Replacing Faulty Heart Devices Costs Medicare $1.5 Billion in 10 Years FRED SCHULTE and CHRISTINA JEWETT OCT. 2, 2017 New York Times https://www.nytimes.com/2017/10/02/health/heart-devices-medicare.html

At least $1.5 billion WASHINGTON — Medicare paid at least $1.5 billion over a decade to replace seven types of defective heart devices, a government watchdog says. The devices apparently failed for thousands of patients. A report released on Monday by the inspector general’s office for Health and Human Services said officials needed to do a better job tracking these costly product failures to protect patients from harm. More detailed reporting could lead to earlier recognition of serious problems with medical devices and faster recalls of all types of “poorly performing” ones, the inspector general’s office said. The report marks the first effort by anyone in government to assess the losses to taxpayers and patients 65 and older from medical gear that proves faulty.

Conservative Estimate Officials said the $1.5 billion lost from the seven devices from 2005 through 2014 was a “conservative estimate.” Patients also paid $140 million in out-of-pocket costs for this care, the report noted. The report found that nearly 73,000 people on Medicare had one of the seven devices replaced because of recalls, premature failures, medically necessary upgrades or infections. It did not outline specific injuries that patients suffered as a result.

Seven different devices The inspector general did not identify the manufacturers of the seven devices, but officials said they included implanted cardio defibrillators and a pacemaker that had either been recalled because of flaws or had “prematurely failed.” Pacemakers and implantable defibrillators are small devices placed under the skin to help treat irregular heartbeats. How best to identify these defects and cut Medicare spending associated with fixing them has been under consideration at various times since 2007, according to the report. But it remains a contentious issue. The inspector general recommended that hospitals and doctors be required to submit detailed information identifying failed devices, like serial and batch numbers, during the billing process.

The Economics Is this a big deal? This comes out to be $150 Million per year in a health economy that pushes $3 trillion. This is .005 percent. While wasted money is wasted money, do we waste money on other things?

The Economics Is this malpractice? From statelawyers.com: Medical Malpractice occurs when a negligent act or omission by a doctor or other medical professional results in damage or harm to a patient. Negligence by a medical professional can include an error in diagnosis, treatment, or illness management. If such negligence results in injury to a patient, a legal case for medical malpractice can arise against: The doctor, if his or her actions deviated from generally accepted standards of practice; The hospital for improper care or inadequate training, such as problems with medications or sanitation; Local, state or federal agencies that operate hospital facilities.

Given everything Is the optimal failure rate 0? Probably not. To get it toward 0, you would Only treat absolutely certain cases. Only use absolutely certain treatment. Is the optimal malpractice rate 0?