I lied, again. But I’m not sorry. I’m a little late to the game as I’ve been busy, but after rechecking a few of my favorite non-primate blogs, I found this gem at On Becoming a Domestic and Laboratory Goddess.
Great Eastern University’s surgical training program covered everybody who performed major survival surgery for research purposes, including board-certified surgeons, veterinarians, technicians and others. People who claimed to have basic surgical competency were thoroughly tested in aseptic technique and basic surgical skills by a surgical trainer, using a simulated animal. Basic skill training was provided by a surgical trainer for those who required it. Advanced training for specialized techniques was provided by the surgical trainer or the research laboratory, using previously euthanized animals and progressing to non-survival surgery, as specified in the IACUC protocol. A veterinarian or training specialist always observed the first one or two survival procedures; if there were perceived problems, the trainer was required to immediately inform the Attending Veterinarian or IACUC chairperson.
The training and testing program worked almost flawlessly, until the veterinarians received a report from a veterinary technician that animals on which Linda Girard, a postdoctoral fellow, had operated two days earlier had a high incidence of wound dehiscence and infection. Some had to be euthanized. Necropsies revealed that the surgical procedure had not been carried out well. When confronted, Girard admitted that she took protocol ‘shortcuts’ because she was overwhelmed with lab work. The shortcuts included wiping instruments with alcohol rather than sterilizing them between procedures on different animals when multiple animals were operated on during the same surgical session. She disinfected but did not change her surgical gloves between procedures on different animals. She used a continuous suture pattern to close the abdominal wound when individual sutures were specified. Lastly, she sutured the peritoneum, muscle and skin as a unit, rather than closing the skin incision independently from the other layers. All of these shortcuts were contrary to her IACUC training. The findings were promptly transmitted to the IACUC, and the committee immediately convened an emergency meeting with Girard and the Principal Investigator (PI) in attendance.
After a discussion, the committee found itself in a quandary. Girard had been properly trained, and her surgical technique had been observed and approved. The current problem had been quickly identified. When Girard and the PI were told by the IACUC what was required to bring the study back into compliance, they immediately agreed to do it. Additional IACUC monitoring of Girard’s work was mandated. But was the infraction of sufficient magnitude for Girard to be suspended? Even if she were not suspended, should this incident be reported to the Office of Laboratory Animal Welfare at the National Institutes of Health? Some IACUC members said yes to the suspension and report, while others disagreed. Those that disagreed said that in order for the committee to suspend Girard or report the incident, the details of the committee’s expectations (e.g., changing surgical gloves between animals) should have been specified in the approved protocol or at least be part of a written IACUC policy. Because neither of these conditions was met, they believed that Girard could not be tightly bound to a nonexistent policy or nonexistent protocol details.
What do you think the Great Eastern IACUC should do?
Down to some Serious Monkey Business:
I’m pretty passionate on this one. I’ve held a position in a significant research lab (who recently made it into Nature–kudos on that!) at A Big Deal University. I have seen the effects of a “minor” procedure go downhill quickly (don’t worry–no one died or got hurt!). My advisor has also given me interesting information (re: the IACUC forms on my campus are extremely extensive and on one level, potentially prohibitive) on IACUC as well, despite the fact s/he studies wild populations only and does not do any captive studies. I have also scrutinized the IACUC at my university intensely; as someone who wants to go into animal welfare law, this is an important issue to me.
But, getting back to subject–do these violations warrant suspension?
My answer: yes. I can’t speak for rats/mice, cats, dogs, pigs, sheep, etc. as I’ve never worked with any of them in a research setting requiring any “surgery” that might be parallel to this situation, but I can somewhat speak with a little experience on non-human primates.
I’m not going to indulge in the emotion-based explanation: not because I don’t feel like it’s a valid point (I think it is), but that isn’t what I feel absolutely warrants the punishment in this particular example. What is damning to me here is that the post-doc admits that she takes “shortcuts,” refuses to do something as simple as changing surgical gloves, and suturing the peritoneum, muscle and skin as a unit. I don’t have to say it, but I will anyways: it’s lazy.
Being lazy isn’t an excuse to skip important steps like basic sterilization. Being lazy can produce harm on the subject which may directly (or indirectly) cause a change in scientific data (e.g., studies based on cortisol levels.) Not to mention, being lazy can caust a lab over thousands of dollars of damage.
At the lab I worked at, the non-human primates in a given study often went for US$1,000. This was the base fee. Now, combine this with basic upkeep (let’s say–and I don’t think this is too farfetched–is probably somewhere around $1,000 a week for chow, manual labor for cage washing, etc.), veterinary fees which are required in most protocols for pre-assignments, post-surgery, post-procedures, etc. which can also be quite pricy (though, I never saw any numbers on that exactly so I can’t really throw a number out on this one). Not to mention, you’ve also probably got lab equipment, drugs (probably ketamine to sedate), and staff to take care of as well. If a non-human primate dies and it isn’t clinically based–you’ll also be paying a pretty penny.
And now, you’ve accidentally (by neglect) caused your non-human primate subject to develop an infection–or worse–dies, that’s a lot of money you’ve thrown down for warped data and an injured or dead subject that you’ll have to be replacing. Maybe it’s because I’m still an undergraduate in college and I’ve lived on welfare before, but that’s a lot of fucking money to be proverbally pissing on because you just don’t want to change a glove or sterilize between procedures.
This kind of thing happens all the time; it might not be something as trite as changing a glove, but sometimes tools do go unsterilized. Sometimes, researchers aren’t careful and the subject can receive a hematoma (bruise) that may require more surgery–and with it, time, money, and data.
I absolutely think that suspension was warranted here based on the fact that it sort of changes the purpose of what we’re after–data; but I’m also an undergraduate with only one laboratory experience so what the hell do I know. What do you think? Was the suspension warranted?