French justice dismissed on Friday a young woman who had both hands transplanted in the United States in 2016, who was claiming reimbursement of more than a million dollars from social security.
“The payment of care provided abroad is for social organizations only a simple option, exceptionally and after a favorable opinion from medical control”, decides the Paris Court of Appeal in its judgment, reversing a previous court decision.
The plaintiff, Laura Nataf, had four limbs amputated in 2007 at the age of 19 after septic shock. In 2013, she was placed on the list of patients awaiting a transplant, in a research program at the Georges-Pompidou public hospital in Paris.
But the health authorities had not renewed the authorization of this program, then the young woman had been placed in “temporary contraindication” at the beginning of 2016. She had then decided to have surgery in the United States on the proposal of her surgeon. Laurent Lantieri, known as one of the pioneers of face transplants.
In February 2016, the Health Insurance had sent a refusal of coverage, but the young woman had nevertheless had surgery at Penn Medicine Hospital in Philadelphia, which then sent her a bill for 1.13 million dollars. .
At first instance in July 2021, the Paris court had canceled the refusal to cover health insurance and ordered it to pay two-thirds of the amount claimed. But the latter had appealed.
“Without ignoring that at the time there was no other service that could accommodate her and that she turned to a foreign team to be able to benefit from the double transplant (…), it is appropriate to hold that the Social Security court could not replace the assessment of the fund, itself bound by the unfavorable opinion of the medical control, to decide on the reimbursement of the care provided abroad”, argues the Court of Appeal.