Dr Timothy Kuklo Still Cited in Medical Literature: The Journal of Bone and Joint Surgery

It is astonishing to me that the fraudulent investigator, Dr Timothy R. Kuklo, who was forced to resign from the Washington University School of Medicine in St. Louis is still cited in the literature.

Dr Kuklo, who is now practicing in a private clinic in Texas, had been on staff at Walter Reed Army Medical Center when he became a paid consultant for Medtronic. He falsified research as a shill for one of their products, Medtronic Infuse Bone Graft, and even faked the signatures of faux co-investigators. The article was published in the The Journal of Bone and Joint Surgery in the United Kingdom prior to its removal by the editors. There is also an American medical journal with the same name.

In the American-based journal issue of May 10, 2010 appears this article. This is the full citation.

Hospital Cost Analysis of Adolescent Idiopathic Scoliosis Correction Surgery in 125 Consecutive Cases, 2010;92:1097-1104. doi:10.2106/JBJS.I.00879

Jonathan R. Kamerlink, MD1, Martin Quirno, MD1, Joshua D. Auerbach, MD2, Andrew H. Milby, BS3, Lynne Windsor, BS4, Laura Dean, BA1, Joseph W. Dryer, MD1, Thomas J. Errico, MD1 and Baron S. Lonner, MD1

1 Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, NYU Medical Center, 820 2nd Avenue, #7A, New York, NY 10017
2 Department of Orthopaedic Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, 1650 Selwyn Avenue, #13E, Bronx, NY 10457
3 University of Pennsylvania School of Medicine, 820 Second Avenue, Suite 7A, New York, NY 10017
4 Department of Finance, NYU Medical Center, 1 Park Avenue, 11th Floor, New York, NY 10016

While I have not read the full article I was able to obtain multiple citations of Dr Kuklo’s research that appear in this article. Scroll down if you access the link to the fifth article.:

J. Bone Joint Surg. Am., May 2010; 92: 1097 – 1104.
*……evaluation that assesses reoperation rates. Kuklo et al. attempted to study this issue by…build on the work recently reported by Kuklo et al. 9 . Such a comparison, however…Pa 1976). 2007;32:2103-10. 9. Kuklo TR , Potter BK, Lenke LG, Polly DW, Jr……

Kuklo et al. attempted to study this issue by evaluating the surgical revision rates for four different constructs 9 . After excluding reoperation for the (latter citation I got from Google and not the article link but it appears to be another citation of Dr Kuklo in the same article.)

As a researcher in the field of history, I would be very wary of citing another author’s work under any circumstances who had been guilty of prior falsification of research for financial gain, who invented data, and who submitted the names of non-participatory authors. I find it astonishing that The Journal of Bone and Joint Surgery (American) that specialises in the area of joint and spine orthopaedic research would publish a peer-reviewed article that used the studies of a disgraced former Army colonel investigator. Has it come to this? Is the medical field so infected with the drive for profit and financial gain–we thought Wall Street was venal–that they have no shame in continuing to cite a medical fraud in this manner?

I will let others vet the article and determine whether its research is professionally useful in the advancement of knowledge and treatment. I simply cannot make that judgment but I can assert my opinion that the researchers either did not know or even more likely did not care that one of the investigators they used in their study, Dr Timothy R. Kuklo, has been banished from academic medicine for research that is fraudulent if not criminal in its claiming non-existent multiple authorship. I also have speculated whether Dr Kuklo’s egregious research misconduct about the efficacy of Medtronic’s product could have led to unnecessary death and injury from improper use of the bone-fusion device.

Article abstract that uses Colonel Kuklo’s [ret] prior research:

Background Although achieving clinical success is the main goal in the surgical treatment of adolescent idiopathic scoliosis, it is becoming increasingly important to do so in a cost-effective manner. The goal of the present study was to determine the surgical and hospitalization costs, charges, and reimbursements for adolescent idiopathic scoliosis correction surgery at one institution.

Methods We performed a retrospective review of 16,536 individual costs and charges, including overall reimbursements, for 125 consecutive patients who were managed surgically for the treatment of adolescent idiopathic scoliosis by three different surgeons between 2006 and 2007. Demographic, surgical, and radiographic data were recorded for each patient. Stepwise multiple linear regression analysis was employed to assess independent correlation with total cost and charge. Nonparametric descriptive statistics were calculated for total cost with use of the Lenke curve-classification system.

Results The mean age of the patients was 15.2 years. The mean main thoracic curve measured 50°, and the thoracolumbar curve measured 41°. The cost varied with Lenke curve type: $29,955 for type 1, $31,414 for type 2, $31,975 for type 3, $60,754 for type 4, $32,652 for type 5, and $33,416 for type 6. Independently significant increases for total cost were found in association with the number of pedicle screws placed, the total number of vertebral levels fused, and the type of surgical approach (R2 = 0.35, p ≤ 0.03). Independently significant increases for reimbursement were found in association with the number of pedicle screws placed and the type of surgical approach (R2 = 0.12, p ≤ 0.02). The hospital was reimbursed 53% of total charges and 120% of total costs. Reimbursement was highly correlated with charge (r = 0.45, p < 0.001). For rehospitalizations, the hospital was reimbursed 65% of charges and 93% of costs.

Conclusions The largest contributors to overall cost were implants (29%), intensive care unit and inpatient room costs (22%), operating room time (9.9%), and bone grafts (6%). There were three significant independent predictors of increased total cost: the surgical approach used, the number of pedicle screws placed, and the number of vertebral levels fused. This study characterizes the relative contributions of factors that contribute to total costs, charges, and reimbursements that can, in time, identify potential areas for cost reduction or redistribution of resources in the surgical treatment of adolescent idiopathic scoliosis.

Previous entries on Doctor Timothy R.  Kuklo

August 20, 2009 Colonel Kuklo resigns from Wash U

July 15, 2009 A.W.O.L. Speculation

June 18, 2009 Million Dollar Baby

June 16. 2009

May 30, 2009

May 22, 2009 Dr Kuklo takes leave of absence

May 22, 2009

May 20, 2009

May 18, 2009

May 17, 2009 Dr Riew first critiqued

May 15, 2009

May 14, 2009

May 13, 2009


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