The former owner of St. Joseph Medical Center has agreed to pay up to $37 million to resolve allegations that cardiologist Mark G. Midei put hundreds of patients through unnecessary heart stent procedures, according to court documents.
As many as 273 patients stand to get payments of at least $134,000 before lawyers' and other fees. The settlement represents a major step toward resolution after more than four years of court fights that began when St. Joseph informed hundreds of people that their surgeries might not have been needed.
The agreement could resolve the legal claims of any patient who received such a notification, ending class-action suits in both Baltimore and federal courts. Though patients could still opt out of the deal and continue to pursue legal action, Hassan Murphy, one of the lawyers for the plaintiffs, said he hopes the settlement will bring the case to a close for many.
"We are pleased to have settled the class actions," he said.
Midei had been a star doctor and major moneymaker at the Towson hospital, but he eventually lost his medical license after the Maryland Board of Physicians found that he falsified records to justify the expensive procedures. He was not named as a defendant in the case and has denied wrongdoing.
Under the terms of the settlement, Catholic Health Initiatives, which owned the hospital, also did not admit to any wrongdoing. A spokesman for the organization said last week that such a deal would end the legal and financial uncertainty of further court battles.
The medical center was sold in 2012 to the University of Maryland Medical System, which did not take on any liabilities arising from the lawsuits.
Baltimore Circuit Judge Sylvester B. Cox gave preliminary approval to the settlement agreement last week, writing in an order that it appeared "fair, reasonable, and adequate." He set a hearing for next month to finalize the deal, which was made public Monday.
The case was filed in January 2010, just weeks after The Baltimore Sun reported that St. Joseph had been sending out notices to patients, warning them that they might have had unnecessary procedures. A flurry of other lawsuits followed.
The small stents are designed to keep open blood vessels in danger of being blocked, but an internal review done amid a federal investigation indicated that a number of Midei's patients had only minor clogging and did not need stents.
Midei was a defendant in a multimillion-dollar Baltimore County suit brought by developer Glenn Weinberg. A jury in that case found that Midei had breached standards of medical care, although a judge vacated the finding.
In that case, the jury could not agree on what damages to award and the judge declared a mistrial. That case remains active, according to court records, because there was a separate finding against the hospital's former owners.
Midei, who now has a health care consulting business, said in an interview last week that many of his patients would not have lived without the stent procedures.
"They are not always a matter of life or death, but rest assured that there are a great number of them for which that is true," he said.
Many of the lawsuits have been settled, under terms that were confidential. In one of the larger settlements, attorney Jay D. Miller announced in May in the middle of a trial on a group of stent cases that his firm had reached a deal covering its 247 clients. A dollar amount was not announced.
But dozens of cases remained open. Plaintiffs in those cases can now choose to cash out by joining the $37 million class-action settlement rather than continuing to fight.
Andrew G. Slutkin, a medical malpractice attorney who has been involved in separate cases against Midei, said last year's agreement and the new settlement are major steps toward ending the litigation.
"It's a big deal," said Slutkin, whose clients have settled. "This is a very significant settlement on behalf of Dr. Midei's victims."
The law firms pressing the class-action case had also brought a federal lawsuit based on similar allegations.
They agreed to drop that lawsuit as part of the deal and to drop a request to have a second class of plaintiffs created. That class would have consisted of people who might have had unnecessary procedures as far back as 1995 but did not receive a notice from St. Joseph.
The parties began negotiating last October with the aid of a Boston-based arbitrator and law professor, according to court documents.
How much the Colorado-based Catholic Health Initiatives, which has annual revenues of almost $11 billion, ultimately has to pay — and how much the plaintiffs receive — depends on how many people come forward with claims.
The health care company has agreed to pay nearly $37 million as long as more than 60 percent of possible claimants ask to join the case, according to court documents.
The plaintiffs' attorneys plan to ask for 40 percent of the total as payment, and other money will go to administrative costs and reimbursements for Medicare, Medicaid and the insurance companies that covered the stent procedures.
In the Baltimore suit, the class is represented by two of Midei's former patients, who will each receive $25,000 on top of any other payment.
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