Sweden’s Supreme Court Upheld Paolo Macchiarini’s Prison Sentence

Surgeon Paolo Macchiarini was once hailed as a pioneer of stem cell medicine. He made headlines in 2011 for completing the world’s first-ever stem cell windpipe transplant in Sweden, but news coverage of the so-called “miracle” doctor’s work eventually took a sharp turn when his patients began dying.

Netflix’s Bad Surgeon: Love Under the Knife examines accusations that Macchiarini is a “fraud and a fantasist.” Featuring interviews with victims’ families, his former fiancée, and colleagues turned whistleblowers, the three-part true-crime docuseries follows their fight to bring Macchiarini to justice.

Bad Surgeon also delves into Macchiarini’s personal life, alleging that he was a compulsive liar who spun stories and even manipulated journalist Benita Alexander to become his fiancée. Alexander went on to expose him, and the fight for justice was still ongoing up until late 2023.

Macchiarini’s Victims & Crimes

While working at Sweden’s Karolinska Institute, Macchiarini performed experimental surgeries on three patients in 2011 and 2012, implanting synthetic tracheas seeded with stem cells from their bone marrows, according to the American Association for the Advancement of Science (AAAS). All three patients died when the implants failed.

Macchiarini hid the truth about the procedures not working, and some of his colleagues accused him of manipulating his research results and performing the risky procedure on at least one person who was not critically ill, despite knowing the risks. (He claimed the procedures were life-saving emergencies.)

Macchiarini was fired from the Karolinska Institute (which selects the Nobel Prize laureates in physiology or medicine) in March 2016 for breaching medical ethics after being accused of falsifying his resume and misrepresenting his work, per the Associated Press. The following year, prosecutors in Sweden charged Macchiarini with manslaughter in connection with the three patients’ deaths.

Citing insufficient evidence to prove manslaughter, prosecutors dropped the case several months later. However, they reopened the case in 2020, charging Macchiarini with aggravated assault and severe bodily harm. The surgeon denied any criminal wrongdoing. (In the interim, an Italian court sentenced Macchiarini to 16 months in prison in 2019 for forging documents and for abuse of office.)

Macchiarini’s Trial & Appeal

Sweden’s Solna District Court cleared Macchiarini of two charges of assault in June 2022, and gave him a “conditional,” or suspended, sentence in the third case, meaning he was not required to serve jail time. However, both Macchiarini and the prosecution appealed the ruling.

In June 2023, the Svea Court of Appeal disagreed with the original decision and found Macchiarini guilty for three cases of gross assault, ruling that he “acted with criminal intent.” As a result, the five-judge panel sentenced Macchiarini to two years and six months in prison.

In a post-decision press release, the Court of Appeal did not question that Macchiarini hoped his method would work. However, the investigation showed that he “realized the risk that the procedures would cause the patients physical injuries and suffering and that he was indifferent to the realization of these risks.”

Macchiarini Spoke Out

At a press conference with his lawyers, Macchiarini denied he intended to harm the patients. “The intention of harming is the most awful accusation that you can make to a doctor,” he said, per AAAS. “In the operating room we were 20, 25 people. What surprises me is, why I am here alone?”

Noting that he felt “imprisoned” already, Macchiarini added that he only regretted accepting the Karolinska Institute’s job offer, and that he was “jobless” and did not expect to be able to work ever again.

At the time, his lead attorney announced the defense team’s plan to appeal the verdict to Sweden’s high court. Macchiarini was not required to report to prison while the appeals process was ongoing, but one of the judges who heard the case said that if the decision was upheld, Macchiarini will likely serve two-thirds of his sentence.

What’s Next

In late October 2023, the Swedish Supreme Court upheld the Svea Court of Appeals verdict, along with the two-and-a-half-year sentence. It was unclear, however, when Macchiarini would be required to report to prison.

Macchiarini’s story will be dramatized in Peacock’s Dr. Death Season 2 on Dec. 21, with actor Edgar Ramírez portraying the disgraced surgeon and Mandy Moore as Benita Alexander.