New doubts about devices


FOR DECADES, PHARMACEUTICAL companies have lavished gifts on doctors, including meals, sports tickets and extravagant trips billed as “educational seminars.” Now there’s growing evidence that such graft, to use the term in its nonmedical sense, is migrating to the fast-growing medical device industry.

Earlier this month, the renowned Cleveland Clinic announced tighter conflict-of-interest rules after a hospital investigation found that its chief executive had a financial relationship with a medical device firm that sold products used in a type of surgery the hospital has advocated. Last month, it was revealed that a former employee at industry giant Medtronic Inc. has filed a whistle-blower lawsuit alleging that the company improperly paid millions of dollars to dozens of surgeons across the country, possibly encouraging them to perform unnecessary surgeries. (One doctor allegedly received $400,000 for eight days of work a year.)

Another worrisome trend: surgeons who own their own medical device companies, which then sell to hospitals where the surgeons work. The practice may be legal, but California’s attorney general has started an investigation into the issue.


At best, questionable financial relationships such as these dilute the public’s faith in doctors. At worst, they may be putting patients’ lives at risk.

Since last year, Guidant Corp. has recalled or issued safety advisories for nearly 88,000 defibrillators and more than 200,000 pacemakers. At least seven deaths have been linked to faulty devices, and company executives evidently knew of problems long before they disclosed them to physicians. The company has used financial incentives to sell its products to doctors; surely those who’ve taken advantage of those incentives without asking too many questions deserve some scrutiny, if not blame.

Like the pharmaceutical industry before it, the medical device industry has agreed to a voluntary code of ethics that bans most industry gifts to doctors. But voluntary guidelines aren’t enough, and few companies are paying attention. As baby boomers age, the industry is set for a huge financial windfall. For their own good as well as that of their patients, doctors and manufacturers must clean up their act.