Lawyer alleges negligence, fraud at St. Joseph Medical Center

An attorney says negotiations with St. Joseph Medical Center over patients who received cardiac stents they might not have needed have collapsed and that he plans to file malpractice claims on behalf of 104 clients.

The lawyer, Jay D. Miller, has scheduled a news conference for Tuesday. The lawsuits against the hospital and Dr. Mark G. Midei, who ran the cardiac catheterization lab, would be the largest number filed against the Towson hospital since problems with stents first surfaced last year after federal authorities subpoenaed records for an investigation into suspected Medicare fraud.

At least two other lawsuits were filed in January — one in Baltimore County, and another in the city seeking class-actions status. Miller, who says he represents nearly 200 patients, said he wants each of his clients to pursue their own claims.

"I want each person to have his or her day in court," Miller said Monday. "Each case is different. Everybody's damages are different. … We're talking about fraud here."

Miller said he plans to file the claims in Maryland's Health Care Alternative Dispute Resolution Office, which arbitrates malpractice cases. Representatives can begin further talks, and either side can appeal in court if it finds the board's decision unsatisfactory. If all sides agree to forgo further talks, the cases can be moved to court without additional meditation.

This batch of lawsuits could be the start of a wave of litigation against the doctor and the hospital, which sent letters to nearly 600 people warning them that the stents they received might have been unnecessary.

Hospital officials have said they settled with federal authorities in the Medicare probe, and upon learning of the allegations involving Midei, immediately removed his privileges and notified patients of potential problems.

In June, the regulatory board that licenses doctors in Maryland filed administrative charges against Midei, who earned $1.3 million from St. Joseph Medical Center in 2009, alleging that he engaged in "gross overutilization of health care services" and falsified reports. As a result, Midei could lose his medical license.

Miller would not discuss specifics regarding his confidential talks with St. Joseph officials, but said the breakdown occurred over how much money each side thought his clients deserved. He said the hospital offered no more than what he characterized as "out-of-pocket expenses" for medication and follow-up visits to doctors not covered by insurance.

The attorney said the patients deserve more. Depending on individual insurance plans, he said, his clients could be out between $20,000 and $50,000 over the course of their remaining years, in part because the procedure requires they take medications with dangerous side-effects.

In a statement, St. Joseph's said it could not comment on claims that have yet to be filed. But they did confirm they're seeking to talk with patients and their lawyers to try to settle any potential claims. The hospital says that not all patients who received letters had an unwarranted procedure.

The hospital, the statement says, "will take responsibility when patients demonstrate that inappropriate care has caused them an injury. … SJMC has invited all the plaintiffs' attorneys to submit supporting medical information so that it can properly and fairly evaluate each claim. SJMC has only received that information in a few cases."

The statement adds that the hospital "respects that some patients want to explore their legal options as a result of receiving a letter regarding their procedure. SJMC had hoped to find common ground with Mr. Miller that would allow for an expedited process to appropriately settle all legitimate claims in a fair manner. Unfortunately, efforts thus far have been unsuccessful."

Midei's attorney, Stephen L. Snyder, said the inability of St. Joseph's to satisfy its patients further harms his client, who denies any wrongdoing.

"The hospital took unprecedented and decisive action in tarnishing and forever destroying Dr. Midei's fine reputation," Snyder said in a statement. "Yet when it comes time to defend these matters, the hospital's conduct frustrates and disappoints these plaintiff's lawyers who are led to believe that the only issue to resolve is how much. It is not."

Miller said the lawsuits will give him a chance to depose key hospital officials and learn more about how Midei allegedly escaped scrutiny. Regulatory documents reported on by The Baltimore Sun in May show that the doctor avoided peer review because, as a department head, he chose which cases would be scrutinized.

State regulators discovered, for example, that in five cases, Midei wrote that patients had 80 percent blockages of coronary arteries, which required stents. But the board found that the arteries were blocked only 50 percent.

Miller, who sought out clients by placing newspaper ads after the letters were sent out, questioned whether St. Joseph officials did all they could to uncover the problem and alleges that the hospital and Midei conspired to perform unnecessary procedures.

"The hospital had to have been aware of what Dr. Midei was doing and they just looked the other way," Miller said. All 104 of his clients filing claims Tuesday received letters from the hospital warning them that they might not have needed the procedure, Miller said.

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