Lauren Esper has fought for her husband’s medical care since shortly after Gabe Brown fell and suffered a traumatic brain injury Sept. 25 while they were on their honeymoon in Jamaica.
Esper spent $25,000 to get a private Jamaican hospital to provide life-saving treatment, then struggled with the effects of Hurricane Helena to get her husband transported to a Florida hospital.
Her fight didn’t end once Brown returned to the United States, however. Brown was eventually transferred to Select Specialty Hospital in Pittsburgh, with plans to move him to UPMC Mercy’s Center for Brain Injury Rehabilitation.
Despite the opinions of UPMC and Select Specialty doctors that Brown would benefit from the center’s services, his health insurer, United Healthcare, denied the transfer, Esper said.
The next step was a peer-to-peer review, where a UPMC Mercy neurologist confirmed to United Healthcare that Brown would benefit from the transfer, Esper said. The insurer denied it again.
“What United Healthcare did was send me a list of nursing homes for Gabe to go to,” Esper said. “Gabe doesn’t need a nursing home. He needed to go to UPMC Mercy.”
From October:‘My husband was dying right in front of me’: Groom suffers brain injury in honeymoon fall
Esper officially appealed the denial and filed a complaint with the Pennsylvania Insurance Department. She also contacted various local elected officials, desperately trying to get Brown the treatment she and his doctors felt that he needed.
State Sen. Dan Laughlin’s office returned her message within 15 minutes. A staff person relayed the message to Laughlin’s chief of staff, David Kozak.
“We have a contact with United Healthcare, so David told them about this constituent who had a pretty high-profile claim and has been in the news,” Laughlin said. “We said United Healthcare should take a fresh look at this.”
United Healthcare overturned its denial by the next day, Dec. 6. The Minnesota-based health insurer, whose CEO was shot and killed in New York City on Dec. 4, did not return repeated messages seeking comment.
“I cried when I heard it was overturned,” Esper said. “It was such a relief. This situation has been nothing but roadblocks. This is where he needs to go, UPMC Mercy.”
Brown was transferred from Select Specialty to UPMC Mercy on Tuesday.
UPMC officials said it’s too soon to provide an update on Brown’s condition. A Select Specialty spokeswoman said that the health system doesn’t comment publicly about its patients, even with family permission, due to patient privacy concerns.
Esper said that her husband continues to make slow, steady progress and has already started occupational, speech and physical therapy at UPMC Mercy. He receives three hours of therapy a day, compared to 10 minutes of therapy three times a week at Select Specialty.
Brown showed progress following skull surgery in November
A key development occurred in November when surgeons at UPMC Presbyterian used a piece of artificial skull to cover an opening made when Brown’s brain was swelling shortly after the accident.
“One of Gabe’s doctors said that his brain may have been sitting a little irregularly in his head without that piece of skull,” Esper said. “He thought his brain would go to its usual place after the piece was attached and we might see improvement. And we did.”
Brown is not fully conscious but does respond to some verbal and physical stimuli. Though he still needs a tracheostomy tube to breathe, he moves his lips at times as if he is trying to talk.
Brown’s father-in-law: ‘He’s in there’
One of the most memorable responses came recently when Esper’s father visited Brown at Select Specialty.
“Gabe is like a son to my dad and when he came and prayed, Gabe had tears in his eyes,” Esper said. “My dad said, ‘He’s in there.'”
Brown is currently on short-term disability and will soon move to long-term disability. Costs not covered by his health insurance, including the $25,000 charged on the couple’s credit cards to pay the Jamaican hospital, have been paid partly by money contributed to Brown’s GoFundMe page.
As of Thursday, people have contributed almost $94,000 for his medical care.
“It’s such a relief to have those funds,” Esper said. “We have started to get medical bills from all the different facilities.”
Contact David Bruce at [email protected]. Follow him on X @ETNBruce.
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