As a young man, Chant Yedalian played a role few mothers would wish for their sons.
He helped his cancer-stricken mom pick out a wig, one so convincing that few knew her hair had fallen out from chemotherapy. Every two weeks, he took it to be cleaned. On her lunch hour, he walked her several blocks from her job as director of a church preschool to her breast cancer treatments at Kaiser Permanente's center in Los Angeles.
Then, on a rainy March day in 1998, he held her hand as Zevart Yedalian heaved her last rattled breath at age 53.
It was the end of her four-year battle with cancer -- and the beginning of Chant's crusade.
Yedalian, now 29, has been waging a legal battle against Kaiser Permanente ever since. He claims that California's largest health maintenance organization wrongly denied his mother a potentially life-saving bone marrow transplant. "They killed my mom," he says.
Kaiser lawyers say the HMO did all it could for Mrs. Yedalian.
The outcome of Yedalian's lawsuit could have broad implications for Kaiser and other HMOs, according to some consumer advocates and attorneys who are closely following the case. About 1,000 Kaiser members or their families file malpractice claims each year. Nearly all of them are subject to arbitration, a long process that limits awards and tends to benefit health plans.
To get his case moved out of arbitration, Yedalian argued that his mother's contract with Kaiser did not meet state legal disclosure requirements, meaning that it was not clear she was giving up the right to a jury trial when she enrolled in the plan. "If the position he is asserting prevails in court, it could provide benefit to people in similar situations, anyone in an HMO seeking a way out of arbitration," says Michael Bidart, a Claremont attorney who was a lead litigator of claims in the Northridge earthquake.
Jamie Court, president of the Foundation for Taxpayer and Consumer Rights in Santa Monica, says that "bottom line, this could mean that a very determined son has found an escape hatch for the private justice system that has never worked appropriately for patients."
Kaiser officials say that no legal precedent is at stake in the case, and that in any event Kaiser has changed its enrollment forms in recent years. But with 6 million members in California, the HMO isn't taking any chances. In the last 4 1/2 years, Kaiser has enlisted three major law firms to take on Yedalian and his one-man cause. The suit was filed in Los Angeles County Superior Court in 1999.
In legal trench warfare -- an apt description of Yedalian's case, with more than 35 volumes of briefs now piled up -- the eventual winner almost always has the bigger law firm and the resources to outlast and outmaneuver the opposition. But occasionally, such circumstances can be overcome by one impassioned individual.
Yedalian was a college student at UCLA when his fight with Kaiser began. He knew nothing about HMOs at first but learned as he put thousands of miles on his Toyota pickup, driving up and down the state hunting documents from insurance and government offices. He got help from a lawyer, paying him with money that he earned by making kitchen cabinets.
Then Yedalian did something extraordinary: He went to Loyola Law School in Los Angeles so he could handle the case himself. He took courses in insurance law and consumer protection. And in May 2002, he graduated in the top 25% of his class. He passed the bar exam a couple of months later and was hired by personal injury firm Cheong, Denove in Santa Monica, where he spends half his time on the Kaiser complaint.
The suit doesn't specify the amount of damages being sought. "It's not about the money; it's that I have to do it," Yedalian says. He made a promise to his dying mother that he would sue Kaiser and not give up until he won, he says. "Sometimes you feel like you want to explode, but you have to keep cool. I turn those feelings right back at them."
Yedalian looks back on the last decade and sees only his mother and the case. The curtains in his office are drawn, its walls bare, save for one yellow sheet with his court calendar. Boxes of documents and loose papers, briefs, letters and law journals are strewn everywhere, on the floor, on top of the couch. There are no pictures on his desk, no trinkets from memorable vacations, nothing except his work papers.
Most of his close friends have disappeared because he hasn't had time for them. Except for a couple of months in 2000 when there was a lull in the case, he hasn't had a date in the last 10 years. On New Year's Eve, Yedalian says, he went to bed early after a rare dinner out with a friend, and the next day he was back in the office, working until 10 p.m.