Las Vegas Sun

March 28, 2024

SUN EDITORIAL:

Problems at UMC

Commissioners should address transparency issues at the troubled hospital

Heart patients undergoing procedures requiring pacemakers and defibrillators at University Medical Center will likely receive devices made by a little-known company called Biotronik.

As The New York Times reported Sunday, last year 95 percent of patients who had a device implanted at Clark County’s public hospital received one made by Biotronik. Nationwide, the company’s market share is about 5 percent, according to industry estimates.

The fact that Biotronik devices are used so frequently at UMC is surprising, but Biotronik made inroads at the hospital in 2008 by hiring several cardiologists as consultants, paying them as much as $5,000 a month, according to the Times. The consultants included four doctors at Nevada Heart and Vascular, which won a contract to provide heart services at UMC in December 2006.

In 2008, Dr. William Resh, managing partner of Nevada Heart and Vascular, urged hospital officials to start buying Biotronik devices. Kathy Silver, UMC’s CEO, recounted that Resh said the devices were more dependable than others, and the hospital started purchasing them. Resh never disclosed his relationship with the company, and Silver didn’t press him on the issue.

At the time, UMC didn’t require any disclosure. The policy has since changed, but Silver said in the case of Nevada Heart and Vascular, the doctors won’t have to disclose any financial relationships until their contract is up.

The situation raises several troubling issues, and several investigations are under way, including:

• A federal inquiry into Biotronik’s marketing practices. Not only did it hire the cardiologists as consultants, but it also hired doctors who refer patients to cardiologists, essentially creating a pipeline of customers.

• As Anjeanette Damon reported in Tuesday’s Las Vegas Sun, Gov. Brian Sandoval ordered an investigation into potential patient safety issues and improper billings.

• The Nevada Board of Medical Examiners, which oversees doctor licensing, is investigating the relationship between the doctors and Biotronik. It is against state law to take fees that would influence patient care.

UMC officials say the devices have performed well and have saved the county money. And doctors certainly have a right to recommend devices they have confidence in.

But the lack of transparency in this matter is a serious concern. The hospital should know doctors’ financial ties in areas that concern treatment, especially in regard to purchasing equipment. And UMC shouldn’t wait until doctors’ contracts come up. It should require that disclosure immediately.

Taxpayers have a stake in this. UMC receives not only federal funding but millions of dollars a year in subsidies from Clark County. Have the Biotronik devices really performed as well as claimed? Given the fact that the hospital moved forward on Resh’s recommendation, without knowing about his financial ties, the county should investigate the claim.

Unfortunately, the Times’ story is emblematic of the problems that have plagued UMC for years. The Clark County Commission has to step up and be more active in its oversight of the hospital. Commissioners have to make sure there are changes and the hospital becomes more transparent.

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