Senate faults Midei for questionable stenting, relationship with Abbott

Senate Finance Committee Chairman Max Baucus, D-Mont., and Ranking Member Chuck Grassley, R-Iowa, have 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, Md., and his relationship with Abbott Laboratories. The Senate report found that the questionable stent implantations cost the Medicare program $3.8 million during that period.

In a press release, Baucus and Grassley said they 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.

“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.”

“The best response to these concerns is total transparency and effective peer review,” Grassley said.

The oversight report also examined the response of St. Joseph to the discovery of the questionable implantations. The report noted that Abbott 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 $690 for a July 21, 2008 crab dinner at Midei’s home attended by Abbott employees and a $1,235 barbecue dinner on Aug. 31, 2008.

Also, the report noted that an internal email showed that when Abbott Executive Vice President John Capek learned in August 2008 that Midei had implanted ‘‘30 stents’’ in a single day, he stated that it ‘‘is the biggest day I remember hearing about even when the [bare-metal stent] market was the only market.’’

After St. Joseph barred the doctor from practicing, Abbott 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. In total, Abbott paid more than $30,000 to Midei to help market the drug-eluting stent Xience V.

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, according to the Senate press release.