Back in 2012, six-year-old Isabella Tolentino of Galveston, Texas went in for an emergency appendectomy while on vacation in the Dominican Republic--but never woke up and ultimately died. Now her mom is suing her insurance company, Blue Cross Blue Shield of Texas, saying their delays and the hospital's incompetence resulted in her daughter's death.
Marissett Tolentino alleges in a lawsuit filed Dec. 17 in Galveston County Court that Blue Cross Blue Shield of Texas denied her sick daughter Isabella a medical jet that they were entitled to under their policy, which led to surgery "being performed in substandard conditions" at a local hospital.
Isabella had her appendix surgically removed at a BCBSTX-authorized facility, Hospiten Bavaro in Punta Cana, but she never came out of the anesthesia and suffered a fatal brain injury, the lawsuit alleges.
Eventually, the insurance company approved the medical jet and airlifted the little girl to Miami, but it was too late to save her, according to the lawsuit.
The story begins on July 5, 2012; when Isabella complained of stomach pains, and later developed chills and a fever. Doctors at Dreams Palm Beach Punta Cana, on the eastern tip of the Dominican Repubilc, diagnosed appendicitis and sent her to Hospiten Bavaro, a local hospital. However, Marissett, who is a nurse at the University of Texas Medical Branch in Galveston, was wary of having the surgery performed in a Dominican hospital and wanted her transferred to a hospital in Miami. However, BCBSTX refused to pay for a medical jet. Their reasoning? Appendicitis was not a severe enough condition in their view to justify a medical jet, and they felt Hospiten Bavaro was competent to perform the surgery. But the surgery went horribly wrong.
The family says that Isabella did not wake up after surgery and was told she was "very unstable," according to the lawsuit. Doctors told them their daughter had vomited while unconscious and blood had come through the intubation.
Hospital staff told them the girl's oxygen levels were low but "not to worry," according to the lawsuit. The next morning Isabella's condition was critical, but the family said BCBSTX, which was aware of her state, made no effort to contact them or approve a jet until the end of the day.
"They insisted on delaying the transfer until a Hospiten doctor sent a report to the doctors in Miami, where Isabella's transfer would be," alleges the lawsuit. "Hospiten staff unreasonably delayed in sending this report and claimed to have difficulties communicating with Miami."
"BCBS was fully aware of the severity of Isabella's condition but still had not authorized the medical jet," the lawsuit alleges. The family also says "precious time was wasted" with delayed paperwork to the Miami hospital where Isabella was to be transferred.
They also allege that both Hospiten Bavaro and BCBSTX refused to authorize the transfer of their daughter until payment was made. Then a medical jet scheduled for 10 a.m. did not arrive until 2 p.m., according to the lawsuit.
When Isabella finally got on the plane, the on-board medical team discovered Hospiten Bavaro had screwed up the surgery eight ways to Sunday. She wasn't getting enough oxygen--she'd been intubated with an infant-sized tube. Doctors at Miami Children's Hospital later discovered that the Dominican doctors had given her way too much anesthesia--she'd gotten a dose more appropriate for a six-foot, 200-pound man. The end result was that Isabella's brain was too badly damaged for doctors to do anything, and Marissett made the difficult decision to take Isabella off life support on July 18, 2012.
Marissett's suit alleges that BCBSTX worked with the hospital to keep her in the dark about possible complications from the surgery, then put red tape above sending needed help. Her lawyer, Mason Herring, says that while the hospital's errors are the primary cause, she can't sue Hospiten Bavaro here in the United States and the Dominican civil courts are extremely hostile to foreigners. Plus, he thinks that the insurance company has some explaining to do about its actions--as he put it, "parts of the story don't add up."
The Tolentinos have set up a foundation in their daughter's memory, the Prinsabella Mia Foundation, to help other kids with brain injuries. Hopefully they can get some answers about what happened to their daughter--and soon.