Dr. Death Season 2: Who Is Dr. Paolo Macchiarini?

Macchiarini , 65, is an Italian doctor who rose to prominence due to his innovative techniques regarding trachea, or windpipe, transplants. Initially using cadaveric tracheas — ones taken from a deceased donor — Macchiarini stripped the windpipes chemically before coating them in the patients' own stem cells to bolster the chances for a successful transplant, according to The Guardian. He began employing the practice in 2008 but by 2011, he'd come up with an entirely new innovation — using fully artificial windpipes grown in a lab, per Vanity Fair. Macchiarini worked at the world-renowned Karolinska Institute in Sweden and some believed that he may one day win the Nobel Prize in Medicine, according to reporting from ABC News. 

Macchiarini performed surgeries on patients around the world, but his image of success began to unravel after he met and began a relationship with reporter Benita Alexander. 

Alexander was a successful and award-winning producer for NBC News, working on a Meredith Viera special about Macchiarini when she first met the surgeon in 2013, according to the previously mentioned Vanity Fair article.

The two bonded while working on the special and eventually fell in love. The couple later became engaged and even planned an elaborate Italian wedding ceremony (one that would purportedly be performed by Pope Francis himself) in 2015, according to an article that Alexander wrote for the Daily Beast. The guest list was a veritable who's who, including the Obamas and Elton John. Soon, however, those lavish plans were revealed to be a mirage. Alexander was first tipped off by a colleague that Pope Francis wasn't even scheduled to be in Italy the day of the wedding, prompting her to question her fiancé's other claims, according to ABC News. She ultimately hired a private investigator who made a stunning discovery — Macchiarini was still married and not divorced, as he had told Alexander.

Alexander suspected that the lies Macchiarini had told extended beyond his personal life and began taking a closer look at his professional endeavors, which quickly led to her former fiancé’s downfall.

Macchiarini developed and implanted the first artificial windpipe in 2011, according to the New York Times. At the time, this procedure was deemed groundbreaking and caught the attention of much of the greater medical world. He performed the procedure a number of times (the New York Times reported that a biomedical researcher documented 20 different cases), but, as the Associated Press reported, Macchiarini's critics claimed that there were no real proven benefits to the procedure and that he was ignoring important tenets of medical ethics in order to continue to operate on patients. For example, according to The Guardian, experimental procedures like artificial windpipe transplants traditionally undergo safety reviews, such as being tested on animals, before use on human patients. However, Macchiarini argued that his procedure was a life-saving necessity for his patients, thus sidestepping those measures.

After her engagement with Macchiarini blew up in 2015, Alexander sent messages to the Karolinska Institute to alert them to her growing concerns about his professional practices, according to ABC News. And around the same time, some of Macchiarini's own colleagues began delving deeper into his surgical outcomes and research, eventually sharing their concerns to the Institute and pressuring them to take action. After years of being supportive of Macchiarini, the Karolinska Institute conducted an investigtion and determined he had, in fact, committed misconduct. He was fired in 2016 and six of his papers were retracted. 

Following the deaths of three patients, Swedish authorities began an investigation into whether Macchiarini was criminally liable in 2016. He was initially charged with manslaughter, though the case never proceeded as it was determined there wasn't enough evidence to convict. However, the case was reopened in 2020 and resulted in his conviction two years later on one count of "causing bodily harm," which is a felony, by a court in Sweden, per Science. He was found not guilty of two other charges and received a suspended sentence.

In 2023, a Swedish appeals court determined that the suspended sentence was too light and sentenced Macchiarini to two-and-a-half years in jail, stating that Macchiarini had "acted with indifference," according to the AP.

"Macchiarini realized the risk of the interventions would cause the patients bodily harm and suffering and that he, even though he has had a hope that the method would work, has been indifferent to the risks' realizations."

Macchiarini has maintained his innocence throughout the criminal case and his lawyer, Bjorn Hurtig, said he intends to appeal the ruling.