In April, a 48-year-old Baptist preacher named Gary Steve Moore underwent spinal-fusion surgery at a hospital in Jackson, Miss., to treat a degenerating disk in his lower back. But within hours after the operation, Moore was dead.

The tragedy raised the question of whether Moore’s neurosurgeon, Dr. Adam Lewis, was justified in performing the operation — and whether he was motivated by money to go ahead with the surgery.

The Wall Street Journal reported that Lewis has a history of ties to medical device makers and owned a stake in Spinal USA, the company whose devices he implanted in Moore’s spine.

Such situations are far from isolated events in the world of back surgery. As the Journal put it, “Rather than use spinal implants from third-party manufacturers, scores of surgeons have started their own device makers to churn out similar designs, putting themselves in a position to benefit financially from the hardware they insert into patients.”

The result, some experts say, is that doctors are performing unwarranted surgeries.

In this case, Lewis was paid $11,514 in surgical fees. Spinal USA received another $6,640 for the implants cage, plate and screws.

Lewis’ attorney, Whit Johnson, said previous, less-invasive treatments had failed to relieve Moore’s pain, and that his client’s financial interest in Spinal USA “had nothing to do with his decision to operate on Mr. Moore.” Johnson said the surgeon used the Spinal USA implants because he had helped design them and believed they “were the best on the market for the procedure.”

As part of its investigation, the Journal asked two other spine surgeons to review the patient’s medical records. They agreed that Moore’s back condition looked mild and didn’t require the procedure Lewis performed. They also concluded that Moore’s history of heart disease and bowel obstructions made him a poor candidate for a surgery as complex as the 360-degree spinal fusion, which involved opening up the patient’s abdomen and back.

“No operation of any kind could be justified,” concluded Dr. Charles Rosen, president of the Association of Medical Ethics and a spine surgeon at the University of California at Irvine medical school.

Meanwhile, potential conflicts of interest among doctors are fueling concerns in Washington. In June, five U.S. senators asked the inspector general of the Department of Health and Human Services to open an investigation into physician-owned device companies. A report from the agency warned that surgeon-owned implant companies are spreading from spine surgery to such areas as hip, knee and cardiac surgery.

Robert T. Nelson

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