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NBC News
15 hours ago
- Health
- NBC News
Parents sue over son's asthma death days after inhaler price soared without warning
When 22-year-old Cole Schmidtknecht tried to get a refill on the inhaler prescribed by his doctor to prevent asthma attacks. The medication that had formerly cost him less than $70 at his Appleton, Wisconsin pharmacy was now priced at more than $500, according to Cole's father, Bil Schmidtknecht. Stunned, Cole left the store with a medication designed to stop asthma attacks once they start, but without the Advair Diskus inhaler he needed to prevent attacks from happening in the first place. Five days after his pharmacy visit last year, Cole had a severe asthma attack, stopped breathing and collapsed. He never regained consciousness and died. Doctors attributed his death to asthma. His parents, Bil and Shanon Schmidtknecht, blame what they say is a dysfunctional system where medications can change in price overnight and without notice. A part of the insurance system that many Americans don't know about was responsible for the spike in Cole's inhaler price. Pharmacy benefit managers, or PBMs, are the middlemen that control behind the scenes which drugs will be on an insurance company's list of covered medications (called its formulary). They add or subtract medications through a process that emphasizes profits for the pharmacy benefit manager by way of 'rebates' from drug makers, said Gerard Anderson, a professor of health policy and management at the Johns Hopkins University Bloomberg School of Public Health. PBMs 'are looking for the drug that makes them the most money,' Andersen said 'It's insane that it's happening in America,' Bil Schmidknecht said. 'It's not broken. It's designed to work this way. It's just hurting us.' The Schmidtknechts are pushing for legislation that would require a 90-day warning when an insurance company's formulary is changed. They are also suing Optum Rx, the PBM that took Cole's Advair Diskus off his insurance company's formulary, and Walgreens, his pharmacy, which, the Schmidtknechts say, didn't offer Cole a way to control his asthma while another solution could be found. Cole had a rescue inhaler to deal with attacks when they occurred. But that type medication by itself isn't strong enough to keep someone out of the emergency room if the attack is severe, said Dr. David Bernstein, a professor in the division of Immunology, allergy and rheumatology at University of Cincinnati. The lawsuit claims that Cole did not get the required 30 days notice of the change; that his doctor wasn't contacted; and that the pharmacy didn't provide Cole with any more affordable options. The Schmidknechts said Cole left the pharmacy with only a rescue inhaler, which is used for quick relief. But that type medication by itself isn't strong enough to keep someone out of the emergency room if the asthma attack is severe, immunologist Dr. David Bernstein, a professor in the division of immunology, allergy and rheumatology at the University of Cincinnati, said. 'It was empty at his house, next to his bed,' Bil said of the emergency inhaler. In a motion to dismiss the Schmidkneckt's lawsuit, Optum Rx expressed 'its deepest sympathies' for Cole's death and said federal law prohibits the case from being brought in state court. Optum also said three alternatives, each with a $5 copay, were available, and its system instructed Walgreens to contact Cole's doctor about those options. Walgreens also offered 'its deepest sympathies and cited privacy for why it can't discuss specifics in the case. In a statement, it added, 'In general, in cases where a medication is not covered by insurance, pharmacy staff may work with the plan, patient, and/or prescriber in an effort to process and dispense the prescription if able.' Cole would be 24 now. When speaking about all the things he could have been doing, his parents nearly break down. 'He was just so young and he had his whole life ahead of him,' Shanon said. 'And it was so preventable and so unnecessary.' For the Schmidkneckts, it's about policy change. 'Justice for Cole, of course, but bigger than that, justice for us all,' Shanon said. Getting that change won't be easy. In the U.S., just three PBMs process 80% of prescriptions. And a big part of the PBM formulary playbook is secrecy, Anderson said. That way, patients don't learn how PBMs make their decisions about drugs and why a medication that had been on the formulary no longer is. Often no one, from the patients to the drug companies to the insurers, is aware of the details of the decisions the PBMs are making. 'They do not share this information widely, as it is considered a trade secret,' Anderson said. The deals are 'a negotiation between the drug companies and the PBM,' Anderson said. 'The drug company wants their drug on the formulary in a favorable position. The PBM wants to get the largest possible rebate.' The 'rebate' is the difference between the list price for a drug and what the PBM can buy it for, which can be 'a very much lower number than the list price,' Anderson said. When there are multiple drugs that do essentially the same thing, then there's a bidding war, usually a silent one. The rewards for the PBMs can be huge. A Federal Trade Commission report released in January found that, over the past few years, the three biggest PBMs — CVS Health Caremark Rx, Cigna's Express Scripts and UnitedHealth Group's Optum Rx — inflated the costs of numerous life-saving medications by billions of dollars. The companies countered that the FTC report's conclusions were misleading. In January, CVS Health said in a statement that it 'is inappropriate and misleading to draw broad conclusions from cherry-picked 'specialty generic' outliers' and that the company's 'top priority is to make health care more affordable.' OptumRx said that it helped eligible patients save $1.3 billion last year and estimated that the median out-of-pocket payment for these patients was $5. To remember Cole, both his parents had a tattoo just like his inked onto their wrists. When they feel overwhelmed they glance down at it to remember the change they want to make in his honor. 'It's just everyone's little reminder, you know, from Cole to just keep living and that we can still be happy,' Shanon said. 'I keep trying to remind myself that happiness and joy and grief can co-exist.'
Yahoo
4 days ago
- Business
- Yahoo
Trump's pardon of Sittenfeld stunned many in Cincinnati, but the move fits a pattern
Anyone trying to explain President Donald Trump's pardon of former Cincinnati City Councilman P.G. Sittenfeld this week would be hard-pressed to find a reason in either man's words or deeds. Trump is the Republican, MAGA-hat-wearing populist who revels in mocking Democrats, while Sittenfeld is the liberal Democrat who once called Trump a 'buffoonish carnival barker.' And yet, despite their obvious differences, something or someone motivated Trump to use one of his greatest presidential powers on Sittenfeld's behalf. Neither Trump nor Sittenfeld is saying who or what may have provided that motivation. But the two men are connected in at least a few ways that could have drawn Trump's attention to Sittenfeld's political corruption case and opened the door to his decision to grant him a 'full and unconditional pardon.' Their most obvious common ground is personal familiarity with a federal prosecution they deemed unfair and politically motivated. Before returning to the White House, Trump faced charges related to his handling of classified documents and his efforts to remain in power after losing the 2020 election. Sittenfeld, meanwhile, got a 16-month prison sentence in a bribery and extortion case that derailed a promising political career. Although Trump has given no indication he's familiar with the details of Sittenfeld's case, the president has complained repeatedly about what he describes as the 'weaponization' of the legal system against him and others. Just one day before announcing Sittenfeld's pardon, Trump pardoned a Virginia sheriff convicted on corruption charges, claiming he was 'a victim of an overzealous Biden Department of Justice.' He's also recently pardoned a state senator in Tennessee, a city council member in Las Vegas, two reality TV stars and former Illinois Gov. Rod Blagojevich, who, like Sittenfeld, is a Democrat. 'Trump is just committed to emptying the prisons of anyone convicted of political corruption,' said David Niven, a political scientist at the University of Cincinnati who's been critical of Trump's pardons. 'I think that's the bottom line.' The effect of Trump's pardons, Niven said, is to undermine the government's ability to prosecute corruption cases while also numbing the public to bad behavior by politicians. In this view, it doesn't matter that Sittenfeld is a Democrat and Trump is a Republican. 'This is much more about corruption than politics,' Niven said. Brian Kalt, a law professor at Michigan State University who specializes in presidential powers, said Trump showed in his first term a willingness to help people who shared his political beliefs. This time, he said, the president has taken a keen interest in anyone who's faced a prosecution related to public corruption. 'He's been pardoning people he identifies with,' Kalt said. Most of those pardons have gone to Republicans or, in Blagojevich's case, to people who've publicly praised Trump. Trump advisor Ed Martin explained Trump's approach to pardons this way in a social media post this week: 'No MAGA left behind.' Sittenfeld doesn't appear to fall into that category. He ran for office as a Democrat and has not publicly said anything supportive of Trump. On the contrary, when Trump was on his way to the Republican nomination in 2015, Sittenfeld posted a short YouTube video critical of Trump and his rhetoric. "Donald Trump has gone from being a buffoonish carnival barker to something darker and far more dangerous," he said. 'The fearmongering, the wanton bigotry, the calls for mass deportation, ethnic registries and the scapegoating of religious minorities – this isn't politics as usual." But Trump might have reason to look past such comments, said Bernadette Meyler, a Stanford University law professor who specializes in constitutional law. She said pardoning someone with whom he has little else in common might serve a purpose for Trump. She said it's easier for the president to argue the public corruption pardons he's granting are based on legal reasons, rather than political reasons, if he gives them to both Republicans and Democrats. 'It helps to legitimize his pardons of Republicans if he can say he's pardoned at least some people accused of similar things who are Democrats,' Meyler said. How did Sittenfeld become one of the lucky few Democrats to make the list? Meyler said most people who get pardons have an advocate, either a lawyer or a prominent person known to the president, who can make the case for the president's intervention. There are at least two lawyers who could fit that bill. After Sittenfeld's indictment in 2020, he turned for help to James Burnham, a well-known Republican attorney and expert in corruption cases who worked in both the first and second Trump administration. Most recently, Burnham served as a general counsel in billionaire Elon Musk's Department of Government Efficiency, or DOGE. Another lawyer with ties to both Trump and Sittenfeld is Yaakov Roth, who argued Sittenfeld's case on appeal and now works as Trump's deputy assistant attorney general in the civil division of the Department of Justice. It's not known whether Burnham or Roth, neither of whom could be reached to comment, or anyone else brought Sittenfeld's case to Trump's attention. Other prominent Sittenfeld supporters either couldn't be reached or declined to comment when asked about the pardon and whether they'd reached out to the president on his behalf. Dick Rosenthal, a Cincinnati philanthropist who in 2021 signed an open letter critical of Sittenfeld's prosecution, said he wouldn't comment because, 'I don't think it would be helpful to your readers, or to P.G., or to my family.' Political donors and supporters have for decades been beneficiaries of presidential pardons, but it's become more difficult under Trump to track money flowing to the president or to his family. Trump recently hosted a dinner and White House tour for investors who'd bought millions of dollars of $TRUMP memecoins, which benefits the Trump family's crypto business. Some of those who attended said they hoped their purchase of the memecoins might give them an opportunity to influence Trump on matters they care about. Niven said Trump's mingling of family business and the presidency is another reason the president is eager to attack public corruption cases like Sittenfeld's. 'This is just about normalizing political corruption,' Niven said. 'It's very useful for him, as he auctions off the White House to the highest crypto bidder, that no one pays a price for political corruption.' Kalt, the Michigan State law professor, said questions about pardons and the motivation for granting them are nothing new. It's the speed and scope of Trump's that have drawn so much attention and criticism. Ultimately, though, the president doesn't have to explain his reasons for pardoning anyone, including Sittenfeld. The pardon power requires no Congressional oversight and no judicial review. It's the president's alone to use as he sees fit. 'Ideally, there would be transparency and accountability,' Kalt said. 'But legally the president has the power to do this however he wants.' This article originally appeared on Cincinnati Enquirer: trump pardon of sittenfeld shocked many, but the move fits a pattern
Yahoo
5 days ago
- Business
- Yahoo
Republicans and Democrats both didn't want to talk about Sittenfeld's political future
President Donald Trump's pardon of former Cincinnati Councilman P.G. Sittenfeld means he could run again for office now that his rights have been restored after his felony bribery conviction. If he wanted to, of course. Sittenfeld didn't say anything publicly on Thursday about his future plans now that his federal corruption case is behind him. Those close to him also weren't talking. Does the man who people once saw as the frontrunner for Cincinnati mayor and one of the region's rising Democratic stars now have a political future again? Republicans and Democrats in Cincinnati seemed united in not wanting to say much about Sittenfeld or his political future, if there is any. The pardon by a Republican president of a Democratic politician has put both parties in an awkward position. As for Sittenfeld himself, he did not respond to messages from The Enquirer seeking comment. In a letter he wrote to the judge in 2023 before he was sentenced to 16 months in federal prison, Sittenfeld said his focus was no longer on his personal ambition but "now about my family life, my faith and about helping others who are enduring life's crucibles.' He still had $850,493 in his campaign committee's coffers as of his last filing in January 2025, according to records with the Hamilton County Board of Elections. His past conviction and Trump endorsement doesn't disqualify him from a future run a public office, even in a city where Trump lost by a three-to-one margin, said David Niven, the University of Cincinnati political professor. But Niven doesn't think you'll see Sittenfeld campaign signs anytime soon based on his past statements and the fact that his previous political life almost cost him everything. "I think he could if he wanted it," Niven said. "People love a redemption story. He obviously demonstrated a capacity to connect with people. But I don't see him on the comeback trail." Cincinnati Vice Mayor Jan-Michele Lemon Kearney, who served with Sittenfeld on city council for less than a year in 2020 before Sittenfeld was suspended from council, had more to say than most. In a texted statement to The Enquirer, she saw some future for Sittenfeld in the city but didn't specify what. "There is more work to do, and with his legal matters behind him, P.G is now able to get back to work in some way for the people of Cincinnati," Kearney said. She praised Sittenfeld's past contributions including to the "underserved communities" and pushing for affordable housing. She said Sittenfeld was working to establish a civil rights commission when he resigned from city council. Many people who knew Sittenfeld and worked alongside him didn't publicly celebrate or condemn the pardon. Democratic Rep. Greg Landsman, who served on Cincinnati City Council with Sittenfeld, released a statement saying he didn't know much about the pardon. "I know what you all know, which is what I'm reading," Landsman said. "I'll wait to learn more, and may have more to say then. In the meantime, I don't know much, other than what I'm reading in the news." One of the region's more prominent Democratic funders and Sittenfeld supporter, philanthropist Richard Rosenthal, told The Enquirer it was better not to say anything. "There's stuff that I'm thinking about, but I don't think that it would be helpful to your readers, or to P.G. or to my family for me to comment on the pardon," Rosenthal said. Republicans who were not sympathetic to Sittenfeld during his political career were reticent to say much about Trump's decision to pardon Sittenfeld. Hamilton County GOP Chairman Russ Mock sent a statement to The Enquirer that gave Trump credit but also expressed concerns about the pardon. "President Trump certainly knows about how federal and state corruption prosecutions can be wielded as political weapons, but it could undermine anti-corruption efforts locally, especially as the original conviction was based on a jury trial with substantial evidence," Mock said. When asked for an interview to elaborate, Mock said he didn't have time. Ohio Republican Party Chairman Alex Triantafilou, who was the Hamilton County chair when Sittenfeld was on city council, did not respond to a message seeking comment. Few of the all-Democratic, nine-member Cincinnati City Council had much to say. The nine members were elected with the pledge of rebuilding public trust in the wake of the corruption scandals that led to the arrest of Sittenfeld and two others Democratic members, Jeff Pastor and Tamaya Dennard. "There's no upside to commenting on that thing," said Cincinnati Councilman Mark Jeffreys, one of nine Democratic city council members. City council members Scotty Johnson, Anna Albi, Meeka Owens and Cincinnati's Democratic Mayor Aftab Pureval declined to comment when asked by The Enquirer on Thursday about Sittenfeld. Councilman Seth Walsh wouldn't speculate on Sittenfeld's future. "The corruption scandal that happened is an incredible black mark that happened on Cincinnati, period," Walsh said. "Whether he has a political future, whether any of the individuals that are involved in it have any future with Cincinnati, is less relevant to me than the work that needs to happen to rebuild the public trust." This article originally appeared on Cincinnati Enquirer: PG Sittenfeld's political future uncertain with Trump's pardon
Yahoo
5 days ago
- Business
- Yahoo
Sittenfeld walks free as Trump continues to redefine corruption on his terms
President Donald Trump's pardoning of former Cincinnati City Councilman P.G. Sittenfeld comes as no surprise. It's par for the course for Trump, a man who fundamentally doesn't believe in the concept of political corruption and is on a crusade to stick it to the justice system for his perceived unfair treatment by the courts and prosecutors. Trump's controversial pardons in his second term have included January 6 rioters and many political allies and loyalists, such as Virginia Sheriff Scott Jenkins, who was convicted for handing out deputy sheriff badges in exchange for more than $75,000 in bribes. The only shocking thing about Sittenfeld's pardon is that he is a Democrat who has publicly criticized Trump. "This pardon is perfectly in keeping with Trump's worldview that anyone in office can solicit and take any benefit from anyone they want," said David Niven, a political science professor at the University of Cincinnati. "The one surprising element is that Sittenfeld is not exactly pro-Trump. It's not like he's at home polishing his Trump statues." More: White House: Trump pardons PG Sittenfeld, ex-Cincinnati councilman convicted of bribery Sittenfeld's conviction on federal bribery and attempted extortion charges ended a promising political career, in which he was the frontrunner for mayor in 2020. The case against him centered on donations to his political action committee, which federal prosecutors said he solicited from an informant for the FBI and FBI agents posing as developers of a downtown Cincinnati project. Prosecutors said Sittenfeld's actions went beyond campaign fundraising and crossed the line into bribery. In his defense, Sittenfeld didn't deny that the interactions took place, but he argued that prosecutors were reading too much into his conversations with the informants. Steve Goodin, a Clifton resident, attorney at Porter Wright and a former Cincinnati councilman, said this notion of "prosecutorial overreach" may have resonated with Trump given his views on the myriad criminal cases brought against him. "Trump has a real problem with the way he was treated," said Goodin, a Republican who was appointed to City Council in 2020 to replace a different member who was suspended for taking bribes. "I'm no fan of Donald Trump, but I think a lot of the criminal cases brought against him were not very well thought out, and a lot of people feel the prosecutors were using bad judgment or being political. I think Trump is trying to use the power of the pardon to send a message about what he feels happened to him." Sittenfeld doesn't have a lot in common with some of Trump's other pardons, either politically or in the scope of their crimes. Maybe Trump wanted to throw Democrats a bone, appear less partisan. There's no real downside politically in freeing a guy who has said he's made peace with being out of politics. And if the conviction didn't wipe out Sittenfeld's standing in the Democratic Party, accepting a pardon from Trump might be the finisher. Editorial: Sittenfeld trial exposed ugly underbelly of Cincinnati politics Trump might also have been trying to distract from some of his sketchier pardons, Niven said. "So many of these other rogue political characters Trump has pardoned were putting money in their own pockets with their corruption. Sittenfeld was right on the line between "this is business as usual" and "this is a step too far," Niven said. "In that sense, this is a much more defensible pardon and less of a grand statement." Goodin said Trump's pardon of Sittenfeld might have averted an even worse outcome for efforts to tamp down on political corruption. Sittenfeld's case was potentially headed to the United States Supreme Court on appeal, and his attorneys were taking a novel approach with a First Amendment defense of his conviction. Goodin said it's possible the high court could have sided with Sittenfeld and opened a Pandora's box that "would have made quid pro quo prosecutions difficult." "The pardon cuts off that part of it," Goodin said. "No bad case law coming from the Supreme Court in the short term." More: Can someone pardoned by president vote again? Can they run for office? What it means Regardless, it feels like justice for the people of Cincinnati wasn't fully served. Sure, the pardon doesn't clear Sittenfeld's name; his conviction remains. But Sittenfeld spent more time out of prison during his appeals (a year) than he did behind bars (four and a half months). Tamaya Dennard and Jeff Pastor, two City Council members who were convicted of taking direct bribes around the same time as Sittenfeld, can't say the same. Sittenfeld's pardon is illustrative of the privilege that some people have available to them. What is inconceivable to the average person is always conceivable to people who have money and connections. It's unknown whether Sittenfeld had some relationship somewhere that gave him the ability to make a case to Trump. But neither the politics nor the principle behind why a Republican president with no love lost for Democrats would let a fairly liberal politician from a "sanctuary city" off the hook makes any sense. It's either connections or, as Goodin put it, "Dead luck." "Sometimes it's better to be lucky than good," Goodin said. "Today, Sittenfeld was lucky." Opinion and Engagement Editor Kevin S. Aldridge can be reached at kaldridge@ On X: @kevaldrid. This article originally appeared on Cincinnati Enquirer: Trump pardon lets Sittenfeld slip past justice | Opinion
Yahoo
6 days ago
- General
- Yahoo
Hamilton County judge, who has been on medical leave for a year, announces retirement
Hamilton County Common Pleas Judge Tom Heekin, who has been on medical leave for more than a year, has decided to retire from the bench. Heekin is undergoing treatment for cancer. He has served as a judge since 2016 when he was appointed by then-Gov. John Kasich. He was elected to a second, six-year term in November 2022 and had four years left in that term Heekin, 64, started his medical leave in April 2024. Since that time, Robert Ruehlman, a retired judge, has been handling Heekin's cases. The Ohio Supreme Court appointed Ruehlman on a temporary basis, officials said. He served as a common pleas judge in Hamilton County for 36 years. It is Gov. Mike DeWine's responsibility to appoint Heekin's successor. In a statement, Court Administrator Thomas Beridon said Heekin's tenure was "marked by his deep understanding of the law, his respect for all who entered his courtroom and his steady leadership." "We are profoundly grateful for his faithful service and continued partnership through this period of transition," Beridon said. Heekin's late father, Tom Heekin Sr., was a municipal judge and common pleas judge in Hamilton County decades ago. Ruehlman, in fact, worked for Heekin's father in the 1970s as a law clerk. Heekin is a graduate of Princeton High School. He received his law degree from the University of Cincinnati in 1988. He was an assistant prosecutor in Hamilton County for several years and later founded the law firm Heekin & Heekin with his brother, Christopher. Heekin was a longtime Republican. But when he ran for reelection in 2022, he switched parties and became a Democrat. In a letter to Gov. Mike DeWine's office, Heekin announced that his retirement will be effective Friday, May 30. This article originally appeared on Cincinnati Enquirer: Hamilton County Judge Tom Heekin announces retirement
