A federal judge yesterday sentenced anesthesiologist Scott Reuben, MD, a pain control researcher who championed multimodal anesthesia, to 6 months in prison and ordered him to pay $55,000 to the federal government and reimburse the drug companies that funded his research.

Dr. Reuben, 51, pleaded guilty to healthcare fraud in February after an investigation at Baystate Medical Center in Springfield, Mass. uncovered that he had faked results in more than 20 peer-reviewed articles on post-op pain management. Since pleading guilty, Dr. Reuben has cooperated with investigations into his research, according to court documents.

Besides the $5,000 fine and $50,000 forfeiture, the court ordered Dr. Reuben to pay back $361,932 to drug makers Pfizer and Merck & Co. and Rays of Hope, a breast cancer research foundation.

Dr. Reuben's studies, which were published in Anesthesia & Analgesia, the Journal of Bone & Joint Surgery and other journals, were integral to the clinical evidence supporting the use of NSAIDs and coxibs as part of a multimodal pain control regimen after orthopedic surgery.

However, from 2002 through 2008, Dr. Reuben falsified data in the studies that were funded by drug makers. For example, a study on using celecoxib after total knee replacement claimed to have 200 patients enrolled, when in fact there were no patients at all. "Dr. Reuben ultimately could not keep up with the enormous number of commitments he had made," said his attorneys, Ingrid Martin and Paul Cirel of Boston, in a court document. As a result of the pressure, Dr. Reuben started faking study results.

Several journals have retracted Dr. Reuben's articles, which were once very influential. Journal editors have complained that Dr. Reuben's fraud has tarnished their journals' reputations and left a gap in the medical literature related to multimodal analgesia. "Most importantly, this information may have harmed thousands of our patients," wrote James D. Heckman, MD, Vernon T. Tolo, MD, and James H. Herndon, MD, of the Journal of Bone & Joint Surgery, in a letter to the court to be considered before Dr. Reuben's sentencing.

Dr. Reuben has been diagnosed with bipolar disorder and major depression and attempted suicide at least 3 times, according to court documents. His mental illness — when he was on an upswing — fueled him with enormous amounts of energy to teach, lecture throughout the country, care for patients and write prolifically. Conversely, his depression caused him to attempt suicide, once with sleeping pills and once by locking himself in a hotel room where he drank 1/3 cup of the insecticide malathion and then cut his wrist, according to court documents.

His attorneys argued that Dr. Reuben should be allowed to serve his sentence at home rather than in prison, which would be a "potentially life threatening sentence," according to court documents. "You have a very serious mental illness at play here," said Ms. Martin in an interview. Dr. Reuben is currently living with his parents, is no longer married, and does not practice medicine or research.

U.S. District Judge Michael A. Posner denied the request for home stay and sentenced Dr. Reuben to 6 months in federal prison, followed by 3 years of supervision. The judge's sentence was, however, much shorter than suggested in federal sentencing guidelines, said Ms. Martin.

Dr. Reuben, who told the courtroom in Springfield that he was sorry for what he had done, will report to a yet-to-be determined prison. The judge recommended the prison in Devens, Mass., which has a medical facility on-site. But the final decision will be made by the federal Bureau of Prisons, said Ms. Martin.

The disclosure of Dr. Reuben's fraud was a surprise to his colleagues and students. Residents and faculty at the Baystate Medical Center even voted him "teacher of the year" in the anesthesia department more than once, according to court documents. However, federal prosecutors argued that Dr. Reuben's professional success does not mitigate the harm he has caused.

"All the while that [Dr.] Reuben was providing excellent patient care and outstanding teaching," wrote the prosecutors, "he was also engaging in research fraud."

Kent Steinriede

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