Duke University Medical Center in Durham. (Image: By Pete Kiehart © 2020 The New York Times)
A college degree at 19. A medical school graduate with a Ph.D. at 27.
By the time he completed training in vascular surgery in 2014, Dr. Sapan Desai had cast himself as an ambitious physician, an entrepreneur with an MBA and a prolific researcher published in medical journals.
Then the novel coronavirus hit, and Desai seized the moment. With a Harvard professor, he produced two studies in May that almost instantly disrupted multiple clinical trials amid the pandemic.
One study’s findings were particularly dramatic, reporting that anti-malaria drugs like hydroxychloroquine, which President Donald Trump promoted, were linked to increased deaths of COVID-19 patients. But that study and another were retracted in June by the renowned journals that had published them, weeks after researchers around the world suggested the data was dubious. Desai, who declined to share the raw information even with his co-authors, claimed it was culled from a massive trove acquired by Surgisphere, a business he started during his residency.
The now-tainted studies helped sow confusion and erode public confidence in scientific guidance when the United States was already deeply divided over how to respond to the pandemic. And the anti-malaria drugs cited in the papers have continued to generate controversy, as new research prompted some scientists to petition for expanding their use against the coronavirus, despite Food and Drug Administration warnings against them.
While the journal debacle has shaken the broader scientific community, many people who have known Desai, 41, described him as a man in a hurry, a former whiz kid willing to cut corners, misrepresent information or embellish his credentials as he pursued his ambitions.
In interviews, more than a dozen doctors who worked with him during training and residency said they had often found him to be an unreliable physician who seemed less interested in patient care than in the medical journal he founded and his company, branded early on as a medical publishing business.
“You couldn’t trust what he said,” said Dr. Vanessa Olcese, a former chief resident who worked with Desai at Duke University Medical Center. “You would verify everything that he did and take everything he did with a grain of salt.”
His performance there and during a later fellowship at the University of Texas Health Science Center raised questions about whether he would be permitted to move to the next level of training. In both instances, he was.
More recently, in February, Desai left his job at a community hospital in a Chicago suburb where he had worked as a surgeon since 2016. He was named as a defendant in three medical malpractice lawsuits last year, court records show. His spokeswoman said he “deems any lawsuit naming him to be unfounded.”
The New York Times interviewed more than two dozen people who have known Desai over the past two decades.
Desai, who declined to be interviewed for this article and did not respond to repeated requests for comment, has defended his company’s data. In an interview in late May, he said it was his “life’s work” to build a company that could provide lifesaving clinical insights to make “the world a better place.”
“We did this because it was an opportunity to help. We’re not making any money from this,” he said. “This is why I went into medicine.”
‘A Giant Roadblock’
Desai was always a striver. During high school in the Chicago suburbs, he took 13 Advanced Placement classes, according to an article in The Daily Herald, a local newspaper. He acquired enough college credits to graduate from the University of Illinois at Chicago at 19.
“His goal was to be the first person at UIC. that ever graduated college in one year,” said Peter Okkema, a biology professor in whose lab the young undergraduate worked.
Desai seemed eager to impress people, the professor recalled, but never sought advice or guidance.
He entered a joint M.D.-Ph.D. program at the university; his doctoral adviser, professor Anna Lysakowski, remembers him as “very bright, very quick.” She also said he told her he was enrolled at John Marshall Law School. (The school has no record of him, a spokeswoman said, and the degree is not on his resume). Several doctors who knew Desai after he moved to Duke for his residency in 2006 recalled his saying he had a law degree and described his license plate listing his supposed credentials: M.D., J.D. and Ph.D.
Over the next five years, his performance and a pattern of behavior at the North Carolina hospital worried colleagues, according to physicians who worked with him there.
In interviews, Drs. Olcese, Mani Daneshmand, Dawn Elfenbein and 10 others — who spoke on the condition of anonymity because they were not authorized to talk to the media or feared retribution from their employers or Duke — said there were broad concerns inside the surgery department about Desai.
The doctors, many of whom were also residents, said they could not trust information he provided about patients’ medical conditions or test results. Several doctors said it became standard practice to double check anything Desai said about a patient, such as how the person had fared overnight or whether a test had been ordered.
Several former colleagues said that often he did not follow through on directives about treating patients and that when he was questioned about it, he sometimes passed blame or offered implausible explanations.
In one instance, Desai did not respond to pages from nurses during an overnight shift while on call, recalled Olcese. When she asked about the missed pages, he said he had been resuscitating an infant by performing a rare, complicated procedure — an incident the charge nurse said never occurred, according to Olcese and another doctor present for Desai’s explanation.
“He was essentially a giant roadblock that you had to work around,” said Olcese, now a neurocritical care doctor at Wexner Medical Center in Columbus, Ohio. “You didn’t want him to bring you down with him.”
In 2008 or early 2009, Olcese and another chief resident shared concerns about Desai with their supervisors — senior physicians and faculty at Duke — during discussions about whether to promote him to the next year of residency. It is unclear what the faculty members discussed during their private deliberations, but ultimately, Desai was moved up. A Duke spokeswoman would confirm only his time there.
After his residency, Desai obtained an MBA in three months from Western Governors University, an online university based in Salt Lake City, the school confirmed. Then, after starting a vascular surgery fellowship at the University of Texas at Houston, he ran into trouble. He had so antagonized some supervisors that they asked the department chairman to expel him, said Dr. Hazim Safi, who was then in that role.
“Some of the attending staff didn’t like his behavior and didn’t want him to graduate,” Safi said in an interview.
While Safi said that Desai could be abrasive, he had worked on papers with the younger physician and was convinced the complaints were driven by personality differences and professional jealousy, not substantive deficiencies in surgical skill or patient care. Instead of failing him, he said, he gave Desai an opportunity to work on his professionalism and interpersonal skills.
“I intervened, and he graduated,” the former chairman said.
At Desai’s most recent post at Northwest Community Hospital in Arlington Heights, Illinois, he became involved in at least four medical malpractice cases that are still pending, including three filed in 2019.
Those suits include a claim that he failed to properly perform surgery to restore circulation to an accident victim’s leg, which later required partial amputation. Another alleges that negligent treatment by Desai and other doctors resulted in the removal of a substantial portion of a patient’s bowel.
The earlier case against the hospital contends that Desai performed surgery in 2016 to remove plaque buildup from a 60-year-old man’s carotid artery, then failed to come to the hospital after he developed swelling in his neck that caused difficulty swallowing and breathing. The patient later died.
Big Data, Big Dreams
By the time Desai left the hospital earlier this year — a hospital spokeswoman said he voluntarily resigned for personal reasons — the novel coronavirus was raging in China and spreading to other countries.
For Desai, whose entrepreneurial projects had grown to include a health data analytics company, the crisis was an opportunity to fulfill his dream of using big data to study outcomes and improve care. The public’s appetite for information was insatiable, and journals were publishing studies faster than ever.
Over the years, Surgisphere had developed a product called QuartzClinical that offered health centers a platform using data analytics to improve outcomes. Desai said the product had enabled Surgisphere to amass a giant registry with anonymized electronic health records from more than 1,200 hospitals and health centers, with data about more than 240 million patient encounters in 45 countries.
While the existence of the database has not been confirmed — Desai cited contractual obligations to keep confidential the identities of participating hospitals — he said he had been building it for a decade with fewer than a dozen employees. Few people were needed, he said, because hospitals could easily input anonymized patient data from disparate electronic health record systems, translating the information into a single, homogenized registry without technical assistance.
One former Surgisphere employee, Ariane Anderson, was surprised by Desai’s assertion, given the difficulties of combining information from disparate institutions with various electronic records systems.
Anderson, who was hired to market QuartzClinical to hospitals and other health centers in 2019, said in an interview that generating interest in the company had been an uphill battle and that entering data into Surgisphere’s system was laborious. When one hospital wanted to try out the system in July 2019, she said, she spent two days there extracting data from a sampling of 200 patients to put into a spreadsheet.
By the end of 2019, Anderson said, she knew of only one hospital that had signed a contract with QuartzClinical, declining to identify it.
The new coronavirus put the company on the map. One of Desai’s projects early this year was to develop a COVID-19 severity scoring tool using data he said came from tens of thousands of registry patients. He offered the tool free to a nonprofit based in Cape Town, South Africa, saying it could identify high-risk patients and help allocate scarce medical resources in remote areas. (The group, the African Federation for Emergency Medicine, rescinded its endorsement of the tool after the studies were retracted.)
Desai also teamed with Dr. Mandeep Mehra, a Harvard Medical School professor, and several others to turn out papers about COVID-19 that were ostensibly based on the patient registry. In May, he won the equivalent of academic medicine’s jackpot: publication in two of the world’s most prestigious journals.
The first paper, citing data from 8,910 COVID patients at 169 hospitals in Asia, North America and Europe, reported that cardiovascular disease increased the risk of bad outcomes but put to rest concerns that blood pressure medications were harmful (it even seemed to suggest a benefit). It was published May 1 in The New England Journal of Medicine.
The next paper, published May 22 in The Lancet, evaluated anti-malaria drugs that Trump has promoted as antidotes to the coronavirus. The researchers claimed to have analyzed the outcomes of nearly 100,000 COVID-19 patients from 671 hospitals on six continents. The results were sensational: Patients treated with chloroquine and hydroxychloroquine were up to five times as likely to have abnormal heart rhythms as other patients — and were at higher risk of dying.
Although it was an observational study, considered to provide relatively weak scientific evidence, the paper’s effect was felt around the world. A physician commenting on CNN called it “the mother of all studies,” and investigators including the World Health Organization halted clinical trials of the drugs. (Some have since resumed.)
The paper soon drew scrutiny from scientists who demanded to know more about the data and began questioning the New England Journal study too. Desai’s co-authors, conceding they had never seen the raw data, called for an independent review, but Desai balked, invoking confidentiality agreements. On June 4, both journals retracted the studies.
Surgisphere’s flashy website has been dismantled. Desai, who gave several interviews before the studies were retracted, has gone silent.
c.2020 The New York Times Company