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Doctor made millions inserting unneeded stents into patients

nytimes.com | 12/06/10

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Read More: criminal, heart disease, stent

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Editor's Note: This is what the world of US medicine is like. It's about profits for doctors and medical companies, ripping off Medicare and the taxpayer is part of it. Sure, there are some exceptions here and there, but the system rewards pills, potions, and procedures. You won't be told how to simply reverse your heart disease in any US hospital; not when they can charge tens of thousands to give you a stent and send you hope knowing you'll be back for more (if you're lucky, and don't drop dead first). You are better off relying on this website and the medical doctors we promote to protect your health, than any other medical system/scheme out there.

Word quickly reached top executives at Abbott Laboratories that a Baltimore cardiologist, Dr. Mark Midei, had inserted 30 of the company's cardiac stents in a single day in August 2008, "which is the biggest day I remember hearing about," an executive wrote in a celebratory e-mail.

Two days later, an Abbott sales representative spent $2,159 to buy a whole, slow-smoked pig, peach cobbler and other fixings for a barbecue dinner at Dr. Midei's home, according to a report being released Monday by the Senate. The dinner was just a small part of the millions in salary and perks showered on Dr. Midei for putting more stents in more patients than almost any other cardiologist in Baltimore.

The Senate Finance Committee, which oversees Medicare, started investigating Dr. Midei in February after a series of articles in The Baltimore Sun said that Dr. Midei at St. Joseph Medical Center, in Towson, Md., had inserted stents in patients who did not need them, reaping high reimbursements from Medicare and private insurance.

The senators solicited 10,000 documents from Abbott and St. Joseph. Their report, provided in advance to The New York Times, concludes that Dr. Midei "may have implanted 585 stents which were medically unnecessary" from 2007 to 2009. Medicare paid $3.8 million of the $6.6 million charged for those procedures.

The report also describes the close relationship between Dr. Midei and Abbott Labs, which paid consulting fees to the cardiologist after he left the hospital. "The serious allegations lodged against Dr. Midei regarding the medically unnecessary implantation of cardiac stents did not appear to deter Abbott's interest in assisting him," the report states.

The case has turned into a legal quagmire for Dr. Midei and St. Joseph, which have been sued by hundreds of patients who claim they received unnecessary implants. Some doctors say the case has revealed a level of inappropriate care that is more common than most patients know.

"What was going on in Baltimore is going on right now in every city in America," said Dr. Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic, who said he routinely treats patients who have been given multiple unneeded stents. "We're spending a fortune as a country on procedures that people don't need."

Dr. Midei's lawyer, Stephen L. Snyder, said that his client's treatment of his patients was entirely appropriate and that Dr. Midei, who has recently practiced medicine at the Prince Salman Heart Center in Saudi Arabia, would be exonerated.

"This is all trumped up to hide the hospital's criminal conduct," said Mr. Snyder, who filed a $60 million lawsuit against St. Joseph on Dr. Midei's behalf accusing the hospital of damaging Dr. Midei's reputation by making false claims about his care. (The hospital responded that the assessments of Dr. Midei's care were done by independent experts.)

Last month, St. Joseph agreed to pay a $22 million fine to settle charges that it paid illegal kickbacks to Dr. Midei's medical practice, MidAtlantic Cardiovascular Associates, in exchange for patient referrals; the hospital did not admit wrongdoing. St. Joseph said in a statement Friday that it now conducts monthly random reviews of stent cases "to assure such a situation cannot occur again."

Read the whole story here.



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