Posted on 02/04/2010 2:35:27 PM PST by Second Amendment First
A Montbello mother says her 9-year-old son's death from severe asthma could have been prevented had Denver Human Services resolved problems with his Medicaid pharmacy benefits.
Zuton Lucero said she called Human Services every three days for months last year when she was suddenly unable to get prescription drugs for her son, Zumante.
The boy's health deteriorated without the medication, his doctor said, and he died at Children's Hospital in July after losing consciousness at his house after an attack.
"I don't want anyone else to be sitting where I'm sitting," Lucero said.
Advocacy lawyers who met Wednesday with the Colorado Attorney General's Office hold up Lucero's story as an example of how serious the Zumante Lucero struggled with asthma since he was a baby. In March, his mother went to fill his Advair prescription, but it was denied. Months of calls followed to Human Services to no avail. The boy, 9, got progressively worse and died in July. (Hyoung Chang, The Denver Post) problems are with the state's $243 million computer system that is supposed to manage benefits — and the county human workers behind it.
"The human system fell down," said Ed Kahn, a lawyer with the Colorado Center for Law and Policy, who is among a group of local and national lawyers weighing a lawsuit against the state for delays in getting food stamps and Medicaid benefits to people. "They are responsible for this kid's death."
The Colorado Benefits Management System is run through county human services offices and manages medical and food-assistance benefits for everyone in Colorado. Since its 2004 installation, the system has been beset by problems.
Lawyers advocating for Colorado's needy sat down with state officials Wednesday to discuss the problems that have the lawyers weighing whether to sue the state as they did in 2005 over similar issues.
"They presented us with some new information, and we listened carefully," Kahn said. "We hope to make a decision in relatively short order about how we are going to move forward."
Lucero, who works as a paraprofessional in Denver Public Schools, said Wednesday that she will continue to tell the story of Zumante's death "to enough people so that it won't ever be anyone else's story."
In addition to working with the advocacy lawyers, she has hired a personal attorney and is exploring a lawsuit against Denver.
Zumante had struggled with asthma since he was 3 months old. But when he was 6, the condition became serious enough for his mother to apply for benefits under Social Security, which also entitles him to Medicaid.
Andrew Lieber was Zu mante's physician since birth. He said the boy's lungs were severely inflamed, and his twice-daily medication, Advair, helped control that.
Last March, Lucero went to fill her son's prescriptions at a Walgreens near her home in Montbello. A worker there said Zumante didn't have prescription-drug coverage anymore.
Lucero says she called Denver Human Services every three days for four months trying to get him drug coverage. Each time she called, an automatic computer report was issued and sent to her house usually showing that all of her children — including Zumante — qualified for Medicaid.
But even when she brought in the reports to Walgreens, she was told the computer system showed he wasn't eligible for pharmaceutical benefits.
Throughout months of frustrating phone calls to Human Services' call-center operators, which often left Lucero in tears, Zumante's health weakened. She managed to reach her caseworker only once. The caseworker told her in March that the problem had been resolved.
Just why the system showed Zumante wasn't eligible for the prescription benefit — when in fact he was — still is not clear.
The little boy, who loved karate, drawing cartoon figures and riding bikes with his brothers and sisters, was often caught in spasms of panic because he couldn't catch his breath.
He went to the emergency room in May and June when the inhalers and nebulizers Lucero carried were not enough.
During the June trip to the ER, Lucero told doctors she wasn't able to get him his Advair.
They gave her some samples. When she told Zumante he was going to get to start taking his medicine again, the boy was so relieved he cried.
But it was too late. The medicine works progressively to keep inflammation down, Lieber said.
On July 16, Lucero was home and heard Zumante call her name from upstairs. He was on the nebulizer and told her he couldn't breathe. She called an ambulance. While she was waiting, Zumante lost consciousness.
She cradled him in the front yard while she waited to hear sirens. By the time paramedics got him to Children's Hospital, he had been unconscious for more than 10 minutes.
For four days, he was kept alive on a ventilator, but when Lucero decided to disconnect it, he died within a few minutes.
Denver Human Services officials said the agency "feels the death of any child as a tragic loss," said spokeswoman Revekka Balancier. "And our department tries very hard to prevent these kinds of tragic accidents."
Read more: http://www.denverpost.com/ci_14329527#ixzz0ebpAfnNW
I would have sold everything I could if I had to get medicine for a child.
This woman is an absolute disgrace.
And what about the dad? Oh well.
>> Something we seriously wrong on both ends.
No doubt.
That's one of those interesting differences between people -- to me it's basically tasteless, but mildly pleasant.
Learn Spanish and travel.
Mexican Riviera is fun and lots to do.
Come back stocked up and if a friend will help, they should get a prescrption.
It's a maintenance drug.
Sounds like to me...this kid was too sick to just be on Advair alone. This lady drug her feet...She could have got an Advair disc somewhere, somehow.
Something stinks here...
She obviously couldn’t afford it. People with money have this unreasonable belief that everyone has a reserve they can tap into. A lot don’t.
advair costs hundreds of dollars a script.
Out of pocket
However I am surprised that the doc did not immediately put the kid on prednisone generic. That should have been more affordable.
I cannotwait for the end of perscription insurance. That is what is driving the cost of meds up.
Just adding the Advair to this kids drug regime doesn't sound like it was the answer. Besides it appears he did get back on it for a couple weeks or so.
He was a lot sicker than that.......Mom should have known.
Poor kid...
FWIW-
If I expressed my disgust at your comments, I would probably be banned.
Stop using that.......
I've seen too many folks die using that stuff........
Just go buy a Ventolin Inhaler
PULMICORT has not been effective for anyone I know and Symbicort never feels quite right.
She took him there twice apparently, the second time they gave her some samples but it would seem his condition had deteriorated so much it didn’t help to go back on the meds. I have to wonder if his condition wasn’t something other than asthma. What I don’t understand is why she didn’t take him to the health services. every city has one with doctors and everything. This is a sad case of people expecting the gov to fix things for them, like the people in N.O. waiting for someone to take care of them instead of finding a way out themselves.
Advair is a steroid fluticasone and a bronchodilator salmeterol mix....most can expect benefits 30 minutes after use....some might take a week.
You are correct...it's not a rescue inhaler.
We don't have the full story here....I'd wager.
FRegards,
I am going to say something that may or may not be the case but should be considered.
Not everyone is bright enough to advocate for themselves in the increasingly complex systems the leftists have developed.
The Bell Curve talks about how this would become increasingly problematic.
This lady didn't try hard enough, IMO.
the sad thing is that there probably isn't more to this story...
It's a unit dose powder which is delivered by the patient's inhalation.
That said...you make a decent point about other MDI's that use a delivery gas.
It can be dangerous.......
Yes, Primatene is OTC. I don’t recommend it unless there’s nothing else available.
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