Many members of the... Cleveland Clinic board of trustees have business relationships with the hospital, which has launched a conflict-of-interest review after a recent news report raised concerns about financial ties to a venture capital fund, the Wall Street Journal reports. Cleveland Clinic CEO Delos Cosgrove on Wednesday said he has asked the board to review potential organizational conflicts of interest after the Journal reported that physicians at the hospital advocate and perform surgeries for atrial fibrillation with a medical device manufactured by AtriCure, despite undisclosed financial ties to the company. The Cleveland Clinic, Cosgrove and some clinic physicians also reportedly had financial ties to CardioVention, whose heart-lung machine allegedly caused the death of a patient at the clinic (Amstrong/Stecklow, Wall Street Journal, 12/17).
Trustee Business Relationships
According to the Journal, A. Malachi Mixon -- chair of the Cleveland Clinic and a member of the executive committee of the board with Cosgrove -- serves as CEO of Invacare, a Cleveland-area company that manufactures wheelchairs and other medical equipment purchased by the hospital. Mixon said that all Cleveland Clinic trustees must complete forms to indicate any business relationships with the hospital and that "a couple dozen" trustees currently have such relationships. According to the last annual report filed by the Cleveland Clinic, the board includes 87 trustees. Mixon said, "It's hard in a small town like Cleveland not to have some relationship with the clinic. It's the biggest organization in town." In a statement, the Cleveland Clinic said, "Trustees are required to disclose all conflicts of interest. Those are then reviewed by our conflict-of-interest committee to ensure that such situations are handled in the best interests of the Cleveland Clinic. Any such situation may require a recusal, a management plan or other appropriate action." Mixon also said that any business relationships between trustees and the Cleveland Clinic will not compromise the independence of the conflict-of-interest review. He added that the board plans to hire an expert "who is highly regarded in industry to do an independent audit of us and review our practices" (Wall Street Journal, 12/17).
Conflicts of Interest Examined
The New York Times on Saturday examined recent news reports about the Cleveland Clinic and profiled cardiologist Eric Topol, who was removed as provost and chief academic officer at the hospital medical school on Dec. 5. According to the Times, his "demotion has drawn attention to the mounting tensions between the clinic's research mission and its deep ties to the businesses that finance that research." Topol, who ended ties with the industry last December, has said his decision to testify against Merck in the first federal trial related to the COX-2 Inhibitor Vioxx was a primary reason for his removal. The Times examined business relationships with Cleveland Clinic for Mixon, Cosgrove and others. According to the Times, "All of this attention threatens to tarnish the clinic's image as an institution conducting world-class medical research." Dr. Jerome Kassirer, a former editor in chief for the New England Journal of Medicine, said that the publicity might lead to changes in how medical research is financed, adding, "The only question is whether it will really embarrass anyone" (Abelson/Saul, New York Times, 12/17).
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