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July 14, 2011

A Maryland medical licensing board has revoked the license of a doctor accused of implanting stents in patients who did not need them.

The Maryland State Board of Physicians has revoked the license of Dr. Mark G. Midei, a Towson, MD physician accused of deliberately falsifying medical records to substantiate the implantation of cardiac stents in patients who had no medical need for the device.

The Board accepted an Administrative Law Judge’s findings from a 2010 evidentiary hearing that Midei violated five provisions of the Medical Practice Act, including provisions prohibiting unprofessional conduct, gross overutilization of health care service, violations of the standard of quality care and failure to keep adequate medical records.

“Dr. Midei implanted cardiac stents unnecessarily in four of five patients in question,” the Board’s Final Decision and Order said. “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 three patients, he also falsely reported that they suffered from unstable angina when in fact they did not.”

Midei was head of the cardiac catheterization clinic at St. Joseph Medical Center. The hospital received $10,000 to $15,000 for each stent inserted.

Although the hospital did not pay Midei per stent, he testified that he understood that he was a big generator of business for the hospital, that the hospital had lost many patients to competition and that its goal was to hold onto the stent business that it saw slipping away.

“Dr. Midei’s violations were repeated and serious,” the Board said. “They unnecessarily exposed his patient to the risk of harm.”

Midei’s improper stent use prompted a December 2010 U.S. Senate Committee on Finance report into improper cardiac stent implants. St. Joseph told the Committee that the hospital hired a panel of experts to review Midei’s cases after receiving a credible complaint of medical fraud. The panel reviewed records for 1,878 stent patients and identified 585 patients that may have received medically unnecessary cardiac stents between 2007 and 2009. St. Joseph Medical Center billed private and public insurers more than $6.6 million for those potentially unnecessary stents. Medicare paid more than half, $3.8 million.

“Hospital patients expect their care to be based on medical need, not profits,” Committee Chairman Max Baucus said. “This report sets forth alarming evidence that patients at St. Joseph Medical Center received unnecessary and potentially harmful stent implants time and again – a pattern that is shocking, disturbing and shameful. Doctors should not be performing invasive medical procedures patients don’t need, and taxpayers certainly shouldn’t be paying for these wasteful and improper implantations.”

Midei cannot petition the board for reinstatement of his license for at least two years.

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