It was dusk as Oakley Yoder and the other summer camp kids hiked back to their tents at Illinois’ Jackson Falls last July. As the group approached a mound of boulders blocking the path, Oakley, then 9, didn’t see the lurking snake — until it bit a toe on her right foot.
“I was really scared,” Oakley said. “I thought that I could either get paralyzed or could actually die.”
Her camp counselors suspected it was a copperhead and knew they needed to get her medical attention as soon as they could. They had to keep her as calm and motionless as possible — the venom could circulate more quickly if her heart raced from activity or fear.
One counselor gave her a piggyback ride to a van. Others distracted her with Taylor Swift songs and candy as the van sped from their location in a beautiful but remote part of the Shawnee National Forest toward help.
First responders met them and recommended Oakley be taken by air ambulance to a hospital.
The helicopter flight transported Oakley 80 miles from a school parking lot just outside the forest to St. Vincent Evansville hospital in Indiana, where she received four vials of antivenin and was then transferred to Riley Hospital for Children in Indianapolis for observation.
Her parents, Josh Perry and Shelli Yoder, were already in bed that night when they got the call about what had happened to Oakley. They jumped in the car and arrived at Riley about two hours before their daughter. Once she made it, doctors closely observed her condition, her toe still oozing and bruised. By lunchtime, Perry said, physicians reassured the parents that Oakley would be OK.
“It was a major comfort for me to realize, OK, we’re getting the best care possible,” said Perry, who is a health care ethics professor at the business school at Indiana University Bloomington. Less than 24 hours after the bite, Oakley left the hospital with her grateful parents.
Then the bills came.
Patient: Oakley Yoder, now 10, of Bloomington, Ind. Insured through Indiana University Bloomington, where her father and mother work as faculty.
Total Bill: $142,938, including $67,957 for four vials of antivenin. ($55,577.64 was charged for air ambulance transport.) The balance included a ground ambulance charge and additional hospital and physician charges, according to the family’s insurer, IU Health Plans.
Service Providers: St. Vincent Evansville hospital, part of Ascension, a nonprofit Catholic health system. Riley Hospital for Children, part of Indiana University Health, a nonprofit health system. Air Evac Lifeteam, an air ambulance provider.
Medical Service: The essential part of Oakley’s treatment involved giving her four vials of snake antivenin called CroFab.
What Gives: When bitten by a venomous snake, there is no time to waste. If left untreated, a venomous bite can cause tissue damage, hemorrhaging and respiratory arrest. Children tend to experience more severe effects because of their relatively small size.
CroFab has dominated the U.S. market for snake antivenin since its approval in 2000. When Oakley was bitten, it was the only drug available to treat venomous bites from pit vipers. (Oakley probably was bitten by a copperhead snake, a type of pit viper, the camp directors told her parents.)
In short, the drugmaker, London-based BTG Plc, essentially had a monopoly.
The average list price for CroFab is $3,198 per vial, according to the health care information tech company Connecture. Manufacturing costs, product improvements and research all factor into the drug’s price, said Chris Sampson, spokesman for BTG.
by Carmen Heredia Rodriguez, Kaiser Health News | Read more:
Image: Chris Bergen
[ed. See also (from the comments): I am the director of The Rattlesnake Conservancy. We are thrilled that you are covering snakebites and educating people without fear-mongering (“Bill Of The Month: Summer Bummer: A Young Camper’s $142,938 Snakebite,” April 30). However, I am concerned that in the radio report on NPR your team mentioned the young lady used a tourniquet and did not mention how dangerous that can be. Many snakebite experts agree that using a tourniquet is dangerous, leading to potentially life-threatening consequences when the tourniquet is removed. Absent loss of life, it also leads to venom accumulation in the limb and significant tissue damage. The best course of action is immobilizing the affected limb and emergency care as soon as possible. No snakebite kits, tourniquets or other devices will help. The only effective treatment for snakebite is antivenom.
The Facebook group “National Snakebite Support” is a crucial tool for anyone who may have been envenomated. The group is staffed by the United States’ top venom specialists and snakebite medical doctors. Their team quickly responds to patients and will communicate with hospital staff on behalf of a patient as needed.
That being said, remember that venom has saved more lives than it has taken. Many medications, including several for blood pressure, arterial clotting and experimental medications, are developed from venomous snakes. For more information, check out our website.
— Anthony Daly-Crews, Buckeye, Ariz.
“I was really scared,” Oakley said. “I thought that I could either get paralyzed or could actually die.”
Her camp counselors suspected it was a copperhead and knew they needed to get her medical attention as soon as they could. They had to keep her as calm and motionless as possible — the venom could circulate more quickly if her heart raced from activity or fear.
One counselor gave her a piggyback ride to a van. Others distracted her with Taylor Swift songs and candy as the van sped from their location in a beautiful but remote part of the Shawnee National Forest toward help.First responders met them and recommended Oakley be taken by air ambulance to a hospital.
The helicopter flight transported Oakley 80 miles from a school parking lot just outside the forest to St. Vincent Evansville hospital in Indiana, where she received four vials of antivenin and was then transferred to Riley Hospital for Children in Indianapolis for observation.
Her parents, Josh Perry and Shelli Yoder, were already in bed that night when they got the call about what had happened to Oakley. They jumped in the car and arrived at Riley about two hours before their daughter. Once she made it, doctors closely observed her condition, her toe still oozing and bruised. By lunchtime, Perry said, physicians reassured the parents that Oakley would be OK.
“It was a major comfort for me to realize, OK, we’re getting the best care possible,” said Perry, who is a health care ethics professor at the business school at Indiana University Bloomington. Less than 24 hours after the bite, Oakley left the hospital with her grateful parents.
Then the bills came.
Patient: Oakley Yoder, now 10, of Bloomington, Ind. Insured through Indiana University Bloomington, where her father and mother work as faculty.
Total Bill: $142,938, including $67,957 for four vials of antivenin. ($55,577.64 was charged for air ambulance transport.) The balance included a ground ambulance charge and additional hospital and physician charges, according to the family’s insurer, IU Health Plans.
Service Providers: St. Vincent Evansville hospital, part of Ascension, a nonprofit Catholic health system. Riley Hospital for Children, part of Indiana University Health, a nonprofit health system. Air Evac Lifeteam, an air ambulance provider.
Medical Service: The essential part of Oakley’s treatment involved giving her four vials of snake antivenin called CroFab.
What Gives: When bitten by a venomous snake, there is no time to waste. If left untreated, a venomous bite can cause tissue damage, hemorrhaging and respiratory arrest. Children tend to experience more severe effects because of their relatively small size.
CroFab has dominated the U.S. market for snake antivenin since its approval in 2000. When Oakley was bitten, it was the only drug available to treat venomous bites from pit vipers. (Oakley probably was bitten by a copperhead snake, a type of pit viper, the camp directors told her parents.)
In short, the drugmaker, London-based BTG Plc, essentially had a monopoly.
The average list price for CroFab is $3,198 per vial, according to the health care information tech company Connecture. Manufacturing costs, product improvements and research all factor into the drug’s price, said Chris Sampson, spokesman for BTG.
by Carmen Heredia Rodriguez, Kaiser Health News | Read more:
Image: Chris Bergen
[ed. See also (from the comments): I am the director of The Rattlesnake Conservancy. We are thrilled that you are covering snakebites and educating people without fear-mongering (“Bill Of The Month: Summer Bummer: A Young Camper’s $142,938 Snakebite,” April 30). However, I am concerned that in the radio report on NPR your team mentioned the young lady used a tourniquet and did not mention how dangerous that can be. Many snakebite experts agree that using a tourniquet is dangerous, leading to potentially life-threatening consequences when the tourniquet is removed. Absent loss of life, it also leads to venom accumulation in the limb and significant tissue damage. The best course of action is immobilizing the affected limb and emergency care as soon as possible. No snakebite kits, tourniquets or other devices will help. The only effective treatment for snakebite is antivenom.
The Facebook group “National Snakebite Support” is a crucial tool for anyone who may have been envenomated. The group is staffed by the United States’ top venom specialists and snakebite medical doctors. Their team quickly responds to patients and will communicate with hospital staff on behalf of a patient as needed.
That being said, remember that venom has saved more lives than it has taken. Many medications, including several for blood pressure, arterial clotting and experimental medications, are developed from venomous snakes. For more information, check out our website.
— Anthony Daly-Crews, Buckeye, Ariz.
