St. Joseph lawsuits could lead to conflicting defense strategies

Malpractice attorneys suing Dr. Mark Midei for allegedly performing unnecessary stent procedures at a Towson hospital say they have gotten a legal boost from a surprising source: Midei himself.

The 53-year-old cardiologist and his lawyer, Stephen L. Snyder, filed a fraud lawsuit last month against his former employer, St. Joseph Medical Center, saying the hospital's claims that Midei performed unwarranted procedures were "erroneous."

The lawsuit places St. Joseph in the position of perhaps having to prove one set of cases against it in order to disprove this one, attorneys say.

St. Joseph sent letters to nearly 600 people last year, warning them that they might have received unneeded stents from Midei, leading dozens of patients to file legal claims against both the hospital and the doctor.

To deflect responsibility in the patient claims, the hospital wants to avoid saying that Midei caused harm, said some lawyers involved in the cases and some who aren't, even though St. Joseph publicly suggested he had through the mailings. But to battle Midei's suit, which claims St. Joseph maliciously ruined his reputation, it needs to show examples of questionable work, they said.

"St. Joe will have to defend Snyder's suit by proving that Midei was negligent and criminal in his conduct, thereby helping all of us suing Dr. Midei for malpractice," Baltimore attorney Andrew G. Slutkin said in an e-mail to The Baltimore Sun.

William H. "Billy" Murphy Jr., who's hoping to get class action status for a malpractice lawsuit his firm filed against Midei and St. Joseph early this year, called the filing "an extraordinary development" shortly after it was made.

The hospital said "it would be inappropriate to discuss our legal strategy," in a statement. Officials added, however, that they want "to ensure that any patient who has received inappropriate treatment resulting in harm has a fair and equitable resolution in his or her case."

In a September op-ed article published in The Sun, Ellen Barton, vice president of governance and administrative services for St. Joseph Medical Center, said "to the best of our knowledge, there have been medical complications in only three patients as a result of the stent procedures."

Further complicating the situation is the relationship among the attorneys. Snyder is better known for representing patients, not their physicians. And he has worked with many of the lawyers suing his client — including Murphy, who's featured in a picture hanging on Snyder's conference room wall.

"Snyder, who is my former law partner, clearly hasn't thought through this lawsuit," Slutkin's e-mail message said.

Snyder, who earlier said a team of lawyers spent months doing little else, bristled at the comment.

"My case stands on its own," he said last week.

Snyder is known for winning big jury verdicts and taking on only homerun cases. His representation of Midei has sent a message, among some litigators at least, that there's another side to the story than the one presented by malpractice attorneys.

On his blog last month, malpractice lawyer Alan J. Belsky said the case will be "ever so closely" watched as it develops.

"Maybe Snyder and his team will move the case along fast enough that if Midei and his attorney ultimately prevail, which, based on the evidence and information available thus far we believe is highly unlikely, many of the claims and lawsuits against Dr. Midei will vanish," wrote Belsky, whose firm, he says, is handling "a number" of stent claims against Midei.

Snyder is not representing Midei in the more than 100 patient claims against him, only in Midei's lawsuit against the hospital.

That lawsuit claims that St. Joseph set out to destroy Midei by telling patients and regulators that his medical records did not appear to support the need for procedures he was performing.

The hospital has vowed to vigorously defend itself, but it "will have to walk a fine line," said Steven H. Levin, a former federal prosecutor who's not involved in the situation.

"At first blush, it would seem to put the hospital between a rock and a hard place," Levin said in an interview. "The hospital will likely have to claim that they believe the work that was done was appropriate and necessary, but to the extent that any unnecessary procedures were done, the hospital will have to take the position that the doctor was acting as a rogue physician."

St. Joseph has already been criticized for defending itself against the patient claims through a general denial, in court papers, of "all allegations of liability." That caused an outcry from malpractice attorneys who said the warning letters appeared to be an admission of responsibility.

But one attorney not affiliated with the cases likened the letters to a vehicle recall, where car makers say there might be nothing wrong with your truck, but you should still get your brakes checked.

That's the position the hospital is taking so far, and attorneys are watching to see what it will present next.

The situation, said Slutkin, is "fascinating."


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