HMO Must Pay $28M For Delaying MRI That Could Have Saved Cancer Patient’s Leg

Back in 2009, a then 17-year-old woman in California visited a Kaiser Permanente office because she was experiencing strange back pain. In the months that followed, she and her mother say they repeatedly requested an MRI but Kaiser doctors would only tell her to lose weight or get acupuncture treatments. All the while, a cancerous tumor was growing that would eventually result in the surgical removal of her right leg, and parts of her pelvis and spine. Believing Kaiser could have caught the cancer earlier if it hadn’t delayed the MRI, a jury has awarded the patient $28 million in damages.

Kaiser operates as both care provider and insurer, with Kaiser doctors treating patients at Kaiser clinics and hospitals. Some have argued that while this may be good for Kaiser’s business, it’s not necessarily good for the patients to have their HMO actually employing their physicians.

The patient in this case alleged that Kaiser was looking out for its bottom line and not looking out for her when doctors refused her and her mother’s requests for an expensive MRI, but instead directed them to nutritionists and acupuncturists.

This didn’t make much sense to the 5’4″, 125 lb. teen, who had a hard time believing that her severe lower back pain could somehow be attributed to her physique.

“I just felt really hopeless and I didn’t understand why they wouldn’t do the test,” she tells the L.A. Times. “[The MRI] was an option, people get them every day, and for some reason I was left out.”

After three months, Kaiser relented and agreed to the MRI, which found the rapidly growing tumor and led to the surgery that took her right leg.

“If it were caught earlier, her limb could have been salvaged,” the patient’s attorney claims.

Kaiser maintains that its doctors did nothing wrong and that an earlier MRI would not have changed the outcome.

“[H]ighly respected medical experts testified that the medical care provided was appropriate,” a rep for company tells the Times. “We will be evaluating in the days ahead how best to respond to this verdict.”