6 Dec – After a Baltimore hospital barred a cardiologist for allegedly performing unnecessary implants of heart stents, the company that manufactures the stents hired him to consult and market the devices, according to internal e-mails and memos released today in a Senate Finance Committee report.

by Marian Wang

ProPublica

Abbott Laboratories manufactured the stents that Dr. Mark Midei used frequently before St. Joseph Medical Center revoked his hospital privileges in May 2009. The hospital decided to bar the head of its cardiology department after an expert panel reviewed patient records and concluded that 585 of his patients may have undergone unnecessary heart procedures to implant the stents, which are used to open blocked arteries in the heart. (Midei disputes this, and has sued the hospital for causing irreparable damage to his career.)

From the Senate report, (posted at ProPublica:

Despite the ethical and legal questions surrounding Dr. Midei, Abbott hired him as a consultant after he was barred from practicing at St. Joseph. Dr. Midei’s duties for Abbot included, among other things, helping the Company market its stents in Japan and working on a safety presentation for Abbott’s newest stent, the Xience V. Dr. Midei was paid $30,623 for this consulting work.

Abbott and its sales representatives had a close relationship with Midei, the documents show. In 2008, the company “paid at least $1,925 for social events at Dr. Midei’s home, including crab and barbecue dinners.”

In August 2008, Abbott paid for the catering of a barbecue dinner the same week that the company’s executive vice president of medical devices sent Midei an e-mail congratulating him on performing 30 stent implants in a single day. The exec called it “a truly outstanding day” and thanked Midei for supporting Abbott’s product.

“In my 15 years of being in this business, I have never seen personal relationships as strong as the ones you have developed with Dr.’s Mark Midei, [name redacted], and [name redacted],” an Abbott sales manager wrote, congratulating a sales representativewho had worked closely with Midei.

Later, when Midei’s practices came into question, Abbott sent him to consult overseas because in the United States, “the press is just too hot.” An email from February this year shows an Abbott executive recommending that the company “continue to work with him, behind the scenes, at this point. We’ve just decided not to have him doing any public type work in the U.S. right now.”

Abbott told the Wall Street Journal that Dr. Midei “has been a highly regarded physician in his field” and said it ended its affiliation with him early this year.

Midei’s attorney, Stephen L. Snyder, asked about the Senate report, told the Baltimore Sun: “Big deal.” He told the Journal that his client got “nothing extraordinary” from Abbott. Maryland’s licensing board has charged his client with violations of state law that could ultimately strip him of his medical license, the Sun reported.

ProPublica has reported that hundreds of doctors who have been accused of misconduct or lacked credentials have been hired by drug companies as speakers and consultants.

The misconduct in the cases we identified was often different from the example highlighted in today’s report, since it was often not directly related to the doctors’ practice of medicine or prescriptions. In response to our reporting, several of the nation’s pharmaceutical companies said they plan to tighten how they screen the doctors they hire.

In a piece published today, California Watch separately reported that three San Diego doctors who accepted $20,000 or more in payments from drug companies are on a list of the state’s top prescribers of antipsychotic drugs to the poor and disabled. While this isn’t a problem if the treatments are needed, the degree to which drug company payments to physicians influences their prescriptions or causes over-prescription is a topic of continuing debate.