Doctor sues Mass. clinic, says Medtronic stent dispute led to firing

November 12, 2009 at 5:05AM

A cardiologist at a Boston-area medical center said he was fired for resisting pressure from two top physicians there to use stents made by Medtronic Inc., even though the stents might not be for some patients.

Dr. David Gossman, who worked at Lahey Clinic for more than 20 years, said in a lawsuit filed last month that Dr. Richard Nesto and Dr. Thomas Piemonte pressed him and other cardiologists to use Medtronic stents, because they believed if the hospital increased use of the product, Medtronic would let Lahey participate in clinical trials for a new heart valve. Trials of the CoreValve are to begin next summer. Testing such devices can help hospitals and physicians attract patients.

Gossman also said in the suit against the hospital and doctors that Piemonte has financial ties to Medtronic. Piemonte is director of interventional cardiology and sits on Lahey's "inventory committee" for the catheterization lab, which chooses products and approves contracts with companies.

Lahey spokesman Steve Danehy said Wednesday the hospital investigated the allegations and found them "totally groundless." Gossman, he said, was dismissed for misconduct that occurred months before he said he was pressured to use Medtronic stents, though he would not elaborate.

Danehy said Piemonte is a member of Medtronic's speakers bureau, paid by the company to lecture physicians about its products, and that the wives of Piemonte and Nesto own stock in Medtronic. Piemonte's wife is a sales representative for the company but does not do business at Lahey, Danehy said. He said the financial ties have not influenced care decisions.

Piemonte did not return a phone call. Nesto said he could not comment.

Medtronic issued a statement that its "process to select potential clinical research sites for the US CoreValve transcatheter valve clinical study was designed to be fair, objective and independent of commercial interests."

Gossman said a Medtronic sales rep approached Piemonte last summer and offered Lahey access to CoreValve trials, predicated on purchase and increased use of Medtronic products.

Gossman said Nesto and Piemonte told a doctor her low use of Medtronic stents jeopardized access to CoreValve.

Gossman said he encouraged colleagues to resist pressure to use Medtronic stents, and during an August lecture expressed concerns about the situation. Two weeks later, Gossman said, he was fired.

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LIZ KOWALCZYK, Boston Globe

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