Allegedly Legitimate Journal Publishes 'Case Study' Based Entirely on a 'Seinfeld' Episode

The paper, which was authored by "Dr. Martin Van Nostrand" of the "Arthur Vandelay Urological Research Institute", was an attempt to highlight the questionable practices of predatory scientific journals.

Published Apr 13, 2017

On 6 April 2017, John H. McCool, founder of a company that helps researchers edit papers for publication in scientific journals, published an opinion piece in The Scientist describing his successful attempt to "troll" what he considered a predatory journal — that is, a journal whose peer-review process is virtually nonexistent, and whose profits are driven by a "pay-to-play" model whereby the authors pay the journal for the honor of publication:

Last month I was invited to submit a paper to a dubious urology journal. I’m not a physician, much less a urologist. But I am an editor of scientific writing who has a strong antipathy for predatory journals. I’m also a Seinfeld fanatic.

So I decided to troll this publication, the MedCrave Group’s Urology & Nephrology Open Access Journal, to see whether they would agree to publish a totally made-up, Seinfeld-themed “case report” about a man who develops “uromycitisis poisoning.”

This was inspired by the classic 1991 episode, “The Parking Garage,” in which Jerry Seinfeld can’t find his car in a mall lot, has to urinate, does so against a garage wall, is caught by a security guard, and tries to get out of a citation by claiming that he suffers from a condition called uromycitisis. Seinfeld argued that, due to his illness, he could die if he doesn’t relieve himself whenever he needs to.

For those who are not Seinfeld fans, "The Parking Garage" is an early Seinfeld classic.  A season three episode based entirely in a mall parking garage, the episode details the troubles the George, Jerry, Elaine, and Kramer have locating their car. One major plot point revolves around Jerry and George’s increasing need to urinate during the course of their search, leading to citations for public urination and the creation of a made up condition called “uromysitisis poisoning” which was unsuccessfully used as a legal excuse.

While we could show a summary of the plot from any one of a number of episode reviews, we can actually turn to the published "scientific" paper itself, titled "Uromycitisis Poisoning Results in Lower Urinary Tract Infection and Acute Renal Failure: Case Report", which details quite closely the developments exactly as they happened in the 1991 episode in its "case presentation" section:

A 37-year-old white male was in a large suburban mall parking garage and was unable to locate his car. After more than an hour of walking up and down flights of stairs and through row after row of cars, searching fruitlessly for his own car, he felt a powerful urge to urinate.

With no restroom available in the garage, and knowing that he suffers from uromycitisis, he feared that if he did not urinate immediately he would develop uromycitisis poisoning. Because of his medically diagnosed condition, and because of the progressive policies of the city in which he resided (New York City), he had been issued a public urination pass, which shielded him from legal prosecution under public sanitation ordinances if, by medical necessity, he urinated in public and was caught and detained and issued a citation by civil authorities.

That day, though, he was not carrying his pass on his person; his younger male sibling had absconded with it. [...]  No authority believed him with respect to his condition, and at all turns he was denied access to a toilet. Essentially, he had been forced to “hold it” for 3 hours. This was much too long for an uromycitisis sufferer. He developed uromycitisis poisoning, characterized by intense abdominal and lower back pain, nausea and vomiting, and severe shaking, and he was transported directly from the jail to the hospital emergency room.

The paper was submitted under the name "Dr. Martin Van Nostrand", an alter ego of the character Kramer, and conducted at the "Arthur Vandelay Urological Research Institute", a play on a recurring George Costanza alter ego/front for unemployment benefits. Among the other Easter eggs present are its "references" section, which lists entirely made-up papers authored exclusively by supporting Seinfeld characters such as "J Peterman" (Elaine’s eccentric boss) and "T Watley" (a sleazy dentist). The paper also explains that uromycitisis was first described by "G Steinbrenner", presumably referencing the late owner of the New York Yankees and one-time fictional boss of George Costanza.

To McCool's surprise, and in spite of the fact that uromysitisis is not a real condition, this scientific journal with an alleged focus on urology accepted the paper after "minor revisions":

To my surprise, a representative at Urology & Nephrology Open Access Journal wrote to say that my manuscript was sent out for peer review. Three days later, it was conditionally accepted. I was asked to make minor revisions—including trimming the abstract and including the phony patient’s lab results—and pay a “nominal” $799 fee, plus tax.

Continuing to dupe the publication, I did all that was asked—except remit payment—and, on March 31, my report was published on the journal’s website (PDF). I have no intention of paying the requested fee.

As of 13 April 2017, the paper itself had been removed from MedCrave Group’s website, but a link to it still exists on its list of recent publications. We have reached out to both the MedCrave publishing group and to the editors of Urology & Nephrology Open Access Journal to expand on their peer-review process and explain how a clearly fabricated story could pass such a review. We have yet to receive a response.

Predatory publishing profits from a system where academics are required to meet publication metrics for tenure. A 2015 study in BMC Medicine described a predatory journal as one that is:

In the scholarly publishing business only in order to collect [article processing charges, APCs] and provide rapid publishing without proper peer review for authors who need publications in their CVs.

The information on the Internet about the journals is often strongly misleading, and the publishers spam academics all over the globe with requests for submissions and reviews and for joining editorial boards.

Frequently, journals that follow a business model built entirely on charging authors a fee result in low quality research dressed up to look official. In worse cases, it allows those motivated by causes other than scientific rigor to present their views to the public under the guise of actual peer-reviewed science.

A notable example of the latter was a paper published (and later deleted, but not retracted) in a journal accused of having predatory practices in November 2016. That study alleged a connection between vaccination and increased risk of  neurodevelopmental disorders like autism based entirely on a survey 451 mothers. Despite numerous debunkings of its method and the removal of the paper from the journal’s website, the flawed paper is still frequently used by those with an anti-vaccine agenda.

For McCool, this exercise was a humorous attempt to expose Medcrave as predatory, but he says he will continue fighting predatory journals in general:

My short-term goal is to expose MedCrave as a publisher that will print fiction, for a price. My long-term goal—an ambitious one, I know—is to stop the production of predatory journals altogether.

The goals presented in the made-up paper are just as lofty. The Arthur Vandelay Urological Research Institute seeks the creation of:

...a national reciprocity program of public urination passes [...] so that people with uromycitisis can be free to urinate, if medically necessary, wherever and whenever they need to not be burdened legally (or, indeed, psychologically) by existing local or state laws and regulations against public urination.


McCool, John H.   "Opinion: Why I Published in a Predatory Journal."     The Scientist.   6 April 2017.

Van Nostrand, M., et al.   "Uromycitisis Poisoning Results in Lower Urinary Tract Infection and Acute Renal Failure: Case Report [removed from website]"     Urology & Nephrology Open Access Journal.   31 March 2017.

Shen, Cenyu, and Björk, Bo-Christer.   “‘Predatory’ Open Access: A Longitudinal Study of Article Volumes and Market Characteristics."     BMC Medicine.   1 October 2015.

Barry, Kevin.   “‘First Peer-Reviewed Study of Vaccinated versus Unvaccinated Children (Censored by an International Scientific Journal) Now Public."     Age of Autism.   23 February 2017.

Alex Kasprak is an investigative journalist and science writer reporting on scientific misinformation, online fraud, and financial crime.

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