Donors are lined up, but insurance snafu delays Tri-City firefighter's transplant [Tri-City Herald (Kennewick, Wash.)]

Mar. 14—Ray Newton was excited to find out if he was going to get a new kidney.

After months of the West Richland fire captain spreading the word, several people had come forward as potential donors.

"It's nice to see that," Newton told the Herald. "When you hear them say you have multiple potential donors, it's like, 'Wow.' ... You can't count your chickens before they hatch, but it gives you a little bit of hope."

But just as soon as Virginia Mason Medical Center was preparing to test the potential donors, Newton got the bad news. His health insurance provider wouldn't cover the transplant at that hospital.

It was frustrating news for the Benton County Fire District 4 firefighter, who is in a race against his failing kidneys to find a replacement.

Newton, 46, has spent about 20 years with polycystic kidney disease. The hereditary, degenerative condition causes growths on his kidneys and has left him unable to go out on fire calls.

He is looking for a replacement before he needs to start on dialysis, which would cost him his career.

It's a journey that he has made with Virginia Mason, which had been authorized by the his insurance provider. But at the beginning of the year, the Washington Fire Commissioner Association switched providers to Cigna.

The district employees get their insurance through the association.

While Virginia Mason is in the new provider's network, they aren't authorized for transplants.

Transplant roadblock

Without having the authorization, any forward momentum was ground to a halt.

Not only does the insurance cover Newton's medical costs, but it also pays for the donor to have their kidney removed. Both of the processes are costly without it.

That left Newton facing the possibility of starting the entire transplant process over with a different hospital, and going through all the testing again, so he could get the transplant approved.

Newton didn't want to start over, so he's started looking for a solution.

His fire chief, Paul Carlyle, and fire commissioners said they were willingness to support him.

"Ray's our longest career hire. He's still setting a record," Carlyle told the Herald. "When he's gone we feel it. ... We're not a huge department. We'll do anything we can do to remove roadblocks and get things accomplished."

Newton said plans are in the works to get a one-time authorization for the transplant. He is hoping it moves forward in the next few weeks.

While he waits for the paperwork to be approved, Newton's body has given him a reprieve. His kidneys continue to be low-functioning, but they aren't getting worse.

"It's bad, but I'm not needing dialysis," he said. "I would love to get transplanted this spring and recuperate over the summer. That's my goal."

Kidney donations

Since word of Newton's need spread, multiple people have signed up as potential donors, including a childhood friend from Spokane. He's also heard from a retired firefighter who was willing to donate in hopes of helping Newton.

"There are people trying," he said. "At least people are out there willing to help. Hopefully something comes out of this and we can move forward."

Newton has been on the transplant list if a donated kidney becomes available, he is hoping to find a living donor.

Kidneys from living donors on average last for about 12 years while a kidney from a deceased donor normally last about eight years.

This story was originally published March 14, 2023, 11:41 AM.

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