Insurance Company Denies Bionic Hand for Triple-Amputee

Kent Carson is on his third appeal for the hand prescribed to him by the Rehabilitation Institute of Chicago

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    NEWSLETTERS

    A west suburban man lost three limbs to Legionnaires Disease, and he's got a chance to have a new biologic hand he can move with his mind. But his insurance company says they won't pay and that' he'll have to continue to live with a hook on his arm.

    Kent Carson had a full life -- travel, a fiancee, a job as a branch bank manager.

    He was so healthy he never missed a day on the job, until the late summer of 2012, when he suddenly began suffering flu-like symptoms and saw his temperature rise to 103 degrees.

    When he finally got to the doctor, he was told to go to the emergency room immediately. The next day, as he lay in a hospital bed, doctors told him he had Legionnaire's Disease.

    In the weeks ahead, he would lose both his legs below the knee and his left arm below the elbow.

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    "They showed me my feet and hands, and they were all black," Carson said. "Not purple or blue, but black. It was a choice between keeping my limbs and dying, or getting the amputations and living. It was the toughest choice I have ever had to make."

    A year later, the 56-year-old learned to navigate the world on prosthetic legs. He and his fiancee moved to a ranch house in Aurora so all the living space would be on the first floor. Carson just got his driver's license and is about to equip the car with hand controls.

    "The next step," he said, "is to go back to work. I want to get back to normalcy."

    To do that, though, he said he would have to replace the hook where his left hand used to be with a bionic hand that functions much more like a natural hand. It has five fingers and would be powered by the muscles left in his arm.

    The only problem is that his insurer, Blue Cross Blue Shield of Minnesota, won't pay for it, and Carson is on his third appeal.

    "Try hitting Ctrl-Alt-Delete with a hook," he said. "You can't tie your shoes; you can't zip a zipper."

    In the kitchen, he isn't able to lift a frying pan or pull out a plate from the cupboard, and he can't use his right hand because he uses a cane to stay steady.

    "You don't have a thumb, and most things like that you cannot do without a thumb. Besides, the hook scares people when they see it."

    In a statement, Blue Cross Blue shield of Minnesota said when "medically necessary, prosthetics should be able to restore natural appearance and function while providing comfort and ease of use... but a prosthesis with individually powered digits... is considered investigative due to a lack of clinical evidence demonstrating its impact on improved health outcomes."

    Carson says he doesn't get it. Other insurers, including Blue Cross Blue Shield of Illinois, have paid for these prosthetic hands, which cost between $80,000 and $120,000, and he was prescribed the hand by doctors at the Rehabilitation Institute of Chicago.

    For now, Carson has no choice but to wait for one more insurance company's decision, a final one from an independent review board.

    "I'm missing two legs and an arm, and I need a cane to walk," he said. "I need that left hand to have my life back."