breast implants Tag Archives — California Insurance Lawyer Blog

August 27, 2021

Kantor & Kantor Files Complaint Against Blue Shield of California for Breach of Contract in a Case Involving Breast Cancer

On August 23, 2021 Kantor & Kantor, LLP filed a complaint against Blue Shield of California in the Superior Court for the State of California, County of Los Angeles alleging Breach of Contract, Breach of the Implied Covenant of Good Faith and Fair Dealing, and violation of California Civil Code Section 3428.

After a routine mammogram in 2013, and a subsequent biopsy, Kantor & Kantor’s client, a 59-year old woman, was advised her risk of developing breast cancer was higher than the general population based on the presence of the papillomatous tissue. Upon being advised that she would be a good candidate for one stage breast reconstruction, plaintiff underwent a bilateral mastectomy with bilateral breast reconstruction in February of 2014.

In 2019 the plaintiff contacted her surgeon reporting chronic pain over the chest wall and into her back, despite physical therapy. Plaintiff reported that the pain had gotten consistently worse over a few years and was limiting her activity and causing daily pain.

September 18, 2019

Breast Implant Removal and the Women’s Health and Cancer Rights Act

by Cari M. Schwartz

The Women’s Health and Cancer Rights Act of 1998 (WHCRA) was signed into law on October 21, 1998. The WHCRA provides protections for individuals who elect breast reconstruction after a mastectomy. The WHCRA covers women who undergo a mastectomy for any medical reason, not just to treat breast cancer.

Under WHCRA, if your group health plan covers mastectomies, the plan must provide coverage for certain services relating to the mastectomy. However, if your coverage is provided by a “church plan” or “governmental plan”, you will need to check with your plan administrator as certain plans may not be subject to this law.

WHRCA rights apply to individual coverage as well and are generally within the jurisdiction of the state insurance department where you live.

September 18, 2019

Breast Implant Removal and Medicare

by Cari M. Schwartz

Medicare is the federal health insurance program for:

People who are 65 or older
People under age 65 with certain disabilities

September 13, 2019

Kantor & Kantor Presents a Webinar About Getting Insurance Coverage for Explant Surgeries

by Kantor & Kantor LLP

Attend our October 2 Webinar About Insurance Coverage

You have had or are considering explant surgery. We understand the physical and emotional pains that made you decide on the procedure. We also understand that thinking about insurance coverage should be the farthest thing from your mind.

We have spoken with so many women about their troubles getting insurance coverage for these explants, that we thought it may help to put together some ideas, facts and resources that may resolve at least one part of these ordeals.

August 23, 2019

Class Action Lawsuit Against Allergan Filed To Protect Women from the Increased Risk of Cancer Resulting from Textured Breast Implants

by Cari M. Schwartz

On August 16, 2019 a nationwide class action lawsuit was filed in the U.S. District Court for the District of New Jersey against the medical device manufacturer Allergan to protect women with Allergan’s textured breast implants from the increased risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which has now been associated with Allergan’s BIOCELL textured breast implants. The case is Jane Doe I, et al. v. Allergan, Inc., et al., No. 2:19-cv-16784 (D.N.J.).

In July, The United States Food and Drug Administration (FDA) requested that Allergan issue a recall of its BIOCELL textured breast implants and tissue expanders, and Allergan agreed and is removing these products from the global market.

The FDA requested that Allergan recall all of its BIOCELL textured breast implants and tissue expanders based on newly submitted Medical Device Reports (MDRs) reporting worldwide cases of BIA-ALCL and BIA-ALCL-related deaths associated with these implants. The FDA’s “analysis was attributed to a new worldwide reported total of 573 unique BIA-ALCL cases including 33 patient deaths. Of the 573 cases of BIA-ALCL, 481 are reported to have Allergan breast implants at the time of diagnosis. In addition, 12 of 13 deaths occurring in patients with BIA-ALCL where the manufacturer was known occurred in patients implanted with an Allergan breast implant at the time of their BIA-ALCL diagnosis. The manufacturer and/or texture is unknown for the remaining 20 reported deaths from BIA-ALCL.”

June 18, 2019

Coverage for Breast Explant Surgery Was Denied – Kantor & Kantor Stepped In and Got the Denial Overturned

by Cari M. Schwartz

It’s a common story shared by an increasing number of women. They received breast implants and after a period of time they started getting sick. While we do not know the exact number, we know that the largest Facebook Group has grown to nearly 83,400 members, with an increase of more than 5,200 in the last 30 days.

A client, whose name is being kept anonymous to protect her privacy, contacted Kantor & Kantor recently for help with an insurance denial. The woman was in failing health and had been experiencing severe medical complications dating back to 2012 after receiving breast implants. The woman referred to her condition as “breast implant illness.”

After consulting with her primary care physician, the woman underwent a bilateral breast MRI which revealed findings consistent with intracapsular rupture in the left breast. Shortly after, she was referred to a plastic surgeon who recommended bilateral breast capsulectomy and implant removal. The procedure, referred to as explant surgery, involves the removal of the implants and the surrounding capsules (or scar tissue).

May 15, 2019

What is Breast Implant Illness or BII?

by Cari M. Schwartz

Getting breast implants can change a person’s life for the better. But in recent years, women have suspected that their breast implants have made them very ill with diseases such as:

May 13, 2019

What is Breast Implant-Associated Anaplastic Large Cell Lymphoma or BIA-ALCL?

by Kantor & Kantor LLP

First reported in 2011, Breast Implant-Associated Anaplastic Large Cell Lymphoma, referred to as BIA-ALCL, is a rare and highly treatable type of lymphoma that can develop around breast implants. This is a cancer of the immune system, not a type of breast cancer. However, when caught early, BIA-ALCL is usually curable.

BIA-ALCL occurs most frequently in patients who have breast implants with textured surfaces. BIA-ALCL has been found with both silicone and saline implants and both breast cancer reconstruction and cosmetic patients. To date, there are no confirmed BIA-ALCL cases that involve only a smooth implant.

Common symptoms of BIA-ALCL include breast enlargement, pain, asymmetry, lump in the breast or armpit, overlying skin rash, hardening of the breast, or a large fluid collection typically developing at least more than one year after receiving an implant, and on average 8 to 10 years after receiving an implant.