For further information or an interview or a copy of the complaint, contact Michael Trunk at michael.trunk@klinespecter.com.
APPLETON, WISCONSIN — January 21, 2025 —Bil and Shanon Schmidtknecht, through their lawyers, Michael A. Trunk, Esquire and Helen A. Lawless, Esquire of Kline & Specter, P.C., Mark Cuker, Esquire of the Cuker Law Firm, LLC, and Jerome A. Hierseman, Esquire of End, Hierseman and Crain, LLC, today filed a lawsuit against OptumRx, Inc. and Walgreens Pharmacy on the one-year anniversary of the death of their son, Cole Schmidtknecht. The suit was filed in the Federal District Court of the Eastern District of Wisconsin.
The lawsuit alleges that on January 10, 2024, Cole tried to fill his prescription for Advair Diskus, an asthma inhaler he had taken for many years, but was told that it would cost him $539 out-of-pocket because it was no longer covered by his insurance. The medication had been covered the previous year at a maximum cost of about $66, but OptumRx, Inc., who managed the pharmacy benefit for Cole’s insurance plan, removed it from the covered drugs on the formulary beginning in 2024. The lawsuit further alleges that OptumRx, Inc. never gave Cole the thirty days’ advance notice of the change required by Wisconsin law, which would have given him the opportunity to request an exception to the formulary change.
The lawsuit alleges that there was no medical reason for OptumRx to refuse to cover the drug, and that OptumRx took it off the formulary solely to collect rebates for other branded drugs. The Schmidtknechts allege that this “non-medical switching” of Cole from a drug that was proven to control his asthma to a different drug, just to generate more rebates for OptumRx, was outrageous conduct and a violation of Wisconsin Law.
The suit alleges that Walgreens failed to take any steps to help Cole get his necessary medication, including asking Cole’s physician to either request an exception from OptumRx or to approve an alternative covered medication. The lawsuit alleges that understaffing at Walgreens led it to have insufficient resources to provide appropriate pharmacy services to clients such as Cole.
Cole’s only choice was to either pay $539 or leave the pharmacy without his asthma medication. Because Cole could not afford to pay $539, he left without his medication.
Five days later Cole suffered a catastrophic asthma attack, was hospitalized, and died on January 21, 2024. He was 22 years old.
“The conduct of both OptumRx and Walgreens was deplorable,” said attorney Michael Trunk of Kline & Specter, P.C. “The evidence in this case will show that both OptumRx and Walgreens put profits first, and are directly responsible for Cole’s death,” Trunk continued. Trunk said that Cole’s parents, Bil and Shanon Schmidtknecht, hope that, through this lawsuit, the death of Cole can be an impetus for change in what is a deeply flawed health system.
The suit seeks punitive damages against both companies.
Inquiries can be directed to Michael Trunk at michael.trunk@klinespecter.com.