Texas Mom Sues After Insurance Denies Claim and Daughter Dies of Appendicitis


Their claim was denied by BCBSTX, according to the family.

"...[I]n their opinion, the medical condition was not severe enough," alleges the lawsuit, and the insurance company "trusted [the] expertise" of its local in-network hospital.

"The denial of this service forced plaintiffs to have Isabella's surgery performed at Hospiten Bavaro," the lawsuit alleges.

The family says that Isabella did not wake up after surgery and was told she was "very unstable," according to the lawsuit. Doctors told them their daughter had vomited while unconscious and blood had come through the intubation.

Hospital staff told them the girl's oxygen levels were low but "not to worry," according to the lawsuit. The next morning Isabella's condition was critical, but the family said BCBSTX, which was aware of her state, made no effort to contact them or approve a jet until the end of the day.

"They insisted on delaying the transfer until a Hospiten doctor sent a report to the doctors in Miami, where Isabella's transfer would be," alleges the lawsuit. "Hospiten staff unreasonably delayed in sending this report and claimed to have difficulties communicating with Miami."

"BCBS was fully aware of the severity of Isabella's condition but still had not authorized the medical jet," the lawsuit alleges. The family also says "precious time was wasted" with delayed paperwork to the Miami hospital where Isabella was to be transferred.

They also allege that both Hospiten Bavaro and BCBSTX refused to authorize the transfer of their daughter until payment was made. Then a medical jet scheduled for 10 a.m. did not arrive until 2 p.m., according to the lawsuit.

Doctors in Miami discovered "brain damage resulting from the oxygen deprivation," according to the lawsuit. Isabella later went into seizures and died.

Tolentino's lawyer said that medical records sent to Miami revealed hospital errors.

"But parts of the story don't add up and don't make sense," said Herring. "We are trying to get to the bottom of that. ... Now, insurance companies are making the decisions about what is a life-threatening sickness or injury -- they are making medical decisions for people."

The family has set up a web page, the Prinsabella Mia Foundation, in memory of their daughter to help other children with brain injuries.

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