Maryland attorneys are spending thousands of dollars to sign up clients who might have had heart stents needlessly implanted by a doctor at St. Joseph Medical Center - cases some say could be clear-cut victories for patients and a steady income stream for their lawyers.
The Towson hospital sent letters to hundreds of patients last month, telling them that the expensive stents in their arteries might have been placed there unnecessarily and under false pretenses. And almost immediately, attorneys began calling for clients online, on TV and in print.
One lawsuit was filed last week in Baltimore County Circuit Court, and the first suit to seek class action status was filed in the city Thursday.
"These patients were misled into having surgeries that they did not need," said attorney William H. "Billy" Murphy, who called a news conference Thursday to announce the class action lawsuit filed by his firm in conjunction with Peter Angelos' office. Among their demands are that the hospital cease its stent procedures unless certain requirements are met and that it pay for a review of patient records.
Hospital officials said they had not seen the court filings Thursday and so couldn't comment on the specifics, but issued a statement saying that they took "aggressive action to correct the problem" as soon as it was revealed and they don't believe affected patients are in any "immediate risk."
"St. Joseph was guided by the belief that it has a moral and ethical responsibility to inform these patients of what happened. This is consistent with our mission and core values. It was the right thing to do," the statement said.
The Baltimore County hospital has identified at least 369 people who might have had unwarranted operations - all tied to a single physician - and more could surface as the examination, prompted by a federal investigation, continues. Lawyers say it's a nightmare admission for the facility, which has a reputation for high-quality heart care. And it's extremely unsettling to the patients, who have to take a blood thinner for the rest of their lives and worry about what might one day go wrong.
For medical-malpractice and personal-injury attorneys, however, it's an opportunity, with the potential for consolidated cases and sizable settlements even though damages may be difficult to show.
We "are investigating potential lawsuits and legal claims," says Saiontz & Kirk. "You may have grounds for filing a Maryland medical malpractice lawsuit," advises Lebowitz & Mzhen. "Please give us a call as soon as possible concerning your legal rights," urges Azrael, Gann & Franz.
"This is a case of very clear liability. ... We'd be happy to take that on," said personal injury lawyer Vadim Mzhen. "What distinguishes this case from just about anything we or other attorneys see is the intent. ... Normally when there's medical malpractice, a doctor makes a mistake, it's not intentionally done. Here this was done intentionally. It's an incredibly distinguishing factor."
Stents, usually threaded into place through the body's bloodstream, act as artificial supports, opening clogged arteries or creating bridges around damaged areas. They're praised by patients as an alternative to open-chest surgery and valued by hospitals in part because they're lucrative, often costing $10,000 or more per procedure.
Clinical guidelines generally require that an artery be at least 70 percent blocked before a stent is placed, and St. Joseph's rules consider anything less than 50 percent blockage to be "insignificant." But Dr. Mark G. Midei, who abruptly lost his privileges at the hospital last summer, is accused of performing stent operations on some people with virtually no blockage, after telling them falsely that they were in danger.
"It's something like when you go to a car mechanic, and you trust them and they tell you you need a new transmission, when in fact, three-quarters of transmission problems don't require a new transmission, but you trust them and you have it done anyway," said Keith S. Franz. His law firm is looking into a handful of cases involving clients who received stents from Midei.
In a statement this month, Midei said he expects to be exonerated and to return to medical practice. "I am confident that I have always acted in the best interest of my patients, and when all the facts are presented, I will continue providing quality medical care to my patients," he said.
Malpractice attorneys acknowledge that the stents probably have helped some patients. But the hospital still recognized an obligation to notify people of the discrepancies it found in medical records and to encourage them to talk to their doctors.
"Questions about potential [legal] liability remain to be resolved," the hospital statement said. "St. Joseph Medical Center takes its responsibility to patients very seriously, which is why we conducted a review and notified patients and physicians."
Lawyers, too, vary on their predictions for legal action. Most see a filing stream of separate suits that are eventually consolidated or granted class status and settled for individual damages, each sum dependent upon the clinical circumstances of each patient.
No one contacted by The Baltimore Sun was willing to speculate on the amount of money at stake, beyond saying simply that a patient's connected death, should there be one, would likely bring in more than outcomes such as anxiety.
Still, the volume of potential plaintiffs alone is enough to attract the attention of at least a dozen plaintiffs' lawyers, including Orioles majority owner Angelos, and spur them to investigate. The Law Offices of Peter G. Angelos PC placed print ads in The Baltimore Sun recently saying that those who received a letter from St. Joseph "may wish to consult a lawyer" and it teamed up with Murphy's firm to file Thursday's lawsuit.
Angelos, who did not return an earlier call for comment, has made millions through civil suits against firms in the asbestos, tobacco and pharmaceutical industries.
Such plaintiffs' attorneys often earn revenue through contingency fees, which average around 30 percent of a court award. "The fact that a number of plaintiffs' lawyers are advertising for these kinds of cases suggests at the least, in their view, there's something here, that at the end of the day, they can make a profit," said Jack Schwartz, a health care law and policy professor at the University of Maryland School of Law.
"But that doesn't mean that it is so," he cautioned. "They just perceive it to be so."
Punitive damages would be hard to show, particularly in Maryland, which requires that there be actual malice to receive such awards. And you can't get damages for speculative "future events," said Maxwell Gregg Bloche, a law professor at Georgetown University.
Austin Kirk of Saiontz & Kirk said his firm, which is advertising for clients on television and has set up a toll-free number for qualifying stent patients, hasn't characterized the potential yet.
"At this point, we don't know how big of a deal it is," Kirk said. "We're investigating the case and looking into the matter. People have important rights that may go beyond apology letter."
On his Maryland Injury Lawyer blog, attorney Ronald V. Miller Jr. labeled the situation a "scandal" and said "the allegations are beyond stunning." But in an interview, he cautioned not to jump to conclusions.
"There's a temptation for many plaintiffs' lawyers to rush to judgment as to what the facts are," Miller said. He added that plaintiffs' lawyers are opportunistic; it's part of the business strategy.
"We've still got to uncover doctor liability and the hospital's liability and whether or not punitive damages would be appropriate, and whether, most importantly, whether the individual patient has suffered significant injury," he said. Still, he sees the possibility for settlements if for no other reason than to enable St. Joseph "to put the scandal behind them once and for all."
He added that his firm has had "several inquiries" from potential stent clients, whose cases he's happy to explore.
You can't share in potential profits, after all, if you're not among the players.