December 12, 2005
Heart Palpitations at Cleveland Clinic
Every year U.S. News and World Report ranks the Cleveland Clinic as the best heart treatment center in the U.S. This morning, a Wall Street Journal investigation into the close financial ties between the head of the clinic and a Cincinnati device start-up company called AtriCure reveals the corrupting influence that financial conflicts of interest are having on America's leading medical institutions.
According to the Journal:
A venture-capital partnership that the Clinic helped found and invested in owns about 4.1% of AtriCure's stock, valued at about $7 million. The Clinic's chief executive, heart surgeon Delos "Toby" Cosgrove, sat on AtriCure's board of directors until March. He also invested personally in the fund and was one of the general partners managing it until, according to a Clinic spokeswoman, he cut his ties to the fund at the end of October. In addition, Dr. Cosgrove will be entitled to royalties for a medical device he developed that AtriCure plans to begin selling next year.
Last week, Cosgrove fired Dr. Eric Topol, who earlier in the week testified against Merck in a product liability lawsuit involving Vioxx, from academic positions that put him on the Cleveland Clinic's ethics panel. Topol's status at the clinic will be discussed today at a board of directors meeting. According to a Cleveland Plain Dealer story last Friday, Cosgrove bested Topol for the top job at the clinic.
But when the board meets today, they might want to discuss these other explosive revelations in the story:
* More than 1,200 patients at Cleveland Clinic have received the AtriCure procedure to curb atrial fibrillation despite the fact the FDA has turned down the company three times because long term data on its efficacy for curbing strokes is "sketchy." All those uses are "off label."
* At least four patients have died shortly after the procedure. Officials at the hospital say the deaths were not related to its use.
* None of the patients were told about the conflicts of interest among top officials at their hospital.
* Cosgrove never revealed his conflicts of interest when speaking about the procedure and mentioning AtriCure by name at a meeting of the American Association of Thoracic Surgery. A clinic spokesperson said his secretary checked the wrong box on the form.
* Cosgrove didn't reveal his conflicts of interest when writing a positive review of the procedure in the Journal of Thoracic and Cardiovascular Surgery. One of his co-authors, who also was a consultant to AtriCure, did.