Insurer’s U-turn too late to save life of transplant teenager
· Lawyer wants company to be charged with murder
· Death inflames debate over US healthcare system
Ed Pilkington in New York
Saturday December 22, 2007
The Guardian
The family of a California teenager plan to sue her health insurer
which refused to pay for a liver transplant until hours before and she
died on Thursday night.
Her family’s lawyer, Mark Geragos, will ask the Los Angeles district
attorney to press murder or manslaughter charges against Cigna
HealthCare, arguing that the firm "maliciously killed" Nataline
Sarkisyan by its reluctance to pay for her treatment. The company
reversed its stance after protesters called for a rethink, but the
decision came too late.
The 17-year-old from Glendale, California, had been in a coma for weeks
after complications following a bone marrow transplant to counter
leukaemia.
After the operation, her liver failed and doctors referred her for an
emergency transplant. Although she was fully insured and had a matching
donor, Cigna refused to pay on the grounds that her healthcare plan
"does not cover experimental, investigational and unproven services".
Cigna’s rejection on December 11 led Sarkisyan’s doctors at UCLA
medical centre, including the head of its transplant unit, to write a
letter to protest that the treatment which they proposed was neither
experimental nor unproven. They called on the firm to urgently review
its decision.
In the absence of a response from Cigna, doctors told the Sarkisyan
family that the only alternative would be for the family to pay. But
they could not afford the immediate down payment of $75,000 (£38,000).
The family, backed by nurses, relatives and Sarkisyan’s friends,
mounted a protest of 150 people outside Cigna’s Glendale offices.
"Cigna cannot decide who is going to live and who is going to die," the
teenager’s mother, Hilda Sarkisyan, told the crowd.
The demo was amplified by an internet campaign orchestrated by the
liberal Daily Kos website and other blogs that bombarded Cigna’s HQ in
Philadephia. In the middle of the rally, a note was handed to Mrs
Sarkisyan saying that Cigna had decided to reverse its decision.
"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," it said in a statement.
The news drew cheers from the crowd, but they quickly grew sombre when
they heard Sarkisyan’s condition had deteriorated. A few hours later,
her life support was switched off.
"She passed away, and the insurance [company] is responsible for this,"
Mrs Sarkisyan told the Los Angeles Daily News.
"Why did it take public humiliation for a multibillion-dollar insurance
company to force them to provide appropriate medical care?" asked
Charles Idelson of the California Nurses Association.
"This is what’s wrong with our health system – insurers decide
treatment, not doctors."
The protests over Sarkisyan’s case point to growing public
disenchantment with the healthcare system in America.
Politicians vying to be the Democratic candidate for the presidential
race next year have prepared plans for reform to bring the 47 million
uninsured Americans into the healthcare net, and to improve terms for
those already insured like Sarkisyan.
The subject was given an added boost this summer by Michael Moore’s
documentary on the state of the American health service, Sicko.
Moore refers to the case of Sarkisyan on his website, under the simple
banner: "Justice delayed is justice denied."
Following the teenager’s death, Cigna issued another statement
yesterday.
"Their loss is immeasurable, and our thoughts and prayers are with
them," it said. "We deeply hope that the outpouring of concern, care
and love that are being expressed for Nataline’s family help them at
this time."
The company recently posted figures for its third-quarter performance
this year, which showed profits up 22%. Next year it expects to earn an
income of up to $1.2bn.