Will Local Hospitals Divulge Unneeded Stents?

On March 3, 2011 Westmoreland Hospital in Greensburg, Pennsylvania publicly acknowledged that in 2010 over 140 patients of Drs. Morcos and Bousramos received unneeded cardiac stents in connection with angioplasty that was performed by these physicians at Westmoreland Hospital.   The unneeded stents were discovered by an independent team of cardiologists invited into the hospital to evaluate the unusually high volume of stents placed by Morcos and Bousramos.  Morcos and Bousramos are interventional cardiologists who specialize in angioplasty.

A few days later, Jefferson Regional Medical Center, located approximately 15 miles south of Pittsburgh, announced that it, likewise, was conducting an investigation to ascertain whether it had a problem with staff interventional cardiologists placing unnecessary cardiac stenting.  Unlike Westmoreland, Jefferson's audit was to be conducted internally rather than through outside independent cardiologists.

Westmoreland has indicated that it will evaluate patient records for the year 2009 to determine if the unnecessary procedures extended beyond 2010 and that it will release the results in May.  Jefferson has not indicated when its investigation will be completed or whether it will publicly acknowledge the results.  Many cardiac patients of both of these institutions are fearful that they may have been victims of unnecessary intrusive procedures and, perhaps, more importantly, that they have been mislead by their cardiologists into believing their condition is worse than it is.

Stents are tiny metal cages used to prop open arteries that are clogged with plaque. The procedure in which the stents are inserted is called angioplasty.  The procedure is performed by a cardiologist who weaves a catheter with a deflated balloon and stent to the location in the artery that is partially filled with plaque.  When the correct location is identified, the balloon is inflated and the stent expands to push the plaque to the interior walls of the artery so as to once again allow the free flow of blood to the heart.  An angiogram is the diagnostic test used to determine if stenting is appropriate.  Typically, cardiologists require the artery to be at least 70% obstructed before stenting is considered medically necessary.  In the cases recently identified by Westmoreland Hospital, all of the patients who received stents had arteries that were less than 70% occluded, sometimes significantly less.