VanDerHorst-Larson: misinformed mother scatters food for the birds

Brian Deer wrote a response to Jennifer VanDerHorst-Larson's letter of complaint to the University of Wisconsin regarding Mr. Deer's invitation to speak there.  Mr. Deer has kindly granted permission to re-print his response.  He is kind when he refers to Ms. VanDerHorst-Larsen as "unwitting" however she is anything but as the "founder of the Canary Party", blaming her child's autism on the MMR jab, opening a clinic which offers "biomedical" treatments and involved with bringing fraud and discredited doctor Andrew Wakefield to Minnesota to convince the local Somali community to stop vaccinating with MMR.

Ms. VanDerHorst's error-riddled and dubious letter along with Mr. Deer's response can be found here.

After the collapse of what was only ever a fringe campaign in the United States, claiming that vaccines were responsible for an epidemic of autism, small groups of ill-informed, misguided and sometimes frankly malicious, people became desperate for attention. This led to a barrage of emails - often abusive or crammed with hate speech - to university staff following my October 2012 lectures in Wisconsin.
The complaint below by one Jennifer VanDerHorst-Larson, who said she was founder of something she called the "Canary Party", was one of the few that didn't ooze with personal bile. But even she hadn't checked her facts.
Ms VanDerHorst-Larson's complaints are numbered, and I respond beneath each.

1. Regarding Mr. Deer's credibility, even those unfamiliar with the details of the controversy would have to question his claim: “Neither I nor BMJ knew Wakefield was in Texas." (Dr. Wakefield has resided in Texas for 11 years and Mr. Deer has "investigated" and reported on him while he has lived in Texas.)

This is a reference by Jennifer VanDerHorst-Larson to a vexatious “gagging” lawsuit filed against the BMJ in Texas, in January 2012, by disgraced former doctor Andrew Wakefield over reports by me in the January 2011 series "Secrets of the MMR scare".  The suit was dismissed by an Austin district court, for lack of jurisdiction, in August 2012.

The BMJ’s jurisdictional case was accompanied by a factual case, supported by a lengthy declaration and supplement by me, verified to be true under penalty of perjury. In June 2012, I was deposed under oath by Wakefield's Texas lawyer for 6½ hours, yielding no evidence whatsoever of any wrongdoing on my part. Were my declaration, supplement and deposition false (and they are so exceptionally detailed that were they not at least substantially true then I would have to be lying), Wakefield's remedy would be obvious. In fact, all of our submissions are true, and are supported by a mass of documentation.

The transparent purpose of the lawsuit was to enable Wakefield to proclaim that he was suing the BMJ, so as to sustain support from persons such as Jennifer VanDerHorst-Larson, to whom he looks for his livelihood.  He chose Texas, where he knows he stands no chance whatsoever of prevailing, rather than England (where defamation laws are notoriously slanted towards plaintiffs, who need to prove nothing, and where defendants carry the burden of proving the truth of what was published) because in England he would have been required under civil procedure rules to pay our costs when he eventually abandoned the case (as he has done three times before, sending me a cheque).

The journalism at issue made no mention of Texas, involved no Texas sources, and was prepared and published at a time when neither the BMJ nor I even knew that Wakefield had remained in the state after being ousted from a job in Austin.  In addition to us participating in three depositions under oath, thousands of pages of discovery was permitted by the BMJ. This discovery produced no reference to any activities connected with Texas, while, in an email exchange, I advised the BMJ editor that I thought Wakefield was in Minnesota (where Jennifer VanDerHorst-Larson was then running an unfounded and irresponsible campaign alleging, among other things, that one in 28 Somalis had autism).  We neither knew nor cared about Wakefield’s whereabouts at the time, and made no inquiries.  This was because my reporting concerned events at the Royal Free hospital and medical school, London, England, during the 1990s.

2. In his letter to the BMJ, National Whistleblower Center board member David Lewis, who examined the "Lancet 12" children's histopathological grading sheets, makes is clear that Wakefield's co-author, pathologist Amar Dhillon, did indeed diagnose colitis "in a number of children" contrary to Mr. Deer's statement at your university that none of the children had bowel disease.

The “National Whistleblowers Center” is a front for the Washington employment law firm Kohn Kohn and Colapinto, which unsuccessfully represented Lewis after he was fired by the Environmental Protection Agency in 2003 following unresolved allegations of research misconduct. Lewis (an authority on sewage sludge) has no qualifications in medicine or pathology, was manifestly incompetent to evaluate bowel histopathology, and took up working with Wakefield at an anti-vaccine conference in Jamaica in January 2011. As I said at my talk at La Crosse, Wisconsin, Lewis’s criticism of my work bizarrely centres on his belief that I know too much about the topics of my writing.  For example, in May 2012 he argued at an anti-vaccine conference in Chicago: “It doesn’t make sense. These are well-written articles by someone who has considerable expertise in medical practice.”

Thanks.

In a statement to the BMJ, the Royal Free pathologist named by Jennifer VanDerHorst-Larson explicitly denied diagnosing colitis, which requires patient histories and clinical input, which he did not have.  The original data upon which Wakefield says he made his 1998 claims in the Lancet of having discovered a new inflammatory bowel disease was obtained by the BMJ in 2011, put out to expert review and published in its entirety by the journal almost a year ago.  We were that sure about what it revealed.  Some five experts in the appropriate gastroenterological specialties, consulted by us, confirmed a lack of enterocolitis in the data.  To my knowledge, the BMJ has since received not one suggestion from any qualified person that the data we published shows what was claimed by Wakefield.

3. Brian Deer stated at your university that Dr. Peter Fletcher was never Chief Scientific Officer of the UK Department of Health. This statement is easily proven false. [Jennifer VanDerHorst-Larson cites an article in the Daily Mail newspaper]. Deer misrepresented the UK's former Chief Scientific Officer, no doubt due to Dr. Fletcher's criticisms of the MMR: "There are very powerful people in positions of great authority in Britain and elsewhere who have staked their reputations and careers on the safety of MMR and they are willing to do almost anything to protect themselves."

It was put to me after one of my lectures that Fletcher was the UK government’s chief scientific officer, which he was not.  He was appointed in the 1970s to be chief scientific officer to the department of health, one of numerous departmental chief scientific officers throughout the civil service. The UK government’s chief scientific officer (the chief scientist) is a senior public figure, generally granted a knighthood, which Fletcher was not. I revealed in 2005 that Fletcher was paid £40,000 to support Wakefield’s claims, but his views of recent years are unknown and are irrelevant to my investigation of Wakefield's misconduct.

4. Wakefield's co-author in the Lancet Paper, Dr. John Walker Smith, was recently exonerated and had his license to practice medicine restored, showing that Deer's allegations against Wakefield and Walker Smith, which were rubber stamped by the General Medical Council, had no foundation.

Walker-Smith – who first claimed (including in his autobiography, first published in 2003) to have performed invasive research with Wakefield on autistic children under an IRB-approved protocol, but then changed his story after the GMC prosecution concluded its case in 2007 – was not exonerated.  The GMC panel’s findings were quashed in the UK administrative court.  This was because the panel had failed adequately to set out the reasoning behind its decision to revoke his license. The judge stated that the panel (of three doctors and two lay members) was entitled to reach its central conclusion – that he had conducted unauthorised research on vulnerable children for no good clinical reason – but that it had failed to explain its reasoning on numerous matters. For example, it had not set down why it preferred the evidence of one witness as opposed to another, and why it did not apply to Walker-Smith's conduct the famous English law “Bolam” test of medical opinion. In short, the prosecution was defeated by defence tactics (exploiting a loophole in the 1983 Medical Act which uniquely permits accused doctors to stand mute in the face of charges), the complexity of the indictment and inadequate input from the panel's legal advisor.

In conclusion, the judge summed up his ruling: "The panel had no alternative but to decide whether Professor Walker-Smith had told the truth to it and to his colleagues, contemporaneously. The GMC's approach to the fundamental issues in the case led it to believe that that was not necessary – an error from which many of the subsequent weaknesses in the panel's determination flowed. It had to decide what Professor Walker-Smith thought he was doing: if he believed he was undertaking research in the guise of clinical investigation and treatment, he deserved the finding that he had been guilty of serious professional misconduct and the sanction of erasure; if not, he did not, unless, perhaps, his actions fell outside the spectrum of that which would have been considered reasonable medical practice by an academic clinician. Its failure to address and decide that question is an error which goes to the root of its determination."

As the judge also made clear, the GMC was entitled to send the case back to the panel (or a new panel) to set out the reasoning for its findings, but as, as I understand it, the GMC took the view that, as Walker-Smith was retired, there would be no public interest in doing so. Among other things, the judge affirmed that claims of IRB approval in Wakefield’s Lancet paper were false and said that there was “no respectable body of opinion” which now endorses Wakefield’s claims linking autism and bowel disease with MMR.
Walker-Smith’s case has no bearing on that of Wakefield, who, on advice from his own legal team, was not funded to appeal the panel's decision. Wakefield’s case involved numerous different charges to those facing his accomplice – including four proven counts of dishonesty – many associated with the fact that, unlike Walker-Smith, he was not a clinician. Wakefield was erased from the medical register in 2010, and that decision is final.

Far from being “rubber stamped”, as Ms VanDerHorst Larson alleges, my findings as of 2004 were endorsed and adopted by the GMC after more than three years of investigation and case preparation by their lawyers. Unlike claims of anti-vaccine campaigners – generally supported by little more than recycled internet fabrications and distortions such as those repeated (probably unwittingly) by Ms VanDerHorst-Larson – my findings have been scrutinised and supported by innumerable editors of three media organisations of international repute, fact-checkers and subeditors, three teams of in-house lawyers, six firms of retained lawyers (including the GMC's), and numerous highly qualified peer reviewers and expert witnesses of preeminent professional stature.

I am presently unaware of any consequential body of professional, media or public opinion to the effect that Wakefield’s Lancet research of 1998 was not fraudulent. Indeed, in October 2012, it was tabulated in a paper published in PNAS, the Proceedings of the National Academy of Sciences, under the category "fraud", as the retracted research with the most citations. In January 2012, Time magazine dubbed Wakefield's work one of the great science frauds of all time. In April 2011, the New York Times described him as "one of the most reviled doctors of his generation".

5. Brian Deer's attacks against Wakefield began when his Sunday Times Editor, Paul Nuki, told him "Find something big" on the "MMR" as Deer himself revealed here [Jennifer VanDerHorst-Larson cites an article I wrote in the BMJ]. Nuki had a DIRECT FAMILY TIE to a government employee responsible for MMR safety. Paul Nuki is the son of Professor George Nuki who sat on the Committee on Safety in Medicines when it passed Pluserix MMR vaccine as safe for use in 1987.

Characteristic of embittered anti-vaccine campaigners, Jennifer VanDerHorst-Larson has altered my words.  I was not invited to “‘Find something big’ on the ‘MMR’”, and I did not reveal this.  At the time in the UK, MMR was by far the biggest running medical media story, and virtually any new information would be regarded by editors as worthy of prominent coverage.  My editor wanted big stories on important topical subjects (as he edited the main Sunday Times news-feature pages) and, at the time, MMR was a big story. I’m not aware of any newspaper that aims to publish small or uninteresting stories.

With regard to Professor Nuki, I'm not sure that even Ms VanDerHorst-Larson is clear about what she's alleging. The suggestion that Paul Nuki’s father, a rheumatologist, sitting on a large supervisory committee in 1987, could have any relevance to my findings in 2004 about Wakefield’s misconduct would be laughable if it wasn’t misrepresented by malignant cranks (among whom I have not included Ms VanDerHorst-Larson) so as to mislead vulnerable people. Professor Nuki was not a “government employee” and the named vaccine product (under a variety of brand names) was licensed throughout the world, including in numerous European countries, such as France, far beyond the writ of any Nuki.  I believe that in some countries it remains in use.

6. In February 2009, Sunday Times proprietor James Murdoch was appointed to the board of MMR manufacturer GlaxoSmithKline with a brief to “help to review external issues that might have the potential for serious impact upon the group's business and reputation"” This was swiftly followed by new attacks on Andrew Wakefield’s reputation by Deer and other Times Newspaper journalists.

My investigation of Wakefield began six years before Mr Murdoch took a nonexecutive directorship of GSK (which he has since resigned).  Mr Murdoch was not the “proprietor” of The Sunday Times, or its parent companies. He has never had editorial responsibility for The Sunday Times, which has an independent editor and directors, but which, like other News Corporation businesses, such as Fox News, has given extensive coverage to anti-vaccine opinions. I've never heard of any Murdoch family member expressing any view about vaccines, and I have never seen anything to suggest that the investigation of Wakefield was of the least interest to drug company shareholders.

7. Mr. Deer failed to disclose that he was privately the author of at least three complaints to the General Medical Council that later took away Wakefield's license. Violating journalistic ethics, Deer had created the very news that he later covered. (GMC created a letter a year later stating Deer was not listed as the complainant.

I have repeatedly disclosed (including in numerous formal “competing interest” statements) that I supplied information from my investigation to the GMC, as was my public and professional duty. This is routine conduct for journalists faced with regulatory bodies inquiring into areas of mutual interest. This involved no violation of journalistic ethics, and I was honoured by my peers with a British Press Award, the highest distinction for a UK newspaper journalist.

Reports that Wakefield was to face a GMC inquiry were published in the UK media on the same day that my first stories on the Wakefield scandal appeared, and before the GMC approached me asking for my full findings.  It would have been irresponsible and perverse for me to decline to produce evidence when requested by a statutory body inquiring into matters impacting on the safety of children.

The GMC stated that I was not the complainant because the GMC itself was the complainant. This is often the case when doctors face serious misconduct charges.

 8. Mr. Deer also failed to disclose that there were no complaints against Wakefield by the children's families, most of whom very strongly support him, and many of whom credit his team with a diagnosis that led to effective treatment of their children's bowel disease.
The father of the only child in Wakefield’s series who was not entered in (failed) UK compensation litigation described Wakefield’s reporting in the Lancet as "a clear misrepresentation of my son’s history” and "an outright fabrication”.

The BMJ has referred to experts all of the raw data on the children’s bowels obtained from the Royal Free hospital and medical school.  No inflammatory bowel disease was identified.  To my knowledge, nobody has ever claimed that autistic children do not suffer from bowel disease: they suffer from all the same diseases as any other children. A panel of America’s leading experts on gastroenterology in autistic children, including the influential Dr Timothy Buie in Boston, publishing in Pediatrics, has rejected Wakefield’s claims of having discovered a bowel disease distinctive to autism (see statement 4).

9. The Lancet withdrew the Wakefield paper seven months after the Lancet's owner, Sir Crispin Davis, became a non-executive director of MMR manufacturer Glaxo SmithKline. His brother, Nigel Davis, was the high court judge who presided over the secret hearing to remove funding from MMR litigation. Nigel Davis then issued a statement (referring to himself in the third person): "the possibility of any conflict of interest arising from his brother's position did not occur to him."

The Lancet withdrew the Wakefield paper in February 2010, after the conclusion of the GMC case, which among other things found that Wakefield did not have the IRB approval he claimed in the text, and after countless irregularities in the paper were exposed during evidence before the panel.  The Lancet editor said of Wakefield’s conduct: “It's the most appalling catalogue and litany of some the most terrible behaviour in any research.”

The judge named by Jennifer VanDerHorst-Larson did not preside over any “secret hearing to remove funding”.  The decision to remove funding had already been taken by the UK Legal Services Commission, and upheld by an independent review panel, after the plaintiffs’ own lawyers submitted that, as the evidence stood, they could not make a case that MMR caused autism.  The named judge (and two others, including in the London appeal court) merely affirmed (in routine judicial reviews) that the procedures had been correctly executed and the decisions properly founded.

It should be a cause of regret that those anti-vaccine campaigners who know the truth of this matter continue to cause distress to vulnerable people by making the false allegations repeated here by Ms VanDerHorst-Larson.  The case against MMR failed in England because critical evidence had been fabricated, while an overwhelming body of scientific research failed to find any link with autism or bowel disease.  A materially identical case to the one that failed in England in 2003 was presented in the US court of federal claims in 2007, and also failed. Special masters in federal court handed down scathing judgments of Wakefield’s theories and personal integrity.

10. The chairman of the GMC panel that struck Wakefield off the medical register, Surendra Kumar, failed to disclose that he owned shares in MMR manufacturer GlaxoSmithKline.

On 3 November 2008, Wakefield, and his two co-defendants in the GMC case, formally submitted to the panel that its chairman had no conflicts of interest.

11.  Mr. Deer's opening slide at the La Crosse talk, clearly intended to refer to Wakefield, speaks volumes about Deer’s lack of neutrality: “If he wasn’t so fucking greedy, he’d a been tougher to spot.” (The only money Wakefield earned as an expert witness was donated, by him, to the Royal Free Hospital. This is well documented.)

There is no record at the Royal Free of Wakefield ever donating any money, nor has any document ever been produced to this effect. Ms VanDerHorst-Larson simply copies out Wakefield's claims, and does not check them. Wakefield has been asked on numerous occasions for such documentation, and, despite extensive discovery in UK litigation and substantial Freedom of Information disclosures by the relevant public bodies, none has ever been found.  Meanwhile, I obtained papers revealing Wakefield’s longstanding concerns that he should be “incentivised” with large amounts of money (on top of the hidden £435,643, plus expenses, from lawyers), including through secret business schemes expressly intended to exploit the vaccine scare he created.

12. Among the more egregious of his many false statements at La Crosse was Mr. Deer's claim that Dr. Wakefield "called on parents to boycott the MMR vaccine." He in fact recommended parents request the single measles, mumps and rubella shots that were available at that time in the UK, rather than the combination shot.

Ms VanDerHorst-Larson's posited distinction is devoid of difference.

Published 18 October 2012

VanDerHorst-Larson: food for the birds