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Their legs were lost Physicians and Health Care Giants Saw Profits


Health|They Lost Their Legs. Doctors and Health Care Giants Profited.

https://www.nytimes.com/2023/07/15/health/atherectomy-peripheral-artery-disease.html

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Kelly Hanna sits in a wheelchair.
Kelly Hanna, whose leg was amputated in 2020, received at least 18 artery-opening procedures on her legs. She was told they would improve blood flow and prevent amputations.Credit...Cydni Elledge for The New York Times

Operating Profits

Medical device makers have bankrolled a cottage industry of doctors and clinics that perform artery-clearing procedures that can lead to amputations.

Kelly Hanna’s leg was amputated on a summer day in 2020, after a Michigan doctor who called himself the “leg saver” had damaged her arteries by snaking metal wires through them to clear away plaque.

It started with a festering wound on her left foot. Her podiatrist referred Ms. Hanna to Dr. Jihad Mustapha. Over 18 months, he performed at least that many artery-opening procedures on Ms. Hanna’s legs, telling her they would improve blood flow and prevent amputations.

They didn’t — for Ms. Hanna or many of his other patients. Surgeons at nearby hospitals had seen so many of his patients with amputations and other problems that they complained to Michigan’s medical board about his conduct. An insurance company told state authorities that 45 people had lost limbs after treatment at his clinics in the past four years.

Dr. Mustapha is no back-alley operator working in the shadows of the medical establishment, an investigation by The New York Times has found. With the financial backing of medical device manufacturers, he has become a leader of a booming cottage industry that peddles risky procedures to millions of Americans — enriching doctors and device companies and sometimes costing patients their limbs.

The industry targets the roughly 12 million Americans with peripheral artery disease, in which plaque, a sticky slurry of fat, calcium and other materials, accumulates in the arteries of the legs. For a tiny portion of patients, the plaque can choke off blood flow, leading to amputations or death.

But more than a decade of medical research has shown that the vast majority of people with peripheral artery disease have mild or no symptoms and don’t require treatment, aside from getting more exercise and taking medication. Experts said even those who do have severe symptoms, like Ms. Hanna, shouldn’t undergo repeated procedures in a short period of time.

Breakdown of hospital vs. outpatient procedures not available.

20,000

40,000

60,000

80,000

100,000 procedures

’11

’12

’13

’14

’15

’16

’17

’18

’19

’20

’21

Hospital

procedures

Hospital procedures

Outpatient

procedures

Outpatient procedures

Kelly Hanna’s Procedures

2019

2020

Feb. 4

Feb. 26

March 5

March 25

July 18

Aug. 8

Aug. 23

Sept. 13

Sept. 20

Sept. 25

Oct. 21

Nov. 15

Feb. 5

March 4

March 19

April 6

April 22

June 10

June 24

July 15

July 16

July 30

base

Blood vessel or vessels the procedure was performed on.

Atherectomies and other procedures on Kelly Hanna’s veins and arteries started in February 2019.

Her records do not always show which vessels Dr. Mustapha performed procedures on, instead only indicating which leg.

That August, Ms. Hanna’s right baby toe had to be amputated.

Just over a year after the first procedure, she had undergone more than a dozen.

When she went to the hospital in July 2020, her right foot was purple and cold to the touch. A vascular surgeon at the hospital, Dr. Judith Lin, said in an interview that she had no choice but to amputate above the knee.

Atherectomies and other procedures on Kelly Hanna’s veins and arteries started in February 2019.

That August, Ms. Hanna’s right baby toe had to be amputated.

Just over a year after the first procedure, she had undergone more than a dozen.

When she went to the hospital in July 2020, her right foot was purple and cold to the touch. A vascular surgeon at the hospital, Dr. Judith Lin, said in an interview that she had no choice but to amputate above the knee.


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