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Self-policing could stem the heartbreaking wave of unnecessary cardiac procedures


Indiana electrophysiologist Scott Kaufman first encountered Gloria Sargent seven years ago in the emergency department of Community Healthcare System in Munster, Indiana. Sargent was vomiting and her heart rate was out of control.

Years later, Kaufman saw another patient, Angela Webb, who was having difficultly simply picking up her grandson.

In both cases, Kaufman determined that the pacemaker-defibrillator that had been surgically implanted in the patients was completely unnecessary. In fact, once the device was removed, the health concerns that had brought the women to Kaufman in the first place disappeared entirely.

Webb and Sargent are among 293 patients who have filed lawsuits against three cardiologists who comprise Cardiology Associates of Northwest Indiana. Their stories, and the experiences of a handful of other patients, were revealed in a New York Times article last week that cut to the core of fraud allegations that are representative of a larger trend across the country.

What is particularly interesting about the situation in Munster is the way in which it evolved from a few sick patients to hundreds of plaintiffs. Kaufman determined that Sargent and Webb were former patients of Arvind Gandhi, one of the partners at Cardiology Associates, and then began noticing a trend. He eventually saw 15 patients formally treated by Gandhi and determined 11 of them underwent unnecessary procedures.

Then he did something truly unheard of: He teamed up with medical malpractice lawyers, the same ones whom he had faced off with in the courtroom twice before. (Both cases against Kaufmann were settled and a medical review panel absolved him of wrongdoing).

The take-home message of the Times article seemed to be if it can happen in a small Midwestern town, then it can happen anywhere.

Unfortunately, it is happening everywhere. This year alone, we've seen dozens of indictments and settlements involving cardiologists, or hospitals that either turned a blind eye or were simply too distracted by the pumped-up reimbursement to pay much attention. In June, a New York hospital paid $18.8 million to settle allegations of unnecessary cardiac procedures. In September, an Ohio cardiologist was convicted of billing Medicare $7.2 million in unnecessary procedures, and a Kentucky cardiologist pleaded guilty to performing unnecessary cardiac stents at Kings Daughters Medical Center, which paid $40 million last year to settle fraud allegations tied to cardiac procedures. Also in June, one of the highest-paid physicians in the country was banned from Medicare after being hit with lawsuits for unnecessary cardiac procedures. And earlier this year, a three-year-old lawsuit was unsealed alleging unnecessary cardiac procedures in one of the largest health systems in the country.