A recent study revealed that less than half of all Americans with stable heart disease should receive guideline-recommended medicines before undergoing angioplasty with coronary stent—a procedure also known as percutaneous coronary intervention or PCI. The ProPublica study suggested that the rush by many physicians to use stents could be the result of heavy financial influence from stent makers.
Now, says Med City News, the U.S. Department of Justice (DOJ) is investigating accusations against cardiologist Dr. Elie Hage Korban and two Tennessee hospitals made in a <"https://www.yourlawyer.com/topics/overview/qui_tam">whistleblower lawsuit. The suit accuses the three of running a scheme meant to defraud government insurance programs by prompting the overuse of medical services, wrote Med City News.
The group was accused by another Tennessee cardiologist, Wood Deming, MD, who claims that Dr. Korban provided bogus symptoms in cardiac patient cases in order to ensure medical procedures were authorized to receive government reimbursement, explained Med City News. Accusations span to Jackson-Madison County General Hospital and the Regional Hospital of Jackson executives and radiologist Dr. Joel Perchik for allegedly “condoning or abetting†Korban’s so-called fraud as well as for colluding in the kick-back.
Heartwire pointed out that the whistleblower claims says that the executives enabled Korban to also order unneeded studies at hospitals in which patients were moved for more unnecessary procedures. Deming also accused the hospitals of assailing those doctors who tried to stop the scheme, going as far as putting them through bad-faith peer reviews, which ultimately led to their losing their staff positions.
This is not the first case concerning overuse of stents. For instance, said Med City News, St. Joseph Medical Center in Maryland advised 369 patients last year that coronary stents received under the care of Mark Midei, MD, might have been implanted unnecessarily. That news resulted in a class action lawsuit in which the hospital settled with no admission of guilt last November. The hospital paid a $22 million fine.
In another outrageous case of stent overuse, 141 patients underwent unneeded angioplasties at Westmoreland Hospital in Western Pennsylvania in 2010. According to a report from The Pittsburgh Tribune Review, the questionable stents were implanted by Drs. Ehab Morcos and George Bousamra, who voluntarily resigned their privileges at Westmoreland.
For several years now, scientific guidelines have called on doctors to try drug therapy—statins, beta blockers, or aspirin—before resorting to angioplasty. Those guidelines were instituted after a 2007 landmark study showed that intensive drug treatment in nonemergency patients with chest pain worked as well as angioplasty. The same study also suggested that many of those given drugs first wouldn’t need an eventual angioplasty. Before that study was published, fewer than half of PCI patients received drug treatment first, then an angioplasty.
