View this article online: https://www.insurancejournal.com/news/west/2009/10/21/104683.htm
A nurse assistant who is in a vegetative state after being attacked at a Pasadena hospital has been unfairly denied care by workers’ compensation and her health insurance, her attorney alleges.
Amelia Mendoza, 52, was attacked twice in April by a violent patient at Huntington Hospital, sustaining blows to her face, head and neck, attorney Russell Glauber said.
Days later, she had a hemorrhagic stroke, and her claims for subsequent health care have been denied by her insurer, Blue Cross, and by workers’ compensation, he said.
Glauber is appealing Mendoza’s workers’ compensation denial and is holding a press conference Tuesday to call on the state board to expedite its response.
Mendoza isn’t expected to recover, Glauber said, and her husband has been forced to quit his job and care for her in their home.
“Both breadwinners are gone,” Glauber said. “If Blue Cross refuses to pay because they say it’s (a) workers’ compensation case, and compensation care is not paying, then who’s left?”
Huntington Hospital spokeswoman Andrea Stradling confirmed Mendoza’s employment at the hospital but said in a statement, “We do not believe that her current condition is related to any work-related injury.”
Stradling said she could provide no further comment because Mendoza’s case is an ongoing workers’ compensation matter.
Blue Cross spokeswoman Peggy Hinz declined to comment, saying she first needed to confirm whether Mendoza was a policyholder.
Glauber said Mendoza was attacked on April 14 and 16, but was told to make an appointment at an in-house workers compensation clinic at Huntington Hospital on April 20.
For unknown reasons, the clinic turned Mendoza away that day, he said. She collapsed while having dinner with her husband at a restaurant that night and has never recovered.
An April 20 note in Mendoza’s medical records says she was “in her usual state of health until about a week ago when she was bitten at work and had increased anxiety about her work injury.”
The records also note that Mendoza had become hypertensive since the incidents.
Dr. Arthur E. Lipper, who was hired by Glauber, has examined Mendoza’s medical records and said he believes the stroke was a result of Mendoza’s workplace injury.
“Whatever conspired to cause her to have her stroke, clearly at least in part transpired after and because she was bitten, hit in the head and neck,” Lipper said. “She was agitated because of it, and then she stroked.
“When somebody who has no known previous history of high blood pressure gets attacked on several occasions and it becomes high, the assumption is it’s caused by the attacks,” he said.