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LaRue V. Accountable Health Care, IPA

Rob Gianelli of Gianelli & Morris and Rene Kern of the Kern Law Group obtained a $7,225,000 jury verdict on behalf of plaintiff Terry LaRue, against Accountable Health Care, IPA ("Accountable") for failure to provide LaRue with timely and necessary medical services, resulting in a permanent and disabling injury to his hand.

Mr. LaRue’s health plan, Health Net, contracted with Accountable to create a network of doctors under Mr. LaRue’s Affordable Care Act plan. Accountable also agreed with Health Net to authorize referrals to specialists for Health Net members when they needed it.

Mr. LaRue fell and sustained a Bennett’s fracture of his left hand. This type of fracture requires surgery within 10 – 14 days to avoid permanent problems. Unfortunately, Accountable took more than six weeks to provide Mr. LaRue with the much-needed surgery. Due to the delay, LaRue’s bone healed in a misaligned position resulting in Complex Regional Pain Syndrome, a chronic pain believed to be caused by damage to the nerves.

After a two and one-half week trial, a unanimous jury awarded Mr. LaRue $7,225,000 in economic and non-economic damages based on Accountable’s negligence and violation of Civil Code section 3428, a law relating to managed care entities.

“Despite being advised of the seriousness of Terry’s injury, Accountable took no steps to authorize surgery for his hand,” said Mr. Gianelli. “We are thrilled to bring this two-year legal battle to a successful close and hold Accountable responsible for its negligence and inadequate network of physicians.”

“Patients who enroll in health plans and pay premiums rightly assume they will be provided with timely, accessible health care,” said Mr. Kern. “We hope our efforts in revealing Accountable’s negligent and unlawful practices will prevent similar situations from occurring in the future. Sadly, Terry still has to suffer tremendous pain.”

Categories: 1405

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