Officials Hesitant in Examining Stent Procedures

Officials nationwide are hesitant in examining the the placement of unneeded stents by interventional cardiologists. 

Stents are tiny metal cages that are inserted into plaque filled arteries to push the plaque to the walls of the arteries and allow for the free flow of blood.  In determining whether stents should be used, cardiologists may rely on a variety of tests to determine the percentage of plaque build-up.  Typically cardiologists do not recommend stenting unless at least 70% or more of the subject artery is clogged with plaque.

Over the last few years a number of doctors around the country have been investigated, prosecuted and/or sued over the placement of stents that were not medically necessary.  Doctors placing the unneeded stents appear to be motivated by  high medicare and insurance reimbursement rates, contracts with stent manufacturers and, in some instances, kick backs from hospitals where the procedures are performed. 

A number of instances of unnecessary stenting have been reported around the country.  Two California cardiologists were discovered engaging in this reprehensible conduct in 2002. 

In December 2009, after six days of deliberation following a three month trial, Mehmood Patel MD,  a Louisiana cardiologist, was convicted of 51 counts of health care fraud as a result of placing stents in patients who did not need them.   

In November, 2010, the Texas Medical Board accused Texas cardiologist Samuel DeMaio MD, of performing unnecessary heart stent and defibrillator implementation procedures.

Likewise, in 2010, a Salisbury, Maryland cardiologist, John McLean MD, was indicted by a federal grand jury on charges associated with unnecessary stent procedures on patients.

In perhaps the most prolific example of unnecessary stenting yet to surface, Towson, Maryland cardiologist Mark Midei MD, was accused , in 2010, of placing stents in almost 600 patients who did not need them.

Most recently, Excela Health, owner of Westmoreland Hospital in Greensburg, Pennsylvania, recently identified two cardiologists, Ehab Morcos MD, and George Bousramos MD, of placing stents in over 140 patients who did not require them.

These examples suggest that oversight is lacking.  Is it not reasonable to conclude that unnecessary stent procedures are taking place in other places not yet identified?  How can any patient know that his doctor did not misrepresent the percentage of blockage?  Why should patients who are ostensibly experiencing serious health concerns have to worry if their own doctor is preying upon them?  What steps have hospitals, regulatory and accrediting agencies taken to investigate past practices and to ensure that this cannot continue?  Will hospitals who, through internal investigation, discover unscrupulous doctors performing unnecessary stenting, acknowledge it publicly or simply try to sweep it under the rug?  Should we rely on hospitals to conduct their own investigations when it may be that these very hospitals are complicit?