CONTACTS 

SUBJECTS
CT Test Mistakes Kaiser Notice Failed Heart Disorder Enlarged Right

2003 -
2003 -    ..
2004 - Summary/Objective
2005 -
200501 - Follow up ref SDS 12 0001. ref SDS 11 0000.
200502 -
200503 - Millie submitted a letter thanking the advice nurse, Arlette, for
200504 - submitting the pathology report on the CT test performed on 060930,
200505 - and noting relief the only finding is pulmonary emboli, previously
200506 - reported by the primary care physician on 061002. ref SDS 0 UR7K
200507 - Millie asks for an assessment of severity in light of enlarged right
200508 - ventricle? ref SDS 0 US6H  Millie notes research indicating she was
200509 - lucky to survive recurrence of pulmonary emboli. ref SDS 0 I75P  She
200510 - asks Kaiser about continuing problems getting comparisons for trend
200511 - analysis, ref SDS 0 I75V, and cites impact on 2nd opinion process that
200512 - seems skeptical of Kaiser imaging test quality control. ref SDS 0 I77Y
200513 - Does persistant failure of analysts to carry out doctor's orders on
200514 - scope of tests reflect communication issues between Imaging and
200515 - Oncology departments? ref SDS 0 I78Y
200516 -
200517 -     [On 061015 received a letter from Arlette reporting that the leter
200518 -     today was submitted to the primary care physician. ref SDS 14 0001
200519 -
200520 -
200521 -
200522 -
200523 -
200525 -  ..
2006 -
2007 -
2008 - Progress
2009 -
200901 - On 060929 the doctor ordered a CT test for pulmonary emboli.
200902 - ref SDS 6 DY5M  The test was performed the next day, and on 061002 the
200903 - doctor called and reported the test diagnoses pulmonary emboli
200904 - recurrence. ref SDS 8 MI5I
200906 -  ..
200907 - Yesterday, Millie received the report from Arlette, ref SDS 12 M56F;
200908 - and, also, from the doctor. ref SDS 12 UE4J
200910 -  ..
200911 - The CT test report presents new and additional issues not disclosed in
200912 - the doctor's notification on 061002. ref SDS 12 0001
200914 -  ..
200915 - A major new issue arises from findings of enlarged right ventricle,
200916 - ref SDS 12 7E5L, which is a known heart disorder. ref SDS 12 L35J
200918 -  ..
200919 - Today, Millie submitted ref DIT 1 0001 to Arlette, who works in the
200920 - Oncology Clinic with the primary care physician, and asking the
200921 - following...
200922 -
200923 -    1.  Thanks for the report.  I am a little relieved the only finding
200924 -        seems to be pulmonary emboli, ref DIT 1 0001, and even that
200925 -        doesn't sound real bad. [from review on 061012, ref SDS 12
200926 -        294Q]
200928 -         ..
200929 -    2.  I will ask the doctor for a source that explains severity of
200930 -        pulmonary emboli in relation to an enlarged "right ventricle" -
200931 -        the report doesn't say how enlarged - slight or near to
200932 -        failure?  Sounds like a measurement was made but the size is
200933 -        not indicated for some reason. ref SDS 12 7E5L  Is it possible
200934 -        to ask about this? ref DIT 1 UM5M
200935 -
200936 -            [On 061015 received a letter from Arlette reporting that
200937 -            the leter today was submitted to the primary care
200938 -            physician. ref SDS 14 0001
200940 -             ..
200941 -            [On 061020 Millie asked the doctor how serious pulmonary
200942 -            embolism, how enlarged is the right ventricle, can she
200943 -            resume working out at the gym? ref SDS 15 VJ4J
200945 -             ..
200946 -            [On 061027 Millie letter advises Kaiser that pulmonary
200947 -            embolism symptoms continue fatigue, shortness of breath;
200948 -            Millie asks about prognosis for getting back in the gym to
200949 -            improve fitness, which previously were attributed to
200950 -            symptoms for pulmonary embolism. ref SDS 16 K24K
200952 -         ..
200953 -    3.  I only mention this because research seems to show that only
200954 -        10% of people get recurrence with pulmonary emboli, but 45% of
200955 -        those who recur die. [reported on 060722, ref SDS 1 BI5J, Since
200956 -        I am now a card carrying member of the 10% group, the number
200957 -        45% somehow jumps out at me, as though I have dodged a bullet.
200958 -        ref DIT 1 9S6G [also cited on 061012, ref SDS 12 N26N]
200960 -         ..
200961 -    4.  I have to admit I am confused by the "Comparison" section.
200962 -        ref DIT 1 RV6M  [reviewed on 061012, ref SDS 12 2935]
200964 -         ..
200965 -    5.  The report compares only with the past two CT tests, and not
200966 -        with the test on Nov 3, 2004?  During the meeting a few weeks
200967 -        ago on Sep 29, the doctor asked for the date of the test when
200968 -        pulmonary emboli was first diagnosed.  We told him the date and
200969 -        I was looking over his shoulder when he wrote Nov 3, 2004 into
200970 -        the computer ordering the CT test for direct comparison with
200971 -        the location that showed pulmonary emboli previously.
200972 -        ref SDS 6 DY5M  Yet the report comes back and doesn't mention
200973 -        this comparison, while going to the trouble of stating a
200974 -        comparison with recent reports, which of course should have
200975 -        been made, but why not tell the doctor his order was performed
200976 -        as specified? ref DIT 1 417F
200977 -
200978 -           [On 061020 primary care physician did not have time to make
200979 -           comparison during examination. ref SDS 15 N96N
200981 -            ..
200982 -           [On 061208 doctor ordered PET scan test to set new baseline
200983 -           for changing chemotherapy to treat IBC; and added to the
200984 -           order request for analysis of pulmonary embolism, and
200985 -           enlarged right ventricle by comparing and contrasting with
200986 -           prior CT tests on 041103 and on 060930, even though CT scan
200987 -           tests are a better diagnostic for this comparison.
200988 -           ref SDS 17 ZY5L
200990 -         ..
200991 -    6.  This has happened previously. ref SDS 12 A55J  When Doctor
200992 -        Johnson requested the prior CT test on May 5, 2006, he wanted
200993 -        comparison with the PET scan test a few weeks earlier on April
200994 -        14, 2006, because the PET scan analyst recommended a follow up
200995 -        CT contrast study of the right axilla and left supraclavicular.
200996 -        However, again, the CT analyst didn't say a word about the PET
200997 -        scan test, but said instead comparison was made with the prior
200998 -        CT test a year earlier when these matters were not at issue.
200999 -        ref DIT 1 A18G
201001 -         ..
201002 -    7.  Doctor Benz did go to the trouble of saying in his recent 2nd
201003 -        opinion that he is not convinced by the Kaiser CT test report
201004 -        on May 5, 2006 that did not report activity in the left
201005 -        supraclavicular, that there is really nothing going on there,
201006 -        because silence in the report could mean it was overlooked.
201007 -        ref DIT 1 O19F
201009 -  ..
201010 - Actually, the Benz 2nd opinion reviewed on 060929 may not quite
201011 - address this particular issue. ref SDS 7 WQ5T
201013 -  ..
201014 - Another part of Benz 2nd opinion cites conflicting imaging reports
201015 - that impact confidence in analysis of left supraclavicular.
201016 - ref SDS 7 7Y4K
201018 -  ..
201019 - Letter to Kaiser continues...
201020 -
201021 -    8.  I guess I am a little uneasy about that too. ref DIT 1 A29M
201023 -         ..
201024 -    9.  Makes you wonder if there are communication issues between
201025 -        oncology and imaging? ref DIT 1 U24F
201026 -
201027 -            [On 061015 received a letter from Arlette reporting that
201028 -            the leter today was submitted to the primary care
201029 -            physician. ref SDS 14 0001
201031 -         ..
201032 -   10.  Well, not to worry!  There are always a few hiccups along the
201033 -        way.  Probably not big deals in cosmic reality. ref DIT 1 O24J
201035 -         ..
201036 -   11.  Thanks again for getting me the report. ref DIT 1 934N  Doctor
201037 -        ******* also sent it just after you did so the coordination to
201038 -        save him time didn't work, but we'll keep trying. ref SDS 12
201039 -        UE4J
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2011 -