THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net
S U M M A R Y
DIARY: June 5, 2010 06:17 PM Saturday;
Rod Welch
Kaiser advised Millie of medical right to choose pain relief in Hospice.
1...Summary/Objective
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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 010427 0830 meeting at Kaiser - Doctor Johnson notes Millie looks
040902 - so good nobody can believe she has such severe cancer, ref SDS 2
040903 - OJ6I; the doctor explained again Millie's cancer has mutated through
040904 - 11 relapses to resist chemotherapy. The doctor advised that Kaiser
040905 - has a new strategy prescribing therapy that is effective for treating
040906 - cancer as a chronic disease by "targeting" the genetic profile of
040907 - cancer that has mutated in patients, like Millie, to resist
040908 - chemotherapy. ref SDS 2 SJ6N
040910 - ..
040911 - On 100501 1037 Millie letter to medical team confirms understanding of
040912 - new strategy to treat Millie's cancer with targeted therapy.
040913 - ref SDS 3 F25O
040915 - ..
040916 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040917 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040918 - of cancer caused by UCSF medical mistakes. ref SDS 4 HH4I
040920 - ..
040921 - On 100502 2143 Kaiser confirms that some patients respond well to new
040922 - "targeted" therapies. ref SDS 5 YX8L Kaiser contends that all of the
040923 - strategies for "targeted" therapies have been executed for Millie,
040924 - which seems conflicting with the record in this case. ref SDS 5 MZ4N
040926 - ..
040927 - On 100503 1522 Millie notifies medical team that time of the essence
040928 - to get the next treatment going. ref SDS 6 TD5W
040930 - ..
040931 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040932 - with Abraxane chemotherapy that seems to be failing, and then after 3
040933 - more weeks without treatment, following a trip abroad, the doctor will
040934 - discuss "next steps." ref SDS 7 YL5N
040936 - ..
040937 - On 100503 2338 Millie reports to medical team that she will implement
040938 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040939 - letter on 010503, as assurance that recovery will be equal to changing
040940 - treatment immediately on 100505. ref SDS 8 6X7S
040942 - ..
040943 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040944 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040945 - communicate with Doctor Johnson, or had already done so, to coordinate
040946 - with Kaiser on planning Millie's next treatment to recover from the
040947 - 11th relapse of cancer. ref SDS 9 NT5N
040949 - ..
040950 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040951 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040952 - ref SDS 10 KE4K
040954 - ..
040955 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040956 - seemingly on an accelerating rise, which threatens to cascade out of
040957 - control, because Abraxane chemotherapy is not effective. ref SDS 11
040958 - L54I
040960 - ..
040961 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040962 - Abraxane. ref SDS 12 KE4K
040964 - ..
040965 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 13 PK9O
040967 - ..
040968 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040969 - Department for standard of care to recover from 11th relapse of cancer
040970 - caused by medical mistakes getting radiation treatments at UCSF on
040971 - referral from Kaiser. ref SDS 14 IZ7N
040973 - ..
040974 - On 100528 0322 Millie requests support from Medicare to separate
040975 - recovery for medical mistakes getting radiation from UCSF, from health
040976 - care benefits limited by Medicare insurance coverage. ref SDS 15 QQ6N
040978 - ..
040979 - On 100528 1031 called Medicare they have formed a team to review
040980 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040981 - response to Millie's claim. ref SDS 16 4W5F
040983 - ..
040984 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040985 - collaborate with UCSF on treatment for Millie to recover from UCSF
040986 - medical mistakes. He discussed treating Millie with MPA, but this was
040987 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040988 - ended the treatment due to fears about blood clot side effects, which
040989 - were believed to cause breathing problems Millie had, though later
040990 - breathing problems were discovered to be caused by defective radiation
040991 - treatment. Since Doctor Johnson said Kaiser has no more treatments
040992 - for Millie, the only way Millie can get relief from pain caused by
040993 - cancer that is progressing without treatment is get treatment in
040994 - Hospice. Since Hospice is the only choice of care offered today,
040995 - Millie accepted this.
040997 - ..
040998 - On 100601 1531 Sharon called to schedule starting Hospice medical
040999 - services beginning tomorrow between 0900 - 1000. ref SDS 3 036C
041001 - ..
041002 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041003 - Sharon's report yesterday, that if Kaiser performs on the insurance
041004 - agreement to provide standard of care for Millie's patient profile,
041005 - than Millie can elect to recover from 11th relapse of cancer, rather
041006 - than continue with Hospice support for dying peacefully. ref SDS 4
041007 - 036C
041009 - ..
041010 - On 100602 1046 Diane received notice from Medicare to file claim for
041011 - Millie to get treatment for recovering from UCSF medical mistakes; she
041012 - is preparing a statement of claim. ref SDS 21 036C Advised Diane to
041013 - use Millie's statement of claim submitted to Kaiser on 100527.
041014 - ref SDS 21 MZ5H Eileen called later and reported that Kaiser denied
041015 - Millie's claim on the grounds that Medicare does not authorize payment
041016 - for treatment to recover from cancer, after a patient starts Hospice.
041017 - ref SDS 21 UN4M Requested that Eileen read he claim and then make a
041018 - good faith determiantion. ref SDS 21 I33H Eileen called back after
041019 - reading the claim and advised the denial of claim has been withdrawn,
041020 - and the matter is referred to Claims Resolution Department.
041021 - ref SDS 21 UN5P
041023 - ..
041024 - On 100603 0449 Millie submits record to medical team confirming
041025 - understandings, ref SDS 22 036C
041027 - ..
041028 - On 100605 1817 Doctor Johnson responded to Millie's letter on 100603,
041029 - explaining Millie's medical right to choose level of pain getting
041030 - Hospice care, ref SDS 0 036C; does not address patient right to choose
041031 - life rather than death in Hospice. ref SDS 0 4R5J
041032 -
041033 -
041035 - ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Doctor Johnson's letter to Millie says...
041402 -
041403 - 1. Subject: Cancer 11th Relapse Work Plan - Hospice Started
041404 - Date: Sat, 5 Jun 2010 15:57:00 -0700
041408 - ..
041409 - 2. Glad you are settling in with Hospice [responding to Millie's
041410 - letter to the medical team on, ref SDS 22 036C, tranasmitting
041411 - the record meeting with Doctor Johnaon at Kaiser on 100601, at
041412 - which time Doctor Johnson pushed keys on a computer and set
041413 - Millie to die, rather than provide treatment. ref SDS 18 4G6G,
041414 - and so the next day, Millie met with Liz to start Hospice.
041415 - ref SDS 22 IX7T
041417 - ..
041418 - 3. Remember, you have the right to choose the level of pain vs
041419 - consciousness that you want to experience [responding to
041420 - Millie's letter to the medical team on 100603, reporting her
041421 - decision to choose a higher level of pain than recommended by
041422 - Hospice, and in order to be conscious and alert to experience
041423 - life, rather than bedridden on pain suppressing drugs.
041424 - ref SDS 22 IX8R, and citing the meeting with Hospice
041425 - on 100602 0913. ref SDS 20 PS7U]
041427 - ..
041428 - Why does a patient have a right to choose level of pain v
041429 - consciousness to ease the path toward death in Hospice, as noted in
041430 - Doctor Johnson's letter today, ref SDS 0 VY4J, but patients do not
041431 - have a right to choose treatment rather than death, reported by Doctor
041432 - Johnson at Kaiser on 100601 0830. ref SDS 18 4G6G
041434 - ..
041435 - For some reason, Doctor Johnson does not report cancer marker CA 15-3
041436 - for blood test on 100529, requested in Millie's letter on 100603 0449.
041437 - ref SDS 22 IX5R
041438 -
041439 - [On 100605 1838 Millie asks Kaiser again for results of
041440 - cancer marker on lab test 100529. ref SDS 24 CG8V
041442 - ..
041443 - [On 100606 1604 Doctor Johnson reports Millie's cancer
041444 - marker for lab on 100529 was CA 15-3 606, ref SDS 25 8H5I,
041445 - considerably less than expected in Millie's letter on
041446 - 100601 0136. ref SDS 17 1Q3P
041447 -
041465 -
041466 -
041467 -
041468 -
041469 -
041470 -
041471 -
0415 -