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by vibr8

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HMO & teen's death

from today's L.A. Times...family blames HMO for teen's death

Date:   12/21/2007 2:12:48 PM   ( 7 y ) ... viewed 1971 times

Family blames HMO for teen's death

 
 
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.
By Molly Hennessy-Fiske, Los Angeles Times Staff Writer
10:41 AM PST, December 21, 2007
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."

molly.hennessy-fiske@latimes.com

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