Mourners attend funeral for teen who died during transplant delay

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By Noaki Schwartz
ASSOCIATED PRESS

3:35 p.m. December 28, 2007

GLENDALE – At 17-year-old Nataline Sarkisyan's funeral Friday, no one mentioned the insurance company that denied a potentially life-saving liver transplant and then reversed the decision hours before the girl died.
Instead, mourners remembered Nataline as an optimist, who loved to dance ballet and tap and never complained about the leukemia she was battling. Nataline lost her three-year fight with the bone marrow cancer on Dec. 20.



AdvertisementAmid the flower arrangements at the front of St. Mary's Armenian Apostolate Church was an arrangement of pink and white carnations shaped as a clock with the hands permanently on 5:50 p.m. – the moment Nataline died. A white casket and large photo of the smiling teen whose brown curls were held in place with a silver headband looked out over the crowd.
Janet Saboundjian told the mourners that her niece's upbeat spirit and “sparkling blue eyes” could brighten the darkest of days. Before checking into the hospital, Saboundjian recalled how Nataline made the family take her shopping for the appropriate outfit.

“We have to wear cute clothes at the hospital because I want the nurses to see we have style,” Saboundjian recalled the teen telling her.

Beneath her brave exterior, Nataline had the complex emotions of any young adult. Printed on a pamphlet at the service were paragraphs lifted out of the teen's scribblings about sadness, love and God.

“Sensitive as I am, I lay down in bed and cry, I cry I do not know why, from anger, or happiness, at this moment my life has changed, no wonder I cry day after day...” Nataline wrote at age 14, the same year she was diagnosed with leukemia.

The day before this Thanksgiving, Nataline received a bone marrow transplant. She later developed a complication that caused her liver to fail.

Philadelphia-based Cigna Corp. initially refused to approve a liver transplant, calling the surgery an experimental procedure that was not covered by the employer's benefit plan. Nataline was covered under the policy of her father, an automotive technician for Mercedez-Benz of Calabasas, said her father Krikor Sarkisyan.

Four doctors appealed to the insurer to reconsider in a Dec. 11 letter. The doctors said patients in similar situations who undergo transplants have a six-month survival rate of about 65 percent.

After a crowd of nurses, community members and family friends picketed outside Cigna's office in Glendale, the company reversed the decision. But by this time, it was too late and Nataline died.

Cigna, which has revealed little since Nataline's death, said Friday its role was to manage the employer's self-funded benefit plan. Under such arrangements, Cigna is paid an administrative fee to process claims and perform other duties on behalf of the employer, who carries the risk and pays for procedures.

In Nataline's case, Cigna determined the liver transplant was not covered under the employer's plan because it was considered experimental based on consultations with an in-house transplant expert and two independent doctors specializing in organ transplantation and leukemia.

Cigna decided to make an exception for Nataline “given our empathy for the family and the unique circumstances of this situation,” said Dr. Jeffrey Kang, Cigna's chief medical officer.

“We volunteered to pay for it out of our own pocket. We decided to ... bear the risk even though we had no obligation to,” Kang said.

Attorney Mark Geragos has said Cigna “maliciously killed” Nataline because it did not want to bear the medical expense of the procedure and aftercare. Geragos said the family will file a lawsuit after the funeral.

On Friday, attendees mourned the loss of an unfulfilled life and recalled the girl who loved the color pink.

Along with traditional black attire, mourners wore touches of pink on scarves, earrings and ties. Some tied pink ribbons around their left arms “so she can be closer to our hearts,” said Raffi Ganoumian, Nataline's cousin.

Outside, friends and family held another cousin who shook as she wept. With her wide blue eyes, brown hair and pink headband, Meghry Achekian, 18, had a faint smile as she recalled that “everyone said we look alike.”

Just a year difference in age, she and Nataline were close and obsessed with the color pink, she said.

“She was a beautiful girl inside and out,” Achekian whispered. “She always had a smile.”