State’s expert in fraud case: Many procedures unnecessary

• By JASON BROWN
• Advocate Acadiana bureau
• Published: Oct 7, 2008 - Page: 1BA - UPDATED: 12:05 a.m.

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LAFAYETTE — The trial for a Lafayette cardiologist accused of health-care fraud continued Monday with testimony from an expert witness who said that many of the medical procedures performed by the well-known doctor were unnecessary and that some of the doctor’s diagnoses were false.

Dr. Mehmood M. Patel currently is on trial for 91 counts of health-care fraud stemming from allegations that he billed the government and private insurers for more than $2 million in unnecessary heart procedures from 2001 to 2004. The trial began last week.

Dr. John Hirshfeld, an interventional cardiologist and professor at the University of Pennsylvania, was the only witness to take the stand Monday. He remained there late Monday afternoon because of lengthy questioning by the prosecution.

Hirshfeld had been contracted by the government to examine patient records and video taken during medical procedures performed by Patel. Prosecutor Kelly Uebinger, an assistant U.S. attorney, questioned him on his findings. In each case, Hirshfeld testified that the procedures were unnecessary.

During opening statements last week, the defense said that Patel would take the stand and testify to the need and reasoning behind each of the procedures he performed.

According to the defense, the expert witnesses had only one piece of the puzzle and were not always taking into account the patient’s history, family past and symptoms.

In one case, Hirshfeld said that Patel put a stent into a 67-year-old patient who had no prior cardiovascular complaints. Hirshfeld said the woman had about a 21 percent blockage in one artery. In order for this type of procedure to be performed, Hirshfeld said, the artery must be narrowed by at least 50 percent. Anything above 70 percent is considered severe.

Images taken before and after the procedure showed that there was no significant difference between the two.

Patel diagnosed another patient with a 60 to 70 percent blockage. Hirshfeld diagnosed it as about 26 percent.

In one case, Hirshfeld said, the patient had a blockage of about 2 percent, almost barely detectable. However, the patient was diagnosed by Patel as having one of about 70 to 80 percent. He said Patel made a false statement in the patient’s record.

As a result of the procedure, the patient developed restenosis, or the renarrowing of an artery after an angioplasty or stent. The patient had a 39 percent blockage and later developed heart failure.

Patel diagnosed another patient as having a blockage of about 70 to 80 percent. Hirshfeld said the blockage was only 9 percent.

“A 9 percent stenosis is trivial,” Hirshfeld said.