Court to decide if stem cell surgery is covered

Published: October 30, 2007  |  Source: lenconnect.com
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ADRIAN — A Manitou Beach man told a jury Tuesday about regaining some control over the lower part of his body after a stem cell surgical procedure on his crushed spinal cord. The Lenawee County Circuit Court jury is to begin deciding today if the treatment was “reasonably necessary” for coverage under Michigan’s no- fault auto insurance law.

Home Owners Insurance Co. is being sued for refusing to reimburse $51,000 Kevin Krohn spent to have the procedure done in Portugal in 2005, claiming it does not meet the legal test for treatments it must pay for under the no-fault law.

Krohn said the improved quality of life leaves no doubt in his mind that the experimental treatment was necessary. Four years after he was left a Paraplegic from car crash injuries, Krohn regained bladder and bowel control and is able to move his hips and legs. His overall health has improved, he said.

“Absolutely. I believe I owed it to my wife and my kids to do anything reasonable to help my condition,” Krohn told the jury.

The legal issue the jury must decide is how to apply the state’s auto insurance law to Krohn’s case. The law requires insurance companies to provide “reasonably necessary” treatment and services to people injured in auto crashes.

Krohn’s attorney, Craig Pollard of Ann Arbor, told the jury during opening statements that testimony from doctors would show the procedure was the only option his client had to improve his condition.

“Without the procedure he has absolutely no chance of recovery,” Pollard said. Cutting-edge technology was used to graft stem cells from his nasal membrane to his injured spinal cord to rebuild nerve connections. The benefits Krohn received are evidence that it was necessary for his recovery, he said.

Home Owners attorney Allen Philbrick, also of Ann Arbor, told the jury that testimony would establish just the opposite. Krohn received an experimental procedure abroad that has not been approved in the United States, he said, and no proof has been offered that it caused the improvements in Krohn’s condition. Intense Physical Therapy that followed the surgery could be responsible, he said.

“We believe that as much as we admire Kevin Krohn for being willing to participate in this experiment, we do not believe this is a no-fault benefit,” Philbrick told the jury.

Krohn told the jury about how he researched the stem cell procedure being done in Portugal by Dr. Carlos Lima. He went to the Rehabilitation Institute of Michigan at Detroit Medical Center where Dr. Steven Hinderer helped arrange the surgery, he said.

“I’m sure the word ‘experimental’ was used, Krohn said. “He said he could not recommend it. Legally, that’s how he had to do it.”

Krohn said he felt improvements immediately after the surgery.

“I could feel my bladder fill,” he told the jury. He regained bowel movement for the first time since the car crash, he said. When he returned to Michigan he began an intense physical therapy program under Hinderer’s direction that he is still continuing at home.

Hinderer said nearly 40 patients in his spinal injury recovery program have traveled to Portugal to receive the stem cell treatment. “In certain individuals, there are recoveries beyond what we would anticipate through normal recovery procedures,” he said in video testimony taken last week and played for the jury.

Normally, people with severe spinal cord injuries experience 99 percent of the recovery they will have within a year of their injuries, Hinderer said. More than four years after his injury, Krohn gained hip Flexion and trace knee extensions as well as regaining bladder and bowel control, Hinderer said.

It is “virtually unheard of” for someone in Krohn’s condition to experience such “substantial improvement,” Hinderer testified. “It would seem likely that the surgery played some role,” he said.

Under questioning by Philbrick, Hinderer said that since the procedure is not approved by the United States Food and Drug Administration it is not a standard of care and therefore, by definition, cannot be classified as necessary. Hinderer said exhaustive research would be necessary to determine Krohn’s recovery could not have occurred without the stem cell graph.

In his video testimony, Lima stated the procedure was necessary for Krohn’s recovery.

“Would he have shown improvement without the surgery?” Pollard asked.

“No. He would not show,” Lima answered. The level of Krohn’s improvement “was quite unexpected,” Lima stated. Krohn’s spinal injury was one of the most severe he has treated in the program, he said. Since 2001, 110 patients have been treated from Portugal, Italy, the United Kingdom, Denmark, Iceland, India and Spain, he said.

“A majority of the patients have some improvements,” Lima said. And improvements continuing year after year, he said.

Philbrick questioned Lima about evaluation methods used in ongoing studies of the procedure and the fact no one in the United States has applied for FDA permission to begin using it here.

Testimony is expected to be completed today in Judge Timothy P. Pickard’s court and the case sent to the jury for a decision.

By Dennis Pelham
Daily Telegram Staff Writer