Welch Company
San Francisco, CA


S U M M A R Y


DIARY: May 12, 2011 07:36 PM Thursday; Rod Welch

Pam notified who people are that provided medical care for Millie.

1...Summary/Objective
2...Case Study Principal Providers Millie's Medical Team


..............
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CONTACTS 

SUBJECTS
Medical Team Millie Buck Biopgraphy Role Health Care Providers Docto

3503 -
3503 -    ..
3504 - Summary/Objective
3505 -
350501 - Follow up ref SDS 33 0000. ref SDS 32 0000.
350502 -
350503 -
350504 -
350506 -  ..
3506 -
3507 -
3508 - Background
3509 -
350901 - Background on 110207 2142. ref SDS 21 I26I
350902 -
350903 - Pam has been training for the half-marathon she and Kim entered and
350904 - scheduled for June, reported on 110204 1052. ref SDS 19 FP5G  She
350905 - mentioned in her letter that training is going well, so she may
350906 - consider doing a full marathon, 26 miles, reported on 110222 1017.
350907 - ref SDS 24 L86X  This was discussed in the letter to Pam on 110223
350908 - 0022. ref SDS 26 LG3T
350910 -  ..
350911 - On 110411 1342 Pam visited and reported injuring hamstring training
350912 - for charity hike to raise money to aid cancer research and honoring
350913 - her brother, ref SDS 28 TY8L,
350915 -  ..
350916 - On 110411 1342 at 1414 letter to Pam with background on recovering
350917 - from hamstring injuries. ref SDS 28 OF4I
350919 -  ..
350920 - On 110512 0813 letter from Pam requests email addresses for Millie's
350921 - health care providers to solicit donations for charity marathon
350922 - raising money to fund cancer research. ref SDS 31 TY6F
350924 -  ..
350925 - On 110512 0847 letter to Pam submits email addresses, ref SDS 32 TY6F,
350926 - opposes soliciting donations from Millie's medical team for cancer
350927 - research, ref SDS 32 166Y; and, notes investing time and effort for
350928 - "yeoman's work" enabling a strong doctor patient partnership leverages
350929 - case management with well ordered record to extend survival and
350930 - quality of life better than spending time hikng and solicitating
350931 - donations for cancer research. ref SDS 32 166Q
350933 -  ..
350934 - On 110512 1147 Pam asks who are the people that provided medical
350935 - services for Millie, so that Pam can approach them individually on
350936 - donating for her cancer research fund raising project. ref SDS 33 TY6F
350938 -  ..
350939 - On 100512 1936 submitted background on who people are that contributed
350940 - to Millie's medical team. ref SDS 0 TY6F
350941 -
350942 -
350943 -
350944 -
350946 -  ..
3510 -
3511 -
3512 - Progress
3513 -
351301 - Case Study Principal Providers Millie's Medical Team
351302 -
351303 - Follow up ref SDS 33 TY6F, ref SDS 32 TY6F, and sent copy to Peggy...
351304 -
351305 -    1.  Subject: Re: Email addresses Cancer Research Fundraising, Millie and Her Son, RIP
351306 -        Date: Thu, 12 May 2011 22:06:54 -0700
351313 -         ..
351314 -    2.  Responding to your additional request for who people are in the
351315 -        list of health care providers who treated your mom, 110512
351316 -        1147, ref SDS 33 TY6F, here is a summary in the order of the
351317 -        email list commending Millie's care, and submitted earlier
351318 -        today on 110512 0847. ref SDS 32 TY6F
351319 -
351320 -            [On 110512 2220 copy of this letter, ref SDS 34 SK8O,
351321 -            attached to letter for Kathy sharing experiences of other
351322 -            nurses. ref SDS 34 0Y7W
351324 -             ..
351325 -            [On 110513 0724 Pam received letter explaining who people
351326 -            are that contributed to Millie's medical team. ref SDS 35
351327 -            TY6F
351329 -         ..
351330 -    3.  Arlette Phillips...
351332 -         ..
351333 -        Arlette is Doctor Johnson's "Girl Friday," to get things done
351334 -        in the bureaucracy at Kaiser.  She actually works for somebody
351335 -        else, but Doctor Johnson counts on Arlette, when he has a
351336 -        problem, including using Kaiser's Knowledge Mangement computer
351337 -        system.  She helped your mom navigate as well.  Arlette loved
351338 -        Millie, and shared her interest in cats.  Your mom's last
351339 -        letter to Arlette provides perspective, submitted on 100603
351340 -        0603, ref SDS 13 036C
351342 -         ..
351343 -    4.  Glory Closson...
351345 -         ..
351346 -        Mil's Coagulation Control case manager guided daily dose levels
351347 -        for warfarin (Coumadin) to treat your mom's pulmonary embolism.
351348 -        Gloria monitored blood counts from labs, and checked for
351349 -        changes in medication to adjust daily warfarin that maintains
351350 -        INR at safe levels.  Doctor Johnson counted on Gloria to check
351351 -        for conflicts in medication prescriptions.  Millie talked to
351352 -        Gloria almost weekly since 041104, when she was diagnosed with
351353 -        PE, ref SDS 1 4Y9G, and so thought of her as a good friend,
351354 -        doing very difficult work, shown by Gloria's call on 061024.
351355 -        ref SDS 4 TZ4I
351357 -         ..
351358 -    5.  Nina Grissom, MD
351360 -         ..
351361 -    6.  Though none of the 2nd opinions supported Kaiser's prescription
351362 -        for mastectomy surgery in September 2005, Doctor Grissom
351363 -        proposed that if your mom decided to approve surgery, then
351364 -        several innovations would optimize results, reported on 050912.
351365 -        ref SDS 2 0001  Doctor Riley-Paul implemented this proposal on
351366 -        051021, and after surgery smiled with a positive signal that
351367 -        Doctor Grissom's work plan would yield favorable results.  Note
351368 -        your brother attended that meeting. ref SDS 3 EG5L
351370 -         ..
351371 -    7.  Robert Johnson, MD
351373 -         ..
351374 -    8.  You met Millie's primary care physician several times at
351375 -        Kaiser, e.g., letter to medical team on 090725 2017.
351376 -        ref SDS 12 T53T   Doctor Johnson called the house after Millie
351377 -        died.  You and Kim listened to his condolences commending
351378 -        Millie's courage and dignity living with rare, aggressive
351379 -        cancer, reported on 100731 1343, ref SDS 16 5E5H  Your mom
351380 -        loved the doctor like a son, reported on 100719 1312.
351381 -        ref SDS 14 RM9G
351383 -         ..
351384 -    9.  Hope Rugo, MD
351385 -
351386 -        Doctor Rugo led the team at UCSF.  She prescribed care for your
351387 -        mom despite variance from protocols.  When UCSF made mistakes,
351388 -        Doctor Rugo put her arm around your mom and said "Don't worry!
351389 -        We're not going to let anything happen to you," reported on
351390 -        081016 2342. ref SDS 9 NW6M  She said Kaiser and UCSF agreed
351391 -        in a letter to fix mistakes with "targeted" treatment, giving
351392 -        Millie a life worth living, reported on 090616 1245.
351393 -        ref SDS 11 KD6L
351395 -         ..
351396 -   10.  Catherine Mitsuoka, nurse
351397 -
351398 -        Millie's primary nurse for treatment in the Infusion Clinic at
351399 -        UCSF.  Patients are assigned randomly to nurses and treatment
351400 -        chairs by scheduling software, but Catherine arranged to always
351401 -        be assigned to care for Millie.  Her willingness to "go the
351402 -        extra mile" for Millie reduced mistakes by maintaining
351403 -        continuity handling a complex case.  Catherine came in early
351404 -        before the Infusion Clinic opened on the 5th floor, so your mom
351405 -        could get blood draws at 0730 in time for the doctor to get the
351406 -        lab report at 0830 on the 2nd floor.  If Mil was late arriving
351407 -        for treatment on the 5th floor due to extended examination on
351408 -        the 2nd floor, Catherine placed a pillow in your mom's chair,
351409 -        so she always got the same location every Thursday morning for
351410 -        3 years.  When Kaiser was unable to service Millie's Power Port
351411 -        for CT tests, Catherine solved the problem at UCSF, avoiding
351412 -        physical and emotional trauma to Millie and political conflict
351413 -        at Kaiser.  Millie saw Catherine most often and for the longest
351414 -        continuous time of all her providers.  They became wonderful
351415 -        friends.
351417 -         ..
351418 -   11.  Brigid Miralda, NP
351419 -
351420 -        Doctor Rugo's primary aid for the 1st 2 years of Millie's
351421 -        treatment at UCSF, working with Jackie, the coordinator for
351422 -        Mil's clinical trial with cetuximab.  Brigid did all the
351423 -        examinations and case work-up to prepare for Doctor Rugo to
351424 -        visit for a new minutes at the end of meetings.  Brigid was
351425 -        initially confused by the complexity of your mom's case.  She
351426 -        soon adapted well, and reported that Millie responded to a new
351427 -        "targeted" treatment for 2 years, more than double any other
351428 -        patient.  She has a great sense of humor that maintains energy
351429 -        and hope under dire circumstances.  Your mom loved hearing
351430 -        "Brigid's rule" - Stable is good!"  Brigid also offered
351431 -        critical assistance solving problems at Kaiser getting a Power
351432 -        Port installed for CT tests and labs without torturous pain and
351433 -        suffering, reported on 080501. ref SDS 7 766K
351435 -         ..
351436 -   12.  Paula McPhail
351437 -
351438 -        Kaiser's claims analyst called Millie 071006, and reviewed
351439 -        Kaiser's refusal to provide care. ref SDS 5 Q963  Doctor Rugo
351440 -        said that "Kaiser cut Millie loose," reported at UCSF on 071018
351441 -        0800, ref SDS 6 W23I  Since your mom needed treatment to
351442 -        survive, she objected.  Doctor Johnson said his prescription
351443 -        was overruled by someone in Vallejo, Doctor Mason, and others
351444 -        whom we never met.  Paula took time to read the record.
351445 -        ref SDS 5 TM37  She prepared a claim for Millie, which was
351446 -        approved months later at a hearing in Oakland.  They overruled
351447 -        the people who had overruled Doctor Johnson, so your mom got
351448 -        treatment in time to be effective.  In 2010, Paula filed
351449 -        another claim for Millie to get treatment prescribed for her to
351450 -        recover from more medical mistakes.  Kaiser and Medicare
351451 -        delayed processing this claim beyond statutory limits, another
351452 -        mistake, resulting in your mom dying before Paula could get an
351453 -        independent hearing in Oakland to again overrule denying
351454 -        prescribed care for your mom.  May have mentioned previously
351455 -        that Paula called in shocked disbelief the day after Millie
351456 -        died.  She was crying and asked that the family give permission
351457 -        to convert the pending claim for care into a review for
351458 -        wrongful death to help others avoid needless suffering that
351459 -        Millie endured for over a year.
351461 -         ..
351462 -   13.  Diane Craig, nurse
351463 -
351464 -        She worked with Catherine in the Infusion Clinic at UCSF.
351465 -        Whenever Catherine was on vacation or sick, Diane was the
351466 -        backup.  She discovered a medical mistake in the dose level of
351467 -        Millie's treatment with Carboplatin, resulting in needless
351468 -        relapse.  Her timely warning minimized injury to your mom.
351470 -         ..
351471 -   14.  Paula Vannicola, Chief Nurse Infusion Clinic
351472 -
351473 -        Paula was instrumental and persistent in getting Kaiser
351474 -        management to overturn resistance in the CT Department using
351475 -        Millie's Power Port for injecting contrast medium.  Paula also
351476 -        made sure the Infusion Department would draw blood using the
351477 -        Power Port, since the staff in the Lab, where blood draws are
351478 -        normally done are not qualified to access port catheters into
351479 -        main arteries, as your mom's was placed.  Your mom's long
351480 -        survival in continuous treatment caused trauma (scarring) to
351481 -        her veins.  This made it very difficult to set IV catheters and
351482 -        draw blood for routine labs.  IVs that normally take about a
351483 -        minute, took several hours of pain and suffering with multiple
351484 -        needle punctures, probing, massaging, etc.  Paula helped
351485 -        eventually overcome labor jurisdictional conflicts, and
351486 -        resistance to change, so that your mom's suffering was greatly
351487 -        reduced.
351489 -         ..
351490 -   15.  Jullin Kwok
351491 -
351492 -        Medicare manager in charge of the Kaiser account in 2007.
351493 -        Jullin submitted via fax the SDS record to Paula McPhail at
351494 -        Kaiser, which Paula turned into a claim, leading to approval
351495 -        for care on referral at UCSF, explained above, so Millie lived
351496 -        another 3 years.   By 2010, Jullin had been promoted and was no
351497 -        longer handling the Kaiser account.  Since she knew about prior
351498 -        mistakes affecting Millie, she ordered immediate review at
351499 -        Medicare of Millie's claim filed on 100527.   Medicare
351500 -        assembled an oversight team and demanded immediate action from
351501 -        Kaiser.  Everyone said Millie would get the care she needed,
351502 -        but dark forces at Medicare and Kaiser worked against favorable
351503 -        outcome.  When to everyone's surprise Mil's claim was denied,
351504 -        Jullin then got Paula to take over at Kaiser to correct obvious
351505 -        error and save Millie's life. Of course time ran out.  Jullin
351506 -        was at all times a big player in your mom's care.  She didn't
351507 -        have to do a thing, but tried her best to make things right.
351509 -         ..
351510 -   16.  Glenna Auerback, Coordinator
351511 -
351512 -        Glenna was Doctor Rugo's coordinator at UCSF for Millie's
351513 -        treatment with Sunitinib clinical trial.  She was generous with
351514 -        her time and attentive to Millie's care.  In August 2008,
351515 -        Doctor Johnson at Kaiser asked your mom to ask UCSF to submit a
351516 -        list of protocols for treating your mom's cancer as a chronic
351517 -        disease. As you know from your brother's experience, not every
351518 -        treatment is effective nor can be tolerated.  Therefore, being
351519 -        prepared to switch agents is essential.  Over the preceding
351520 -        years, follow on treatments were discussed in meetings at UCSF.
351521 -        Doctor Rugo's team kept saying in October and November that the
351522 -        doctor had identified many treatments ready for Millie, but
351523 -        they did not submit the list to Kaiser.  Finally, on 090121,
351524 -        Glenna called and said UCSF lost their list of treatments
351525 -        planned for Millie.  They asked Millie to submit a list from
351526 -        her records of prior discussions.  The list was submitted
351527 -        immediately.  Millie also hired a doctor, who travels the
351528 -        research circuit, to prepare an additional list of cutting edge
351529 -        treatments with the highest potential to treat Millie's rare
351530 -        patient profile.  This was submitted to Glenna.  She was then
351531 -        instrumental helping Doctor Rugo formulate a promising
351532 -        prescription with PARP that is targeted to cancer, and so is
351533 -        well tolerated with no side effects, but is further aimed
351534 -        directly at Millie's rare patient profile.
351536 -         ..
351537 -   17.  Nichole Daamen, MD
351538 -
351539 -        Doctor Daamen refused to take "no" for an answer, when Kaiser
351540 -        kept losing results of Millie's biopsy to evaluate triple
351541 -        negative status.  Normally, doctors leave administrative "leg
351542 -        work" to nurses, techs, clerks, and administrators.
351543 -        Thankfully, Doctor Daamen rose above formalities to get the job
351544 -        done, because results were critical to expand the pool of
351545 -        treatments for helping your mom.  Hard to imagine so many
351546 -        things can go wrong ordering one biopsy, a very routine
351547 -        procedure.  To appreciate the effort Doctor Daamen expended on
351548 -        your mom's behalf see case study on this "world's record" of
351549 -        errors - reported, 081016 2342, ref SDS 9 W26G
351551 -         ..
351552 -   18.  Tara Lacey, NP
351553 -
351554 -        Tara was Millie's final nurse at UCSF for Doctor Rugo.  She was
351555 -        outstanding in every respect being very careful and thorough to
351556 -        track you mom's progress.  Tara first recognized during a
351557 -        morning meeting in late March that there was a mistake in the
351558 -        Radiation Oncology Department diagnosing cancer (IBC) in
351559 -        Millie's breastbone, as "reaction to radiation."  She didn't
351560 -        tell Millie, but said she would call Doctor Hsu to report her
351561 -        findings, so he would be prepared to meet with Millie later
351562 -        that  afternoon.  Doctor Hsu said he didn't get a call from
351563 -        Tara.  Months later in June, the truth came out, and Tara was
351564 -        heart broken.  Tara later called Millie late at night to say
351565 -        Doctor Rugo wanted Millie to get treatment at Kaiser
351566 -        temporarily with chemotherapy, which had already been
351567 -        determined conflicts with Mil's patient profile, but as a stop
351568 -        gap for 2 months until PARP was ready at UCSF for Millie to
351569 -        recover from mistakes in March and April.
351571 -         ..
351572 -   19.  Gwen Stritter, MD
351573 -
351574 -        Millie met Doctor Stritter at a medical conference sponsored by
351575 -        the Wellness Community.  The doctor presented a paper on new
351576 -        treatments for cancer and clinical trials available to
351577 -        patients.  When UCSF called and reported losing the list of
351578 -        treatments Millie needed for survival, and asked Millie to
351579 -        submit a list, Millie hired Gwen to summarize her research into
351580 -        a list of treatments sorted according to the most promising
351581 -        results for Millie's patient profile.   This list was then
351582 -        submitted for the medical team to be prepared for providing
351583 -        care in time to be effective.  UCSF reported in a meeting on
351584 -        090616 that Kaiser and UCSF agreed in a letter to use one of
351585 -        the treatments on Gwen's list, PARP, for Millie to recover from
351586 -        UCSF medical mistakes.
351588 -         ..
351589 -   20.  Joe (I-Chow) Hsu, MD
351591 -         ..
351592 -        Doctor Hsu in UCSF Radiation Oncology performed medical
351593 -        services on assignment from Doctor Rugo for Millie to recover
351594 -        from delays in the Breast Care Department providing systemic
351595 -        treatment due to losing the list of therapies for treating
351596 -        Millie's cancer as a chronic disease.  Doctor Hsu was notified
351597 -        that the most severe cancer was in Millie's breastbone, and
351598 -        this needed urgent treatment to save her life.  Doctor Hsu laid
351599 -        out radiation treatment zones.  He hired a contractor to build
351600 -        molds that guide equipment to provide precise radiation
351601 -        coverage that optimizes recovery, while avoiding injury to
351602 -        non-cancerous tissue.   Both objectives failed.  Months later
351603 -        Millie was treated for radiation injury to her lungs, and on
351604 -        090609, Doctor Hsu pointed to your mom's bleeding breastbone
351605 -        and said:  "This is a mistake."  This is not reaction to
351606 -        radiation as we have been saying since March, but is advancing
351607 -        cancer due to an error laying out the treatment zones, or
351608 -        possibly an error in the molds.  To his great credit, the
351609 -        doctor ordered immediate aggressive systemic care for Millie to
351610 -        recover, and to be performed in the Breast Care Clinic under
351611 -        Doctor Rugo's supervision, noted above.
351613 -         ..
351614 -   21.  Christopher Diederich, PhD
351615 -
351616 -        Chris assisted Doctor Hsu in Radiation Oncology laying out
351617 -        treatment zones for Millie's care.  He was primarily involved
351618 -        in providing this care.
351620 -         ..
351621 -   22.  Lee Davidson, MD
351622 -
351623 -        Chief of Radiology at Kaiser in Walnut Creek, Doctor Davidson
351624 -        wrote a letter to Millie apologizing for errors and omissions
351625 -        in the CT Department, and advised that staff would be counseled
351626 -        to avoid recurrence.  Your mom's primary care physician, Doctor
351627 -        Johnson, who was also Chief of Oncology for the Kaiser Diablo
351628 -        region, told Millie on several occasions that Doctor Davidson
351629 -        felt very badly about what happened to her and that the doctor
351630 -        was "in her corner" fighting along with Paula Vannicola to get
351631 -        changes at Kaiser, which were resisted for political and
351632 -        financial reasons, but were needed for your mom to survive.
351634 -         ..
351635 -   23.  I support your contacting Millie's medical team to say thanks
351636 -        for helping your mom, as noted in the letter earlier today on
351637 -        110512 0847. ref SDS 32 166Y
351638 -
351645 -
351646 -
351647 -
351648 -
351649 -
351650 -
351651 -
351652 -
351653 -
3517 -