The family of a man that died before a health insurance company approved his treatment has won over a quarter of a million euros in compensation
The Provincial Court of Malaga has awarded compensation of 264,582 euros to a family whose father, a 61-year-old man, died on August 25, 2015 as a result of damage to his health that occurred during the six days that the private health insurer Caser was slow to authorise the urgent intervention that was needed.
The victim, according to the legal bases of the sentence, suffered a pseudoaneurysm in the right femoral artery, at the level of the inguinal region, after the removal, on July 20, 2015, of the central line that had to be placed in a private hospital in Malaga as a result of a surgical intervention in the gastric area.
A few days later, on July 26, the doctors treating him asked the insurance company for authorisation to perform an urgent intervention with which they would try to repair the medical problem and stop the bleeding with the placement of a “covered stent.”
In the following six days, the medical reports indicate that the intervention to place the prosthesis is only delayed because they have not received administrative authorization for it from the patient’s insurance company. The operation, in the end, could not be carried out until August 1 and the insured died 24 days later.
The lawsuit filed on behalf of the family by the lawyer Damián Vázquez, legal collaborator of the association ‘El Defensor del Paciente’, was rejected in the first instance, but the Fifth Section of the Malaga court now rules Caser’s responsibility in the death and awarded damages to the family.
“It is evident – indicate the magistrates – that there was a delay in the processing of the authorization for the placement of the ‘stent’, since the first medical reports that establish the need for its placement are from July 26 and this (prosthesis) did not “It is placed until August 1 due to the lack of authorization from the defendant entity.”
Sources: lasprovincias.es and Malaghoy.es and other media outlets
Stent operations are a common medical procedure used to treat blocked or narrowed arteries. A stent is a small, metal mesh tube that is inserted into the artery to keep it open and improve blood flow.
The procedure is usually performed by a cardiologist or an interventional radiologist.
The stent operation involves the following steps:
- Preparation: Before the procedure, the patient is given a local anesthetic to numb the area where the catheter will be inserted. The patient may also be given medication to help them relax.
- Insertion of catheter: A catheter is inserted into the artery through a small incision in the groin or arm. The catheter is guided to the site of the blockage using X-ray imaging.
- Balloon angioplasty: A small balloon is inflated at the site of the blockage to widen the artery and improve blood flow.
- Stent placement: A stent is then inserted into the artery at the site of the blockage. The stent expands to fit the size of the artery and holds it open.
- Recovery: After the procedure, the patient is monitored for a few hours to ensure there are no complications. Most patients can go home the same day or the next day.
Stent operations are generally safe and effective, but like any medical procedure, they do carry some risks. These risks include bleeding, infection, and damage to the artery.
Insurers are generally slow in approving medical operations due to a process called prior authorisation. Prior authorisation is a process where insurers require doctors to obtain approval before performing certain medical procedures or prescribing certain medications. This process is intended to reduce wasteful and inappropriate healthcare spending, but it can also lead to delays in patient care.