DeMaio Resolves Unnecessary Stenting Charges With Board

Shelley Wood

November 28, 2011

November 25, 2011 (Austin, Texas) — The Texas interventional cardiologist investigated by his medical board and sued by eight patients over allegations he'd performed a range of unnecessary procedures has emerged from his three-year ordeal with no restrictions to his license and all but one lawsuit behind him.

As previously reported by heartwire , Dr Samuel DeMaio (Star State Heart, El Paso, TX) first made headlines in August 2010 when it came to light that the Texas Medical Board filed a complaint alleging that DeMaio had violated standards-of-care in nine patients dating back to 2008–2009.

According to the board's original complaint, DeMaio placed multiple stents in areas of insignificant or moderate disease; performed multiple angiograms in patients who were asymptomatic and had normal stress tests; unnecessarily implanted an ICD in two patients; failed to adequately inform patients of risks; failed to obtain informed consent for the off-label use of a stent in one patient; and inappropriately administered propofol to one patient, contributing to the patient's demise.

In the mediated agreed order signed earlier this month, however, the board's findings are dramatically curtailed, saying only that the board had found DeMaio to have placed multiple, elongated, overlapping drug-eluting stents in areas of insignificant or only moderate disease, and that his "reading of angiography film as it relates to percentage of arterial occlusion was flawed and disagreed with IVUS imaging performed."

One Lawsuit Unresolved

Speaking with heartwire , DeMaio said the board, "has dropped most of their original allegations," adding that he's emerged with no restrictions on his license and no formal reprimand. He also settled with the board neither admitting nor denying the allegations against him.

Moreover, of the eight lawsuits brought against him, two have been resolved in his favor, and he's been dismissed from the other five. These five cases were all settled with payments made to the patients from codefendants that DeMaio would not name, but not, he stressed, from him or his insurer on his behalf.

In the case of the final lawsuit, DeMaio emphasized to heartwire: "I don't want to settle the lawsuit because it’s a case where I don't think I did anything wrong, and my attorney thinks I can fight it."

This last case, according to the Austin Statesman involves a patient in his 80s who alleges DeMaio implanted 32 stents over a 13-month period. DeMaio has previously discussed this case in some depth with heartwire , acknowledging that 32 stents was "an exceptional number," but noting that the patient had refused bypass surgery.

The resolution with the medical board, as well as the outcome of the lawsuits so far, means that DeMaio will not be listed for any demeanors in the National Practitioner Data Bank.

Terms and Conditions

In the agreed order, the Texas Medical Board imposed a range of terms and conditions on DeMaio, including that he complete 30 hours of CME over the next 12 months, including 10 hours on medical record-keeping, 15 hours on the topic of cardiac stenting procedures, and five hours on ethics. DeMaio must also have another physician monitor his practice for eight monitoring cycles and pay an "administrative penalty" of $10 000 within 90 days.

Of note, the order also stipulates that all ongoing investigations regarding DeMaio are resolved and that any future complaints made against him regarding stenting, angiography, ICD appropriateness "or similar allegations" pertaining to his practice in greater Austin from January 1, 2001 to September 1, 2009 "shall not be opened and [are] considered resolved."

A Return to the Austin Area

Speaking with heartwire about the cases reviewed by the board, DeMaio said he refused to admit to any wrongdoing, saying he'd happily "stand up in front of a group of cardiologists" to explain his decision-making. In all of the cases in question, he said, he did not proceed with a stent except in patients who had either an abnormal nuclear scan or symptoms, and an IVUS showing stenosis of 70% or more. Fractional flow reserve (FFR) testing was not available at the time the procedures in question were performed, he added.

DeMaio has maintained that the allegations made against him, all brought to the board anonymously, "were part of a smear campaign" originating from a hospital where he used to practice. That institution, which DeMaio has not named, stands to lose business when a new hospital founded in part by DeMaio opens in April 2012 in nearby Lakeway, just 16 miles from Austin.

DeMaio is to be the medical director at the new hospital. He also plans to open his practice in Lakeway in January 2012.

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