CONTACTS
SUBJECTS
White Blood Cell Condition Blood Test Shows Too Low Doctor Johnson A
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 72 0000. ref SDS D0 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - After getting the blood draw in the Infusion Clinic on the 5th floor
040902 - at 1145, ref SDS D2 TP9L, Millie went to the Breast Care Clinic on the
040903 - 2nd floor, implementing the revised schedule submitted by Mike
040904 - yesterday, and confirmed in Millie's letter to the team, reported on
040905 - 090615 1516. ref SDS C9 YW5X
040907 - ..
040908 - Doctor Rugo attended the meeting at the onset with Tara. They worked
040909 - together doing the examination, which is unusual. Normally Tara does
040910 - examinations, and Doctor Rugo visits at the end of the meeting for 5
040911 - or 10 minutes, when she is onsite. Today, signaled a new phase of
040912 - stronger support to recover from medical mistakes getting radiation
040913 - services from UCSF on referral from Kaiser, which caused cancer to
040914 - spread, and created breathing problems, reported by Doctor Hsu last
040915 - week on 090609 0900. ref SDS B5 W65W
040917 - ..
040918 - Starting treatment today required 160 tasks listed in SDS records from
040919 - 090310, when Millie notified the team that IBC seemed to persist in
040920 - the breastbone, ref SDS 48 O56X On 090312, Tara reported increased
040921 - inflammation in the breastbone was not cancer, but reaction to
040922 - radiation. ref SDS 52 YX9F Doctor Hsu concurred, saying Millie's
040923 - letter on 090310 was a mistake. ref SDS 52 UL5L On 090220, the
040924 - medical team was asked about an MRI or other test to assess patient
040925 - concern about progression of cancer in the breastbone. ref SDS 42 EA5P
040926 - At the meeting on 090312, the medical team planned to rely on visual
040927 - examination, ref SDS 52 F893, and did not address using MRI testing.
040928 - ref SDS 52 BY8L On 090330, UCSF decided not to perform MRI testing to
040929 - assess recovery from IBC with radiation. ref SDS 64 LO5N
040931 - ..
040932 - Doctor Rugo and Tara had reviewed correspondence on Millie's care
040933 - since the prior examination on 090514, ref SDS 72 TP9L
040934 -
040935 - 1. Doctor Rugo's letter to Kaiser notifies
040936 - Millie's primary care physician, Doctor
040937 - Johnson, that the best evidence at UCSF
040938 - Cancer Center shows MPA is the best
040939 - treatment for Millie to recover
040940 - from 8th relapse of
040941 - cancer........................... 090514 0830, ref SDS 72 DI63
040943 - ..
040944 - 2. Millie notifies medical team results of
040945 - meeting at UCSF - Doctor Rugo prescribed
040946 - MPA to implement Doctor Johnson's strategy
040947 - at Kaiser for UCSF to treat Millie's
040948 - cancer as a chronic disease
040949 - in order to recover from
040950 - 8th relapse...................... 090514 2346, ref SDS 73 LF3H
040952 - ..
040953 - 3. Doctor Rugo notifies medical team
040954 - that Doctor Johnson refuses to
040955 - order treatment which Doctor
040956 - Johnson requested UCSF
040957 - to prescribe..................... 090515 0952, ref SDS 74 GR4O
040959 - ..
040960 - 4. Millie demands that Kaiser order treatment
040961 - prescribed by UCSF at the request of
040962 - Millie's primary care physician, Doctor
040963 - Johnson, and required by Millie's medical
040964 - insurance agreement with Kaiser to provide
040965 - treatment based on the best evidnece
040966 - which in this case is
040967 - MPA prescribed by
040968 - Doctor Rugo...................... 090515 1017, ref SDS 75 6Q8W
040970 - ..
040971 - 5. Doctor Rugo's letter to medical team
040972 - wishes Millie good luck getting Kaiser
040973 - to perform insurance agreement to provide
040974 - treatment based on best evidence of
040975 - Doctor Rugo's letter to Kaiser
040976 - on 090514 prescribing
040977 - MPA.............................. 090515 1518, ref SDS 77 PW7H
040979 - ..
040980 - 6. Millie notified Doctor Rugo that Doctor
040981 - Johnson filing appeal for Kaiser to treat
040982 - Millie with MPA protocol prescribed
040983 - by UCSF for Millie to recover
040984 - from the 8th relapse of
040985 - cancer........................... 090516 0858, ref SDS 78 SY4J
040987 - ..
040988 - 7. Millie's letter notifies medical team that
040989 - Doctor Johnson received a draft to expedite
040990 - filing appeal to correct mistake in Kaiser
040991 - Outside Referral Department refusing to
040992 - implement Doctor Johnson's strategy treating
040993 - Millie's cancer as a chronic disease in
040994 - time for Millie to recover from
040995 - Millie's 8th relapse of
040996 - cancer........................... 090518 0017, ref SDS 79 R16I
040998 - ..
040999 - 8. Doctor Johnson notified medical team that he
041000 - changed his mind; instead of filing an appeal
041001 - with Member Services to correct Doctor Mason's
041002 - refusal to follow Kaiser's insurance policy
041003 - he sent the draft appeal to alert Doctor Mason,
041004 - and told Millie to file an appeal with Member
041005 - Services, which is an error, since Millie has
041006 - not been denied medical services; and the
041007 - doctor further says he is relieved of
041008 - responsibility to prescribe treatment
041009 - for Millie to recover from cancer,
041010 - because Kaiser's Outside Referrals
041011 - Department has a better
041012 - understanding
041013 - of Medicare...................... 090519 1536, ref SDS 80 5K7H
041015 - ..
041016 - 9. Millie's letter to medical team demands
041017 - Kaiser provide treatment to recover from
041018 - 8th relapse of cancer, and asks Doctor
041019 - Rugo at UCSF for a "drop dead date" that
041020 - estimates how much time treatment can be
041021 - delayed helping Kaiser comply with
041022 - insurance requirements to provide
041023 - medical care in time to
041024 - be effective..................... 090519 1613, ref SDS 81 8V8H
041026 - ..
041027 - 10. Doctor Johnson notified medical team that
041028 - Kaiser "offers" Millie Gemzar or Navelbine
041029 - single-agent chemotherapy, which he says
041030 - are high risk to fail for Millie's patient
041031 - profile, and are likely to cause Millie
041032 - harm; and Kaiser refuses treatment with
041033 - MPA prescribed by UCSF Cancer Center
041034 - as targeted to treat Millie's patient
041035 - profile in time to be effective
041036 - recovering from 8th relapse
041037 - of cancer........................ 090520 1113, ref SDS 82 UC9G
041039 - ..
041040 - 11. Millie notifies medical team she has called
041041 - Kaiser for 3 days and left messages to speak
041042 - with Doctor Johnson assisting Kaiser implement
041043 - insurance agreement to treat Millie for the
041044 - 8th relapse of cancer, and nobody has returned
041045 - calls for 3 days; Millie relates Doctor Johnson
041046 - disclosed in the meeting at Kaiser on 090515
041047 - that Navelbine and Gemzar do not meet Kaiser's
041048 - standard of care for Millie's patient profile,
041049 - and so he would get in trouble for prescribing
041050 - these agents in Millie's case; Millie asks
041051 - Doctor Johnson as the primary care physician
041052 - to explain trade-offs between risks and
041053 - benefits of Gemzar and Navelbine compared
041054 - to MPA prescribed by Doctor Rugo at UCSF
041055 - Cancer Center; and Millie demands
041056 - that Kaiser provide treatment
041057 - suitable to Millie's patient
041058 - profile.......................... 090520 1137, ref SDS 83 5K9M
041060 - ..
041061 - 12. Doctor Johnson notifies medical team that
041062 - Gemzar and Navelbine comply with Kaiser's
041063 - standard of care for treating cancer; does
041064 - not say these single-agent chemotherapy
041065 - agents are suitable for
041066 - Millie's patient
041067 - profile.......................... 090520 1703, ref SDS 84 HN4I
041069 - ..
041070 - 13. Millie notified medical team of calls to
041071 - Kaiser and leaving messages the past 3 days
041072 - asking Doctor Johnson to prescribe treatment;
041073 - Doctor Johnson's letter on 090520 1703 saying
041074 - Gemzar and Navelbine are options for Millie,
041075 - ref SDS 84 HN4I, conflicts with guidance during
041076 - the meeting at Kaiser on 090515 1140 saying
041077 - Gemzar and Navelbine are not appropriate
041078 - for Millie's patient profile, and that Doctor
041079 - Johnson would get in trouble if an audit shows
041080 - he prescribed these single-agent chemotherapy
041081 - agents for Millie, because Millie's patient
041082 - profile now resists single-agent chemotherapies,
041083 - ref SDS 76 658J; on 090330 Millie notified
041084 - medical team that cancer relapsed; on 090412
041085 - Millie requested treatment for 8th relapse of
041086 - her cancer; on 090514 UCSF Cancer Center notified
041087 - Kaiser that MPA is the best choice of treatment
041088 - targeted to Millie's patient profile; on 090515
041089 - Doctor Johnson at Kaiser agreed; since Kaiser
041090 - has not provided care, Millie asked Kaiser
041091 - Expedited Claims to assist Oncology preparing
041092 - a workup to order treatment prescribed by
041093 - UCSF Cancer Center or such other care
041094 - suitable for Millie's patient profile;
041095 - Millie asks Doctor Rugo how much time
041096 - can be invested on administrative
041097 - delay before treatment
041098 - will no longer be
041099 - effective........................ 090520 1710, ref SDS 85 P65H
041101 - ..
041102 - 14. Millie's letter to Doctor Rugo at UCSF with
041103 - copy to Doctor Hsu asks about getting treatment
041104 - with hyperthermia and Doxil, while Kaiser
041105 - resolves delays ordering MPA prescribed by
041106 - Doctor Rugo for Millie to recover from from
041107 - 8th relapse of cancer, which Millie reports
041108 - is getting worse every day, and since Kaiser
041109 - has previosuly authorized treatment with
041110 - hyperthermia and Doxil, which Doctor
041111 - Rugo recommended earlier on 090129
041112 - for Millie to recover from her
041113 - 7th relapse...................... 090521 0211, ref SDS 86 6M4F
041115 - ..
041116 - 15. Doctor Johnson notifies Millie without notice
041117 - to medical team and saying Millie can "choose"
041118 - which next treatment regimen that Millie
041119 - wants, and that no treatment would be
041120 - considered more superior than
041121 - another.......................... 090521 2006, ref SDS 87 UD5H
041122 - the doctor says Millie needs
041123 - urgent treatment and so should
041124 - notify Kaiser which treatment Millie
041125 - chooses by the end of the week, which
041126 - is the next day in roughly
041127 - 12 hours......................... 090521 2006, ref SDS 87 HC8O
041128 - the doctor further tells Millie
041129 - to call Medicare for prescribing
041130 - treatment suitable for Millie's
041131 - patient profile, rather than
041132 - call her doctor in Kaiser
041133 - Oncology........................ 090521 2006, ref SDS 87 HC93
041135 - ..
041136 - 16. Millie notifies medical team that Pamela
041137 - Powel in Kaiser Expedited Claims agreed
041138 - to assist the team prepare a workup and
041139 - Tumor Board review to develop a treatment
041140 - plan for Millie to recover from
041141 - the 8th relapse of
041142 - cancer.......................... 090522 0813, ref SDS 88 7Z5V
041143 - Millie cites shock being suddenly
041144 - told by Kaiser to "choose" treatment,
041145 - because for 8 years, Doctor Johnson
041146 - has always prescribed treatment,
041147 - and has never presented any
041148 - alternatives for patient
041149 - to "choose"..................... 090522 0813, ref SDS 88 7Z4R
041150 - Millie chooses treatment with
041151 - hyperthermia and Doxil in order to
041152 - implement Doctor Rugo's treatment plan
041153 - submitted to Kaiser on 090129 - reported
041154 - on 090130, ref SDS 31 HK3V, and to meet
041155 - Doctor Johnson's warning today that
041156 - treament is needed tomorrow, ref SDS 87
041157 - HC8O, targeted to Millie's patient
041158 - profile, shown by effective recovery
041159 - the past 4 months from treatment
041160 - with radiation and
041161 - hyperthermia.................... 090522 1000, ref SDS 88 715V
041163 - ..
041164 - 17. Doctor Johnson notifies medical team
041165 - that Kaiser has prepared workup on
041166 - change in Millie's medical condition
041167 - relapsing for the 8th time and with
041168 - breathing problems that have not been
041169 - diagnosed; Kaiser does not submit
041170 - the workup, nor prescribe care;
041171 - the doctor says Millie's case
041172 - is too complex for help from
041173 - review by a Kaiser Tumor
041174 - Board........................... 090522 1247, ref SDS 89 XO5O
041175 - Kaiser refuses to prescribe
041176 - treatment for Millie to recover
041177 - from 8th relapse of cancer, and
041178 - maintains that Millie must choose
041179 - between single-agent chemotherapy
041180 - treatments Gemzar and Navelbine
041181 - which the doctor has previously
041182 - reported are not effective for
041183 - Millie's patient profile,
041184 - but are good treatments
041185 - for other cancer
041186 - patients........................ 090522 1247, ref SDS 89 4Q8H
041187 - Kaiser refuses to order treatment
041188 - prescribed by Doctor Rugo at UCSF
041189 - targeted to Millie's patient profile
041190 - demonstrating best evidence for
041191 - Millie to recover from 8th relapse
041192 - of cancer; conflicts with patient
041193 - history showing Kaiser has
041194 - ordered similar treatment
041195 - 8 times........................ 090522 1247, ref SDS 89 4Q88
041196 - Kaiser confirms prior guidance
041197 - that Gemzar and Navelbine proposed
041198 - by Kaiser to treat Millie probably
041199 - won't work, because Millie's patient
041200 - profile resists single-agent drugs;
041201 - Kaiser says that rather than choose
041202 - treatments which will likely fail,
041203 - Millie can choose to die in
041204 - Hospice care................... 090522 1247, ref SDS 89 4Q98
041206 - ..
041207 - 18. Millie notifies medical team that
041208 - Kaiser recommends urgent treatment
041209 - should start soon to recover
041210 - from 8th relapse of
041211 - cancer......................... 090522 1351, ref SDS 90 7R7J
041212 - requests medical advice on
041213 - results expected from treating
041214 - Millie's patient profile with single-agent
041215 - chemotherapy Gemzar and Navelbine - will
041216 - this be weeks of agonizing side effects
041217 - and then progression of cancer
041218 - that requires treatment "targeted"
041219 - to Millie's patient
041220 - profile........................ 090522 1351, ref SDS 90 2T4S
041221 - Millie asks for advice on
041222 - Kaiser clinical
041223 - trials......................... 090522 1351, ref SDS 90 2T4V
041224 - Millie asks for advice comparing
041225 - treatment with hyperthermia, radiation,
041226 - and Doxil, and other appropriate
041227 - agents......................... 090522 1351, ref SDS 90 2T4Y
041228 - and Millie notified medical
041229 - team she chooses treatment with
041230 - hyperthermia and radiation,
041231 - and Doxil, ext................. 090522 1351, ref SDS 90 2T5R
041233 - ..
041234 - 19. Doctor Johnson advises Millie and without
041235 - notice to medical team that CPT 11 listed
041236 - in the doctor's medical chart to treat
041237 - Millie for breast cancer is usually
041238 - prescribed to treat colon
041239 - cancer......................... 090522 1953, ref SDS 91 YT5M
041240 - the doctor does not answer
041241 - Millie's question to compare treatment
041242 - with hyperthermia, radiation, etc; the
041243 - doctor advises he has "no idea" how to
041244 - advise Millie about results to expect
041245 - from treatment with Gemzar and Nabelbine
041246 - proposed by Kaiser, because these
041247 - single-agent chemotherapy treatments
041248 - may not work at all for Millie's
041249 - complex patient profile to
041250 - recover from her 8th
041251 - relapse of
041252 - cancer......................... 090522 1953, ref SDS 91 UW6G
041254 - ..
041255 - 20. Millie submits claim to Paula in Kaiser
041256 - Member Services Claims Resolution Department
041257 - demanding prescription for treatment of 8th
041258 - relapse of cancer, and citing referral from
041259 - Expedited Claims where Paula had previously
041260 - advised Millie to file a
041261 - claim.......................... 090523 0148, ref SDS 92 2P6J
041262 - Millie claims letter from primary
041263 - care physician advising paitient to
041264 - choose the next treatment fails to
041265 - perform Millie's entitlement under
041266 - insurance EOC Section 2 for her doctor
041267 - to explain trade-offs of possible
041268 - treatments and prescribe standard
041269 - of care for Millie's patient
041270 - profile in time to be
041271 - effective...................... 090523 0148, ref SDS 92 DQ5V
041272 - Millie cites patient history
041273 - showing Kaiser routinely prescribes
041274 - clinical trials for standard of
041275 - care treating Millie's
041276 - complex patient
041277 - profile........................ 090523 0148, ref SDS 92 DQ8P
041278 - Millie demands that Kaiser
041279 - notify her immediately of her
041280 - next treatment because the
041281 - doctor has notified the medical
041282 - team that Millie needs urgent
041283 - treatment quickly to prevent
041284 - cancer from cascading out
041285 - of control..................... 090523 0148, ref SDS 92 DQ9Q
041287 - ..
041288 - Millie's letter to Kaiser Member Services
041289 - Claims Resolution Department with copy
041290 - to medical team objects to delaying treatment
041291 - of worsening cancer being in a "loop" where
041292 - Kaiser Expedited Claims Department sent
041293 - Millie's demand for care to Member Services
041294 - Claims Resolution Department, which then
041295 - proposed further 5 - 10 day delay sending
041296 - demand for immediate treatment
041297 - back to Expedited
041298 - claims......................... 090528 1228, ref SDS 93 UD5H
041300 - ..
041301 - Millie demands treatment under
041302 - EOC Section 2 that requires primary
041303 - care physician to provide medical
041304 - services applying standard of care
041305 - for Millie's patient
041306 - profile........................ 090528 1228, ref SDS 93 4N3R
041308 - ..
041309 - Millie requests address for
041310 - driving immediately to sign documents
041311 - Member Services Claims Resolution says
041312 - will take 5 - 10 days to process by
041313 - mail, so that treatment can begin
041314 - immediately; Kaiser fails to
041315 - expedite care.................. 090528 1228, ref SDS 93 4N7U
041317 - ..
041318 - Millie reports cancer progressing
041319 - and so to mitigate damages from Kaiser's
041320 - failure to perform EOC requirements
041321 - she will get care from others
041322 - and bill Kaiser................ 090528 1228, ref SDS 93 4N8X
041324 - ..
041325 - Millie's letter notifies UCSF authorized
041326 - payment to mitigate damages from Kaiser
041327 - failure to perform duty to prescribe
041328 - treatment in time
041329 - to be effective................ 090528 1334, ref SDS 94 UD5H
041331 - ..
041332 - cancer worsening after 2 months
041333 - without treatment, causing left
041334 - arm lymphedema to
041335 - increase....................... 090528 1334, ref SDS 94 2L6W
041337 - ..
041338 - 21. Doctor Rugo notifies medical team
041339 - she guesses Millie can get treatment
041340 - when Millie decides
041341 - to do so....................... 090528 1613, ref SDS 95 XZ4M
041342 - and proposes Millie get treatment
041343 - with gemcitabine............... 090528 1613, ref SDS 95 4T6K
041344 - patient history indicates Doctor
041345 - Rugo "guesses" incorrectly, since
041346 - case study shows that at all times
041347 - Kaiser has required the doctor
041348 - to write a chemotherapy
041349 - order based on best
041350 - evidence....................... 090528 1613, ref SDS 95 KM4K
041351 - Doctor Rugo proposes working
041352 - out trial therapy after gemcitabine
041353 - and maintains the patient would be
041354 - liable for cost sharing beyond
041355 - terms of agreement with Kaiser
041356 - that requires Kaiser to prescribe
041357 - treatment suitable to patient
041358 - profile and based on best
041359 - evidence....................... 090528 1613, ref SDS 95 4T70
041361 - ..
041362 - 22. Millie notifies medical team thanking
041363 - Doctor Rugo for proposing interim treatment
041364 - at Kaiser with gemcitabine, not previously
041365 - proposed by the team for treating
041366 - Millie's patient
041367 - profile......................... 090528 1652, ref SDS 96 MZ7N
041368 - Millie needs a prescription; she cannot
041369 - walk into the Chemotherapy Infusion
041370 - Clinic at UCSF nor at Kaiser and
041371 - get any treatment she wants; a doctor
041372 - must prepare and sign a chemotherapy
041373 - order specifying the best treatment
041374 - for Millie's patient
041375 - profile......................... 090528 1652, ref SDS 96 RS4H
041376 - Millie asks the medical team to compare
041377 - gemcitabine proposed by Doctur Rugo's
041378 - letter with other
041379 - treatments...................... 090528 1652, ref SDS 96 B24S
041381 - ..
041382 - 23. Millie's letter to medical team reports
041383 - research shows Doctor Rugo's prescription
041384 - for gemcitatine is the same as
041385 - Gemzar.......................... 090529 1109, ref SDS 97 448K
041386 - ..
041387 - Kaiser has not prescribed treatment
041388 - for Millie to recover from 8th relapse
041389 - of cancer despite continues
041390 - requests begining
041391 - on 090401....................... 090529 1109, ref SDS 97 0M5U
041392 - Doctor Johnson advised on 090515
041393 - that Gemzar is not standard of care
041394 - for Millie's patient profile, and he
041395 - would get in trouble, 090515 1140,
041396 - ref SDS 76 658J, at Kaiser if Gemzar
041397 - was given to Millie; and further
041398 - Gemzar side effects will cause
041399 - severe suffering compared to
041400 - targeted drugs.................. 090529 1109, ref SDS 97 0M5X
041402 - ..
041403 - 24. Doctor Johnson reports being confused
041404 - by complexity of Millie's patient history
041405 - in correspondence correlated with objectives
041406 - for recovery applying Kaiser's insurance
041407 - obligations to provide medical
041408 - care............................ 090959 1751, ref SDS 98 SZ9J,
041409 - Doctor Johnson complains Millie's
041410 - letter to medical team is misleading,
041411 - ref SDS 0 FS5F, reporting she needs
041412 - urgent treatment to recover from an
041413 - 8th relapse of cancer, and Kaiser
041414 - has not prescribed
041415 - treatment....................... 090529 1751, ref SDS 98 6R6I
041416 - Doctor Johnson reports Kaiser's
041417 - letter on 090520 offered Millie treatment
041418 - with 2 single agent treatments Gemzar and
041419 - Navelbine; does not cite a prescription
041420 - for a chemotherapy order required
041421 - for Millie to get
041422 - treatment....................... 090529 1751, ref SDS 98 U26R
041423 - Doctor Johnson confirmed Kaiser's
041424 - letter on 090521 requires Millie choose
041425 - between Gemzar and Navelbine treatment
041426 - and without explaining trade-offs based
041427 - on best evidence; and ignoring Kaiser
041428 - documentation indicating Gemzar is not
041429 - appropriate for Millie's patient
041430 - profile, and saying no
041431 - treatment is superior
041432 - to another...................... 090529 1751, ref SDS 98 U33Q
041434 - ..
041435 - 25. Millie reports to medical team good
041436 - condition for treatment of 8th relapse
041437 - of cancer, explains having no
041438 - intent to mislead Doctor
041439 - Johnson......................... 090531 1544, ref SDS 99 LD4O
041440 - Millie worried cancer spreading
041441 - to areas not treated with radiation;
041442 - cancer marker CA 15-3 320, 400% higher
041443 - than criteria Kaiser applies to
041444 - treat cancer.................... 090531 1544, ref SDS 99 IH4Q
041445 - Millie requests Kaiser prescribe treatment
041446 - based on best evidence showing standard
041447 - of care for her patient
041448 - profile......................... 090531 1544, ref SDS 99 IH6S
041449 - cites Kaiser correspondence saying
041450 - Gemzar and Navelbine may not be effective
041451 - for Millie's patient profile; and, single
041452 - agent chemotherapies will likely
041453 - have severe side
041454 - effects......................... 090531 1544, ref SDS 99 IH6V
041455 - MPA prescribed by Doctor Rugo
041456 - at UCSF targeted to Millie's patient
041457 - profile has high liklihood of
041458 - success, and minimal side
041459 - effects......................... 090531 1544, ref SDS 99 IH8Q
041460 - Gemzar and Navelbine treatment will
041461 - fail after weeks and months of agony
041462 - and so requires Kaiser to be prepared
041463 - to prescribed follow on agents
041464 - for treating Millie's cancer
041465 - as a chronic
041466 - disease......................... 090531 1544, ref SDS 99 IH9S
041468 - ..
041469 - 26. Millie notifies medical team that since
041470 - Kaiser has not prescribed treatment required
041471 - by the insurance agreement, and since her
041472 - cancer is getting worse, and since Doctor
041473 - Johnson and Doctor Rugo have warned that
041474 - Millie needs urgent treatment targeted to
041475 - her patient profile for recovering from 8th
041476 - relapse of cancer, Millie therefore ordered
041477 - treatment from UCSF that implements
041478 - Doctor Rugo's prescription
041479 - sent to Kaiser on 090514
041480 - for using
041481 - MPA............................ 090531 2227, ref SDS A0 2E4K
041483 - ..
041484 - 27. Millie's letter to UCSF confirms
041485 - arrangements for starting treatment
041486 - to recover from 8th relapse
041487 - of cancer...................... 090601 0818, ref SDS A1 1P8M
041488 - asks about getting another CT
041489 - test for baseline to start new
041490 - treatment, since delays at Kaiser
041491 - have outdated the test on 090413
041492 - performed to start
041493 - treatment...................... 090601 0818, ref SDS A1 6Y4X
041495 - ..
041496 - 28. UCSF calls Millie to coordinate starting
041497 - treatment for 8th relapse of cancer because
041498 - Kaiser lost the documents; advises
041499 - that Millie needs another CT test
041500 - becasue test on 090413 has expired
041501 - due to delays starting
041502 - treatmet........................ 090601 0818, ref SDS A1 PP6U
041504 - ..
041505 - 29. Millie notifies medical team that Kaiser
041506 - has ordered chemotherapy treatment with
041507 - Gemzar for Millie to recover from 8th relapse
041508 - of cancer; Kaiser Pharmacy confirms treatment
041509 - with Gemzar is not appropriate
041510 - for Millie's patient
041511 - profile........................ 090601 1847, ref SDS A2 9M6F
041512 - urgent treatment was delayed because
041513 - Doctor Johnson delivered a Chemotherapy
041514 - Order for Millie to get Gemzar, but the
041515 - Order was not signed, the doctor then
041516 - went home to recover from a headache,
041517 - and so Millie's treatment cannot
041518 - be scheduled until the doctor recovers
041519 - and returns to work and signs
041520 - the chemotherapy
041521 - order.......................... 090601 1847, ref SDS A2 0C7S
041522 - Millie disclosed having notified
041523 - UCSF of willingness to pay for MPA
041524 - treatment and seek recovery from Kaiser
041525 - for failure to prescribe care; and
041526 - this has been deferred pending
041527 - Kaiser's performance of
041528 - insurance requirments.......... 090601 1847, ref SDS A2 0C9Q
041529 - work plan for implementing
041530 - Kaiser's order to treat Millie
041531 - with Gemzar.................... 090601 1847, ref SDS A2 0C5S
041533 - ..
041534 - 30. Millie notified medical team that
041535 - Doctor Johnson sent a Kaiser "secure"
041536 - email only to Millie and responding to
041537 - Millie's notice presenting Kaiser's "work plan"
041538 - to the medical team on 090601, ref SDS A2 9M6F,
041539 - that implements the doctor's order for Millie
041540 - to get chemotherapy treatment with Gemzar;
041541 - Millie explains that Kaiser's "secure" email
041542 - cannot be accessed; Millie requests
041543 - resubmission using email format everyone
041544 - on the medical team has been using for
041545 - 8 years so there is transparency
041546 - that expedites urgent
041547 - care in time to be
041548 - effective...................... 090602 1340, ref SDS A3 H56W
041550 - ..
041551 - 31. Millie notifies medical team "Good news"
041552 - that labs show blood counts are strong
041553 - enough for Millie to start chemotherapy
041554 - treatment with Gemzar to recover
041555 - from 8th relapse of
041556 - cancer......................... 090602 1518, ref SDS A4 07AD
041557 - Millie asks if another CT test
041558 - is needed for baseline to evaluate
041559 - response to treatment starting
041560 - Gemzar......................... 090602 1518, ref SDS A4 J48T
041562 - ..
041563 - 32. Doctor Johnson advises that CT test
041564 - to evaluate response to treatment is
041565 - not needed for Millie starting Gemzar
041566 - to recover from 8th relapse
041567 - of cancer...................... 090603 1121, ref SDS A5 07AD
041569 - ..
041570 - 33. Millie notified medical team that Queenie
041571 - in Kaiser Pharmacy called today, and
041572 - presented prior guidance from Brad on
041573 - side effects for Millie from Gemzar,
041574 - and Queenie is sending a letter to
041575 - confirm Kaiser's guidance in
041576 - Millie's case.................. 090603 1637, ref SDS A6 07AD
041578 - ..
041579 - 34. Doctor Johnson reports Millie's cancer
041580 - marker has declined to CA 15-3 289, still
041581 - second highest in patient history, and
041582 - showing urgency to start treatment;
041583 - Doctor Johnson comments he is
041584 - glad Millie can start
041585 - treatment...................... 090604 1010, ref SDS A7 07AD
041587 - ..
041588 - 35. Millie commends medical team for cancer
041589 - marker dropping 30 points in 2 weeks after
041590 - rising 70 points in 6 weeks, demonstrates
041591 - continuing recovery from radiation treatments
041592 - that ended on 090317, and in turn enabling
041593 - increased exercise that strengthens
041594 - immune system to resist
041595 - cancer......................... 090604 1021, ref SDS A8 07AD
041597 - ..
041598 - 36. Millie received documentation from Kaiser
041599 - that discloses for the first time that Gemzar
041600 - has high risks for Millie's patient profile;
041601 - requires extreme caution after having radiation
041602 - treatment, which Millie received for 4 weeks
041603 - in February and March, and contiues to suffer
041604 - side effects; Kaiser further says treatment
041605 - with Gemzar requires avoiding blood thinners,
041606 - and Millie is required to take blood thinners
041607 - every day to prevent death from pulmonary
041608 - embolism; Gemzar can cause low blood counts
041609 - that leads to infection and death,
041610 - Millie has a history
041611 - of low blood
041612 - counts......................... 090605 1447, ref SDS A9 V34K
041614 - ..
041615 - 37. Kaiser's Quality Care office was notified
041616 - with copy to Doctor Johnson, and requesting
041617 - a letter showing Kaiser verfies Gemzar
041618 - is safe for Millie's patient
041619 - profile........................ 090605 2215, ref SDS B0 L55T
041620 - letter demanded................ 090605 2215, ref SDS B0 LF7S
041621 - Millie needs treatment plan for care
041622 - in the event Gemzar is not
041623 - effective...................... 090605 2215, ref SDS B0 LE6W
041624 - what will Kaiser prescribe
041625 - next........................... 090605 2215, ref SDS B0 LE5W
041627 - ..
041628 - 38. Millie notifies Doctor Hsu that radiation
041629 - side effects from treatment at UCSF in
041630 - Feb-Mar have worsened causing bleeding
041631 - wound in breastbone area; requests
041632 - examination for the doctor to
041633 - prescribe treatment that
041634 - expedites recovery............. 090607 2253, ref SDS B1 KS62
041636 - ..
041637 - 39. Kaiser Quality Care Department, Zoe,
041638 - notifies Millie that planning and commitments
041639 - for the Quality Control Department to facilitate
041640 - quality care with medical team was a
041641 - mistake; nothing was ever done
041642 - to provide quality care in
041643 - this case...................... 090608 1209, ref SDS B2 CN4G
041645 - ..
041646 - 40. Doctor Hsu schedules meeting Millie
041647 - at UCSF on 090609 0900 to examine
041648 - side effects from radiation treatment
041649 - during Feb-Mar and prescribe
041650 - medication to increase
041651 - recovery....................... 090608 1331, ref SDS B3 FC3K
041653 - ..
041654 - 41. Millie confirms schedule to meet
041655 - Doctor Hsu at UCSF on 090609 0900
041656 - to evaluate treatment to recover
041657 - from side effects caused by
041658 - radiation treatment during
041659 - Feb - Mar...................... 090608 1346, ref SDS B4 OM4F
041661 - ..
041662 - 42. Doctor Johnson refused to submit a letter
041663 - with written confirmation of verbal medical
041664 - advice to ignore Kaiser published guidance
041665 - for safe treatment with Gemzar of
041666 - Millie's patient
041667 - profile........................ 090609 1422, ref SDS B6 DC4K
041669 - ..
041670 - 43. Millie's letter notifies medical team
041671 - that Doctor Hsu's examination at UCSF
041672 - on 090609 diagnosed bleeding wound in
041673 - breastbone area was not side effects
041674 - of radiation treatment; expanding wound
041675 - was caused by medical mistakes omitting
041676 - radiation treatment of IBC in breastbone
041677 - during Feb-Mar; IBC untreated for 6 months
041678 - got worse causing tumor to spread beyond
041679 - radiated areas, and to the lungs which
041680 - caused Millie to suffer breathing problems;
041681 - Doctor Hsu ordered CT test to evaluate
041682 - scope of injury, and prescribed MPA
041683 - clinical trial for UCSF's first effort
041684 - to provide effective treatment
041685 - for Millie to recover
041686 - from UCSF medical
041687 - mistake.......................... 090610 0043, ref SDS B7 N630
041689 - ..
041690 - 44. Doctor Hsu confirms UCSF treatment plan
041691 - to recover from medical mistakes failing
041692 - to provide treatment of IBC in Millie's
041693 - breastbone area requires CT test to
041694 - start treatment for 8th relapse
041695 - of cancer with
041696 - MPA.............................. 090610 1443, ref SDS C0 G63H
041698 - ..
041699 - 45. Submit to UCSF blood test at Kaiser
041700 - on 090602, and planning submission to
041701 - UCSF of a CD with computer files on
041702 - the CT test scheduled for 090612
041703 - and confirm Millie can get treatment
041704 - MPA even with some fluid on
041705 - the lungs........................ 090610 1509, ref SDS C1 9F4J
041707 - ..
041708 - 46. Millie notifies medical team Gemzar
041709 - treatment prescribed by Kaiser on
041710 - 090601 deferred due to conflict with
041711 - patient profile discovered on 090605
041712 - pending MPA prescribed by UCSF to treat
041713 - changes in patient profile for Millie
041714 - to recover from UCSF medical mistake
041715 - beginning on 090219 and discovered on
041716 - 090609 causing cancer to spread with
041717 - breathing problems; Millie coordination
041718 - CT test at Kaiser ordering computer
041719 - files transmitted to UCSF for
041720 - evaluating recovery from
041721 - medical mistakes................. 090610 2213, ref SDS C3 WS6I
041723 - ..
041724 - 47. Coordinating Kaiser to perform additional
041725 - blood test UCSF required for Millie to
041726 - start MPA treatment recovering
041727 - from 8th relapse of
041728 - cancer........................... 090611 1637, ref SDS C5 5H4F
041730 - ..
041731 - 48. Agenda submitted to medical team for
041732 - meeting with Doctor Rugo on 090616 to
041733 - start MPA treatment prescribed by
041734 - Doctor Hsu for Millie to recover from
041735 - medical mistakes UCSF made providing
041736 - radiation services in Feb-Mar that
041737 - caused 8th relapse of cancer
041738 - and worsening breathing
041739 - problems......................... 090613 2348, ref SDS C7 XO6I
041741 - ..
041742 - 49. Doctor Rugo notifies the medical team
041743 - that the doctor believes she is restricted
041744 - by some disclosed reason from making timely
041745 - response to patient corresondence via email
041746 - which has been applied for the past 2 years;
041747 - Doctor Rugo tells Millie to call the UCSF
041748 - Triage nurse for medical
041749 - issues........................... 090614 1027, ref SDS C8 I13F
041751 - ..
041752 - 50. UCSF changes schedule of tasks for
041753 - Millie to meet with Doctor Rugo
041754 - starting MPA treatment
041755 - at UCSF.......................... 090615 1516, ref SDS C9 YW5X
041757 - ..
041758 - 51. Background leading to UCSF ending
041759 - MPA treatment is reported in the
041760 - record on subitting an agenda
041761 - for the team to be prepared
041762 - to meet on 090716................ 090715 0224, ref SDS E4 QM5O
041764 - ..
041765 - Doctor Rugo initially noticed swelling of right breast that now has
041766 - lymphedema reaction to radiation treatment during Feburary and ending
041767 - on 090317.
041769 - ..
041770 - Last week on 090609 Doctor Hsu was concerned that untreated IBC tumor
041771 - in Millie's breastbone area could be causing cancer in her lungs.
041772 - ref SDS B5 W66P The doctor ordered a CT test to evaluate affect of
041773 - this new problem on Millie's lungs, evidenced by symptoms of difficult
041774 - breathing and persistant cough. ref SDS B5 W65W During the meeting on
041775 - 090514 0830, Doctor Rugo was concerned that progression of "ground
041776 - glass opacities," which describes nodules in lungs, were found in the
041777 - prior CT test on 090413, as reported on 090415, ref SDS 66 RV78, and
041778 - were caused by Millie's radiation in February and March, ref SDS 72
041779 - DE8M, and were in turn causing difficulites breathing, and cough.
041781 - ..
041782 - Mike called the next day on 090610 and advised that Doctor Rugo wanted
041783 - the files for the CT test delivered to UCSF in order to make a
041784 - thorough review of Millie's breathing problems cited by Doctor Hsu.
041785 - ref SDS B9 S537 The CT test was performed at Kaiser on 090612 1120.
041786 - The CT scan files were delivered to UCSF later in the afternoon on
041787 - 090612 1439 stored on CDs for the both the test on 090612, and the
041788 - prior test on 090413. ref SDS C6 UD5H
041790 - ..
041791 - During the meeting today, Doctor Rugo advised that UCSF has not yet
041792 - completed review of the computer scan files for Millie's CT tests on
041793 - 090413 and 090612, which were both delivered to UCSF in the afternoon
041794 - on 090612, ref SDS C6 UD5H, as requested by the doctor, per Mike's
041795 - call on 090610 1438. ref SDS B9 S537
041796 -
041797 - [On 090706 0301 Millie received a letter from Mike, Doctor
041798 - Rugo's coordinator, saying his investigation discovered that
041799 - nobody at UCSF ordered review of Millie's CT test scan files,
041800 - ref SDS E3 1L6N, which were same-day hand- delivered to UCSF on
041801 - 090612, ref SDS C6 UD5H, per Mike's request on 090610 for
041802 - timely review by UCSF. ref SDS B9 S537
041804 - ..
041805 - Doctor Rugo asked Mike for Kaiser's radiology report on the CT test
041806 - last week on 090612 1120, since Kaiser Radiology has primary
041807 - responsibility to report on its own scans.
041809 - ..
041810 - Doctor Rugo explained that "ground glass opacities" can increase even
041811 - after radiation treatments end. She wants to see if the CT test last
041812 - week reports any increase from the prior test on 090413, and which she
041813 - discussed in the meeting on 090514. ref SDS 72 NL9I The doctor seemed
041814 - to indicate that timely notice of rising ground glass opacities
041815 - enables treatment to prevent Millie's breathing problems from getting
041816 - worse.
041817 -
041818 - [On 090617 1954 Millie's letter asks medical team if "ground
041819 - glass opacities" causing breathing problems will be treated as
041820 - cancer with MPA, or presents a new problem that requires
041821 - separate treatment? ref SDS D7 7J4Q
041823 - ..
041824 - [On 090618 1743 Millie's letter asks medical team for
041825 - further tests, examination, and treatment to recover from
041826 - breathing problems. ref SDS D8 TG3X
041828 - ..
041829 - Mike explained that he called this morning and asked Kaiser for their
041830 - report, while Millie was getting the punch biopsy, reported 090616
041831 - 1000. ref SDS D0 4G4G The Kaiser Radiology Department told Mike that
041832 - Kaiser has not yet completed review of Millie's CT test on 090612.
041834 - ..
041835 - Doctor Rugo commented that state law requires reporting results on CT
041836 - scans within 24 hours. She expects the reports are available, and
041837 - asked Millie to get them from Kaiser for submission to UCSF, as soon
041838 - as possible.
041839 -
041840 - [On 090617 0112 Millie's letter notifies medical team that
041841 - Doctor Rugo at UCSF requested Kaiser's radiology report for
041842 - Millie's CT test at Kaiser on 090612, because UCSF did not have
041843 - enough time to make an independent review and prepare a
041844 - radiology report from the scan files that were hand-delivered
041845 - to UCSF on 090612 at the request of UCSF. ref SDS D3 VS7X
041847 - ..
041848 - [On 090617 0842 called Kaiser to coordinate getting
041849 - radiology report submitted to UCSF for Millie's CT test on
041850 - 090612. ref SDS D4 NQ5G
041852 - ..
041853 - [On 090617 0842 at 0927 Al Hutchins, Manager of Radiology
041854 - Reporting for Kaiser in Walnut Creek, apologized for 2-day
041855 - delay sending the report to UCSF for Millie's test on 090612;
041856 - and seemed to concur that reports are required to be completed
041857 - within 24 hours of tests. ref SDS D4 6U5F
041859 - ..
041860 - [On 090617 1637 Arlette at Kaiesr notifies Millie that report
041861 - for the CT test on 090612 was submitted to UCSF via FAX on
041862 - 090617, responding to Millie's letter to the medical team on
041863 - 090617. ref SDS D5 UD5H
041865 - ..
041866 - Doctor Rugo seemed very pleased today reporting good news...
041868 - ..
041869 - The doctor said that "everybody is now on board" at Kaiser and UCSF
041870 - for Millie's treatment plan going forward to recover from mistakes
041871 - with radiation in February and March, and beginning with MPA, as
041872 - recommended by Doctor Hsu on 090609, ref SDS B5 1P3K, to implement
041873 - Doctor Rugo's treatment strategy in the UCSF letter to Kaiser on
041874 - 090514. ref SDS 72 DI63 This appears to reflect Millie's draft appeal
041875 - for Doctor Johnson submitted on 090518 0012, which explained
041876 - consolidating referral work to treat Stage V patients for long term
041877 - survival. ref SDS 79 W93Q
041879 - ..
041880 - This aligns with Paula's call yesterday, saying UCSF is liable to
041881 - Kaiser for the cost of Millie recovering from medical mistakes at
041882 - UCSF, and that she would coordinate with Outside Referrals for case
041883 - management, reported on 090610 0930. ref SDS B8 FU5N
041884 -
041885 - [On 090617 0112 Millie notifies medical team that MPA
041886 - treatment was started to recover from 8th relapse of cancer
041887 - and breathing problems caused by mistakes providing
041888 - radiation medical services at UCSF during Feb and Mar.
041889 - ref SDS D3 VS7R
041891 - ..
041892 - [On 090617 0112 Millie notifies medical team that Doctor Rugo
041893 - reported "everybody is on board" at Kaiser and UCSF to treat
041894 - Millie's cancer as a chronic disease going forward with agnets
041895 - targeted to Millie's cancer. ref SDS D3 VS9P
041897 - ..
041898 - [On 090617 1715 Millie letter to Kaiser thanks Arlette for
041899 - facilitating arrangements on 090610, ref SDS C2 2X72, so that
041900 - Millie can get MPA treatment at UCSF, and notes the treatment
041901 - may not be effective. ref SDS D6 MC7X
041903 - ..
041904 - [On 090626 0301 Millie submits agenda to medical team for
041905 - meeting at Kaiser to review Millie's progresss recovering from
041906 - UCSF medical mistakes providing radiation treatment that caused
041907 - cancer to spread, ref SDS D9 0E9V; untreated IBC has become so
041908 - severe that Millie hates looking at herself in the mirror.
041909 - ref SDS D9 0E9Y
041911 - ..
041912 - [On 090626 1140 Doctor Johnson prescribes MPA in the medical
041913 - chart for Kaiser's approval of UCSF's treatment plan for Millie
041914 - to recover from medical mistakes from UCSF providing radiation
041915 - medical services. ref SDS E0 837H
041917 - ..
041918 - [On 090706 0301 telecon with Mike, Doctor Rugo's coordinator,
041919 - discussed UCSF work plan for Millie to recover from medical
041920 - mistakes providing radiation services on referral from Kaiser,
041921 - and which caused radiation injury to Millie's breathing, and
041922 - spread Millie's cancer. ref SDS E2 QY5H
041924 - ..
041925 - [On 090716 2106 Tara calls and advises PARP not ready, so asks
041926 - Millie to get treatment at Kaiser until September. ref SDS E5
041927 - EE6P
041929 - ..
041930 - [On 090725 2017 Doctor Johnson reported that Millie's survival
041931 - far longer than expected for her disease trajectory has been
041932 - achieved through "yoeman's work" providing comprehensive
041933 - communication, ref SDS E6 T58U that keeps everybody on the same
041934 - page, as Doctor Rugo notes today. ref SDS 0 D647
041936 - ..
041937 - [On 100302 0830 Doctor Johnson notes Millie's survival 3 -
041938 - 4 times longer than expected for her disease is a unique
041939 - case achieved through "yeoman's work" performing medical
041940 - management. ref SDS F3 FC67,
041942 - ..
041943 - [On 100909 0905 letter to Diane, Catherine, Tara, Doctor
041944 - Rugo, Doctor Johnson, with thanks for condolences on
041945 - Millie's memoriam, and noting the team made progress
041946 - treating cancer as a chronic disease, and now there is time
041947 - to assess how what was done well can help others, and what
041948 - could have been done better for a better outcome.
041949 - ref SDS F6 TY7W
041951 - ..
041952 - Millie asked if Doctor Rugo has discussed with Doctor Johnson at
041953 - Kaiser follow on treatments, which Glenna reviewed with Doctor Rugo on
041954 - 090121 1017, ref SDS 26 EV53, including research for "targeted"
041955 - treatments, and clinical trials, reviewed later on 090204, ref SDS 33
041956 - 4R3S, and submitted to the medical team on 090326? ref SDS 63 DW5S
041957 - Doctor Johnson has emphasized importance of timely treatment for
041958 - Millie's cancer as a chronic disease, which requires a list of
041959 - treatments to be prepared for quickly transitioning to the next
041960 - treatment, because Millie's cancer has mutated into aggressive cells
041961 - that grow rapidly, cited by Doctor Johnson in a call on 090123,
041962 - ref SDS 28 OZ6N, and discussed during the meeting at Kaiser on 090325.
041963 - ref SDS 61 L15M At that time during the meeting on 090325, Doctor
041964 - Johnson asked Millie for the list of treatments targeted to Millie's
041965 - patient profile. ref SDS 61 GO4O The next day on 090326, Millie
041966 - submitted a list to the medical team showing 10 new treatments,
041967 - ref SDS 63 DW5S, which are "targeted" for Millie's complex patient
041968 - profile, as set out in the record on 090204. ref SDS 33 4R3S
041970 - ..
041971 - Doctor Rugo smiled and said that Millie is lucky to have such a
041972 - thorough, well connected record that helps the medical team find
041973 - crucial details. She explained medical records become very complex
041974 - for stage 4 cancer patients in continual care, like Millie the past 8
041975 - years. Effective oncology must recognize many details from prior
041976 - treatment, illustrated on 080219 1100. ref SDS 8 L18L See as well
041977 - case study on 061020 1640. ref SDS 4 T25H
041979 - ..
041980 - Millie, said, "Well, I am lucky, because Rod types everything up, so
041981 - he knows many details from continually making connections in the
041982 - record that are hard for the rest of us to remember, and he can look
041983 - them up quickly to help us. The doctor said, "I know that, Millie.
041984 - It often seems overwhelming to all of us, but I know it is essential
041985 - for someone to manage complexity in order to provide comprehensive
041986 - care." This aligns with Doctor Stritter's report with related
041987 - background on 090206 0747, ref SDS 35 7Q7J, and further with Doctor
041988 - Rugo's coordinator, Glenna, on 090121 1017. ref SDS 26 H95J
041990 - ..
041991 - Doctor Rugo then said today that she has communicated in a letter with
041992 - Doctor Johnson to plan follow on treatment for Millie after MPA, and
041993 - in order for Millie to recover from UCSF medical mistakes performing
041994 - radiation treatments in February and March, which were discovered by
041995 - Doctor Hsu on 090609. ref SDS B5 W65W Doctor Rugo further advised
041996 - that Kaiser and UCSF have agreed in the email that after MPA, UCSF
041997 - will next provide something called the "PARP" group of treatments,
041998 - which are "targeted" to Millie's patient profile. PARP is one of the
041999 - "targeted" agents listed in 2nd opinion received from Doctor Stritter
042000 - on 090204 1747, ref SDS 33 9J6Y, and submitted to the team on 090326.
042001 - ref SDS 63 DW5S PARP is targeted to Millie's triple negative status,
042002 - which seems very attractice, since this status otherwise reduces
042003 - Millie's treatment options. Last year on 081016, Doctor Rugo ordered
042004 - a biopsy to test for status change that could increase the pool of
042005 - treatments for Millie. ref SDS 10 W26G Since the test found Millie is
042006 - still triple negative, PARP seems like a good prospect for helping
042007 - Millie like cetuximab did for 2 years, beginning in 2007, which was
042008 - also targeted to triple negative status, reported on 070116 1406.
042009 - ref SDS 5 RT7K
042011 - ..
042012 - Doctor Rugo's report today planning therapy targeted to cancer for
042013 - treating Millie's complex patient profile, aligns with the meeting at
042014 - UCSF last month. At that time on 090514, the doctor explained UCSF
042015 - has many treatments lined up for Millie, and that some are phase I and
042016 - II trials which she feels can treat Millie's cancer as a chronic
042017 - disease for a long time to come applying doctor discretion for medical
042018 - necessity to adjust study protocols based on Millie's history of prior
042019 - medications. ref SDS 72 3F7M
042020 -
042021 - [...below, UCSF applies doctor discretion to adjust treatment
042022 - protocol for Millie's patient profile by omotting chemotherapy
042023 - with cyclophosphade from MPA clinical trial protocol.
042024 - ref SDS 0 YO4J
042026 - ..
042027 - Also on 090514, Doctor Rugo was worried that Kaiser would not approve
042028 - treating Millie's cancer as a "chronic disease," ref SDS 72 3F82, so
042029 - the report today that Kaiser and UCSF have agreed in writing on
042030 - treating Millie with therapy targeted to cancer for recovering from
042031 - UCSF medical mistakes offers a roadmap to a future worth living.
042032 -
042033 - [On 090617 0112 Millie notifies medical team Doctor Rugo
042034 - reports everybody at Kaiser and UCSF is "on board" to treat
042035 - Millie's cancer as a chronic disease, ordered by Doctor
042036 - Johnson, and the next treatment after MPA will be PARP targeted
042037 - to Millie's patient profile, and that Kaiser and UCSF have done
042038 - strategic planning to provide proactive care for Millie.
042039 - ref SDS D3 VS9P
042041 - ..
042042 - Reporting a letter agreement for UCSF to provide care for Millie to
042043 - recover from medical mistakes getting rediation treatments at UCSF,
042044 - implements understandings from Paula in Kaiser's Claims Resolution
042045 - Department, who coordinated with Kaiser's Outside Referrals department
042046 - for case management, reported on 090610 0930. ref SDS B8 FU5N This
042047 - aligns with Mike's letter the next day on 090611, asking Kaiser where
042048 - to send a requisition to pay for lab work at Kaiser, which was ordered
042049 - for Millie's treatment at UCSF to recover from radiation medical
042050 - mistakes. ref SDS C4 YU3N
042052 - ..
042053 - [On 100108 1618 UCSF notifies Kaiser that Millie cannot get
042054 - treatment for cancer with PARP that includes a protocol for
042055 - Carboplatin, because Millie's was previously treated with
042056 - Carboplatin chemotherapy, and UCSF fails to compare trade-offs
042057 - exercising discretion to balance Millie's medical necessity for
042058 - life-saving treatment with PARP, which UCSF and Kaiser
042059 - indicated on 090616 was the best choice for Millie to recover
042060 - from life-threatening medical mistakes made by UCSF.
042061 - ref SDS F1 FM5I
042063 - ..
042064 - [On 100427 0830 Doctor Johnson reported Millie's cancer has
042065 - mutated to resist chemotherapy, and so she needs a new strategy
042066 - to treat her cancer as a chronic disease with therapy targeted
042067 - to her patient profile. ref SDS F4 SJ6N Aligns with Doctor
042068 - Johnson's review of PARP targeted to Millie's triple negative
042069 - status, reported on 100112 0830, ref SDS F2 N586
042071 - ..
042072 - [On 100527 0217 Millie files claim to recover from injuries
042073 - caused by medical mistakes getting radiation treatments from
042074 - UCSF on referral from Kaiser. ref SDS F5 IZ7N
042076 - ..
042077 - Doctor Rugo also mentioned a protocol combining Gemzar with another
042078 - agent. The doctor advised that, if Millie had received Gemzar
042079 - treatment prescribed last week at Kaiser, Millie would not able to get
042080 - treatment with the "targeted" protocol that includes Gemzar, when
042081 - needed later in her care. Doctor Rugo feels that having several
042082 - treatments lined up is essential for smooth transition that maintains
042083 - continuity treating Millie's cancer as a chronic disease, which has
042084 - been effective for Millie recovering from 8 relapses over the past 8
042085 - years.
042087 - ..
042088 - [On 090716 2106 Millie notifies medical team that UCSF delayed
042089 - starting Millie's treatment with PARP until September, because
042090 - Millie suffered painful breathing that might be caused by MPA
042091 - so this treatment ended before PARP protocol was ready in
042092 - September. ref SDS E5 EE6P
042094 - ..
042095 - [On 090909 Doctor Johnson advised that his schedule had cleared
042096 - to have enough time for reviewing treatment options submitted
042097 - on 090326, and providing analysis comparing trade-offs in order
042098 - to prescribe treatment with the best chance of being effective.
042099 - ref SDS E7 VF60
042101 - ..
042102 - [On 090922 0810 Millie asks medical team about progress
042103 - starting PARP, and review of other targeted therapies.
042104 - ref SDS E8 NW6S
042106 - ..
042107 - [On 091027 0830 Doctor Johnson disclosed that there still has
042108 - not been enough time to review follow on treatments for Millie,
042109 - and that he has not heard from Doctor Rugo on UCSF's progress
042110 - starting the PARP protocol. ref SDS E9 GN5G
042112 - ..
042113 - [On 100112 0830 Doctor Johnson reviews published guidance
042114 - on 2nd opinion PARP therapy targeted to treat Millie's
042115 - cancer with triple negavie patient profile. ref SDS F2 N586
042117 - ..
042118 - [On 100527 0217 Millie files claim to recover from injuries
042119 - caused by medical mistakes getting radiation treatments from
042120 - UCSF on referral from Kaiser. ref SDS F5 IZ7N
042122 - ..
042123 - Requested copies of correspondence between Kaiser and UCSF to verify
042124 - treatment planning and commitments will meet requirements for Millie's
042125 - care going forward.
042127 - ..
042128 - Doctor Rugo advised that she cannot provide the letter to Millie,
042129 - because it presents planning for a number of other patients at Kaiser,
042130 - which she and Doctor Johnson are planning to have treated at UCSF.
042132 - ..
042133 - This aligns with Doctor Johnson's report last month on 090515, that he
042134 - has other patients, who can benefit from treatment at UCSF Cancer
042135 - Center. ref SDS 76 657K
042137 - ..
042138 - Asked Doctor Rugo if she wants to be removed from distribution of the
042139 - record on Millie's care coordinating work between Kaiser and UCSF? On
042140 - 090514, the doctor explained that comprehensive care is difficult for
042141 - Millie's long, complex patient history. Since Doctor Rugo reported
042142 - getting 500 email a day, ref SDS 72 LS6I, her schedule is very hectic,
042143 - so there is less time to make sense of complicated details that
042144 - discover opportunity and avoid mistakes.
042146 - ..
042147 - Doctor Rugo said today that she wants to continue getting patient
042148 - correspondence coordinating Millie's treatment to recover from cancer,
042149 - continuing case management practice the past 2 years using SDS to
042150 - maintain a well ordered record for accurate understanding of patient
042151 - history. Doctor Rugo noted advantages of timely, accurate patient
042152 - history in SDS records that facilitate collaboration with Doctor
042153 - Johnson providing backup primary care at Kaiser, reported on 090514
042154 - 0830. ref SDS 72 LS5M
042156 - ..
042157 - [On 090725 Doctor Johnson described doctor/patient partnership
042158 - in Millie's case is doing yeoman's work to keep a well ordered
042159 - record for effective case management. ref SDS E6 T58R
042161 - ..
042162 - [On 090725 "evidence based" medical practice requires a well
042163 - ordered record, which takes yeoman's work that complements
042164 - mainstream technology for health care case management.
042165 - ref SDS E6 MP8O
042167 - ..
042168 - [On 090725 confirm in letter to medical team that Doctor Rugo
042169 - asked to continue getting correspondence on case management for
042170 - Millie's care. ref SDS E6 T64U
042172 - ..
042173 - [On 100104 0930 Doctor Sandhu reported that SDS records
042174 - improved case management coordinating patient care between the
042175 - VA Medical Center in San Francisco and the VA Clinic in
042176 - Martinez. ref SDS F0 PP8W
042178 - ..
042179 - Doctor Rugo said that since Millie will now be treated at UCSF for
042180 - primary care of cancer and breathing problems to recover from UCSF
042181 - medical mistakes performing radiation treatments in Feb and Mar,
042182 - discovered by Doctor Hsu during examination at UCSF on 090609,
042183 - ref SDS B5 W65W, that Millie should now call the Triage nurse at UCSF
042184 - to get advice about immediate medical problems, rather than call
042185 - Kaiser for emergency care. Tara prepared written guidance for when
042186 - Millie should contact the UCSF Triage Department.
042188 - ..
042189 - This new guidance today aligns with Doctor Rugo's letter a few days
042190 - ago telling Milling to contact the UCSF Triage nurse rather than
042191 - Kaiser for guidance on future medical issues, reported on 090614 1027.
042192 - ref SDS C8 I13F
042194 - ..
042195 - UCSF taking responsibility for Millie's care to recover from medical
042196 - mistakes further alings with Mike's letter to Kaiser last week on
042197 - 090611, asking if Kaiser needs a requestion from UCSF to pay for lab
042198 - work at Kaiser requested by Doctor Hsu to develop the UCSF work plan
042199 - for Millie's care. ref SDS C4 YU3N
042200 -
042201 - [On 090617 0112 Millie notifies medical team that MPA
042202 - treatment was started to recover from 8th relapse of cancer
042203 - and breathing problems caused by mistakes providing
042204 - radiation medical services at UCSF during Fef and Mar.
042205 - ref SDS D3 VS7R
042207 - ..
042208 - [On 090701 2121 Millie notifies medical team that Jean Anne in
042209 - UCSF Triage Department responded to Millie's many request for
042210 - treatment of breathing problems the past few months, and with a
042211 - prescription to relieve symptoms while the medical team
042212 - continues research to find a remedy to recover Millie's former
042213 - strong breathing capacity. ref SDS E1 DZ6U
042215 - ..
042216 - The doctor is pleased now to have Mike assigned to help coordinate
042217 - work on Millie's care going forward at UCSF. This reduces the burden
042218 - on her to track details, even though she is very good at details, as
042219 - discussed during the meeting on 090514. ref SDS 72 LS5M
042221 - ..
042222 - Tara submitted MPA pills for Millie's new treatment. Millie starts
042223 - with 4 pills a day, which amounts to 1000 mg, and to implement Doctor
042224 - Rugo's treatment plan presented to Kaiser on 090514, ref SDS 72 DI63,
042225 - which now seems to have full support of the medical team, per above.
042226 - ref SDS 0 D647 Doctor Rugo withheld pills for chyclophosphamide and
042227 - Methotrexate, also, planned on 090514, in order to avoid conflicts
042228 - with Millie's patient profile. ref SDS 72 265I
042230 - ..
042231 - [On 090626 1140 MPA missing from Kaiser medical chart list of
042232 - Current Medications. ref SDS E0 G55G
042234 - ..
042235 - Mille comes back in 2 weeks for a blood draw on Monday, 090629. This
042236 - has to be on Monday, because UCSF has to send blood samples to the
042237 - University of Indiana the next day on 090630.
042239 - ..
042240 - Mike made a mistake and scheduled the blood test at 1400 on Monday
042241 - 090629.
042243 - ..
042244 - Millie agreed to get the blood draw on 090130 to perform requirements
042245 - starting a new treatment. The medical team agreed, that regular
042246 - meetings with Doctor Rugo will be scheduled as normal on Thursdays at
042247 - 0800 - 0900.
042249 - ..
042250 - After meeting with Doctor Rugo in the Breast Care Clinic on the 2nd
042251 - floor, we visited Catherine and Nola in the Infusion Clinic on the 5th
042252 - floor. Catherine changed the time for the blood draw on 090630 from
042253 - 1400 to the normal time for Millie to get blood draws at 0800.
042254 -
042255 -
042256 -
042257 -
042258 -
042259 -
042260 -
042261 -
042262 -
042263 -
0423 -