Audit finds medically unnecessary stents placed
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After discovering 149 coronary stent implants in 141 patients in 2010 that may not have been medically necessary, Excela Health hospital system is offering free help to patients directly affected and advice to other people who may be concerned about similar health conditions.
Robert Rogalski, Excela chief executive officer, on Thursday confirmed that two Westmoreland Hospital cardiologists who are no longer members of the Excela staff, Ehab Morcos and George Bou Samra, were found to have performed the procedures after concerns arose among the medical staff at the Greensburg hospital.
In people whose arteries to the heart have been narrowed or blocked by fatty plaque, coronary stents are inserted during catheterization to support artery walls and keep oxygen-rich blood flowing to the heart muscle.
Mr. Rogalski explained that after he was appointed CEO in February 2010, he learned of suspected problems, so in May, Excela hired Mercer Medical Audit, a nationally known assessment firm, to do a random survey of cardiology professionals in Excela. After that, doctors were able to provide documentation for their decisions.
Mercer's first review was sent to a panel of seven cardiologists from around the country, explained cardiologist Jerome Granato, Excela's chief medical officer. They judged how the cases were handled and that led to a focus on the two local doctors.
"The second review ... looked at every single case these physicians took in 2010," Dr. Granato said. Eight additional outside cardiologists joined the review as it studied the circumstances of when the stents were used. Many factors are included in a decision, including a patient's symptoms, response to stress tests and the severity of blockage in the artery.
"In general, 70 percent [blockage] is the threshold," Dr. Granato said. The review panel looked at patients with 50 percent blockage or less to determine if their plaque buildup was considered significant enough to justify a stent. Of that group, the 141 patients were identified and notified by mail Thursday of their situation and urged to contact their physicians, cardiologists or the hospital with their questions. Each was assigned a personal patient liaison to take them through any followup.
First Published March 4, 2011 12:00 am
