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Family Blames HMO For Teen's Death

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  • Family Blames HMO For Teen's Death

    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."
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