Paolo Macchiarini in court – “The sole intent was to cure”

Paolo Macchiarini’s surgical procedure was illegal, life-threatening and caused severe and prolonged suffering to patients the prosecution claimed when the trial against the Italian surgeon began on Wednesday last week.

“Furthermore, the surgical procedures took place time and time again, despite serious complications, and even though there were no signs that the method would work,” Chief Prosecutor Jim Westerberg said in his case presentation.

63-year-old Paolo Macchiarini, first praised and later questioned and criticised, appeared in Solna District Court wearing a sober dark blue suit, tie, handkerchief in his breast pocket and his grey hair in a small ponytail.

Sitting next to his public defender, lawyer Björn Hurtig, he listened intently to the two prosecutors and took diligent notes with his pen.

The indictment concerns transplants of artificial trachea that Paolo Macchiarini performed on two men and a woman at the Karolinska University Hospital in 2011-2012.

During the surgical procedures, the patients’ trachea was removed and replaced with a plastic trachea infested with bone marrow cells from the patient. The idea was that the body, with the help of the bone marrow cells and other growth factors, would develop the synthetic organ into a functioning trachea.

It failed. All three patients are now dead, and the surgeon is charged with three counts of aggravated assault. According to the lawsuit, he caused the patients severe bodily injuries and long-term suffering.

According to prosecutor Jim Westerberg, the alleged surgical procedure had not been preceded by experiments on animals, and no transplantation of a synthetic trachea had previously been performed on humans.

“The procedure was performed for the first time on patient number 1. No one knew if it would work, not even Macchiarini, of course.”

Paolo Macchiarini himself denies that he inflicted any injury or suffering on any of the patients in the criminal sense.

“On the contrary, his only intention was to provide his current patients with medical care to cure the lifethreatening conditions they were in,” said lawyer Björn Hurtig at the district court hearing.

According to Paolo Macchiarini, the procedures in question were healthcare, not research, and it was the caregiver’s responsibility to apply for all necessary permits. He also denies being the medical manager responsible for the surgical procedures, which took place under the auspices of the Karolinska University Hospital.

The criminal classification of aggravated assault requires that there is intent, and the prosecution believes that the intent is strengthened, among other things, with reference to the investigations and decisions made by the Karolinska Institute.

“It is clear that Macchiarini deliberately withheld complications after surgery, deliberately beautified his patients’ conditions, and also provided false and untrue information in his scientific articles, including that of existing ethical permissions for these procedures. This made it possible to continue with the procedures, even though there were actually no signs that the method would work,” said Jim Westerberg.

The trial will continue with the defence’s presentation, questioning of the accused and a long line of expert witnesses, as well as, among other things, showing a film from one of the operations. The trial is expected to last 13 days and end on May 23rd.

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