Posted on 02/04/2010 2:35:27 PM PST by Second Amendment First
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/ci_14329527#ixzz0ebpAfnNW
I wonder if she’s even a citizen.
I know, from not having insurance myself, that they ARE programs out there by the manufactures that will give away the medicine. The Dr. should have stepped in. This doesn’t sound right. What kind of Dr. lets a kid die?
Dunno about theft, but I’d be banging on the door of Salvation Army and similar agencies.
I wonder how many packs a day the "mother" smoked?
I agree.
However, having just come off a rather frightening 2 month asthma flare, it still gives me the heebie-jeebies.
I bet the apartment they lived in still had full cable TV.
Socialized medicine kills.
A paraprofessional what? Is this a fancy way of saying teacher’s aide? That’s not exactly a road to fantastic riches, though don’t most schools have awfully good health benefits?
There is either more to this story or the mother is sick.
Sarah Palin you were right. Death panels. Even when they’re not even supposed to be doing that.
Not only can you get free samples from your doctor, there are all sorts of coupons floating around everywhere. Some of the coupons are so good we didn't even submit a claim to the health insurer. And there is also a patient assistance program that Glaxo advertises heavily. Not to mention that if you want to order from Canada you can get it for less than half price.
But, with that said, my husband uses it and it works perfectly. He was never able to keep his asthma under control until Advair (any exercise would start him wheezing). Now he can do martial arts, bike, and hike with no distress.
Our insurer has raised the copay substantially on the stuff, but even if they struck it from the covered drugs we would find a way to get it by hook or crook.
This woman just sat around waiting for the government to do something. As soon as she did go to the doctor he gave her free samples, but she had waited too long.
Government dependency = death.
“works as a paraprofessional in Denver Public Schools”
I have no idea what that means and Denver is heavily union and pro illegal, sanctuary city, so she had plenty of options IMHO.
A quick search shows they earn about $11/hr. As it is the school district, I would think they would offer medical insurance as well.
It is not taxpayer’s responsibility to provide for other people’s children.
Why didn’t she bring him into ER and say my son can’t breath?!
Government dependancy kills. (As well.)
Maybe OZama is right. With Medicaid in action there would be no need to form a death panel.
Okay, so why is her child eligible (or not eligible) for Medicaid? Or SCHIP or whatever it’s called in Colorado? Does the school system not provide insurance for its employees and their families? Did she decline coverage? This raises more questions than it answers. Obviously she is depending on the state, if she claims the state is responsible for her child’s medicine. So, if she is employed, the question has to be why was the kid on Medicaid and, since she had a job, why she didn’t just buy his medicine?
That is an interesting question.
Her outrage is just a little late. It was a horrible tragedy but she should not profit from her son’s death through a wrongful death lawsuit. She is also at fault.
Wonder if there was some other reason she did not want to be a squeaky wheel.
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