BMJ 2015;350:h982 doi: 10.1136/bmj.h982 (Published 20 February 2015)
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NEWS Migraine doctor is suspended for serious breach of professional standards Clare Dyer The BMJ
Andrew Dowson, a leading migraine specialist, has been suspended from the UK medical register for four months for a “serious breach of professional standards” in the conduct of a clinical trial.
Dowson, director of headache services at King’s College Hospital in London, was co-principal investigator with Peter Wilmshurst, a cardiologist, in the Migraine Intervention with STARFlex Technology (MIST) trial to test whether a new device for closing patent foramen ovale could cure migraine.1 After casting doubt on the accuracy of the trial’s results Wilmshurst was sued by the device’s US based manufacturer, NMT Medical, in a notable libel case, which was eventually abandoned when the company went into liquidation and which helped to bring about reforms to English defamation law.
A panel of the Medical Practitioners Tribunal Service found that Dowson had been dishonest in signing a clinical trial agreement that said he was “not involved in any regulatory or misconduct litigation or investigation” in 2005, when he had been under investigation by the General Medical Council (GMC) over his breach of protocol in a Botox trial. He was also found to have been dishonest in failing to inform the West Midlands multi-centre research ethics committee, whose approval was needed for the MIST trial, that he had breached the trial protocol in the Botox trial and been removed as chief investigator.2
The panel accepted that the only parties to the clinical trial agreement were Dowson and NMT, who were both aware of the investigation into the Botox trial, and that as a result no one had been misled. But the panel chairman, Stephen Miller, said that Dowson had an over-riding duty not to sign “a patently false statement.”
His failure to disclose his history to the research ethics committee compromised its ability to evaluate the case for ethical approval of the trial, and it denied the other investigators important information about him that they were entitled to have, Miller said. Dowson was also found to have given a misleading report about the trial results at a conference, which, the panel said, “denied the scientific community the information it needed
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to properly evaluate the significance of the MIST trial findings,” although he was cleared of dishonesty on that occasion. Dowson’s counsel told the panel that Dowson had given up research, that the breaches happened more than 10 years ago, that no evidence showed any similar breaches in the interval, and that no risk was posed to patient safety. The counsel argued that the right sanction would be a condition barring Dowson from research.
But the panel said that Dowson had a tendency to shift responsibility on to others, such as NMT and his legal advisers, for matters that were largely his own responsibility, and it said that it could not be confident that the misconduct would not be repeated in another field of practice. The panel was also concerned that he seemed not to have learnt lessons from the Botox case in 2006, in which the GMC found him guilty of research misconduct.
In deciding on the sanction the panel took account of mitigating factors, including testimonials “of the quality of your patient care, of your kindness and humanity, and of your valued contributions to teaching, training and professional charitable work extending over many years.” It also took into consideration the “excessive” length of time the case had been hanging over him and the stress caused when it was withdrawn and then reinstated by the GMC. The panel noted “a strong public interest” in allowing Dowson to return to work. “However,” it concluded, “the period of suspension has to be sufficient to send a clear signal to you, the profession and the public that your misconduct is unacceptable; it must also allow you to assure a future panel that there is no significant risk of repetition.” The suspension will take effect in 28 days unless Dowson appeals. 1 2
Dowson A, Mullen MJ, Peatfield R, Muir K, Khan AA, Wells C, et al. Migraine intervention with STARFlex Technology (MIST) trial. Circulation 2008;117:1397-404. Dyer C. Headache doctor found guilty of dishonesty in research misconduct case. BMJ 2015;350:h709.
Cite this as: BMJ 2015;350:h982 © BMJ Publishing Group Ltd 2015
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BMJ 2015;350:h982 doi: 10.1136/bmj.h982 (Published 20 February 2015)
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