Untreated Infant Dies Due To HMO Clerical Error, Family Has No Remedy

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Chad Aitken – Woodland Hills, CA

As told by his mother, Heather:

To have your life fall apart when one piece of the puzzle comes out is very devastating. This is what happened to my family when my HMO refused to see my son, Chad, after a routine vaccine.

Chad died because of denied care by my HMO. He was just one in a number of children and adults who are getting hurt by the managed care industry because they are treated like a number, not a human.

The difficulties began when I took my 5 1/2 month old son in for a checkup. Chad was given vaccine shots at this appointment which caused a subsequent reaction. I called my HMO and requested they see Chad again because of a reaction to the shots. At this time, the pediatrician became hostile with me and accused me of having used their facilities for six months without insurance. I was confused by this accusation because I had just had the baby five months ago, and another one of my children had a minor operation, and no one had mentioned our insurance coverage before to us.

Although we had been members of my HMO for over five years, the doctor told us that we had been coming in under fraudulent circumstances and refused to see my son. This accusation was due to a clerical mix up on our insurance coverage dates through my husband’s ex-employer.

Refusing treatment after an invasive procedure like drug injections is not only unethical, it is unconscionable. If doctors administer treatment, they are supposed to follow through with the job-not leave it half way. When my son was refused treatment, I did what my HMO told me to do by giving Chad breathing treatments for asthma. This breathing problem was directly related to Chad’s adverse reaction to the vaccine shots. But without my HMO seeing and treating Chad for this reaction, what could have been prevented, became fatal. Chad Aitken senselessly died on August 8, 1995. The microscopic report clearly indicated that the cause of death was due to Chad’s reaction to the vaccine shots.

We feel the take over of the medical profession by HMO administrators is a threat to the health and safety of everyone-young and old. It is apparent the HMO industry is only concerned with wealth, not health. I have heard so many horror stories because my HMO was too busy and it did not matter to them what happened to patients. I trusted this facility to take care of my children. As a mother and a human being, I thought I was doing the right thing. I never thought my HMO would abandon us.

My life without my son has been devastating and I wouldn’t want to see another parent go through the same nightmare as we have been put through.

Because we received our health care through our employer, we can recover no damages against our HMO. ERISA, the Employment Retirement Income Security Act, contains an unintended loophole that prevents me from seeking damages against my HMO for denying Chad the care he needed. This law must be changed. In the long run, my HMO probably saved money now that Chad is dead.

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