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CT based health insurer reduces coverage for risky procedure

On Behalf of | May 15, 2015 | Firm News, Medical Malpractice |

Today, a hysterectomy, which is the removal of a woman’s uterus by surgical methods, is considered to be a routine procedure. However, following warnings from the Federal Drug Administration regarding the use of laparoscopic power morcellators, the Hartford, Connecticut based health insurer Aetna announced that it would end coverage of hysterectomies performed by the morcellators because of the risk the procedure poses for spreading cancer.

In essence, laparoscopic power morcellation grinds and shreds tissue into smaller fragments and then using laparoscopic instruments, the small pieces of tissue are removed through tiny incision sites in the abdomen. According to the FDA, this procedure has a risk of spreading cancerous tissue. The risk is greater when the procedure is used for the removal of the uterus and to remove fibroids in the uterus. Aetna noted that because the safety of the procedure had not been demonstrated, it would reduce the coverage for it.

However, the Hartford based insurer noted a couple of exceptions. If another procedure would be life-threatening, then laparoscopic power morcellation would be covered. Furthermore, for those patients for whom another procedure would not be effective and fertility could be maintained, the procedure would be covered.

Generally, a medical procedure should not leave a patient in a worsened condition or result in harm. Furthermore, where a regulatory agency such as the FDA has issued warnings against using a procedure, the said procedure must be used sparingly or not at all. It is important for women to discuss options with their healthcare providers and weigh the risks and benefits of the procedure.

If a person is injured by a negligent medical provider, then they may be able to recover compensation for their injuries. Those who believe they may have a claim for medical malpractice may wish to speak with an attorney regarding their case.

Source: Independent Record, “Aetna curtails coverage of surgical tool tied to cancer risk,” May 5, 2015

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