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A year after Dr. Michele Carbone abruptly resigned as head of the University of Hawaii Cancer Center, the controversial researcher is still dogged by unresolved allegations that he failed to properly disclose potential financial conflicts of interest.

These potential conflicts include millions of dollars in consulting fees paid by attorneys defending asbestos-related companies in lawsuits brought by people who had mesothelioma, a form of cancer usually caused by job-related exposures to asbestos.

Carbone is a well-known researcher who specializes in mesothelioma, and directs a laboratory conducting related research. The payments were received over a period of at least eight years, including the five years he served as Cancer Center director.

Carbone revealed details of the payments last year while testifying under oath during pre-trial proceedings in a California lawsuit. He was a defense witness in an asbestos case that resulted in a $19 million judgment for the plaintiffs.

Copies of the transcript were previously provided to both the UH administration and the University of Hawaii Professional Assembly (the faculty union), and recently obtained by Civil Beat.

In addition to the consulting fees, Carbone testified that he successfully solicited two gifts totaling $4.3 million from Honeywell Corp, a Fortune 100 company reportedly facing more than 47,000 legal claims stemming from asbestos used in brake pads manufactured by a subsidiary.

The gifts were given anonymously to the University of Hawaii Foundation, which shielded the identify of the donor corporation from the public and, in turn, funded the mesothelioma research being conducted in Carbone’s laboratory.

The disclosures have given new impetus to allegations originally raised by critics within the Cancer Center, including researchers Unhee Lim and Adrian Franke. The conflict of interest issues were raised recently before the UH Manoa Faculty Senate, made up of faculty elected from their respective academic units.

The case calls into question how well the university is fulfilling its legal responsibilities to identify, avoid or mitigate conflicts that could affect the design, conduct or reporting of federally funded research.

The Senate’s Committee on Professional Matters met earlier this month with top campus administrators to discuss the allegations and the university’s responses to date, according to the committee agenda posted online. Those attending the meeting included Manoa Interim Chancellor Robert Bley-Vroman; Vassilis Syrmos, vice president for research and innovation of the UH System; and Dwight Takeno, director of collective bargaining & employee relations.

Carbone stepped down as Cancer Center director in November 2014 amid criticism of his management style and claims of excessive spending.

Details Disclosed

Carbone testified under oath during a deposition held Nov. 7, 2014, in the offices of a San Francisco law firm. In a session lasting six hours, he detailed his asbestos-related consulting, explained why he did not consider it to create any conflict of interest, and described soliciting the multimillion dollar gift from Honeywell.

Carbone said he typically charges $10,000 to review medical records, including tissue samples, and offer a diagnosis of whether or not a person is suffering from mesothelioma.

Any additional work as an expert witness, whether in pre-trial proceedings or testifying at a trial, would be billed at a standard rate of $1,000 an hour, Carbone testified.

He was asked if the $1,000 an hour applies to all of the time flying from Hawaii to the mainland for a consultation? His answer: “Everything.”

Carbone detailed his asbestos-related consulting, explained why he did not consider it to create any conflict of interest, and described soliciting the multimillion dollar gift from Honeywell.

The lawyer asked again: “Sitting on the airplane?”

Carbone: “Everything.”

Under questioning, Carbone initially said he rarely responds positively to requests to serve as an expert witness. “Generally, my answer is ‘no,’” he said.

“So I have a lot of people who call me, and I would say that almost always I say ‘no, thank you,’” Carbone testified.

The plaintiff’s attorney asked how often he says “yes” to such requests. Initially. Carbone said he couldn’t remember.

When pressed, Carbone responded with a number. “Fifty,” he said.

“And is that 50 cases per year or 50 cases over your life?,” the attorney asked.

His reply: “I said it would be 50 over a year.”

Carbone went on to confirm a rough estimate of his income from these cases would be at least $500,000 per year, and had been at this level for the previous eight years.

Before that, he made less because he was then charging only $400 an hour, Carbone said.

Turning to the research funds from Honeywell, Carbone testified he did not submit a grant proposal.

Instead, he pitched his research to two of the corporation’s lawyers in Washington, D.C., including Honeywell International’s general counsel.

“I explained to her how important it could be for companies to support research on mesothelioma,” Carbone said. “And my argument that the way to solve this problem is through research.”

Carbone has been among a small group of researchers who have identified a gene mutation that makes a person with the mutation very susceptible to cancer, whether caused by asbestos or other factors. And Carbone has reportedly taken the theory to controversial lengths, arguing that the gene mutation alone is capable of causing mesothelioma, even without any exposure to asbestos.

It’s a theory that has obvious appeal to the asbestos companies as they try to defend against the billions of dollars in potential legal liability.

But at least in this deposition, Carbone repeatedly rebuffed attempts by the plaintiff’s attorney to draw broad conclusions from his research.

“In science we are very conservative,” Carbone responded at one point in the questioning. “And so we write ‘possible.’ We never state — make strong statement. Even if we think something, we write to suggest it because we’re always trying to downgrade.”

“What I see that you do in a court of law is that you do the opposite,” he said to the attorney questioning him. “So we’re talking about two different worlds.”

What Conflict?

Late in the deposition, the plaintiff’s attorney noted that other academics serving as expert witnesses disclosed their work for corporate clients, while Carbone reported having no conflicts despite making lots of money from asbestos companies.

“I’m not making money off of asbestos companies,” Carbone replied. “What do you mean?”

Then came this exchange:

Question: “The lawyers for asbestos companies have hired you for years to testify for them.”

Answer: “Well, if you want to see it that way, you see it that way.”

Q: “I mean, isn’t that true?”

A: “No. Not the way I see it. But if you see it that way, you see it that way.”

Financial Conflicts And Academic Research

In recent years, federal funding agencies have been stung by public criticism over the disclosures of secret corporate funding of academic research.

For example, disclosures that scientists disputing the health effects of tobacco were being funded by cigarette companies undermined public confidence in federally funded research, and in the value of research generally.

As a result, federal regulations were tightened in 2011 to require disclosure of any “significant financial interest” that could create bias because of a researcher’s personal financial conflicts of interest.

Prior to the 2011 changes, it was left up to individual researchers to determine whether any financial interest valued at $10,000 or more was related to their federally funded research, triggering the need for disclosure.

After the amendments, researchers are now required to report to their employing institution any financial interest valued at $5,000 or more that is “related to the Investigator’s institutional responsibilities.”

Carbone’s $500,000 or more in annual fees from asbestos-related lawsuits would be 100 times more than the reporting threshold, and would appear to be clearly related to his responsibilities, which as director included all research done by the Cancer Center’s staff as well as his own laboratory team’s research on mesothelioma.

At least, one might add, “if you want to see it that way.”

And the university is responsible to determine whether a reported financial interest should be treated as a “financial conflict of interest (FCOI),” which means, according to federal regulations, “a significant financial interest that could directly and significantly affect the design, conduct, or reporting” of the federally funded research.

Appearances Are Important

The UH conflict of interest policy recognizes two kinds of conflicts. “Conflicts of commitment” arise when outside activities of a researcher or employee “are substantial and overly demanding of the Employee’s time and attention, and interfere with the Employee’s obligations and responsibilities to the University.”

Conflicts of interest “refers to situations in which an employee’s financial, professional, or other personal interests may influence, or appear to influence, the employee’s judgment in fulfilling his or her responsibility to the University.”

So the appearance of a conflict may be as important as a conflict that actually produces bias in research, according to both federal regulations and UH policies.

One key part of the university’s role is to review reported “significant financial interests,” determine those that should be flagged as financial conflicts of interest, and report those to the federal funding agencies. The federal guidelines also call for certain information about such conflicts to be publicly disclosed on the university website, or made available in writing within five days of a request.

Prior to his resignation as director of the Cancer Center, Carbone was the fifth-highest-paid employee of the university.

Failure to report conflicts of interest, and the failure of the university to deal with them, can bring harsh federal sanctions, including the cut-off of federal research funds.

Notes distributed following the faculty senate committee’s meeting with the Manoa chancellor and the vice-president for research, recapping the main points of their discussion, indicate that the university is not currently pursuing any of the conflict-of-interest allegations against Carbone.

Due to confidentiality policies, it is unknown whether Carbone’s expert witness fees or solicitation of Honeywell funding were either reported to or reviewed by the university for possible conflicts.

Cancer Center researchers Lim and Franke, who took part in the discussion, say they were told the university would not pursue the conflict-of-interest issues unless they first file formal complaints with the National Institutes of Health, essentially forcing the university’s hand.

The university may, however, be investigating whether the demands of the former director’s extensive outside consulting creates a “conflict of commitment” to the detriment of the university.

It’s a fair question. Prior to his resignation as director of the Cancer Center, Carbone was the fifth-highest-paid employee of the university. Only the football coach, the medical school dean, the university president and the Manoa chancellor were paid more.

But the $500,000 or more he earned from outside consulting was significantly more than his $412,000 salary.

Should that have triggered some sort of review by the university? There’s no indication that it did, which leads to more questions: Were the UH conflict-of-interest policies actually being followed? Is there a gulf between the comprehensive-sounding policies and actual administrative performance?

Good questions. No answers currently available.

And the continuing ambiguity isn’t good for the university. As Lim told me, “it undermines public confidence in the whole research enterprise.”

Disclosure: Ian Lind’s wife, Meda Chesney-Lind, is a member of the Manoa Faculty Senate and sits on the Committee for Professional Matters.