Lawyering-up medicine Research integrity

Gabrio Bassotti: snip-snip and copy-paste surgeon

Gabrio Bassotti's gang uses patients as a source of research material: no consent or ethics approval needed. The patients are real, but the research results are fake.

Gabrio Bassotti is surgeon and professor of gastroenterology at the University of Perugia in Italy. The proud moustache wearer looks rather like your local village butcher, and this is what Bassotti’s gang actually does to their patients: they chop off pieces of them, without consent. The intestine sections, removed on various pretences from hundreds of patients for already two decades, are being used for Bassotti’s peer-reviewed research. Since he, as a good scientist, needs controls, some patients keep losing parts of their healthy intestines for this purpose.

The patients have no clue, according to Bassotti’s own words, nobody ever signed any consent, informed or otherwise, and in most cases there was not even a pretence of an ethics vote. A source informed me that the University of Perugia never issued any ethics approvals to Bassotti. Apparently his flimsy argument suffices: while cutting up his patients to immediately prepare histological tissue sections, Bassotti and his gang members pretend they do have no research plans in mind. In Italy, this idiotically spurious claim is apparently enough for Bassotti to remain a rich doctor and respected university professor, instead of spending decades behind bars for grievous bodily harm.

As if this is not enough, Bassotti’s research, unethically done with body parts from his clueless patients, is also scientifically highly problematic. His papers are basically sideshows of rotating histology images, which are reused again and again in different papers, standing in for different medical conditions and different patients. Does he ever do any actual research with his patients’ intestinal tissue? Or does he feed it to his dog, while fabricating figures from some old pictures using Powerpoint?

Nobody cares. Not the University of Perugia, not the Italian state prosecutor, and certainly not the medical research community, who as of peer reviewers and academic editors happily approve Bassotti’s papers despite the data falsification and the blustering openness about massive patient abuse.

Some people do care though. The Milan-based veteran journalist Sylvie Coyaud wrote about Bassotti in October 2019:

“Between 1999 and 2004, for example, during surgeries Bassotti and his co-authors  have cut away healthy parts of the colon in 39 live patients, without their knowledge, in compliance with “local ethical rules and the recommendations of the Declaration of Helsinki “[ sic ]. Those pieces of intestine did not serve any diagnostic or therapeutic purposes, but to “study the enteric nervous system”.

Coyaud also added that Bassotti “has 421 publications mostly bought from Baishendeng chicken-plucking journals“. Some “scientists” are so abysmally bad that they need rigged data to get their papers even into a predatory journal. Like here, in Baishendeng’s World Journal of Gastroenterology:

Coyaud reported Bassotti’s PubPeer record (then at around 16 papers, now over 60) to his University of Perugia. Who surprisingly replied and announced an investigation. In January 2020, Coyaud posted a follow-up article, titled “The Bassotti Gang“. Turned out, the university decided not to investigate anything and forwarded the issue to the court of law. No, Bassotti is not being investigated for suspected grievous bodily harm on his unconscious and clueless patients, neither is this about the falsified data in his papers. The court issue is apparently purely administrative, about faculty recruitment calls.

I perfectly understand this. Italian legal authorities has zero inclination to follow up on at least 5 homicides committed by Paolo Macchiarini in Florence, the suspect womanslaughter tool here being a trachea transplant. The accessories to his crimes are all in medical employment, several of the key characters are in Italy. Bassotti’s gang snipping away bits of intestine form clueless patients? Certainly not a crime in Italy. In fact, just as in Germany I was sentenced for what Macchiarini’s gang did, so is Coyaud being sued in Italy for slandering Bassotti:

Bassotti’s Valentine’s Day present to Coyaud: a lawsuit for defamation.

Coyaud is right, there is indeed a gang at work. Bassotti’s key coauthor on almost all of the currently 60 papers with ethics and/or data integrity concerns is Vincenzo Villanacci, professor at the University of Brescia at the pathological anatomy department. Some other Bassotti Gang members are Bruno Salerni, Riccardo Nascimbeni and Renzo Cestari, three more professors in Brescia, as well as Elisabetta Antonelli, Bassotti’s department colleague in Perugia. Many studies were multi-centre, meaning patient abuse took place not only at the university hospital of Perugia, but also in the clinics in Brescia, Milan and even in Liestal in Switzerland.

Some other people care also, they flagged Bassotti’s published data manipulations on PubPeer. Another person who does care, is a reader of my site who made this dossier, listing the ethics problems with Bassotti publications.

Please find the dossier here.


Patient tissues removed without consent to produce falsified research.

So far, Bassotti suffered only one retraction. The only journal which apparently seemed to care about the lack of patient consent in his “research”, was some Romanian gastroenterology journal. The paper Sica et al 2016 disappeared into thin air, retracted allegedly upon authors’ request.

In the following paper, Bassotti and colleagues removed pieces of inflamed but also of healthy intestinal tissue (controls) from at least 40 patients, for research purposes. No patient consent or ethics approval was obtained, the authors simply pretended it was a “retrospective study” and declared they did not need any approvals or consent for it. Which is a shameless fib, but the journal’s editors and peer reviewers did not mind.

V. Villanacci, G. Bassotti, R. Nascimbeni, E. Antonelli, M. Cadei, S. Fisogni, B. Salerni, K. Geboes Enteric nervous system abnormalities in inflammatory bowel diseases Neurogastroenterology and motility (2008) doi: 10.1111/j.1365-2982.2008.01146.x

“This Neurogastroenterology and Motility paper (2008) duplicates images that were used over the time to indicate, alternatively : 1) normal subjects (2), b) patients with slow transit constipation (2); and 3) ulcerative colitis (in this paper). At the time this paper This paper was published in 2008 and at that time all the other 4 papers were already published. One of this paper in the same journal, in 2007.”

The stealthy patient butchery for research samples apparently didn’t suffice to create any useful scientific results though. So the the authors simply used some old pictures from their old papers, and presented them in new context. Later on, the reused the images from Villanacci et al 2008 again because why not.

The illustrations are just a small sample of the massive travesty that paper is, the rest is on PubPeer. Also in the next paper, tissue samples were taken from at least 40 patients without any consent or ethics approval:

G Bassotti, V Villanacci, R Nascimbeni, E Antonelli, M Cadei, S Manenti, L Lorenzi, A Titi, B Salerni The role of colonic mast cells and myenteric plexitis in patients with diverticular disease International Journal of Colorectal Disease (2013) doi: 10.1007/s00384-012-1554-z

It might have been the same 40 patients as before, or maybe 40 new ones, only Bassotti will know, or maybe even doesn’t anymore. Healthy intestine was cut off secretly because Bassotti needed some research material for “a retrospective study”: “Control specimens were taken at least 3 cm from the resection margin in tumour-free areas.

Also here, images were reused for a parallel publication, in a different context. In the next paper, 39 patients had pieces of their intestine removed, 10 of these were again controls where healthy tissue was cut off for research purposes, without any knowledge of the patients, and of course without any ethics approval.

G. Bassotti, V. Villanacci, R. Nascimbeni, M. Cadei, S. Manenti, G. Sabatino, C. A. Maurer, G. Cathomas, B. Salerni Colonic mast cells in controls and slow transit constipation patients Alimentary Pharmacology & Therapeutics (2011) doi: 10.1111/j.1365-2036.2011.04684.x

Here, pictures from Villanacci et al 2008 discussed above, return.

The Bassotti et al 2011 paper declared: “Twenty of these patients have previously been investigated in a study on enteric nervous system (ENS)
abnormalities.
” This was the referenced study, it used 36 patients, of whom 10 were clueless controls who lost their bits of their healthy intestine (“Control specimens were taken at least 5 cm from the resection margin in tumour free areas”):

G Bassotti, V Villanacci , C A Maurer , S Fisogni , F Di Fabio , M Cadei , A Morelli , T Panagiotis, G Cathomas , B Salerni The role of glial cells and apoptosis of enteric neurones in the neuropathology of intractable slow transit constipation Gut (2006) doi: 10.1136/gut.2005.073197

At least 40 slides were prepared for each patient, the paper says, from biopsies taken without any consent. The authors even stopped pretending it was a retrospective study because no medical journal editor and reviewer gave a toss what their medical peers did to patients somewhere in Italy. Bassotti et al just don’t mention the issue of ethics approvals or consent at all.

A figure from that paper was reused a year later in a different context, while some of the Bassotti et al 2006 figures were recycled from Villanacci et al 2008. The next paper looks like a complete work of fiction. It namely describes “53 en bloc ESD specimens retrospectively collected from the archives of the Institute of Pathology of Modena and the Institute of Pathology of Brescia during a 5-year period (2000–2005)”. Which cannot be true.

L. Reggiani Bonetti , R. Manta , M. Manno , R. Conigliaro , G. Missale , G. Bassotti , V. Villanacci Optimal processing of ESD specimens to avoid pathological artifacts Techniques in Coloproctology (2018) doi: 10.1007/s10151-018-1887-x

The specimens preparation is described as such:

“Forty endoscopically resected specimens were gently posed on a cellulose board, then put into a special fenestrated boxes (biocassettes for mucosectomy, Bioptica®, Milan, Italy) and covered with a thin sponge, as previously described [2, 7]”

The two references lead to papers by Villanacci from 2012 and 2014. The technology is therefore at least 10 years younger than the fresh patient samples it was used on. If you lie so much as these scientists do, you get caught up in your own web of lies. Question is: does anyone at all care? Probably not.

And anyway, the data in that paper is old, it was published by Bassotti and Villanacci before, including in the paper describing the referenced time-travelling technique, Villanacci et al Tech Coloproctol 2014. If the data ever existed as such, that is.

How about 200 patients now, operated 2009-2010 in Brescia? The following paper declares:

“The study protocol was approved by the institutional review board, even if it provided for the totally anonymous use of tissue blocks so that the informed consent of the patient was not deemed mandatory.”

V Villanacci , T Not , R Nascimbeni , F Ferrara , A Tommasini , SManenti , E Antonelli , Gabrio Bassotti Gastrointestinal Foxp3 expression in normal, inflammatory and neoplastic conditions Pathology (2011) doi: 10.1097/pat.0b013e3283485e37 

No details about that mysterious approval are provided, probably because it never was granted or even sought. Reminder: University of Perugia never granted any approvals to Bassotti, as a source claims. As as for lack of patient consent: it only proves how rotten medical sciences are, where academic editors and peer reviewers take no issue whatsoever with blatant abuse of patients. The paper is merely 9 years old, and of course it also contains duplicated figures:

The patient abuse was standard practice for the Bassotti Gang, recorded for the past 2 decades. For Bassotti et al 2005, 49 patients operated between 1999 and 2004 were clueless that their surgeons removed pieces of their intestine (including 10 controls with healthy tissue) for research purposes. For Villanacci et al 2006, 16 female patients suffering from constipation were treated with the unorthodox technique of surgical resection, where a part of colon was removed. Why? The only reasonable explanation is that Bassotti needed 20 histological slides from each patient for his research. There was of course NO informed consent to that.

But that was nothing: for the study Bassotti et al 2007, two institutionalised patients with Alzheimer and dementia who also suffered from constipation, lost their entire full-length colon to Bassotti’s research. Obviously these specific patients were not in a fit state to give consent, but the surgeon gang never sought approval from their next of kin or an ethics review board. Also operated were 26 constipation patients and 10 cancer patients, the latter lost bits of their healthy intestine because control sections for research were needed. The patients never signed any consent, there was no ethics approval, but Bassotti gang declared snidely:

“The studies were carried out in accordance with local ethical guidelines,
following the recommendations of the Declaration of Helsinki (Edinburgh revision, 2000).”

The editors and reviewers of that Wiley journal Neuropathology probably had a big laugh when approving that paper for publication. I mean, who does not enjoy cutting up clueless and trusting old people? Perks of being a doctor, apparently.

One image, five journals. Bassotti is ready to sue over this.

In Bassotti et al 2009, again 34 constipation patients were subjected to surgical resection, again 10 control patients lost parts of their healthy intestine for Bassotti’s research, all operated most obviously for research purposes between 2007 and 2009. Their doctors again fabulated:

“As this was a retrospective study, no individual patient identification was involved and no study-driven clinical intervention was performed; therefore no ethical approval was necessary”

A retrospective study is something where doctors find some old tissue samples in the clinic archives and then use them for their research. But when doctors immediately process the freshly removed patient material into thin sections for histological slides, and during other surgerical interventions even intentionally cut off some healthy intestine for “controls”: this is most definitely not a retrospective study. This is something which needs an informed consent from all patients and an institutional ethics approval, something Bassotti and his gang probably was rightly worried not to receive. So they did it anyway, and quickly figured out that absolutely nobody minds or cares.

This all is a clear breach of the Nuremberg Code of 1947, designed in the aftermath of the horrendous abuse committed by Nazi doctors on their concentration camp victims, for the purpose of medical experiments. Patient rights, designed to protect them from excessive research curiosity from certain doctors and scientists, were further enshrined in the Declaration of Helsinki in 1964 and the Oviedo Convention in 1999. Bassotti wiped his arse with all three of these, he even went so far as to declare that his unethical activities were perfectly compliant.

Hoya macrophylla: “The Ambassadors vs celiac histology.”

In Bassotti et al 2009, 29 patients lost pieces of their intestine in 2007-2008, also without any consent or ethics approval. Rossi et al 2011 used 64 patients, and the paper simply refused any mention of consent or ethics approval, not even a snide statement why these were allegedly not required. And indeed, nobody minded.

Bassotti et al 2012 is painted as a “retrospective study” to obscure the fact that 44 patients operated between 2007 and 2009 never gave any consent to removal of their intestine tissue for research purposes. Also here, 10 served as controls who unwillingly donated healthy sections of intestine for Bassotti’s dishonest research.

In one of his rare PubPeer appearances, Bassotti defended against criticism of his study Bassotti et al 2015 with:

the study was carried out according to ethical guidelines for retrospective studies using anonymized data

180 patients, of them 15 controls, were used there, without their knowledge. They did not provide any consent, but because Bassotti already did the deed, he declared the analysis a “retrospective study” which requires no ethics vote. Bassotti posted same comment on Villanacci et al 2008, where it was declared:

“As no individual patient identification was involved and no study-driven clinical intervention was performed, a simplified Institutional Review Board approval was obtained and no patient consent was considered necessary.”

He doesn’t say who approved his use of unethically procured human samples, because it was presumably Bassotti himself. In Villanacci et al 2016, Bassotti and his gang again describe 39 patients of whom they cut off enough gallbladder material for 40 slides each, without any consent or ethics approval. The paper Ippolito et al 2016, which used material from 19 patients, declares:

“Since the study was performed on archival material, no individual patient identification was involved, and no study-driven clinical intervention was performed. Accordingly, a simplified procedure for Institutional Review Board approval was followed. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed”.

Apparently, once you extract patient tissues illegally without consent, you can use those legally as archival material for follow-up studies. The exact details of the ethics approval, not even the name of the approving institution, are omitted, probably because Bassotti et al simply approved it themselves. In Canavese et al 2017, 83 patients were declared a “retrospective study”, no consent and “no ethical approval was necessary”. Also here, the academic editors and peer reviewers could not have cared less.

3 different paper, different diseases, same histology images

Patients are a renewable resource, plenty more where these came from. Primum non nocere your colleague’s career.


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6 comments on “Gabrio Bassotti: snip-snip and copy-paste surgeon

  1. Leonid: Again, great work bringing attention to a long festering problem. As I commented on PubPeer: “It is disappointing that the author (Bassotti) hasn’t responded after the initial response. This leaves the readers of this paper, and the many others recently flagged on PubPeer, with the impression that the full answer will not satisfy readers’ concerns.”

    Regarding the failure to investigate the abuse of patients “under the knife” in Perugia, this seems to be the Italian authorities’ modus operandi: https://en.m.wikipedia.org/wiki/Murder_of_Meredith_Kercher

    Like

  2. Smut Clyde

    Bassotti seems to be convinced that as long as the sources of his anatomical specimens are anonymised so that they cannot recognise themselves as the unconsenting donors, all ethical concerns evaporate.

    Like

  3. …and let us not forget another gastroenterology star from the University of Perugia, Stefano Fiorucci:
    https://pubpeer.com/search?q=stefano+fiorucci

    Like

  4. Like

  5. Pingback: Nobody cares - Ocasapiens - Blog - Repubblica.it

  6. Pingback: Chloroquine witchdoctor Didier Raoult: barking mad and dangerous – For Better Science

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