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An unfolding scandal at the University Hospital Zurich (USZ) in Zurich, Switzerland, has prompted criminal inquiries after an independent commission’s report, released at the end of April, linked more than 70 unexpected patient deaths in the cardiac surgery unit to the period 2016-2020 under then-chief Francesco Maisano. The commission found that implantable devices — notably the Cardioband— may have been used inappropriately or when not clinically indicated, and that internal warning signs were acted on too late. In response, the Zurich Office of the Chief Public Prosecutor has opened a criminal investigation, assembling an interdisciplinary team and assigning four specialized prosecutors to examine the cases from 2016 to 2020.

Cardioband: Device Safety Concerns

The former head of cardiac surgery at the USZ, Maisano, played a key role in developing the Cardioband. The heart valve implant is used to treat a leaky tricuspid valve. The Cardioband is delivered via a catheter through the femoral vein and secured to the tricuspid annulus with multiple anchors. The band is then tightened via the catheter, reducing the annular diameter and bringing the valve leaflets closer together. This restores the valve’s seal.

In the summer of 2024, the system lost its approval for the European market. It is therefore no longer available as a treatment option. It was never approved in the US.

Criminal Probes, Systemic Failures

The trigger for this action was the report from the investigative commission. The hospital board subsequently filed a complaint. Specifically, the case involved 11 deaths and 13 instances of medical device use.

Judicial authorities have received three criminal complaints naming persons unknown and alleging negligent homicide, bodily injury, and document forgery. In addition, there were 11 reports regarding the potentially improper use of medical devices.

“The case is highly unusual; it is very large and has a scale we are not really accustomed to,” explained Brigitte Tag, a criminal and medical law expert at the University of Zurich, Zurich, Switzerland, in an interview with Swiss Radio and Television (SRF). The case is now sending shockwaves through medical law and the healthcare system in Switzerland.

Dismissed Whistleblower, Institutional Failures

At a press conference, Monika Jänicke, managing director of the USZ since 2023, commented on the events and failures: “We cannot undo the suffering; the pain remains.”

In an interview with the Tages-Anzeiger, Jänicke said the hospital — which dismissed the whistleblower — is now looking for ways to compensate him. (Tages-Anzeiger is a major Swiss daily newspaper.)

The USZ’s managing director declined to comment on the fact that the man had lost his job. This issue is in the past, she said, when she was not yet at the USZ.

André Plass was formerly a senior physician in the Department of Cardiac Surgery at USZ and brought the entire affair to light. In 2019, he reported to the hospital management that complications, possible cover-ups, and problematic procedures in Maisano’s team were not being properly addressed. This made him the whistleblower in the case. It created entrenched positions, with many speaking of intrigues.

The hospital management dismissed Plass in 2019, but he was rehired due to public pressure. The USZ then dismissed him a second time at the end of September 2020.

The Zurich Administrative Court ruled that the dismissal was lawful because Plass ultimately refused to participate in discussions with the hospital director. Some employees also opposed Plass’s continued employment. Given these circumstances, the court ruled that the termination was permissible. However, the administration was not without fault either.

Plass’s reports did not go without consequences, however: In response to the allegations, the USZ initiated an investigation by external lawyers, which partially confirmed his claims.

Finally, in May 2026, after the investigation commission’s report was presented, the hospital management publicly apologized. “It is gratifying that the serious grievances are now becoming known and that the events are being dealt with so that something like this does not happen again in the future,” Plass said.

According to the online magazine 20 Minuten, he is irritated that the hospital administration once again defended his dismissal at the press conference, citing the fact that he had not been a team player. This, he said, continues to demonstrate a questionable mindset.

Successor Faced False Accusations

Paul Vogt, who became head of the Cardiac Surgery Clinic and Maisano’s successor in July 2020, also had negative experiences. He soon found evidence of an unusually high number of deaths and wrote an email to the hospital administration a few weeks after taking the job. In it, he reported on the deaths and serious complications.

Afterward, he himself became the target of attacks: He was anonymously reported for an operation in which a patient had died. He was also accused of having falsified the surgical report afterward. The charge of negligent homicide was quickly dropped; Vogt was later acquitted of the forgery charge in court.

Secret Group Spread Allegations

In a later court trial, Vogt said the hospital administration had long been aware of the problems. As early as 2018, there had been indications of increased mortality.

“He was shocked by the conditions he found,” Vogt said, according to the interrogation transcript: few patients, poor procedures, and an excessively high mortality rate.

And something else had puzzled him: When he took over as hospital director, quality-control data was missing. When asked, the USZ did not confirm this to the Tages-Anzeiger. In fact, every operation and its outcome should be recorded in the registry of the Swiss Society for Cardiac Surgery.

The Tages-Anzeiger reported, there was reportedly a secret group of Maisano supporters at USZ called “Honest Falcon.” The group allegedly sent anonymous emails to the media, politicians, and the hospital management, spread accusations against Maisano’s critics, attacked Plass, and filed the anonymous criminal complaint against Vogt.

The group is also said to have passed on surgical details to the media and deliberately spread distorted information. Their aim was presumably to reinterpret the scandal as a mere personnel conflict. The members of the group were never identified.

What Happens Next?

Who is liable now? The USZ has set up an information and counseling center for those affected who suffered harm under Maisano. No binding commitments for compensation have been made yet. Those affected and their families face years of legal proceedings.

According to SRF, the Canton of Zurich would have to pay because the USZ is a cantonal institution. Whether anyone can be held criminally liable must be decided by the courts — and in each case individually. According to SRF, Maisano could not be reached for comment. He is now the director of a heart valve clinic in Milan.

This story was translated from Medscape’s German edition.