St. Jude's Chief Fights Reports of Device's Flaws As St. Jude Medical defends itself against reports of deaths and injuries linked to problems with an implanted heart device, it finds itself in familiar territory. Since 2005, two competitors, Medtronic and Guidant, have faced similar scrutiny about critical flaws in their products. But St. Jude is distinguishing itself with what doctors and others say is a rare response - a scorched-earth defense of its policies and products. The company's chief executive, Daniel J. Starks, has led that charge, accusing Medtronic of trying to undercut St. Jude to gain business. He and other company executives have also gone after a prominent researcher, contending he made crucial errors and showed bias in a study critical of a St. Jude heart device component at the center of the safety issue. Mr. Starks's mode of attack, however, may be backfiring. On Tuesday, the medical journal that published the report challenged by St. Jude said it had rejected the company's request to retract it. And interviews suggest that some of Mr. Starks's comments are putting off some doctors essential to St. Jude's success - specialists who implant heart devices. "I don't think he is helping his company," said Dr. Laurence M. Epstein, a heart device expert in Boston who consults for Medtronic and St. Jude. I think that any time you get defensive, it looks bad. On Tuesday, St. Jude stock continued a downward spiral, closing at $38.53 a share, down 13 percent since March 30. The scope of the problem involving the component, a wire or lead that connects a defibrillator to a patient's heart, is still unfolding. The lead, a model called the Riata, has been implanted in about 128,000 patients worldwide. Electrical wires within the Riata lead are breaking through the insulation and causing unintended shocks in some patients. An even greater concern is that the wires may fail when needed to deliver a lifesaving jolt to restore a failing heart to normal beating. The company stopped selling the Riata in late 2010. But the intensity of St. Jude's response appears to reflect a high-stakes effort to protect its newer lead, the Durata, from any suggestion that it might be prone to the same problem. The Durata has an added insulation sheath that St. Jude says should prevent the problem; thus far, it has a good safety record, but data is only a few years old. It is little wonder, given the importance of the Durata to St. Jude's future, that company officials would aggressively defend it. Still, Mr. Starks's manner appears to run the risk of alienating physicians. For example, in comments to Wall Street analysts in January, he described as a "nonevent" a recent meeting of leading device experts in Minneapolis who had gathered to better understand the safety problems posed by the Riata and how to address the lead's risks in patients. Doctors are grappling with the issue of whether it is more dangerous to remove the lead if it is failing, or leave it in. In his comments, Mr. Starks seemed to minimize the meeting's value, describing it as "lightly attended." He added he also saw it as a sales opportunity for St. Jude, claiming that many doctors in attendance used competitors" products. "From that perspective, it was a good meeting," he said. One expert who attended the meeting, Dr. Charles Swerdlow, said that St. Jude executives like Mr. Starks might better serve the company's interests by focusing on patients and their safety. He and other doctors have complained that St. Jude was slow to respond to the Riata problem and initially tried to play it down. "I hope that St. Jude is putting as much effort into helping patients with Riata leads as they are into pointing out flaws in studies that identified the failures," said Dr. Swerdlow, who practices in Los Angeles. He consults primarily with Medtronic but has also worked with St. Jude. Another expert, Dr. Anne Curtis, said she doubted Mr. Starks's suggestion that the meeting was filled with physicians who did not use the company's devices. However, Dr. Curtis, who serves on the St. Jude medical advisory board, said she thought the company had been open in dealing with the Riata issue.