You might remember hearing about the cardiologist who was fired in 2009 over allegations that he had performed unnecessary stent procedures. You might also recall that this cardiologist had close ties to Abbott, and the notorious pig roast the company sponsored at the doctor's house. But what about the senior Abbott employee who suggested that a Baltimore Sun columnist should be physically confronted for his coverage of the scandal?
This lesser-known part of the story of Mark Midei, MD, could provide a case study on Things You Should Never Say Over Email (especially corporate email).
According to a Senate Finance Committee report in December 2010, an Abbott employee wrote in an email, "Don't you have connections in Baltimore? Someone needs to take this writer outside and kick his ass! Do I need to send the Philly mob?"
The writer in question was Jay Hancock, a former Baltimore Sun columnist, whose Jan. 22, 2010, column questioned the "extraordinary promotion and advertising" that have made drug-eluting stents a multibillion-dollar business. Interestingly, Hancock's column doesn't even mention Abbott specifically. Nonetheless, the columnist obviously struck a nerve.
Was the email's author serious about sending someone to beat up Hancock? Probably not. Should they have known better than to put such a threat (serious or not) in a corporate email? Definitely.
Revisiting the Midei-Abbott relationship
Relationships between medical device companies and physician consultants has long been a complicated and controversial topic, and the feds have continued to aggressively investigate medtech companies suspected of kickback schemes.
Financial ties between physicians and industry eventually led to the passage of the Physician Payments Sunshine Act as part of the Patient Protection and Affordable Care Act of 2009. Now, pharmaceutical and medical device companies must report payments to physicians to the government, which are then made publicly available.
According to the 2010 Senate Finance Committee report, Midei began "heavy use" of Abbott's drug-eluting stents in the third quarter of 2008. The report notes that Abbott was particularly impressed with Midei after he implanted 30 stents in a single day, possibly setting a record. Two days later, Abbott paid $1,235 for a barbeque dinner (the aforementioned pig roast) at Midei's home. Attendees included staff from the catheter lab at St. Joseph's Medical Center, other healthcare professionals from the Baltimore area, several representatives from Abbott, and representatives from other manufacturers, and their guests. An Abbott sales rep organized the event, which was themed "Appreciation Q&A." The report also notes a $690 crab dinner at Midei's home attended by Abbott employees to discuss the company's vascular products and business strategy.
Wanting to tell his side of the story, Midei had two lengthy phone conversations in 2012 with Larry Husten, a medical journalist covering cardiology news. In April 2012, Forbes published a two-part series based on these conversations. Husten said that, according to Midei, the pig roast was not an anomaly because the cath lab directors at all three Baltimore hospitals had annual picnics that were usually sponsored by a medical device company.
"I understand that that leaves a bad taste in people's mouths," Midei told Husten, adding that he would not do it again, knowing what he did at the time of the interview.
After Midei was barred from practicing at St. Joseph in 2009, he contacted Abbott asking for advice, according to the Senate Finance Committee report. Later that year, in follow-up correspondence with the head of Abbott's vascular group, Midei wrote: ‘‘. . . I might be interested in working with you if the opportunity arose. I would not rule out a full-time position as my practice has been mortally wounded in Baltimore due to a toxic political environment.’’
In December 2009, Robert "Chip" Hance, who worked at Abbott for 23 years and is now the CEO at Regatta Medical, according to his LinkedIn profile, wrote to another Abbott employee about the possibility of Midei doing some work for the company.
Abbott ended up paying Midei $30,623 in consulting fees after he was fired from St. Joseph. This, according to the Senate Finance Committee report, was 10 times the amount of money he was previously paid by the company. In 2008 and 2009, Abbott paid the doctor $3,400 and $3,000, respectively, for his work on the company's medical advisory board.
"The serious allegations lodged against Dr. Midei regarding the medically unnecessary implantation of cardiac stents did not appear to deter Abbott’s interest in assisting him," the authors of the report wrote.
The company did, however, steer clear of using Midei to market stents in the United States because of the negative press he was receiving at the time. The company instead used Midei in the field in Japan/China as well as for home office activities such as developing presentation slides, according to the report. In January 2010, Abbott sent Midei to Japan to help market the Xience V stent, but bad publicity caused the trip to be cut short.
Still, the report shows that Abbott continued to work with Midei behind the scenes, though it is not clear when the relationship officially ended.
"Dr. Midei has been a highly regarded physician in his field, with whom Abbott had consulted in the past. Our affiliation with Dr. Midei ended early this year," Abbott said in a statement to MD+DI in December 2010.
Editor's note: In the process of conducting research for this Trivia Tuesday article, it was discovered that Midei died April 3, 2023, according to his obituary.