Psychiatrist gave false diagnoses to patients for clinical trials

Numerous patients of Dr. Aleksandar Miljatović from the Palilula Health Center were surprised when they found out that he entered dozens of diagnoses of serious neurological and psychiatric diseases in their electronic records, which they did not suffer from, writes BIRN. At the time of writing the diagnoses, Dr. Miljatović was conducting a clinical trial of a drug used in people with brain damage.

An angry and agitated young man entered the “Dr. Milutin Ivković” Health Center in Palilula at the beginning of January 2021 and in a raised voice demanded an urgent conversation with the managers of that institution and psychiatrist Aleksandar Miljatović. Mladić, whose name is known to BIRN’s editorial staff and who, for the sake of privacy, will be referred to as Saša in the following text, was a patient of the Mental Health Protection Service and used to come to the psychiatrist because of the usual troubles – problems in the family, at work, …

A few days earlier, in DZ Palilula, he received the health certificate he needed to get a high-risk job. What Saša did not know at the time was that the certificate contained a whole list of severe neurological and mental disorders that he did not suffer from, and which were entered in his electronic health record by psychiatrist Dr. Aleksandar Miljatović, BIRN reported.

Diagnoses were entered under codes, next to which there was no explanation of what they meant.

Saša did not get the job. The authorities in the company could not believe that they were looking at a person who, at least according to the documentation, was so sick. Unsuspecting employers even recommended him to ask for state aid, given his severe neurological and mental condition, BIRN added.

The young man asked the Health Center for an urgent explanation. The doctors, who were interviewed by BIRN journalists, said that with a cursory glance at Sasha’s medical record, they noticed that he did not have these diagnoses before December 2019 and that strange things began to happen with each new visit to the psychiatrist Dr. Miljatović. when new illnesses were reported to Sasha, under a code.

BIRN writes that as soon as he threatened to inform journalists and lawyers about everything, Dr. Aleksandar Miljatović immediately deleted part of his diagnoses – later the others were also deleted. DZ Palilula’s lawyers justified themselves to the patient that there was a mistake, that it was an individual case and that the mistake would be corrected immediately by deleting the diagnoses from the Heliant health information system.

After that stormy day on Palilula, work at the health facility continued as usual, the legal service did not react, and psychiatrist Miljatović continued to receive patients as before.

Perhaps everything would have stopped at this, if in the following days and months a large number of patients, who were treated by Dr. Miljatović, had not come to DZ Palilula to complain about the same problem – they were confused by the fact that they had dozens of diagnoses under a code and that that their diagnoses started multiplying since the beginning of 2019. Some patients were given as many as 30 diagnoses, adds BIRN.

The manipulation of diagnoses coincides with the period when Dr. Miljatovic attempted to conduct a clinical trial of the drug pimavanserin, which is used to improve brain function in people with degenerative and progressive brain damage. BIRN’s months-long research, which is based on collected documentation, interviews with sources and patients, shows that this is not a unique case – BIRN interlocutors state that there have been examples of correspondence or corrections of diagnoses in clinical trials, especially in psychiatric patients. but never on this scale.

“Patients are not easy to find. They have to trust you. This is especially important in psychiatric patients. Therefore, patients who are not adequate are often included. “Diagnoses are being faked so that doctors can collect a sufficient number of patients for clinical trials,” one doctor, who wished to remain anonymous, told BIRN.

How many such patients were there in DZ Palilula who were given diagnoses? Director of the Health Center, Dr. Aleksandar Stojanović, told BIRN that only by establishing a special commission would it be possible to determine how many people have been harmed by being registered with serious psychiatric illnesses that they do not have.

“Nobody knows that.” Maybe there are 10 of them, maybe there are 1000. If he worked for two years at the Health Center and if he worked according to the procedure – that means they can receive five to eight patients, no more, because their examination takes an hour each. “Calculate 365 days for five patients, we don’t know if he (recorded the diagnoses) for each one,” says Stojanović.

What followed was no less problematic – in order to calm the patients down, the Health Center began to erase their diagnoses in a way that is not prescribed by law. Although the director of the Health Center initially claimed that diagnoses could only be erased with a court order, the practice in this case showed that doctors also did it without a prior decision by the judicial authorities and without the findings of an expert committee made up of experienced doctors, as required procedure, writes BIRN.

As a consequence of all this, some doctors of the Mental Health Service at the Palilula Health Center told BIRN that a number of patients lost trust in psychiatrists and gave up treatment even with other psychiatrists.

“They feel betrayed and no longer believe that the doctor’s intention is to help them.” The consequences of this scandal will be long-term,” says one doctor from this health center.

According to research by BIRN journalists, psychiatrist Aleksandar Miljatović is still working with patients, currently in a private practice in Čukarica, Belgrade. In his biography on the office’s website, it is not stated that he worked at the Health Center in Palilula, but he is presented as the former head of the Day Psychiatric Hospital KBC Zvezdara, who has 20 years of experience in the treatment of depressive states, anxiety-phobic disorders and dementia.

By the time the text was published, the police and the prosecutor’s office did not even invite him to an informative interview, and psychiatrist Aleksandar Miljatović did not respond to messages and calls from BIRN journalists.

“It’s a very simple matter. He made up diagnoses and showed pharmacists false information that he was giving that medicine and that they had such and such symptoms. Even the pharmaceutical company can’t find that out, because they won’t call patients. He has patients, that’s for pharmacists if they trust him, and they trusted him a lot. It is an ideal basis for him to pass,” said Director of the Health Center, Dr. Aleksandar Stojanović, to BIRN, answering the question of whether the clinical research of the drug pimavanserin is related to the manipulation of diagnoses.

Director Stojanović claims that no patient who went to the psychiatrist Miljatović received the unresearched drug pimavanserin. The drug is used in patients with Alzheimer’s or Parkinson’s disease, and it can also be used in severe forms of epilepsy, schizophrenia, mental retardation, dementia, severe depressive episodes or psychopathic personality disorders.

Dr. Miljatović prescribed to patients exactly the diagnoses that coincide with what the drug is intended for, which is in the clinical trial phase. As BIRN has learned from Dr. Miljatović’s former colleagues, even while working at KBC Zvezdara, he participated in clinical drug research for years, but as part of the medical team. By the way, not only the institution where the drug is tested earns money from clinical studies of a drug, but financial compensation is also provided for research doctors in the projects.

Read more on BIRN’s website.