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Clinical Infectious Diseases 2005

Thomas Butler, Physician- Scientist, prisoner

The paragraphs below are the abstract and edited summary of an article in Clinical Infectious Diseases 2005; 40:1644-8, entitled "Destroying the Life and Career of a Valued Physician-Scientist Who Tried to Protect Us From Plague: Was It Really Necessary?"

* * * * *

Thomas Campbell Butler, at 63 years of age, is completing the 1st year of a 2-year sentence in federal prison, following an investigation and trial that was initiated after he voluntarily reported that he believed vials containing _Yersinia pestis_ were missing from his laboratory at Texas Tech University. We take this opportunity to remind the infectious diseases community of the plight of our esteemed colleague, whose career and family have, as a result of his efforts to protect us from infection by this organism, paid a price from which they will never recover.

Dr. Thomas C. Butler has had a long and successful career that has focused on problems and illnesses of underprivileged persons, including those in the developing world and indigent patients in this country. His curriculum vitae lists >170 published peer-reviewed articles, reviews, and chapters, with his most important contributions being made in the areas of diarrheal diseases, typhoid fever, plague, and relapsing fever, as well as investigations of therapeutic modalities for other infectious diseases. His work in the late 1960s on oral rehydration therapy in Dhaka and Calcutta, India, resulted in one of the earliest articles describing the important clinical applications of basic physiologic studies of patients with cholera and led to the 1st use of oral rehydration solution in a refugee camp in Calcutta in 1971.

Although the agent of plague, _Yersinia pestis_, is a potential weapon of bioterrorism, it is also endemic in the United States and many other parts of the world, as pointed out in all major texts and reviews, including some written by Tom Butler. Indeed, as pointed out in Butler's 1983 monograph about plague, "In the United States during these same years (1970s), the number of human cases of plague increased several fold", and, on average, there are 2-15 known cases reported each year in the United States, with >40 cases occurring in some years.

Butler's work on plague, which includes published chapters, peer-reviewed articles, and reviews, goes back 35 years, to his service in the Vietnam War. In 2000, he began a collaboration with colleagues at the University of Tanzania in which he served as a consultant and provided a reference laboratory for a study designed to compare the efficacy of gentamicin and doxycycline therapy in clinically ill patients with _Y. pestis_ infection. The study was reviewed by Tanzania's medical research review board and was conducted at the University of Tanzania and under government authority; the institutional review board at Texas Tech University apparently exempted the project from review, because Dr. Butler was serving only as a consultant, without direct patient care responsibilities. The study was successfully completed; samples were provided to the US Army at Fort Detrick, Maryland, and the Centers for Disease Control and Prevention Laboratory in Fort Collins, Colorado; data were provided to the Food and Drug Administration; and a manuscript awaits publication. Because Dr. Butler's laboratory acted as a reference laboratory for the study, clinical and laboratory specimens were exchanged, and all original specimens were returned to Tanzania, as per contractual agreements.

In January 2003, Dr. Butler could not locate 30 vials of plague specimens and reported this to the safety officer at Texas Tech University; the Federal Bureau of Investigation (FBI) was notified by Texas Tech University, which resulted in 60 FBI agents rapidly descending upon Texas Tech University and the briefing of government officials, apparently up to the level of President George W. Bush. According to reliable sources, Butler was questioned by FBI agents without legal counsel which he waived, because he felt he had nothing to hide, he had worked with the military and federal agencies for years on this and other projects, and he genuinely wanted to help the FBI allay public fears. Testimony at the trial indicates that, after many hours of interrogation without sleep, and with the assurance that such interrogation would prevent any legal action, he signed a statement to the effect that the vials may have been autoclaved. He was then put in handcuffs and jailed, having been accused of lying to the FBI (a charge for which he was later acquitted). Jonathan Turley, an attorney for Butler and a professor at George Washington University School of Law, noted that "this made no sense. He would never have created a controversy to conceal the accidental destruction of vials". After being incarcerated for 6 nights in county jail without bail, Butler was allowed to post bail of US$100 000 (which was later increased to $250 000) but remained under house arrest, with electronic monitoring. He was not to contact colleagues who were on a witness list, and he had no access to his computer or e-mail for many months, despite having worked as Chief of the Infectious Diseases Department at Texas Tech University and having lived in Lubbock for 16 years, where he and his wife were raising 4 children and enjoying much respect in the community.

Butler was offered a plea bargain which involved pleading guilty to lying and spending 6 months in jail but declined and chose to risk trial by jury to clear his name. Although the original concerns of bioterrorism were not supportable, multiple additional charges largely unrelated to the disappearance of the vials containing _Y. pestis_ were filed (i.e., "piled on"), including illegal transportation of plague bacteria, tax evasion, embezzlement, and fraud, for a total of some 69 charges carrying a maximum sentence of 469 years in prison and US$17 million in fines. Many of the charges had to do with contract disputes Butler had with his university (which are normally handled through civil, not criminal, proceedings) and were unrelated to the original charges associated with the disappearance of the vials. During the trial, prosecutors described Dr. Butler as an "evil genius" and compared him to "a cocaine dealer smuggling illegal drugs," and they emphasized the accusations of lying to the FBI and endangering the public and made repeated references to terrorism, actions many felt were designed to create an atmosphere of fear in the conservative West Texas courtroom.

Ultimately, a jury acquitted Butler of most of the original charges, including lying to the FBI, and the charge of tax evasion; he was convicted of charges related to one overseas shipment of an express-mail package containing "lab specimens" originally from Tanzania (a technical violation) back to his collaborators in Tanzania and of charges concerning contracts and indirect administrative charges associated with grants received from pharmaceutical companies. However, the former dean of Texas Tech University who had helped recruit Butler, was aware of Dr. Butler's grants and consultancies and had encouraged him to finance his research and fund his salary with them. Testimony also indicated that others at Texas Tech University were aware of and/or had signed his contracts; there were apparently no rules against such arrangements at the time. During his trial, members of the Texas Tech University administration testified against Butler, despite strong support from his colleagues and friends. The role of the Texas Tech University administration in the prosecution of Dr. Butler has been of great concern to faculty throughout the nation and is considered by many to be unprecedented. In attempts to explain this behavior toward a prominent and respected tenured faculty member, questions have been raised about pressures that may have been exerted on the university through its biodefense contracts with the Department of Defense.

The judge (who was obviously sympathetic) imposed a sentence of 2 years (to run concurrently), rather than the 10-year sentence corresponding to his conviction, and a payment of approximately US$38 000 to Texas Tech University, rather than $1 million. Many wrote to the judge urging a suspended sentence with community service; rumor has it that the judge did not do so out of concern that this would result in an automatic federal appeal for an even longer sentence.

Reactions in favor of Butler and expressions of concern about the handling and impact of the case have been strong, including comments from the Human Rights Committee of the National Academy of Sciences (NAS), the Institute of Medicine (IOM), the National Academy of Engineering, and the New York Academy of Sciences. The presidents of the NAS, the IOM, and the European Society of Clinical Microbiology and Infectious Diseases, as well as many prominent scientists and physicians, wrote to then Attorney General John Ashcroft to express their concern about the impact of the prosecution of Dr. Butler (the presidents of the NAS and the IOM had written only once before to an attorney general, Janet Reno, and their letter was concerned with the prosecution of Los Alamos National Laboratory scientist Wen Ho Lee).

4 academy members who are Nobel Laureates wrote, on behalf of themselves, that "this respected colleague has been subjected to unfair and disproportionate treatment." Media coverage has been extensive; Science, The Scientist, The New York Times, The Los Angeles Times, The Baltimore Sun, BBC, CBS, and many other news sources have run stories suggesting that Butler may have been a victim of the widespread fear about (bio)terrorism and may have been singled out, presumably to serve as an example, as part of a flawed strategy to fight bioterrorism.

Dr. Tom Butler, a physician-scientist and member of the IDSA, respected by all colleagues who know him and his work, has been stripped of his professorship, tenure, salary, and medical license and has spent his life savings and retirement to defend himself. He and his family have no sources of income. His situation is a cautionary tale to all of us, especially those who work with biological agents with potential for use in bioterrorism, even if in collaboration with governmental laboratories and scientists.

Can we help Butler's situation? All concerned individuals can help Dr. Butler and discourage misuse of current laws designed to defend us against terrorism by writing to members of Congress, to the Department of Justice, or to the newly confirmed Attorney General Alberto Gonzales.

Dr. Butler's appeal is currently pending in the US Court of Appeals for the 5th Circuit.. He has exhausted his personal savings and retirement funds. If you wish to assist his defense by providing expenses for his appeal, donations to the Thomas Butler Legal Defense Fund may be sent to Daniel C. Schwartz, c/o Bryan Cave LLP, 700 Thirteenth St. NW, Washington, D.C. 20005.


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[There but for the the roll of the dice could go any one of us (unless of course we had the good fortune to work with non-communicable agents instead of an agent like Y. pestis).- Mod. DK].

[We at ProMED-mail consider what has happened to Dr. Thomas Butler to be unconscionable and on a par with events that occurred in China and Cuba (see references below). In the past we have posted on these human rights abuses and called for assistance in putting pressure on the offenders. By posting this article we are doing just that, calling upon ProMED-mail subscribers to assist in putting pressure on the judicial system in the USA for permitting this injustice and abuse of the legal system to go forward. - Mod.MPP]

[see also:
SARS, concerned citizens imprisoned - China 20030619.1509 1998
---- Official secrets and public health 19980622.1162 1997
Dengue/DHF - Cuba: doctor sentenced 19971125.2360 .........................dk/lm/pg/mpp


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