Issue: February 2018
Unnecessary Cardiac Procedures: Getting to the Heart of the Risks

Introduction

Liability for Unnecessary Cardiac Procedures

The benefits and risks of all medical procedures must be weighed, including the necessity of the procedure itself. A 2016 study explored ten of the riskiest instances of medical overuse and found that cardiac procedures were among the most unnecessary and overused medical treatments.   

 

Cardiac catheterization procedures, including diagnostic angiograms and angioplasties (performed to unclog arteries), are among the most commonly questioned procedures. Whether these, and other cardiac procedures, are medically necessary, or whether some are performed more for the financial benefit of the providers than the health benefit of the patients, has been questioned.   

 

Injuries related to unnecessary cardiac procedures can lead to litigation, which can result in high verdicts or settlements. For example, an agreement for an undisclosed amount was reached in a 2017 settlement of 80 lawsuits alleging unnecessary cardiac procedures at one hospital.   

 

Attorneys, physicians, insurers, employers, and other potential parties to litigation need to understand the liability issues that may arise in connection with unnecessary cardiac procedures.


The Perspectives: Improve Your Strategy

Attorneys:

What proof is needed to recover for an injury related to an unnecessary cardiac procedure? And, what is a potential strategy for the attorney to employ?

Physicians:

How can liability for medical malpractice be avoided for an allegedly unnecessary cardiac procedure? And, what is a potential strategy for the physician to employ?

Insurers:

Can a payout under a medical malpractice liability policy be avoided by proof that the health provider was not negligent or there was no coverage for the physician’s actions related to an unnecessary cardiac procedure? And, what is a potential strategy for the insurer to employ?

Employers:

Can an employer be liable for the cost of a worker’s unnecessary cardiac procedure? And, what is a potential strategy for the employer to use?


Practice the Technique: Checklists

Attorneys:

Check this list of facts and circumstances tending to show a provider’s liability for malpractice or negligence for an injury involving an unnecessary cardiac procedure.

Physicians:

Presented is a checklist of items a physician must consider when defending against claims of malpractice or negligence involving an alleged unnecessary cardiac procedure.

Insurers:

The insurer should check these “red flags” and inconsistencies when investigating a claim of malpractice or negligence for an injury involving an unnecessary cardiac procedure.

Employers:

Use this checklist to determine if the employee’s heart attack, heart failure, angina pectoris, chest pain, shortness of breath, or similar cardiac problem is “work related” and occurred “in the course of the employment.”

Expert Analysis

How Can the ACC Cardiovascular Registry Help Prevent Unnecessary Procedures?

Ralph G. Brindis, MD, MPH, MACC

What Evidence Is Needed to Prove an Unnecessary Stenting Procedure?

William M. Sullivan, Jr., JD

How Is Cardiac Overtreatment Regulated?

Zack Buck, JD, MBE

Litigation

Alternative Dispute Resolution

Arbitration or mediation may be required by contract or statute, may be mandated by the court or, in some circumstances, may be the appropriate method for a negotiated resolution.


Reasons to Reach Settlement

The following are reasons why the attorney, physician, insurer, or employer would want to reach settlement, and not take the action to trial.


Reasons to Go to Trial

The following are reasons why the attorney, physician, insurer, or employer would want to take the action to trial.


Jury Awards and Settlements

How much have juries awarded and what settlements have been reached recently in cases involving unnecessary cardiac procedures?



Medical Examples

Cardiac Procedures

This section provides detailed medical information on common cardiac procedures including angioplasty, stenting, angiograms, cardiac catheterization, and bypass and grafting. Also discussed is the patient’s prognosis and ability to work after these procedures.



Law and Medicine Resources

Law and Medicine Resources

Provided is a listing of law and medical resources for further information on cardiac procedures.



Unnecessary Cardiac Procedures: Getting to the Heart of the Risks

Table of Contents
Introduction

Expert Analysis
   Ralph G. Brindis, MD, MPH, MACC
   William M. Sullivan, Jr., JD
   Zack Buck, JD, MBE

The Perspectives: Improve Your Strategy
   Attorneys
   Physicians and Health Providers
   Insurers
   Employers and Risk Managers

Practice the Technique: Checklists
   Attorney Checklist
   Physician Checklist
   Insurer Checklist
   Employer Checklist

Alternative Dispute Resolution

Reasons to Reach Settlement

Reasons to Go to Trial

Jury Awards and Settlements

Cardiac Procedures

Law and Medicine Resources