Posted on 12/21/2007 4:46:27 PM PST by Cagey
The family of a California teenager who died awaiting a liver transplant said they would sue the insurer whom they blame for their daughter's death.
Nataline Sarkisyan, a 17-year-old from Glendale, Calif., died Thursday just a few hours after her insurer, Cigna HealthCare, approved a procedure it had previously described as "too experimental."
Attorney Mark Geragos said that Cigna "maliciously killed her" and that he hopes to press murder or manslaughter charges against Cigna HealthCare for the death of Sarkisyan.
District Attorney spokeswoman Sandi Gibbons declined to comment on the request for murder or manslaughter charges, saying it would be inappropriate to do so until Geragos submits evidence supporting his request.
"They took my daughter away from me," said Nataline's father, Krikor, who appeared at a news conference with his 21-year-old son, Bedros.
Cigna appears to have reversed its decision to deny the transplant after about 150 teenagers and nurses protested outside its Glendale office Thursday. "Protestors are here, the war is here," Hilda Sarkisyan, the girl's mother, told the group hours before her daughter's death. "We have a war here."
The Sarkisyan family claims that Cigna first agreed to the liver transplant surgery and had secured a match weeks ago. After the teen, who was battling leukemia, received a bone marrow transplant from her brother, however, she suffered a lung infection, and the insurer backed away from what it felt had become too risky a procedure.
"They're the ones who caused this. They're the one that told us to go there, and they would pay for the transplant," Hilda Sarkisyan said.
Geri Jenkins of the California Nurses Association said the Sarkisyans had insurance, and medical providers felt comfortable performing the medical procedure. In that situation, the the insurer should defer to medical experts, she said.
"They have insurance, and there's no reason that the doctors' judgment should be overrided by a bean counter sitting there in an insurance office," Jenkins said.
Doctors at the UCLA Medical Center actually signed a letter urging Cigna to review its decision. Nataline Sarkisyan was sedated into a coma to stabilize her as the family filed appeals in the case.
During the middle of Thursday's protest, Hilda Sarkisyan fielded a call from Cigna alerting her that her daughter's procedure had been given the green light. Cigna released a statement announcing the company "decided to make an exception in this rare and unusual case and we will provide coverage should she proceed with the requested liver transplant."
If this family felt so strongly about the surgery, they should have proceeded and then sued the insurance company for the cost later. I do not understand this postponement of action if the family felt so strongly.
This story seems like health care by mob rule. If these people think that insurance companies are difficult to deal with, just wait until universal rat care is enacted. The only way to obtain treatment will be mob rule unless you are in the politically connected rat class.
Exactly.
I have paid for heath care that the Insurance wouldn’t cover, because I felt that the treatment they approved was substandard.
It was ultimately my choice
Although that is true...Liver transplant in a patient with multiple comorbidities is experimental.
She doesn’t sound like an ideal surgery candidate under any circumstance.
“Does it make sense to use a healthy organ in a body riddled with leukemia when there are better prospects awaiting transplants?”
Might not.
But the doctors take that into account when figuring out who gets the organ.
It’s not supposed to be the insurance company’s call.
sitetest
“If this family felt so strongly about the surgery, they should have proceeded and then sued the insurance company for the cost later.”
I know a few people who have had organ transplants, including a dear friend who had a liver and kidney transplant.
At least in the cases of which I know, the hospital won’t proceed with treatment unless you have health insurance, or unless you cough up the cash before the surgery for the surgery and some amount of post-op treatment. The anti-rejection drugs alone can cost tens of thousands of dollars per year.
My friend who had the liver and kidney transplant - the operation alone cost around $600,000. Her drugs are around $3,000 per month.
It wouldn't be surprising to me if the family were unable to cough up several hundred thousand dollars, cash.
This is why folks are supposed to buy health insurance. To cope with catastrophic health costs. It sorta defeats the purpose if the doctors think the patient can benefit by a standard, but costly procedure, but the health insurance company refuses to cough up the bucks.
sitetest
The young lady needed more than a new liver ~ just read the story ~ she had a succession of serious health failures.
Sometimes stuff happens and people die.
Yes.
I would have sold my house and everything else and gone into debt before I let my daughter die because of a lack of money.
I hope I never have to face that situation, but one is ultimately responsible for one’s family, you have to do what you have to do.
As my late beloved grandma would say, "that and a nickel will get you on the subway".
Absurd, slip-and-fall lawyer BS.
Ultimately, events of this sort will result in some sort of nationalized health care. It does not matter what you or I think about it - in the end, the public will see a pretty girl that died too young and a cold, heartless insurance company. They will make a predictable conclusion. Note that I do not say a right (or wrong) conclusion - I said a predictable conclusion.
There is a reason this story hit the wires - and it has nothing to do with the young woman’s demise.
The girl here was going to die of leukemia ~ ......
We haven’t heard the doctors side of this.
If She were to receive the transplant and die,and the liver was no longer considered suitable for transplant, and another potential recipient died because they got bumped off the list, could THEY sue?
Hard call.
My Aunt went in for a standard ruptured disc and died of Staph.
No one sued.
Health care should be between a patient and doctor.
Lawyers and administrators need not apply IMHO
Medical insurance is a contract. Buying medical insurance does not mean that the insurance company is compelled to pay for any treatment that you desire. Insurance companies enforce medical contracts as they interpret them. I do not know the facts of this case nor the intracies of medical insurance law to indicate if the insurance company was right to deny coverage.
I am sorry about this poor girl’s death but I do not blame the insurance company even if the insurance loses in a lawsuit. If insurance companies are forced to pay for any treatment demanded, medical insurance rates will rise even higher. The insurance company did not deny treatment. They denied coverage.
Ya, I saw that later...
So her death wasn’t really a result of lack of money.
“We haven’t heard the doctors side of this.”
Actually, we kind of have heard the doctors’ side of this. They wanted to go forward with the surgery.
And there were a lot of doctors involved with the decision. The folks who were going to do the surgery, the folks who determine who gets which organ.
“If She were to receive the transplant and die,and the liver was no longer considered suitable for transplant, and another potential recipient died because they got bumped off the list, could THEY sue?”
There are set rules governing who gets organs. They take into account whether you’re sick enough to outrank everyone else who could benefit from the organ in question, and whether you’re too sick to benefit from the organ. That this girl was approved for the organ is evidence that a large number of doctors with different interests approved of this procedure, and determined that this was the best candidate for this liver. When you sign up for the waiting list, you accept those rules.
“Health care should be between a patient and doctor.”
I agree. But the first fundamental purpose of third-party insurance is to pay for medically-indicated health care that is beyond the reach of ordinary folks.
The health insurer actually GOT BETWEEN the patient and her doctors this time.
Whatever ill befalls the insurer and its top management personnel, they earned it.
sitetest
I’m not surprised, I’ve had Cigna in the past, and they denied every claim I ever filed. Piece of crap insurance. I started calling it the “claims denial department” as opposed to the “claims department” since they never paid one for me.
It sounds like a case of to much bureaucracy to me.
Prayers for all involved.
interesting the comments here against this young woman,
but if she were terri schiavo
the comments would be opposite.
“The insurance company did not deny treatment. They denied coverage.”
In that one must either have a guarantee from the insurance company to pay for a transplant, or one must have several hundred thousand dollars, sometimes closing in on the better part of a million dollars, in cash to obtain treatment, I think that this is a distinction without a difference. They damned her to death. They deserve like treatment.
“Buying medical insurance does not mean that the insurance company is compelled to pay for any treatment that you desire.”
That’s true. Years ago, I had a crazy aunt who kept asking for doctors to treat her for cancer, though multiple x-rays and such over a period of 20 years showed that she had no cancer. Until she got cancer. We always figured it was 20 years’ of x-rays that did her in.
Certainly, no insurer would have been obligated to pay for cancer treatment while she was cancer-free.
But if you’re looking for something that is part of the ordinary standard of care, they must pay for it.
In that the girl’s doctors approved of the operation, and the folks who hand out the organs approved of her receiving the operation, there is a strong presumption that the operation was part of the ordinary standard of care.
Organs aren’t handed out to “hopeless cases.” It’s sort of a tough situation for folks on the waiting list. You hope that you get sick enough to be the next person for a suitable organ, but then don’t get too sick while you’re waiting (morbidly) for someone to die who will have a suitable organ for you. Because, if you get too sick, then the organ folks will give the organ to the next person on the list who can use it.
I suspect that Mr. Geragos took up this case because he needs easy money.
sitetest
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