Teen girl dies after her insurance company nixes transplant

SuzannePjam

Stories like this just burn me up. It's hard to believe insurance companies are still determining what medical procedures are necessary regardless of what the doctors feel the patient needs.

Teen dies after insurance nixes transplant
17-year-old girl needed new liver; company initially refused payment


GLENDALE, Calif. - A 17-year old died just hours after her health insurance company reversed its decision not to pay for a liver transplant that doctors said the girl needed.
Nataline Sarkisyan died at about 6 p.m. Thursday at University of California, Los Angeles Medical Center. She had been in a vegetative state for weeks, said her mother, Hilda.
"She passed away, and the insurance (company) is responsible for this," she said.
Nataline had been battling leukemia and received a bone marrow transplant from her brother. She developed a complication, however, that caused her liver to fail.
Doctors at UCLA determined she needed a transplant and sent a letter to CIGNA Healthcare on Dec. 11. The Philadelphia-based health insurance company denied payment for the transplant.
On Thursday, about 150 teenagers and nurses protested outside CIGNA's office in Glendale. As the protesters rallied, the company reversed its decision and said it would approve the transplant.
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."
Officials with CIGNA could not immediately be reached for comment Thursday night.

urbanhippie

I work for the NHS in the UK and sometimes the decisions made about who can and cannot receive treatment make me angry... :mad:

I think that in future I'll just be thankful that it's not left in the hands of insurance companies who's first thought is for their shareholders :(

Uncle Leo

Hey that's the market. It's too bad, but insurance companies don't make money paying for surgeries.

(Edit: Please recognize my sarcasm)

Jimmydean55

That is such bullshit. Fuckin insurance companies. Fuck em. Fuck em in the ass with a big rubber dick and break it off and beat em with the rest of it.

I feel so horrible for this girl and her family.

bobnkat

If I had kept the $7800.00 I've paid to BCBS over the past 3 years I would now have more than enough money to pay my current medical bills. I was diagnosed with hyperthyroidism 5 months ago. My endocrinologist more or less told the fuckers I would most likely die if I don't have most of my thyroid removed and their response was "sorry to hear that but there's nothing we can do at this time." I'm paying them 50.00 a week for nothing. They have no right to play GOD with my life just because it might affect their bottom line.
Regardless of what anybody thinks, I'm a living breathing human being, not just some member # on a sheet of paper.

I can understand how her family feels. You pay for something thinking it will be there when you need it & then you just get fucked over. I hope they sue the hell out of CIGNA. I hope if I die somebody will sue the fuckers I have so that my babies won't be left with a mountain of bills and no mother. I have life insurance but still....I'd like to be able to look down (or up) and see the BCBS president's head mounted over the fireplace...

Jimmydean55

bobnkat wrote:

If I had kept the $7800.00 I've paid to BCBS over the past 3 years I would now have more than enough money to pay my current medical bills. I was diagnosed with hyperthyroidism 5 months ago. My endocrinologist more or less told the fuckers I would most likely die if I don't have most of my thyroid removed and their response was "sorry to hear that but there's nothing we can do at this time."

Tell the doctor to do the surgery and tell them you will pay them in installments. And at the same time tell your insurance company to get fucked.

And although he might be quite the polarizing figure, go to michaelmoore.com and send in your story to him. It may help to get some action done. Also, call your insurance co and ask them to cover your bills and after they tell you no, tell them they'll be featured in michael moore's next movie. That actually worked for somebody.

Indian Summer

Why didn't the girls parents just say they would pay out of pocket, and go ahead with the transplant? Sounds like the mother didn't want to do the procedure if the insurance wasn't going to pay.

sponger

I'm no doctor, but I'm guessing a "vegatative state" is something beyond, say, a coma. I have no doubt that actuaries should not be making decisions for physicians, but I would like to think that someone would have the sense to put me down if I were to ever become vegetized.

Indian Summer

sponger wrote:

but I would like to think that someone would have the sense to put me down if I were to ever become vegetized.

NEVER "think" or "assume" that. That's what advance directives and living wills are for.

sponger

Indian Summer wrote:

NEVER "think" or "assume" that. That's what advance directives and living wills are for.

Never say never.

SundaySilence

Indian Summer wrote:

Why didn't the girls parents just say they would pay out of pocket, and go ahead with the transplant? Sounds like the mother didn't want to do the procedure if the insurance wasn't going to pay.

"In a Dec. 11 letter to CIGNA’s transplant department, four UCLA physicians said that Nataline “currently meets criteria to be listed as Status 1A” for a transplant and urged the company to “urgently re-review her case” and their denial. CIGNA said it denied the care 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.”

On Dec. 14, Hilda Sarkisyan was told by the hospital that a healthy liver was available, but because CIGNA had refused authorization, the family would have had to make an immediate down payment of $75,000 to proceed, an amount the family could not afford."

http://biz.yahoo.com/bw/071220/20071220006182.html?.v=1

sponger wrote:

I'm no doctor, but I'm guessing a "vegatative state" is something beyond, say, a coma. I have no doubt that actuaries should not be making decisions for physicians, but I would like to think that someone would have the sense to put me down if I were to ever become vegetized.

The family was forced to make the decision to take her off life support, and she later died.

http://abcnews.go.com/GMA/CancerPreventionAndTreatment/story?id=4038257&page=1

miskin

this should be the states responsability not private insurance companies. the american system sucks unbelievably.

everyone should have a right to free healthcare.

know1

It's not the insurance companies. It's the CONCEPT of insurance. Let's get rid of it....NOW!

sponger

miskin wrote:

this should be the states responsability not private insurance companies. the american system sucks unbelievably.

everyone should have a right to free healthcare.

Would you trust the government to make ethical decisions for your family?

Doctors....doctors should make medical decisions and no one else.