[Updated] Mark Midei, the interventional cardiologist who has been accused of implanting hundreds of unnecessary stents at St. Joseph Medical Center in Maryland, was congratulated by Abbott Labs for implanting 30 stents in one day. “I heard thru the grapevine that you had a truly outstanding day with Xience in the labs on Friday, perhaps setting the single day implant record,” wrote an Abbott official. Two days later, Abbott spent $2,159 for a barbecue at Midei’s house that included a whole smoked pig and other fixings.
The details of Midei’s relationship with Abbott are contained in a 170-page report from the US Senate Committee on Finance. News stories on the report appear in today’s Baltimore Sun, New York Times, and Wall Street Journal. Click here to download a PDF of the Senate report.
Abbott provided the following statement to the Sun: “Dr. Midei has been a highly regarded physician in his field, with whom Abbott had consulted in the past. Our affiliation with Dr. Midei ended early this year.”
After Midei was forced to leave St. Joseph he worked as a paid consultant for Abbott, helping the company market its stents. According to the Sun, Abbott officials said it was “the right thing to do because ‘he helped us so many times over the years.'” However, after the publicity over his case became more intense, the company prematurely ended his visit to Japan to promote the Xience V. Midei subsequently worked in Saudi Arabia at the Prince Salman Heart Center but that job was also discontinued due to the bad publicity.
Abbott was not happy with the consequences of the Midei affair. After the series of articles in the Baltimore Sun began to appear, stent procedures declined in the region, including a dramatic 46% drop at St. Joseph. According to the Sun:
One Abbott official suggested that local connections or the “Philly mob” should intervene to silence Baltimore Sun columnist Jay Hancock for his coverage of the scandal, saying “someone needs to take this writer outside and kick his ass!”
Midei’s attorney told the Sun that the report doesn’t add anything to the evidence against Midei and that he believes Midei will be vindicated.
In December 2008, an Abbott regional sales manager praised the sales representative who worked with Midei:
As you prepare to complete another year in the top 5 in rankings, I want to again congratulate you on this remarkable feat. Moreover, the relationships you have formed at accounts like St. Joe’s, Union, and Hopkins are hallmarks of what every rep strives for in their accounts. In my 15 years of being in this business, I have never seen personal relationships as strong as the ones you have developed with Dr.’s Mark Midei, [name redacted], and [name redacted].’’
Here is the press release from the Senate Finance Committee:
Baucus, Grassley Outline Millions of Wasted Taxpayer Dollars, Examine Reports Of Hundreds of Improper Cardiac Stent Implantations
Finance Leaders Release Report Detailing Relationship Between Doctor, Medical Device Manufacturer, Possible Pattern of Wasteful, Medically Unnecessary Stent Implantations
Washington, DC – Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa) today released a Finance Committee report detailing the case of a doctor who reportedly implanted nearly 600 potentially medically unnecessary stents from 2007 through mid-2009 at St. Joseph Medical Center in Towson, Maryland, and his relationship with the manufacturer of the stents, Abbott Labs. The Senators’ report found that the questionable stent implantations cost the Medicare program $3.8 million during that period. Baucus and Grassley initiated their inquiry as part of the Committee’s oversight role of the Medicare and Medicaid programs and the Senators’ efforts to protect taxpayer dollars from waste, fraud and abuse after media reports unveiled the alleged improper procedures.
“Hospital patients expect their care to be based on medical need, not profits. This report sets forth alarming evidence that patients at St. Joseph Medical Center received unnecessary and potentially harmful stent implants time and again – a pattern that is shocking, disturbing and shameful. Doctors should not be performing invasive medical procedures patients don’t need, and taxpayers certainly shouldn’t be paying for these wasteful and improper implantations,” said Baucus. “Even more disconcerting is that this could be a sign of a larger national trend of wasteful medical device use, which is why we included aggressive new tools in the new health care law to fight fraud, waste and abuse. The health care law improves screening of medical providers and increases oversight to root out fraud, waste and abuse like this, shining a spotlight on problems like these and helping ensure cases like this don’t happen again.”
“The best response to these concerns is total transparency and effective peer review,” Grassley said.
The health care oversight report also examined the response of St. Joseph Medical Center to the discovery of the questionable implantations. The report notes that Abbott Labs placed the Maryland doctor on its “Project Victory” list of top stent volume cardiologists and paid for at least two social events at the doctor’s home, including a barbeque and crab dinner, in 2008. After St. Joseph Medical Center barred the doctor from practicing, Abbott Labs hired the doctor to promote and prepare safety reports on its stents in China and Japan, according to internal documents the company provided to the Committee.
From fiscal year 2004 to fiscal year 2009, the Medicare Part A program paid an estimated $25.7 billion for cardiac stent procedures and approximately $108.9 billion for 6.9 million procedures related to medical devices. Fraud, waste and abuse in the health care system cost Americans at least $60 billion a year – three percent of total health care spending. Other similar cases of apparently improper cardiac procedures have been uncovered at medical facilities across the country. Baucus and Grassley launched their review of this case to look for patterns that might have implications for preventing waste, fraud and abuse in Medicare and Medicaid.