As a former CRA and clinical coordinator, I can tell you that this is an absurdly dirty business where every kind of corruption is inevitable and facilitated. CROs know their job is not to run a clean trial, but to get favorable results for the investigational product and to make it seem like there was a clean trial.

Every team has "cleaners" to tidy up little problems like this and to assess whether or not it's likely to ever be found out. They assumed there would be no digging into the database or that they could stop it from happening. In my experience, clinical trials, the FDA, and even NIH studies are completely unreliable. I've seen all data that undermined the desired outcome "cleaned" away and I have heard all manner of misconduct, one prominent researcher simply reversing all of the "no" answers.

Clinical trials and NIH studies are mostly high end public relations features.