A few days ago, I blogged about a new study published this week in the Journal of the American Medical Association. The authors of the study, which was conducted by professionals of six leading heart health organizations including the American Society of Nuclear Cardiology, the Association for Thoracic Surgery and the American Heart Association, determined that half of all angioplasties performed to widen arteries in non-emergency situations may be unnecessary or "inappropriate".
An angioplasty, also known as a Percutaneous Coronary Intervention, is a procedure which widens blocked or clogged arteries. A collapsed balloon catheter is inserted into the blood vessel using a guide wire, then inflated. The inflation causes the fatty deposits within the vessel to be crushed and allows for improved blood flow. The balloon catheter is then deflated and withdrawn.
In my blog on the topic, I urged patients and the medical community to keep researching the impact of these inappropriate procedures on patients. Coincidently, right after I posted it, I was sent a number of emails in response from a number of readers about a doctor whose license was just revoked for performing unnecessary angioplasties.
Dr. Marc Midei, the head of the cardiac catheterization clinic of St. Joseph Medical Center in Towson, Maryland was "blasted" by the Maryland Board of Physicians in an 88 page report for allegedly performing hundreds of unnecessary surgical procedures on his patients. Ultimately, The Board found that Midei violated five provisions of the Medical Practice Act including provisions prohibiting unprofessional conduct, gross overutilization of health care service, violations of the standard of quality care and failure to keep adequate medical records. His license was officially revoked on July 13, 2011.
According to the report, the State Board of Physicians found that in "four of the five patients cases they reviewed, Midei "willfully fabricated information about the severity of arterial blockages" and unnecessarily implanted stents within their blood vessels. According to the State Board, "In every one of the patients, he falsified the extent of blockage of the patients' coronary arteries by reporting that it was 80% when it was in reality lower - and in most cases much lower. In three patients, he also falsely reported that they suffered from unstable angina when in fact they did not." As a result of the findings, a total of 585 patients were sent letters by the State Board warning them that Midei may have unnecessarily inserted a stent into their body. A stent is a medical device used to open blocked arteries. Midei is now facing hundreds of civil suits and patients are gunning for him to receive criminal sanctions.
Midei's actions generated a large amount of revenue for St. Joseph Medical Center. The hospital reportedly received $10,000 to $15,000 for each stent inserted. Furthermore, his actions prompted a December 2010 U.S. Senate Committee on Finance to report on improper cardiac stent implants. The Committee determined that St. Joseph billed private and public insurers more than $6.6 million for potentially unnecessary stents and that Medicare paid 3.8 million, more than half of that amount.
The decision, coupled with the recent study I blogged about a few days ago, has sent waves of panic throughout medical communities all over the county as many physicians re-evaluate their methods of determining what procedures are truly necessary for their patients. Message boards on the decision have become congested as both patients and doctors weigh in on the divisive decision of the State Board with the majority of commentators finding Midei's actions to be "shameful", "disturbing" or "shocking". Unfortunately, Midei does have a handful of supporters, mostly from the medical community, that argue that the patients should have received "second opinions" before undergoing the procedures that Midei suggested.
Personally, I find Midei's actions unethical, disturbing, and potentially life-threatening. I also find Midei's supporters' assertions that patients should have known they needed to get a second opinion shocking. Midei was the head of the cardiac catheterization unit of St. Joseph Medical Center. Determining whether a patient has a severely blocked artery and needs a stent inserted is not typically difficult decision for a competent physician with a lot of experience to make. Midei's patients had every right to expect that the head of a large catheterization unit would know what he was doing in these cases. I hope that Midei is punished to the full extent of the law both civilly and criminally.I also hope that physicians all around New York State hear about this case and take it to heart. What do you think? Leave me a comment and let me know what you think of this important decision by the Maryland Board of Physicians. Furthermore, if you think that you have received a potentially life-threatening unnecessary procedure, such as an angioplasty, please call to discuss your legal options. I can be reached toll-free at 1-866-889-6882.