Girl Dies Hours After Transplant Decision

[Sluff]

Girl Dies Hours After Transplant Decision
By ALICIA CHANG,AP
Filed Under: Nation News

LOS ANGELES (Dec. 21) - The family of a 17-year-old girl who died hours after her health insurer reversed a decision and said it would pay for a liver transplant plans to sue the company, their attorney said Friday.

Nataline Sarkisyan died Thursday at about 6 p.m. at the University of California, Los Angeles Medical Center. She had been in a vegetative state for weeks, said her mother, Hilda.

 Matt Sayles, AP Nataline Sarkisyan died Thursday night at a hospital in Los Angeles hours after her insurer reversed an earlier decision and approved payment for a liver transplant. She had been critically ill after battling leukemia.
 
Attorney Mark Geragos said he plans to ask the district attorney to press murder or manslaughter charges against Cigna HealthCare in the case. The insurer "maliciously killed her" because it did not want to bear the expense of her transplant and aftercare, Geragos said.

Nataline had been battling leukemia and received a bone marrow transplant from her brother. She developed a complication that caused her liver to fail.

Doctors at UCLA determined she needed a transplant and sent a letter to Cigna Corp.'s Cigna HealthCare on Dec. 11. The Philadelphia-based health insurance company denied payment for the transplant, saying the procedure was experimental and outside the scope of coverage.

The insurer reversed the decision Thursday as about 150 teenagers and nurses rallied outside of its office. But Nataline died hours later.

"They took my daughter away from me," said Nataline's father, Krikor, who appeared at the news conference with his 21-year-old son, Bedros.

Despite the reversal, Cigna said in an e-mail statement before she died that there was a lack of medical evidence showing the procedure would work in Nataline's case.

"Our hearts go out to Nataline and her family, as they endure this terrible ordeal," the company said. "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."

In their letter, the UCLA doctors said patients in situations similar to Nataline's who undergo transplants have a six-month survival rate of about 65 percent.

District Attorney spokeswoman Sandi Gibbons declined to comment on Geragos' planned request for murder or manslaughter charges, saying it would be inappropriate to do so until Geragos submits evidence supporting the request.

One of the doctors, Robert Venick, declined to comment on Nataline's case when reached at his office Friday.


Copyright 2007 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. All active hyperlinks have been inserted by AOL.

[Black]

The people across the street lost their daughter-in-law in a similar situation.  By the time the insurance approved all of the paperwork, after battling over it for a couple of years, she was almost too week to survive the surgery, and died a few months later before she could even be put on the list.  If she had been approved by the insurance company when her doctors first said she needed it, she'd probaby be alive today.

[George Jung]

I saw this story on the news today while I was at the bank and was totally captivated (in disgust and dis belief), while everyone around me hardly noticed (so it seemed).  Very sad story.  I am curious if this would have happened with socialized medicine.

[okarol]

RN's Statement on Death of Nataline Sarkisyan: 'CIGNA Should Have Listened to Her Doctors And Approved the Transplant a Week Ago'

Friday December 21, 2:54 pm ET

GLENDALE, Calif.--(BUSINESS WIRE)--The California Nurses Association/National Nurses Organizing Committee today blasted insurance giant CIGNA for failing to approve a liver transplant one week earlier for 17-year-old Nataline Sarkisyan, who tragically died last night just hours after CIGNA relented and agreed to the procedure following a massive national outcry.

On Dec. 11, four leading physicians, including the surgical director of the Pediatric Liver Transplant Program at UCLA, wrote to CIGNA urging the company to reverse its denial. The physicians said that Nataline “currently meets criteria to be listed as Status 1A” for a transplant. They also challenged CIGNA’s denial which the company said occurred because their benefit plan “does not cover experimental, investigational and unproven services,” to which the doctors replied, “Nataline’s case is in fact none of the above.”

“So what happened between December 11, when CIGNA denied the transplant, and December 19 when they approved? A huge outpouring of protest and CIGNA’s public humiliation. Why didn’t they just listen to the medical professionals at the bedside in the first place?” asked Geri Jenkins, RN, a member of the CNA/NNOC Council of Presidents who works in a transplant unit at the University of California San Diego Medical Center.

On Thursday, CIGNA was bombarded with phone calls to its offices across the country while a rally sponsored by CNA/NNOC, with the substantial help of the local Armenian community, drew 150 people to the Glendale offices of CIGNA – all of which produced the turnaround by CIGNA to finally reverse its prior denial of care.

CNA/NNOC Executive Director Rose Ann DeMoro called the final outcome “a horrific tragedy that demonstrates what is so fundamentally wrong with our health care system today. Insurance companies have a stranglehold on our health. Their first priority is to make profits for their shareholders – and the way they do that is by denying care.”

“It is simply not possible to organize major protests every time a multi-billion corporation like CIGNA denies care that has been recommended by a physician,” DeMoro said. “Having insurance is not the same as receiving needed care. We need a fundamental change in our healthcare system that takes control away from the insurance giants and places it where it belongs – in the hands of the medical professionals, the patients, and their families.”


Contact:

For California Nurses Association
Charles Idelson, 510-273-2246
Liz Jacobs, RN, 510-435-7674
Shum Preston, 510-273-2276

http://biz.yahoo.com/bw/071221/20071221005718.html?.v=1

[goofynina]

I am a firm believer in destiny and although the insurance company did her wrong, it was still her time to go.    R.I.P. Nataline

[paris]

I just read another article that said she was in a vegetative state and that having cancer would make her ineligible for a transplant. I feel like we haven't heard all the story yet.  We all know how hard it is to get approved for a transplant.  I feel so bad for her family. Sounds like they have been trying to find cures for their daughter for a long time.  Prayers being said for all of them.

[okarol]

Our neighbor across the street is legal counsel for Cigna. Apparently his address has been given out and some threats have been made.

[Wattle]

 I am curious if this would have happened with socialized medicine.

We have socialized medicine. I am sure decisions are made all the time without the knowledge of the patient. I also have Private Health Insurance, which I pay for monthly. You still have to know the system and your own health requirements. And be willing to fight for how you want to be treated.
I don't understand the process in the States of the insurance company having the final say, shouldn't it be upto the health officials?

I had a close friend die from complications following a Bone marrow Transplant a few years ago. We were all very active in her care. If she had needed a liver transplant you can guarantee we would have had her on the list! We were all with her when she died.

My heart goes out to the family. 

[okarol]

 Dec. 27, 2007, 10:57PM

LETTERS
Criticism over 'Heartless'
Houston Chronicle

His own experience
There has been considerable media coverage of the patient awaiting a liver transplant who died before the operation could take place. Now, the Chronicle's editorial board expresses the case as "heartless" because CIGNA, the company providing health coverage, denied coverage of the operation until shortly before the patient died. (Please see "Heartless / CIGNA's decision to deny teen a liver transplant until it was too late highlights flaws in health care system," Editorial, Dec. 25.) I have strong criticism of the media coverage because it generally seems to provide only those details viewed to support the position that it is attempting to make.

There is no mention in the editorial of who provided the insurance coverage for the three-year battle with leukemia; likely it was CIGNA. The bone marrow transplant was paid by someone; might it have been CIGNA?

I experienced acute kidney failure seven years ago and after 2½ years on dialysis, I very fortunately was blessed with a kidney transplant. Before I was placed on the waiting list, I had to pass a very detailed physical exam, which included blood tests, a TB test, a hepatitis test, an AIDS test, an EKG, a stress test, a heart catheterization, a chest X-ray and other cancer tests. The Hospital Transplant Board reviewed my case and I was approved. If it had not said yes, there would have been no transplant.

The point is, organs are rationed and there is a long waiting list. I know the process for deciding who gets an organ varies by organ type, but I am surprised that a patient who had progressive cancer for three years with a bone marrow transplant less than a month before her death would be the best candidate for an organ. No wonder it was viewed as experimental.

Yes, CIGNA caved at the last minute under extreme public pressure, press coverage and a lurking tort bar. But that cannot be the way medical decisions are made.

HAROLD G. JACOBSON
Houston
----------------
In fairness to CIGNA
Perhaps the Chronicle could move past highlighting this one incident of denying a liver transplant to promote universal health giveaway and research just how many other life-saving medical decisions CIGNA has made over, say, the past year.

What the editorial board presented is hardly representative or fair, and is less than ethical journalism.

EDWARD A. ROSS JR.
Spring
--------------------
Universal limits

In Tuesday's editorial "Heartless," it was suggested that universal health coverage would have prevented the tragic death of a 17-year-old Californian with leukemia who was denied payment for a liver transplant by her insurance company.

There is a difference between universal health coverage and unlimited amounts of money for medical care. Medicare, the "universal health care" for seniors, often denies procedures, as it has a budget that calls for the government to act as the insurance company that will often deny authorization for payment.

Universal health care for all citizens or citizens of a specific state will also have budgetary limitations. Cases such as this might or might not get approval for payment.

W.K. GREENE
League City
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http://www.chron.com/disp/story.mpl/editorial/outlook/5407700.html