CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 32 0000. ref SDS 29 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 -    1.  On 080829 1200 Doctor Johnson reported in the medical chart
040902 -        that examination at Kaiser diagnosed 5th relapse of IBC,
040903 -        ref SDS 1 1Z6O; advised Millie to notify Doctor Rugo that
040904 -        Kaiser will authorize treatment with "targeted drugs" for
040905 -        Millie's relapse, because Millie has been treated with all of
040906 -        the chemotherapy agents available at Kaiser. ref SDS 1 PX5V
040908 -         ..
040909 -    2.  On 080829 2256 Millie's letter to the medical team reports
040910 -        Doctor Johnson's finding of swelled LN in left supraclavicular,
040911 -        ref SDS 2 RP8T, and Millie's progression of disease requires
040912 -        targeted treatments, ref SDS 2 RP9R; Kaiser wants UCSF to
040913 -        prescribe new treatment in time to be effective. ref SDS 2 RP9W
040915 -         ..
040916 -    3.  On 081024 1150 Doctor Johnson authorized payment for Millie
040917 -        continuing treatment on clinical study at UCSF, ref SDS 3 K67J;
040918 -        explained requirements for treatment to start in time to be
040919 -        effective because Millie's cancer has mutated into a more
040920 -        aggressive disease; the doctor entered into Kaiser's medical
040921 -        chart approval for treatment on referral at UCSF. ref SDS 3
040922 -        OZ5F
040924 -         ..
040925 -    4.  On 081024 1354 Millie's letter notifies medical team that
040926 -        primary care physician authorized treatment on referral to UCSF
040927 -        with clinical study for double agent "targeted" treatment,
040928 -        because Kaiser does not have treatments that can help Millie
040929 -        recover from IBC. ref SDS 4 XZ8W
040931 -         ..
040932 -    5.  On 081219 1140 Doctor Johnson finds favorable response to
040933 -        treatment of IBC 5th relapse with sunitinib, ref SDS 5 3L9L;
040934 -        doctor cites urgency of timely treatment increases when Millie
040935 -        suffers relapse; delay increases risk of losing control for
040936 -        cancer that mutates into more aggressive disease. ref SDS 5
040937 -        KU6F  Doctor Johnson asked Millie to notify Doctor Rugo about
040938 -        planning treatment for the 6th relapse to ensure treatment
040939 -        starts in time to be effective, ref SDS 5 V93O, and asked for a
040940 -        letter from UCSF to facilitate the next referral, ref SDS 5
040941 -        SU8G; because the 6th relapse will be very serious, ref SDS 5
040942 -        NS8H; further emphasized need for letter from UCSF recommending
040943 -        treatment on referral from Kaiser. ref SDS 5 E84J
040945 -         ..
040946 -    6.  On 090115 0700 response to sunitinib treatment indicates IBC
040947 -        on breastbone area stable to worse, everything else looks
040948 -        stable. ref SDS 6 124N
040950 -         ..
040951 -    7.  On 090116 0913 Glenna called to ask about Millie's response to
040952 -        treatment; cited the record no 090115. ref SDS 7 JY6L
040954 -         ..
040955 -    8.  On 090116 1030 Millie blood test at Kaiser cancer marker CA
040956 -        15-3 303 rises 100 points - 3 times higher than at anytime in
040957 -        patient history. ref SDS 8 PQTQ
040959 -         ..
040960 -    9.  On 090116 1348 Glenna letter notifies Doctor Rugo Millie's
040961 -        response to treatment causing rising fatigue, and IBC on
040962 -        breastbone area looks worse. ref SDS 9 4P5M  Millie's letter
040963 -        later in the afternoon confirms understandings that IBC in
040964 -        breastbone area looks stable to worse. ref SDS 10 IS6G
040966 -         ..
040967 -   10.  On 090118 0700 respnose to sunitinib treatment IBC now seems
040968 -        worse in breastbone area. ref SDS 11 124N
040970 -         ..
040971 -   11.  On 090121 1017 Glenna calls to ask about Millie's response to
040972 -        treatment, ref SDS 13 AJ3J; reported rising cancer marker CA
040973 -        15-3 303 on test at Kaiser 090116, and signals 6th relapse of
040974 -        cancer, ref SDS 13 N95K; aligns with IBC worse in breastbone
040975 -        area, reported in patient history on sunitinib treatment
040976 -        reported 090120. ref SDS 12 124N
040978 -         ..
040979 -   12.  On 090122 2321 after Millie returns from treatment in
040980 -        Emergency Room Department for injury to shoulder; message on
040981 -        answering machine from Glenna, Doctor Rugo diagnosed 6th
040982 -        relapse, wants Millie to end treatment with sunitinib in order
040983 -        to remove toxicity from system so that she can start a new
040984 -        treatment next week on 090129. ref SDS 14 J47F
040986 -         ..
040987 -   13.  On 090123 1326 Doctor Johnson called and concurs Millie has
040988 -        suffered IBC relapse with cancer marker CA 15-3 303 in blood
040989 -        test on 090116 at Kaiser; confirms Millie's cancer has mutated
040990 -        to resist treatments available at Kaiser, authorizes UCSF to
040991 -        prescribe next treatment. ref SDS 15 RK6O
040993 -         ..
040994 -   14.  On 090130 1722 reports meeting at UCSF 090129 0830 finds
040995 -        cancer spreading rapidly, ref SDS 16 4S8O, Doctor Rugo
040996 -        prescribes treatment with hyperthermia and Doxil to regain
040997 -        local control, ref SDS 16 4S8O; starting treatment for 6th
040998 -        relapse of IBC was delayed by communication problems.
040999 -        ref SDS 16 AY8Q
041001 -         ..
041002 -   15.  On 090204 0219 Millie asks Doctor Rugo to submit an opinion on
041003 -        likely scenarios and possible treatment options so that
041004 -        proactive management will avoid scrambling at the last minute
041005 -        to get things done for the next treatment, ref SDS 17 278T,
041006 -        that were required for the current hyperthermia treatment
041007 -        scheduled to begin tomorrow on 090205, and shown by case study
041008 -        in the record on 09204 1914 listing chronology of delays.
041009 -        ref SDS 18 MN5I
041011 -         ..
041012 -   16.  On 090204 1914 Doctor Rugo advised that Millie's treatment for
041013 -        IBC would be evaluated in a meeting after treatment with
041014 -        radiation and hyperthermia on referral from Kaiser to the UCSF
041015 -        Radiation Oncology Department. ref SDS 18 278T
041017 -         ..
041018 -   17.  On 090204 1930 Millie letter advises that Kaiser and UCSF have
041019 -        become a winning team providing effective and comprehensive
041020 -        care treating cancer as a chronic disease. ref SDS 19 W84Q
041022 -         ..
041023 -   18.  On 090210 Lena called to schedule meeting with Doctor Rugo at
041024 -        UCSF on 090212 0830. ref SDS 20 XU5N
041026 -         ..
041027 -   19.  On 090213 1140 Doctor Johnson supported proactive planning to
041028 -        treat Millie's next relapse of IBC as a chronic disease,
041029 -        ref SDS 21 GD3I, and approved meeting with Doctor Rugo at UCSF
041030 -        to start research so that treatment can begin in time to be
041031 -        effective. ref SDS 21 WZ6K
041033 -         ..
041034 -   20.  On 090317 0915 Millie completes treatment wtih radiation and
041035 -        hyperthermia; Doctor Hsu scheduled to see Millie on 090423 1315
041036 -        to evaluate response to treatment. ref SDS 23 5Q42
041038 -         ..
041039 -   21.  On 090324 0548 Millie's letter notifies medical team that
041040 -        follow up meeting to assess response to treatment will be at
041041 -        UCSF on 090423 1315. ref SDS 24 CT9R
041043 -         ..
041044 -   22.  On 090401 1210 Pam called in Kaiser's Outside Referrals office
041045 -        and updated the scope of the referral for Millie's care to
041046 -        include Doctor Hsu and Doctor Rugo, and that care will be
041047 -        automatically extended 6 months to a year. ref SDS 26 KT8G
041049 -         ..
041050 -   23.  On 090402 1520 Millie notified medical team that referral for
041051 -        Millie's care was conformed to medical requirements.
041052 -        ref SDS 27 LG4G
041054 -         ..
041055 -   24.  On 090402 0119 Doctor Rugo responded in a letter saying to send
041056 -        information on Kaiser's referral authorization to the UCSF
041057 -        "authorization person." ref SDS 28 WB8F
041059 -         ..
041060 -   25.  On 090402 0855 Millie sent a letter to Glenna at UCSF asking
041061 -        for assistance following up on Doctor Rugo's request to involve
041062 -        the "authorization person," with respect to discussions
041063 -        yesterday with Pam at Kaiser. ref SDS 29 U25I
041065 -         ..
041066 -   26.  Glenna called and said she forwarded Doctor Rugo's letter from
041067 -        last night, and including a copy of Millie's letter on the
041068 -        authorization issue to two people with request to follow up as
041069 -        Doctor Rugo requests. ref SDS 29 PPTS
041071 -         ..
041072 -   27.  On 090403 1054 Millie sent a letter to Juanella Faison, listed
041073 -        as an assistant for Doctor Rugo, ref SDS 31 L494, asking to
041074 -        implement planning for Millie to meet with Doctor Rugo on
041075 -        090423 0800.
041077 -         ..
041078 -   28.  On 090407 0956 called and talked to Roy in UCSF Breast Care
041079 -        Clinic who advised UCSF has still not scheduled Millie to meet
041080 -        with Doctor Rugo on 090423 0800; also asked for assistance to
041081 -        implement Doctor Rugo's request on 090402 to submit information
041082 -        on the scope of Millie's referral to the "authorization person"
041083 -        at UCSF. ref SDS 32 PP8X
041084 -
041085 -
041086 -
041088 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Received call from Amanda who supports Doctor Rugo in the Breast Care
041402 - Clinic.  She related having received a message from Roy this morning
041403 - about Doctor Rugo's letter on 090402 0119, ref SDS 28 LA6H, asking for
041404 - the "authorization person" to process new information on Kaiser's
041405 - referral for Millie's care, which was submitted to the medical team on
041406 - 090401 1520. ref SDS 27 LG4G
041408 -  ..
041409 - Amanda advised she cannot find Millie's letter sent 090401 1520,
041410 - ref SDS 27 LG4G, and further she cannot find Kaiser's referral for
041411 - Doctor Rugo to see Millie on 090423, and so that meeting cannot be
041412 - scheduled.
041414 -  ..
041415 - Amanda asked that Millie send another copy of the letter to the
041416 - medical team explaining referral arrangements with Kaiser, so that
041417 - Amanda can investigate and take appropriate action to ensure Millie
041418 - gets timely care.
041419 -
041421 -  ..
0415 -
0416 -
0417 - 1129
0418 -
041801 - Forwarded Millie's letter to the medical team on 090401 1520,
041802 - ref SDS 27 LG4G to Amanda at UCSF, per her request.
041803 -
041805 -  ..
0419 -
0420 -
0421 - 1152
0422 -
042201 - Amanda called back and said she received the forwarded copy of
042202 - Millie's letter to the medical team on 090401 1520 explaining
042203 - discussions with the Outside Referral office at Kaiser. ref SDS 27
042204 - LG4G
042206 -  ..
042207 - Amanda advised that she talked to Doctor Rugo.  The doctor will be out
042208 - of town on 090423, and so wants Tara to make an examination on the
042209 - 23rd, and then report to Doctor Rugo, as Tara planned to do following
042210 - examination of Millie at UCSF on 090312 0800. ref SDS 22 SS4F
042212 -  ..
042213 - Amanda will ask Doctor Rugo about changing the date of meeting on
042214 - 090423 to meet on a date convenient to Doctor Rugo's schedule.
042215 -
042216 -            [On 090407 1442 called Kaiser to implement planning and
042217 -            resolve problems for Millie's CT test scheduled on 090413
042218 -            to ensure there is enough time for Kaiser to issue reports
042219 -            for labs and the CT test that will be available in time for
042220 -            Doctor Rugo's examination on 090423. ref SDS 33 WB6G
042222 -             ..
042223 -            [On 090408 1113 letter to medical team confirms Millie is
042224 -            scheduled to meet with Tara on 090423 0830. ref SDS 34 E54L
042226 -             ..
042227 -            [On 090408 1113 letter to medical team confirms Amanda
042228 -            checking with Doctor Rugo about changing the date for
042229 -            Millie's examination to a date convenient for the doctor.
042230 -            ref SDS 34 QW7Q
042231 -
042232 -
042233 -
042234 -
042235 -
042236 -
042237 -
042238 -
042239 -
042240 -
0423 -