Insurance & Personal Injury Attorney in Claremont, California

Rahm v. Kaiser: The Case of the Delayed MRI

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Rahm was an extremely challenging case. But, as goes with challenges go the rewards. Anna Rahm was a teenager, 17 years of age, living with her parents and three siblings in the San Fernando Valley when she began to experience pain radiating down her right leg. She wasn’t an athlete. She wasn’t involved in strenuous physical exercise. And it was unusual to the family chiropractor that she would be suffering from this type of a condition. And after several weeks and a couple of months of treatment, she wasn’t getting any better. So, the family chiropractor told her mother that she should take her to their health insurance with Kaiser to take her to Kaiser to get an MRI because he figured something was going on causing this problem.

She went with her mother to the primary care physician they had selected at Kaiser. And they were told that they wouldn’t get an MRI, that they first had to wait, and that she needed to take some pain medication first, and that, by the way, she should go on a diet. She was five foot four and weighed 124 pounds when she was told that. And she was not at all obese. But they wouldn’t give her an MRI.

She then was continuing to suffer, and they went back on several occasions and weren’t getting any attention, and they weren’t getting an MRI. Three and a half months went by, and finally the primary care physician, after they were complaining and the mother was trying to be her advocate said, “Something is wrong because she’s getting worse.” They finally relented, and gave her an MRI. Unfortunately, when they did the MRI, they learned that she had a very aggressive and large tumor in her pelvis. It was called an osteosarcoma upon diagnosis.

And the nature of this type of tumor, we learned later through the doctors, was this rare form of cancer, doubles in size every 30 days. And so what began as a treatable and surgically repairable form of cancer at the beginning had ballooned into this huge tumor which then resulted in her having a surgery which took half her pelvis and her right leg.

We believe that it was more than just medical malpractice, but instead that Kaiser Foundation Health Plan, the insurance part of Kaiser, had a practice of not funding adequately the MRI machines and the rights of the doctors to utilize the MRIs. So we started it off as an insurance bad faith case, as we normally do. And from the beginning, Kaiser defended it by saying, “This is really a medical malpractice case, not a bad faith case.” And we then went up the appellate ladder. They took a writ. We won. It came back down to trial. But then, the trial judge ruled against us on the bad faith, saying, “That’s part of what managed care is all about.” And did not let us go forward with the case as a bad faith case.

So there I was, believe it or not, four years, five years into it, with over $700,000.00 of our own money invested in that case, for experts, and everything else that had to be done to work it up. And I had nothing left but a simple medical malpractice case. So as a last resort, I had no other choice. They offered zero on that case. And so we went to trial. Their basic argument was that the delay of three and a half months would not have made a difference in the outcome, and that she would have suffered the same harm. And our position was you know, if that tumor was inside of the daughter of one of the executives at Kaiser, she would have had an MRI, and that it’s easy to say it wouldn’t made any difference unless, of course, it’s in your daughter’s pelvis, or your own pelvis. And it makes a big difference when it’s doubling in size every 30 days. And thankfully, the jury agreed with us, and awarded her a total including future medical costs of over $28 million.

Los Angeles, CA personal injury lawyer Michael J. Bidart talks about a memorable case in which he was able to get an impressive settlement for his client who lost her leg. He explains that the Rahm case presented significant challenges, but as with challenges, there are also rewards. Anna Rahm, a 17-year-old girl, began experiencing unexplained leg pain. Despite not being involved in strenuous physical activity, the pain persisted, leading her family chiropractor to suspect an underlying issue and recommend an MRI through their health insurance provider, Kaiser.

Anna and her mother visited a primary care physician at Kaiser, hoping to get the recommended MRI. However, they were denied and told to wait, take pain medication, and even advised to go on a diet, despite Anna’s healthy weight. Frustrated by the lack of attention, they persisted, but it took three and a half months before the primary care physician finally agreed to the MRI. Tragically, the MRI revealed a large and aggressive tumor called osteosarcoma in Anna’s pelvis.

This form of cancer was particularly devastating as it doubled in size every 30 days. Initially treatable, the delay in diagnosis and treatment resulted in a major surgery that involved the removal of half of Anna’s pelvis and her right leg. Our belief was that Kaiser Foundation Health Plan, the insurance division of Kaiser, had a systemic practice of inadequately funding MRI machines, limiting doctors’ access to this crucial diagnostic tool. We pursued the case as an insurance bad faith claim, but Kaiser contended it was a medical malpractice matter.

After multiple legal battles, including appellate proceedings, we found ourselves left with only a medical malpractice case. Despite investing significant personal funds, over $700,000, for expert opinions and case development, we had no choice but to proceed to trial. Kaiser’s argument centered around the claim that the three and a half months’ delay would not have altered the outcome, asserting that Anna would have suffered the same harm regardless. Our stance countered that if the tumor had been inside the daughter of a Kaiser executive, they would have prioritized the MRI, highlighting the tumor’s rapid growth rate.

Ultimately, the jury sided with us and awarded Anna a total of over $28 million, accounting for future medical expenses as well. This outcome provided some measure of justice for Anna’s suffering and underscored the importance of timely and appropriate medical care, especially in cases where conditions can rapidly worsen.

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