A malpractice lawyer is accusing Dr John Wang (Union Memorial Hospital, Baltimore, MD), a member of the committee tasked with stopping improper stenting in Maryland, of improper stenting in his own practice.
The Baltimore Sun reports that medical malpractice attorney Jay Miller has filed complaints with the state health claims arbitration office against Dr John Wang. Miller alleges that Wang, Dr Mark Midei, and Dr Kourosh Mastali wrongfully stented patient John Bowers in 2005 and 2006, when the three interventionalists were partners in MidAtlantic Cardiovascular Associates (a practice that has since disbanded). Miller also charges that Wang overstated the extent of coronary disease in patient Lorie Skillman to justify implanting a stent.
Dr Midei had his medical license revoked in July of this year after he was found to have repeatedly violated the Medical Practice Act by implanting hundreds of unneeded stents while working at St Joseph Medical Center in Towson, MD.
Midei is one of several high profile cases of alleged overstenting in recent years.
Technical Advisory Group
Dr Wang is part of the Technical Advisory Group on Oversight of Percutaneous Coronary Intervention Services, a group of experts tasked by the Maryland Health Care Commission (MHCC) to develop recommendations for legislative changes that would improve oversight of coronary intervention labs in the state.
The committee has recently issued its most recent report at a public meeting of the health commission, which can be found here.
“The allegations could cast a shadow over the work of the advisory committee,” the Sun reports. Wang was nominated for the committee by the Maryland chapter of the American College of Cardiology (ACC).
Among the group’s recommendations is a new law requiring that all hospitals that provide percutaneous coronary intervention services undergo continuing evaluation of its performance based on established standards. They also recommend that cath labs be subject to periodic peer review.
Until this case gets resolved it remains a speculative exercise to establish who’s in the right. Whatever, it seems that legislation can’t come quickly enough for all sides if the public is to have faith in its clinicians, clinicians can confidently exercise clinical judgment and healthcare providers can be assured that their money is being spent appropriately. Exercising clinical judgment has to remain in the hands, in this case of the Interventional Cardiologist, but the ground rules guiding application of expensive treatments clearly need spelling out.