A world-renowned Massachusetts anesthesiologist appears to have perpetrated what may be one of the most extensive cases of medical fraud, faking data and even making up entire studies in at least 21 cases.

Scott Reuben, the former chief of acute pain at Baystate Medical Center in Springfield, Mass., admitted that he falsified data in 10 articles in Anesthesia and Analgesia, as well as an additional 11 articles in journals including Acute Pain, Anesthesiology, and others. The studies all related to Reuben's area of expertise -- multimodal anesthesia, or the combined use of different classes of pain medications. Reuben was one of the leaders in the area.

The findings leave the field of multimodal anesthesiology in disarray. "There's no question that conceptually multimodal analgesia is the way to go for postoperative pain management," said Steve Shafer, the editor-in-chief of Anesthesia and Analgesia, but Reuben's studies provided key evidence supporting the combined use of the Pfizer pain drugs Celebrex and Lyrica. Without those studies, "we know a lot less than we thought we knew," he said.

The fraud was uncovered at Baystate's annual Research Week research presentation, when Reuben presented preliminary findings from a study that had not been cleared by the hospital's Institutional Review Board (IRB), which oversees ethics in human trials. At the meeting, Hal Jenson, the chief academic officer of the hospital, noticed the problem. The lapse prompted Baystate to conduct an audit of his past work, which eventually uncovered an extensive history of falsification dating back to 1996, said Jane Albert, a public affairs representative for the hospital. As a result of the findings, Reuben was put on medical leave and barred from research and educational activities for at least 10 years, according to an article in Anesthesiology News. The hospital has no plans to press charges, according to the article. Reuben did not respond to an email query from The Scientist seeking comment.

Reuben also collaborated with Pfizer on a number of trials, but the findings of those studies are not in question, Shafer said. "It would be impossible to fabricate the data in such trials. The level of auditing is just too intense," he said. Pfizer could not be reached for comment.

"I've worked with Scott, I've known him for many, many years. He has been a very productive researcher, and the fact that 21 of these studies are in part, or all fabricated, is extraordinarily distressing," said James Rathmell, the chief of pain medicine at Massachusetts General Hospital in Boston, who reviewed some of Reuben's papers for the journal Anesthesia and Analgesia.

In addition, Reuben falsely included Evan Ekman, an orthopedic surgeon at Southern Orthopaedic Sports Medicine in Columbia, SC, on two of his papers in Anesthesia and Analgesia, Ekman told The Scientist. Ekman collaborated with Reuben on one paper, but subsequently found out that his name had been included in two other manuscripts he had never seen. Concerned, he requested that the editorial board send him a copy of the signature. "It was just a blanket forgery," he said. "It doesn't really look anything like my signature."

The results are a huge embarrassment to the field, said Ekman. Rathmell agreed. "My selfish worry is that there will be collateral damage, that nobody will trust anything that we as researchers do," he said. "But in terms of how we treat patients, the impact is pretty small."


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