Greetings. Please tell me, if you can, the first major law suit
against an HMO/Managed care compancy in California. I believe the case
involved a woman with breast cancer. She was denied a bone marrow
transplant on the basis of it being seen as too experimental at the
time. She died. Her brother, an attorney, sued and won 22+ mil @
first. Can you find this case, date, an article, etc? Thank you in
advance

Hi daniellaqh:

I believe the case you are thinking of was the one in 1993 regarding
Nelene Fox, of Temecula, California. The initial verdict awarded her
almost $90 million, though.

Some interesting information about the case can be found in the following pages:

The End of Health Care - Who Plays God in a System Bent on Profit?
URL: http://www.makingakilling.org/chapter1.html
Quote: "Health Net's practices are legendary. The woman whose case
first shined the spotlight on the company was Temecula, California
resident Nelene Fox. Her brother, Mark Hiepler, then a young lawyer,
tried the case.
In December of 1993, a California jury found that Nelene was denied a
bone marrow transplant, despite being a prime candidate for the
procedure. The jury, outraged that Health Net employees themselves
received bone marrow transplants, awarded $89.1 million to Fox's
family for Health Net's conduct. Later, Health Net paid a much smaller
out-of-court settlement, because of the family's desire for closure."

Woe is HMO 
URL: http://www.salon.com/health/feature/1999/10/14/hmo_suit/print.html
Quote: "Before the Goodrich verdict, the largest in California, $89
million in damages, went to Nelene Fox's family in 1993. At 38, Fox, a
Temecula, Calif., woman, was diagnosed with breast cancer. Her
insurance company, Health Net, would not authorize the treatment -- a
bone-marrow transplant -- because it considered it experimental. She
decided to go outside the network and raise the $200,000 for the
treatment herself. She died four months after finishing the procedure,
and also, before the verdict came down.
'Probably the worst part of the whole thing for her was going into the
street, and having bake sales to raise the money because none of us
had the money; it was humiliating to make her whole life public,' says
her brother, attorney Mark Hiepler, who also represented her. 'I can
never prove that the delays and staying up 24 hours a day to raise the
money [killed her]; I just proved that the denial was in bad faith.
But it's the emotional stress someone goes through when they're
fighting for their life and their health insurance. Many people have
said that it's easier to fight cancer than their health insurance.'"

A Flood of Litigation? Predicting the Consequences of Changing Legal
Remedies Available to ERISA Beneficiaries
URL: http://www.rand.org/publications/IP/IP184/
Quote: "Several large, high-profile awards in recent years have
created apprehension among health plans. For example, in 1993 a jury
in Southern California awarded almost $90 million to the estate of
Nelene Fox after her insurer, HealthNet, failed to approve autologous
bone marrow transplantation and high-dose chemotherapy treatment for
breast cancer (Eckholm, 1993). The case was subsequently settled for
an undisclosed sum during the course of an appeal."

Search Strategy (on Google):
* lawsuit HMO California "Breast cancer" "bone marrow"
* "Nelene Fox" brother lawsuit "bone marrow"
* "Nelene fox" lawsuit

I hope this helps. 

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