Maryland Medical Malpractice Lawyer Blog

When Myles Massey was born on September 1, 2007, along with his brother, Henry, a medical mystery began to unfold. The twin boys were born prematurely in a Washington state hospital, but it was only Myles who exhibited signs that something was wrong. It took years, but Myles’ family has finally determined the cause of the bacterial infection that overtook his small body, leaving him unable to walk or talk, while sparing his brother who developed normally.
A copy the article can be found here. .

The Massey’s initial medical malpractice suit filed in 2009, which named the doctor’s and hospital that treated Myles at the time of his birth for his contraction of the rare bacteria, cited poor infection control practices as the cause of his systematic decline. However, despite numerous tests, investigators were never able to link the bacteria to any of the doctors or the hospital.

In early 2011, a company by the name of Triad Group became the subject of an FDA investigation which found that the alcohol prep pads they were manufacturing and distributing were contaminated with the bacteria. It was then that the Massey’s mystery was solved. The hospital where Myles was born confirmed that their neonatal intensive care unit used the Triad alcohol wipes. It’s not clear why Myles was affected by this bacterium while his brother and other infants in the NICU were not, but the alcohol prep pads have been almost conclusively deemed the source of the bacteria found in Myles’ bloodstream. The Massey’s lawsuit, now amended, includes the manufacturers and distributors of the alcohol prep pads.

The rare bacterium, called “bacillus cereus,” is most often a food-borne illness but can attack individual’s with weak immune systems, causing other infections. The alcohol prep pads, which contained the bacterium in this case, have been recalled but were widely distributed and included in things such as, pre-packaged kits used for self-injection of medications.

Almost one year after being charged with violating the Medical Practice Act and engaging in medical malpractice in Towson, Maryland, former St. Joseph’s Medical Center cardiologist Dr. Mark G. Midei has had his license revoked by the Maryland State Board of Physicians. This case has proven to be instructive as to the steps the Board takes when determining appropriate sanctions for misbehaving doctors.

In one of the most talked-about medical malpractice cases in the Baltimore-area, Dr. Midei was accused of implanting unnecessary cardiac stent in many patients. Specifically, the Board found that Dr. Midei falsified blockage percentages in five patients’ coronary arteries and unnecessarily implanted cardiac stents in four of those patients.
The formal findings of the Board were as follows:
• that Dr. Midei committed unprofessional conduct by failing to deal honestly with patients and colleagues;
• that Dr. Midei made intentional, non-accidental and non-inadvertent false reports;
• that Dr. Midei over-utilized health care services;
• that Dr. Midei violated the standard of quality care; and
• that Dr. Midei failed to keep adequate medical records.

In cases where a doctor is found in violation of one or more provisions of the Medical Practice Act, the Board may: (1) reprimand the doctor; (2) impose a probation period; or (3) suspend/revoke the license of the doctor. These disciplinary actions are intended to protect the public, rather than push the offender. In determining which sanction to impose, the Board often evaluates several factors. For example:
• how long the doctor has been licensed for and whether (s)he has had prior violations;
• the frequency of the violations;
• the seriousness of the violations – i.e., whether and the extent to which the violations put patients at risk of harm; and
• whether there is evidence that the doctor acted in bad faith.

The Board determined that license revocation was the appropriate sanction for Dr. Midei because of the habitual and serious nature of his violations. Not only did the Board believe that Dr. Midei had put his patients in present risk because of the unnecessary stent procedures, but he also put them at future risk because of the falsified information now present in their medical records. Patients were also caused to incur medical expenses beyond what they should have. Importantly, there was evidence that Dr. Midei acted in bad faith, and contrary to his medical training, in determining the extent of the blockages in his patients.

A copy the administrative decision regarding the case can be found here.

Dr. Mark Midei’s medical license was revoked today by the Maryland Board of Physicians. A copy of the Final Decision and Order can be found here. As set forth in decision, the Board found that Dr. Midei engaged in “unprofessional conduct” and “blatant falsehood.” It found that he is guilty of “failing to deal honestly with patients and colleagues,” that he created “willfully false reports,” and that he unnecessary implanted people with cardiac stents. The Board stated that it found Dr. Midei’s testimony “not credible.” The Board also indicated that Dr. Midei had economic motivation for his misconduct.

In the 11 page decision, other phrases that were used to describe Dr. Midei included the following: “implanted cardiac stents unnecessary”; “falsified the extent of blockage of the patients’ coronary arteries by reporting that it was 80% when it was in reality lower – and in most cases much lower”; in three of the patients, he also falsely reported that they suffered from unstable angina when in fact they did not”; “violated the standard of quality care”; “falsely reported”; “intentional, non-accidental and non-inadvertent false reports that exaggerated the degree of coronary stenosis”; willfully false reports”; “overutilized health care”; “implanted stents unnecessarily, documented clinical indications inaccurately, exaggerated the extent of stenosis and failed to consider more optimal therapies”; “blatant falsehood”; “willfully false nature of some of Dr. Midei’s reports”; “Dr. Midei’s violations were repeated and serious”; “unnecessary stents exposed patients to the risk of harm”; “Dr. Midei’s willful creation of false percentage numbers for the degree of occlusion of coronary arteries is indefensible and amounts to a deliberate and willful fabrication of medical records”; “false findings used to justify unnecessary stent insertions”; “Dr. Midei acted in bad faith.”

A study published in June 2011 provided a somewhat unexpected result - doctor’s offices and hospitals are equally as likely to be sued for medical malpractice. This finding is surprising because the majority of patient safety initiatives focus on inpatient care at hospitals. The finding of this study, however, indicates a need for the focus to shift to outpatient settings as well. The Journal of the American Medical Association study can be found here.

In 2009, of approximately 11,000 medical malpractice payments made on behalf of physicians, close to half stemmed from errors occurring in doctor’s offices. The study revealed that while hospitals and doctor’s offices are equally as likely to face medical malpractice suits – the error or negligence behind those suits differ. In hospitals, malpractice most often results from unsuccessful surgery giving rise to negative outcomes. In doctor’s offices, on the other hand, incorrect diagnosis is most often to blame. While this indicates the necessity that doctor’s offices adopt the same kind of checklists and systems that have been in place in hospitals for many years, it also demonstrates how essential it is that outpatient care standards become a greater focus in the medical community.

Other reports have indicated that for every one hospital discharge, there are as many as thirty outpatient visits. A ratio of this magnitude displays the seriousness of any chronically deficient care in physician’s offices.

The article regarding this study can be found here.