CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 17 0000. ref SDS 12 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - On 090519 1613 Millie responded, ref SDS 10 8V8H, to the Doctor's
040902 - letter earlier yesterday afternoon on 090519 1536, ref SDS 9 5K7H;
040903 - and, Millie asks the doctor to prescribe treatment so she can recover
040904 - from cancer, as done previously in patient history, ref SDS 10 TY3X,
040905 - and further as planned by the doctor during the meeting on 090515
040906 - 1140. ref SDS 8 655R  Millie also asked the doctor to call on
040907 - expediting treatment in time to be effective, see again on 090520
040908 - 1613, ref SDS 10 TY4W; and Millie asks Doctor Rugo for a "drop dead"
040909 - date on how soon treatment must start in order to be effective, also,
040910 - reported on 090519 1613. ref SDS 10 TX4W
040912 -  ..
040913 - Since Kaiser has delayed ordering treatment, reported on 090520 1710.
040914 - ref SDS 15 ZF4Q, then earlier this morning, on 090521 0211 Millie's
040915 - letter to Doctor Rugo at UCSF with copy to Doctor Hsu asks about
040916 - getting treatment with hyperthermia and Doxil, while Kaiser resolves
040917 - delays ordering MPA prescribed by Doctor Rugo for Millie to recover
040918 - from 8th relapse of cancer, which Millie reports is getting worse
040919 - every day, ref SDS 16 FM7Q, and since Kaiser has previosuly authorized
040920 - treatment with hyperthermia and Doxil, which Doctor Rugo recommended
040921 - earlier on 090129 for Millie to recover from the 7th relapse.
040922 - ref SDS 16 6M4F
040924 -  ..
040925 - Millie received a letter from Doctor Johnson responding to Millie's
040926 - letter to the medical team on 090520 1710, and requesting that Kaiser
040927 - prescribe treatment suitable for Millie's patient profile for
040928 - recovering from 8th relapse of cancer. ref SDS 15 P65H   Doctor
040929 - Johnson's letter was sent through Kaiser's Knowledge Management System
040930 - (reviewed on 060106 1400, ref SDS 1 FE4I, and finding this method
040931 - paralyzes productivity because transparency and timely coordination
040932 - with the medical team are not supported, also on, 060106 1400,
040933 - ref SDS 1 MT9I); the doctor's letter therefore was not disclosed to
040934 - the medical team, and it did transmit the Doctor Johnson's medical
040935 - chart for the meeting on 090515, ref SDS 8 YT5N, and saying...
040936 -
040937 -    1.  Subject:  Last Visit/Recommendations
040938 -        Date Received: 5/21/09 2:53 PM
040942 -         ..
040943 -    2.  You can choose which next treatment regimen that you want.  At
040944 -        this time, no treatment would be considered more superior than
040945 -        another.
040947 -  ..
040948 - This seems to respond at least in part to the letter to the medical
040949 - team on 090520 1719, and to the discussion with Pamela in Expedited
040950 - Claims on 090520 1203, ref SDS 14 IU4E, and which was followed up
040951 - yesterday morning with Pamela's call at 0930. ref SDS 17 UD5H
040952 -
040953 -            [On 090522 1000 Millie notifies medical team that she
040954 -            chooses additional treatment with hyperthermia and Doxil in
040955 -            order to implement Doctor Rugo's treatment plan submitted
040956 -            to Kaiser on 090129 - reported on 090130, ref SDS 4 HK3V,
040957 -            and to meet Doctor Johnson's warning today that treament is
040958 -            needed tomorrow, ref SDS 0 HC8O, that is targeted to
040959 -            Millie's patient profile, shown by effective recovery the
040960 -            past 4 months from treatment with radiation and
040961 -            hyperthermia. ref SDS 18 715V
040963 -             ..
040964 -            [On 090522 1247 Doctor Johnson notifies medical team that
040965 -            Kaiser proposes treating Millie to recover from her 8th
040966 -            relapse of cancer with single-agent chemotherapy protocols
040967 -            using Gemzar and Navelbine, because these are "good choices
040968 -            and known choices" for Millie's care. ref SDS 19 4Q8H
040970 -             ..
040971 -            [On 090522 1351 Millie asks Doctor Johnson if Kaiser's
040972 -            proposal to treat Millie with Gemzar and Navelbine will be
040973 -            effective, or will Millie just suffer weeks of agony from
040974 -            adverse side effects, and then have progression of cancer
040975 -            that requires changing to treatment "targeted" for Millie's
040976 -            patient profile? ref SDS 20 2T4S
040978 -             ..
040979 -            [On 090522 1953 Kaiser discloses that Millie's doctor has
040980 -            "no idea" how treatment Kaiser propose for Millie with
040981 -            Gemzar and Navelbine will affect Millie's complex patient
040982 -            profile; the doctor says these single-agent chemotherapy
040983 -            treatments may not work at all for Millie to recover from
040984 -            8th relapse of cancer. ref SDS 21 UW6G
040986 -             ..
040987 -            [On 090529 1751 Doctor Johnson complains that patient email
040988 -            responding to Kaiser correspondence is confusing,
040989 -            ref SDS 22 SZ9J, and complains that the patient has not
040990 -            responded, which conflicts with the first complaint,
040991 -            ref SDS 22 U34S, and indicates the doctor has ignored
040992 -            patient requests for an explanation comparing treatment
040993 -            alternatives, and further ignores Kaiesr guidance that
040994 -            Gemzar presents extreme risks for Millie's patient
040995 -            profile.
040997 -             ..
040998 -            [On 090605 1447 Millie received documentation from Kaiser
040999 -            with additional problems Gemzar presents for Millie's
041000 -            patient profile, saying that Gemzar requires extreme
041001 -            caution given after a patient has been treated with
041002 -            radiation, which Millie received for 4 weeks in February
041003 -            and March, and contiues to suffer side effects; Kaiser
041004 -            further says treatment with Gemzar requires avoiding blood
041005 -            thinners, and Millie is required to take blood thinners
041006 -            every day for PE. ref SDS 23 V34K
041008 -  ..
041009 - Submitting the medical chart for the meeting on 090515 goes a long way
041010 - toward providing a work up on Millie's patient profile, requested
041012 -  ..
041013 - Telling the patient to "choose" a treatment conflicts with patient
041014 - history of the doctor prescribing care.  Millie has never been asked
041015 - to "choose" a treatment.  At all times during the past 8-years, Kaiser
041016 - has prescribed Millie's treatment as called out in EOC section 2,
041017 - reviewed on, 070927 1311, ref SDS 2 WS6M, and as presented to Kaiser
041018 - Expedited Claims Department in a call with Pamela earlier today on
041019 - 090520 1203. ref SDS 14 9595
041021 -  ..
041022 - Saying at this time, no treatment would be considered more superior
041023 - than another conflicts with the doctor's concern on 090325 that
041024 - Millie's cancer is highly resistant to single agent drugs.
041026 -  ..
041027 - This was repeated during the meeting last Friday on 090515.
041028 - ref SDS 8 658J  The doctor cited in a letter yesterday morning risks
041029 - for Millie's patient profile from single-agent drugs, reported on
041030 - 090520 1113. ref SDS 13 UC9G
041032 -  ..
041033 - Doctor Johnson's letter continues...
041034 -
041035 -    3.  In that you are beginning to progress again, you need to make
041036 -        this decision soon.  Please let me know by the end of the week.
041038 -  ..
041039 - Doctor Johnson's warning late on Thursday evening at 2006 that Millie
041040 - needs immediate treatment by the end of the week, which is just 12
041041 - hours away, aligns with Millie's letter to Doctor Rugo and Doctor Hsu
041042 - at UCSF reporting cancer spreadily rapidly, reported earlier today on
041043 - 090521 0211. ref SDS 16 FM7Q
041044 -
041045 -            [On 090522 0813 Millie notifies medical team that she
041046 -            chooses additional treatment with hyperthermia and Doxil in
041047 -            order to implement Doctor Rugo's treatment plan on 090129 -
041048 -            reported on 090130, ref SDS 4 HK3V, and to meet Doctor
041049 -            Johnson's warning today that treament is needed tomorrow,
041050 -            ref SDS 0 HC8O, that is targeted to Millie's patient
041051 -            profile, shown by effective recovery the past 4 months from
041052 -            treatment with radiation and hyperthermia. ref SDS 18 715V
041054 -  ..
041055 - Kaiser places Millie in an untenalbe position for the first time in 8
041056 - years of care suddenly telling the patient to "choose" a treatment and
041057 - within 12 hours; this causes severe and unnecessary emotional trauma,
041058 - since Millie notified the medical team cancer had begun to progress on
041059 - 090331 2047. ref SDS 6 Q64R  A few weeks later, Millie requested
041060 - treatment, reportd on 090412 2241. ref SDS 7 9S9Y  Kaiser has had 2
041061 - months to diagnose and prescribe treatment suitable for Millie's
041062 - patient profile; yet, still today, Kaiser refuses to provide care
041063 - targeted for Millie to recover from the 8th relapse of cancer.
041065 -  ..
041066 - Doctor Johnson's letter continues...
041067 -
041068 -    4.  If you consider the Clinical Trial at UCSF, you can call
041069 -        1-800-MEDICARE and they will determine if it is appropriate.
041071 -  ..
041072 - Medicare has no role and no experience with Millie's patient history.
041073 - Millie's insurance policy with Kaiser EOC section 2 requires the
041074 - primary care physician to order care targeted to treat Millie's
041075 - complex patient profile, reported on 070927 1311. ref SDS 2 WS6M
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