A Senate investigation has found that a Baltimore-area cardiologist may have implanted 585 heart stents from 2007 to 2009 that were medically unnecessary, while collecting millions in reimbursements from Medicare and private insurance.
The Wall Street Journal reports that even after the cardiologist, Mark Midei, was barred last year from continuing to practice at St. Joseph Medical Center in Towson, Md., Abbott Laboratories — whose stents he used — hired him as a sales consultant.
Earlier, Abbott provided Midei with such perks as a $2,159 barbecue dinner at the doctor’s home two days after he inserted 30 stents in a single day in August, 2008, which the Senate Finance Committee investigative report said was a possible company record.
The New York Times noted that Midei continued to insert large numbers of stents into patients even after a landmark study published in 2007 in The New England Journal of Medicine found that many patients given the devices would do just as well without them.
Last year, after receiving a complaint from one of its own employees about Midei’s practices, St. Joseph retained a panel of experts to look into the matter. The panel reviewed 1,878 cases in which Midei inserted stents into patients from January 2007, to May 2009, and found that 585 patients might have received unnecessary devices. Medicare, the Times said, paid $3.8 million of the $6.6 million charged for those procedures. The Baltimore Sun later published a series of articles about the case, prompting the Senate investigation.
Some doctors say the case suggests that inappropriate care is far more widespread than most patients know.
Part of the problem, the Times reported, is that hospital executives celebrate, rather than question, cardiologists who perform unusually high numbers of stent procedures. The revenue from each procedure can be more than $10,000.
“Hospital patients expect their care to be based on medical need, not profits,” Sen. Max Baucus, the Democratic chairman of the Finance Committee, told the Times. “Even more disconcerting is that this could be a sign of a larger national trend of wasteful medical device use.”
The federal Medicare program spent $3.5 billion last year on stent procedures.
Midei’s lawyer said that his client’s treatment of his patients was entirely appropriate and that the doctor would be exonerated. St. Joseph said in a statement Friday that it now conducts monthly random reviews of stent cases.
Abbott, based in North Chicago, Ill., called Midei “a highly regarded physician in his field.” The company declined to comment on its relationship with the doctor, other than to say Abbott’s affiliation with him ended early this year.
