First Jury Award Issued Under Texas Patients’ Rights Law
A Dallas County jury last Friday ordered Cigna Healthcare of Texas to pay $13 million in damages to the family of a Texas man who died after the HMO "forced him out" of a skilled nursing facility, marking the first jury award allowed under the state's patients' rights law, the Ft. Worth Star-Telegram reports (Banstetter, Ft. Worth Star-Telegram, 6/29). The case involved Herschel Pybas, a member of Cigna's Medicare+Choice plan, who was admitted to a skilled nursing facility in December 1998. Pybas had congestive heart failure and renal failure and a history of stroke, anemia, upper respiratory infection and malnutrition (Elliott, Houston Chronicle, 6/29). According to the lawsuit, Pybas was "forced out" of the facility in less than one month, despite his physician's request that he remain there. Cigna indicated that it would provide nursing care for Pybas at home, but Pybas was released before the home care was ready (Ft. Worth Star-Telegram, 6/29). One day after being released, Pybas was taken to the hospital in "grave condition," and died five days later. Evidence in the case indicated that Cigna officials never reviewed Pybas' medical records before deciding he should be released from the facility, according to George Young, the Pybas' attorney. In 1997, Texas passed the first-in-the-nation law allowing patients to sue their HMOs if they are denied medical care. Young said that about 20 to 30 cases have been filed under the law, with several having been settled out of court. The only other case to go to trial ended in a victory for the HMO. Cigna is considering an appeal in the case according to spokesperson David Feng (Houston Chronicle, 6/29).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.