The insurer had initially refused to pay: A liver transplant lawsuit

Nataline Sarkisyan was a very sick teenager. She had been diagnosed at 14 with leukemia. Her cancer went into remission after two years of chemotherapy, but it returned last summer.

The day before Thanksgiving, she received a bone marrow transplant from her brother. Unfortunately, a complication caused her liver to fail.

Her parents asked CIGNA, their insurer, to authorize a liver transplant. CIGNA initially refused to pay for it, saying it did not cover experimental or unproven treatments.

Four doctors at UCLA submitted a letter to CIGNA on December 11 that urged the insurer to reconsider, saying that in Nataline's case the liver transplant would be neither experimental nor unproven. They cited the survival rate in such cases.

The University of California at Los Angeles Medical Center told the family on Dec. 14 that a liver was available, if the family could pay a down payment of $75,000, in view of CIGNA's denial of authorization. The family couldn’t afford it.

On Thursday, Dec. 20, following a rally by 150 nurses and community members outside its office in suburban Los Angeles, CIGNA changed its decision. But it was too late; Nataline died a few hours later.

Nataline's father has retained a lawyer, Mark Geragos, to bring a lawsuit against the insurer, asserting the initial refusal of the liver transplant contributed to Nataline's death.

Advice: Check the customer satisfaction ranking of your insurer, and switch if their rankings are low.

Browse for related stories in the index at the very bottom of this page, or read a story about the affordability of a liver transplant.

Thanks to Alicia Chang for the source article in today's Boston Globe.

I never even had the symptoms of a stroke: Wrong information in patient charts

Dr. Richard Botney is a 52-year-old anesthesiologist who works at Oregon Health and Science University. Several years ago, he visited a specialist to check out a bothersome lump in his cheek. He took some medicine, and the problem went away.

Out of curiosity, he thumbed through his chart and was surprised to find a comment from the doctor saying he had a stroke.

"I never even had the symptoms of a stroke. No visual changes, no weakness, no numbness, nothing," he said. He flagged the mistake to his specialist, but didn't pursue it, as the error hasn't affected his insurance or disability coverage.

At the Serma web site for physicians, at least two other doctors wrote about times when they had noticed wrong information in their own charts when they themselves had been patients. The chart of one doctor with multiple sclerosis incorrectly said he had multiple brain tumors, which caused him trouble in getting reimbursement from his insurer for the necessary medications. A second doctor who had had several operations was shocked to see the results of physical exams and other tests that had never been performed; presumably they pertained to a different patient.

Whatever their causes, these errors are often hard to correct. Like a resilient weed, they resist permanent removal. The reason: Later "progress notes" by a doctor can refer back to an earlier one. In today’s electronic era, a doctor can cut and paste an incorrect comment into another progress note, so even if one is removed, another remains to spawn more in the future. Patient, Beware!

Advice: Ask to see your chart, and make sure the information is accurate.

Browse among related stories, indexed at the very bottom of this page, or read a more serious wrong patient error story.

Thanks to Alicia Chang for the source article in the Nov. 23 issue of the Atlanta Journal-Constitution.