CardioExchange Archive

The Maryland Board of Physicians has revoked the medical license of Mark Midei–the interventional cardiologist accused of implanting hundreds of unnecessary stents at St. Joseph Medical Center in the community of Towson. In its Final Decision and Order the Maryland Board found that Midei was guilty of unprofessional conduct, willfully making a false report, gross overutilization of health care services, violating the standard of quality care, and failure to keep adequate medical records.

The Maryland board issued its final decision today, following a 7-day evidentiary hearing in which Midei was present (and in which he was represented by 9 attorneys), and a subsequent oral appeal on June 22, 2011.

The finding was based on a detailed review of 5 cases. This review, according to the board, was entirely distinct and separate from the investigation of Midei performed by St. Joseph Medical Center.

The board found that Midei “implanted cardiac stents unnecessarily in four of the five patients in question. In every one of the patients, he falsified the extent of blockage of the patients’ coronary arteries by reporting that it was 80% when it was in reality lower– and in most cases much lower.” In 3 cases Midei said the patients had unstable angina when they did not. In addition, in all cases he failed to obtain the Active Coagulation Time (ACT) and “instead simply administered heparin while inserting the catheter,” endangering one patient who had already received an anti-coagulant.

In its lengthy decision, the board “noted some inconsistencies or equivocations in the testimony of Dr. Midei’s primary expert witness, Dr. O’Neill.” The board discredited much of O’Neill’s testimony as it was based on “later-remembered, unrecorded symptoms– symptoms that Dr. O’Neill learned about only orally, from Dr. Midei.” O’Neill, according to the board, was paid $30,000 by Midei for his expert testimony. The state’s expert witness, Matthews Chacko, received $1,400.

The ruling also states that Midei claimed in his defense “that it is appropriate for him to write ‘80%’ to describe a blockage that is in fact less than 50%.” The board said this was “a blatant falsehood that resulted in patients receiving unneeded stents as well as the creation of false records…”

The board rejected Midei’s contention “that the fact that a cardiologist sent a patient to him is in itself evidence of significant symptoms that required his intervention by the placement of stents.”

The board also rejected Midei’s defense that he was not paid  based on volume. The board noted that he was hired as an employee by the hospital “at triple his previous salary” and that “he was employed under circumstances in which any employee would feel at least some pressure to produce a high volume of stents.”