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Bereaved family to sue insurer after dispute over liver transplant
Approval came too late for teen
By Alicia Chang, Associated Press | December 22, 2007
LOS ANGELES - The family of a 17-year-old leukemia patient said yesterday it would sue Cigna Corp. over her death, asserting the health insurance company's initial refusal to pay for a liver transplant contributed to her death.
"They took my daughter away from me," said Nataline Sarkisyan's father, Krikor, with tears in his eyes at a news conference at his lawyer's office.
The Philadelphia-based insurer had initially refused to pay for the procedure, saying it was experimental. The company reversed the decision Thursday as about 150 nurses and community members rallied outside of its office in Glendale in suburban Los Angeles. Nataline died just hours later.
The insurer "maliciously killed" Nataline because it did not want to bear the expense of her transplant and aftercare, said family lawyer Mark Geragos. He did not say when or in what court he would file the civil lawsuit.
Geragos also said he would ask the district attorney's office to press murder or manslaughter charges against Cigna, an allegation that one legal expert described as difficult to prove.
A spokeswoman for the district attorney declined to comment, saying it would be inappropriate to do so until Geragos submits evidence supporting his request.
The family's "loss is immeasurable, and our thoughts and prayers are with them," Cigna said in a news release yesterday. "We deeply hope that the outpouring of concern, care and love that are being expressed for Nataline's family help them at this time."
Nataline was diagnosed with leukemia at 14. Her cancer went into remission after two years of chemotherapy treatment but it returned last summer.
She received a bone marrow transplant from her brother the day before Thanksgiving but later developed a complication that caused her liver to fail. She was in a vegetative state for some time, her mother Hilda said.
Nataline was taken off life support at the University of California, Los Angeles Medical Center on Thursday, her mother said. The teen died within the hour.
In a Dec. 11 letter to Cigna, four doctors had appealed to the insurer to reconsider. They said patients in similar situations who undergo transplants have a six-month survival rate of about 65 percent.
The letter sent by the UCLA doctors questioned the company's explanation that it does not cover experimental or unproven treatments, saying Nataline's case was neither.
One of Nataline's doctors, Robert Venick, declined to comment on her case. UCLA Medical Center staff refused to make her other doctors available for comment.
Despite the reversal of its decision, Cigna said in an e-mail statement before she died that there was a lack of medical evidence showing the transplant would work in Nataline's case.
The case raised the question in medical circles of whether a liver transplant is a viable option for a leukemia patient because of the immune-system-suppressing medication such patients must take to prevent organ rejection. Such medication, while preserving the transplanted liver, could make the cancer worse.
Transplantation is not an option for leukemia patients because the immunosuppressant drugs "tend to increase the risk and growth of any tumors," said Dr. Stuart Knechtle, who heads the liver transplant program at the University of Wisconsin at Madison and was not commenting specifically on Nataline's case.
The procedure "would be futile," he said.
The hospital told Nataline's family on Dec. 14 that a healthy liver was available, but that without Cigna's authorization, the family would have to make a down payment of $75,000, an amount the family could not afford.
The California Nurses Association organized the rally Thursday outside the insurer's offices in Glendale.
Rose Ann DeMoro, executive director of the nurses group, said in a statement that the outcome was "a horrific tragedy that demonstrates what is so fundamentally wrong with our health care system today."
"Insurance companies have a stranglehold on our health," she said. "Their first priority is to make profits for their shareholders - and the way they do that is by denying care."
"Every politician who thinks the answer to our healthcare crisis is more insurance should stop and think about Nataline Sarkisyan," DeMoro said. "Insurance is not care. Paying for insurance coverage is not the same as assuring you will receive appropriate care, even when recommended by a physician as it was for Nataline."
