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UIC officials defend handling of misconduct by researcher who put kids at risk

Dr. Mani Pavuluri, a child psychiatrist at the University of Illinois at Chicago, is under investigation by state regulators over her research into children with bipolor disorder. | Joshua Clark / UIC Photo Services

University of Illinois at Chicago officials told faculty, staff and students Tuesday that research misconduct by Dr. Mani Pavuluri, one of the campus’ star faculty members, was an anomaly and that there are no systemic oversight problems at the institution.

Still, the university’s president and chancellor acknowledged in emails Tuesday to ProPublica Illinois that the campus can improve oversight of research, especially when it involves children.

The message came after a ProPublica Illinois investigation revealed that the National Institute of Mental Health recently ordered the university to repay $3.1 million in grant money it received to fund one of Pavuluri’s studies on bipolar disorder among children.

The federal agency demanded the refund in November after finding “serious and continuing noncompliance” by the UIC psychiatrist, as well as failures by a university institutional review board, a faculty panel responsible for reviewing research involving human subjects.

Pavuluri’s research remains under investigation by federal officials, according to the university.

“The case of Dr. Pavuluri’s research misconduct is believed to be an isolated event,” Mitra Dutta, UIC’s vice chancellor for research, and Dr. Anand Kumar, head of the psychiatry department, wrote in a campus-wide email.

They said it was the only time UIC ever has reimbursed grant funds due to human-subjects noncompliance.

The university already had returned about $800,000 it received for two of Pavuluri’s other federally funded studies.

This story was co-published with <a href="" target="_blank" rel="noopener">ProPublica Illinois</a>.
This story was co-published with ProPublica Illinois.

Pavuluri’s study, which began in 2009 and was shut down in 2013, was designed to use imaging to look at how the brains of adolescents with bipolar disorder function during a manic state, then after eight weeks of treatment with the powerful drug lithium.

Pavuluri, a tenured psychiatry professor, violated terms of the federal grant by testing lithium on children younger than 13 even though she was told not to. She also failed to properly alert parents of the study’s risks, failed to conduct required pregnancy tests on some girls and falsified data to cover up the misconduct, records show.

Eighty-nine of the 103 subjects enrolled in the study — 86 percent — did not meet the eligibility criteria to participate, records show. They were too young, had previously used psychotropic medication or didn’t meet other guidelines to participate.

The ProPublica Illinois investigation revealed lax oversight throughout Pavuluri’s clinical trials. Among other issues, Pavuluri was on a panel responsible for monitoring the clinical trial as it proceeded.

The National Institute of Mental Health found several problems with the university’s review of Pavuluri’s research protocol. The IRB conducted an “insufficient initial review” of Pavuluri’s plans, including not having the research protocol at the time of the review, then approved an expedited review without adequate documentation.

The IRB also failed “to request or review the rationale for the change in age range” during the review of an amendment lowering the age of eligible participants to 10 years old, the records show.

The UIC panel also didn’t spot omissions in consent forms provided to research subjects or their parents, including that lithium isn’t FDA-approved for children under 12. And the forms didn’t disclose alternative treatments.

On Tuesday, UIC officials said they outlined steps they took after identifying problems with Pavuluri’s work when a child enrolled in the lithium study was hospitalized in January 2013. The university reported its findings to NIMH and other federal agencies, initiated an audit of Pavuluri’s research, stopped three of her studies and alerted about 350 study subjects or their parents about the noncompliance, they said.

Following an internal investigation in 2015, UIC suspended Pavuluri’s research indefinitely.

University officials have declined to release a copy of the investigative report as well as some of their communications with federal agencies, citing privacy laws and other reasons. They also have refused to say who participated in the audit or in the internal investigation, citing an ongoing federal investigation.

After reviewing the investigative report, Michael Amiridis, UIC’s chancellor, wrote that Pavuluri’s conduct reflected a “pattern of placing research priorities above patient welfare.” Amiridis ordered a review of her clinical practice, barred her indefinitely from conducting research and directed her to retract several scientific journal articles based on the three studies. Three articles were retracted.

University of Illinois at Chicago child psychiatrist Mani Pavuluri and a check for the grant money UIC had to reimburse the federal government for failing to comply with guidelines on research integrity and the use of human subjects. | Lincoln Agnew / Pro
University of Illinois at Chicago child psychiatrist Mani Pavuluri and a check for the grant money UIC had to reimburse the federal government for failing to comply with guidelines on research integrity and the use of human subjects. | Lincoln Agnew / ProPublica Illinois

Yet she continued to treat or oversee the care of more than 1,200 patients after 2013, records show.

University officials said Tuesday that a review of Pavuluri’s medical practice “demonstrated high quality patient care with appropriate clinical documentation.”

Pavuluri, who joined UIC in 2000, founded the Pediatric Mood Disorders Program for children with bipolar disorder, depression and other disorders, which draws patients from around the country. She secured about $7.5 million in grant funding from the National Institutes of Health while at UIC.

Pavuluri, 55, plans to retire from UIC at the end of June. She made the decision after meeting with her supervisors in February to discuss the NIMH decision and demand for repayment.

In an interview, she said she was shouldering too much of the blame and that the university also was at fault. “It was in their interest to kind of maybe see this as one person’s mistake [rather] than the responsibility of the IRB as well,” she said.

University officials said there were no systemic issues of lax research oversight, citing a 2014 audit conducted by the U.S. Department of Health and Human Services. Theys said the audit found that human-subjects research “was performed upholding the highest standards in ethical and responsible research conduct.”

But federal agencies did find problems beyond those in Pavuluri’s research after conducting an onsite evaluation of UIC’s system for protecting human research subjects in July 2014. A letter from HHS’ Office of Human Research Protections to Dutta later that year said that, in approving other research projects, university institutional review boards “sometimes lacked sufficient information to make the determinations required for approval of research.”

The letter cited a study — not a Pavuluri project — that an IRB approved before it had enough information and other studies for which research approval was expedited when it shouldn’t have been.

In emails to ProPublica Illinois on Tuesday, Amiridis said officials will continue to review IRB processes, and Timothy Killeen, president of the University of Illinois, said he is confident the campus handled the matter appropriately.

“UIC takes these matters seriously and is committed to the highest standards of research integrity now and into the future — particularly regarding research issues involving minors,” Killeen wrote.

Jodi S. Cohen is a reporter for ProPublica Illinois. If you or your child participated in one of Dr. Mani Pavuluri’s studies, she’d like to hear about your experience. Email her at