A guest blog by Chris Douglas, 8th February 2012
After Judy Mikovits was dismissed by the WPI, I sought clarification from Annette Whittemore regarding the institute’s plans for the UK study so that I could decide whether or not to continue as a participant. It subsequently emerged that both my blood sample and consent form had been lost. Perhaps, predictably, the WPI blamed Dr Mikovits’ housekeeping and tried to ‘move me along’.
Let me state, at this point, that I really do not care whether Judy Mikovits, Annette Whittemore or the Easter Bunny personally lost my blood sample and consent form. What I care about is receiving a sincere apology and a credible explanation from the organisation (not an individual employee) responsible for the study I participated in.
At the risk of doing the work for the WPI, such a communication might go something like this.
Dear xxxx –
We are deeply sorry to have to inform you that we do not have your blood sample or consent form.
We have made inquiries with the phlebotomy company who drew your blood, the couriers who shipped the blood to the US and within the US, and another lab that handled the blood. We also contacted other participants who had their blood drawn on the same day as you.
Based on these findings, we believe that your blood and consent form [select option]:
(a) was not collected by the courier in the UK.
(b) was lost by the courier in international transit.
(c) was mislaid by the other US lab that received your blood.
(d) was lost in transit between the other US lab and the WPI.
(e) was lost at the WPI.
We take this matter most seriously and can assure you that the issue is being addressed with the greatest attention. We will notify you if, and when, further information comes available.
In the meantime, please find attached a blank consent form for you to sign and return. We have added a clause which refers to the lost blood sample and preceding consent form and which allows you to choose how both should be handled in the event that they are discovered (e.g. retained for study, destroyed, etc.).
We thank you for your patience and understanding in this matter and hope that you will continue to support the WPI in its future endeavours.
With kind regards,
Xxxx
Instead, after a four month email correspondence on the matter, the University of Nevada, Reno, Institutional Review Board stated simply:
“We are not at liberty to discuss with you any investigations that may have been undertaken by our office. I can assure you, however, that we take seriously the oversight of any research studies conducted on our campus that include human participants, including those conducted at WPI.
“Our office and the WPI have on numerous occasions answered your question about the whereabouts of your consent form and blood sample. There is no record of either. We appreciate you contacting our office regarding this issue but we are unable to provide any further information to you.”
As a consequence, I have sent the following email to the US NIAID representatives who manage the R01 grant that funds the UK study (i.e. Dr Christopher Beisel and Dr Catherine Laughlin, Chief of the Virology Branch). I asked Khaly to publish this so that other participants of WPI studies are made aware of the issue. Thanks to her for doing so.
—– Original Message —–
From: xxxxx
To: cbeisel@niaid.nih.gov
Cc: catherine.laughlin@nih.gov
Sent: Tuesday, February 07, 2012 12:00 PM
Subject: R01 Grant Holder Loses Blood Sample and Consent Form
Confidential. Without Prejudice.
Dear Christopher
R01AI078234 Grant Holder Loses Blood Sample and Consent Form
I am a British participant in a research programme funded by NIH grant no. R01AI078234 (New Strategies to Decipher the Pathophysiology of Chronic Fatigue Syndrome). As you will be aware, this, initially, was awarded to the Whittemore Peterson Institute (WPI) at the University of Nevada, Reno (UNR), and its then Principal Investigator (PI), Dr Judy Mikovits.
In 2011, I had cause to consider whether or not to withdraw informed consent to this study and so entered into related correspondence with the WPI and the UNR’s Institutional Review Board (IRB). As a result, I discovered that the WPI had lost both my blood sample and consent form and either cannot, or will not, identify where these might be. Indeed, in the final correspondence from the UNR IRB, I was told that: “Our office and the WPI have on numerous occasions answered your question about the whereabouts of your consent form and blood sample. There is no record of either.”
That the WPI has lost my blood and consent form is alarming enough but that both they, and the UNR IRB, repeatedly respond with ‘we can not help you’ is simply deplorable.
When I asked the UNR IRB if a formal investigation had taken place that would include, for example, contacting the phlebotomists who drew the blood in the UK, the courier who shipped the blood to the US, any other labs that may have had access to the blood, other participants whose blood was drawn on the same day, etc., I was told that: “We are not at liberty to discuss with you any investigations that may have been undertaken by our office.”
In effect, both the WPI and the UNR IRB have washed their hands of me and are not honouring the ethical and legal commitment of participant protection as stated on the consent form that I signed in good faith.
This attitude is particularly contemptuous given that, not only did travel to the blood draw harm my health but, as per many participants in this British study, I donated financially to the cost of the venue hire (a curious anomaly in light of the WPI’s million dollar funding from the US NIH and, perhaps, a breach of IRB ethics in itself).
I would appreciate any advice you can offer on how to progress this matter to a more satisfactory conclusion, viz to identify the precise whereabouts of my blood sample and consent form and/or the point between Devon, UK and UNR, US at which they were lost.
I also would appreciate advice on how to withdraw consent given that the WPI and UNR IRB deny I am, or ever have been, a participant in this study.
Finally, I wish to express concern that, following a recent NIH review, the WPI has been allowed to retain the R01 funds. Having been a previous supporter of the institute, it is with great regret that I now suggest this organisation is neither capable, nor responsible, enough to manage such a large US Government grant.
A responsible organisation would have investigated thoroughly the loss of my blood sample and consent form and presented me with a credible explanation. Instead, all the WPI and UNR IRB have said is that the previous PI may have held the documents and such issues will not occur “in the future”.
This is akin to a manufacturer refusing to investigate a product complaint because the Production Director no longer works for the company. The complaint, however, remains the responsibility of the manufacturer (not its ex-employee), just as the lost blood and consent form remain the responsibility of the research institute (not its ex-PI). If the WPI can not grasp this basic rule of good conduct, how can it be trusted with over $1m of US taxpayers’ research dollars? I find this situation even more worrying given the WPI President’s current involvement in civil embezzlement litigation.
In addition, my own experience should raise concerns about other participants’ blood samples and consent forms, particularly those drawn in the UK during the last two weeks of July 2010. Regardless of assurances about blood draws “in the future”, how many samples already may have been lost or misidentified without the WPI or participants yet knowing it?
Please note that this letter will be placed in the public domain so that other participants of the WPI’s studies are made aware of the issues that I have encountered. I consider it only fair that others should have access to these facts when considering their own continued participation in such research.
Yours sincerely,
xxxxx.
Sequence of Events
26th July 2010
My blood was drawn in Ashburton, Devon, UK, by Phlebotomy Services International (PSI), a US company working on behalf of the WPI. At this time, I signed a consent form of which I have a blank copy (not a signed copy as the venue was a small hotel and did not have copying facilities).
Blood was drawn from two other participants at this venue and from additional participants on the same day at a different venue. It is my understanding that all blood samples and consent forms from these draws were collected from PSI by FedEx (for shipment to the US) later that day.
17th October 2011
I emailed the WPI’s President, Annette Whittemore, to request clarification of the status of this research but received no response other than two acknowledgements from her daughter, Andrea, on 25th October and 1st November.
15th November 2011
In the absence of a response from the WPI, I emailed the UNR IRB to ask who held consent forms for the study and whether the holder has a legal obligation to provide copies to participants.
17th and 30th November 2011
The UNR IRB acknowledged receipt of my inquiry, the latter email stating that the WPI was reviewing my request for a copy of my consent form.
16th and 22nd November 2011
I emailed Kellen Jones-Monick, the WPI’s Office Manager, to request clarification of the study’s status and, also, who holds participants’ consent forms.
22nd November 2011
Kellen confirmed that the WPI holds the consent forms and that she could provide copies upon request.
I requested a copy of my consent form from Kellen (request sent again on 27th November 2011).
5th December 2011
Kellen confirmed that both my blood sample and consent form had been lost.
“After carefully reviewing our study records, I was unable to find a consent for you. I also checked with the lab to determine whether or not we have your blood sample and it appears we never received one. Therefore, according to our records you are not enrolled in the R01.”
6th December 2011
I replied to Kellen with questions concerning the feasibility and ethics of identifying blood samples in the lab and forwarded the correspondence, without prejudice, to Nancy Moody, Director, Office Human Research Protection, at the UNR IRB.
15th December 2011
I prompted Kellen for a reply to my questions and she confirmed that it was not a breach of ethics for her to identify coded blood samples in the lab.
16th December 2011
I requested further clarification of Kellen’s reply and restated that I wanted to know the whereabouts of my blood and consent form.
20th December 2011
Kellen confirmed that “It is not a breach for me to access the master code and verify it against coded samples in the lab” and that “We have a meeting scheduled with an IRB representative at the end of the month regarding this matter.”
I replied to ask whether ‘this matter’ referred specifically to my case and, also, to clarify the identity of an unknown email recipient who had been copied on our correspondence without my permission.
Kellen’s response to the first query was a non-committal: “We communicate with the IRB regularly in regards to every matter concerning human subjects.” To the second query: “…Carli, our VP and legal representative.”
22nd December 2011
I asked Kellen why the WPI’s legal representative had been copied on the correspondence and without my permission.
23rd December 2011
Kellen confirmed that “Carli is in charge of compliance issues and is in continuous communication with the IRB.”
27th January 2012
I emailed Nancy Moody at the UNR IRB to ask if there had been any progress regarding my lost blood sample and consent form.
Nancy confirmed that Michelle Johnson of the UNR IRB completed a review and: “There is no blood specimen or informed consent document found in the study documentation regarding your enrollment in the study. The previous Investigator is no longer with WPI. It is unknown what the Investigator did with documentation if she was in receipt of it. Carli West Kinne of WPI has informed you of no record of your participation in this study, also. IRB has concluded our review of the study team and documents. Administrative procedures are in place to mitigate from such poor study record keeping in the future.”
I replied that I had not been contacted by Carli or anyone else at the WPI since 23rd December. I stated that I did not accept the WPI attributing the loss of my blood sample and consent form solely to the previous PI and so absolving itself of all responsibility. I asked if a formal investigation had included the phlebotomists, international courier, any other lab involved, other participants, etc.
Michelle Johnson replied that:
“We are not at liberty to discuss with you any investigations that may have been undertaken by our office. I can assure you, however, that we take seriously the oversight of any research studies conducted on our campus that include human participants, including those conducted at WPI.
“Our office and the WPI have on numerous occasions answered your question about the whereabouts of your consent form and blood sample. There is no record of either. We appreciate you contacting our office regarding this issue but we are unable to provide any further information to you.”