Los Angeles County Jury Finds Aetna Legally Responsible for Death of HMO Member
A Los Angeles County jury yesterday found that Aetna U.S. Healthcare of California "unreasonably withheld" care from an HMO member and is legally responsible for the member's death, the Los Angeles Times reports. The jury had planned to award Rosenburg's family $426,000 for economic damages and pain and suffering, but the two sides reached a settlement before deliberations ended; attorneys said that they "wanted to hear the jury's decision after the seven-week trial to gauge whether their arguments had resonated with jurors," the Times reports (Ornstein, Los Angeles Times, 11/15). In the case, the family of Murray Rosenburg, who died of cancer-related complications in 2000, alleged that Aetna prematurely discharged Rosenburg from a hospital and transferred him to a nursing home that did not provide adequate care. Rosenburg, who had multiple myeloma, a bone marrow cancer, received four chemotherapy treatments at a Los Angeles-area hospital and was transferred to a nursing home covered by Aetna's Medicare+Choice plan. After Rosenburg's condition worsened, he returned to the hospital and subsequently died of congestive heart failure. The lawsuit alleged that Rosenburg was discharged from the hospital by a physician who headed a medical group connected with Aetna and that the physician had a financial incentive to discharge patients early. The lawsuit also alleged that Rosenburg did not receive the medications prescribed to him and did not receive care from a physician. Aetna has denied the allegations (California Healthline, 9/30). The jury found that Aetna's "unreasonable failure" to provide care contributed to Rosenberg's death (AP/Sacramento Bee, 11/15). However, the jury ruled that Aetna did not act with "malice, fraud or oppression," which means that the insurer is not liable for punitive damages (Los Angeles Times, 11/15).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.