Heart Stents and Informed Consent
Since the first human heart stent was implanted in 1986, stents have been used millions of times to open blocked coronary arteries in people who have just had a heart attack. For these people heart stents are lifesaving.
However, heart stents have also been implanted in millions of people who have stable heart disease and who are not having a heart attack. For these people heart stents are often not the best choice.
Hospitals that are paid by Medicare are required to “utilize an informed consent process that assures patients or their representatives are given the information and disclosures needed to make an informed decision about whether to consent to a procedure, intervention, or type of care that requires consent.”
Unfortunately, medical providers often do a poor job of providing heart stent patients with the information needed to make informed decisions. In fact, many studies suggest that medical providers may be intentionally misleading patients to believe that heart stents prevent future heart attacks and extend life, knowing that this is not true.
For example, a 2010 study in the Annals of Internal Medicine “Patients’ and cardiologists’ perceptions of the benefits of percutaneous coronary intervention for stable coronary disease” concluded that “Cardiologists’ beliefs about PCI reflect trial results, but patients’ beliefs do not. Discussions with patients before PCI should better explain anticipated benefits.” While 88% of patients thought that PCI would reduce the risk of heart attack, “63% of cardiologists believed that the benefits of PCI were limited to symptom relief. Of cardiologists who identified no benefit of PCI in 2 scenarios, 43% indicated that they would still proceed with PCI in these cases.”!
Patients may see a picture of a stent holding open a narrowed artery and naturally assume that the risk of a future heart attack is reduced. Unfortunately, most heart attacks are caused by soft, vulnerable plaque that builds up inside the wall of a coronary artery and suddenly ruptures, not by a narrowed artery that slowly closes.
Hospitals have strong financial incentives to recommend unnecessary heart stents. On the other hand, Medicare patients have little incentive to resist since the taxpayer is picking up the tab. The result is massive overspending in the Medicare program on unnecessary heart stent operations. Overtreatment may be a major reason that the United States spends twice as much per capita as other industrialized countries on healthcare.
To curb this overtreatment problem, the Department of Justice is paying large rewards to individuals who bring successful cases. Have you received a heart stent paid for by Medicare in the last 6 years? Was the heart stent for stable coronary heart disease and not an emergency stent to open a blockage caused by a heart attack? Did you believe at the time that the stent would prevent future heart attacks and extend your life?
If you answer “Yes” to these questions, please give me a call. You may be able to earn a substantial award and help assure that more future patients are given the information needed to make an informed decision.
Article written by Christopher Crennen, Colorado attorney, 303-777-8743