Texas Interventional Cardiologist Subject of Anticompetitive Lawsuit

Megan Brooks

November 10, 2021

Doctors Hospital of Laredo, Texas, and the Laredo Physicians Group have filed a lawsuit against interventional cardiologist Ricardo Cigarroa, MD, alleging that he engaged in anticompetitive conduct over the availability of cardiologists in Laredo.

Also named in the lawsuit are Cigarroa Heart and Vascular Institute, Laredo Texas Hospital Company (doing business as Laredo Medical Center) and Laredo Physician Associates (LPA).

According to the complaint, in August 2020, Doctors Hospital and Laredo Physicians Group began actively recruiting cardiologists to the city of Laredo.

The complaint states that, with more than 260,000 residents, the city should have a minimum of 20 cardiologists. However, Laredo currently has only eight cardiologists and only six are interventional cardiologists. 

The lawsuit alleges that when Cigarroa got wind of these recruitment efforts, he entered into a conspiracy with the Cigarroa Institute (a cardiology outpatient clinic) and Laredo Medical Center, the largest acute-care hospital in the city, to engage in "anticompetitive and tortious behavior."

"Their conspiracy had a simple but pernicious goal: deprive Doctors Hospital and Physicians Group of the doctors and employees needed to compete and provide interventional cardiology services to the Laredo market," the complaint reads. 

The alleged conspiracy unfolded in multiple steps, it notes, with Cigarroa issuing threats to Doctors Hospital, Laredo Physicians Group, and prospective interventional cardiologists being recruited.

Through threats and coercion, multiple qualified interventional cardiologists who were interested in joining Laredo Physicians Group, and to whom the group extended employment offers, decided not to join, the complaint states.

It further claims that Cigarroa, his son, and his nephew — who represent more than half of the interventional cardiologists in Laredo — informed Doctors Hospital that they would "no longer respond" to emergency calls at Doctors Hospital.

The complaint further alleges that after "scaring off competitors and further cementing their dominant market power and position," the defendants targeted Arthur Santos, MD, Laredo's only cardiovascular surgeon who was employed by Laredo Physicians Group.

"Defendants successfully induced Dr. Santos to agree to join Defendant Laredo Physicians Associates (LPA), breaching his enforceable non-compete contractual provision," the complaint states.

The defendants then allegedly induced the cardiothoracic surgery technicians at Doctors Hospital to join Laredo Medical Center (LMC) and work with Cigarroa and Santos, the complaint says.

"The conspiracy to monopolize Laredo's interventional cardiology market is a win-win-win for Defendants. Dr Cigarroa and the clinic avoid competition for interventional cardiological services, while LMC is left as the only provider of acute cardiology services in Laredo, gaining additional patients and corresponding increased revenue," the complaint reads.

"Meanwhile, Doctors Hospital's acute-care cardiology program will be threatened with extinction and, critically, Laredo patients are left with higher health care costs and greater health risks and without competitive market alternatives," it states.

Cigarroa Responds

According to the Laredo Times, in a statement responding to the anticompetitive conduct lawsuit, Cigarroa said: "This lawsuit is a dispute between a for-profit corporation and a physician who has demonstrated over 30 years of commitment to his patients and patient care in this community."

"It's unfortunate that the executives [at] Doctors Hospital have chosen to put profit above the well-being of their patients and employees. Their actions confirm that they care more about their bottom line than they do about our residents and reaffirms how disconnected they are from our community," Cigarroa said.

"My top priority continues to be the health of all Laredo residents. I will never stop caring for the patients that I love, and I will continue to help save lives," Cigarroa said, according to the Times article.

"I am humbled to have received numerous calls of support from many Doctors Hospital employees. Their words of encouragement are a true testament to the strong relationships I have within the medical community," Cigarroa added.

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