid. Committee members acknowledge that they may have classified as questionable some perfectly acceptable work simply because the co-authors had not kept their data.

“But you see, the principle of this is that I shouldn’t put my name on a paper on which I don’t have assurance that it is adequately supervised,” said Peters, chairman of the investigating committee.

” . . . I think what (some co-authors) had done is that they had allowed their names to be put on lots of papers to make their bibliography longer. And I think that’s one of the fundamental things that the committee felt was wrong in this whole process.”

Blame on University

Peters also placed blame on the university and its system.

“If the faculty assumes that the whole fault was Dr. Slutsky’s, then the faculty is very likely to get caught this way again,” he said. “If the faculty says we fell down on this too, and we should do some things, then perhaps there will be some progress.”

The committee offered 13 recommendations for preventing future fraud cases, though members are skeptical about the prospects of early adoption. Their first recommendation was that “peer review of faculty should focus on the quality, not the quantity, of published work.”

Other recommendations included closer scrutiny of researchers’ roles in published work, greater co-author responsibility for reviewing manuscripts, more methodical supervision of research trainees and reiteration of school policies on unethical research practices.

The committee also recommended that medical journals review manuscripts “with more care, especially with regard to statistical evaluations.”

As a result of the scandal, some younger researchers lost significant chunks of their bibliographies, either because papers were declared fraudulent or because the researchers chose to excise Slutsky’s now-notorious name.

One former collaborator recalled bitterly being rejected for a job by a medical group that feared its reputation would be tainted. Another, now in academic medicine elsewhere, said Slutsky’s name on his bibliography raises the suspicions of faculty members.

“Even though my papers have come out clean, Bob’s name is still on them,” he said. “When people read Slutsky et al. , they’re going to raise their eyebrows. And that is particularly distressing because I know those studies have been done honestly and UCSD has judged them honest.

” . . . And I really resent that, particularly at this stage. I’m young, and I’m trying to make it and I’m trying to work very hard. It’s not easy to have these other things interfere with it, to go to a meeting and have person after person say, ‘What the hell were you doing there?’ As though it’s my fault.”

Some Optimism

As for the university, officials expressed some optimism that the rigor of UC San Diego’s investigation of the case might serve as a counterweight to the criticism that the university and faculty had been duped.

“Well, some people say negative things about our having been taken in for so long,” Friedman said. “ . . . But (the committee) did try to be tough. And we tried, by being as tough as we were, to get a message across to people. A lot of people have read the articles that have come out and know what happened and know that the institution is prepared to be aggressive. And maybe that will encourage people to come forward more.”

Slutsky is working as a physician at Westchester County Medical Center in Valhalla, N.Y., and is serving a residency in a new specialty, anesthesiology. A hospital official said Slutsky has changed his last name. Efforts to reach him over the last 18 months have been unavailing.

Neither New York nor California medical licensing authorities have penalized Slutsky, although California regulators have solicited a copy of UC San Diego’s report. Investigations of doctors are confidential, and state officials declined to comment on the case.

Slutsky did hire a Manhattan lawyer who in late 1985 mailed letters of retraction to the publishers of 15 of his papers. The letters said simply that Slutsky had come upon new information that rendered the information in the articles questionable.

“He never admitted that he had faked anything,” Friedman said in a recent interview. “He has never admitted publicly that he has done anything fraudulent.”