NIH tells Congress it lacked authority to investigate whistleblower complaints about Axel Grothey’s sexual misconduct

Women who report sexual misconduct to NIH may find that their complaints have a limited shelf life—these complaints may become null, or at least ineligible for “even a cursory review” once perpetrators cut ties with NIH.

NIH may be “constrained” from investigating sexual misconduct at NIH-funded institutions once alleged perpetrators are no longer affiliated with grantee institutions, according to NIH Principal Deputy Director Lawrence Tabak, writing in a letter to members of Congress.

Tabak’s letter, dated Sept. 17, is NIH’s response to an Aug. 9 congressional letter asking NIH to describe the procedures employed for rooting out sexual misconduct committed by advisors (The Cancer Letter, Aug. 10, 2021). 

The congressional letter, addressed to NIH Director Francis Collins, also asks for an explanation of policies used in investigating sexual harassment complaints from whistleblowers.

NIH leadership is still not fully protecting women and other victims of sexual harassment from achieving their rightful place in science.

Rep. Cathy McMorris Rodgers (R-WA)

The initial letter was signed by Rep. Cathy McMorris Rodgers (R-WA), ranking member of the House Committee on Energy and Commerce, and Rep. H. Morgan Griffith (R-VA), ranking member of the House E&C Subcommittee on Oversight and Investigations. Their Democratic counterparts didn’t sign the letter. 

The congressional inquiry is based on The Cancer Letter’s investigative story of the case of Axel Grothey, an oncologist who was able to retain an influential advisory position at NCI even after being disciplined by three states for inappropriate sexual behavior that involved a mentee (The Cancer Letter, May 28, 2021).

In the Grothey case, two women reported Grothey’s misdeeds to NIH and NCI in April and May 2019, with no results. The NIH Office of Extramural Research sent an automated response to one of the women and never followed up.

Tabak said NIH was unable to conduct an inquiry into allegations of sexual misconduct because Grothey had left Mayo Clinic—an NIH-funded institution—in May 2018, a year before the complaints were filed with NIH, and was no longer “key personnel” on NIH grants.

“Dr. Grothey was not employed by an NIH grantee institution in 2019,” Tabak wrote in the Sept. 17 letter. “Dr. Grothey was not then and is not now key personnel on any NIH award. Nor was he at the time or is he at the present employed by an institution that receives NIH funding. This greatly constrained NIH’s authority to make inquiries or conduct even a cursory review of the allegations made.”

NIH didn’t respond to questions from The Cancer Letter for this story.

“NIH leadership is still not fully protecting women and other victims of sexual harassment from achieving their rightful place in science,” Rodgers, the Energy and Commerce Republican leader, said to The Cancer Letter. “There are still two critical questions Dr. Collins has yet to answer for Congress: 

“Where are NIH plans to foster a safer environment for junior faculty? Why isn’t NIH uniformly implementing across all institutes and centers the new policies to properly vet candidates for NIH leadership positions so a case like Dr. Grothey’s never happens again?”

Reportage by The Cancer Letter prompted NCI Director Ned Sharpless to remove Grothey from the NCI National Clinical Trials Network’s Gastrointestinal Steering Committee, which he co-chaired. More than 10 cancer organizations and institutions have censured or barred Grothey (The Cancer Letter, June 4, 2021).

In his letter, Tabak did not describe NIH’s rationale for allowing Grothey to remain on the NCI steering committee until May 27, 2021—two years after the two women filed complaints with NIH, and a year after medical boards in Minnesota, Tennessee and Arizona issued reprimands against Grothey.

“The NIH Office of the Director worked with and strongly supported Dr. Sharpless in his removal of Dr. Grothey from an NCI steering committee,” Tabak wrote.

Rep. Frank Pallone (D-NJ), chairman of the E&C Committee, and Rep. Diana DeGette (D-CO), chair of the E&C Subcommittee on Oversight and Investigations, are cc-ed in Tabak’s letter.

Karyn Goodman, the remaining co-chair of the GI Steering Committee following Grothey’s termination, said NIH could have initiated an investigation earlier.

“I believe that the response from Lawrence A. Tabak, D.D.S., Ph.D. did not fully address the NIH’s lack of any response to the email notifications in 2019 from two women who had filed complaints of sexual misconduct at Mayo Clinic, leading to an investigation and his departure from Mayo Clinic in 2018, and filed grievances to the Minnesota Board of Medical Practice, which ultimately led to a reprimand and fine for engaging in ‘unethical or improper conduct’ in March 2020,” Goodman said to The Cancer Letter. 

“The NIH could have investigated the womens’ complaints earlier given the leadership position Dr. Grothey held as the NCI GI Steering Committee co-chair where he played an influential role in the decision-making about study concepts that were proposed, oftentimes by junior faculty,” Goodman said. 

“Unfortunately, these situations have for too long been brushed under the rug, and it took media coverage by The Cancer Letter to initiate any action.”

Advocates: Poor excuses for multiple failures by NIH leadership

Does NIH’s authority to ask questions peter out the moment an alleged perpetrator leaves an NIH-funded institution? 

Do NIH leaders owe the women an explanation for why Grothey was allowed to remain on the NCI steering committee?

The Cancer Letter asked two experts on professional misconduct to review Tabak’s response:

Pringl Miller, founder and executive director of Physician Just Equity, a nonprofit that provides peer support for physicians who experience harassment, discrimination, and retaliation; and 

Shea Holman, director of law and policy at the Purple Campaign, a nonprofit focused on ending sexual harassment in the workplace.

Miller and Holman have no involvement in the Grothey case. Their full remarks appear here.

NIH’s apparent inaction on the Grothey case is unjustifiable, Miller said to The Cancer Letter

“In the interest of adhering to their no-tolerance policy and being a stakeholder in the scientific and academic community, I would think that ethically, [NIH] would be obligated to pursue the proper course of action,” Miller said. “They may not have legal standing if the perpetrator is not receiving NIH funds and/or working at an NIH-funded site. 

“I think the fact that Dr. Grothey had during the events, but not at the time of recognition, is a poor excuse for their inaction,” Miller said. “[NIH leadership] should have taken action when the complaints were brought to their attention.”

NIH is facing bipartisan pressure to formulate rules on sexual harassment for institutions receiving NIH funds through grants or cooperative agreements. A disclosure provision, contained in the FY2022 House appropriations committee bill, would give NIH the authority to “issue regulations” that would delineate reporting requirements for institutions (The Cancer Letter, July 23, 2021).

Many individuals who experience sexual harassment remain silent because they assume that their institutions will not take corrective action—and NIH exemplifies that problem in the Grothey case, Holman said to The Cancer Letter.

“We advocate for fair and thorough investigations and steps demonstrating accountability, neither of which have fully occurred here,” Holman said. “Although NIH has stated it is unable to legally require reporting of sexual misconduct by outside entities, NIH failed to conduct even the most basic follow-up that it promises to internal employees and employees at awardee institutions. 

“The organization did not follow up with these women, did not reach out to senior leadership to ask about a timeline to investigate or restrictions placed on Grothey, or inquire whether corrective action was being taken,” Holman said.

“Not only did NIH fail to reach out to the awardee institution, but it failed to maintain any transparency with the reporting parties on whether an investigation would occur or what corrective action would take place.”

NIH’s support for Sharpless’s decision to fire Grothey from the NCI steering committee is “only one element of accountability, ‘ Holman said.

“Grothey maintained his position at NCI as a co-chair of the National Clinical Trials Network GI Steering Committee and NIH has failed to explain why Grothey wasn’t removed from the committee at the time the complaints were made,” Holman said.

NIH should be held accountable for their inaction, particularly in light of their Feb. 28, 2019, update on Efforts to Address Sexual Harassment in Science, Miller said. 

“‘Demonstrate accountability and transparency’—how did they do that in Dr. Grothey’s case?” Miller said. “‘Provide clear channels of communication’—they didn’t do that, because the complaints went unaddressed as far as I can tell until The Cancer Letter contacted NCI in May 2021. Did the NIH ‘incorporate the survivors’ perspectives into future actions’?”

“A need-to-know basis”

In the Aug. 9 congressional letter, lawmakers sought clarification on NIH’s policies on confidentiality:

“It is unclear why the NIH cannot provide confidentiality to such whistleblowers but is able to maintain confidentiality of other personnel or intellectual property information,” the congressional letter states. “We … want to ensure that the NIH is holding its committee leaders to the highest standards of conduct and to promote a safe work environment for junior researchers, particularly those in mentor relationships that are vulnerable to abuse of authority.”

NIH doesn’t inform individuals who report sexual harassment of the outcome of investigations at NIH-funded institutions, said Holly Atkinson, a clinical professor at the City University of New York, a member of Physician Just Equity, and past president of Physicians for Human Rights, a nonprofit that investigates and documents human rights violations.

“The NIH says ‘it is on a need-to-know basis’ … they wouldn’t even provide us with a definition when asked for further clarification of what they mean by ‘need to know basis,’” Atkinson said to The Cancer Letter. “We, as survivors, of course, need to know.

“[It’s] so easy for an institution to say, ‘We investigated their complaint, there is no problem—doesn’t rise to level of sexual harassment.’ NIH then just goes away? Not enough transparency on the NIH investigation part. Reporters risk coming forward to NIH and get little in return.”

NIH perpetuates “ongoing trauma to survivors” through a system that places all risk on the individuals who report, said Anu Anandaraja, a pediatrician, a member of Physician Just Equity, a public health educator, and founding director of Women Together Global Inc.

“Reporters are not guaranteed confidentiality and are also told not to expect any information on progress or outcome of investigation, thereby placing the reporter at risk of further retaliation but with no means to prove it,” Anandaraja said to The Cancer Letter. “How is this a safe, effective or survivor-friendly system? We know that this process deters reporting and will grossly underestimate the incidence of sexual harassment among grantees and grantee institutions.”

In his letter, NIH’s Tabak noted that a “large proportion” of over 300 individuals who were being investigated for misconduct were “removed from peer review committees” while NIH investigated allegations.

“In June 2021, NIH provided the [Advisory Committee to the Director] with an update of its approaches to addressing sexual harassment, along with results to date,” Tabak wrote. “At that time, the Office of Extramural Research had handled extramural harassment (sexual and other) allegations involving over 300 individuals since 2018. A large proportion of these individuals were removed from peer review committees, at least temporarily, while allegations were being assessed. The update was well-received by the ACD.”

However, NIH has failed to follow its own procedures for enforcing accountability in the Grothey case, Holman points out.

“NIH has policies which state the organization will follow up with the relevant applicant/grantee institution to request information such as timeline to investigate and restrictions on persons designated on an award,” Holman said. “Yet, NIH allowed Grothey to maintain his position at NCI as a co-chair of the National Clinical Trials Network GI Steering Committee and allowed him to retire with his reputation intact. 

“As a result, NIH leadership should explain why it failed to follow its own policies in this case.”

Tabak’s Sept. 17 letter in response to the congressional inquiry follows: