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The System of Disciplining a Rogue Physician

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.

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