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.

In his suit, Gossman also paints a detailed, and highly unflattering, picture of Piemonte and his relationship with Medtronic. Gossman describes Piemonte as a doctor mired in conflict caused by his “significant financial interests” in the company. He says that Piemonte’s wife is a sales rep for the company and that the pair “retains substantial holdings” of Medtronic stock. He also notes Piemonte’s service as a paid speaker on behalf of the company. For a speech that took place in June 2009, for instance, around the time Gossman alleges the CoreValve deal was taking place, Piemonte traveled to a Connecticut restaurant to discuss the latest research on Endeavor, some of which was suggesting that restenosis wasn’t really a problem. In exchange for his time, Piemonte was paid $2,000.

Any attempt to interpret these kinds of transactions is colored by the murky union between doctors and pharmaceutical companies. Whereas new drugs often come out of company labs, the creation of a medical device requires much more involvement from the doctors who will be implanting it. “People of Dr. Piemonte’s stature tend to be sought after by many device companies. He’s a very brilliant fellow,” says a former resident. “I think he’s got the ethics to know if there is an issue.”

Considering the climate of suspicion surrounding medical ethics, it’s easy to make Piemonte’s relationship with Medtronic sound shady. Yet the information about Piemonte that Gossman didn’t include in his suit is just as interesting as the details he did. Although Piemonte’s wife does work for Medtronic, she neither sells stents nor conducts business with Lahey. The couple currently co-owns four shares in the company, worth about $200 (though, as a longtime employee, she may own more shares solely in her name). As for Piemonte himself, his 2009 earnings from Medtronic speaking engagements totaled $4,000, all of which he donated to charity.

IN HIS LAWSUIT, perhaps not surprisingly, Gossman emerges as a doctor solely motivated by the best interests of patients. Yet over the years at the hospital, he had earned a complicated reputation. Though he was widely considered an excellent doctor, he was also seen by some as an abrasive colleague. “He would definitely speak his mind,” says a former Lahey cardiologist. Even one of his former coworkers — one who believes Gossman raised an important issue — thinks the way he asked his question at the big department meeting exemplified his lack of tact. “That’s kind of the shitty personality of Dave — that’s why some members of the staff didn’t like him,” this person says. “That’s not a political way to bring it up. That’s the personality conflict that gets you in trouble.”

According to a Lahey spokesman, Steven Danehy, Gossman’s termination had nothing to do with his allegations about the hospital and Piemonte. For years, Danehy says, hospital officials fielded complaints about Gossman’s behavior from people inside and outside the building, though he declined to detail those complaints. “We’re trying to take the high road on this,” he says. He adds the clinic fired him only after numerous attempts to correct his disruptive behavior. (Says Gossman: “There was never a [time] where they said, ‘You’re on thin ice,’ or words implying that. This was a bolt out of the blue.”)