A Baltimore County judge denied Mark Midei's appeal for reinstatement of his medical license, ruling that there was "substantial evidence" for the Maryland Board of Physicians to revoke it last year after finding that the Towson cardiologist falsified patient records to justify the placement of unnecessary coronary stents.
The decision ends an ordeal that began more than three years ago, when an anonymous letter was sent to the state board, claiming Midei, a well-regarded physician who earned a seven-figure salary at St. Joseph Medical Center, was improperly treating patients.
The allegations soon snowballed, leading to Midei's forced resignation from St. Joseph in 2009, the revocation of his medical license in 2011, and the embattled hospital's sale earlier this year. More than 200 lawsuits have been filed against Midei and St. Joseph by former patients who claim the star doctor abused their trust and put their lives at risk.
"The Board's decision to revoke [Midei's] license … is not arbitrary or capricious" and it "shall be affirmed," Circuit Court Judge Susan Souder wrote in a 25-page opinion that was signed Monday and delivered to the court clerk's office Tuesday morning.
Midei said he was "disappointed deeply" by the judge's choice to uphold the revocation.
"I remain certain of the soundness of my medical decisions throughout my 25-year career as an interventional cardiologist in Baltimore. I am also certain that my practice did not differ from that of my colleagues at St. Joseph, in Baltimore, or across the United States," he said in an e-mailed statement.
In 2010, Midei filed a lawsuit asking $60 million in compensatory damages and up to $540 million more in punitive reparation from St. Joseph and its parent company. The filing claimed that the entities set up Midei as a scapegoat to deflect attention from federal investigators, who were looking into a kickback scheme between the hospital and a separate cardiology group that once employed Midei.
But the suit was dismissed in late April, after a judge found that Midei wasn't allowed to sue because he had signed a release when he was ousted from St. Joseph. His attorney, Stephen Snyder, has said Midei will likely appeal that ruling.
The cardiologist was stripped of his medical license 10 months ago after board members found that he violated five provisions of the state's Medical Practice Act: committing unprofessional conduct, falsifying reports, grossly overusing health care services, breaching standards of care and failing to keep adequate medical records.
He is said to have overestimated the amount of blockage in patient arteries, then treated the phony maladies with expensive mesh stents, which look similar to the spring inside a ballpoint pen. They are used to prop open compromised passageways to restore blood flow and relieve symptoms like chest pain. St. Joseph identified roughly 600 people who might have received such inappropriate procedures, and sent each of them a warning letter.
Board members said Midei's "repeated and serious" violations "unnecessarily exposed his patients to the risk of harm" and increased "the cost of the patients' medical care."
Midei fought the ruling, which led to a lengthy hearing before an administrative law judge, who upheld the decision, and thousands of pages in exhibits and testimony, which were then turned over to the Baltimore County court for another review, at Midei's request.
He argued in court filings that the license revocation was "not supported" and was "based on erroneous legal analyses and irrelevant factors." Midei has long maintained that he operated in his patients' best interests and claimed that he estimated blockages based on what he saw at the time of diagnosis. He attributed discrepancies found by others to variability in physician perceptions and the poor quality of images under review.
A court hearing was held in March to discuss the final effort to preserve his license, and Midei said afterward that he felt "optimistic."
But Souder found that a "reasoning mind" would come to the same "bad faith" conclusions about Midei's behavior that both the medical board investigators and the administrative judge reached. "There is substantial evidence to support these findings," Souder wrote, again upholding the board's decision.
In his statement, Midei said, "I am hopeful that when these judicial decisions are evaluated outside of the legal and political firestorm of Baltimore, unbiased decisions will be rendered. In the meantime, I hope to handle the ongoing scrutiny with continued dignity, decency, and grace."
The Maryland board said Midei could apply for reinstatement in mid-2013.
A medical board in Ohio, Midei's home state, also moved to revoke his license there, which expires in July, based on the actions and accusations in Maryland. Officials sent him a letter in December offering him an opportunity for a hearing.
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