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Did Hospital Adequately Warn, Review Records on Stent Implants?

We initially reported on allegations of medical stents being improperly placed into potentially hundreds of patients at St. Joseph Medical Center in Towson in August, when the matter first began to assume media prominence.

Since then, the medical malpractice story has grown in all dimensions. In an October update, we noted the filing of several lawsuits in the matter, and we followed up further in a November post that focused on Dr. Mark G. Midei's first public comments in the case.

Many media stories have routinely focused on Dr. Midei's personal liability for the stents implanted into patients unnecessarily while he was supervisor of the hospital's cardiac catheterization lab.

Liability questions obviously swirl around the hospital, as well, and it has taken strong actions over the past months to isolate itself from Midei and to stress that it has acted responsibly and with due care toward patients.

Some medical experts question whether the hospital has done enough. It has been noted, for example, that there is marked variance between the findings of the hospital's internal investigation and the rhetoric in the letters it later sent to approximately 600 patients.

As to the former, hospital doctors noted "the substantial likelihood of harm" to many of Midei's patients, as well as "the potential for serious complications" arising from the stent implants. In the letter sent by St. Joseph administrators, that type of wording and tone is absent, with patients merely being informed that the subsequent clinical review "was different than the original report and may be relevant to your ongoing care and treatment."

The hospital also limited its review to cases going back no further than two years, noting that the risk of clotting was greatly diminished after that period. Medical experts also question that decision. "I can't see any reason why it would be defensible to limit the review of cases to the previous two years," says Robert. M Veatch, professor of medical ethics at Georgetown University.

"I think they should go back as far as necessary to inform patients," states Dr. Robert Truog, the director of clinical ethics at Harvard Medical School.

Dr. David Holmes, a Mayo Clinic cardiologist, says that all relevant data needs to be disclosed, without regard to timelines, "so lessons can be learned from it."

Related Resource: articles.baltimoresun.com "St. Joseph should review additional Midei cases" December 12, 2010

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