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Denver boy, 9, died after state-benefits error denied him asthma medication
Denver Post ^ | February 4, 2010 | Allison Sherry

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


TOPICS: News/Current Events
KEYWORDS: asthma; influenza; obamacare; steroids
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Expect more of these "tragic accidents" the more government is involved in health care, although I can't believe the mother did not outright purchase the medication rather than let her child die because "it wasn't covered".
1 posted on 02/04/2010 2:35:27 PM PST by Second Amendment First
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To: Second Amendment First

And Dr.’s have samples. My children were given a sample of Advair. Something we seriously wrong on both ends.


2 posted on 02/04/2010 2:38:51 PM PST by machogirl (First they came for my tagline.)
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To: Second Amendment First

"Socialized medicine does not have Death Panels!"


3 posted on 02/04/2010 2:39:37 PM PST by TigersEye (It's the Marxism, stupid! ... And they call themselves Progressives.)
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To: Second Amendment First

Ms. Lucero needs to be a little concerned as to why she couldn’t provide for her son.


4 posted on 02/04/2010 2:40:13 PM PST by SJSAMPLE
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To: Second Amendment First

Why didn’t she just buy it? This doesn’t make sense! The medication to save her son’s life was in a box a few feet in front of a wooden counter.


5 posted on 02/04/2010 2:41:37 PM PST by Soothesayer (The United States of America Rest in Peace November 4 2008)
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To: machogirl

Another dead child on (Saint) Obama’s watch.
This may be the reason we don’t go around claiming to be the black Jesus with the Denver Post watching.


6 posted on 02/04/2010 2:42:41 PM PST by Hans
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To: Second Amendment First

Something doesn’t jive right with this story?!! MONTHS without the meds? What’s wrong with this picture?


7 posted on 02/04/2010 2:42:43 PM PST by RoseofTexas
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To: Second Amendment First

I’m sorry, if my child is that ill I’m buying medication myself. What kind of mother sits around waiting for some bureaucrat to get their sh*t together rather than scrounging up the money and getting what her child needs? The woman had a job, don’t tell me she couldn’t get the money.

See what the liberal welfare state does to people? This mother’s common sense was destroyed and her child paid the price.


8 posted on 02/04/2010 2:43:12 PM PST by ElenaM
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To: Second Amendment First

Advair runs about $175/mo. full price.

However, severe asthma was controlled relatively well before Advair.

From the way this article reads, the kid was in a constant state of airway inflamation. Generally, this is not the way asthma operates. Asthma usually needs some sort of environmental trigger before it starts.

I’m 51, almost died from my asthma a couple of times in my youth. I survived and managed before Advair was even invented.

I say this, because I think there’s a lot more to this story than is being reported.


9 posted on 02/04/2010 2:43:56 PM PST by stylin_geek (Greed and envy is used by our political class to exploit the rich and poor.)
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To: Second Amendment First

OLTG’s Rules for a Long and Happy Life #5467 “Do not ever rely on a government bureaucracy for life and death issues.”


10 posted on 02/04/2010 2:46:04 PM PST by Onelifetogive (Flame away...)
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To: Second Amendment First

I would sit in a bare house before letting my (future) child go without food or medication.


11 posted on 02/04/2010 2:46:48 PM PST by scott7278 ("...I have not changed Congress and how it operates the way I would have liked." BHO)
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To: ElenaM
What kind of mother sits around waiting for some bureaucrat to get their sh*t together rather than scrounging up the money and getting what her child needs?

The kind that believes electing obama will solve all her problems.

12 posted on 02/04/2010 2:47:20 PM PST by Second Amendment First
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To: ElenaM

I’d want to know some more details. Could be that mom was caught between a rock and a hard place, such as she can’t legally tap into some other discount program if she is “eligible for Medicaid.” Therefore to get the stuff she has to lay out MSRP which virtually nobody else has to pay (not even insurers). So chose to keep food on her table and try lesser treatments. I’d like to know what happened to the dad?


13 posted on 02/04/2010 2:48:48 PM PST by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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To: Second Amendment First

Who would let their child die because the government wouldn’t pay for the medicine?


14 posted on 02/04/2010 2:48:51 PM PST by dangerdoc
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To: Second Amendment First

60 doses of the generic Advair is $50 (just checked). Maybe someone could have helped her or something. Wow.


15 posted on 02/04/2010 2:49:45 PM PST by autumnraine (You can't fix stupid, but you can vote it out!)
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To: Soothesayer

A careful reading of this story indicates this mother and her child are being supported by the state, that is, welfare, food stamps, Medicaid, etc. She expects the state to provide for them and If the state doesn’t provide for them, they die. That is what socialism is all about. Now the woman is going to sue the state. I predict a lot more of this in our future as we are all herded into socialized medicine and other inefficient collective arrangements.


16 posted on 02/04/2010 2:49:53 PM PST by La Lydia
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To: machogirl

As a parent that was also my first thought...there is nothing that would stop me from getting medicine my kid needed....including flat out theft.

I wouldnt have put up with it for 4 days much less four months....

I suspect there is more to this story than we’ve been told....


17 posted on 02/04/2010 2:50:55 PM PST by Crim
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To: Hans

Now that Social Security is officially broke and may need a bailout, look for more people to be denied.


18 posted on 02/04/2010 2:52:05 PM PST by machogirl (First they came for my tagline.)
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To: Second Amendment First

The mother is stupid and the one to blame. She should have done anything possible to get the medicine.


19 posted on 02/04/2010 2:52:06 PM PST by Mark was here (The earth is bipolar. ---- "OBAMA: THE GREAT MISTAKE OF 2008")
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To: La Lydia

from the article...

“Lucero, who works as a paraprofessional in Denver Public Schools”


20 posted on 02/04/2010 2:52:09 PM PST by Crim
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To: La Lydia

I wonder if she’s even a citizen.


21 posted on 02/04/2010 2:53:34 PM PST by lady lawyer
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To: Crim

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?


22 posted on 02/04/2010 2:54:43 PM PST by machogirl (First they came for my tagline.)
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To: Crim

Dunno about theft, but I’d be banging on the door of Salvation Army and similar agencies.


23 posted on 02/04/2010 2:54:48 PM PST by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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To: stylin_geek
"Asthma usually needs some sort of environmental trigger before it starts."

I wonder how many packs a day the "mother" smoked?

24 posted on 02/04/2010 2:55:16 PM PST by Slump Tester (What if I'm pregnant Teddy? Errr-ahh -Calm down Mary Jo, we'll cross that bridge when we come to it)
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To: La Lydia

I agree.

However, having just come off a rather frightening 2 month asthma flare, it still gives me the heebie-jeebies.


25 posted on 02/04/2010 2:55:49 PM PST by kimmie7 (THE CROSS - Today, Tomorrow and Always!)
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To: Mark was here

I bet the apartment they lived in still had full cable TV.


26 posted on 02/04/2010 2:56:02 PM PST by A_perfect_lady (I miss having a First LADY.)
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To: Second Amendment First

Socialized medicine kills.


27 posted on 02/04/2010 2:56:14 PM PST by Brilliant
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To: Crim

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?


28 posted on 02/04/2010 2:56:46 PM PST by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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To: Second Amendment First

There is either more to this story or the mother is sick.


29 posted on 02/04/2010 2:57:15 PM PST by philetus (Keep doing what you always do and you'll keep getting what you always get.)
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To: Brilliant

Sarah Palin you were right. Death panels. Even when they’re not even supposed to be doing that.


30 posted on 02/04/2010 2:58:08 PM PST by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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To: stylin_geek
I don't know anybody who pays full price for Advair. We certainly never have.

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.

31 posted on 02/04/2010 2:58:27 PM PST by AnAmericanMother (Ministrix of ye Chasse, TTGC Ladies' Auxiliary (recess appointment))
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To: Crim

“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.


32 posted on 02/04/2010 2:58:37 PM PST by dynachrome (Barack Hussein Obama yunikku khinaaziir!)
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To: Crim

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.


33 posted on 02/04/2010 2:58:38 PM PST by Second Amendment First
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To: Second Amendment First

It is not taxpayer’s responsibility to provide for other people’s children.


34 posted on 02/04/2010 2:59:34 PM PST by CodeToad (If it weren't for physics and law enforcement I'd be unstoppable!)
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To: Second Amendment First

Why didn’t she bring him into ER and say my son can’t breath?!


35 posted on 02/04/2010 2:59:48 PM PST by AU72
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To: Brilliant

Government dependancy kills. (As well.)


36 posted on 02/04/2010 3:00:22 PM PST by WestwardHo (Whom the god would destroy, they first drive mad.)
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To: TigersEye

Maybe OZama is right. With Medicaid in action there would be no need to form a death panel.


37 posted on 02/04/2010 3:00:29 PM PST by Slyfox
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To: Crim

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?


38 posted on 02/04/2010 3:00:30 PM PST by La Lydia
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To: Slump Tester

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.


39 posted on 02/04/2010 3:02:19 PM PST by Truth is a Weapon (Truth, it hurts soooo good!)
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To: AnAmericanMother

Wonder if there was some other reason she did not want to be a squeaky wheel.


40 posted on 02/04/2010 3:02:36 PM PST by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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To: CodeToad

Yep, if you can’t afford the kid then be responsible. Don’t put the burden on the taxpayers.


41 posted on 02/04/2010 3:02:52 PM PST by randomhero97 ("First you want to kill me, now you want to kiss me. Blow!" - Ash)
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To: Second Amendment First
We don't have sufficient information to say the woman could have gotten the prescription filled by simply paying for it.

Give you an example ~ I need a certain medication. I went on a trip and forgot to take my pills. I went to a pharmacy and asked if they could call my pharmacist and get authorization for 14 pills ~ a very minor fraction of what I needed.

They did that. I got my pills and it was all good.

Little did I know that "the law" requires that when I change pharmacies, even under the conditions I described, I have effectively made a permanent change and will have to go back to my doctor for a new prescription to restart service at my old, local pharmacy.

The "law" that did this to me is called MEDICARE. The bureaucrats don't care one way or the other if I pay for my medications out of my pocket, or the taxpayer's, they've decided that my acquisition of life sustaining medications is a very secondary issue next to the question of WHERE I GO for those medication.

This little boy's medication is more carefully monitored than the stuff I use ~ probably because it costs more AND can be dangerous to some people. It's unlikely his mother could have gotten the medicine ever again if she changed the payment method since that would disrupt the activities of the sleuths looking for misuse.

Someone at Denver's Human Services probably knows the answer ~ and that's going to be that Medicaid reporting requirements supercede the needs of the patients, even in cases where absence of the medication will cause death.

There's no reason Medicaid should be less stringent than Medicare.

42 posted on 02/04/2010 3:03:09 PM PST by muawiyah ("Git Out The Way")
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To: AU72

This is true, the welfare set aren’t usually afraid to use the ER as personal doctor’s office and a life threatening emergency like that would push the case to the front of the line.


43 posted on 02/04/2010 3:04:15 PM PST by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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To: Second Amendment First

I can’t believe she didn’t just have the prescription transferred to another pharmacy. That would have been my response to showing Walgreens the reports that said she had benefits. If they wouldn’t have followed up, I would have found a pharmacy that would.


44 posted on 02/04/2010 3:05:37 PM PST by Hoffer Rand (There ARE two Americas: "God's children" and the tax payers)
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To: Second Amendment First
although I can't believe the mother did not outright purchase the medication rather than let her child die because "it wasn't covered".

BUMP that.
Democrat parasites have no concept of working, or paying for anything themselves.
They entitled!

45 posted on 02/04/2010 3:06:33 PM PST by Lancey Howard
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To: AnAmericanMother

The other thing I forgot about Advair is that it is not a “rescue inhaler.” For Advair to work, it requires a daily regimen.

If the kid had gone months without using Advair, it wouldn’t be instantly effective.

I’ve gotten by with a Primatene rescue inhaler. It’s rather nasty, but, it’s better than nothing.

Even at $175/mo., most parents can find it in their budget, if their child needs medication that badly. Plus, if the kid was in that much distress, time to head to the emergency room.


46 posted on 02/04/2010 3:06:57 PM PST by stylin_geek (Greed and envy is used by our political class to exploit the rich and poor.)
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To: muawiyah
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.

Sounds like she had the script in hand, but wasn't willing to pay for it.

47 posted on 02/04/2010 3:07:06 PM PST by Second Amendment First
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To: randomhero97

It’s really hard to blame someone for taking a goodie that the law itself provides for.


48 posted on 02/04/2010 3:07:07 PM PST by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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To: stylin_geek

ew primatene.
I’ve done that one myself. Nasty stuff.
The Symbicort I just started is almost as bad, though. lol


49 posted on 02/04/2010 3:09:25 PM PST by kimmie7 (THE CROSS - Today, Tomorrow and Always!)
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To: Second Amendment First
You missed my point. I've already found out that if you change the source ~ whether you pay or the government pays, that's the end of the line on your REFILLS.

Remember, live sustaining medicines are more dangerous than Marijuana ~

50 posted on 02/04/2010 3:10:29 PM PST by muawiyah ("Git Out The Way")
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