First of all, it’s a little minimizing to call Paolo Macchiarini a “bad surgeon.” He’s more than just a bad surgeon. He’s bad at lots of other things, too.

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But his ill-advised, life-ending experimental surgeries were what really put Macchiarini on the map, getting the attention of the folks behind Netflix’s Bad Surgeon. Putting aside the genuinely impressive stories that he allegedly put out into the world — like that the Pope was on board to officiate his wedding and that he’d performed surgery on at least two separate American presidents — his real show-stopper came in the form of a plastic replacement trachea and his willingness to stick it into people’s necks. The process reads like something out of a poorly researched science fiction blockbuster, and involves rubbing a fake plastic windpipe down with stem cells from the donor’s bone marrow, hoping that the stem cells will do some science magic and turn into a new throat.

Plastic and bone marrow are great for a lot of things, but tagging in for pieces of throat on a permanent basis isn’t one of them. The results were horrendous — three out of three patients treated with Macchiarini’s experimental procedure were dead within five years of their surgery, and all experienced nightmarish complications. Meanwhile, Macchiarini’s “research” wound up at the receiving end of a load of scientific skepticism, and allegations of fraud followed close behind.

What consequences did ‘Bad Surgeon’s’ Paolo Macchiarini face?

And for a while, Macchiarini got away with it. Taken to court for his, again, wildly unsubstantiated treatments, he managed to avoid repercussions, claiming that the surgeries that he performed represented the last, best hope for his patients and that without his help, they would have died immediately. The tactic worked.

Until it didn’t.

In June 2023, appeals judges ruled that the Bad Defendant had not, in fact, been treating his three transplant patients under “emergency conditions” in two out of three cases, and his actions may have kept those patients from living as long as they might have. Macchiarini was sentenced to two and a half years in prison. He appealed and was not required to turn himself in until the appeals process had concluded.

Then, in November 2023, the independent science journalists at Science.org reported that his request was denied. There’s been no official word yet as to whether Macchiarini has surrendered himself to authorities, but the short answer to the question “Is Paolo Macchiarini in jail?” is “If he’s not yet, he will be soon.”