A federal jury convicted a retired Eastern Shore cardiologist Tuesday of health care fraud and related charges for placing unnecessary coronary stents in the arteries of dozens of patients, then billing private and public insurers hundreds of thousands of dollars for the procedures.
John R. McLean, 59, who surrendered his medical privileges at Peninsula Regional Medical Center in 2007 after a hospital investigation, faces a maximum of 35 years in prison at his sentencing, scheduled for Nov. 10, according to the Maryland U.S. attorney's office.
The verdict was reached after a two-week trial in Baltimore's U.S. District Court.
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101 W Lombard St, Baltimore, MD 21201, USA
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"Placing unnecessary stents in the hearts of patients is a crime of unthinkable proportions," Nicholas DiGiulio, a special agent in charge for the U.S. Department of Health and Human Services, Office of Inspector General, said in a statement. "We will continue working to bring to justice those who practice greed rather than good medicine."
McLean is the second U.S. physician to face federal prison time recently for inappropriate stent placement, behind a Louisiana doctor who was sentenced to a 10-year term in 2009. Another Maryland cardiologist, Mark G. Midei, was stripped of his medical license earlier this month by the state Board of Physicians on similar allegations, though he has not been criminally charged.
Their cases raise questions about the quality of health care in America, particularly within the field of interventional cardiology. Studies have repeatedly shown that stents, which prop open compromised arteries to improve blood flow, are overused. A report published this month in the Journal of the American Medical Association, for example, showed that half the non-emergency stent procedures studied in the United States were medically questionable or outright unnecessary.
The tiny mesh tubes can restore blood flow and save the life of someone undergoing a heart attack or improve the quality of life for someone with symptoms of clogged arteries, such as shortness of breath. But they can also lead to blood clots and other dangerous complications in recipients.
Both McLean and Midei were found to have purposely overestimated the arterial blockage in their patients and falsified medical records to justify the stents, which are inserted through a relatively simple procedure that typically costs $10,000 or more.
McLean's defense lawyer said his client's stent decisions were sound and supported by patient symptoms, though prosecutors disagreed.
"We do not bring federal prosecutions based on discretionary judgments that might be disputed by reasonable medical professionals," Maryland U.S. Attorney Rod Rosenstein said in a statement.
Midei's former employer, St. Joseph Medical Center in Towson, has already repaid several million dollars in federal funds it received for stent procedures alleged to be unnecessary. A judge will determine the amount McLean must forfeit at his sentencing; prosecutors said they will ask for assets worth more than $700,000.
McLean was criminally indicted in late August on one count of fraud and six counts of making false statements to insurers and patients from 2003 through 2007, while working at Peninsula Regional Medical Center in Salisbury. Investigators claim in court documents that he performed more than 200 unnecessary stent procedures in total, however.
One of the false-statement counts was dismissed, though he was convicted on all other counts.
In October, the Maryland Board of Physicians also filed professional charges against McLean for "immoral or unprofessional conduct in the practice of medicine." That investigation continues.