Midei's attorney calls doctor's industry ties typical

When Dr. Mark G. Midei, who's accused of placing cardiac stents into patients who didn't need them, allowed stent maker Abbott Laboratories to throw parties at his Monkton home and accepted thousands in consulting fees, it was business as usual for the medical profession, his attorney said Friday.

"All of these events were legal; they were done uniformly by all practitioners," said lawyer Stephen L. Snyder, adding that "this is the way it's done" between product sales people and doctors.

An investigative report released Monday by the U.S. Senate Committee on Finance detailed a comfortable and sometimes lucrative relationship between Abbott and Midei, who was the cardiology director at St. Joseph Medical Center in Towson before his termination last year.

Abbott paid Midei roughly $37,000 in consulting fees and chipped in nearly $2,000 for a crab feast and pig roast at Midei's home. The report questions whether Abbott "indirectly encouraged Dr. Midei to intensify his use of stents, with unfortunate results."

"I'm sure a lot of that goes on in all kinds of businesses, except in the pharmaceutical industry where patients' lives are at stake, it's more serious," John Mack, editor of Pharma Marketing News, said in an interview this week.

The appearance of impropriety and some federal cases involving kickback claims have led trade groups to toughen their ethical guidelines over the past few years.

The Advanced Medical Technology Association, a trade group known as AdvaMed, revamped its rules last year. They say that companies like Abbott can pay for modest meals for health care workers but that they "should be in a setting that is conducive to bona fide scientific, educational, or business discussions" and that they "should not be part of an entertainment or recreational event."

The guidelines also say that paying a physician for consultant work "should not be based on the volume or value of the consultant's past, present or anticipated business."

E-mails from Abbott representatives, obtained by the Senate committee, claim they hired Midei as a consultant after he was fired from St. Joseph because it was the right thing to do: "he helped us so many times over the years," one message states.

On its website, Abbott said it incorporates the AdvaMed code, and company officials certified that it was in compliance this summer.

Abbott declined this week to answer specific questions about its financial outlays involving Midei, issuing a statement instead that said the company "supports the work of many medical organizations and health professionals as part of our commitment to advance medical science."

Snyder said Friday that his client, who favored Abbott stents, wasn't influenced by interactions with company representatives and that the device maker "never paid anything to Dr. Midei" in exchange for the use of its stents.

"A crab feast and a picnic is hardly a perk," Snyder said. He denounced the Senate report as incomplete and complained that investigators never interviewed Midei.

A hearing is scheduled to begin Tuesday to determine the "extent" that Midei's medical license "will be preserved," Snyder said.

The Maryland Board of Physicians, which oversees doctor discipline and licensing, filed professional charges against Midei in June, accusing him of violating the Medical Practice Act by falsifying patients' records to make it appear they needed treatments.

Snyder said he expects "full vindication" of Midei through the hearing, though it could be months before the results are known. The proceedings, which are closed to the public, are expected to last a week, and it could take an additional 90 days before the judge issues recommendations to the board, Snyder said.