Medical board took months to investigate Midei
Tricia Bishop reports that Dr. Mark Midei, alleged by St. Joseph Hospital to have implanted more than 500 coronary-artery stents that may have been unneeded, is now charged by the Maryland Board of Physicians as follows: "Willfully makes or files a false report or record in the practice of medicine" and "Grossly overutilizes health care services." The proceedings could lead to the loss of his license.
A couple aspects of the story are noteworthy:
-- The board received its initial complaint about Midei in November 2008. An anonymous person describing him/herself as a St. Joseph employee detailed 36 cases in which stents had supposedly been improperly placed. The board received another, similar complaint in April 2009. But it didn't launch the investigation until it was notified on July 19, 2009, that St. Joseph had revoked Midei's privileges.
-- The board charging document includes the first bits of explanation from Midei to be made public. To wit:
Midei explained the discrepancy by saying he routinely used certain percentages — 70, 80, 90 -- as shorthand to signify mild, moderate or significant blockage, the document claims. But he conceded, after reviewing his cases, that there was "significantly lower percentages of stenosis than he had initially dictated at the time of the procedure."
Midei also told hospital staff that he considered other clinical symptoms aside from test results when determining whether to place a stent, according to the charging document.
When queried by St. Joseph officials about the stents, according to the charging document, Midei "expressed 'a little bit of surprise' that he had an established pattern of overestimating the degree of stenosis by consistently using the default percentages."