The lawyer for the family whose daughter died after CIGNA declined to pay for her liver transplant said that he will urge the DA’s office to press manslaughter charges against CIGNA for having “maliciously killed her.” [AP]

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  1. Pinget says:

    Good. Glad to hear it.

  2. erratapage says:

    I’ll be interested to see if the DA goes for it. It sounds awfully “Law & Order” to me.

  3. paleck says:

    @erratapage: Next year I’m(assuming the Writer’s Guild strike ends eventually) sure we’ll see a Law & Order episode on it!

  4. LiC says:

    They refused to pay for an operation the hospital wouldn’t perform without the money upfront? Why did they wait for insurance money, if she’s gonna die why didn’t the hospital perform the operation? Why isn’t he suing the hospital?

  5. Eric says:

    I think the people who denied a life saving operation should go to prison.

  6. mopar_man says:

    Not that a bunch of money will bring the daughter back but hopefully it’ll make those idiots at CIGNA think again about denying somebody coverage. Will CIGNA be in the running for worst company in the US next year? Time will tell.

  7. canerican says:

    Ummm, I think that CIGNA deserves a big fat lawsuit and to lose lots of money, but be reasonable. The DA has to act in accordance with the law, wrongful death maybe, negligent homicide, maybe, manslaughter, absolutely not.

    I won’t jump to a conclusion. It’s easy to blame CIGNA, but can we be rational and wait to hear both sides? Perhaps we are missing something, I doubt CIGNA is right, but they deserve a rebuttal.

  8. r4__ says:

    As someone who’s also covered by them:
    God, I hate CIGNA. Every interaction with them is just ridiculous, plus apparently the plan I’m enrolled in due to my father doesn’t actually have any doctors, hospitals, or physical therapy centers within two hours’ driving distance.

  9. bohemian says:

    Wrongful death, sue the pants off of them. Money is the only thing that matters to insurance companies.

  10. JiminyChristmas says:

    This is the part that gets me:

    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.

    You have a group of doctors asserting that their patient needs a transplant. I’m assuming that the doctors wouldn’t recommend a procedure that was likely to be futile. So, how in the world does an insurance company have the standing to second guess their judgment?

    Likewise, in what world is a liver transplant an experimental treatment? The linked article states that patients in this girl’s situation have a 65% survival rate after a transplant. Insurance routinely covers chemo for cancer patients whose chance of long-term survival doesn’t come anywhere close to that.

  11. ChrisC1234 says:

    I don’t think they should go after Cigna, they should go after the @$$hats who actually wouldn’t approve the surgery. I’ll give them the benefit of the doubt and assume that the first rejection was an automated computer-driven response. Once they started appealing the thing though, it’s people who have become useless “parts” of the system, which are part of the problem. Go after all of the people who didn’t want to do something because it’s someone else’s problem.

  12. Boberto says:

    The liver transplant was indicated because she was very likely in the process of end of life multi organ failure.

    Should the Insurance Company be held criminally liable? Abso-F***ing-lutely.

    Will they? Probably not. I think that the medical facility is on par with the insurer in terms of liability.

    Why couldn’t they have just did the transplant, and then fight over the reimbursement later?

    I do really like the prospect of jail time for these Guys. They talk about jail time because ERISA exempts the insurance company from any financial liability.

    Oops! That’s not quite right. Cigna’s liability WOULD have been the cost of the transplant and aftercare, if they had decided to go through with it without an authorization.

    Our Government enacted ERISA legislation in order to protect employer sponsored pensions from going belly up in the event of a lawsuit (and we all know how great that worked).
    The courts later extended those protections under ERISA to HMO’s.

    So perhaps we may see an HMO executive standing trial or perhaps even in jail.

    Perhaps then we may find the healthcare lobbyists on K street not quite so enthusiasticly opposed to ERISA or even healthcare reform.

  13. UpsetPanda says:

    I’m not sure how this is malicious…I mean, doesn’t malice imply that someone cared in the first place?

  14. humphrmi says:

    FYI the family is being represented by Mark Geragos. This is the guy who defended Scott Peterson (which I guess didn’t turn out well, depending on your perspective) but also some high profile cases like Michael Jackson and Winona Ryder.

    Good to hear that they didn’t get some fly-by-night lawyer. They’re going to need him.

  15. DoctorMD says:

    Wait I thought consumerists all wanted affordable health insurance? Just so you know that procedure would not have even been considered under socialized medicine.

  16. Buran says:

    @ChrisC1234: The individuals are acting on the behalf of their employer. Hence, the employer is the right one to sue.

  17. burgundyyears says:

    Ahh, yes, Mark Geragos, the defender of the rich and white. At least this will bounce around the headlines ad nauseum now. ugh.

  18. squikysquiken says:

    Of course the doctors said she needed the operation. Good case of CYA, maybe they figured the family was sue-happy so it was easier to pass the bucket. Doctors have zero incentive to be the ones saying: “I am sorry, but there is nothing meaningful we can do at this point.”. They don’t want to get sued, and they stand to get paid more for trying one more procedure.

    I am sorry for the family’s loss; but it is not because we can do something that we should. And since I don’t know all the story, I’d abstain to comment on whether Cigna was right but I can sure see their point of view. Why should everybody else pay for a (expensive) procedure that has little if no chances of helping. She was in a vegetative state, her health declining really fast. Health care is a limited resource and at some point, it is better to let go.

    What makes me so mad is that this family will never be able to grieve properly. The media, lawyers and attention will just keep this sad story around them forever. They will never give up this fight because they will never be able to grieve and move on. Nobody will convinced me that those lawyers are not in for the money too, they don’t care about any of that; they see an opportunity to blackmail Cigna with bad PR. Insurances are not white knights and by far, but it doesn’t make the family and the lawyers anymore right.

  19. JiminyChristmas says:

    @doctormd: The procedure would have been even less likely to happen if she didn’t have insurance at all, as is the case with 47 million Americans.

    As for ‘affordable’ health insurance: no matter what it costs, what good is it when the insurer delays or denies coverage for treatment your doctor recommends?

  20. speedwell (propagandist and secular snarkist) says:

    “… Mark Geragos, the defender of the rich and white…”

    Riiight, because a deathly ill immigrant teenager is soooo engaged in oppressing the poor and nonwhite. Power to the people, man.

  21. LionelEHutz says:

    Too bad State AG’s never give corporations the death penalty.

  22. marsneedsrabbits says:

    Stupid doctors, thinking they know everything, requesting services and care for their patients without being able to guarantee 100% & beyond a shadow of a doubt that everything will turn out fine.
    Who are they to second guess the insurance company?

  23. TangDrinker says:

    My heart goes out to the family of this poor girl.

    One of my parents had a liver transplant (due to Hep C infection obtained while working at a mental hospital in the 1980s). That parent had to be screened on a constant basis for any sign of cancer – if cancer was found, the transplant would not go ahead, mainly for the reasons listed in this article (immuno-suppressant meds needed for the transplant would make the cancer worse). Transplant went through, parent is healthy (well, still has hep c, but otherwise, is completely healthy…)

    I’m not sticking up for the insurance company, I’m just sayin’ what happened in our family.

    Oh, and every one PLEASE sign up to donate your organs – and tell your family members of your wishes. Please.

  24. humphrmi says:

    @burgundyyears: Depends on if you consider Michael Jackson white or not ;-)

  25. tk427 says:

    @SQUIKYSQUIKEN: you mentioned that she was in a vegetative state

    In one article the mother stated that Natalie was in a “vegetative state” and in another that she was “unresponsive in intensive care” for three weeks before she died on the 21st. IANAD but there is a big difference between the two.

    vegetative = loss of cognitive function
    unresponsive = not responding to treatment

    I doubt if she had no brain activity or was beyond hope when four doctors agreed that she needed a transplant on the 11th.

  26. Kevin Cotter says:

    My wife, a physician, used to work in a heavily Cigna covered community. She explained to me how fast Cigna would send a representative when somebody was in a coma – to recommend pulling the plug to save money. These were commonly comas that the patient would recover in a few days, but Cigna would sometime beat the family to the hospital and start demanding termination of any life support. Cigna kills!


    Kevin
    [investnaked.googlepages.com]
    [velcroman98.googlepages.com]

  27. somecop says:

    @Kevin Cotter: What plug is there to pull when one is in a coma?

  28. ne0shell says:

    too bad she wasn’t an illegal alien. She would’ve gotten the operation for free and no wait to boot.

  29. Boberto says:

    @TangDrinker: I can’t speak with any experience to Liver transplants and hepatitis infections, but I can tell you that in New York, inmates held under the department of corrections routinely receive kidney transplants. Of those renal transplant candidates with Hepatitis C infection, they spend far less time on the waiting list. They are transplanted much faster than those without the hep c infection because the (hep c cadaveric) organs would otherwise go to waste.

    Go to jail, get an organ on the State’s tab. Only in New York.

  30. Boberto says:

    @doctormd: What is the difference in the qualifying criteria set for organ transplant? And in what Countries are you talking about? UK? Sweden? France? Canada? Give me some facts here.

    BTW-Go sign up at lifesharers dot commmmmmm
    A simple premise there. You sign up, if you die first, your organs go to a member on THAT list. If you need an organ while a member, you get an organ from that same list. Six month wait after signing up before you can get on the list, regardless of acuity or co-morbidity.
    Self, Wife and all Children are members.

  31. KogeLiz says:

    Why didn’t they just do the transplant anyway?

    Also, if someone i knew was waiting for a liver transplant and a person in a ‘vegetative state’ got the transplant before them, i might be kinda pissed.

  32. Keter says:

    1. [snarky] We should follow China’s lead and just execute the executives.

    2. [not snarky] Those of you who think socialized medicine is a good idea need to read the BBC news site regularly…it is full of horror stories in which people die on waiting lists or are denied needed care when unqualified pencil-pushers overrule doctors. It’s so bad that good doctors do not stay in Britain…the doctors there are imported from third-world countries and often have inadequate educations.

  33. RvLeshrac says:

    @doctormd:

    From what I can see, organ transplants are covered by several (if not all) of Canada’s provincial health services, and by the UK NHS.

    The information is tough to find, though.

    They obviously don’t cover *all* transplants – patients with inoperable tumors, mid-to-late stage cancers, or other terminal illnesses are always at the bottom of the list as far as organ donation goes, as are some specific cases (alcoholics don’t get liver transplants).

    Where did you get your information from?

  34. RvLeshrac says:

    @RvLeshrac:
    ‘donation’ should read ‘transplant’

  35. RvLeshrac says:

    @RvLeshrac:
    (and they obviously aren’t going to cover, say, a face transplant, so don’t bring it up)

  36. SuffolkHouse says:

    The people who whine about “socialized medicine” never couple their complaints with solutions to the problems.

    These healthcare outfits are just plain evil. I would like to know how to give money to this man’s legal efforts.

  37. WraithSama says:

    I find it ironic that the insurance company stands to lose more money in a forthcoming lawsuit than they would have shelled out to perform the procedure in the first place.

  38. Chongo says:

    I’m so torn on the issue of private vs. government health care. Is there any resource that breaks it down by advantage / disadvantage? One of the major disadvantages I can think of right off the bat would be that the government can’t even get the whole process for approving drugs right… and so many other bureaucratic problems with getting things done. Why would we want to trust our lives to a system that is so dysfunctional?

  39. b612markt says:

    WOW – this is really crazy. My head is spinning. I can only root for the guy who is suing because if I was in the position the girl was in – I’d want my insurance to NOT wait!

  40. speedwell (propagandist and secular snarkist) says:

    @boberto: Yes, definitely, LifeSharers is a must. That wasn’t brought home to me until two years after I joined, when I had to have my right kidney removed. My left kidney is fine… for now… but if it ever begins to fail, I will be glad of my membership. In exchange, my fellow LifeSharers members have first pick of whatever I have that can do anyone good after I’m gone.

  41. reykjavik says:

    This is ridiculous. Just kill the CEO. Nothing will make a company think twice about their actions than having their CEO’s picked off one by one. :)

  42. reykjavik says:

    To all the people saying they wouldn’t want a “government worker” deciding on their treatment is an idiot. Government workers are notorious for wasting money! If there ever is a person you want to decide whether you get treatment, its a guy who couldn’t care less about the bottom line and also can’t get fired! Trust me, you WANT a government worker deciding whether you get treatment.

    Its the people who get bonuses and have a steak in the bottom line that you don’t want making a decision. Because those guys get paid a bonus when you die young.

  43. HeHateMe says:

    I find it a little ironic that the same folks that talk about how horrible our govt is, at how incompetent, ignorant, incapable, and just plain bad the govt is, are the ones that are speaking out the loudest about wanting that very same govt to handle their health care. Hmmm… Guess it isn’t so bad after all. Is it? Hehe

  44. squikysquiken says:

    @tk427: From the article: “She was in a vegetative state for some time, her mother Hilda said.” This is more than unresponsive to treatment.

  45. RvLeshrac says:

    @HeHateMe:

    The government being horrible and a government agency handling health care are two different things.

    Nothing stops you from purchasing your own health insurance in any of the countries with socialized health care.

    Plenty of things stop the poor from being able to afford health insurance.

    My mother’s premium is $403/mo. When YOUR health insurance costs nearly $5,000/year, you can whine about the evils of socialized health care.

  46. tk427 says:

    SQUIKYSQUIKEN:
    True, the linked article referred to her being “in a vegetative state for some time”, in another (LA Times) article she was “unresponsive in intensive care for about three weeks”. I’m quoting the press here. I could not find a direct quote attributed to her mother. The only source I would trust to have all the facts is the request by the doctors who qualified Nataline for a transplant on Dec 6th.