According to the original account, the pencil/pen thing wasn't about an audit trail, and both the IRB and hospital admin were equally silly.
> IRREGULARITY #3: Signatures are traditionally in pen. But we said our patients would sign in pencil. Why?
> Well, because psychiatric patients aren’t allowed to have pens in case they stab themselves with them. I don’t get why stabbing yourself with a pencil is any less of a problem, but the rules are the rules. We asked the hospital administration for a one-time exemption, to let our patients have pens just long enough to sign the consent form. Hospital administration said absolutely not, and they didn’t care if this sabotaged our entire study, it was pencil or nothing.
> IRREGULARITY #3: Signatures are traditionally in pen. But we said our patients would sign in pencil. Why?
> Well, because psychiatric patients aren’t allowed to have pens in case they stab themselves with them. I don’t get why stabbing yourself with a pencil is any less of a problem, but the rules are the rules. We asked the hospital administration for a one-time exemption, to let our patients have pens just long enough to sign the consent form. Hospital administration said absolutely not, and they didn’t care if this sabotaged our entire study, it was pencil or nothing.
https://slatestarcodex.com/2017/08/29/my-irb-nightmare/