An Army cardiologist on Friday was sentenced to pay more than $12,700 in fines and restitution for accepting free meals and illegal payment from Guidant Sales, whose representatives sought to boost sales of heart implant devices.
TACOMA — An Army cardiologist on Friday was sentenced to pay more than $12,700 in fines and restitution for accepting free meals and illegal payments from Guidant Sales, whose representatives marketed implant devices used at military hospitals.
In a sentencing memorandum filed this week in U.S. District Court, prosecutors said the gifts and money helped transform Maj. Jason Layne Davis, who practices at Madigan Army Medical Center, into an “aggressive user and advocate” of the heart-implant devices manufactured by Guidant, a subsidiary of Boston Scientific.
Judge J. Richard Creatura, in announcing the sentence for Davis’ misdemeanor count, said the total of fines and restitution reflects the sum of “every dinner, every bottle of wine and every other gratuity that you have ever received from Guidant.”
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The case is a rare instance of the Justice Department prosecuting a doctor for taking money and gifts from a pharmaceutical company or medical-device maker, and results from Davis’ position with the federal government, which prohibits such gifts and payments from vendors.
The case also offers an unusual, behind-the-scenes look at how these companies target doctors in what prosecutors wrote was a “deliberate, Machiavellian policy.”
Boston Scientific representatives told prosecutors how they used lavish meals as a way to help gain doctors’ business, and noted they once footed the bill for $300 bottles of wine before reining in that expense to a $100-per-bottle limit.
Davis, in a lengthy statement to the court on Friday, accepted responsibility for taking illegal payments but noted that other Army medical personnel also had accepted expensive dinners even though the Army prohibits acceptance of gifts worth more than $20.
Davis is the former chief of cardiology at Madigan and received a Bronze Medal for his service in Iraq. He is scheduled to be deployed to Afghanistan.
“I engage people. I care about them. I try to mentor, and in the course of doing that, I will certainly admit that I have made some mistakes,” Davis told the judge. “There is more to this than some rogue physician who is corrupt — because I am not corrupt, sir.”
The sentencing followed a plea agreement reached earlier this year with Davis. Last November, Boston Scientific paid $600,000 to settle a civil lawsuit stemming from the payments to Davis.
Davis said he had a lost his grandfather to heart disease and was eager to get the training that would allow him to implant defibrillators that could save lives. He said he paid some expenses out of his own pocket to earn credentials.
As Davis gained the ability to implant the devices, Boston Scientifics’ spending on the doctor sharply escalated, according to the prosecutor’s sentencing memorandum.
In 2005, when Davis had yet to complete the process of earning his credentials, Boston Scientific spent $298 on the doctor for meals and other items.
In 2006, after Davis began implanting the devices, the company spent $1,709 for meals and other items, according to the sentencing memorandum.
Then in 2007 — when Davis was primarily responsible for implanting the devices at Madigan — the company spent $3,388, “treating him and his wife to multiple, extravagant meals with significant tabs for alcohol,” prosecutors wrote.
That same year, Boston Scientific paid Davis $2,000 to make a 45-minute presentation.
Also in 2007, Davis collected more than $4,800 from Boston Scientific for allowing company employees to watch him perform seven cardiac-implant procedures. It was these payments that resulted in Davis’ guilty plea.
Davis’ advocacy of Boston Scientific included making bulk purchases of the company’s implant devices, despite federal rules and Madigan contract language that appeared to forbid that practice, prosecutors wrote.
In civilian medical practice, drug- and medical-device company payment practices have sparked fierce ethical debates, with critics saying the money may represent kickbacks for favoring a company. But, generally, such practices have not resulted in criminal penalties.
A joint investigation by The Washington Post and ProPublica, a nonprofit investigative news organization, found at least 15 drug and medical-device companies have paid $6.5 billion since 2008 to settle accusations of marketing fraud or kickbacks. However, none of the more than 75 doctors named as participants in those actions were sanctioned.
Jenny Durkan, the U.S. attorney in Seattle, noted there is a higher standard in the military, where doctors are explicitly forbidden to take third-party payments for their medical services. “Military doctors must owe their allegiance to the soldiers and families they treat — not to drug companies or makers of medical devices,” said Durkan, in a statement released in January as the plea deal was announced.
The Seattle Times reported in August that a Madigan whistle-blower, retired Col. Michael Eisenhauer, had expressed concerns to superiors as early as 2010 that Davis’ dealings with Boston Scientific may also have compromised patient care.
At the time the plea deal was reached in January, prosecutors said they believed patient care had not been affected. But after the plea deal was reached, the Defense Department followed up on a whistle-blower recommendation for a quality-assurance review of Davis’ implants, according to the sentencing memorandum.
The review suggested guidelines were not met or were contradicted in four of 30 cases examined in 2006 and 2007 involving Davis and a second Madigan Army doctor. But the review “failed to pinpoint any lapses in the quality of care,” according to the sentencing memorandum.
Eisenhauer said Friday his specific concerns involved 2008 and 2009 cases, and he questioned why they weren’t included in the review.
“Davis is not a bad doctor. This is a very sad day for him, and a sad day for the Army Medical Department,” said Eisenhauer, who has maintained Davis lacked oversight from commanders who were in charge during the period of the illegal payments.
The judge noted numerous letters of support from colleagues and patients attesting to Davis’ medical skills and character, and said he hoped Davis’ federal conviction would not curtail his career.
“It would be a terrible loss to the community if you were not able to practice medicine,” the judge said.
Hal Bernton: 206-464-2581 or email@example.com