2 spine surgery class-action suits making headlines

Alan Condon -  

Two spine surgery class-action lawsuits have made headlines in recent months, with patients joining forces to challenge a major commercial insurer and a well-known health system in the Pacific Northwest:

1. Renton-based Providence Health & Services Washington and two of its former neurosurgeons are accused of harming hundreds of patients by performing unnecessary spine surgeries.

One patient alleges she cannot speak after a cervical spine surgery damaged her vocal cords, and another patient claims he cannot work because of permanent nerve damage as a result of a lumbar spine surgery. Four Washington residents are named as plaintiffs in the class-action suit, with more expected to join, attorney Bill Gilbert told Becker's

"Although the events in question occurred at one Providence hospital in the southeast region of Washington state, we initiated a broad and comprehensive internal review of our policies, practices and procedures to ensure robust compliance with government requirements and the delivery of high-quality care," a Providence spokesperson told Becker's.

In April, Providence agreed to pay $22.7 million to resolve allegations that it defrauded federal healthcare programs through unnecessary spine surgeries. 

2. A 239-person class-action lawsuit related to the alleged denial of lumbar artificial disc replacement is moving forward against Aetna.

The lawsuit, which stems from 2019, argues that Aetna improperly limits coverage for lumbar artificial disc replacement by treating the procedures as "experimental and investigational."

Contrary to Aetna's stance, lumbar disc replacement was approved by the FDA more than 15 years ago, and most spine surgeons consider it a safe and effective procedure for lumbar disc disease. 

"It's really indefensible at this point for [Aetna] to say that it's experimental and investigational when it's been FDA approved since 2004," Jack Zigler, MD, of Plano-based Texas Back Institute, told Becker's. "There have been almost 150,000 to 200,000 or more global implants already. So they're just posturing. Other insurance companies have tried to do the same thing, but they've had class-action lawsuits by patients who are more educated than the insurance company 'experts,' and those companies have all capitulated. They've all settled those cases on the eve of trial."

Aetna did not respond to Becker's request for comment.

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