Did a celebrated researcher obscure a baby's poisoning?
11 days ago
- #forensic toxicology
- #opioid crisis
- #medical ethics
- Rani Jamieson gave birth to a healthy boy, Tariq, in 2005. After delivery, she was prescribed Tylenol-3 (codeine and acetaminophen) for pain relief.
- Tariq initially thrived but suddenly stopped feeding and became lethargic. He was pronounced dead at 12 days old, with no apparent anatomical cause of death.
- Toxicology reports later revealed Tariq died from codeine and morphine poisoning, leading to respiratory suppression.
- Gideon Koren, a pediatrician and toxicologist, concluded Rani's genetic predisposition (ultra-rapid metabolizer) caused high morphine levels in her breast milk, poisoning Tariq.
- Koren published findings in *The Lancet*, warning against codeine use during breastfeeding, leading to global regulatory changes.
- David Juurlink, a toxicologist, later challenged Koren's findings, arguing Tariq's toxicology data suggested direct administration of Tylenol-3, not breast milk poisoning.
- Juurlink's analysis revealed inconsistencies in Koren's research, including fabricated case reports (e.g., 'Baby Boy Blue') and omitted toxicology details (e.g., high codeine levels in Tariq's stomach).
- Koren's credibility was further damaged by the 'Motherisk scandal,' where his lab's flawed drug testing led to wrongful child removals in Canada.
- Despite evidence, *The Lancet* has not retracted Koren's paper, and his conclusions continue to influence medical guidelines and legal cases.
- The case highlights systemic issues in scientific publishing, institutional oversight, and the lasting impact of flawed research on public health.