A jury has awarded more than $7 million to a plaintiff who alleged that his HMO delayed treatment for his hand injury.

Facts and Allegations

Terry LaRue, a freelance sports videographer, was insured under a Health Net IFP CommunityCare HMO plan administered by Health Net of California Inc. Health Net contracted with an independent physician association, Accountable Health Care IPA, that agreed to provide medical services to members enrolled in the HMO.

Mr. LaRue sustained a Bennett's fracture – a fracture of the base of the first metacarpal bone – of his left hand while working on an assignment near Denver. He subsequently was referred to an orthopedic surgeon to perform surgery the next day.

According to Mr. LaRue, however, that surgeon would not accept his insurance and by the time he found a surgeon to perform surgery, his fracture had partially healed and consolidated in a malposition. As a result, the metacarpal had to be re-fractured and pinned. Mr. LaRue claimed that the delay in receiving surgery caused permanent injuries to his hand.

Mr. LaRue sued Health Net, Accountable, and Dr. Birinder Brara. He alleged that the actions of Health Net and Accountable constituted a breach of contract and that Accountable and Dr. Brara's failure to timely refer him to an appropriate hand surgeon constituted medical malpractice. He also alleged that Accountable's actions constituted negligence in violation of the California law that mandated that managed care providers adhere to standards of “ordinary care.”

Health Net and Dr. Brara agreed to settle with Mr. LaRue, and the case proceeded to trial against Accountable.

Result

The jury found that Accountable was negligent and that this negligence was the cause of Mr. LaRue's harm. It also determined that Mr. LaRue's damages totaled $7,225,000.

The case is LaRue v. Health Net of California, Inc., No. BC566095 (Cal. Super. Ct. L.A.Cty. May 4, 2017). Attorneys involved include: Robert S. Gianelli; Gianelli & Morris; Los Angeles, CA, for Terry J. LaRue; Rene J. Kern Jr.; The Kern Law Group PC; Los Angeles, CA, for Terry J. LaRue; Richard D. Carroll; Carroll, Kelly, Trotter, Franzen, McKenna & Peabody; Long Beach, CA, for Birinder S. Brara; Craig de Recat; Manatt, Phelps & Phillips, LLP; Los Angeles, CA, for Health Net of California Inc.; Michael D. McClelland; McClelland Advocacy Ltd.; Sacramento, CA, for Accountable Health Care IPA.

FC&S Legal Comment

This report is based on information that was gleaned from an article that published by VerdictSearch's sister publication, The Recorder; Berbay Marketing & PR; and an interview of plaintiff's counsel. Defense counsel declined to contribute.

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