Mount Sinai Hospital v. Zorek
271 N.Y.S.2d 1012 (1966)
Issues
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Nature Of The Case
This section contains the nature of the case and procedural background.
Facts
Doctor John J. Bookman had a patient named Jane Zorek, the wife of D. Jane was 5 feet 2 inches, and well over 200 pounds. The doctor had been treating her for a number of medical problems arising from her obesity -- including abscesses, cysts, and skin grafts. In 1962, when this had caused sebaceous gland trouble, he had her hospitalized. In the hospital, she was put on a rigid reducing diet restricted to 800 calories a day and lost seven and one-half pounds. The third-party defendant, Associated Hospital Service of New York (D1), with whom D had a family Blue Cross contract, paid the expenses. Out of the hospital, Jane was unable to maintain her weight loss and was plagued by recurring boils and cysts. Doctor Bookman concluded that hospitalization was required and had her admitted to P. This time she was put on what is known as the 'Duncan Regime' -- a rigid starvation diet, in which the patient receives no calories at all, only fluids, vitamins, and minerals. During her three-week stay, she lost 17 1/2 pounds without adverse effects. This time D1 refused payment. D1 argued that obesity is neither a disease nor an injury, it is clear that Blue Cross coverage is not limited only to those calamities. P sued D for payment and D sued D1 as a third party defendant. D1 argues that hospital confinement was not necessary for proper treatment of Jane's obese condition and that the care rendered to her during her stay in the hospital was convalescent or sanitarium-type care which the contract excludes.
Holding & Decision
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Legal Analysis
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