CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 22 0000. ref SDS 21 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 100501 1037 Millie letter to medical team confirms Kaiser's new
040902 - strategy to treat Millie's cancer with "targeted therapy." ref SDS 20
040903 - F25O  Millie requests Kaiser immediately switch from Abraxane
040904 - chemotherapy that has failed, and implement Doctor Rugo's plan at UCSF
040905 - on 090616, to treat Millie with PARP that is "targeted" to Millie's
040906 - rare patient profile of "triple negative" and avoids pain and
040907 - suffering from chemotherapy side effects, and for the purpose of
040908 - recovering from UCSF medical mistakes. ref SDS 20 U47P and ref SDS 20
040909 - U49V
040911 -  ..
040912 - On 100501 2017 Millie received letter from Doctor Rugo saying she will
040913 - communicate with Doctor Johnson at Kaiser on the work plan for Millie
040914 - to recover from the 11th relapse of cancer. ref SDS 21 HH4I
040916 -  ..
040917 - On 100502 0140 Millie responds to Doctor Rugo's letter reporting
040918 - commitment to communicate with Doctor Johnson at Kaiser on the work
040919 - plan for Millie to recover from 11th relapse of cancer. ref SDS 22
040920 - HH4I
040922 -  ..
040923 - On 100502 2143 Millie received secure email from Kaiser that is
040924 - difficult to open. ref SDS 0 HH4I  The next day was able to open the
040925 - letter, and discovered Doctor Johnson confirms that some patients can
040926 - be treated successfully with "targeted" therapies; he recalls that
040927 - this strategy has already been executed for Millie. ref SDS 0 YX8L
040928 -
040929 -
040930 -
040932 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Doctor Johnson's letter says...
041302 -
041303 -    1.  Subject: Re: Cancer 11th Relapse Requires Targeted Therapy Overcome Resistance to Chemotherapy (PHI)
041304 -        Date: Sun, 2 May 2010 15:10:49 -0700
041314 -         ..
041315 -    2.  This is a secure, encrypted message.
041317 -         ..
041318 -    3.  To view your secure message:
041319 -
041320 -    4.  *Desktop users:*
041321 -
041322 -        Open the attachment (message_zdm.html) and follow the
041323 -        instructions.
041324 -
041325 -    5.  *BlackBerry users:*
041326 -
041327 -        Install the Voltage SecureMail for BlackBerry application
041328 -
041329 -           https://voltage-ps-0000.kp.org/brand/zdm/mobile.ftl
041330 -
041331 -    6.  * Other mobile users: *
041332 -
041333 -        Forward this message to: zdm@vsn.voltage.com <#> and check your
041334 -        inbox for a link to view the message.
041336 -         ..
041337 -    7.  *NOTICE TO RECIPIENT:*T If you are not the intended recipient
041338 -        of this e-mail, you are prohibited from sharing, copying, or
041339 -        otherwise using of disclosing its contents.  If you have
041340 -        received this e-mail in error, please notify the sender
041341 -        immediately by reply e-mail and permanently delete this e-mail
041342 -        and any attachments without reading, forwarding, or saving
041343 -        them.  Thank you This message was sent using Kaiser SecureMail.
041344 -        Email Security Powered by Voltage IBE™ 	
041346 -         ..
041347 -    8.  Copyright 2003-2009 Voltage Security, Inc. All rights reserved.
041348 -        Proofpoint is a registered trademark of Proofpoint, Inc. in the
041349 -        United States and other countries.
041351 -         ..
041352 -    9.  Attachment...
041353 -
041354 -        message_zdm.html
041356 -  ..
041357 - This thing seems to use IE, and requires setting "cookies" on which
041358 - exposes risks of virus attacks, spam, phishing, and access to
041359 - confidential computer data.  Conflicts with patient requirements for
041360 - confidentiality.
041362 -  ..
041363 - Previously, Millie received a "secure email" from Doctor Johnson at
041364 - Kaiser and could not open it, reported on 100106 1317. ref SDS 12 TU4G
041365 - After several days trying to open the doctor's letter sent through
041366 - "secure email," Millie sent a letter notifying the medical team to use
041367 - public domain email for timely, efficient communications, reported on
041368 - 100108 0852. ref SDS 13 MW4P
041369 -
041370 -            [On 100601 0830 Doctor Johnson reported he received
041371 -            securemail from Doctor Rugo at UCSF encrypted to protect
041372 -            confidentiality of Millie's health records, but he could
041373 -            not open the letter; he sent Doctor a securemail advising
041374 -            he could not open her securemail, and he received back a
041375 -            public domain email from Doctor Rugo that she could not
041376 -            open Doctor Johnson's letter from Kaiesr; as a result of
041377 -            failed communcation with email and telephone for over a
041378 -            month, Doctor Johnson was unable to prescribe treatment for
041379 -            Millie to recover from medical mistakes getting radiation
041380 -            treatments at UCSF on referral from Kaiser; resulting in
041381 -            Millie being forced into Hospice to die. ref SDS 27 D658
041383 -  ..
041384 - The next day, Millie was trying to open the doctor's attachment, and
041385 - had difficulty following complicated instructions, per above.
041386 - ref SDS 0 EQ4G  She somehow deleted the entire letter.
041387 -
041388 -            [On 100503 1522 Millie notifies medical team of difficulty
041389 -            handling secure email. ref SDS 23 TD5T
041391 -             ..
041392 -            [On 100503 1945 Kaiser resubmitted letter sent initially
041393 -            with "secure email" for protecting patient confidentiality,
041394 -            and using public domain email with level of confidentiality
041395 -            acceptable to the patient for efficient communication.
041396 -            ref SDS 24 YL5N
041398 -             ..
041399 -            [On 100504 1609 Sara, Practice Manager for UCSF Oncology
041400 -            Breast Care Clinic, called and notified Millie that lawyers
041401 -            in the UCSF Risk Management Department want Millie to use
041402 -            secure email to comply with Federal regulations; Sara does
041403 -            not know what Federal regulations apply in this case, nor
041404 -            what the regulations say that justify denying the patient
041405 -            the right to choose the level of confidentiality suited to
041406 -            the patients need for communicating effectively with her
041407 -            medical team, and with transparency that encourages
041408 -            accuracy and timeliness. ref SDS 25 ZV6M
041410 -  ..
041411 - Kaiser's "secure email" was finally retrieved later in the afternoon
041412 - on 100504 from a backup, and after considerable effort, was able to
041413 - open the letter, which says...
041414 -
041415 -            [On 100505 0411 Millie notified medical team that Kaiser's
041416 -            "secure email" sent on 100502 was finally retrieved on
041417 -            100504. ref SDS 26 8J7X
041419 -  ..
041420 - Doctor Johnson says...
041421 -
041422 -    1.  Subject: Re: Cancer 11th Relapse Requires Targeted Therapy
041423 -        Overcome Resistance to Chemotherapy (PHI)
041424 -        Sent: Sun May 2, 2010 3:10 PM (2 days ago)
041435 -         ..
041436 -    2.  I am sorry but I believe there must have been some sort of
041437 -        miscommunication during that last visit. My point was that
041438 -        once someone becomes resistant to chemotherapy, sometimes new
041439 -        strategies, such as with "targeted therapies" can be
041440 -        successfully employed.
041442 -  ..
041443 - This seems to align with record for the meeting at Kaiser on 100427
041444 - 0830. ref SDS 18 SJ6N
041446 -  ..
041447 - Doctor's letter continues...
041448 -
041449 -    3.  I went on to say that in your case those available strategies
041450 -        had already been executed.  I am sorry that you thought that I
041451 -        was saying that I had, or there was, something new.
041453 -  ..
041454 - This representation seems conflicting with the record.  On 090325
041455 - Doctor Johnson asked Millie to submit a list of targeted therapies for
041456 - review by the medical team.  This was done in a letter the next day on
041457 - 090326 0058. ref SDS 6 DW5S
041459 -  ..
041460 - Since 090326, there is nothing in the record showing any of these new
041461 - "targeted" therapy strategies have been "executed" for Millie's care,
041462 - contrary to Kaiser's letter today, per above. ref SDS 0 MZ4N
041463 -
041464 -            [On 100503 1522 Millie notifies medical team that time of
041465 -            the essence to get the next treatment going. ref SDS 23
041466 -            TD5T
041468 -             ..
041469 -            [On 100505 0411 Millie notified medical team that Kaiser's
041470 -            "secure email" sent on 100502 was finally retrieved on
041471 -            100504. ref SDS 26 8J7X
041473 -  ..
041474 - Later on 090616, Doctor Rugo said she had many targeted treatments
041475 - lined up for Millie, starting with MPA, and planned to treat Millie's
041476 - next relapse, after MPA, with PARP. ref SDS 11 KD6L
041478 -  ..
041479 - More recently on 100112, Doctor Johnson reviewed Kaiser documentation
041480 - on PARP describing breakthrough targeted treatment for Millie's
041481 - patient profile having triple negative status. ref SDS 14 N586
041483 -  ..
041484 - None of these treatments have been "executed."  Millie's favorable
041485 - experience for nearly 2 years with cetuximab shows advantages of
041486 - "targeted" therapies described in the article on PARP.
041488 -  ..
041489 - Kaiser's first treatment for Millie with the "gold standard" of
041490 - chemotherapy failed after 2 cycles.  Kaiser did not abandon the
041491 - chemotherapy strategy, because it had been "executed," but went on to
041492 - try other chemotherapy agents.
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