Two members of the group that awards the Nobel Prize in Physiology or Medicine at Sweden’s Karolinska Institute have been asked to resign over their involvement in a scandal over the work of an Italian transplant surgeon. Board members at the Karolinska Institute who have not yet quit will be fired, according to Reuters.

The red flags were there from the beginning

The doctor at the center of the scandal is an Italian surgeon named Paolo Macchiarini, who developed and transplanted bioengineered windpipes grown from patients’ own stem cells. Two of his patients died, and Macchiarini has been accused of scientific misconduct. He continues to deny these allegations.

The two scientists who have been asked to resign, Anders Hamsten and Harriet Wallberg, were thought to have ignored warnings about Macchiarini. The red flags were there from the beginning, according to a report from the Karolinska Institute. Not only did he have incorrect information on his curriculum vitae — like a resume, but with more science — his publications contained "questionable" data, and he didn’t cooperate well with other researchers.

Hamsten was vice chancellor of the Karolinska Institute during the investigations that acquitted Macchiarini of misconduct, and Wallberg was president of the university during his recruitment. "This is a case in which a long chain of poor and absent decisions enabled a visiting professor to contravene the rules and ethical principles," said Karin Dahlman-Wright, acting vice chancellor of the Karolinska Institute, in a news release.

An external investigation released last week revealed that the three patients Macchiarini performed experimental trachea transplants on at the Karolinska University Hospital weren’t sick enough for the experimental surgeries to be ethical. What’s more, according to the report, the science was too shaky to be performing these surgeries on humans and there "were clear weaknesses in how the informed consent was obtained."

"A long chain of poor and absent decisions"

A second case summary released this week and presented in a news conference on Monday revealed that the Karolinska Institute hired the now-disgraced surgeon Macchiarini despite red flags. His contracts were renewed twice "without any evaluation of his activities," and there were serious problems with the way the misconduct investigations were handled.

The scandal is serious enough that Bo Risberg, a former head of ethics at Karolinska, says that no Nobel prize should be awarded in medicine for at least two years, according to The Telegraph. Instead, the money that would have gone to a scientist should be paid to the families of the patients Macchiarini experimented on, Risberg says.