A response from Dr. Nancy Olivieri

I write to correct the errors and misrepresentations in the review by Hoey and Todkill1 („The Olivieri story, take three”; Oct. 11, 2005) of Miriam Shuchman's book.2 Many physicians may wish to appreciate more completely the significance of the extensive list of inaccuracies and omissions in Shuchman's story, which I provided to the CMAJ five months before this review appeared.

Contrary to the claims of the book review, the University of Toronto did not commission the 1998 „Naimark report.” This was funded by the Board of Trustees of the Hospital for Sick Children (Sick Kids'), a body distinct from the University. The first effective involvement by the University came only after it was pressed to defend my academic freedom by international experts, the University of Toronto Faculty Association, and the Canadian Association of University Teachers (CAUT).

By their title („The Olivieri story, take three”), Hoey and Todkill imply that Shuchman's book was the third legitimate „take” on the long-running saga involving me, the University, a drug company and Sick Kids'. Positioning Shuchman's „take” as authoritative does not acknowledge that her account relies on anonymous quotes, unnamed sources, and allegations long since discredited.

Presumably (according to Hoey and Todkill) „take one” was the Naimark report, and „take two” was the report of the independent inquiry commissioned by the CAUT (2001; which referenced not only all the information accepted by Naimark but several hundred additional documents). On Hoey's and Todkill's own reasoning, „take three” should be the Report of the College of Physicians and Surgeons of Ontario (CPSO; 2001) — confirming the CAUT Report's findings and concluding that my conduct had been „commendable.” „Take four” should be the University of Toronto's dismissal (2002) of the allegations made against me by Sick Kids' and based on Naimark's report. Because Hoey and Todkill omitted to mention these later reports, the reader may forget that they fully exonerated me. No reasonable person could imagine that any „legal settlements” could have been „brokered” if the Naimark's „findings” against me had retained credibility. These later reports have been followed by numerous other „takes” authored by scholars and medical researchers upholding my research methods and integrity. Why were the „takes” that exonerated me — all a matter of public record — not noted by the CMAJ editors?

It should be a matter of concern to CMAJ readers that, long after a series of independent inquiries dismissed Naimark's „findings” against me as baseless, Hoey and Todkill attempt to rehabilitate Naimark's report. Even Shuchman's book, while reporting that Naimark relied heavily on allegations by a physician whose „... claims were damaging to Olivieri ... persuasive ... and led directly to Naimark's conclusion ...”, acknowledges that this physician was disciplined by the University and the CPSO for „professional misconduct” in connection with attacks against me.3 In this respect, Hoey and Todkill show even more bias against me than the book they reviewed.

CMAJ readers might also be interested to know that, 12 days prior to publication of the review, an expert panel convened by the FDA unanimously recommended that Exjade (deferasirox), an oral iron chelator manufactured by Novartis, be licensed for prescription sale in the USA.4 The date of this FDA panel hearing had been publicly announced on August 30, 2005, shortly before the CMAJ editors hurriedly undertook to produce their review — of a book they had ignored for months. In her book, Shuchman implies that a different orally active iron chelator, deferiprone, should be licensed by the FDA — while presenting a comparison (from an anonymous source) of certain qualities of Novartis' defasirox to „Metamucil.” The FDA nonetheless accepted the advice of its expert panel, and licensed Novartis' defasirox.5

This is not the first time these CMAJ editors have commented derisively on those who understand the significance of this controversy differently from themselves (and Shuchman). For instance, in 2002 they issued this statement: „We thought we'd heard enough, and written enough, about Nancy Olivieri's dispute ... We entertained the idea of using [The Olivieri Report]6 as a doorstop.”7 Their bias becomes more apparent in light of the fact that these editors published this comment after the „doorstop”'s findings — exonerating me and refuting Naimark's report — were independently confirmed by the CPSO and the University of Toronto.

Finally, respected medical journals now observe guidelines with respect to conflicts of interest — including immediate family connections — during submission, review and publication of data. Hoey and Todkill apparently do not hold themselves to this minimum standard: in their flattering review of Shuchman's book, they omitted to disclose that Shuchman's husband, Dr. Donald Redelmeier, is a member of the CMAJ's editorial board. They also do not disclose that Dr. Redelmeier has been a co-author with a physician whose allegations against me were relied upon in the Naimark report.8