This spring, a few days after his 2nd birthday, Brigland Pfeffer was playing with his siblings in their San Diego backyard.
His mother, Lindsay Pfeffer, was a few feet away when Brigland made a noise and came running from the stone firepit, holding his right hand. She noticed a pinprick of blood between his thumb and forefinger when her older son called out, “Snake!”
“I saw a small rattlesnake coiled up by the firepit,” she said.
Pfeffer called 911, and an ambulance transported Brigland to Palomar Medical Center Escondido.
The Medical Procedure
When they arrived, Brigland’s hand was swollen and purple.
Antivenom, an antibody therapy that disables certain toxins, is usually administered via an intravenous line, directly into the bloodstream. But emergency room staffers struggled to insert the IV.
“They had so many people in that room trying his head, his neck, his feet, his arms — like, everything to find a vein,” Pfeffer said.
Brigland during his hospital stay, after he was bitten by a rattlesnake in his San Diego backyard. After problems administering a starting dose of antivenom, emergency room staffers found a way that worked and stabilized the 2-year-old. He received 30 total vials of the antivenom Anavip. (Lindsay Pfeffer)
Still unable to start the antivenom, a doctor asked for her permission to try drastic measures. “Just get something going,” she recalled pleading.
It worked. Using a procedure that delivers medicine into the bone marrow, the medical team gave Brigland a starting dose of the antivenom Anavip.
He was transferred to the pediatric intensive care unit at Rady Children’s Hospital, where he received more Anavip.
The swelling that had spread to his armpit slowly decreased. A couple of days later, he left the hospital with his grateful parents.
Then the bills came.
The Final Bill
$297,461, which included two ambulance rides, an emergency room visit, and a couple of days in pediatric intensive care. Antivenom alone accounts for $213,278.80 of the total bill.
The Billing Problem: The High Cost of Antivenom
The Centers for Disease Control and Prevention estimates venomous snakes bite 7,000 to 8,000 people in the United States every year. About five people die. That number would be higher, the agency says, if not for medical treatment.
Many snakebites happen far from medical care, and not all emergency rooms keep costly antivenom in stock, which can add big ambulance bills to already expensive care.
It often takes more than a dozen vials, typically costing thousands per vial, to treat …