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Panel studying stents narrowing down suspicious facilities

A state committee investigating overuse of cardiac stent procedures in Maryland hospitals expects to complete its data analysis by the end of the month and identify facilities that require further study, representatives said Tuesday during a state legislative briefing.

The analysis was spurred by the case of Dr. Mark G. Midei, a cardiologist who has been accused of placing artery-opening stents in hundreds of patients at St. Joseph Medical Center who didn't medically need them.

Robert Murray, executive director of the Health Services Cost Review Commission, said he's refined administrative hospital data to better gauge which centers may be installing an unusually high number of stents.

"We believe these data are extremely accurate and it constitutes a very robust data set," Murray told the House Health and Government Operations Committee on Tuesday during a briefing that lasted more than two hours.

An investigative report submitted to the legislature in September said a second hospital, in addition to St. Joseph, was under examination for potential stent overuse. The hospital was not identified.

But Dr. Mark Turco, an interventional cardiologist at Washington Adventist Hospital in Takoma Park, raised questions about the reliability of Murray's data and encouraged investigators to use more detailed clinical information submitted to the National Cardiovascular Data Registry.

Data provided to The Baltimore Sun by the HSCRC earlier this year in response to a Public Information Act request showed that Washington Adventist and Union Memorial in Baltimore appeared to have higher-than-typical stent placement rates. Both hospitals have said their procedures are justified.

The legislative committee, led by Baltimore Del. Peter Hammen, who requested the state investigation, has created draft legislation that would make information sharing among regulatory agencies easier, a move designed to improve oversight.

And Turco submitted another draft bill that would enhance state oversight of cardiovascular catheterization labs.

"We must introduce legislation that will re-establish the trust of our patients," Turco said, speaking on behalf of the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions, which maintain procedure guidelines. "Voluntary changes just will not work."


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