Cancer victim's son driven by HMO fight
LOS ANGELES -- As a young man, Chant Yedalian played a role few mothers would wish for their sons.
He helped his cancer-stricken mom pick out a wig, one so convincing that few knew her hair had fallen out from chemotherapy. Every two weeks, he took it to be cleaned. On her lunch hour, he walked her several blocks from her job as director of a church preschool to her breast cancer treatments at Kaiser Permanente's center in Los Angeles.
Then, on a rainy March day in 1998, he held her hand as Zevart Yedalian heaved her last rattled breath at age 53.
It was the end of her four-year battle with cancer -- and the beginning of Chant's crusade.
Yedalian, now 29, has been waging a legal battle against Kaiser Permanente ever since. He claims that the health maintenance organization wrongly denied his mother a potentially life-saving bone marrow transplant. "They killed my mom," he says.
Kaiser lawyers say the HMO did all it could for Zevart Yedalian.
The outcome of Chant Yedalian's lawsuit could have broad implications for Kaiser and other HMOs, according to some consumer advocates and attorneys who are closely following the case. About 1,000 Kaiser members or their families file malpractice claims each year. Nearly all of them are subject to arbitration, a long process that limits awards and tends to benefit health plans.
To get his case moved out of arbitration, Yedalian argued that his mother's contract with Kaiser did not meet state legal disclosure requirements, meaning that it was not clear she was giving up the right to a jury trial when she enrolled in the plan.
Jamie Court, president of the Foundation for Taxpayer and Consumer Rights in Santa Monica, says that "this could mean that a very determined son has found an escape hatch for the private justice system that has never worked appropriately for patients."
Kaiser officials say that no legal precedent is at stake, and that in any event Kaiser has changed its enrollment forms in recent years. But with 6 million members in California, the HMO isn't taking any chances. Since the suit was filed in Los Angeles County Superior Court in 1999, Kaiser has enlisted three major law firms to take on Yedalian.
In legal trench warfare -- an apt description of Yedalian's case, with more than 35 volumes of briefs now piled up -- the eventual winner is almost always the one with the bigger law firm and the resources to outlast and outmaneuver the opposition. But occasionally, such circumstances can be overcome by one impassioned individual.
Yedalian was a college student at the University of California, Los Angeles, when his fight with Kaiser began. He knew nothing about HMOs at first but learned as he drove up and down the state, hunting documents from insurance and government offices. He got help from a lawyer, paying him with money he earned by making cabinets.
Then Yedalian did something extraordinary: He enrolled at Loyola Law School in Los Angeles so he could handle the case himself. He studied insurance law and consumer protection. And in May 2002, he graduated in the top 25 percent of his class. He passed the bar exam a couple of months later and was hired by Cheong, Denove, a personal injury firm in Santa Monica, where he spends half his time on the Kaiser complaint.
The suit doesn't specify the amount of damages being sought. "It's not about the money, it's that I have to do it," Yedalian says. He made a promise to his dying mother that he would sue Kaiser and not give up until he won, he says.
Yedalian knows that some see his quest as a foolhardy drive by a grief-stricken son who is unable to let go or move on. The fight already has consumed most of his twenties, and it is still possibly years away from resolution.
Zevart Yedalian was diagnosed with advanced breast cancer in May 1994. She hoped to be accepted for a special bone marrow transplant plus high-dose chemotherapy -- a risky, experimental, and expensive procedure. To be accepted for the procedure, Yedalian's suit alleges, Kaiser patients needed a 55 percent score on a heart-function test known as a MUGA scan, which measures a patient's ability to tolerate the procedure. Zevart Yedalian scored 53 percent and was rejected.
Yedalian alleges that nearly all other US hospitals that offered the treatment had a MUGA requirement of 50 percent, and that Kaiser inflated the qualifying criteria so it could deny treatment and thus save millions of dollars.
