Medical malpractice due to unnecessary heart stenting may warrant punitive damages in addition to compensatory damages.  Generally, “medical malpractice” means the same thing as “medical negligence,” though some people mistakenly believe that malpractice sounds worse.  A finding of malpractice or negligence hinges on proving that a doctor or hospital fell below accepted standards of medicine.  These standards are based on what is reasonable under the circumstances, and must be proven by an expert in medicine, usually a physician from the same or a related specialty as the treating doctor.

When negligence is proven, a jury is charged with awarding compensatory damages which will include past and future medical expenses, past and future loss of wage and benefits, and past and future pain, suffering, loss of usual activities and loss of enjoyment of life.  However, in some circumstances, punitive damages may also be awarded.  The Journal of the American Medical Association (JAMA) recently reported on a practice that may support an award of punitive damages: unnecessary heart stenting (also called cardiac catheterization or cardiac stenting).

What is Heart Stenting?

Heart stents are used to open up clogged arteries in the heart.  They are placed via a catheter that is usually inserted into an artery in the leg and threaded up to the arteries of the heart. The operator can use balloon angioplasty or a stent to open up the clogged artery.  This process is called revascularization.  In the JAMA article, cardiologists reviewed a registry of patients who had undergone noncardiac surgery.  They found that when the preop work up revealed evidence of partially clogged arteries, the surgeon frequently recommended that the patient undergo a heart catheterization before surgery.

The researchers pointed out that partially clogged arteries are frequently found when surgery patients undergo angiographic testing.  They reported that obstructive disease was found in 48.1% who underwent angiography.  86.3% of angiography patients who underwent prior stress testing, had positive results on imaging.  The registry further revealed that 23.1% of asymptomatic patients and 48.3% with obstructive disease were referred for percutaneous or surgical revascularization.  It turns out that many of these surgeries were unnecessary.

The JAMA article referred to guidelines published jointly by the American College of Cardiology (ACC) and the American Heart Association (AHA) showing that they “currently do not recommend routine coronary revascularization before noncardiac surgery just to reduce perioperative cardiac events.”  Tellingly, the article suggests that one motivating factor for the unnecessary procedures is “financial gain.”  In other words, doctors are performing unnecessary surgery in order to make a buck.

Under Ohio law, if a doctor misleads a patient or misrepresents the benefit of a surgery, then the elements of an intentional tort may be established.  When intent, malice or fraud are proven, punitive damages may be awarded in addition to compensatory damages.  As medical lawyers with over 60 years of experience handling these types of claims, we have investigated matters where doctors have subjected patients to unnecessary risks.  When this occurs, and the procedure results in a complication that causes injury to the patient, like a stroke, heart attack or wrongful death, the case for punitive damages can be made.  Feel free to comment below if you or a loved one has had an unnecessary heart stenting procedure.

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