In an era of rising scrutiny of cardiac care, physicians are learning that their legal fates may hinge on one number—70%.
That's how much blockage in a coronary artery the government says should be documented to justify the placement of a cardiac stent, the wire mesh device that can keep a clogged blood vessel open.
Stent surgeries are more profitable for hospitals' cardiac-care departments, compared with less-intensive therapies that in many cases work just as well for patients. Studies show stents are overused in elective surgeries, and cardiologists vary widely from region to region in how often they implant them.
Closely following the research showing overuse are a growing number of criminal and civil cases alleging interventional cardiologists knowingly implanted stents in patients who had little if any blockage, needlessly exposing them to the risks of invasive procedures. At least four hospitals have settled civil cases in the past two years, and three cardiologists have been convicted of criminal fraud related to stent overuse. Many more civil cases against doctors are pending.