CONTACTS 

SUBJECTS
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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 13 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - The cancer marker increased 50 points for the blood test 2 weeks ago.
040902 -
040903 - IBC seems visibly worse now, including increased swelling of left that
040904 - has lymphedema from IBC.
040906 -  ..
040907 - On 091019 0007 Millie notified the medical team that UCSF efforts to
040908 - treat Millie's cancer at Kaiser for Millie to recover from medical
040909 - mistakes performing radiaton at UCSF during Feb and Mar, now need to
040910 - end, ref SDS 13 WV63, and a new treatment is needed...
040912 -  ..
040913 - On 091019 0007 Millie submits agenda for meeting at Kaiser on 091020
040914 - to evaluate 9th relapse of cancer. ref SDS 13 WV63
040916 -  ..
040917 - On 091027 0830 Millie meeting with primary care physician, Doctor
040918 - Johnson, with Pam observing; the doctor reported significant drop on
040919 - cancer marker CA 15-3 299 from 350 a few weeks earlier, and indicating
040920 - possible continuing response to treatment. ref SDS 14 DR6M  The Doctor
040921 - Johnson reported examination shows stable cancer, ref SDS 14 GN7W, and
040922 - so orders another cycle of Gemzar rather than switch to a treatment
040923 - targeted to Millie's patient profile. ref SDS 14 BK9M
040925 -  ..
040926 - This morning, Millie submitted the following letter to the medical
040927 - team presenting the agenda for meeting at Kaiser to evaluate 9th
040928 - relapse, and progress finding a "targeted" treatment for Millie's
040929 - patient profile...
040930 -
040931 -    1.  Subject: Agenda Meeting Kaiser Nov 12 0930 Treatment Plan 9th Relapse Cancer and Breathing Problems Caused by Medical Mistakes at UCSF
040932 -        Date: Thu, 12 Nov 2009 08:33:14 -0800
040949 -         ..
040950 -    3.  The letter to the team on 091019 reported continuing problems
040951 -        using the Power Port for infusion treatments, blood draws, CT
040952 -        tests. etc. ref SDS 13 0Z9P  These problems occur because Power
040953 -        Ports are relatively new technology.  They significantly reduce
040954 -        costs performing the work, and eliminate a lot of discomfort I
040955 -        otherwise suffer using conventional IV methods.  However,
040956 -        specific details for use, though fast and easy to perform, are
040957 -        either not known or forgotten due to infrequent use by various
040958 -        department staff.  I proposed solving the problem by writing a
040959 -        protocol, which can be cited in your referrals for my care, and
040960 -        checked for procedures at the time services are performed.
040962 -         ..
040963 -    4.  During the meeting today, I would like to get a copy of the
040964 -        protocol which I can cite to assist providers when needed, or
040965 -        hear how Kaiser proposes to solve the problem without a
040966 -        protocol.
040967 -
040968 -            [On 091112 0930 Doctor Johnson sent an internal electronic
040969 -            letter to Paula notifying the Chemotherapy Infusion Clinic
040970 -            that the doctor prescribes blood draws and chemotherapy
040971 -            infusion treaments using Millie's Power Port with a 1"
040972 -            high-strength Huber Needle in order to avoid the high risk
040973 -            of compounding Millie's cancer and lymphedema from using
040974 -            conventional needle penetrations in her arms. ref SDS 15
040975 -            UN8F
040977 -         ..
040978 -    5.  Confirming understandings from the meeting in your office on
040979 -        091027, when my daughter Pam attended, and we teleconferenced
040980 -        with Rod at the VA, you indicated that due to limited time you
040981 -        and Doctor Mason had not collaborated with Doctor Rugo and
040982 -        Doctor Hsu on UCSF's treatment plan for me to recover from
040983 -        medical mistakes at UCSF performing radiation treatments on
040984 -        referral from Kaiser, and cited by Doctor Hsu on 090609.  As
040985 -        you recall, I requested the UCSF treatment plan, and notified
040986 -        the medical team on 090610 that UCSF proposed MPA.  You
040987 -        approved this plan, and Doctor Rugo took control of my case on
040988 -        090616 to mitigate damages I suffer from UCSF medical mistakes.
040989 -        This included transferring Triage support from Kaiser to UCSF.
040990 -        ref SDS 7 EE70
040991 -
040992 -            [On 091112 0930 Kaiser's medical chart, which was not
040993 -            received until months later, ref SDS 15 655J, represents
040994 -            incorectly that the doctor presented potential risks (side
040995 -            effects and complications) and benefits of the recommended
040996 -            and alternative oncologic treatment(s).  I have answered
040997 -            the patient's questions.  I believe the patient is
040998 -            competent and can understand the recommendations that I
040999 -            have made.  The patient agrees with these recommendations -
041000 -            none of this occurred - the doctor prescribed Abraxane for
041001 -            Millie's next relapse, and did not compare trade-offs with
041002 -            other oncology treatments, ref SDS 15 PUGK, contrary the
041003 -            request in Millie's letter today transmitting the agenda,
041004 -            per above, ref SDS 0 LE3R, and further requested also
041005 -            below. ref SDS 0 LE3R
041007 -         ..
041008 -    6.  A month later on 090716, Tara Lacy advised during a meeting at
041009 -        UCSF that my advancing injuries from UCSF mistakes that caused
041010 -        breathing problems required ending treatment with MPA, due to
041011 -        concerns about possible PE side effects. ref SDS 9 EE9X  Tara
041012 -        called later that night on 090716 and said that Doctor Rugo was
041013 -        out of town, and had not had time to line up an effective
041014 -        replacement treatment.  She explained that your strategy to
041015 -        hold "gold standard" [chemotherapy] treatments in reserve could
041016 -        be used on an interim basis with Gemzar, while the [team] finds
041017 -        another "targeted" treatment suitable to my patient profile [as
041018 -        listed on 090213, ref SDS 3 ES7I].
041020 -         ..
041021 -    7.  Doctor Rugo planned on 090616 to start me on PARP "targeted"
041022 -        treatments to replicate the experience with cetuximab that
041023 -        provided care without side effects for nearly 2 years.
041024 -        ref SDS 7 KD6L
041026 -         ..
041027 -    8.  Recall at that time in 2007 - 2008 I was hiking 3 - 8 miles per
041028 -        day 4 - 5 times per week, reflecting your strategy to treat my
041029 -        cancer as a chronic disease with "targeted" drugs that maintain
041030 -        quality of life.
041032 -         ..
041033 -    9.  In the call on 090716, Tara further related Doctor Rugo's
041034 -        request that I get the Gemzar treatment at Kaiser, because UCSF
041035 -        believed Kaiser could deliver the treatment at less cost than
041036 -        at UCSF [... and which the Kaiser Oncology Pharmacist advised
041037 -        on 090601, was not appropriate for my patient profile,
041038 -        ref SDS 6 8J8L, risking loss of energy, agony, infection, and
041039 -        death, ref SDS 6 FR8L ...]  To mitigate damages, I agreed to
041040 -        this request.  While my cancer has been held somewhat in check
041041 -        under Brigid's rule that "stable is good" [diagnosed by Doctor
041042 -        Johnson on 091027 0830, ref SDS 14 DR6M], I can barely function
041043 -        due to onerous side effects of Gemzar treating cancer spread
041044 -        due to mistakes at UCSF, and from breathing problems also
041045 -        caused by radiation injury at UCSF.  I cannot hike one lap at
041046 -        Lafayette.  I can barely walk from the parking lot to meet with
041047 -        you today at Kaiser due to side effects of Gemzar.
041048 -
041049 -            [On 091112 0930 medical chart incorrectly reports "energy
041050 -            level stable still able to walk Lafayette reservoir,"
041051 -            ref SDS 15 RT94, conflicts with letter submitting agenda
041052 -            for the meeting, ref SDS 0 L65W, and which was read to
041053 -            start the meeting. ref SDS 15 4W8K
041055 -         ..
041056 -   10.  At all times, I have tried to be a good partner.  However, at
041057 -        no time have I waived my right to recover damages from Kaiser
041058 -        and UCSF for failure to recover from medical mistakes at UCSF
041059 -        on referral from Kaiser.  My claim has been filed and forwarded
041060 -        to Paula pending performance by the medical team.  I realize
041061 -        that treating a stage V cancer patient presents challenges.  I
041062 -        will continue to work constructively to assist the team in
041063 -        mitigating damages, which primarily entails finding another
041064 -        "cetuximab" solution for extending my life in a manner that is
041065 -        worth living.
041066 -
041067 -               [On 091112 1412 notified Paula in Kaiser's Claims
041068 -               Resolution Department to process Millie's claim for
041069 -               recovery from medical mistakes getting radiation
041070 -               treatment from UCSF on referral from Kaiser, ref SDS 16
041071 -               KJ6F; Paula indicated that Kaiser refuses to demand
041072 -               performance from UCSF, and to charge UCSF for necessary
041073 -               and reasonable costs of Millie's recovery, because
041074 -               Kaiser has a good business relationship with UCSF, and
041075 -               Kaiser fears that holding UCSF accountable for medical
041076 -               mistakes would harm Kaiser's good business relationship.
041077 -               ref SDS 16 A593
041079 -                ..
041080 -               [On 100528 0322 Millie requested Medicare support for
041081 -               quality care, and conformance with entitlement to
041082 -               recover from medical mistakes getting radiation treation
041083 -               on referral from Kaiser, ref SDS 17 QQ6N; asked Medicare
041084 -               to hold Kaiser accountable for Millie's care because
041085 -               desire to have good business relationship with UCSF does
041086 -               not excuse failure to provide effective care.
041087 -               ref SDS 17 QZ5U
041089 -         ..
041090 -   11.  I fully appreciate we may fail to find another "cetuximab"
041091 -        solution.  I only ask for reasonable efforts to try, to
041092 -        investigate, to review and determine my next treatment based on
041093 -        best evidence [of "trade-offs" as discussed during the prior
041094 -        meeting and confirmed in my letter later that day on 090725
041095 -        2017, ref SDS 11 T58U].
041097 -         ..
041098 -   12.  You further indicated [during the meeting at Kaiser] on 091027
041099 -        that since my cancer marker CA 15-3 299 dropped about 50
041100 -        points, this indicated my condition remained "stable", and so
041101 -        it was not necessary to switch immediately to another
041102 -        treatment. ref SDS 14 DR6M  You scheduled follow up today to
041103 -        consider if we can reasonably squeeze another cycle of Gemzar
041104 -        or must change treatments in order for me to survive.
041106 -         ..
041107 -   13.  I believe there has been a subsequent CA 15-3 299 reading for
041108 -        last week, which may suggest "stability" that justifies another
041109 -        cycle with Gemzar, or it could indicate this is the end of
041110 -        Gemzar effectiveness, and we must immediately change
041111 -        treatments.  The meeting today can verify the record to
041112 -        accurately assess this issue, as much as possible.
041114 -         ..
041115 -   14.  Today, we need to review the 20 or so treatments submitted
041116 -        previously to the team, including Doctor Rugo's PARP treatments
041117 -        discussed on 090616. ref SDS 7 KD6L
041118 -
041119 -            [On 091112 0930 Kaiser's medical chart, which was not
041120 -            received until months later, ref SDS 15 655J, represents
041121 -            incorectly that the doctor presented potential risks (side
041122 -            effects and complications) and benefits of the recommended
041123 -            and alternative oncologic treatment(s).  I have answered
041124 -            the patient's questions.  I believe the patient is
041125 -            competent and can understand the recommendations that I
041126 -            have made.  The patient agrees with these recommendations -
041127 -            none of this occurred - the doctor prescribed Abraxane for
041128 -            Millie's next relapse, and did not compare trade-offs with
041129 -            other oncology treatments, ref SDS 15 PUGK, contrary the
041130 -            request in Millie's letter today transmitting the agend,
041131 -            per above, ref SDS 0 LE3R, and further requested also
041132 -            above. ref SDS 0 L64X
041133 -
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0412 -