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GOVERNMENT RUN HEALTHCARE (MEDICAID) FAILS CHILD---WILL IT FAIL ALL OF US IF OBAMCARE BECOMES LAW?


Denver boy, 9, died after state-benefits error denied him asthma medication
Posted: 02/04/2010 01:00:00 AM MST
Updated: 03/02/2010 03:41:44 PM MST

Zuton Lucero, with her daughter Ashantay, 8, holds a picture of her 9-year-old son, Zumante, who died of asthma in July after a state-benefits error denied him his prescription coverage. (Hyoung Chang, The Denver Post)

A Montbello mother says her 9-year-old son's death from severe asthma could have been prevented had Denver Human Services resolved problems with his Medicaid pharmacy benefits.

Zuton Lucero said she called Human Services every three days for months last year when she was suddenly unable to get prescription drugs for her son, Zumante.

The boy's health deteriorated without the medication, his doctor said, and he died at Children's Hospital in July after losing consciousness at his house after an attack.

"I don't want anyone else to be sitting where I'm sitting," Lucero said.

Advocacy lawyers who met Wednesday with the Colorado Attorney General's Office hold up Lucero's story as an example of how serious the

Zumante Lucero struggled with asthma since he was a baby. In March, his mother went to fill his Advair prescription, but it was denied. Months of calls followed to Human Services to no avail. The boy, 9, got progressively worse and died in July. (Hyoung Chang, The Denver Post)
problems are with the state's $243 million computer system that is supposed to manage benefits — and the county human workers behind it.

"The human system fell down," said Ed Kahn, a lawyer with the Colorado Center for Law and Policy, who is among a group of local and national lawyers weighing a lawsuit against the state for delays in getting food stamps and Medicaid benefits to people. "They are responsible for this kid's death."

The Colorado Benefits Management System is run through county human services offices and manages medical and food-assistance benefits for everyone in Colorado. Since its 2004 installation, the system has been beset by problems.

Lawyers advocating for Colorado's needy sat down with state officials Wednesday to discuss the problems that have the lawyers weighing whether to sue the state as they did in 2005 over similar issues.

"They presented us with some new information, and we listened carefully," Kahn said. "We hope to make a decision in relatively short order about how we are going to move forward."

Lucero, who works as a paraprofessional in Denver Public Schools, said Wednesday that she will continue to tell the story of Zumante's death "to enough people so that it won't ever be anyone else's story."

In addition to working with the advocacy lawyers, she has hired a personal attorney and is exploring a lawsuit against Denver.

Zumante had struggled with asthma since he was 3 months old. But when he was 6, the condition became serious enough for his mother to apply for benefits under Social Security, which also entitles him to Medicaid.

Andrew Lieber was Zu mante's physician since birth. He said the boy's lungs were severely inflamed, and his twice-daily medication, Advair, helped control that.

Last March, Lucero went to fill her son's prescriptions at a Walgreens near her home in Montbello. A worker there said Zumante didn't have prescription-drug coverage anymore.

Lucero says she called Denver Human Services every three days for four months trying to get him drug coverage. Each time she called, an automatic computer report was issued and sent to her house usually showing that all of her children — including Zumante — qualified for Medicaid.

But even when she brought in the reports to Walgreens, she was told the computer system showed he wasn't eligible for pharmaceutical benefits.

Throughout months of frustrating phone calls to Human Services' call-center operators, which often left Lucero in tears, Zumante's health weakened. She managed to reach her caseworker only once. The caseworker told her in March that the problem had been resolved.

Just why the system showed Zumante wasn't eligible for the prescription benefit — when in fact he was — still is not clear.

The little boy, who loved karate, drawing cartoon figures and riding bikes with his brothers and sisters, was often caught in spasms of panic because he couldn't catch his breath.

He went to the emergency room in May and June when the inhalers and nebulizers Lucero carried were not enough.

During the June trip to the ER, Lucero told doctors she wasn't able to get him his Advair.

They gave her some samples. When she told Zumante he was going to get to start taking his medicine again, the boy was so relieved he cried.

But it was too late. The medicine works progressively to keep inflammation down, Lieber said.

On July 16, Lucero was home and heard Zumante call her name from upstairs. He was on the nebulizer and told her he couldn't breathe. She called an ambulance. While she was waiting, Zumante lost consciousness.

She cradled him in the front yard while she waited to hear sirens. By the time paramedics got him to Children's Hospital, he had been unconscious for more than 10 minutes.

For four days, he was kept alive on a ventilator, but when Lucero decided to disconnect it, he died within a few minutes.

Denver Human Services officials said the agency "feels the death of any child as a tragic loss," said spokeswoman Revekka Balancier. "And our department tries very hard to prevent these kinds of tragic accidents."




Read more: http://www.denverpost.com/dontmiss/ci_14329527?sou...

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  • Dan D March 03, 2010 21:21:23
    Dan D
    +2
    As tragic as this is, I don't think you get anywhere using anecdotal evidence to support one side of the health care debate or the other. There are too many stories either way.

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  • Fannie March 04, 2010 06:45:25
    Fannie
    +1
    They try very hard when it's their child, but not poor children.
  • Dan D March 03, 2010 21:21:23
    Dan D
    +2
    As tragic as this is, I don't think you get anywhere using anecdotal evidence to support one side of the health care debate or the other. There are too many stories either way.
  • SCOOP--... Dan D March 04, 2010 15:05:11
    SCOOP--RIP, MY DEAR MAX
    You are so right. There are horror stories everywhere for people with and without insurance.
  • Sister Jean March 03, 2010 21:14:32
    Sister Jean
    +1
    I am on Medicaid and it pays for me ...it also paid a quarter million when asthma put me in a coma
  • SCOOP--... Sister ... March 03, 2010 21:20:23
    SCOOP--RIP, MY DEAR MAX
    I know it helps some, but it failed this young boy and he died. I just think the government is incapable of handling something as critical as this. You are very luck your situation was handled correctly. I have several friends on Medicaid who have solicited my help in contacting their representatives in congress. They have been denied medication and critical treatment over and over again. My best friend's husband nearly died about a month ago because of all this bureaucracy. I have good healthcare. I agree we must have healthcare reform. Why can't this be done without the government being the ones to make the decisions that affect our health? We must have the reform, but the government running things isn't going to work. They don't have too good of a track record with the Post Office, AMTRAK, Medicare, Medicaid and Social Security.
  • Sister ... SCOOP--... March 03, 2010 21:23:07
    Sister Jean
    +1
    they also paid 15,000 for my broken wrist last year....they paid my Dad's final hospital bill $23,000
  • SCOOP--... Sister ... March 03, 2010 21:27:26
    SCOOP--RIP, MY DEAR MAX
    +1
    Again, I think you are one lucky lady. There is good and bad situations in all programs as well as in private healthcare coverage.
  • Sister ... SCOOP--... March 03, 2010 21:29:10
    Sister Jean
    +1
    and my Dad hit it lucky too...system has wotked for me for over 15 years
  • SCOOP--... Sister ... March 03, 2010 21:37:19
    SCOOP--RIP, MY DEAR MAX
    I pray Sister Jean that your good fortune in this matter continues. You are truly blessed and your dad was too.
  • SCOOP--... Sister ... March 03, 2010 21:42:59
    SCOOP--RIP, MY DEAR MAX
    When I worked for AT&T, I was a union steward and officer. I spent a lot of my time talking to our insurance company provider and the doctors when the members were denied benefits for legitimate illnesses. I was very successful in helping many of my members get the benefits they should have had. It is very stressful for people who are legitimately sick to be denied benefits such as a paycheck (if they have sick benefits) medication and treatment. One of my members was attacked and shot 6 times and the company fired her while she was in ICU. It took a lot, but we got it worked out. There are millions and millions of horror stories out there for those who have insurance and for those who don't have insurance. Many of the problems are a result of human error. I just pray that we can someday find a way to cover our citizens, decrease the size and intrusion of our government, lower taxes and get people back to work. I pray every day for our leaders and for God to keep America safe. I know God's will will be done in America.
  • Sister ... SCOOP--... March 03, 2010 21:47:57 (edited)
    Sister Jean
    +1
    medicaid is for the poorest ...I don't know how other insurance works..I know my bro in law was put on Cobra once his work insurance ran out.He had a stroke at 58 I DO know illegals are well taking care of in R.I.
  • SCOOP--... Sister ... March 03, 2010 22:16:05
    SCOOP--RIP, MY DEAR MAX
    I know pretty much how private healthcare with companies work. I have friends and a sister on medicaid and I know from what they have told me. I am going to be on Medicare beginning May 1 (I cannot wait. lol) so I will learn something about that. I guess I am blessed because my private healthcare will cover what medicare doesn't cover. God is so good.

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SCOOP--RIP, MY DEAR MAX

SCOOP--RIP, MY DEAR MAX

Waxahachie, TX, US

February 18, 2009 21:27:42

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