Conducted to prevent medical malpractice exposure, an audit of the Excela Health hospital system revealed that 141 patients in 2010 received 149 coronary stent implants that may not have been medically necessary. As a result, the hospital system is providing free assistance to patients who were affected and is also providing advice to those who have concerns about their heart health. Two cardiologists who performed the unnecessary procedures have been released from the staff of Excela.
Usually, coronary stents are placed in a patient's artery or arteries to the heart when the artery has narrowed or has been blocked by deposits of fatty plaque. The coronary stents are inserted through a catheterization process and support artery walls. The stents open or maintain oxygen laden blood flow to the heart. Issues with coronary stents were recognized in February 2010 and in May 2010 a medical audit firm was hired to review procedures conducted by Excela Health hospital system.
The audit began with an initial review using a panel of seven cardiologists from across the United States. The cardiologists analyzed patient cases and the review process narrowed the audit down to two doctors. An additional review phase was conducted that reviewed every case the two doctors worked on over 2010. Eight more doctors were used during the second phase. Doctors looked at patients' symptoms, patients' responses to stress tests and patients' blockage severities when making their case decisions.
The general blockage threshold of when a stent is recommended is 70 percent. The review panel looked at patients with 50 percent or less blockage to determine whether their condition warranted a stent. The 141 patients were discovered within that reviewed group. Each patient was contacted and was informed to reach their doctor. Adverse effects are not expected for patients who received medically unnecessary stents. Within the first year of placement, there is a one percent risk of blood clot caused by a stent.
Source: Pittsburgh Post-Gazette, "Audit finds medically unnecessary stents placed," Jill Daly, 3/4/11