CIGNA: Will Pay $3 Million In Negligence Suit
An Arizona County Superior Court jury ruled against CIGNA HealthCare of Arizona Monday in a $3 million decision that "makes managed care companies more accountable for the actions of physicians they contract with." The Arizona Republic reports that the case involved a Phoenix woman who contended CIGNA was responsible for delayed diagnosis of a spinal infection that led to her permanent disability. Kara Wilson twice sought care at a CIGNA urgent care center for back pain and was told it was "back strain or sprain." She then went to her CIGNA primary care provider, who eventually referred her to a physical therapist. It was not until some time later, when "Wilson couldn't walk" and was taken to the emergency room, that "CIGNA approved her referral to a specialist, who immediately ordered an MRI, which showed Wilson had an infection in her spinal cord." It took another two weeks for the infection to be properly diagnosed as E. coli. Despite a year-long course of antibiotics, "radical fusion surgery to remove a portion of her damaged spinal cord" and four years of rehabilitation at the Mayo Clinic, Wilson is 37% disabled and in chronic pain, according to Pat McGroder, her lawyer.
Third Party Obligation
"The jury assigned 75% of responsibility for Wilson's problems to CIGNA; 10% to Dr. Michael J. Brennan, an orthopedic surgeon who performed surgery on Wilson's back; and 15% to Wilson for not being persistent in demanding care." McGroder said, "The question is, are HMOs responsible for the physicians they represent as qualified and that they send their members (to) without any choice?" CIGNA officials said they will appeal the decision. In a prepared statement, the insurer said: "CIGNA HealthCare of Arizona supports the care provided by its doctors and does not feel the medical evidence supports this verdict" (Snyder, 4/15).