CONTACTS 

SUBJECTS
INR 2.5 Blood Test 070301 Notify Kaiser Coagulation Control Clinic B

1203 -
1203 -    ..
1204 - Summary/Objective
1205 -
120501 - Follow up ref SDS 11 0000, ref SDS 9 0000.
120502 -
120503 -
120504 -
120505 -
120506 -
120508 -  ..
1206 -
1207 -
1208 - Progress
1209 -
120901 - INR 2.5 Stable Normal Notify Kaiser Coagulation Control Clinic
120902 -
120903 - Follow up ref SDS 11 K14H, ref SDS 10 SE6N.
120904 -
120905 - On 070302 Millie notified Gloria in the Coagulation Control Clinic
120906 - that the blood test on 070301 yielded results of INR 2.5. ref SDS 11
120907 - K14H  Subsequent review of the blood test report received from UCSF on
120908 - 070301 revealed significant differences in "normal" range criteria.
120909 - ref SDS 10 8W46  This presents the possibility that INR 2.5, is 100%
120910 - too high, ref SDS 10 SE6N, citing the record on 061214, ref SDS 4
120911 - 0001, rather than in the middle of the normal range, as reported in a
120912 - letter, ref DIP 2 0001, on 070302 to Gloria in the Coagulartion
120913 - Control Clinic. ref SDS 11 K14H
120915 -  ..
120916 - Millie submitted ref DIT 1 0001 to Jackie at UCSF with a copy to
120917 - Arlette and to Gloria saying...
120918 -
120919 -    1.  Per your request [on 070301, ref SDS 9 0U8K], on 070302 I
120920 -        notified Gloria at Kaiser's Coagulation Control Clinic in
120921 -        Martinez that the UCSF blood test on 070301 shows INR 2.5.
120922 -        ref SDS 11 K14H, ref DIT 1 0001
120924 -         ..
120925 -    2.  Can you please clarify evident differences between INR 2.5
120926 -        listed as "high" in UCSF blood test for 070301 and Kaiser
120927 -        diagnostics that show INR 2.5 occurs within the normal range.
120928 -        ref SDS 10 I35J, ref DIT 1 RE5O
120930 -         ..
120931 -    3.  Hopefully, I am reading the test report incorrectly; however,
120932 -        it appears that in the UCSF scheme INR 2.5 is more than double
120933 -        the upper range of 1.2, which in the Kaiser scheme would be the
120934 -        equivalent of INR over 6.  If so, this changes considerably
120935 -        understandings in my letter to Kaiser on 070302 suggesting
120936 -        changes to Coumadin may not be needed. ref SDS 11 K14H
120937 -        ref DIT 1 RE6M
120939 -  ..
120940 - Review of blood test results on 070301 indicates INR 2.5 might be
120941 - double the normal range, ref SDS 10 SE6N, which could presents high
120942 - risks of hemorraging, citing the record on 061214. ref SDS 4 0001
120943 -
120945 -  ..
120946 - Planning INR Evaluated Blood Test on 070308
120947 - Coordination Request Kaiser Communicate Directly with UCSF
120948 -
120949 -
120950 -    4.  By copy, I am notifying Gloria to coordinate with Jackie for
120951 -        any clarifications on INR protocol to assess changes in
120952 -        Coumadin treatments.  Recall, that UCSF plans another blood
120953 -        test on Thursday, 070208.  INR can be tested again at that
120954 -        time. ref DIT 1 RE7K
120956 -  ..
120957 - This implements Gloria's request for another blood test to evaluate
120958 - INR on 070308. ref SDS 11 U24Y
120960 -  ..
120961 - Letter to Jackie at UCSF concludes...
120962 -
120963 -    5.  Please let me know of any changes in treatment.
120964 -
120965 -            [...below, Jackie forward's Millie's letter to Brigid for
120966 -            clarification of INR. ref SDS 0 MF8Q
120968 -             ..
120969 -            [...below, Brigid says correct range is 2 - 3, ref SDS 0
120970 -            MF3V, so INR 2.5 is consistent, and can skip blood test
120971 -            next week.
120972 -
120973 -
120974 -
120975 -
1210 -

SUBJECTS
UCSF Confirms Correct Range for Coumadin Treatments INR 2.0 - 3.0 De

2203 -
2204 - 1616
220501 -  ..
220502 - INR 2 - 3 Correct Range Blood Test Coumadin Treatments Pulmonary Embolism
220503 - UCSF Confirms Correct Range for Coumadin Treatments INR 2.0 - 3.0
220504 -
220505 - Millie received ref DRT 1 0001 from Brigid responding to Millie's
220506 - letter, which was forwarded to Brigid by Jackie, and saying...
220507 -
220508 -    1.  [Responding to your letter today, March 5, 2007, ref SDS 0
220509 -        XG5H, which was received from Jackie, ref SDS 0 MF8U, and
220510 -        requesting clarification of UCSF blood test diagnostics,
220511 -        ref SDS 0 3A4Y, that reported on March 1, 2007 your INR 2.5 was
220512 -        more than double the normal range from .9 - 1.2 listed in the
220513 -        UCSF report. ref SDS 10 SE6N, ref DRT 1 0001
220515 -         ..
220516 -    2.  Different labs have different values systems, if the goal is to
220517 -        keep Mille at a therapuetic level her INR should be between
220518 -        2-3. ref DRT 1 5I6F
220519 -
220520 -            [...below, Millie coordinates communications with Gloria
220521 -            and Arlette at Kaiser. ref SDS 0 2C6L
220523 -  ..
220524 - This clarifies question on 070301 about different blood test criteria
220525 - for INR shown UCSF blood test. ref SDS 10 SE6N
220526 -
220527 -
220528 - ************************
220530 -         ..
220531 -    1.  Monday, March 05, 2007 4:07 PM, ref DRT 1 1Y4G
220533 -         ..
220534 -    2.  From:  Jackie
220536 -         ..
220537 -    3.  To:  Brigid
220539 -         ..
220540 -    4.  Subject:  INR 2.5 Clarification Coordination Plan Kaiser UCSF Clinical Study
220542 -         ..
220543 -    5.  please clarify....! [INR issue presented in letter from Millie
220544 -        **** dated today, ref SDS 0 XG5H, March 5, 2007], ref DRT 1
220545 -        RN4H
220547 -  ..
220548 - Jackie submit's Millie's letter to Brigid for clarification of INR
220549 - criteira. ref SDS 0 XG5H
220550 -
220551 -            [...above, Brigid explains INR in UCSF blood tests.
220552 -            ref SDS 0 MF3V
220553 -
220554 -
220555 -
220556 -
2206 -

SUBJECTS
Thank You UCSF Commend Timely Clarification INR Criteria Managing Co

3303 -
3304 - 1622
330501 -  ..
330502 - Coordinate Communication Kaiser UCSF INR Blood Test Standards Coumadin
330503 -
330504 - For some reason, Brigid did not submit her letter clarifying UCSF
330505 - blood test standards for INR to manage Coumadin treatments for
330506 - pulmonary embolism, per above, to either Arlette or Gloria at Kaiser.
330507 - ref SDS 0 SN5O
330509 -  ..
330510 - This may reflect UCSF policy presented on 070301 for patients to
330511 - coordinate communications with the primary care provider. ref SDS 9
330512 - O67N  At that time, Brigid cited INR blood test as an example of
330513 - coordination that UCSF relies on patients to perform. ref SDS 9 0U8K
330515 -  ..
330516 - Millie submitted ref DIT 1 0001 to Brigid at UCSF with copies to
330517 - Jackie, also, at UCSF, and to Arlette and Gloria at Kaiser to
330518 - coordinate communication on INR for managing Coumadin to treat
330519 - pulmonary embolism, and following up Gloria's call on 070302 asking
330520 - about INR results for the blood test on 070301. ref SDS 11 U24Y
330522 -  ..
330523 - Millie says to Brigid...
330524 -
330525 -    1.  Thanks very much for timely response to my letter this morning
330526 -        requesting clarification of UCSF blood test report on March 1,
330527 -        2007. ref SDS 0 XG5H  Your letter today indicates INR 2.5 in
330528 -        the UCSF blood test corresponds to Kaiser's protocol for
330529 -        Coumadin to treat my pulmonary embolism. ref SDS 0 SN5O
330531 -         ..
330532 -    2.  Doesn't look like Gloria got a copy of your letter, so by copy
330533 -        will submit your analysis interpreting the blood test in the
330534 -        record on 070301. ref SDS 10 075H
330535 -
330536 -           [On 070306 Millie requests feedback from Gloria to verify
330537 -           accuracy of understandings that Kaiser is satisfied with
330538 -           UCSF blood test on INR for prescribing Coumadin to treat
330539 -           pulmonary embolism, and advises current regimen will
330540 -           continue until further notice. ref SDS 12 FJ9K
330542 -            ..
330543 -           [On 070307 Gloria confirmed Millie's current Coumadin
330544 -           treatment should be continued based on UCSF blood test
330545 -           reporting. ref SDS 13 UH4M
330547 -         ..
330548 -    3.  Jackie thanks for timely coordination.
330550 -  ..
330551 - Jackie coordinating with Brigid today, aligns with UCSF policy
330552 - reported on 070301. ref SDS 9 PR4L  Failure to make distribution to
330553 - Kaiser for timely, accurte communications further aligns with UCSF
330554 - policy. ref SDS 9 O67N
330555 -
330556 -
330557 -
330558 -
330559 -
330560 -
3306 -