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SUBJECTS
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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 11 0000.
040502 -
040503 -
040504 -
040506 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Background on ordering the CT test at Kaiser in Oakland is in the
040902 - record on 081024. ref SDS 11 285H  At that time, the primary care
040903 - physician asked Millie to coordinate with the CT Department at Kaiser
040904 - in Walnut Creek to perform the CT test using Millie's Power Port for
040905 - injecting contrast medium. ref SDS 11 V58K
040907 -  ..
040908 - During a call to the CT Department, Dennis seemed receptive to doing
040909 - the test at Kaiser in Walnut Creek, and asked for background on doing
040910 - the CT test with Millie's Power Port at Oakland a month ago on 080911.
040911 - ref SDS 11 PPVW
040913 -  ..
040914 - Millie submitted the following letter with background on the work plan
040915 - for doing Millie's CT test, which was submitted to Doctor Rugo and the
040916 - medical team on 081024 1407. ref SDS 10 IY5J
040917 -
040918 -    1.  Subject: CT test at Kaiser Walunt Creek Nov 7 1pm Using Power Port
040919 -        Date: Tue, 28 Oct 2008 20:25:08 -0800
040933 -         ..
040934 -    2.  This confirms discussion when you called last Friday on 081024
040935 -        (Oct 24, 2008) about Millie's CT test scheduled for 081107 (Nov
040936 -        7) at 1pm. ref SDS 11 PPVW  The CT test is needed for timely
040937 -        treatment of cancer under a work plan presented on 081016 for
040938 -        referral UCSF.
040940 -         ..
040941 -    3.  You requested background, ref SDS 11 KH7G, on using the Power
040942 -        Port for the CT test at Kaiser in Oakland last month on 080911.
040943 -        ref SDS 5 3594
040945 -         ..
040946 -    4.  The CT Technician, Angela, who did the test on 080911 can be
040947 -        reached by phone at 510 752 5062.
040948 -
040949 -            [On 081029 called and talked to Dennis about doing Millie's
040950 -            CT test at Kaiser in Walnut Creek. ref SDS 12 QK7M
040951 -
040952 -            [On 081029 Florida confirms Kaiser CT department approves
040953 -            doing test using Millie's Power Port, access scheduled in
040954 -            Infusion Clinic 081107 1230. ref SDS 13 4E3G
040956 -             ..
040957 -            [On 081030 Steve with Bard called and reported talking to
040958 -            Angela with the CT Department at Kaiser in Oakland, and
040959 -            then to Dennis at Kaiser in Walnut Creek; Steve feels
040960 -            Kaiser in Walnut Creek is good to go for Millie's CT test
040961 -            on 081107. ref SDS 16 XN9C
040963 -         ..
040964 -    5.  If you need assistance reviewing the record, please call me at
040965 -        925 608 8947.
040967 -         ..
040968 -    6.  My test in Oakland was done in a trailer in the parking lot
040969 -        just outside and near the Infusion clinic in the hospital.  The
040970 -        attendant described this trailer facility as having slightly
040971 -        "advanced" CT equipment compared to the regular CT test
040972 -        facility inside the hospital across the street. ref SDS 5 2U79
040974 -         ..
040975 -    7.  This might be a point of inquiry.
040976 -
040977 -            [On 081030 Steve with Bard reported visiting the Kaiser CT
040978 -            Department in Oakland; and feels any advances or changes in
040979 -            equipment used for Millie's test on 080911 related to
040980 -            quality of the scans and not to connections nor use of the
040981 -            Bard Power Port. ref SDS 16 XN5H
040983 -         ..
040984 -    8.  Notice that Angela credited support from Bard, the Power Port
040985 -        manufacturer, for clarifying power injection procedures.
040986 -        ref SDS 5 JG43
040988 -         ..
040989 -    9.  By copy to Steve Sigl, I am notifying Bard of the schedule for
040990 -        the test at Kaiser in Walnut Creek on 081107, and request Bard
040991 -        support again, subject to your discretion.  Steve is the
040992 -        District Manager, and can be reached by phone at 925 200 6419.
040993 -
040994 -            [On 081029 called Steve about progress arranging to support
040995 -            the CT test at Kaiser in Walnut Creek. ref SDS 14 Q866
040997 -             ..
040998 -            [On 081029 Steve called from Kaiser in Oakland; he will
040999 -            discuss with Angela procedures for the prior test on
041000 -            080911, and he will call Dennis at Kaiser in Walnut Creek
041001 -            with orientation for Millie's next test on 081107 using the
041002 -            Bard Power Port. ref SDS 14 8G6T
041004 -             ..
041005 -            [On 081030 called and left message for Steve requesting
041006 -            results of coordination with Dennis and Angela on Millie's
041007 -            CT test at Kaiser in Walnut Creek on 081107. ref SDS 16
041008 -            Q866
041010 -             ..
041011 -            [On 081030 Steve with Bard called and reported talking to
041012 -            Angela with the CT Department at Kaiser in Oakland, and
041013 -            then to Dennis at Kaiser in Walnut Creek; Steve feels
041014 -            Kaiser in Walnut Creek is good to go for Millie's CT test
041015 -            on 081107. ref SDS 16 XN9C
041017 -             ..
041018 -            [On 081107 Bard was unable to support the test at the
041019 -            Kaiser CT Department in Walnut Creek. ref SDS 17 2F51
041021 -             ..
041022 -            [On 081108 Steve asks how the test went at Kaiser using
041023 -            the Bard Power Port; explains Bard could not support the
041024 -            Power Port customer on 081107, as requested by customer on
041025 -            081028, and reminded on 081106, because Bard was busy
041026 -            attending a class to support future customers for Bard
041027 -            radiographic technology. ref SDS 18 4P4K
041029 -             ..
041030 -            [On 081111 Steve asks how Bard can help Kaiser smooth out
041031 -            the rough edges on technology transfer for the Bard Power
041032 -            Port, ref SDS 19 HZ5I, aligns with Bard's letter on 081108
041033 -            offering to help. ref SDS 18 MT5Q
041035 -         ..
041036 -   10.  Cooperation among all hands made the last CT test successful.
041037 -
041038 -            [On 081107 Dennis, the supervisor of CT tests at Kaiser in
041039 -            Walnut Creek, was not available to support the CT test
041040 -            using new technology for the 2nd time, ref SDS 17 VR4L; Pat
041041 -            who had worked on Millie's prior test using the Power Port
041042 -            for the 1st time, and had scheduled the current test, did
041043 -            not remember Millie nor that the test would use Bard Power
041044 -            Port technology, ref SDS 17 MX4L, Steve, District Manager
041045 -            for Bard, who had talked to Dennis and said Kaiser was
041046 -            ready to do the CT test with the Power Port, and Julie, who
041047 -            had offered to support the test on-site, did not have time
041048 -            to visit Kaiser to support the 2nd attempt to prform a CT
041049 -            test using Bard equipment which had previously failed on
041050 -            the 1st attempt, at Kaiser in Walnut Creek;, ref SDS 17
041051 -            2F6S; communications to collaborate on coordinating the
041052 -            work, failed by relying on memory of people under stress
041053 -            with limited time. ref SDS 17 2F32
041055 -         ..
041056 -   11.  The test in Oakland on 080911 used my Power Port that was
041057 -        accessed with a Huber needle earlier in the day at UCSF for my
041058 -        cancer treatment, ref SDS 4 OY4J, and left in place for the CT
041059 -        test in Oakland. ref SDS 5 LK3R  That was the plan for the
041060 -        current test, however, on 081023 Doctor Rugo advised my
041061 -        treatments at UCSF are ended due to progression of disease,
041062 -        ref SDS 9 D65G, shown by the biopsy at Kaiser [on 081022,
041063 -        reported by Doctor Daamen in Head and Neck at Kaiser in Walnut
041064 -        Creek the next day on 081023. ref SDS 8 4Q9Q]  Therefore, since
041065 -        I will not get treatment at UCSF on 081107, for the CT test on
041066 -        081107 I will need the Power Port accessed at Kaiser in the
041067 -        Infusion Clinic.
041069 -         ..
041070 -   12.  By copy I am asking Paula to facilitate scheduling port access
041071 -        on 081107 at 1230, and then to remove the needle and flush the
041072 -        port after the test OA 1345.
041073 -
041074 -            [On 081029 called Infusion Clinic to schedule Millie for
041075 -            Power Port access on 081107 1230 in time to get CT test at
041076 -            1300. ref SDS 13 7P8R
041078 -             ..
041079 -            [On 081028 Florida confirms Kaiser CT department approves
041080 -            doing test using Millie's Power Port, access scheduled in
041081 -            Infusion Clinic 081107 1230. ref SDS 13 4E3G
041083 -             ..
041084 -            [On 081107 CT Department at Kaiser in Walnut Creek
041085 -            accomplished the test according to work plan. ref SDS 17
041086 -            7F40
041088 -         ..
041089 -   13.  Note that the Huber needle should be 1 inch with high pressure
041090 -        tubing, shown by product specification for Lifeguard Safety
041091 -        Needle used at UCSF for the CT test on 080911, and reported in
041092 -        patient history on 080724. ref SDS 2 N79U
041094 -         ..
041095 -   14.  Of course Bard also has high pressure Huber needles for CT
041096 -        tests using the Bard Power Port.  Paula advised on 080725 that
041097 -        the Infusion Clinic in Walnut Creek has on hand 1" Huber
041098 -        needles with high pressure tubing. ref SDS 3 FQ37
041100 -         ..
041101 -   15.  This should be verified.
041103 -         ..
041104 -   16.  You mentioned during the call on Friday, 081024, that the
041105 -        Radiology Department in Walnut Creek is working with the
041106 -        Oakland people to resolve concerns about CT techs using the
041107 -        Power Port that accesses a central artery, rather than veins in
041108 -        the arm. ref SDS 11 2061  You seemed to indicate this might be
041109 -        addressed by issuing a memorandum of procedure, protocol, ect.,
041110 -        and/or by arranging for support during the test from a nurse in
041111 -        Interventional Radiology. ref SDS 11 618M
041113 -         ..
041114 -   17.  Nora and Kathi were very effective in this role for the CT test
041115 -        on 080718. ref SDS 1 A39Q
041116 -
041117 -            [On 081107 Heather with Interventional Services (IS) was
041118 -            very effective in CT Department at Kaiser in Walnut Creek
041119 -            supporting the test according to the work plan. ref SDS 17
041120 -            2E4Y
041122 -         ..
041123 -   18.  Problems at that time using the Huber needle will be addressed
041124 -        for the current test with support from Paula's team in the
041125 -        Infusion Clinic.  This was effective in Oakland and so should
041126 -        work in Walnut Creek.
041128 -             ..
041129 -            [On 081028 Florida confirms Kaiser CT department approves
041130 -            doing test using Millie's Power Port, access scheduled in
041131 -            Infusion Clinic 081107 1230. ref SDS 13 4E3G
041133 -             ..
041134 -            [On 081030 Steve with Bard called and reported talking to
041135 -            Angela with the CT Department at Kaiser in Oakland, and
041136 -            then to Dennis at Kaiser in Walnut Creek; Steve feels
041137 -            Kaiser in Walnut Creek is good to go for Millie's CT test
041138 -            on 081107. ref SDS 16 XN9C
041140 -             ..
041141 -            [On 081107 CT Department at Kaiser in Walnut Creek
041142 -            accomplished the test according to the work plan.
041143 -            ref SDS 17 2E4Y
041145 -         ..
041146 -   19.  We should try to confirm arrangements by the end of the week,
041147 -        and determine if this test can be done in Walnut Creek as
041148 -        scheduled on 081107.  Alternatively, we can schedule the work
041149 -        in Oakland again to provide more time for resolving pending
041150 -        issues.
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