FAMILY BLAMES HMO FOR TEEN’S DEATH
Los Angeles Times, CA
Dec 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.
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."