Kentucky

Hundreds of patients allege needless heart procedures done at Saint Joseph-London

LONDON — Doctors performed unneeded heart procedures on hundreds of people in recent years at Saint Joseph-London hospital to unjustly enrich themselves, the patients have charged in a series of lawsuits.

Attorneys filed a complaint last week on behalf of more than 280 Saint Joseph heart patients. The defendants include the hospital and parent company Catholic Health Initiatives, 11 doctors, seven medical practices, and a management service.

That lawsuit follows more than 30 complaints that Louisville attorney Hans G. Poppe filed beginning a year ago for individual plaintiffs.

There will be additional claims against the hospital, said Poppe, who is handling the large lawsuit with Warner Wheat, who works in his firm, and London attorney Gary Hudson.

Sharon Hershberger, spokeswoman for Saint Joseph-London, said in a statement that the facility is aware of the complaint — apparently referring to the latest lawsuit with nearly 300 heart patients — and takes the allegations seriously.

Hershberger said Saint Joseph could not comment further on pending litigation.

The hospital, doctors and other defendants in the lawsuits have denied wrongdoing in their responses in court.

Details in the lawsuits vary based on the facts of each case, but in total, they allege that heart doctors took part in medical misconduct on a grand scale at Saint Joseph-London, going back years in some cases, to get payments from the state and federal governments, insurance companies and patients.

The doctors installed pacemakers and stents, which are used to open a narrowed artery, in people who didn't need them, and did unnecessary cardiac catherizations, in which a tube is inserted into the heart to check for problems, the lawsuits charge.

Some patients even underwent unneeded open-heart surgery, Poppe said.

Poppe said the problems were too pervasive to blame on occasional mistakes, or on judgment calls about the proper way to treat a patient.

"The pattern and practice is so far removed from the (proper) standard of care," Poppe said.

Doctors named in the lawsuits told patients their heart problems were worse than they really were in order to convince them to undergo procedures, and concealed the risks of the procedures, the lawsuits claim.

For instance, doctors "dramatically misrepresented" the extent of arterial narrowing Edward Marshall faced, according to the lawsuit Poppe and London attorney Gary Hudson filed for him.

Doctors implanted a pacemaker in Marshall at Saint Joseph in 2009 that he didn't need, and later performed unnecessary catheterization and stent procedures on him, the lawsuit claims.

Marshall, of Laurel County, would not have agreed to undergo the procedures if he had known the risks and his true condition, the lawsuit said.

Marshall discovered he had undergone unnecessary procedures when he started going to a different group of heart doctors, his lawsuit said.

The people who had unnecessary procedures at the hospital suffered pain and health risks, incurred medical costs — and will continue to do so — and face the risk of complications and more procedures, the lawsuits claim.

Marshall's was the first of the wave of lawsuits over the last year alleging widespread "profit-driven misconduct," as his claim put it.

The lawsuits allege that while the doctors pushed unneeded procedures, Saint Joseph was complicit in a civil conspiracy because they allowed the doctors to work at the hospital and failed to properly oversee them.

Saint Joseph profited from the doctors' alleged misconduct, the lawsuits claim.

The latest lawsuit also includes claims by more than 50 spouses of heart patients that they have lost their spouses' "love, affection, counsel, companionship, services, society, and consortium."

The lawsuits seek unspecified damages.

Poppe said the state Board of Medical Licensure is investigating issues cited in the complaints.

The state Cabinet for Health and Family Services Office of Inspector General is not investigating claims about unnecessary heart procedures being performed at Saint Joseph-London, said Jill Midkiff, spokeswoman for the cabinet.

However, the agency did investigate a complaint in February 2011 and concluded the hospital had been deficient in reviewing the necessity of heart catheterizations performed there, according to a document Poppe provided.

An unnamed doctor on the hospital's quality assurance committee said he had never reviewed records or cases "regarding medical necessity or the overutilization of cardiac catheterizations," the document said.

One patient told an investigator he had had about 20 heart cath procedures — the last one when he came to the hospital because of kidney stones — and that his primary care doctor couldn't understand why, according to the document.

The hospital submitted a plan to improve review of the necessity for services.

Complaints about unnecessary heart procedures have grown in recent years around the nation, according to published reports.

For instance, a doctor at a Catholic Health Initiatives hospital in Maryland lost his license after being accused in 2009 of doing hundreds of unneeded stent procedures, according to the Baltimore Sun.

In another case, Hospital Corporation of American has faced allegations of unnecessary stent procedures being performed at some of its hospitals, the New York Times recently reported. Medicare reimburses hospitals about $10,000 for a heart stent, the newspaper reported.

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