Maryland Doctor Loses License Over Unnecessary Heart Stents

A Maryland doctor accused of implanting hundreds of medically unnecessary coronary stents has been stripped of his license by a state board, after it was determined he falsified patient records and put them unnecessarily at risk. 

The Maryland Board of Physicians revoked Dr. Mark G. Midei’s medical license (pdf) this week, finding him guilty of unprofessional conduct, willfully making false medical reports, gross overutilization of health care services, violating standards of quality care, and failing to keep adequate medical records.

The board only looked at five of about 600 patients who may have been given unnecessary heart stents by Midei to reach its conclusions. The revocation of his license means that Midei will no longer be able to practice medicine in Maryland.

Since late 2009, St. Joseph Medical Center in Towson, Maryland has sent more than 600 letters to Dr. Midei’s former patients, alerting them that a subsequent review of their medical procedure indicates that they may have been implanted with a coronary heart stent they did not need. In many of the cases, Midei told patients they had severe coronary blockages, when in reality they only had minor blockages that did not require a stent placement.

Stent procedures, which are designed to prop open arteries that are significantly blocked, can cost $10,000 or more. Typically it is necessary for there to be at least a 70% artery blockage for a stent implant to be necessary, and many patients who have received these letters were originally told that they had blockages over that amount. However, after a subsequent review of records from the procedure, many of the patients were found to have blockages that were well under 50%, which is generally considered “insignificant.” Some patients who received stents had blockages as low as 10%.

The discovery of the problems with unnecessary heart stents by Dr. Midei was first uncovered by a U.S. Justice Department (DOJ) investigation into Medicare fraud and claims of kickbacks between the hospital and the MidAtlantic Cardiovascular Associates (MACVA), of which Midei was a member at one time. He was kicked out of his position at the hospital shortly after the investigation got underway.

In November 2010, St. Joseph reached a $22 million settlement agreement with DOJ over the charges. However, the investigation into Midei is still ongoing and hundreds of former patients are continuing to pursue lawsuits over unnecessary stents received at St. Joseph hospital.

The Maryland Board of Physician’s investigation found improper coronary stent procedures were undertaken in four of the five cases it investigated.

“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,” the board determined.

The board also determined that Midei told patients that they suffered from unstable angina when it was not true.

Midei’s attorneys suggested that the decision by the board was due to intense political pressure.