"It came as a complete surprise to me," he said of the offer, and made him "feel like a baseball star."

"I loved the people at St. Joe, the patients at St. Joe," he said. "It had become my identity."

Midei called MACVA Chief Executive Hank Yurow to resign, and Yurow exploded, knowing that the loss of Midei would scuttle the merger.

"He said he would sue me into the Stone Age, he was going to destroy me personally and professionally," Midei recalled last week.

Yurow, who did not respond to messages from The Sun, eventually expressed regret in a court deposition for his comments, though Midei's supporters still wonder if the CEO, since retired, harbored animosity and retaliated.

Less than a year after Midei joined St. Joseph in January 2008, an anonymous complaint was sent to the Maryland Board of Physicians, which oversees physician licensing, listing the medical record numbers for 36 St. Joseph patients and the dates they received stents from Midei.

The tipster wrote "to report medical fraud in regard to the unnecessary procedures by Dr. Mark G. Midei in St. Joseph hospital, Towson, Maryland," according to the November 2008 letter. "He has performed stent procedures in the coronary (heart) arteries which have insignificant blockages."

A second letter, listing an additional 41 procedures, was sent to the board in late April 2009.

"The allegation was fairly sophisticated," Midei says in hindsight. "It had to come from somebody with access to information at the hospital."

Around the same time, according to hospital records, "several MACVA physicians" told an employee of St. Joseph who had several stents implanted by Midei that his procedures were unnecessary.

Under other circumstances, that might have triggered an internal review of Midei's work and a correction plan that allowed him to keep working under supervision, doctors have said in court testimony.

But St. Joseph was already under scrutiny, making officials more cautious.

'Under the bus'

The CSA surgeons had taken their MACVA kickback complaints to the federal government, eventually filing a whistle-blower lawsuit against 55 defendants, including St. Joseph, which was accused of collusion and forced to replace its leadership team in early 2008.

While looking into the alleged extortion, federal investigators caught wind of the allegations against Midei.

The prosecutor in charge of the case pressured St. Joseph to initiate a thorough review of Midei that met Department of Justice specifications, according to minutes from the hospital's Medical Executive Committee.

It felt like the "government was in the room," one doctor would later testify. "There was this underlying concern ... that there was another entity that was looking at how we dealt with this and what we did."

Midei's attorney, Stephen Snyder, says St. Joseph officials threw Midei "under the bus" — snitching on him in hopes it would earn them leniency in the kickback case.

St. Joseph declined to comment for this story.

Hospital leaders asked Midei to take "paid time off" in May 2009 while St. Joseph investigated. A staff doctor found that the employee complaint, initiated by MACVA analysis, was valid. A consultant also found instances of unacceptable stenting after reviewing about 15 cases, though his analysis was later deemed incomplete.