garysher

Family blames HMO for teen's death
By Molly Hennessy-Fiske, Los Angeles Times Staff Writer December 21, 2007

Cigna refused to pay for a 17-year-old leukemia patient's liver transplant until the family staged a protest Thursday, but Nataline Sarkisyan died shortly after the reversal.


A grieving family is blaming an insurance company for the death Thursday of a 17-year-old leukemia patient, who died hours after the company reversed course and agreed to pay for her to receive a liver transplant.

Nataline Sarkisyan was being treated at UCLA Medical Center, where she had been unresponsive in intensive care for about three weeks, her mother said.

"She had a 65% chance of survival if she had gotten the liver," Hilda Sarkisyan said from her home this morning.

The Sarkisyans' insurer, Philadelphia-based Cigna HealthCare, denied the transplant earlier this month.

Doctors at UCLA sent a letter Dec. 11 to Cigna emphasizing that Nataline was eligible for a transplant, Hilda Sarkisyan said. But Cigna refused to pay, citing a lack of medical evidence the procedure would help.

Hilda Sarkisyan said the company was trying to save money. "They just like to collect. They don't want to deliver," she said.

On Thursday, the family rallied supporters online and staged a protest at Cigna's Glendale office with about 150 people, including many members of the local Armenian community and the California Nurses Assn., which had released statements supporting the family's cause.

Later in the day, Cigna released a statement approving the transplant payment.

"Although it is outside the scope of the plan's coverage, and despite the lack of medical evidence regarding the effectiveness of such treatment," spokesman Wendell Potter wrote, "Cigna HealthCare has decided to make an exception in this rare and unusual case, and we will provide coverage should she proceed with the requested liver transplant. Our thoughts and payers are with Nataline and her family at this time."

Nataline died about 6 p.m.

Cigna spokesmen did not respond to e-mail and telephone requests for comment this morning. The family's lawyer planned a news conference later today to discuss the situation.

Charles Idelson, spokesman for the Oakland-based California Nurses Assns., called Cigna's handling of the Sarkisyan's case "outrageous."

"If Cigna could approve the transplant yesterday in response to hundreds of phone calls and people pounding on their door in Glendale, why couldn't they have done it eight days earlier?" Idelson said this morning.

He said his group, which represents 75,000 nursing professionals, the majority in California, has recently rallied around a number of patients who have been denied care.

While it isn't clear that Cigna could have saved Nataline by approving the transplant earlier, Idelson said, the insurer should have trusted her doctors.

"The transplant was recommended by the medical professionals at the bedside," Idelson said. "They should have been listened to."
Family blames HMO for teen's death - Los Angeles Times

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highway80west

I read that, too, before this was posted. Sad. My company almost went with CIGNA once, but stuck with Blue Cross. Good thing.

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sgtdmski

And in Britian it is the government so what is the difference???? The government run health in Britain has denied treatment to individuals, especially older individuals because of the limit of the resources.

dmk

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Conservatism, I repeat is not an ideology. It does not breed fanatics....But if you want men who seek, reasonably and prudently, to reconcile the best in wisdom of our ancestors with the change which is essential to a vigorous civil social existence, then you will do well to turn to conservative principles
-Russell Kirk-

garysher

Sarge, can you provide any examples or is your evidence purely anecdotal?

Specifically, do you know of any teenagers in Britain who were denied a liver transplant because of cost?

Or anyone who was denied a life-saving surgery and allowed to die because of cost?

Incidentally I wonder how that hairdresser in Inglewood is doing trying to raise $200k to treat her breast cancer?

Or maybe she's already dead.

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sgtdmski

No teenage, notice I said older individuals, this is especially true for those with kidney disease who need dialysis. I actually met quite a few older Brits here in K-Town enjoying a cruise of Alaska, not to mention access to dialysis.

I have listened to first hand stories of how because of their age, they are often bumped from the list or made to wait longer in order to receive treatment. They come here and naught a complaint.

dmk

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Conservatism, I repeat is not an ideology. It does not breed fanatics....But if you want men who seek, reasonably and prudently, to reconcile the best in wisdom of our ancestors with the change which is essential to a vigorous civil social existence, then you will do well to turn to conservative principles
-Russell Kirk-

garysher

But do you know of anyone in Britain who was refused critical treatment by the NHS and who died as a result?

Which is what you insinuated in your earlier post tying to knock "the government"!

And presumably those Brits you met on the cruise were:

A) not critically ill
B) able to afford to travel the world to find health care
C) could have paid for private treatment in the UK for a lot less money

The health care issue revolves around providing care to people who CANNOT afford it.

Not wealthy Brits who fly to the US and pay exorbitant prices, nor rich Republican candidates whose campaigns are funded by insurance companies.

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pensacola_niceman

WHat do you bloody expect? Claims like that are very detrimental to the company's bottom line. The shareholders demand a profit you know.

highway80west

Anybody ever seen the movie, "The Rainmaker", which stars Matt Damon and Jon Voight? It's based on a John Grisham novel, and can well echo this situation we are discussing. PN is right. Money means more to the insurers like CIGNA and the fictional Great Benefits (in the movie I mentioned) than patients do.

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Ralph

Not to play the Devils advocate, but I was just wondering if the writer that works for the LA Times expects to have a pay check coming next week, or did the author of the script just donate their time and energy to bring us this story of how someone was a "victim" with obvious reflections on, if we but had a national health care system? The point is, everyone has an "angle" to look out for their best interest, to propagate for the best return for their investment. The parent of the Child, invests toward their interest by protesting, the Insurance Co. claims they were slow to act due to unproven methodology, the writer that brought the story to the attention of the public has underlying motives. Hey, we call this system CAPITALISM. It's not perfect but it has provided the best, bar none, life style for any peoples that have ever existed on this planet. We by majority have more work than than we do workers, as evidenced by illegal immigration explosion, I don't see many people risking their lives to take a row boat to get back into Cuba, I don't see a Wall standing erect to keep people from escaping the eastern communist block nations. But I do notice nations such as France taking a step back and giving their system a good "once over" as evidenced by the conservative turn in the government.

Sure, its sad to see someone sick, but in reality that's life, we are born, we live until we die and that little space that happens in between is called "LIVING"......If anyone spends the most part their life playing the "victim", and blaming All life's problems on others without taking responsibility for their own freewill choices, you turn around and look and we have more invested in dying than than we do living. Live hard, respect others, be responsible, and take care of yourself. No one will do it for you, they may pretend, but in the end everyone is looking out only for their best interest. None of us should have to live like this, and we don't have to. Simply treat people the way that you expect to be treated, EXPECT NOTHING MORE, ACCEPT NOTHING LESS. Ralph

garysher

A rather mean-spirited, naive and simplistic analysis there Ralph.

The fact is no nation on the planet is entirely capitalist nor entirely socialist.

All successful economies, including the US, are mixed economies - they use a mix of capitalist and socialist policies.

Drug research, subsidised farming and public education are examples of socialist policies in the US.

Of course there will always be heated debate about how much of each, but that is the reality.

Universal health care is far from perfect, but at least it's available to anyone regardless of their ability to pay.

I think eventually the US will catch up to the world's other industrialised nations and come up with a way to provide healthcare for all its citizens.

I'm interested to know how you reconcile your opposition to universal health care and your dehumanisation of illegal immigrants, with your professed Christian beliefs?

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