A Towson attorney filed a foot-high stack of claims Tuesday in a state arbitration office on behalf of 101 patients alleging conspiracy, negligence and fraud against St. Joseph Medical Center and its former star cardiologist, Dr. Mark G. Midei, who is accused of performing hundreds of unnecessary cardiac stent procedures.
The filings, a precursor to court action, came after settlement talks between the hospital and medical malpractice attorney Jay D. Miller broke down over the amounts his clients should be paid.
They represent the first step in a significant wave of civil litigation involving Midei, who has already been sued in a handful of court filings this year. But more legal action could follow, encompassing other doctors and hospitals, Miller said.
"I think [the problem is] nationwide," said Miller, who is also looking into potential claims against Union Memorial Hospital in Baltimore.
St. Joseph, Union Memorial and Washington Adventist Hospital in Takoma Park have questionably high rates of stent placements among Maryland hospitals, according to a Baltimore Sun analysis of state records. And a state committee revealed last month that an unnamed Maryland hospital, in addition to St. Joseph, is currently under investigation for similar stent allegations, and that a third inquiry is possible.
Both Union Memorial and Washington Adventist have said in statements to The Baltimore Sun that they have not been contacted about any state investigation and that quality care is their chief concern. Union declined to address Miller's claims directly, but said that its doctors perform procedures "according to best practices within the cardiology profession."
Midei, who earned $1.3 million from St. Joseph in fiscal year 2009, is accused of falsifying medical records to make it appear that patients have clogged arteries, then inserting mesh stents into their healthy veins as an allegedly unwarranted treatment.
He has strongly denied the allegations, and his supporters have said he's being unfairly targeted.
St. Joseph removed Midei from duty last year, shortly after it learned of the allegations, and said it launched a comprehensive investigation of hospital records going back two years. Midei was the only cardiologist found to have performed unnecessary medical procedures, and the hospital sent warning letters to 600 of his patients saying their stents may be unwarranted.
A physician oversight board filed professional charges against Midei this summer, alleging "gross overutilization of health care services" among other violations of state law. That case, which could affect his medical license, has yet to be resolved.
No criminal charges have been filed against Midei, though a U.S. Senate committee is investigating whether Medicare fraud occurred. Last year, a Louisiana cardiologist was sentenced to 10 years in federal prison for similar allegations of fraud connected to overuse of procedures, and a Salisbury cardiologist was indicted on such charges this summer.
Midei's attorney, Steven L. Snyder, has repeatedly said that his client did no wrong, that he is not under criminal investigation and that the hospital's actions ruined his reputation.
In a statement, St. Joseph said it couldn't comment on the specifics of Miller's claims.
"The fact that SJMC sent a letter to certain patients is not proof of liability," the statement said."SJMC will take responsibility when patients demonstrate that inappropriate care has caused them an injury."
Miller recently placed an advertisement seeking stent patients from other hospitals, claiming his office has "now uncovered information that this was not limited to St. Joseph's Hospital and Dr. Midei." He specifically asks for people who've received stents at Union to reach out.
"Hundreds of people have responded," he said Tuesday.
Martha "Jane" Phillips, who has a long history of cardiac trouble, is worried that she received unnecessary stents from a doctor at Union Memorial in September 2006.
She provided two different catheterization reports to The Baltimore Sun, written four months apart. The first, dated May 2006, says that "there does not appear to be any discrete obstructive disease" in her left anterior descending artery. But in September of that year, another doctor at Union recorded a "70 % narrowing" of the same artery and placed two stents there.
"I was shocked when I came out with more stents," she said. "I had no blockage four months ago."
She said she filed a complaint with the Maryland Board of Physicians this summer, after Midei's story broke, and is awaiting its response before talking to a lawyer.
"Everybody I talked to back then thought this was just a figment of my imagination, that someone would treat you when you didn't need treatment," she said. "People really didn't believe that doctors would do this."
In a statement, Union said federal patient privacy laws prevent the hospital "from responding to anything related to a patient's particular medical care. We encourage anyone with concerns about a stent they have received, or a stent they may need, to discuss this with their physician."
St. Joseph has urged its patients to take similar action, though Miller called the hospital's professed concern disingenuous Tuesday.
"They're saying one thing and doing another," he said.
tricia.bishop@baltsun.com