The GMC kangaroo court charges; the Lancet evaluation; the High Court decision

The GMC kangaroo court 2004 — 2010: the Lancet evaluation
Dr. Andrew Wakefield was catapulted into notoriety as he and two of his colleagues Professor John Walker-Smith, MD and Dr. Simon Murch were accused of “serious professional misconduct”; “dishonest,” misleading,” and “irresponsible” behavior. They were subjected to the longest grueling 6-year GMC prosecutorial process to determine their “fitness to practice” medicine.

The GMC panel was chaired by Dr. Surendra Kumar who failed to disclose his financial stake in GlaxoSmithKline, manufacturer of the MMR vaccine used in the UK; or that he sat on two medicine licensing committees. (Read here)

The charges against Dr. Wakefield:

  • Subjecting children to medically unnecessary tests to help a class action lawsuit;
  • Failure to obtain ethical clearance;
  • Selectively recruiting children for the lawsuit rather than through “consecutive referral”
  • Failure to disclose his involvement in a class action lawsuit for which he was paid 55,000 pounds;
  • Concealing an interest in a patent for a competing vaccine being developed.

His Rebuttal:

  • The children underwent tests that were “clinically indicated” and medically necessary;
  • There were two separate studies – as confirmed by all three doctors accused by the GMS.
  • The litigation study began after Professor Walker-Smith had already examined the 12 children who were the subjects of the Lancet report (1998).
  • Professor Walker-Smith had “blanket ethical clearance” carried over from St. Bartholomew Hospital;
  • Approval for additional blood tests from the ethics board had been obtained for the published study;
  • Diagnostic tests for children for the legal case did not require ethics approval;
  • The 55,000 pounds was a research grant not related to theLancet study; the hospital used the money to pay the salary of a lab technician;
  • Wakefield did not hold a competing patent;
  • The Royal Free School of Medicine applied and held a patent for a therapeutic single measles vaccine.

(Read: Professor William Long, PhD, JD The Autism File, 2009)

None of the parents of the children in the study complained. They reported that their children benefited medically from the treatment they had received and they supported Dr. Walker-Smith and Dr. Wakefield throughout the proceedings.

The Lancet editors’ evaluation of the charges and the evidence
The editor of The Lancet had also received a copy of the six allegations and the available documentation to support the allegations. The editors followed ethics publication guidelines and shared the allegations and documents with the four senior authors who responded in writing. They refuted the allegations and defended the clinical appropriateness of the medical procedures performed. After evaluating the allegations, the documents and the authors’ written response, the Lancet editors found “no evidence to support the allegations” – except for the “perception of a potential conflict of interest” by the lead author, Dr. Wakefield.

The Statements by the Lancet editors and the letters by three co-authors were published online on Feb. 23, 2004. The fourth letter from Dr. Peter Harvey (who has since died) was published separately; it confirmed that Dr. Wakefield is not a lone wolf; it provided references to 17 confirmatory peer reviewed publications that lent validity to the findings reported in the Lancet article.

I too write as a co-author of the Lancet paper of 1998 referred to by Simon Murch in his letter.1 Statements in this letter cannot be allowed to pass without comment. There is a growing body of scientific evidence to show a relation between the measles, mumps, and rubella (MMR) vaccine, enterocolitis, ileocolonic lymphoid nodular hyperplasia, and autism.

The histologically unique condition ileocolonic lymphoid nodular hyper-plasia, which is not a normal variant,2,3 is associated with a diffuse entero-colitis. There are significant immunological and inflammatory abnormalities specific to this condition.4–12

There is evidence that affected children absorb undigested peptides with opioid properties,13 and that the most powerful of these opioids are derived from casein and gluten. Exclusion of casein and gluten from the diet has proven beneficial effects on autistic children’s behaviour.14

Evidence of persistent measles virus infection in the gut has been identified.15,16 The virus identified in most of these children was shown to be consistent with the measles virus RNA from the MMR vaccine.17 These children also have measles virus RNA in the blood, which is also consistent with that of the MMR strain.16 Measles virus RNA has also been detected in the spinal fluid of 19 of 28 children with regressive autism and bowel disease and in one of 37 control samples (unpublished data).

Much is made of the epidemiological studies that have failed to show an association between MMR and autism. However, these studies are open to serious criticism.18,19 Murch was a co-author on 11 of the 17 peer-reviewed publications and presentations that I cite. These present a step-by-step cascade of evidence starting with the recognition of the clinical condition, followed by the pathology of the gut disease, the immunological and inflammatory abnormalities, the identification of measles RNA in the gut, blood, and cerebrospinal fluid, and subsequent identification of this RNA as being consistent with MMR virus.

I am an adult neurologist, not a paediatrician, not a gastroenterologist, and not an immunologist. Even so, taking a dispassionate and wide view of the published and unpublished information, I think there is increasingly compelling evidence for a causative link between the MMR vaccine, a unique gastrointestinal disease, and regressive autism.

I examined the original cohort of children, and they had no physical neurological abnormalities. I have recently seen one of them again. His behaviour is much worse, at times being uncontrollable. He has developed epilepsy and bilateral extensor plantar responses. The problem now is to identify the numbers of children involved, and the susceptibility factors. In the meantime, consideration should be given to offering children single-injection measles vaccinations.”

For references, see http://image.thelancet.com/extras/03cor12097webref.pdf
[The list of references is no longer posted on the Lancet website]

The purpose of GMC protracted proceeding (2004 –2010) was to vilify Dr. Wakefield because the parents of autistic children hailed him as a hero. He was declared to be an irresponsible doctor who showed “callous disregard for the distress and pain the children might suffer.” He was branded as posing a great danger to public health because he had raised alarms about the safety of the MMR vaccine. Inasmuch as the number of children who suffer with autism continues to increase at an alarming rate – in the U.S. the prevalence rate increased from 1 in 10,000 in 1980; to 1 in 250 in 2002; to 1 in 45 in 2014 – the alarms about the MMR vaccine will continue to reverberate. (Latest CDC data here)

May, 2010: GMC struck Dr. Wakefield and Professor Walker-Smith from the medical register.
The Lancet
then retracted the article, despite its own evaluation that the allegations were not supported by evidence. Dr. Richard Horton, the Lancet editor retracted what he knew to be a scientifically valid, groundbreaking study, for an arguable conflict of interest. In light of the journal’s own far more significant conflict of interest – and the subsequent attacks leveled at him by the editor of the BMJ (as will be shown) suggests that the retraction was likely done under pressure. (Read BMJ & Lancet Wedded to Merck CME Partnership; read also, the COTO Report)

Professor Walker-Smith and Dr. Wakefield appealed to the British High Court. But Dr. Wakefield withdrew his appeal when his insurance company would not cover the high cost. (Read here and here)

On March 7, 2012, the British High Court, overturned the GMC panel’s verdict
The High Court completely exonerated Professor John Walker-Smith, who had appealed the GMC’s action. Justice John Mitting severely criticized the entire GMC disciplinary process:

“there was distortion of evidence, inadequate analysis, inadequate and superficial reasoning and explanation, inappropriate rejection of evidence, ‘flawed’ and ‘wrong’ reasoning, and ‘numerous and significant universal inadequacies’…. Fundamental errors…[that]  go to the heart of the case. They are not curable. The panel’s determination cannot stand. I therefore quash it.” (March 2012)

There was no fraud in the Lancet study
The twelve Lancet children’s medical history and condition had been independently evaluated and documented by a team of medical experts led by Professor Walker-Smith, considered the father of pediatric gastroenterology who was the lead clinician at the Royal Free Hospital and by senior pathologist Dr. Amar Dhillon – not Dr. Wakefield.

“By the time the paper was accepted for publication, as mentioned in an appendix to the Lancet paper, up to January 28, 1998, a further 40 children had been so investigated, 39 with the syndrome reported in the paper. The children were all investigated specifically and exclusively by clinical need to determine whether bowel inflammation was present that could then be appropriately treated.” (Statement by Professor John Walker-Smith)

The GMC panel was driven by corporate business interests and government health bureaucrats; both of who have high stakes in protecting the sanctity of vaccines. By dismissing Professor Walker-Smith’s testimony, the GMC panel demonstrated that it was unfit to make fair and reasoned judgments. Justice Mitting noted that:

the medical records provide an equivocal answer to most of the questions which the panel had to decide. 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 was the only time the case was heard before a proper judicial venue.