PATIENT ABILITY TO PAY - A MEDICAL CONSIDERATION IN STANDARD OF CARE?

In Murray v. UNMC Physicians, Neb.. No. S-10-455, (9/16/11), the Plaintiff’s wife, Ann Murray suffered from pulmonary arterial hypertension, a chornic constriction of the blood vessels in the lungs which pressures the heart, ultimately leading to death.  Flolan (epoprostenol sodium), is a very expensive drug that is effective in the direct vasodilation of pulmonary and systemic arterial vascular vessels. 

 

Doctors at UNMC determined that Mrs. Murray was a candidate for treatment with Flolan, but delayed treatment in order to find out whether her insurance would pay for it.  The patient would require it for the rest of her life at an annual cost of about $100,000.00.  Mrs. Murray died while waiting for an answer from her insurance company.  If those were the only facts this would be a different case. 

 

The complicating factor is that the abrupt withdrawal of the drug due to the inability to pay or other factors can be life threatening because of rebound pulmonary hypertension.  Some patients have died from the rebound. The jury found in favor of the UNMC doctors. Mr. Murray appealed to the Nebraska Supreme Court on the basis that ability to pay cannot influence the standard of care in Nebraska.  The Court was faced with the issue as to whether to judicially alter the statutory standard of care in Nebraska to conform to medical realities.  It chose not to do so, but decided the case on the narrower issue of whether the ability to pay, because of the unique situation in this case, was a medical factor (the pulmonary rebound factor) as opposed to a financial consideration.  There decision seems right on the facts of this case, but raises interesting issues for the future.

 

http://op.bna.com/hl.nsf/r?Open=mapi-8lunq8

 

Comments

[Insoles]

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[writers job]

Specialists at UNMC confirmed that Mrs. Murray was a competitor for medication with Flolan, but deferred medication so as to root out in case her protection could pay for it.