CONTACTS 

SUBJECTS
Meeting Scheduled Begin Treatment UCSF 070131 Cetuximab Carboplatin

5203 -
5203 -    ..
5204 - Summary/Objective
5205 -
520501 - Follow up ref SDS 26 0000. ref SDS 25 0000.
520502 -
520503 - UCSF has scheduled Millie to get treatments starting next Wednesday;
520504 - follow on treatments will be on Thursdays, as originally planned to
520505 - accomodate Millie's schedule. ref SDS 0 4Y9N  Jackie explained a
520506 - different scenario on resolving the conflict between UCSF and Kaiser.
520507 - ref SDS 0 4Y62  Jackie sent a letter to UCSF requesting Millie be
520508 - given another CT test for an accurate baseline to evalute
520509 - effectiveness of treatment. ref SDS 0 Z24H
520510 -
520511 -     [On 070127 Millie notified while on vacation about plans for
520512 -     meeting and treatment next week at UCSF. ref SDS 28 UM7Q
520513 -
520514 -
520516 -  ..
5206 -
5207 -
5208 - Progress
5209 -
520901 - Treatment Scheduled Next Wednesday Kaiser Policy Conflict Resolved
520902 - Policy Conflict Kaiser Medicare Resolved Treatment Scheduled for Millie
520903 -
520904 - Follow up ref SDS 26 YF8U, ref SDS 25 YF8U.
520905 -
520906 - Jackie called this afternoon, and said that Doctor Rugo wants to see
520907 - Millie next Wednesday on 070131, and after the meeting, Millie will
520908 - then get treatment at UCSF.  Jackie said that she will call later to
520909 - set the time for Millie to meet with Doctor Rugo on Wednesday.
520911 -  ..
520912 - This confirms Jackie's phone message yesterday, advising that the
520913 - authorization problem was resolved following Millie's letter to
520914 - Kaiser. ref SDS 26 0001
520916 -  ..
520917 - In the call today, Jackie explained that Doctor Rugo decided to see
520918 - Millie on Wednesday to start her on the clinical study, rather than on
520919 - Thursday, which will be the regular day for Millie to get treatments,
520920 - as planned on 070117. ref SDS 20 QM89  Jackie advised that Doctor Rugo
520921 - wants to have a full hour available for the initial examination, and
520922 - her schedule for this Thursday is already booked, so she would have to
520923 - squeeze Millie into a crowded schedule, and there would not be time
520924 - for a full hour.
520925 -
520926 -     [On 070127 Millie notified while on vacation about plans for
520927 -     meeting and treatment next week at UCSF. ref SDS 28 UM7Q
520929 -  ..
520930 - We reviewed understandings on 070117 that the first, and possibly the
520931 - second and third treatments will take several hours, because drugs
520932 - will be given slowly in order for a doctor to monitor side effects.
520933 - ref SDS 20 3E8J
520935 -  ..
520936 - Jackie advised that UCSF agreed to treat Millie after Doctor Rugo was
520937 - satisfied that UCSF will get paid, as reported yesterday, ref SDS 26
520938 - 6K3L, and that Millie will not be stuck with unexpected bills, because
520939 - Kaiser and Medicare dispute coverage, discussed previously with Jackie
520940 - on 070123. ref SDS 25 J43I
520942 -  ..
520943 - Jackie related having met with Doctor Rugo yesterday or the day
520944 - before.  During the meeting, Doctor Rugo called the UCSF Business
520945 - Office.  The call was on a speakerphone, so Jackie heard the entire
520946 - discussion.  The Business Office representative may have been Lisa,
520947 - cited in Michelle's letter from Kaiser on 070123, ref SDS 25 PR3V, and
520948 - in Pam's call from Kaiser yesterday, ref SDS 26 4T3I, but Jackie is
520949 - not sure about the other party, except that they worked in the
520950 - Business Office.
520951 -
520952 -        [On 070126 Arlette called and confirmed that Kaiser submitted
520953 -        referral authorization for Millie to get treatment at UCSF.
520954 -        ref SDS 27 F179
520956 -  ..
520957 - Jackie seemed to explain that UCSF did not receive an authorization
520958 - number faxed from Kaiser, contrary to understandings from the call
520959 - yesterday. ref SDS 26 6K3L
520961 -  ..
520962 - Jackie indicated that Lisa or another representative in the UCSF
520963 - Business Office spent 6 hours or so contacting Medicare and discussing
520964 - payment for Millie's treatment, and that based on those discussions,
520965 - the Business Office representitive (possibly Lisa) assured Doctor Rugo
520966 - that the Business Office is satisfied UCSF will be paid for Standard
520967 - of Care and other expenses for treating Millie that are not paid the
520968 - drug trial program, as originally agreed between Doctor Rugo and
520969 - Millie's primary care physician at Kaiser, reported on 061230.
520970 - ref SDS 10 3X6K  After this call, Doctor Rugo told Lisa to continue
520971 - arrangements for Millie's treatment at UCSF.
520973 -  ..
520974 - This scenario conflicts significantly with understandings during a
520975 - call fro Pam yesterday afternoon on 070124. ref SDS 26 4T3I
520976 -
520977 -
520978 -
520979 -
5210 -

SUBJECTS
CT Scan Test Ordered UCSF Baseline Clinical Study Cetuximab Carbopla

7003 -
700401 -  ..
700402 - CT Test Ordered Evaluate Cancer Treatment Status Pulmonary Embolism
700403 -
700404 - Follow up ref SDS 26 PQ4Q, ref SDS 25 J438.
700405 -
700406 - Jackie plans to call Kaiser and request a PET/CT test, which Jackie
700407 - mentioned in the telephone message yesterday on 070124, ref SDS 26
700408 - PQ4Q, and discussed in more detail on 070123. ref SDS 25 J438
700410 -  ..
700411 - Considered protocol test requirements.  Jackie seemed to indicate that
700412 - CT tests are typically prescribed for the treatment Millie will be
700413 - getting, rather than a PET/CT test.
700415 -  ..
700416 - This aligns with Millie's patient history of treatment on the Taxotere
700417 - and bevacizumab (Avastin) trial, where Millie got monthly CT tests,
700418 - rather than PET or PET/CT tests.  Jackie therefore plans to check with
700419 - Doctor Rugo about requesting a CT test rather than a PET/CT test.
700421 -  ..
700422 - Jackie was not aware that Millie has pulmonary embolism.  She
700423 - indicated today that this issue has not been mentioned during
700424 - discussions with Doctor Rugo and UCSF staff, so she does not know if
700425 - the doctor is aware of Millie's PE condition.
700427 -  ..
700428 - Reviewed patient history where Doctor Benz 2nd opinion for Millie
700429 - received on 041117, ref SDS 4 OT5Q, facilitated discovery by Kaiser
700430 - that Millie has pulmonary embolism, and so resulted in treatment for
700431 - Millie ending on the Avastin trial, reported on 041104. ref SDS 3
700432 - RZ4I
700434 -  ..
700435 - Jackie decided to submit a letter to Kaiser documenting UCSF request
700436 - for Millie to get another CT test for the reasons presented during the
700437 - telecon on 070123. ref SDS 25 J438  UCSF will ask for the form of the
700438 - CT test to evaluate pulmonary embolism, cited in the record on 060120.
700439 - ref SDS 7 S56G  This test can assess Millie's progress toward
700440 - recovery, including diagnostics on enlarged right ventricle, which the
700441 - primary care physician requested for the PET/CT test on 061227, as
700442 - reported on 061208, ref SDS 9 EY5O, and which Kaiser did not perform,
700443 - reported on 070102, ref SDS 13 AK9H, possibly because pulmonary
700444 - embolism requires a special CT test which may not be part of the scope
700445 - for a PET/CT test.
700446 -
700447 -     [On 070126 Arlette reports Kaiser received UCSF's letter and
700448 -     scheduled Millie for a CT test. ref SDS 27 Z24H
700450 -  ..
700451 - Patient profile test data for pulmonary embolism can support the
700452 - doctor's notice during the meeting at Kaiser on 070105 that Millie is
700453 - cleared to return to exercise at the gym to increase fitness that
700454 - strengthens the immune system, essential for recovery from cancer.
700455 -
700456 -
700458 -  ..
7005 -
7006 -
7007 - 1748
7008 -
700801 - Received copy of Jackie's letter to Arlette at Kaiser presenting
700802 - Doctor Rugo's request that Kaiser schedule Millie for a CT test, and
700803 - that the test evaluate pulmonary embolism, which also assess enlarged
700804 - right ventricle, called Cor Pulmonale.
700805 -
700806 -     [On 070126 Arlette reports Kaiser received UCSF's letter and
700807 -     scheduled Millie for a CT test. ref SDS 27 Z24H
700808 -
700809 -
700810 -
700811 -
700812 -
700813 -
700814 -
700815 -
700816 -
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700819 -
7009 -