Hand grafted to the United States, she fights for a $ 1 million refund by the Secu

This is a case with more than a million dollars that the Paris Court of Appeal will study this Thursday. Transplanted with both hands in the United States in 2016, because she considered this type of operation then impossible in France, a young woman is in fact pursuing Social Security in order to obtain a refund of her bill.

For the first time in July 2021, the Paris judicial court overturned the refusal to take charge and ordered the Paris primary health insurance fund (CPAM) to pay two-thirds of the sum, but the latter appealed.

Amputation of all four limbs after septic shock

The complainant, Laura Nataf, had her four limbs amputated in 2007 at the age of 19 after a septic shock. In 2013, she was included in the list of patients in the care of the transplant, as part of a research program at the Georges-Pompidou Hospital in Paris (AP-HP). But later, no compatible woman was found. Health authorities are not renewing the program’s license and Laura has been removed from the list, her lawyer Valérie Sellam Benisty told AFP.

His surgeon, Laurent Lantieri, then offered to have an operation in the United States and publicized the case, lashing out at an “administrative and bureaucratic overload” and deploring the lack of funding “to make these innovations” in France. In February 2016, he sent Social Security a refusal to take care. In addition, the young woman is having surgery in August at Penn Medicine Hospital in Philadelphia, which has a $ 1.13 million bill next year.

The Cnam is defending itself

In its letter of refusal of care in the United States, the Caisse nationale d’assurance maladie explains that it has directed Laura Nataf “to an experimental program open to the Hospices civils de Lyon on bilateral allograft of hands and forearms.” arm, which would have made it possible to obtain the necessary care in France and the assurance of care, ”Cnam told AFP. “Ms. Nataf did not choose this option. As such, we believe that the refusal to take on the opposite charge is validly justified, ”the public institution added.

“It’s completely wrong” to say that “Laura could have been operated on under the same conditions in France,” said Ms. Sellam Benisty, recalling her removal from the waiting list. In 2016, “transplants were suspended in France due to lack of funding for research projects, due to a lack of donors and economic constraints,” said the lawyer. “The medical world is unanimous on the impossibility of such a transplant in France during the period that occupies this case.”

Me Sellam Benisty also argues that refusal of care must be sent by registered mail, signed and accompanied by a “detailed medical opinion”, this was not the case with the “laconic” letter received by his clientele. .

The first greffe d’une main made in France in 1998

La France was the pioneer of this type of operation, with the first transplant of a major performed in 1998 at the Hospices civils de Lyon (HCL) by Jean-Michel Dubernard, on a New Zealand patient suffering from a cutting accident. In 2000, the new world premiere, with the first graft of both hands and part of the forearms, on a 33-year-old painter in a building amputated after being seriously injured in the explosion of an artisanal rocket.

Moreover, until 2016, only six other patients benefit from this double transplant, allowed at home under the Hospices civils de Lyon (HCL) program. In 2017, following in particular the case of Laura Nataf, France undertook to better define the legal and financial framework for this type of transplant.

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