CONTACTS 

SUBJECTS
Cetuximab Carboplatin Clinical Study 2nd Arm 6th Cycle 3rd Treatment

1003 -
1003 -    ..
1004 - Summary/Objective
1005 -
100501 - Follow up ref SDS D9 0000. ref SDS D5 0000.
100502 -
100503 -
100504 -
100505 -
100506 -
100507 -
100509 -  ..
1006 -
1007 -
1008 - Progress
1009 -
100901 - Background on Millie's treatment in the clinical study is reported on
100902 - 080508. ref SDS 97 TZ8I
100904 -    ..
100905 -   Taxotere Capecitabine 2nd Relapse IBC Treatment After Mastectomy
100906 -
100907 -   Follow up ref SDS D9 X33O, ref SDS D5 X33O.
100908 -
100909 -   Millie had left mastectomy on 051021.  Biopsy at that time reported
100910 -   no findings of cancer.  Approximately 8 months later on 060707 the
100911 -   doctor diagnosed IBC relapse and prescribed treatment. ref SDS 5
100912 -   PF3O
100913 -
100914 -    1.  Cycle 09 and 01 ................... 060721, ref SDS 6 407N
100915 -    2.  Cycle 10 and 02 ................... 060814, ref SDS 8 LY6O
100916 -    3.  Cycle 11 and 03 ................... 060908, ref SDS 8 407N
100917 -    4.  Cycle 12 and 04 ................... 060929, ref SDS 8 407N
100918 -    5.  Cycle 13 and 05 ................... 061020, ref SDS 9 407N
100919 -    6.  Cycle 14 and 06 ................... 061110, ref SDS 10 407N
100920 -    7.  Cycle 15 and 07 ................... 061201, ref SDS 11 407N
100922 -    ..
100923 -   Cetuxiab Alone Clinical Study
100924 -
100925 -   Follow up ref SDS D9 356I, ref SDS D5 356I.
100926 -
100927 -                   Total    Cetuximab
100928 -    8.  Cycle 01 and 08 and 01 01.......... 070201, ref SDS 13 SG8I
100929 -    9.  Cycle 01 and 08 and 02 02.......... 070208, ref SDS 14 SG8I
100930 -   10.  Cycle 01 and 08 and 03 03.......... 070215, ref SDS 15 SG8I
100931 -   11.  Cycle 01 and 08 and 04 04.......... 070222, ref SDS 16 SG8I
100932 -   12.  Cycle 02 and 09 and 01 05.......... 070301, ref SDS 17 SG8I
100933 -   13.  Cycle 02 and 09 and 02 06.......... 070308, ref SDS 19 7T3H
100934 -   14.  Cycle 02 and 09 and 03 07.......... 070315, ref SDS 20 7T3H
100935 -   15.  Cycle 02 and 09 and 04 08.......... 070322, ref SDS 21 7T3H
100936 -   16.  Cycle 03 and 10 and 01 09.......... 070329, ref SDS 22 7T3H
100937 -   17.  Cycle 03 and 10 and 02 10.......... 070405, ref SDS 23 7T3H
100938 -   18.  Cycle 03 and 10 and 03 11.......... 070412, ref SDS 24 7T3H
100939 -   19.  Cycle 03 and 10 and 04 12.......... 070419, ref SDS 25 7T3H
100940 -   20.  Cycle 04 and 11 and 01 13.......... 070426, ref SDS 26 7T3H
100941 -   21.  Cycle 04 and 11 and 02 14.......... 070503, ref SDS 27 7T3H
100942 -   22.  Cycle 04 and 11 and 03 15.......... 070510, ref SDS 28 7T3H
100943 -   23.  Cycle 04 and 11 and 04 16.......... 070517, ref SDS 29 7T3H
100944 -   24.  Cycle 05 and 12 and 01 17.......... 070524, ref SDS 30 7T3H
100945 -   25.  Cycle 05 and 12 and 02 18.......... 070531, ref SDS 31 7T3H
100946 -   26.  Cycle 05 and 12 and 03 19.......... 070607, ref SDS 32 7T3H
100947 -   27.  Cycle 05 and 12 and 04 20.......... 070614, ref SDS 33 0001
100948 -   28.  Cycle 06 and 13 and 01 21.......... 070621, ref SDS 34 0001
100949 -   29.  Cycle 06 and 13 and 02 22.......... 070628, ref SDS 35 0001
100950 -   30.  Cycle 06 and 13 and 03 23.......... 070705, ref SDS 36 0001
100951 -   31.  Cycle 06 and 13 and 04 24.......... 070712, ref SDS 36 0001
100952 -   32.  Cycle 07 and 14 and 01 25.......... 070719, ref SDS 37 0001
100953 -   33.  Cycle 07 and 14 and 02 26.......... 070726, ref SDS 35 0001
100954 -   34.  Cycle 07 and 14 and 03 27.......... 070802, ref SDS 36 0001
100955 -   35.  Cycle 07 and 14 and 04 28.......... 070809, ref SDS 38 0001
100956 -   36.  Cycle 08 and 15 and 01 29.......... 070816, ref SDS 39 0001
100957 -   37.  Cycle 08 and 15 and 02 30.......... 070823, ref SDS 40 0001
100958 -   38.  Cycle 08 and 15 and 03 31.......... 070830, ref SDS 40 0001
100959 -   39.  Cycle 08 and 15 and 04 32.......... 070906, ref SDS 41 0001
100960 -   40.  Cycle 09 and 16 and 01 33.......... 070920, ref SDS 42 0001
100961 -   41.  Cycle 09 and 16 and 02 34.......... 070927, ref SDS 43 0001
100962 -   42.  Cycle 09 and 16 and 03 35.......... 071004, ref SDS 44 0001
100963 -   43.  Cycle 09 and 16 and 04 36.......... 071011, ref SDS 45 0001
100964 -   44.  Cycle 10 and 17 and 01 37.......... 071018, ref SDS 46 0001
100965 -   45.  Cycle 10 and 17 and 02 38.......... 071025, ref SDS 47 0001
100966 -   46.  Cycle 10 and 17 and 03 39.......... 071101, ref SDS 33 0001
100967 -   47.  Cycle 10 and 17 and 04 40.......... 071108, ref SDS 48 0001
100968 -   48.  Cycle 11 and 18 and 01 41.......... 071115, ref SDS 49 0001
100969 -   49.  Cycle 11 and 18 and 02 42.......... 071122, ref SDS 35 0001
100970 -   50.  Cycle 11 and 18 and 03 43.......... 071129, ref SDS 52 0001
100971 -   51.  Cycle 11 and 18 and 04 44.......... 071206, ref SDS 53 0001
100972 -   52.  Cycle 12 and 19 and 01 45.......... 071213, ref SDS 56 0001
100973 -   53.  Cycle 12 and 19 and 02 46.......... 071220, ref SDS 59 0001
100974 -   54.  Cycle 12 and 19 and 03 47.......... 071227, ref SDS 60 0001
100975 -   55.  Cycle 12 and 19 and 04 48.......... 080103, ref SDS 61 0001
100976 -   56.  Cycle 13 and 20 and 01 49.......... 080110, ref SDS 64 0001
100977 -   57.  Cycle 13 and 20 and 02 50.......... 080117, ref SDS 65 0001
100978 -   58.  Cycle 13 and 20 and 03 51.......... 080124, ref SDS 66 0001
100979 -   59.  Cycle 13 and 20 and 04 52.......... 080131, ref SDS 68 0001
100980 -   60.  Cycle 14 and 21 and 01 53.......... 080207, ref SDS 72 0001
100981 -   61.  Cycle 14 and 21 and 02 54.......... 080214, ref SDS 73 0001
100982 -   62.  Cycle 14 and 21 and 03 55.......... 080221, ref SDS 36 0001
100983 -   63.  Cycle 14 and 21 and 04 56.......... 080228, ref SDS 78 0001
100984 -   64.  Cycle 15 and 22 and 01 57 01  00... 080306, ref SDS 81 TZ8I
100986 -    ..
100987 -   Cetuxiab with Carboplatin Clinical Study 2nd Arm
100988 -
100989 -   Follow up ref SDS D9 5B6J, ref SDS D5 5B6J.
100990 -
100991 -   On 080207 doctor reports IBC may be spreading. ref SDS 71 GH5H
100992 -   Follow up examination on 080219 Doctor Rugo diagnosed progression of
100993 -   disease. ref SDS 91 3J4I  Photographs show spread of IBC rash,
100994 -
100995 -             2nd
100996 -             Arm              Cetuximab Carboplatin
100997 -   65.  Cycle 01 15 and 22 and 02 58 02  01... 080313, ref SDS 82 TZ8I
100998 -   66.  Cycle 01 15 and 22 and 03 59 03  01... 080320, ref SDS 83 TZ8I
100999 -   67.  Cycle 01 15 and 22 and 04 60 04  01... 080327, ref SDS 84 TZ8I
101000 -   68.  Cycle 02 16 and 23 and 01 61 05  02... 080403, ref SDS 85 TZ8I
101001 -   69.  Cycle 02 16 and 23 and 02 62 06  03... 080410, ref SDS 88 TZ8I
101002 -   70.  Cycle 02 16 and 23 and 03 63 07  03... 080417, ref SDS 90 TZ8I
101003 -   71.  Cycle 02 16 and 23 and 04 64 08  03... 080424, ref SDS 92 TZ8I
101004 -   72.  Cycle 03 17 and 24 and 01 65 09  04... 080501, ref SDS 95 5B6J
101005 -   73.  Cycle 03 17 and 24 and 02 66 10  05... 080508, ref SDS 97 5B6J
101006 -   74.  Cycle 03 17 and 24 and 03 67 11  05... 080515, ref SDS 98 5B6J
101007 -   75.  Cycle 03 17 and 24 and 04 68 12  05... 080522, ref SDS 99 5B6J
101008 -   76.  Cycle 04 18 and 25 and 01 69 13  06... 080529, ref SDS A2 5B6J
101009 -   77.  Cycle 04 18 and 25 and 02 70 14  07... 080605, ref SDS A3 5B6J
101010 -   78.  Cycle 04 18 and 25 and 03 71 15  08... 080612, ref SDS A6 5B6J
101011 -   79.  Cycle 04 18 and 25 and 04 72 16  08... 080619, ref SDS A9 5B6J
101012 -   80.  Cycle 05 19 and 26 and 01 73 17  09... 080626, ref SDS B4 5B6J
101013 -   81.  Cycle 05 19 and 26 and 02 74 18  10... 080703, ref SDS B9 5B6J
101014 -   82.  Cycle 05 19 and 26 and 03 75 19  11... 080710, ref SDS C2 5B6J
101015 -   83.  Cycle 05 19 and 26 and 04 76 20  11... 080717, ref SDS C8 5B6J
101016 -   84.  Cycle 06 20 and 27 and 01 77 21  12... 080724, ref SDS D5 5B6J
101017 -   85.  Cycle 06 20 and 27 and 02 78 22  13... 080731, ref SDS D9 5B6J
101018 -   86.  Cycle 06 20 and 27 and 03 79 23  14... 080807, ref SDS 0 5B6J
101020 -  ..
101021 - Today is the 3rd treatment of the 6th cycle with cetuximab and
101022 - Carboplatin together.  This is the 23rd treatment overall with
101023 - cetuximab on the 2nd arm of the clinical study, but is only the 14th
101024 - treatment with Carboplatin due to low blood counts.
101026 -  ..
101027 - Diane is the nurse today.  Catherine is on vacation until 080821.
101028 -
101029 -
101030 -
101031 -
101032 -
1011 -

SUBJECTS
Schedule Treatment Cetuximab Carboplatin 080821 Weekly Through 08121

1703 -
1704 - 0812
170501 -  ..
170502 - Schedule Weekly Treatments Continue on Thursdays
170503 -
170504 - Follow up ref SDS D5 1K7H, ref SDS B4 IK7H.
170505 -
170506 - Visted with Lena, an attendant at the front desk of the Breast Care
170507 - Clinic.
170509 -  ..
170510 - Lena will check on the times for meetings with the doctor on 080818,
170511 - and on 081016, which were missing from the schedule received from UCSF
170512 - on 080724. ref SDS D5 EQ5H
170513 -
170515 -  ..
1706 -
1707 -
1708 - 0858
1709 -
170901 - Lena called.
170902 -
170903 - The doctor will meet with Millie after her treatments at 1130 on
170904 - 080918, and the following month on 081016. ref SDS D5 SO8F
170906 -  ..
170907 - Lena verified that this will be okay based on patient history of never
170908 - before having met with the doctor after treatment, in that the purpose
170909 - of meeting is to approve readiness for treatment to start a new cycle.
170911 -  ..
170912 - Lena advised that the medical team feels Millie's good health, shown
170913 - by examination on 080724, ref SDS D4 FH7M, citing favorable results,
170914 - ref SDS D4 4D4K, from the CT test on 080718, as reviewed on 080723,
170915 - ref SDS D3 EO8F, permits meeting after treatment on these two
170916 - occassions.  The 1130 meeting time is only an estimeate, since
170917 - treatments can sometimes run over, and seeing the doctor at scheduled
170918 - times is not always possible.  If circumstances change, then the
170919 - schedule can be adjusted.
170921 -             ..
170922 -            [On 080811 Millie's letter to the medical team requested
170923 -            clarification of the UCSF schedule. ref SDS E6 P96Y
170925 -             ..
170926 -            [On 080821 meeting with medical team the current schedule
170927 -            was not clarified nor changed and so seems to stand
170928 -            confirmed. ref SDS E7 HT6N
170929 -
170930 -
170931 -
170932 -
170934 -  ..
1710 -
1711 -
1712 - 0951
1713 -
171301 - Visited Nola in the Infusion Clinic.  She submitted an updated
171302 - schedule from work on 080724. ref SDS D5 1K7H
171304 -     ..
171305 -    Date  Time  Staff      Sta Type Dept  Loc  Dur Number Cycl/Trmnt
171306 -    -----------------------------------------------------------------
171307 -    080814 0800  Catherine    PEN  AC1  CCINF  INF  20  14587586  06  04
171308 -    080814 0900  Catherine    PEN  AC4  CCINF  INF  60  14587609  06  04
171309 -    080821 0800  Catherine    PEN  AC1  CCINF  INF  20  14587612  07  01
171310 -    080821 0830  Rugo         PEN  CHF  BCC    Z4F  30  14348712  07  01
171311 -                 Brigid
171312 -                 Jackie
171313 -    080821 0900  Catherine    PEN  AC4  CCINF  INF  60  14587616  07  01
171314 -    080828 0800  Catherine    PEN  AC1  CCINF  INF  20  14587621  07  02
171315 -    080828 0900  Catherine    PEN  AC4  CCINF  INF  60  14587630  07  02
171316 -    080904 0800  Catherine    PEN  AC1  CCINF  INF  20  14647227  07  03
171317 -    080904 0900  Catherine    PEN  AC4  CCINF  INF  60  14647245  07  03
171318 -    080911 0820  Catherine    PEN  AC1  CCINF  INF  20  14821159  07  04
171319 -    080911 0900  Catherine    PEN  AC4  CCINF  INF  60  14821156  07  04
171320 -     ..
171321 -    080918 0820  Catherine    PEN  AC1  CCINF  INF  20  14821189  08  01
171322 -    080918 0900  Catherine    PEN  AC4  CCINF  INF  60  14821187  08  01
171323 - *  080918 1130  Rugo         PEN  CHF  BCC    Z4F  30            08  01
171324 -                 Brigid
171325 -                 Jackie
171326 -    080925 0800  Catherine    PEN  AC1  CCINF  INF  20  14821209  08  02
171327 -    080925 0900  Catherine    PEN  AC4  CCINF  INF  60  14821201  08  02
171328 -    081002 0820  Catherine    PEN  AC1  CCINF  INF  20  14821224  08  03
171329 -    081002 0900  Catherine    PEN  AC4  CCINF  INF  60  14821217  08  03
171330 -    081009 0820  Catherine    PEN  AC1  CCINF  INF  20  14821235  08  04
171331 -    081009 0900  Catherine    PEN  AC4  CCINF  INF  60  14821231  08  04
171332 -     ..
171333 -    081016 0800  Catherine    PEN  AC1  CCINF  INF  20  14821257  09  01
171334 -    081016 0900  Catherine    PEN  AC4  CCINF  INF  60  14821243  09  01
171335 - *  081016 1130  Rugo         PEN  CHF  BCC    Z4F  30            09  01
171336 -                 Brigid
171337 -                 Jackie
171338 -    081023 0800  Catherine    PEN  AC1  CCINF  INF  20  14881004  09  02
171339 -    081023 0900  Catherine    PEN  AC4  CCINF  INF  60  14881000  09  02
171340 -     ..
171341 -    081030 0800  Catherine    PEN  AC1  CCINF  INF  20  14881017  09  03
171342 - ** 081030 0900  Catherine    PEN  AC4  CCINF  INF  60  14881533  09  03
171343 -    ...
171344 -    ...
171345 -    ...
171346 -    081113 0830  Rugo         PEN  CHF  BCC    Z4F  30  14820731  10  01
171347 -                 Brigid
171348 -                 Jackie
171349 -    ...
171350 -    ...
171351 -    ...
171352 -    ...
171353 -    ...
171354 -    081211 0830  Rugo         PEN  CHF  BCC    Z4F  30  14820734  11  01
171355 -                 Brigid
171356 -                 Jackie
171357 -    ...
171359 -       ..
171360 -   *  The medical team approved Millie meeting for examination after
171361 -      treatment for the 8th and 9th cycles, ref SDS 0 SO8F, per above.
171362 -      ref SDS 0 U15Y
171363 -
171365 -       ..
171366 -  **  There was a mistake in the schedule for 081030.  Nola scheduled
171367 -      the blood draw, but scheduled treatment the next day on 081031 at
171368 -      0900.  This conflicts with patient history performing treatment
171369 -      immediately after blood draws that show the patient condition is
171370 -      safe for treatment.
171371 -
171373 -  ..
1714 -
1715 -
1716 - 1108
1717 -
171701 - Called Nola.  She said the computer sometimes makes mistakes trying to
171702 - correlate treatment schedules with nurse workloads.
171704 -  ..
171705 - Nola canceled the erroneous treatment on 081031, and scheduled
171706 - Millie's treatment on 081030 at 0900 after the blood draw. ref SDS 0
171707 - H433
171708 -
171709 -
171710 -
171711 -
171712 -
171713 -
171714 -
1718 -

SUBJECTS
Return to Work Physician Approval Effective 080811 Disability Adjust

4003 -
400401 -  ..
400402 - Return to Work Physician Approval 080811
400403 -
400404 - Follow up ref SDS E2 FN80.
400405 -
400406 - On 080804 Millie submitted a letter to the doctor requesting a release
400407 - for returning to work, which was requested by N&P. ref SDS E2 0D8O
400409 -  ..
400410 - Visiting with Lena this morning, she and a colleague will draft a
400411 - letter responding to Millie's letter on 080804.  Lena checked and
400412 - determined that UCSF policy and procedure permits Brigid to sign the
400413 - physician's release for returning to work.
400414 -
400415 -
400417 -  ..
4005 -
4006 -
4007 - 0917
4008 -
400801 - Lena called back.
400802 -
400803 - The letter is ready for Millie to pick up at the front desk in the
400804 - Breast Care Clinic.
400805 -
400807 -  ..
4009 -
4010 -
4011 - 1017
4012 -
401201 - Visited the Breast Care Clinic on the 2nd floor, and received
401202 - Brigid's letter.
401203 -
401205 -  ..
401206 - Medical Disability Physician Release Return to Work
401207 - Physician Release Return to Work from Medical Disability
401208 - Kaiser UCSF Excellent Medical Services Stage IV Patient Return to Work
401209 -
401210 - Follow up ref SDS E2 0D8O, ref SDS D8 645J.
401211 -
401212 - On 080724 examination by Brigid at UCSF indicated Millie continues to
401213 - recover from 4th relapse of IBC. ref SDS D4 FH7M
401215 -  ..
401216 - Millie received ref DRT 1 0001 signed by Brigid, per planning approved
401217 - by the doctor. ref SDS 0 U17L  The UCSF letter for Millie was in an
401218 - envelope at the front desk, and says...
401219 -
401220 -    1.  To whom it may concern:
401222 -         ..
401223 -    2.  This is in response to a letter received on 8/4/2008 from my
401224 -        patient Mildred ****, ref SDS E2 0D8O, that she is under my
401225 -        care at the UCSF Comprehensive Cancer Center and to inform you
401226 -        that my patient is able to resume work as of the following
401227 -        date: 8/11/2008. ref DRT 1 0001
401229 -         ..
401230 -    3.  Limitations/Restrictions:   None, ref DRT 1 WS6I
401232 -  ..
401233 - Return to work approval by Millie's physician implements guidance by
401234 - primary care physician for cancer patients to stay engaged on the job
401235 - as a component of health care to recover from cancer, reported on
401236 - 030606. ref SDS 1 LZ3L  On 041019 Doctor Guardino made a similar
401237 - recommendation during a meeting at Stanford Cancer Center. ref SDS 4
401238 - NN6N
401240 -             ..
401241 -            [...in another record today, Millie thanks UCSF for timely
401242 -            response, and submitted to NP the UCSF letter with
401243 -            physician release for return to work from medical leave.
401244 -            ref SDS E4 AF5J
401246 -  ..
401247 - Physician approval for Millie to return to work cites Millie's letter
401248 - to UCSF with copy to NP on 080804 and stating Millie would resume
401249 - prior schedule working 3 days per week that fits her continuing
401250 - treatments at UCSF. ref SDS E2 GU4W  UCSF letter responds to NP
401251 - request in a letter dated 080728, received the next day on 080729.
401252 - ref SDS D8 645J  The NP request on 080728 responded Millie's letter on
401253 - 080725, ref SDS D6 645J, notifying NP that Millie can return to work
401254 - from medical disability on 080811. ref SDS D6 H78X
401256 -             ..
401257 -            [On 080808 Tim Blevins at NP requested signed copy of UCSF
401258 -            physician release from medical leave for Millie to return
401259 -            to work; and to delay starting work on 080811 so that NP
401260 -            has time to review recent changes to staffing. ref SDS E5
401261 -            F55H
401263 -  ..
401264 - UCSF letter continues...
401265 -
401266 -    4.  Please do not hesitate to call with any questions. ref DRT 1
401267 -        SS6L
401269 -         ..
401270 -    5.  Thank you. ref DRT 1 4T6O
401272 -  ..
401273 - "Return to work" status is a major achievement and milestone in
401274 - Millie's seven (7) year treatment for cancer.  Restoring a stage IV
401275 - cancer patient to work status demonstrates excellent care by Kaiser
401276 - and UCSF, based on comments by the surgeon on 080606. ref SDS A4 0T6I
401277 - Review at that time indicates stage IV cancer patients have only a 10%
401278 - chance of survival for 7 years.  Millie's recent surge in energy and
401279 - fitness while undergoing weekly treatments for 18 months may offer a
401280 - path for others that enable a high quality of life symbolized by
401281 - "returning to work."
401282 -
401283 -
401284 -
401285 -
401286 -
4013 -

SUBJECTS
CT Test Find Qualified Test Department for Next Test with Power Port
CT Test Find Qualified Department for Next Test Using Power Port and

4904 -
490501 -  ..
490502 - CT Test at UCSF Use Millie's Power Port
490503 - Find Qualified CT Test Department for Next Test Using Power Port
490504 -
490505 - Follow up ref SDS E3 848F.
490506 -
490507 - On 080501 Brigid reported that UCSF has been doing CT tests with Power
490508 - Ports for over a year. ref SDS 94 TQ6F  On 080606 Kaiser scheduled
490509 - Millie for surgery to upgrade her port catheter device to a Power Port
490510 - for doing CT tests. ref SDS A4 IT6M  On 080617 Kaiser scheduled Millie
490511 - for a CT test on 080718 using a Power Port, ref SDS A8 DF55, which
490512 - would be accessed in the Infusion Clinic. ref SDS A8 DF6Y  On 080627
490513 - Millie's primary care physician made plans to ensure the CT test could
490514 - be performed using Millie's Power Port by personally assisting the
490515 - work, if necessary, reported in the medical chart. ref SDS B5 CO3H
490517 -  ..
490518 - Surgery to implant the Power Port was performed on 080708, ref SDS C0
490519 - 0001, and Millie received from Kaiser "Instructions for Use," with
490520 - complex guidance on Power Injection Procedures using the Power Port
490521 - for CT tests. ref SDS C0 JE7N  On 080709 Millie's letter asked Kaiser
490522 - to review Power Port procedures in time to be prepared for the
490523 - Millie's CT test on 080718. ref SDS C1 TR9X  Millie noted in the
490524 - letter on 080709 that experience from the CT test on 080718 will
490525 - provide training to develop skills and procedures using Power Ports
490526 - for injection of test contrast medium. ref SDS C1 VK5I
490528 -  ..
490529 - On 080711 Kaiser reported they were still in the process of learning
490530 - to use Power Port technology for CT tests, and had not yet reviewed
490531 - manufacturer's instructions for use to be prepared for Millie's test
490532 - on 080718.  Millie would be the first patient using Power Port
490533 - technology at Kaiser Walnut Creek CT Department. ref SDS C3 JQ55
490534 - Millie submitted several alternate work plans for Kaiser to be
490535 - prepared to perform the CT test with the Power Port, which required
490536 - reviewing manufacturer's Instructions for Use. ref SDS C3 JR6T
490538 -  ..
490539 - On 080718 the CT test at Kaiser in Walnut Creek failed using Millie's
490540 - Power Port. ref SDS C9 LK3R  Causation centers on lack of familiarity
490541 - with manufacturer's Instructions for Use. ref SDS C9 WI7G
490543 -  ..
490544 - Millie will require another test in about 5 weeks.  On 080718 Millie
490545 - notified the doctor about problems with the test using the Power Port.
490546 - ref SDS C9 I43R  She asked in a follow up letter on 080721 about plans
490547 - to prepare for the next test. ref SDS D1 CW9U
490549 -  ..
490550 - Kaiser has not responded during the ensuing 3 weeks.
490552 -  ..
490553 - Since Kaiser seems to be taking a hands off approach to addressing
490554 - issues using Millie's Power Port for the next CT test, reported on
490555 - 080804, ref SDS E1 MS7W, asked this morning about doing the next test
490556 - at UCSF, where the CT Department has experience using Power Ports,
490557 - noted by Brigid on 080501. ref SDS 94 TQ6F
490559 -  ..
490560 - Lena said this idea was presented to Brigid.
490562 -  ..
490563 - Brigid will conference with Doctor Rugo about collaborating with
490564 - Millie's doctor at Kaiser to find CT test support using Millie's Power
490565 - Port.
490566 -
490567 -            [On 080811 Paula at Kaiser Infusion Clinic investigating
490568 -            solutions to support CT Department for Millie's next test
490569 -            OA 080912; issue has been elevated, but no progress from
490570 -            management reported at this time, ref SDS E6 LD3H; there
490571 -            seems to be at least three (3) solutions. ref SDS E6 CW3O
490572 -            Paula coordinating with primary care physician about
490573 -            contacting Kaiser Oakland to perform Millie's next CT test.
490574 -            ref SDS E6 DE79
490576 -  ..
490577 - Another option is to do the next CT test at Kaiser in Oakland.
490578 - Research on 080804 indicates the Oakland office has been doing CT
490579 - tests with Power Ports for over a year. ref SDS E1 5U7G
490580 -
490581 -            [On 080811 Sheree called to schedule Millie's next CT test
490582 -            at Kaiser in Oakland; Paula confirmed the Oakland office
490583 -            has experience doing CT tests with Power Ports. ref SDS E6
490584 -            L465
490586 -  ..
490587 - There are three (3) issues doing the test at UCSF...
490588 -
490589 -        1.  Can Kaiser and UCSF agree on Millie getting CT test at UCSF
490590 -            within existing referral arrangements, discussed in
490591 -            November, per Paula's letter received on 071128.
490592 -            ref SDS 51 TH8L
490594 -             ..
490595 -        2.  Can the test be done the same day as treatment for cancer
490596 -            so that Millie does not have to make 2 trips to San
490597 -            Francisco?
490599 -             ..
490600 -        3.  Will the cost to Millie be less than or equal to Millie's
490601 -            cost at Kaiser?
490602 -
490603 -
490604 -
490605 -
490606 -
490607 -
490608 -
4907 -

SUBJECTS
Blood Tests Labs Infusion Clinic Evaluate Safe Chemotherapy 1st Trea

5703 -
5704 - 0800
570501 -  ..
570502 - Labs Blood Test
570503 -
570504 - Follow up ref SDS D9 FW5N, ref SDS D5 FW5N.
570505 -
570506 - Adding Carboplatin to the treatment protocol now requires weekly blood
570507 - tests to determine if the immune system is strong enough for safe
570508 - chemotherapy treatment, reported on 070201, ref SDS 13 XR40, and citing
570509 - the clinical study protocol received from UCSF on 070116. ref SDS 12
570510 - 5U7Z
570512 -  ..
570513 - During treatment, Diane submitted results of the test.
570514 -
570529 -     ..
570530 -    Log#:                   080807 08:15
570531 -    <----------------------- U C S F -----------------------> <-------------  Kaiser -------------->
570532 -    Type                 Results   Units        Normal        ACRO   Type            Units        Normal
570533 -     ..
570534 -    CBC with DIFF & PLT CT                                     CBCD
570535 -     ..
570536 -    WBC COUNT               4.9    x10E9/L     3.4  -   10     WBC   WBC x10-3        K/uL     3.4  -  10.0
570537 -    RBC COUNT      L        3.65   x10E12/L      4  -   5.2    RBC   RBC x10-6        M/uL    3.60  -  5.70
570538 -    HEMOGLOBIN             12.4    g/dL         12  -   15.5   HGB   Hemoglobin       g/dL    11.5  -  15.0
570539 -    HEMATOCRIT             36.3    PERCENT      36  -   46     HCT   Hematocrit       %       34.0  -  46.0
570540 -    MCV                    99      fL           80  -   100    MCV   MCV              fL      80.0  -  100.0
570541 -    MCH                    34.0    pg           26  -   34     MCH
570542 -    MCHC                   34.3    g/dL         31  -   36     MCHC
570543 -    PLATELETS             216      x10E9/L     140  -  450     PLT   Plt x10-3        K/uL     140  -  400
570544 -
570545 -        Performed at Mt Zion Clinic Lab, 1600 Divisadero, San
570546 -        Francisco, CA  94115
570547 -    ..
570548 -     (NEUTS x 1000 = ANC for Kaiser)
570549 -    NEUTS         L         2.41   x10E9/L     1.8  -  6.8     N-A   ANC                      1500
570550 -    Neutrophils    Not Reported                                      Neutrophils       %        50  -  70
570552 -     ..
570553 -    LYMPHS                  1.84   x10E9/L     0.9  -  2.9     L-A   Lymphocytes       %        20  -  50
570554 -    MONOS                   0.38   x10E9/L     0.1  -  0.6     M-A   Monocyte          %         0  -  11
570555 -    EOS                     0.20   x10E9/L       0  -  0.4     E-A   Esoinophils       %         1  -  5
570556 -    BASOS                   0.08   x10E9/L       0  -  0.1     B-A   Basophil          %         0  -  2
570557 -
570559 -     ..
570560 -    <----------------------- U C S F -----------------------> <-------------  Kaiser -------------->
570561 -    Type                 Results   Units        Normal        ACRO   Type            Units        Normal
570563 -     ..
570564 -    CREAT with eGFR
570565 -    CREATININE              0.39   mg/dL      0.42  - 1.06     CR    Creatinine        mg/dL   0.6  -  1.2
570566 -
570567 -      Note: Creatinine assay changed to IDMS standardization on
570568 -      February 4, 2008 causing decrease in results of approximately
570569 -      0.09 mg/dL
570571 -     ..
570572 -    eGFR if Caucasian     >60      mL/min                      GFRC
570573 -    eGFR if African Amer  >60      mL/min                      GFRA
570574 -
570575 -      eGFR corrected for 1.73 sq meters of body surface area
570576 -      Note:  eGFR is only an estimation. Please see online Lab Manual
570577 -      for potential limitations.
570578 -      Performed at Mt Zion Clin Lab, 1600 Divisadero, San Francisco,
570579 -      CA  94115
570580 -
570581 -
570582 -
5706 -

SUBJECTS
Absolute Neutrophils Count ANC 6850 Above 1500 NEUTS 6.85 Above 1.5

6603 -
660401 -  ..
660402 - NEUTS Increase Neupogen Continue 2 Treatments Per Week New Cycle
660403 - Side Effects Neupogen Treatments Continue Mild Tolerance Acceptable
660404 -
660405 - Follow up ref SDS D9 PU6K, ref SDS D5 PU6K.
660406 -
660407 - Blood counts increase this week, shown by the Lab report today with
660408 - NEUTS 2.41, ref SDS 0 QY6H, compared with NEUTS 1.92 last week on
660409 - 080731, ref SDS D9 QY6H  This continues well above the minimum of 1.5
660410 - for Millie to safely get chemotherapy treatment today.  Increase in
660411 - blood counts today improves on consecutive weeks of declining counts
660412 - while getting chemotherapy treatment with Carboplatin.  Indicates 2
660413 - Neupogen treatments per week may be back on a path of rising
660414 - effectiveness, so that Millie will not need a 3rd weekly Neupogen
660415 - treatment in order to continue getting effective care in the clinical
660416 - study.  Results today seem to present brighter prospects than the
660417 - condition indicated last week on 080731. ref SDS D9 PU6K
660419 -  ..
660420 - Side effects of Neupogen reported on...
660421 -
660422 -               080803................, ref SDS E0 9W9I
660423 -               080726................, ref SDS D7 9W9I
660424 -               080721................, ref SDS D2 9W9I
660425 -               080713................, ref SDS C5 RM94
660426 -               080629................, ref SDS B8 6Q5J
660427 -               080628................, ref SDS B6 6Q5J
660428 -
660429 - ...show lessening effects, suggesting increased ability to tolerate 2
660430 - Neupogen treatments per week.  Along with rising blood counts today,
660431 - there may be less need for adding a 3rd Neupogen treatment per week,
660432 - which could reduct Millie's ability to get these treatments.
660433 -
660434 -
660435 -
660436 -
660437 -
660438 -
660439 -
660440 -
660441 -
6605 -