Cigna Corporation Refused To Pay. The decision of Cigna Corporation to deny coverage for a teenage girl’s liver transplant likely killed her. The family of Nataline Sarkisyan, a 17-year old leukemia patient, blamed Cigna on Friday for her death, saying 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’s father, Krikor, at a news conference at his lawyer’s office. Apparently, the Philadelphia-based insurer had initially refused to pay for the procedure, saying it was experimental; however, the company reversed its decision on Thursday when approximately 150 nurses and community members rallied outside of its office in Los Angeles’s suburban Glendale. Cigna’s change of decision came too late and Nataline died hours later.

According to family attorney Marl Geagos, Cigna “maliciously killed” Nataline because it did not want to bear the expense of her transplant and aftercare. Geagos did not say when or in what court he would file the civil lawsuit, but 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 and “a little bit of grandstanding.” 

A district attorney’s office spokeswoman 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 Friday. “We deeply hope that the outpouring of concern, care, and love that are being expressed for Nataline’s family help them at this time.”

She Later Developed a Complication.

Nataline was diagnosed with leukemia at age 14 and received a bone marrow transplant from her brother the day before Thanksgiving. She later developed a complication that caused her liver to fail and fell into 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 and died within the hour.

In a December 11th letter to Cigna, four doctors had appealed to the insurer to reconsider saying that patients in similar situations who undergo transplants have a six-month survival rate of about 65%. The case raised the question among at least one medical expert over whether a liver transplant is a viable option for a leukemia patient because of the immune-system-suppressing medication patients must take to prevent organ rejection. The conflict with the medications is that while they preserve the transplanted liver, they could worsen the cancer. Also, transplantation is not an option for leukemia patients because the immunosuppressant drugs the patient is required to take following organ transplant “tend to increase the risk and growth of any tumors,” said Dr. Stuart Knechtle. Knechtle 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.

Geragos’ attempt to get the district attorney to press murder and manslaughter charges against Cigna would be difficult to prove unless the defense can show that the company somehow intentionally caused Nataline’s death, said Rebecca Lonergan, a law professor at the University of Southern California.

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