8 ms·

Did a celebrated researcher obscure a baby's poisoning?

184 points by littlexsparkee 9mo ago

https://web.archive.org/web/20260126132426/https://www.newyorker.com/magazine/2026/02/02/did-a-celebrated-researcher-obscure-a-fatal-poisoning https://web.archive.org/web/20260126132426/https://www.newyo... https://archive.ph/GA6XV https://archive.ph/GA6XV

junofan 9mo ago
> He asked Rieder about the case. > “Oh, we made it up,” Rieder replied. Interesting anecdote. Something to keep in mind.
- NedF 9mo ago
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- bloomingeek 9mo ago
  This statement shocked me! These are professional people whose careers are on the line? It's no wonder many don't trust "experts" today, despite knowing almost nothing about the expert's field of knowledge. (I don't fall into this group, but I admit to being fearful of what highly educated humans are capable of.)
rekabis 9mo ago
Humans are fallible. Humans have egos. Humans can be intentionally dishonest. But the Scientific Method is the only functional bullshit detection system we have. When it is allowed to work, science corrects itself and excises the falsehoods. It’s a shame that outsized egos within The Lancet and other orgs are still very much in play.
- fasterik 9mo ago
  This is a nuanced point that anti-science people often get wrong. The existence of fraudulent studies, dishonest researchers, the replication crisis, etc. does not invalidate science as an institution. It just means we need to be careful about distinguishing between individual opinions and the scientific consensus. We also need to keep in mind that the consensus is never 100% correct; it's always subject to change and we need to update our beliefs as new evidence comes in.
  - afh1 9mo ago
    Science as an "institution" serves only to protect egos, fraudsters, and politicians. When citizen science is ridiculed and "the institution of science" is glorified this is what you get. And anyone who dares to profess this, is a loony, a conspiracy theorist, an anti-scientific person, etc.
    - deleted 9mo ago
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  - InterviewFrog 9mo ago
    Ironically, being anti-science is pro-science. Skepticism of institutions and consensus is the scientific method. The main reason being scientific consensus can lag reality significantly, especially when career incentives discourage dissent. The history of science includes many cases where consensus was wrong and critics were marginalized rather than engaged. Deference to science as an authority is the opposite. Feynman has a quote on this: "Science is the belief in the ignorance of experts. When someone says, 'Science teaches such and such,' he is using the word incorrectly. Science doesn't teach anything; experience teaches it. If they say to you, 'Science has shown such and such,' you might ask, 'How does science show it? How did the scientists find out? How? What? Where?' It should not be 'science has shown' but 'this experiment, this effect, has shown.' And you have as much right as anyone else, upon hearing about the experiments — but be patient and listen to all the evidence — to judge whether a sensible conclusion has been arrived at."
    - knome 9mo ago
      >Ironically, being anti-science is pro-science. Skepticism of institutions and consensus is the scientific method skepticism is necessary, but not sufficient. if they merely nay-say institutions and then go with their gut, it's certainly not. only when someone attempts to rationally disprove a position, offering alternate testable theories and actually performing those tests is science done. if you suspect an institution is wrong, that's fine, but it's just a hunch until someone does a test.
    - 9mo ago
- Aeglaecia 9mo ago
  obviously the scientific method is perfect , but i think i remember reading that the majority of studies are non reproducible, so things clearly arent perfect in practice. if one truly believes in the fallibility of humans, they also believe in the fallibility of the applying the scientific method - how could the output of of a fallible process ever be non fallible? confounding variables, hidden variables, incomplete sample spaces, etc ... these cannot ever be accounted for with certainty , thus i trust the scientific method as much as any human lol
  - QuadmasterXLII 9mo ago
    Doing a PhD, I got to see a tension first hand that clarifies the reproducibility question: most of the papers I read were visibly garbage, but reading papers was a necessary step in achieving tasks. Every student at some point tries to achieve their concrete tasks without sifting through the dung heap to see how other people lied about their approach to the tasks, and it doesn't work- the garbage is a necessary ingredient and or enough authors are truthful. The best media representation I've seen of this process is the youtube channel Explosions&Fire, which attempts to replicate entertaining-looking chemistry papers. He's often mad at the authors of the papers he's using in any given episode, but following their breadcrumbs is still effective enough (compared to I guess mixing acids and stuff based on vibes?) that he keeps at it.
  - knowitnone3 9mo ago
    If they are not reproducible, then they are not valid studies and not using the scientific method which requires reproducibility. So yes, the scientific method is indeed perfect. lol
- direwolf20 9mo ago
  the Scientific Method is really just one method of science. It's a very good one, but it has strict requirements that can't be met in all studies.
mjhay 9mo ago
The idea of an opioid OD from breast milk immensely strains credulity in the first place. Such a claim should really have been put under much more of a microscope.
bomewish 9mo ago
Great read.
pama 9mo ago
Such a distressing yet believable story where ambition overtook integrity … I hope Lancet improves its handling of such case studies.
- bloomingeek 9mo ago
  My motto has always been: "Don't let your car or your doctor get too old, they'll both kill you." Doesn't exactly apply to this case, but the idea is you have to trust something, so you must err on the side of caution. I know a thousand more things about cars then I will ever know about doctoring, which scares the hell out of me.
stefantalpalaru 9mo ago
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Morizero 9mo ago
> A toxicological screening of the “white curdled material” had detected codeine but not morphine. But Koren had claimed that the gastric contents “exhibited high morphine” levels—with no mention of codeine—“ruling out administration of Tylenol-3 to the baby.” > “I don’t know what happened in that house, on that night, but I do know that someone gave this baby crushed Tylenol-3,” likely mixed in breast milk or formula. “That’s the only way these numbers make sense.” Does no one care that this is potentially a murder case?
- teraflop 9mo ago
  I'd guess that everybody involved (including the coroner's office) tacitly understands that even if the baby was deliberately or negligently killed, there's very little chance after 20 years of finding evidence of who did it, in order to demonstrate guilt beyond a reasonable doubt. And if there's no chance of a conviction, there's no benefit to anybody from reopening the investigation. The scientific case about infant opioid poisoning in general is a separate issue, of course. But assigning blame in this particular case doesn't have any bearing on that.
  - pickleRick243 9mo ago
    > And if there's no chance of a conviction, there's no benefit to anybody from reopening the investigation. It's probably true that without a chance of conviction, standard protocol dictates that public resources should not be expended on reopening the investigation. But I was also heavily distracted while reading the article, scanning optimistically for the happy (under the circumstances) ending where justice is served. I certainly don't think there is "no benefit to anybody".
    - teraflop 9mo ago
      Serious question: if the chance of evidence leading to a convistion is very very small, what would be the benefit of opening an investigation? Just to go through the motions on principle? And what would they even investigate?
djeastm 9mo ago
I'd just like to invoke Betteridge's Law of Headlines. "Any headline that ends in a question mark can be answered by the word no." It is based on the assumption that if the publishers were confident that the answer was yes, they would have presented it as an assertion; by presenting it as a question, they are not accountable for whether it is correct or not. https://en.wikipedia.org/wiki/Betteridge%27s_law_of_headlines https://en.wikipedia.org/wiki/Betteridge%27s_law_of_headline...
- likpok 9mo ago
  The article clearly lays out that the answer is yes. It points to specific ways the researcher adjusted their reporting to mislead readers. I think the key here is where Koren attempts to specifically account for the stomach content explanation: he misrepresents the lab results and claimed they showed the opposite of what they did.
- Twisol 9mo ago
  I'd just like to invoke the principle to "not judge a book by its cover". The article here is very well written and does a great job of conveying the perspectives and opinions of many parties. I would recommend reading the article in spite of its headline.
  - maxbond 9mo ago
    Razors should guide, not replace, your engagement with the subject matter.
- throw4847285 9mo ago
  It's a rhetorical device.
- strken 9mo ago
  I would suggest that when there's a possible crime, as there would be in this case, even a clearly guilty murderer caught red-handed holding a knife and screaming "I DID IT" will be an "alleged" perpetrator.
- 9mo ago
deleted 9mo ago
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krautburglar 9mo ago
Tylenol 3 is an old & inexpensive medication. One has to wonder if one of Koren's undisclosed revenue sources was a manufacturer of pricier on-patent opioids (like Sackler).
cong-or 9mo ago
The toxicology is pretty damning: codeine without morphine in stomach contents means someone crushed up Tylenol-3 and gave it to a 12-day-old baby. That's not a metabolic quirk—it's homicide. Koren's "ultra-rapid metabolizer" theory provided cover, and his research went on to clear 17 other caregivers in similar deaths. How many of those were actually murdered infants?
Metacelsus 9mo ago
>“The fact that the paper still exists means that medical students, pharmacy students, and, presumably, genetics students are being taught this as if it’s a real thing, and it has implications,” Juurlink told Scherer. Yup. This paper was a lesson in my genetics class (2017)
mikkupikku 9mo ago
> The only data point in the scientific literature that had shaken his theory of the case was the near-death of Baby Boy Blue. He asked Rieder about the case. “Oh, we made it up,” Rieder replied. What the actual fuck.
radiator_1451 9mo ago
I'm not surprised that The Lancet is slow or unwilling to correct the record after falling for yet another fraud. [1] https://en.wikipedia.org/wiki/Fraudulent_Lancet_MMR_vaccine-autism_study https://en.wikipedia.org/wiki/Fraudulent_Lancet_MMR_vaccine-... [2] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00118-X/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
greazy 9mo ago
I truly believe the training medical doctors receive affects how they conduct research. They are far more likely to ignore uncertainty and jump to conclusions.

cucumber3732842 9mo ago

There is no potential "principal" here that is distinguishable from posturing and dick swinging. Unless you find some unforeseeable smoking gun any conviction will necessarily be questionable at best. That doesn't really serve much of a purpose beyond saying "we're the prosecutor's office, look how bad ass we are, look how we somehow manage to convict someone decades later, fear us". Never mind the fact that dredging this stuff up is not likely to be good for the family and that odds are all of these deaths are purely accidental/negligent so it's not like you're going after a "real criminal".

radiator_1451 9mo ago
Investigating a murder is posturing? I really don't understand the "bad ass, fear us" language. Do you consider all criminal investigations to be as frivolous? > odds are all of these deaths are purely accidental/negligent How can you say that given that the article presents evidence that > "... someone gave this baby crushed Tylenol-3,” likely mixed in breast milk or formula Is that an accident according to you, or do you have any evidence that the article is wrong about that conclusion?
- cucumber3732842 9mo ago
  >Investigating a murder is posturing? I really don't understand the "bad ass, fear us" language. Do you consider all criminal investigations to be as frivolous? >How can you say that given that the article presents evidence that Take a freakin step back and look at the big picture. Someone lost their kid, their first kid FFS. Even if a crime was technically committed along the way call it time served. On a technical level, this is almost certainly not chargeable as a murder. Evidince of intent is lacking and almost certainly does not exist. The best you might be able to do is some negligent wrongful death manslaughter type thing, exact details depending on how such things are defined in the jurisdiction. Just based on plausibility these cases are almost certainly accidents. Very few mothers or the people around them murder newborns in the jurisdictions we're talking about. So if you did find intent, like a text exchange or something, the best you're likely to do is prove intent in the exact opposite direction and that no harm was meant. So then you have to prove negligence or something, which is also likely to be uphill. And this all assumes you can pin it on one person. No good purpose is served by this. You're not getting some hardened criminal off the streets or putting someone in jail for an act committed with a bad frame of mind. Best case you wind up punishing someone using some negligince wrongful death type statues that's written based on the assumption that the person who caused the death DGAF about the deceased. Even if you pull that off this person is probably the mother or father or a grandparent who already lost their kid or grandkid for it so there's a real tinge of double jeopardy to the whole thing. This serves no purpose other than a show of force by the prosecuting office. The "real" crime committed here is not accidentally giving one's infant the wrong pills (someone gave a kid Tylenol, it's not like it was Xanax or booze to shut them up or some other thing everyone knows you don't do), the facts are likely to stack up in a way that make that act a non-criminal accident. So what you're doing in practice is screwing up one or more people's lives, to much fanfare, because they failed to tell the whole truth to the state a decade or more ago. Now, I get that that might sound like a good thing to some people, but those people are bad people and their ideas are bad ideas. >Is that an accident according to you, or do you have any evidence that the article is wrong about that conclusion? Stop trying to re-frame my assertion as an issue with the article rather than a critique of the proposed action (prosecuting someone). I know you'd rather discuss that, because that's much more defensible than a hypothetical decision to prosecute, and I do not accept your slight of hand.
  - radiator_1451 9mo ago
    Calm down. I'm not trying to re-frame anything, perhaps I misunderstood you because your reasons for not prosecuting are incomprehensible to me. Do I understand correctly that you think a murder (or involuntary manslaughter etc) is not "as bad" because the perpetrator was close to the victim? > this person is probably the mother or father or a grandparent who already lost their kid or grandkid Would you say the same about a man who (perhaps accidentally) killed his wife 20 years ago and covered it up? "He's already lost his wife, time served, no reason to investigate." Speaking as a parent, giving a 12 days old infant Tylenol is clearly absurd and just as unreasonable as giving them booze.
    - cucumber3732842 9mo ago
      >Would you say the same about a man who (perhaps accidentally) killed his wife 20 years ago and covered it up? "He's already lost his wife, time served, no reason to investigate." There is a massive gulf of intent there and I think it speaks volumes that you cannot (or worse, decline to) identify it. >Speaking as a parent, And also speaking as a person who's been espousing the opinions you've been espousing thus far, that's more than just "parent" >giving a 12 days old infant Tylenol is clearly absurd and just as unreasonable as giving them booze. People are stupid. Shit happens. I know it seems wild now and everyone turns into a screeching moron about it now but the "suck on a finger dipped in booze" thing was not abnormal (note for said screeching morons: I did not say "considered tasteful") for decades. Doesn't surprise me that someone would give an infant a fraction of a pill of Tylenol as a sleep aid not knowing they have the opioid type and that the fraction they chose is enough to kill the kid one shot.
      - radiator_1451 9mo ago
        > Doesn't surprise me that someone would give an infant a fraction of a pill of Tylenol as a sleep aid not knowing they have the opioid type and that the fraction they chose is enough to kill the kid one shot Note that this is just a story you made up, we really don't know what happened. You're also leaving out that if somebody did this by accident, they also chose to keep quiet about it for 20 years. Doesn't that speak about "intent"? Also, giving a 12 days old baby a "normal" Tylenol, say one with 500 mg acetaminophen, is a very bad idea. The normal dose for a 3 month old is 60 mg (for fever, not as a "sleep aid"). Doses above 200 mg/kg can cause acute toxicity, so for a slightly small baby of 2500 g, you're there already. Perhaps thinking that there's a "safe" type of Tylenol to give a baby as a "sleep aid" (what??) is a good example of "People are stupid". With my example with the wife, I'm simply trying to establish why you seem to consider children (or rather babies) to be not worthy of the same justice as adults. How about an adult who accidentally kills their elderly parent, would you consider that worth investigating, or should it also not be investigated on the principle of "they lost their parent"? Or further, at what age do you no longer consider it morally justifiable to accidentally (or otherwise) kill one's child and cover it up? 5 years old, 10, 18? To me, being stupid does not mean you're allowed to give your elderly father 10 Tylenols as a "sleep aid" and claim "shit happens" if he dies. I might want to call a person of that viewpoint a "bad person with bad ideas" or a "screeching moron", but I'd like to stay above such childish namecalling.
- inquirerGeneral 9mo ago
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mindslight 9mo ago

The "happy ending" where one of the parents and their three other kids find out that the other parent likely killed the older brother they never met? That doesn't sound very happy to me, but maybe we have different definitions of happy? When I tried reading into the causes of so-called SIDS it seemed like at least some of the cases were a catch-all diagnosis that included cases where parents inadvertently killed their infants (eg co-sleeping and rolling onto them). Fundamentally I think there often isn't much upside to fully fleshing out the truth of cases where parents have already paid the heaviest price.

lmm 9mo ago
> The "happy ending" where one of the parents and their three other kids find out that the other parent likely killed the older brother they never met? That doesn't sound very happy to me, but maybe we have different definitions of happy? While "happy" isn't the word I'd use, that seems better than knowing that this could happen to any baby at any time and nothing would be done.
- inquirerGeneral 9mo ago
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maxbond 9mo ago
We don't know it was the parents. Could've been a babysitter. Could've been a grandparent. New parents often have help.
BLKNSLVR 9mo ago
Man, SIDS. It's specifically non-specific, but the worry it causes is quite specific. My daughter, as a baby, always managed to find a way to sleep on her stomach. Wouldn't sleep on her back, but almost magically by comparison would fall asleep lying on her stomach (face to one side or the other, not straight down, obviously - I hope). We tried various combinations of devices, arrangements of pillows and cushions, tight wraps, to keep her lying on her back, but babies are remarkably, if involuntarily, wilful (or she was, anyway, and remains to this day). I worry about very few things, but for the first few nights we'd regularly get up to check on her, and literally be holding our breath waiting for her to expel hers. Out of necessity the every-parents-SIDS-fear, from allowing the baby to sleep on their stomach, had to be removed from our psyche so that we could continue to function day-to-day. Said baby is now, thankfully, a semi-healthily functional teenager. As functional as teenagers get anyway :)
- globalnode 9mo ago
  during covid they actually laid hospital patients face down (suspended i think?) to help with breathing when a ventilator wasnt available. this behaviour reminds me of that, perhaps your baby was doing this to help with breathing? i dont know...
- mindslight 9mo ago
  I swear, all the shit they push at new parents. You can see the point to much of it, and it's obviously going to be a very stressful time regardless. But there's the same inescapable bureaucratic dynamic where once something becomes legible, the system pathologically emphasizes those few bits over and over and over, to the detriment of balanced judgement - both your own and most healthcare providers if you try to get some nuance out of them. It's understandable that they're trying to help the people who might not be the most competent at following the guidelines, because there is still harm reduction to be had there. But it pushes the instruction-followers into the territory of "well, this probably doesn't apply to us because XXX", which is an epistemologically terrible place to be. We're still joking about how much they repeated the advice to keep the belly button dry, when it was relevant for like maybe two whole weeks.
t0bia_s 9mo ago
SIDS was named in 1969, might be related to combined vaccines. https://www.chop.edu/vaccine-education-center/vaccine-safety/vaccines-and-other-conditions/sudden-infant-death-syndrome-sids https://www.chop.edu/vaccine-education-center/vaccine-safety...
- VMG 9mo ago
  have you read the linked page? > However, since immunizations are given to about 90 percent of children less than 1 year of age, and about 1,600 cases of SIDS occur every year, it would be expected, statistically, that every year about 50 cases of SIDS will occur within 24 hours of receipt of a vaccine. However, because the incidence of SIDS is the same in children who do or do not receive vaccines, we know that SIDS is not caused by vaccines.
radiator_1451 9mo ago
I mean, if it was the case that one parent killed the child (Which, to be clear, we don't know. It could have been anybody who had access to the child at the time), then I'd think the best outcome is them getting convicted of it. I don't know why so many people treat homicide as "not a big deal" when it comes to babies. Consider an unrelated hypothetical scenario, a family father accidentally hits and kills somebody with his car. He flees from the scene and is not discovered for 20 years. Would you then not attempt to prosecute him because it would be sad for his family to know? And now consider the case if it was his own child that died.
- mindslight 9mo ago
  It's not that it's "not a big deal", rather the problem is you're up against the limits of details fading to time, negligence, etc. The best case here you're probably looking at each parent blaming the other parent for either doing it or at least letting it happen. But really my main issue was with characterizing such a thing as a "happy ending". While it's generally good for justice to be served, we should still be wary of people who are a bit too gleeful about punishment.

steelbrain 9mo ago

> Does no one care that this is potentially a murder case? Did we read the same article? Why are you so quick to jump the gun here? > Koren obtained a sample of Rani’s breast milk, which she had kept in her freezer. His lab measured its morphine concentration at eighty-seven nanograms per millilitre. If this is in the breastmilk, it will end up in the stomach, and it may end up in gastric contents. I don't understand this urge to demonize the parents, who on top of having lost a child, have to stand these witchtrials.

pickleRick243 9mo ago
Are you Koren? Did we read the same article? The one that calls into question anything Koren says or claims? From the article I read: "A twelve-day-old infant cannot crawl. It cannot grab, and it cannot put something into its own mouth. “It also cannot swallow a Tylenol-3 pill,” Juurlink told me. “I don’t know what happened in that house, on that night, but I do know that someone gave this baby crushed Tylenol-3,” likely mixed in breast milk or formula. “That’s the only way these numbers make sense.”"
- Twisol 9mo ago
  Also relevant to the quote selected by 'steelbrain: > Recently, Parvaz Madadi has undergone a painful process of revisiting her past work and memories. [...] She added that she had no confidence in the measurement of Rani’s breast-milk sample, because it had been handled by Koren’s lab. There is a lot to process in this long article. The quote selected by 'steelbrain, concerning Koren's measurement occurs very, very early on, and much of the rest of the article is about contrasting Koren's early presentations of the material against others' testimony. It's worth reading the whole thing To 'steelbrain: cherry-picking one single quote out of a nuanced article does the journalism here a dire disservice. It's okay for different people to have different beliefs and takeaways from the article. However, your own defense of the biological mechanism here is directly argued against in the "same article" you are admonishing others over reading. That is not conducive to a discussion in good faith.
likpok 9mo ago
The article goes into detail about how this level of morphine in the breastmilk could not have given the baby a lethal (or even clinically effective) dose. Furthermore, Koren lied about what the tests showed the stomach contents to be: he omitted codeine entirely. Codeine (per the article) would not be expected to be transferred by breastmilk -- it's metabolized into morphine to be effective.
- irishcoffee 9mo ago
  This should be further up: it's metabolized into morphine. There are some giant red flags with this situation. How awful.
maxbond 9mo ago
> If this is in the breastmilk, ... Note that you and GP are talking about different values of "this." GP is talking about codeine, you're talking about morphine. The difference between the two is at the crux of this article.
- alterom 9mo ago
  > GP is talking about codeine, you're talking about morphine. The difference between the two is at the crux of this article. It appears that they didn't really read the article before commenting. The entire point, the damning evidence is that the child that died had codeine in his stomach, which he absolutely couldn't get from breast milk.
Twisol 9mo ago
> I don't understand this urge to demonize the parents, who on top of having lost a child, have to stand these witchtrials. Neither the article nor the commenter you replied to has demonized the parents. Yes, both the evidence discussed in the article and the opinions of those interviewed indicate direct administration of a pharmaceutical; it is appropriate to discuss this. Nobody has pointed the finger at anyone; it would indeed be quite inappropriate for such a discussion to be held in this forum.
mlyle 9mo ago
The original death finding falls just from simple back-of-napkin math. 87 ng/mL. Baby eats 30mL per hour. That's 2.6 micrograms of morphine. Elimination half life in neonates of ~8 hours means 30 micrograms in system at equilibrium if constantly fed this and the baby absorbs all of it (takes 4-5 half lives to get to that) and pharmacokinetics are linear. In reality a neonate likely absorbs well under 1/3rd, so you'd expect under 10 micrograms in equilibrium. 25-50 micrograms/kilogram is normal dosing of morphine in a neonate when it is necessary, every 6 hours (resulting in a peak systemic concentration of ~60-120 ug/kg after repeated dosing). Compare -- 60-120 ug/kg therapeutic dosing to 10 micrograms in the neonate's body (3-4 kilos, so 3 ug/kg??) And then, you end up with acetaminophen and codeine in the neonate's stomach, with no morphine... Even though these do not end up in breast milk in significant quantities.