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Calif. teen's family sues Cigna over transplant



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No. 10
from Ludlow
Old Dec 31, 2008, 01:27 AM

Default Re: Calif. teen's family sues Cigna over transplant
Originally Posted by Straydandelion View Post
A lot of information on the web about HMO's now and quite a bit negative.. http://www.makingakilling.org/chapter1.html .. some seem to go so far as to dictate the treatment options a doctor can discuss with their patients. IMO this is very sad.
Dr. Linda Peeno, mentioned in Making a Killing, was also featured in SiCKO. She is one of my heroes too for exposing the dastardly things medical insurers do. They really are of no value in our health care system. We need to get rid of them and put the billions of dollars they suck out of the system back into the actual care of actual patients. We need HR 676: privately delivered, publicly funded health care for all.
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No. 11
Old Dec 31, 2008, 10:22 AM

Default Re: Calif. teen's family sues Cigna over transplant
I read the full article and it said that the petition made by the doctors stated patients had a 65% chance of living 6 months. Her doctors, not the insurance co. I'm wondering if the additional 6 months was to buy them more time to repeat the bone marrow donation or try different treatments. Otherwise, it does sound just like it would delay the inevitable. I am wondering how much quality of life she would have had. If you think I am judging, though, I am not, because I have lost a child and now also work in hospice. So while I can grieve for her parents, I am wondering if Tired MD had a point in 'saying it was a waste of resources.' In comparison to someone who could've lived much longer with the liver I mean. Don't get me wrong, I despise insurance companies!
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No. 12
from TiredMD
Old Dec 31, 2008, 02:32 PM

Default Re: Calif. teen's family sues Cigna over transplant
Originally Posted by Ludlow View Post
Given that HER physicians who actually examined her and knew all the circumstances of her case said she qualified for the transplant, I don't get why you think you can call the case. Or are you like Bill Frist who can diagnose Terry Schiavo's brain health after viewing her in edited video? And please recall he was 100% wrong.
Senatory Frist was foolish, and most physicians had a hearty laugh at his "diagnosis". But that's beside the point and you clearly only brought it up in an attempt to discredit me. Good try.

But in answer to your question: Here is what her own attorneys and doctors said:

- she was diagnosed with leukemia, had a BMT, and had cancer recurrence
- she developed acute liver failure as a consequence of her treatment
- she fell into a "vegetative state" prior to being considered for a transplant
- she had a 65% chance of living 6 months, if she survived the transplant

That's from the family's attorneys.

And that's not even bringing up the fact that anti-rejection drugs likely could have worsened her leukemia.

There is a profound shortage of organs in this country. Giving a precious liver to a cancer-ridden child with a coin-flip's chance of living half a year is irresponsible and a waste.

I'm greatful she didn't get that liver. And I'm sure the family of the person who did is as well.
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No. 13
from herring_RN
Old Dec 31, 2008, 02:51 PM

Default Re: Calif. teen's family sues Cigna over transplant
I heard her mother and brother (on TV) say that she was alert when the physicians recommended a liver transplant She said she was looking forward to Christmas.

Insurer's U-turn too late to save life of transplant teenager

...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....

http://www.guardian.co.uk/world/2007....international
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No. 14
Old Dec 31, 2008, 03:19 PM

Default Re: Calif. teen's family sues Cigna over transplant
Originally Posted by TiredMD View Post
Senatory Frist was foolish, and most physicians had a hearty laugh at his "diagnosis". But that's beside the point and you clearly only brought it up in an attempt to discredit me. Good try.

But in answer to your question: Here is what her own attorneys and doctors said:

- she was diagnosed with leukemia, had a BMT, and had cancer recurrence
- she developed acute liver failure as a consequence of her treatment
- she fell into a "vegetative state" prior to being considered for a transplant
- she had a 65% chance of living 6 months, if she survived the transplant

That's from the family's attorneys.

And that's not even bringing up the fact that anti-rejection drugs likely could have worsened her leukemia.

There is a profound shortage of organs in this country. Giving a precious liver to a cancer-ridden child with a coin-flip's chance of living half a year is irresponsible and a waste.

I'm greatful she didn't get that liver. And I'm sure the family of the person who did is as well.
I think you brought up some great points, what was the point of the transplant? The insurance covered the BMT which cost hundreds of thousands of dollars, but at some point enough is enough. You wonder why your insurance cost so much!
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No. 15
Old Jan 01, 2009, 12:56 AM

Default Re: Calif. teen's family sues Cigna over transplant
I don't care about cost. I would rather be in poor than let a child that could live die. But there is a scarcity of organs available and many that need them. I do think that risk/life expectancy does have to play a part in the decision making process as to who gets what. I know without a doubt that the 6 months that the liver may have bought her would've been treasured by her parents and I truly grieve for them. It is hideous to lose a child. But if someone else could get 6 years from that same liver, I have to say my answer was clear. (Plus tired MD did bring up a good point about the unfortunate fact that the anti= rejection drugs could play havoc with her leukemia.) I'll keep them in my prayers.
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No. 16
from TiredMD
Old Jan 01, 2009, 01:13 AM

Default Re: Calif. teen's family sues Cigna over transplant
Originally Posted by withasmilelpn View Post
I don't care about cost.
I do.

Everyday in this country people are clamoring over the the increasing cost of health care. 47mil Americans who can't afford insurance (actually it's more like 7mil, the AMA is kind of lying about the numbers, but whatever). People utilizing the ER because they don't have a primary care doc. People going bankrupt due to high copays and hospital bills.

Then at the same time we turn around and expect insurance companies to spend hundreds of thousands of dollars on a transplant patient who already had a BMT and suffered a recurrence. Do people think insurance money magically grows on trees? Doesn't anyone recognize that the money paid out by the CIGNA gets recouped through premiums on everyone else? It's easy to get all choked up over the dying teenager, but that's because nobody gets to see the poor suckers going broke from medical bills who aren't photogenic enough to rate a protest by the nursing unions.

I recognize that the girl's parents would have paid any amount of money to get a couple more months with their daughter. But they weren't paying, you and I were. And at some point, somebody has to wipe away the stink of mindless emotion and say enough is enough.

Sometimes good people get sick, and sometimes kids die. Throwing scarce money and usable organs after a failed cause doesn't do anybody any good.
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No. 17
Old Jan 01, 2009, 07:38 PM

Default Re: Calif. teen's family sues Cigna over transplant
Originally Posted by TiredMD View Post
I do.

Everyday in this country people are clamoring over the the increasing cost of health care. 47mil Americans who can't afford insurance (actually it's more like 7mil, the AMA is kind of lying about the numbers, but whatever). People utilizing the ER because they don't have a primary care doc. People going bankrupt due to high copays and hospital bills.

Then at the same time we turn around and expect insurance companies to spend hundreds of thousands of dollars on a transplant patient who already had a BMT and suffered a recurrence. Do people think insurance money magically grows on trees? Doesn't anyone recognize that the money paid out by the CIGNA gets recouped through premiums on everyone else? It's easy to get all choked up over the dying teenager, but that's because nobody gets to see the poor suckers going broke from medical bills who aren't photogenic enough to rate a protest by the nursing unions.

I recognize that the girl's parents would have paid any amount of money to get a couple more months with their daughter. But they weren't paying, you and I were. And at some point, somebody has to wipe away the stink of mindless emotion and say enough is enough.

Sometimes good people get sick, and sometimes kids die. Throwing scarce money and usable organs after a failed cause doesn't do anybody any good.
So, would you do any transplants? I agree that health care does require rationing, but the main determination should be quality of life and success rates in my mind. I've already said that I think you are right, the poor girl probably would not been a good candidate.
What about those who are? I took care of a woman who had a kidney transplant, she lived 11+ years with it and had an active, productive life.
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No. 18
Old Jan 01, 2009, 08:03 PM

Default Re: Calif. teen's family sues Cigna over transplant
I was all for the family suing Cigna until I read the article. Now, I am torn.
I do not think it was right for Cigna to deny the liver transplant because they think it's "experimental." I also don't think insurance companies should have the right to decide the patients care. That is what doctors are for.
However, I agree with others who have said that she was not a good candidate for a new liver. It seems like they were just trying to buy more time for her but ultimately, there was not much more they could do. They might have been taking a liver from someone who has been waiting much longer and could have had a longer life of better quality.
Then again, if it were my family member, I'm sure I would feel completely different.
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No. 19
from toady83
Old Jan 01, 2009, 08:57 PM

Default Re: Calif. teen's family sues Cigna over transplant
Live donor kidney transplants have a 10% rejection rate, while cadaver are around 30%. Liver transplants have a higher rejection rate of about 50 - 60%. While it is not considered experimental, researchers are trying to get that rejection rate down. Liver transplants are more difficult to perform than kidney transplant. There are alot of factors to be considered with transplants.
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