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Wyden and Murray gave multiple issues for the Aetna CEO to address: "Please provide a written description of Aetna's claims review process, including the specific responsibilities of medical directors, nurses and chief medical officers, as well as any other company employees who are involved in such decisions." 312

While the details of Alyssa's case are extraordinary -- the Grandma Betty trick, the escape from the hospital with police on their heels -- the core of her story is not uncommon in many ways, according to patient advocates.Dr. Julia Hallisy, founder of the Empowered Patient Coalition, says families often tell her that a hospital won't allow their loved one to transfer to another facility. Often, they're afraid to say anything publicly or on social media."You sound like a crazy person -- that your family member was held hostage in an American hospital," she said. "People can't believe that would happen. It's like the stuff of a science fiction story."Kristen Spyker said it happened to her family.When Spyker's son was born with a rare heart defect, she says she told doctors at the Ohio hospital where he was born that she wanted him to have a surgical repair at a hospital with a larger pediatric heart program.She said the heart surgeon at the first hospital refused to send her son's medical records to other hospitals. She also says a surgeon resisted her efforts to transfer her newborn son to another hospital to get a second opinion on what surgery he should have for a rare heart defect."The surgeon said, 'This is my patient. This is my show. I'm the boss, and I say what happens,' " she said.She said a social worker, accompanied by hospital security guards, then came into her son's hospital room and said she was worried that Spyker had postpartum depression that was affecting her ability to make decisions for her son's care.Spyker said the hospital discharged her son only after she threatened legal action.Her son then had a successful procedure at another hospital -- a different procedure than the one recommended by the first doctor.When she told her story on Facebook, Spyker said, other parents shared similar stories."It was parent after parent after parent saying 'this happened to us,'" she said. "They had been so embarrassed to talk about it, but they felt freer when I said it happened to us."Spyker was one of several people who spoke with Alyssa's parents last year while their daughter was at Mayo.In a statement to CNN, the American Hospital Association addressed conflicts between families and hospitals."Communication between physicians and patients is extremely important in working to identify the best treatment," said Dr. Jay Bhatt, senior vice president and chief medical officer of the organization. "Each patient is unique. It is for this reason that the majority of hospitals have patient advocates on staff to help patients and families navigate the care process. Hospitals recognize that patients are critical members of any care team and many are employing new strategies to ensure their voice and perspective is heard and accounted for."When hospitals and families get into intense conflict, Hallisy, a dentist who practices in San Francisco, says human emotions can run amok. She says she saw it happen when her daughter, Katherine, was being treated for cancer."People think that doctors are immune to petty disagreements, but they're human beings, and sometimes ego and primitive emotions take over," she said.She said that in Alyssa's case, she wonders whether a sensitive hospital staffer, perhaps a social worker, could have prevented the situation from becoming as contentious as it did.She thinks back to her daughter, who died at age 10. She remembers the sadness and fear of having a very sick child, as well as the stress of taking care of her two other children and keeping her dental practice afloat while her daughter was in and out of the hospital.She thinks about how Alyssa was near death and how her parents had five younger children 130 miles away, as well as farms and a family business to run."They were under incredible stress," Hallisy said. "They'd almost lost a child, and they had other responsibilities, too. You would think that someone at Mayo would be trained to see that." 3956

While fully autonomous cars are in testing, semi-autonomous competitors to the Super Cruise include the Audi Traffic Jam Pilot, BMW Traffic Jam Assistant, Nissan/Infiniti ProPilot, Mercedes Benz Drive Pilot, Tesla Autopilot, and Volvo Pilot Assist. 248

When officers arrived at the scene, they found a man matching the description provided by the callers, Monahan said."The suspect then took a two-handed shooting stance and pointed an object at the approaching officers, two of whom were in uniform," he said.Four officers discharged their weapons, striking the man, Monahan said. They then gave him first aid and called for an ambulance to take him to the hospital, where he was pronounced dead."It appears we fired 10 rounds between the four officers," Monahan said. The unidentified officers, who were not wearing body cameras, discovered the metal pipe at the scene. 618

While Scripps La Jolla Hospitals and UC San Diego Medical Center both ranked high in various specialties, neither hospital made U.S News & World Report’s “Best Hospitals Honor Roll,” which recognizes hospitals for their performance across multiple areas of care. 266