There Will Be Blood and Money

And a lawsuit. And many, many questions about the relationship between a local hospital and the world’s largest medical device company.

ONE OF THE WORLD’S BEST hospitals sits just off I-95 in Burlington, between the sprawling shopping mall and the office parks of tech firms. Founded in 1923, the Lahey Clinic has over the years built itself into a paragon of modern medicine. Home to more than 400 physicians working on the leading edge of their respective disciplines — from urology to gastroenterology to oncology — Lahey treats more than 3,000 patients each day.

[sidebar]But some of the most important areas in the clinic aren’t operating rooms or research stations. They’re storage units. Located in the interventional cardiology labs on the hospital’s fifth floor, these cabinets contain the expensive and highly specialized equipment that Lahey doctors use to treat patients with heart problems: catheters, angioplasty balloons, and the wire-mesh stents that prop open weakened arteries. Those stents are among the most expensive of the extraordinarily expensive devices stored here: A single one, which is about the size and length of the spring in a retractable pen, can wholesale for $1,800.

Over the past 15 years, stents have become ubiquitous in the treatment of narrowed or blocked blood vessels, better known as heart disease, the leading cause of death in the United States. Last year alone, the device was implanted in more than one million people, a number that translates into big business. The stent market is now worth $4 billion a year for the companies that sell the devices to hospitals.

With one of the busiest cardiology departments in the state, the Lahey Clinic is considered a particularly sought-after client for stent companies. The question of just how desirable Lahey’s business is, and how far a company might go to keep it, became a highly contentious issue inside the hospital last summer — largely thanks to one man: a veteran cardiologist named David Gossman.

The controversy started in late August 2009, during a routine meeting of Lahey’s cardiology department. Though he framed his concerns in hypothetical terms, Gossman wondered aloud why the hospital was using a certain brand of stent. The question may have been vague, but Gossman left little doubt that he believed a line had been crossed, that the choice of the stent was the result of a questionable deal between the hospital and the device’s maker.

Less than two weeks after the meeting, Gossman was fired. Told that he had to leave the clinic’s campus immediately, he was allowed to grab his laptop and his jacket from his office. The rest of his personal effects would be boxed up and sent to his home.

To some observers, the episode seemed like a classic whistleblower case: A trusted employee threatens to expose an unethical deal, only to have his company fire him in retaliation. That was exactly how Gossman portrayed the situation when he filed a lawsuit against the hospital and two of his former colleagues last October.