BRONX, New York (WABC) — A father of two from the Bronx, who was denied a number of occasions for surgical procedure on a uncommon illness, has now been accepted for the doubtless life-saving process in a reversal from his insurance coverage firm.

Anthony Di Laura, 35, of Throggs Neck, has a uncommon illness known as Pseudomyxoma Peritonei, which is attacking his stomach organs.

He was identified in August 2020, only a few months after discovering out that he and his spouse, Jackie Cucullo, have been going to have their first little one.

Di Laura underwent three surgical procedures to attempt to take away the diseased tissue, but it surely was discovered to be cancerous and he started seven months of chemotherapy. Around the identical time, Cucullo turned pregnant with the couple’s second little one. Neither the surgical procedures nor the chemotherapy was profitable in combating the illness and most cancers.

“This cancer has caused me to diminish who I am and my being,” a frail, pale Di Laura advised Eyewitness News 7 On Your Side Investigates Reporter Kristin Thorne. “And I’m fighting it every day to not let it take control of that.”

Doctors not too long ago advised Di Laura his most suitable choice could also be hospice.

Cucullo heard about a health care provider on the Cleveland Clinic in Ohio who had not too long ago carried out the nation’s first multi-organ transplant on a Minnesota man dying from the identical illness. The process concerned eradicating the person’s diseased stomach organs and changing them with wholesome ones.

Di Laura traveled to the Cleveland Clinic final spring and underwent greater than two dozen checks to see if he could be eligible for a similar process. In Di Laura’s case, the physician would take away his abdomen, giant gut, small gut, and spleen and change them with wholesome organs.

On April 21, whereas nonetheless in Ohio, the clinic knowledgeable Di Laura he had been accepted for the surgical procedure.

“It was the biggest sigh of relief,” he stated.

Shortly thereafter, Di Laura’s insurance coverage, Empire BlueCross BlueShield, denied the process citing it as “investigational.”

“Everything in life could be considered investigational,” Cucullo stated. “How do we make headway in the medical field? This has to happen.”

Di Laura appealed the choice. It was denied once more and two extra occasions after that, even though the surgeon at Cleveland Clinic wrote to Empire to specific his perception that the surgical procedure was medically crucial to save lots of Di Laura’s life. Cucullo stated the physician additionally spoke with docs at Empire.

Empire wrote of their denial letters to Di Laura that “medical studies do not show that this surgery is safe or will improve your short or long-term health if there has been this type of spread. We also got an opinion from a doctor outside of our health plan. This doctor treats people with your condition. This doctor agrees that medical studies do not show that this surgery is safe or will improve your short or long-term health.”

Empire despatched to Eyewitness News their scientific steerage which states {that a} “multi-visceral” transplant, just like the one Di Laura is requesting, is contraindicated for sufferers with metastatic most cancers, like Di Laura.

Empire stated a number of exterior surgeons reviewed Di Laura’s request.

“The external reviewers considered several articles in the published, peer-reviewed literature – including at least one article authored by the treating surgeon – and also reviewed a couple of abstracts submitted by the surgeon with this request,” the corporate stated in a press release.

However, in a press release on Thursday, Empire reversed their choice and stated that they’d now cowl the process with the surgeon on the Cleveland Clinic.

“Together with Mr. Di Laura’s medical team, our clinical team made the decision to cover Mr. Di Laura’s procedure with the surgeon at the Cleveland Clinic. The transplant surgeon provided additional information to demonstrate this procedure has shown early promise in case reports from the UK and could be the only option left that may improve health outcomes for Mr. Di Laura. We will continue to support him and his family as we move forward.”

Before Empire’s reversal, as a result of they’d denied Di Laura’s attraction thrice, the one recourse Di Laura had was to file an emergency attraction with the New York State Department of Financial Services. Di Laura had submitted it this week.

“Who are these people that are going to be reviewing now my husband’s life?” Cucullo stated.

Di Laura stated he’s in stomach ache 24/7. He has to get his diet partially by way of a tube and he has a tube popping out of his stomach to empty the fluid that regularly builds up all through the day due to the illness.

Cucullo stated she was advised by Cleveland Clinic in the event that they have been to carry out the surgical procedure out-of-pocket it will value anyplace between $500,000 and $1 million.

The family has started a GoFundMe campaign to boost cash for that potential value and some other remedy Di Laura could need to bear.

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