After Peter Wilmshurst published research in 2000 linking migraine with patent foramen ovale, NMT Medical developed the STARflex closure device and recruited him for the MIST trial. Wilmshurst identified a substantial discrepancy between echocardiogram interpretations by implanting cardiologists and his own review, finding a significantly higher proportion of patients with residual cardiac shunts. An independent review supported his figures, after which he presented and discussed the results publicly.
NMT Medical filed a libel action against Wilmshurst in 2007 and brought additional suits during the dispute. The litigation ended when the company declared bankruptcy three years later. The case became part of the wider UK libel-reform debate, alongside British Chiropractic Association v Singh; that campaign contributed to the Defamation Act 2013. The source characterizes the lawsuits as vexatious retaliation, while the documented clinical issue was a disputed interpretation of trial evidence rather than a proven finding of intentional device fraud.