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Colby Cosh: The Canadian pediatric medicine researchers who 'made it up'

When doctors publish fake medical news, they should expect to lose the public's trust

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On Tuesday morning, a fresh shockwave passed over Canadian pediatric medicine, which has had a difficult start to the year 2026. In January, the New Yorker published an investigative piece by Pulitzer-winning feature writer Ben Taub. Taub’s article describes a long-running feud between the disgraced doctor Gideon Koren, founder of the ill-fated Motherisk lab at Toronto Sick Kids, and his former colleague and co-author David Juurlink, a Sunnybrook Hospital and U of Toronto pharmacologist.

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Canadians may have somewhat overlooked the New Yorker piece precisely because the Motherisk scandal is so well known here, thanks to widespread newspaper reporting (particularly by the Toronto Star) that exposed the sloppy science of the lab and documented a pattern of scientific and personal misconduct by Koren, who retired in 2015 and forfeited his Ontario medical license in 2019. Motherisk’s bad drug-testing procedures tainted the entire Ontario child-protection system for a decade and led to injustice on a hideous scale.

Colby Cosh: The Canadian pediatric medicine researchers who 'made it up' Back to video

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The Taub story does not, in fact, focus on Motherisk. It’s about the controversy over a 2006 Lancet paper, a discussion of a single case of fatal poisoning, authored by Koren and four other doctors (including James Cairns, a former deputy chief coroner of Ontario who has, like Koren, since surrendered his medical license). The paper claims that a baby boy in Toronto, Tariq Jamieson, had died when his mother — acting on doctor advice — took Tylenol-3, a prescription medication containing acetaminophen and codeine. In the opinion of Koren and his co-authors, a terrifying thing had happened: the mother had passed codeine to her newborn through her breast milk, and he had overdosed when it was metabolized to morphine in his own liver.

Not long after the publication of the paper, Juurlink was in Scotland for a conference when a Scottish colleague asked him why nobody had noticed that his friend’s screwy Canadian paper was nonsense. (Never change, Scotsmen.) It seemed biologically impossible for the amount of morphine found in the autopsy of Tariq to have resulted from his mother’s low-level ingestion of Tylenol-3. There was (at the time) no evidence anywhere else in the world medical literature that such a thing was possible. And parallel reports sent to other journals showed that Tariq’s body also contained acetaminophen, at levels clearly indicative of a directly administered dose of Tylenol-3.

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Juurlink began to work the case, eventually getting permission for a personal review of the confidential case files of the coroner. Those revealed that Tariq’s stomach contents contained a mass of unmetabolized codeine, confirming that the Lancet paper was based on a pharmacokinetic fantasy scenario.

Here I’ll leave off describing Juurlink’s frustrating battle to have the Lancet paper retracted, the coroner’s report publicized, and the women of the entire planet reassured about the exotic possibility of passing drugs to their babies through breast milk. I don’t want to rewrite Taub’s entire story, so let it suffice to observe that the New Yorker still gets people’s attention real fast. The Lancet finally published an “Expression of Concern” about the dubious paper on Feb. 3.

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But that wasn’t the end of the fallout. The strongest corroborating evidence for the Koren breast-milk scenario was a second case report in the official journal of the Canadian Paediatric Society, Paediatrics & Child Health. In 2010, Koren had published an account therein with a colleague, Michael Rieder, of a “Baby Boy Blue” who had to be saved with naloxone after breastfeeding from a mother who took Tylenol-3. As Taub explains, Juurlink ran into Rieder a few years later and asked him about the Baby Boy Blue case, which had the same puzzling features as the one in the Lancet. Rieder astonished him by uttering four unbelievable words:

It turns out, as the celebrated Retraction Watch weblog reported Wednesday morning, that the journal was routinely allowing doctor-authors to concoct details of utterly nonexistent cases for “teaching purposes,” something that was indicated nowhere in the published versions of the reports. The “Baby Boy Blue” report, in particular, had been cited as genuine in other journals, and even caused Juurlink a moment or two of doubt about his detective work. The editor of Paediatrics & Child Health, citing the awkward moment in Taub’s piece, has announced a plan to add disclaimers to a series of 138 reports previously presented as genuine.

But how was this insane editorial policy allowed to survive for 25 years? (The journal is published by some fly-by-night outfit called … uh … the Oxford University Press.) The journal’s instructions to authors acknowledged that it was all right to make up biographical and pathological data for the teaching reports, which then infested the world’s medical-literature databases with undisclosed fictions. Some physicians seem to have submitted real cases with accurate details in good faith, but dozens or hundreds of them must have noticed the instructions and had no problem with them.

You can’t help but wonder about Canadian national pathologies — no pun intended — in reading all this stuff. Our obnoxious habit of confusing privacy with secrecy was at work in the official suppression of the details of the Tariq Jamieson case. (Do coroners exist to serve the public interest, or just to padlock information?) The same problem is apparently the source of the deranged and anti-scientific behaviour of Paediatrics & Child Health and, at one remove, the Paediatric Society itself. A spokesperson for the society told Retraction Watch, in apparent total seriousness, that the undisclosed publishing of fictional cases was necessary to “protect patient confidentiality.” Maybe sometime we’ll get to the bottom of the biggest mystery of all: public loss of trust in the medical profession.

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