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: April 9, 2009 03:37 PM Thursday;
Rod Welch
Doctor Johnson amends referral treatment at UCSF to include blood tests.
1...Summary/Objective
2...Creatinine Needed for CT Test 1500 Requires Blood Test 1330
3...Blood Draw Changed to 1330 Chem Infusion Clinic for CT Test 1500
4...Telecon Doctor Johnson Coordinate Treatment Planning at UCSF
5...Radiation Side Effects Subside Examination Deferred
6...Examination Deferred Because Symptoms Radiation Side Effects Subside
7...Coordinate CT Department Correct Errors Publishing CT Test Reports
8...Consolidate Findings CT Tests Coordinating with Doctor Davidson
9...Doctor Davidson Reviews Consolidating Findings for Normal CT Report
10...Labs Ordered at UCSF Facilitate Treatment 7th Relapse IBC
..............
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CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS E0 0000. ref SDS D3 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - The letter today follows up patient history on Doctor Johnson
040902 - coordinating with UCSF to treat Millie's 8th relapse of cancer as a
040903 - chronic disease...
040904 -
040905 - 1. Examination at Kaiser found significant
040906 - recovery with sunitinib protocol at
040907 - UCSF treating Millie's 6th
040908 - relapse of cancer................. 081219, ref SDS 45 QW5J
040910 - ..
040911 - 2. Doctor Johnson asks Millie to coordinate
040912 - with Doctor Rugo for UCSF to begin plan
040913 - for treating Millie's next relapse of
040914 - cancer as a chronic disease, because
040915 - multiple mutations makes cancer cells
040916 - resistant to treatment and more
040917 - aggressive so there is less
040918 - time to begin the next
040919 - treatment......................... 081219, ref SDS 45 5D6H
040921 - ..
040922 - 3. Primary care physician calls about
040923 - Millie's fall and treatment in ER for
040924 - separated shoulder the day before on
040925 - 090122; advises review of patient history
040926 - requested in ER release instructions
040927 - shows Millie does not need
040928 - treatment for high
040929 - blood pressure.................... 090123, ref SDS 57 ZI5I
040931 - ..
040932 - 4. Doctor Johnson indicated during call
040933 - that Millie's patient history of CT
040934 - tests over the past 7 years shows no
040935 - evidence of distant metastasis, except
040936 - in the axilla and supraclavicular
040937 - regions, which are symptoms of IBC;
040938 - at this time, shows IBC is
040939 - only problem to
040940 - solve............................. 090123, ref SDS 57 8K6K
040942 - ..
040943 - 5. Primary care physician cites Millie's
040944 - blood test on 090116 shows cancer marker
040945 - CA 15-3 303 rising to historic highs
040946 - signals severe relapse of IBC for
040947 - 6th time; Millie needs immediate
040948 - treatment at UCSF for her
040949 - cancer as chronic
040950 - disease........................... 090123, ref SDS 57 RK6O
040952 - ..
040953 - 6. Sudden reversal with severe relapse
040954 - of IBC that requires immediate
040955 - change of treatment reported
040956 - from examination at
040957 - UCSF.............................. 090130, ref SDS 60 4S8O
040959 - ..
040960 - 7. Doctor Rugo prescribes immediate
040961 - treatment at UCSF in radiation
040962 - oncology department for
040963 - 7th relapse....................... 090130, ref SDS 60 TZ6H
040965 - ..
040966 - 8. Urgent treatment was delayed a week
040967 - due to communication problems
040968 - at UCSF........................... 090130, ref SDS 60 AY8Q
040970 - ..
040971 - 9. Approval for Kaiser referral to UCSF
040972 - was delayed by documentation
040973 - errors............................ 090202, ref SDS 62 SP6H
040975 - ..
040976 - 10. Kaiser expedites referral authorization
040977 - in order for UCSF to provide urgent
040978 - treatment quickly enough for
040979 - Millie to recover................. 090202, ref SDS 61 LC7H
040981 - ..
040982 - 11. UCSF proposes 3-week delay to begin
040983 - planning Millie's treatment for
040984 - recovering from 6th relapse of
040985 - of IBC............................ 090202, ref SDS 62 SP7M
040987 - ..
040988 - 12. Doctor Rugo notifies medical team
040989 - Millie needs urgent treatment quickly
040990 - in time to be effective recovering
040991 - from 6th relapse of
040992 - IBC............................... 090202, ref SDS 63 Y15J
040994 - ..
040995 - 13. Millie's letter to UCSF implements Doctor
040996 - Johnson's requests for UCSF strategy
040997 - to treat Millie's cancer as a
040998 - chronic disease................... 090203, ref SDS 64 278T
041000 - ..
041001 - 14. Doctor Rugo's letter explains planning
041002 - to evaluate response to hyperthermia
041003 - treatment and arrange continuing
041004 - care based on another
041005 - CT scan........................... 090204, ref SDS 66 278T
041007 - ..
041008 - 15. UCSF advances Millie's care in Radiation
041009 - Oncology Department 3 weeks; scope of
041010 - radiation and hyperthermia evaluated
041011 - by Dcotor Hsu and Doctor
041012 - Chang............................. 090205. ref SDS 68 0001
041014 - ..
041015 - 16. CT and xray tests taken, and layout
041016 - of treatment fields performed to
041017 - build molds for Millie's
041018 - radiation......................... 090209. ref SDS 73 9R61
041020 - ..
041021 - 17. Examination primary care physician
041022 - at Kaiser finds severe progression
041023 - of IBC in 6th
041024 - relapse........................... 090213, ref SDS 75 4W5I
041026 - ..
041027 - 18. Millie lucky to survive stage IV cancer
041028 - for 8 years because cancer mutates to
041029 - defeat treatments; and medical maladies
041030 - increase which makes recovery
041031 - more difficult to
041032 - achieve........................... 090213, ref SDS 75 NY7L
041034 - ..
041035 - 19. Complexity of case management grows
041036 - during long term survival prevents
041037 - keeping a well ordered record
041038 - essential for effective
041039 - care.............................. 090213, ref SDS 75 9L8O
041041 - ..
041042 - 20. Emotional trauma occurs from surprise
041043 - by medical professionals that Kaiser
041044 - and UCSF have enabled long term surivial
041045 - for a disease that normally is
041046 - difficult to control.............. 090213, ref SDS 75 ML4I
041048 - ..
041049 - 21. Communication leverages synergy
041050 - for Millie's care at Kaiser and UCSF
041051 - which helps prevent problems from
041052 - "falling through the cracks; fewer
041053 - mistakes, and timely response
041054 - helps the medical team
041055 - increase longevity,
041056 - also seems very
041057 - annoying.......................... 090213, ref SDS 75 FZ4H
041059 - ..
041060 - 22. Doctor urges proactive management to
041061 - plan Millie's next treatment because
041062 - there will be less time to recover
041063 - before cancer gets out of control
041064 - for Millie's next
041065 - relapse........................... 090213, ref SDS 75 UP6L
041067 - ..
041068 - 23. Millie's efforts the past 8 years to
041069 - combine medical treatment with vigorous
041070 - exercise was supported by research
041071 - showing exercise can be a strong
041072 - component of cancer
041073 - care.............................. 090213, ref SDS 75 GC40
041075 - ..
041076 - 24. Indian fable illustrates long-term survival
041077 - getting continuous treatment for cancer
041078 - becomes increasingly difficult to perform
041079 - complex clinical, logistical, and financial
041080 - case management; study of Millie's patient
041081 - history shows level of effort to maintain
041082 - well ordered record for effective
041083 - management increases exponentially
041084 - into a crushing burden
041085 - for patients and
041086 - providers......................... 090213, ref SDS 75 IG5O
041088 - ..
041089 - 25. Graph prepared by primary care physician
041090 - shows Millie's good fortune surviving a
041091 - very aggressive cancer with relatively
041092 - high quality of life into an 8th year
041093 - of continuous treatment that normally
041094 - causes early demise due to emotional
041095 - trauma and clincial failures from
041096 - complex case management........... 090213, ref SDS 75 4W72
041098 - ..
041099 - 26. Millie felt life was slipping away in
041100 - October when the 5th relapse was diagnosed
041101 - leading Millie to ask what was going to
041102 - happen to her; Doctor Rugo provided
041103 - encouragement saying "We're not
041104 - going to let anything happen
041105 - to you"........................... 090213, ref SDS 75 F148
041107 - ..
041108 - 27. Collaboration between Kaiser and UCSF
041109 - combines experience with research;
041110 - communication optimizes Millie's care
041111 - beating the odds for long-term survival
041112 - by integrating Kaiser's team care
041113 - practice with UCSF model
041114 - of comprehensive
041115 - care.............................. 090213, ref SDS 75 685I
041117 - ..
041118 - 28. Multiple relapse of cancer causes cells
041119 - to mutate into disease that resists
041120 - treatment; Millie surviving 6 relapses
041121 - needs highly specialized care and
041122 - so should ask Doctor Rugo to begin
041123 - planning for the next relapse
041124 - to treat Millie's cancer as
041125 - a chronic disease................. 090213, ref SDS 75 R75G
041127 - ..
041128 - 29. Doctor Rugo has responded by scheduling
041129 - a meeting with Millie at UCSF on
041130 - 090312............................ 090213, ref SDS 75 6P7G
041132 - ..
041133 - 30. Doctor Johnson underscored importance
041134 - timely care for Millie by offering
041135 - religious perspective on transition
041136 - from a vigorous life that may end
041137 - for Millie in less than a
041138 - year.............................. 090213, ref SDS 75 646L
041140 - ..
041141 - 31. Hospice care helps patients and families
041142 - cope with final days of life without
041143 - suffering significant physical
041144 - and emotional pain................ 090213, ref SDS 75 VW63
041146 - ..
041147 - 32. Life ending scenarios have been presented
041148 - to Millie many times the past 5 years;
041149 - case study reflects Millie's physical
041150 - resiliance and strength of character
041151 - that enables exceptional longevity
041152 - for her aggressive
041153 - cancer............................ 090213, ref SDS 75 L19H,
041155 - ..
041156 - 33. Collaboration on case management for
041157 - long-term survivors of cancer becomes
041158 - frustrating because everybody loses
041159 - control of increasingly
041160 - complex medical
041161 - records........................... 090213, ref SDS 75 JL9L
041163 - ..
041164 - 34. Lab and CT test reports illustrate
041165 - frustration, because providers do not
041166 - have enough time to enter results
041167 - from other doctorsrs in the medical
041168 - chart, because doctors prefer to
041169 - rely on local diagnostics
041170 - rather than referral
041171 - data.............................. 090213, ref SDS 75 NY4H
041173 - ..
041174 - 35. Cancer marker CA 15-3 wide disparities
041175 - between Kaiser and UCSF illustrates
041176 - why doctor's rely on local data
041177 - rather than referral
041178 - diagnostics....................... 090213, ref SDS 75 A46O
041180 - ..
041181 - 36. Case management takes a lot of will
041182 - power for due diligence to
041183 - maintain a well ordered
041184 - record............................ 090213, ref SDS 75 J27J
041186 - ..
041187 - 37. Meeting at Kaiser changed to 4 week
041188 - interval, rather than 8, as done the
041189 - past 2 years, provides effective support
041190 - for UCSF to start next treatment in
041191 - time to avoid losing control of
041192 - Millie's cancer................... 090213, ref SDS 75 QX5O
041194 - ..
041195 - 38. Millie requests explanation of treatment
041196 - plan. Doctor Rugo's letter to Kaiser on
041197 - 090129 discussed hyperthermia with Doxil,
041198 - reported on 090130. Has the plan changed
041199 - to use "lower dose" radiation rather
041200 - than Doxil. Will both be
041201 - used, or some other
041202 - agent............................. 090218, ref SDS 76 TH5W
041204 - ..
041205 - 39. Millie reports to medical team meeting
041206 - with Doctor Johnson at Kaiser on 090213
041207 - was optimistic Millie might have 3 - 6
041208 - months of recovery, but will need
041209 - treatment from Doctor Rugo for
041210 - cancer as a "chronic
041211 - disease".......................... 090218, ref SDS 76 TH6U
041213 - ..
041214 - 40. Millie requests reponse from UCSF to the
041215 - letter on 090209 requesting explanation
041216 - of treatments for side effects from
041217 - radiation and hyperthermia described by
041218 - Doctor Hsu during the meeting on
041219 - 090205. Does the treatment
041220 - plan address side effects
041221 - prospectively..................... 090218, ref SDS 76 TH7V
041223 - ..
041224 - 41. Radiation and hyperthermia begins
041225 - at UCSF for Millie to recover from
041226 - 6th relapse of
041227 - IBC............................... 090219, ref SDS 77 E57G
041229 - ..
041230 - 42. Millie's letter to UCSF requests
041231 - explanation of radiation and hyperthermia
041232 - treatments for recovering from
041233 - IBC............................... 090220, ref SDS 78 EA4Q
041235 - ..
041236 - 43. Hyperthermia treatment planning
041237 - on 090209 report received
041238 - from UCSF......................... 090220, ref SDS 79 PR4Y
041240 - ..
041241 - 44. Hyperthermia science, theraputic
041242 - rationale and applications with
041243 - other modalities presented in
041244 - BSD professional paper received
041245 - from UCSF......................... 090220, ref SDS 79 GK6F
041247 - ..
041248 - 45. Millie's letter to UCSF requests work
041249 - plan for radiation treatments to
041250 - recover from 6th relapse of
041251 - IBC............................... 090223, ref SDS 80 3N9J
041252 - and asks for scientific paper
041253 - using radiation to treat
041254 - IBC............................... 090223, ref SDS 80 T49U
041256 - ..
041257 - 46. Radiation combined with hyperthermia
041258 - treatment plan received from
041259 - UCSF.............................. 090226, ref SDS 81 D452
041261 - ..
041262 - 47. Blood test at Kaiser for meeting
041263 - at UCSF on 090312 to evaluate
041264 - effectiveness of radiation
041265 - and hyperthermia after
041266 - 3 weeks........................... 090309, ref SDS 83 6Z4F
041268 - ..
041269 - 48. Agenda submitted to medical team to
041270 - be prepared for productive meetings
041271 - at UCSF scheduled on 090312 to evaluate
041272 - response to treatment after getting
041273 - 3 weeks of radiation and hyperthermia
041274 - to recover from 6th relapse
041275 - of IBC............................ 090310, ref SDS 84 PR4Y
041277 - ..
041278 - 49. Called Kaiser to get results of blood
041279 - test on 090309 for submission to medical
041280 - team for being prepared to meet at
041281 - UCSF on 090312; Florida says results
041282 - pending from lab; says to call back
041283 - on 090311 to get the report
041284 - for distribution.................. 090310, ref SDS 85 JH4H
041286 - ..
041287 - 50. UCSF letter from Tara proposed canceling
041288 - meeting scheduled by Doctor Rugo for
041289 - 090312 to evaluate response to
041290 - treatment, and also Millie's
041291 - concern about growing
041292 - side effects...................... 090310, ref SDS 86 PR4Y
041294 - ..
041295 - 51. Millie letter to primary care physician
041296 - at Kaiser coordinates getting report
041297 - for blood test on 090309 for
041298 - meeting at UCSF on
041299 - 090312............................ 090311, ref SDS 87 S84F
041301 - ..
041302 - 52. Blood test report for Millie's lab on
041303 - 090209 was not submitted by Kaiser to
041304 - UCSF due to telephone and fax machine
041305 - problems; UCSF relied on backup
041306 - copy hand delivered by
041307 - Millie............................ 090312, ref SDS 90 XE3K
041309 - ..
041310 - 53. Examination at UCSF Breast Care Clinic
041311 - finds signs of recovery from 6th relapse
041312 - of IBC; Millie responding well after
041313 - 3 weeks of treatment with radiation
041314 - and hyperthermia; severe side
041315 - effects observed.................. 090312, ref SDS 90 YX9F
041317 - ..
041318 - 54. Cancer marker CA 15-3 missing from
041319 - blood test for Millie's lab at Kaiser
041320 - on 090309; missing diagnostic
041321 - complicates evaluating
041322 - response to treatment............. 090312, ref SDS 90 YX5F
041324 - ..
041325 - 55. Doctor Rugo planning to implement
041326 - request by Doctor Johnson at Kaiser
041327 - for UCSF to treat Millie's cancer
041328 - as a chronic disease.............. 090312, ref SDS 90 QQ9L
041330 - ..
041331 - 56. Examination at UCSF Radiation Oncology
041332 - department concurs Millie recovering
041333 - from 6th relapse of IBC by responding
041334 - to radiation and
041335 - hyperthermia...................... 090312, ref SDS 90 F88K
041336 - discloses side effects severely
041337 - blistering skin will worsen for a
041338 - month, and then gradually
041339 - recover........................... 090312, ref SDS 90 F860
041340 - that radiation and hyperthermia
041341 - will continue to destroy cancer cells
041342 - for weeks and even months after ending
041343 - treatments on
041344 - 090317............................ 090312, ref SDS 90 VL4O
041346 - ..
041347 - 57. After meeting with UCSF at 0800, called
041348 - Kaiser at 1437; was on "hold" for 90
041349 - minutes; Cisi in the Chemotherapy
041350 - Clinic came online and advised that
041351 - CA 15-3 was not listed in Kaiser's
041352 - for Millie's lab on
041353 - 090309............................ 090312, ref SDS 91 JO8O
041355 - ..
041356 - 58. Millie's letter to medical team reports
041357 - productive meetings at UCSF on 090312
041358 - with favorable findings that Millie
041359 - is recovering from 6th
041360 - relapse of
041361 - IBC............................... 090313, ref SDS 92 Q49L
041363 - ..
041364 - 59. Millie's final treatment at UCSF with
041365 - radiation and hyperthermia to
041366 - recover from 6th relapse
041367 - IBC............................... 090317, ref SDS 94 9L7K
041369 - ..
041370 - 60. Millie received at UCSF orientation and
041371 - medications for home care to treat severe
041372 - side effects from radiation treatments
041373 - that will get worse for a few weeks
041374 - before starting to get
041375 - better............................ 090317, ref SDS 94 M442
041377 - ..
041378 - 61. Arlette checked the computer and
041379 - concluded a mistake occurred at the
041380 - lab not testing for the cancer marker
041381 - on the blood test for 090309. Arlette
041382 - entered a supplemental order for
041383 - Millie to get another blood
041384 - draw at no charge
041385 - later today....................... 090317, ref SDS 95 Y04R
041387 - ..
041388 - 62. Kaiser reported CA 15-3 251 for blood
041389 - test on 090317 that corrected problems
041390 - with lab on 090309 which omitted cancer
041391 - marker needed for the meeting at UCSF
041392 - on 090312 to evaluate response to
041393 - treatment; results today indicate
041394 - strong recovery from 6th relapse
041395 - of IBC............................ 090323, ref SDS 96 Y077
041397 - ..
041398 - 63. Millie's letter notifies medical team
041399 - radiation and hyperthermia treatments
041400 - were completed on 090317; submits agenda
041401 - for meeting today evaluating response
041402 - to treatment with, and recovery from
041403 - side effects from radiation
041404 - and hyperthermia on
041405 - referral to
041406 - UCSF.............................. 090324, ref SDS 97 PR4Y
041408 - ..
041409 - 64. Meeting at Kaiser reveiw response to
041410 - treatment at UCSF for 6th relapse of
041411 - cancer, planning arrangements
041412 - for treating next
041413 - relapse........................... 090325, ref SDS 98 E54L
041415 - ..
041416 - 65. Shoulder injury recovering on schedule
041417 - following treatment in ER on 090122,
041418 - physical therapy; increased energy
041419 - after ending chemotherapy enables
041420 - faster recovery with
041421 - exercise.......................... 090325, ref SDS 98 YU6K
041423 - ..
041424 - 66. Examination finds strong response to
041425 - treatment with radiation and hyperthermia
041426 - at UCSF ended on 090317 aligns with
041427 - significant decline in cancer
041428 - marker reversing continuous
041429 - rising tread for the
041430 - past year......................... 090325, ref SDS 98 D452
041432 - ..
041433 - 67. Disease trajectory graph shows Millie
041434 - may be nearing a point of rapid
041435 - decline with next relapse
041436 - of cancer......................... 090325, ref SDS 98 P39M
041438 - ..
041439 - 68. Hospice care can be investigate in order
041440 - to be prepared for smooth transition
041441 - as patient enters decline phase
041442 - of cancer trajectory.............. 090325, ref SDS 98 JS5I
041444 - ..
041445 - 69. Streamlined referral procedures
041446 - delivering care required in order
041447 - for the medical team to be
041448 - prepared treating cancer
041449 - as a chronic
041450 - disease........................... 090325, ref SDS 98 P43G
041452 - ..
041453 - 70. Stress increases beyond capacity to cope
041454 - managing chronic disease with procedures
041455 - designed for routine cancer care;
041456 - doctor approves Millie for
041457 - vacation to get needed
041458 - rest.............................. 090325, ref SDS 98 M35H
041460 - ..
041461 - 71. Lab mistakes and delays hamper delivering
041462 - referral care in time to be effective
041463 - treating stage IV cancer; patient facing
041464 - 7th relapse at risk; providers under
041465 - stress angry that someone is
041466 - changing doctor's orders
041467 - for patient care.................. 090325, ref SDS 98 RB3G
041469 - ..
041470 - 72. Lab mistakes and delays chronic problems
041471 - prevent treating cancer as chronic
041472 - disease on referral to UCSF
041473 - case study........................ 090325, ref SDS 98 KZ6N
041475 - ..
041476 - 73. Cancer chronic disease timely treatment
041477 - essential for Millie's 7th relapse
041478 - stage IV IBC; Kaiser has no chemotherapy
041479 - agents for Millie's narrow patient profile
041480 - triple negative; prescribes care
041481 - on referral to UCSF;
041482 - case study........................ 090325, ref SDS 98 L15M
041484 - ..
041485 - 74. Pain relief needed; Millie suffering
041486 - physically and emotionally from severe
041487 - radiation side effects; pain and
041488 - suffering will get worse for several
041489 - more weeks until Millie begins to recover
041490 - from radiation burn; Doctor Johnson
041491 - prescribes zink and Domeboro supplement
041492 - treatment prescribed at UCSF for
041493 - severe radiation side
041494 - effects........................... 090325, ref SDS 98 P39I
041496 - ..
041497 - 75. Medical tests ordered at Kaiser for
041498 - 090413 for examinations at UCSF on
041499 - 090423 to plan Millie's treatment
041500 - for the next relapse
041501 - of IBC............................ 090325, ref SDS 98 P36O
041503 - ..
041504 - 76. Medical tests ordered 10 days prior to
041505 - meetings at UCSF allows enough time
041506 - for correcting mistakes and expediting
041507 - delays so that data is delivered
041508 - when needed....................... 090325, ref SDS 98 LX5I
041510 - ..
041511 - 77. Patient asked to coordinate on correcting
041512 - mistakes in CT Department by consolidating
041513 - findings in a single report, rather than
041514 - publising multiple reports for
041515 - each test......................... 090325, ref SDS 98 P53O
041517 - ..
041518 - 78. Letter to Kaiser confirms understandings
041519 - from meeting on 090325 that reported a
041520 - favorable response after completeing
041521 - treatment at UCSF on 090317 with
041522 - radiation and hyperthermia
041523 - protocol.......................... 090326, ref SDS 99 5V7O
041525 - ..
041526 - 79. Kaiser plans visual examination with
041527 - CT tests to evaluate response to treatment
041528 - at UCSF with hyperthermia and
041529 - radiation......................... 090326, ref SDS A0 1V4N
041531 - ..
041532 - 80. Millie submits patient history showing
041533 - Kaiser has had problems relying on visual
041534 - examination and CT tests to assess IBC;
041535 - she submits research showing enhanced
041536 - MRI is reported to be effective
041537 - supplementing visual and
041538 - CT test modalities................ 090326, ref SDS A1 5V7O
041540 - ..
041541 - 81. Millie's letter asks about progress
041542 - reviewing research to solve problem
041543 - of diminishing treatments for
041544 - Millie's expanding patient
041545 - profile........................... 090326, ref SDS A1 QM3V
041547 - ..
041548 - 82. Millie's letter notifies medical team
041549 - meetings scheduled at UCSF on 090423
041550 - will evaluate response to radiation and
041551 - hyperthermia treatments that ended
041552 - on 090317, and develop plan
041553 - to treat Millie's cancer
041554 - as a chronic
041555 - disease........................... 090326, ref SDS 99 DW4R
041557 - ..
041558 - 83. Millie's letter notifies medical team
041559 - Doctor Johnson scheduled lab and CT
041560 - tests 10 days early on 090413 in order
041561 - to have enough time to submit reports
041562 - to UCSF for preparing to have a
041563 - productive meeting on 090423
041564 - that will plan next
041565 - treatments........................ 090326, ref SDS 99 DW5Y
041567 - ..
041568 - 84. Millie's letter thanks Doctor Stritter
041569 - for continued interest in her case, and
041570 - advises that Stritter 2nd opinion research
041571 - to solve problems of diminishing treatments
041572 - for Millie's expading patient profile
041573 - were submitted to the medical
041574 - team.............................. 090326, ref SDS A2 1V4N
041576 - ..
041577 - 85. Millie's letter reports to Doctor
041578 - Stritter suffering caused by radiation
041579 - side effects; does not feel well
041580 - after 4 weeks of intense
041581 - treatments........................ 090326, ref SDS A2 PX6Y
041583 - ..
041584 - 86. Doctor Johnson responds to Millie's
041585 - submission of research showing enhanced
041586 - MRI technology can effectively supplement
041587 - visual and CT modalities to assess
041588 - response to treatment of IBC 6th
041589 - relapse, saying he will talk about
041590 - it at the next visit in 6
041591 - weeks............................. 090326, ref SDS A3 T64N
041593 - ..
041594 - 87. Doctor Johnson responds to Millie's
041595 - request for progress reviewing research
041596 - to solve problems of diminishing treatments
041597 - for expanding patient profile, saying
041598 - he will talk about it at the
041599 - next visit in 6
041600 - weeks............................. 090326, ref SDS A3 T64N
041602 - ..
041603 - 88. Millie letter from Doctor Stritter asks
041604 - to be notified about progress considering
041605 - 2nd opinion options for solving problem
041606 - of diminishing treatments for
041607 - Millie's 7th relapse
041608 - of IBC............................ 090326, ref SDS A4 Q16O
041610 - ..
041611 - 89. Millie letter to medical team reports
041612 - rising pain from radiation side effects,
041613 - asks about using Domeboro
041614 - to supplement
041615 - silvadene......................... 090328, ref SDS A5 4S9W
041617 - ..
041618 - 90. Millie reports continued recovery from
041619 - IBC after completing radiation and
041620 - hyperthermia 2 weeks
041621 - earlier........................... 090328, ref SDS A5 4S4V
041623 - ..
041624 - 91. Doctor Hsu letter to Millie schedules
041625 - examination to relieve pain and suffering
041626 - side effects from radiation side
041627 - effects following treatment
041628 - to recover from IBC that
041629 - ended on 090317................... 090328, ref SDS A6 H27I
041631 - ..
041632 - 92. Millie's letter to UCSF confirms meeting
041633 - with Doctor Hsu on 090401 to get pain
041634 - relief from radiation side
041635 - effects........................... 090328, ref SDS A7 H27I
041637 - ..
041638 - 93. Doctor Hsu asks Millie to change time
041639 - of meeting on 090401 to afternoon
041640 - to accomodate tumor board
041641 - meeting........................... 090328, ref SDS A8 SA4J
041643 - ..
041644 - 94. Millie letter to UCSF asks Doctor Hsu
041645 - to meet on Monday 090330, rather than
041646 - Wedensday 090401 to expedite
041647 - pain relief....................... 090328, ref SDS A9 CM5K
041649 - ..
041650 - 95. Doctor Hsu agrees to advance examination
041651 - of Millie for prescribing pain relief
041652 - proposes meeting on 090330 in the
041653 - afternoon......................... 090328, ref SDS B0 4Z6I
041655 - ..
041656 - 96. Millie letter to UCSF asks to meet on
041657 - 090330 0800 rather than in the
041658 - afternoon to expedite getting
041659 - pain relief....................... 090328, ref SDS B1 MR3K
041661 - ..
041662 - 97. Doctor Hsu letter schedules meeting
041663 - at UCSF 090330 1200 to expedite pain
041664 - relief for Millie from radiation
041665 - side effects...................... 090328, ref SDS B2 F34O
041667 - ..
041668 - 98. Millie letter confirms meeting at
041669 - UCSF 090330 1200 to expedite pain
041670 - relief from radiation
041671 - side effects...................... 090328, ref SDS B4 W55N
041673 - ..
041674 - 99. Meeting at UCSF Doctor Hsu advises
041675 - Millie shows response to treatment
041676 - with radiation and hyperthermia
041677 - treatments........................ 090330, ref SDS B4 E54L
041679 - ..
041680 - 100. UCSF prescribes increase Silvadene
041681 - 1% Cream to reduce severe pain
041682 - suffering from radiation and
041683 - hyperthermia treatment side
041684 - effects........................... 090330, ref SDS B4 9A66
041686 - ..
041687 - 101. Writing things down reduces mistakes
041688 - at UCSF so people do not forget complex
041689 - details; prevents things from falling
041690 - through the cracks, because people
041691 - can find the "needle in a haystack"
041692 - essential for effective
041693 - comprehensive care................ 090330, ref SDS B4 9B65
041695 - ..
041696 - 102. Vitamin E plus pentoxifylline (Trental)
041697 - prescribed by UCSF when severe side effects
041698 - from radiation and hyperthermia continue
041699 - 2 - 3 months after completing
041700 - treatments........................ 090330, ref SDS B4 T487
041702 - ..
041703 - 103. Vitamin E plus pentoxifylline (Trental)
041704 - to recover from radiation and hyperthermia
041705 - side effects, this will be a
041706 - minimum 6 month
041707 - treatment......................... 090330, ref SDS B4 T54H
041709 - ..
041710 - 104. Millie letter reports to medical team
041711 - results of interim, exigent examination
041712 - at UCSF that finds severe radiation side
041713 - effects subsiding slowly as expected,
041714 - and Millie is recovering from 6th
041715 - relapse of IBC; prescribes
041716 - increased dose of
041717 - silvadene cream................... 090330, ref SDS B5 E54L
041719 - ..
041720 - 105. Millie requests correction of error
041721 - scheduling meeting with Doctor
041722 - Rugo on 090402, since meeting
041723 - already scheduled for
041724 - 090423............................ 090330, ref SDS B5 6F8Y
041726 - ..
041727 - 106. Millie's letter notifies medical team
041728 - new symptoms chills and elevated
041729 - temperature 99.4 fever; experienced
041730 - unusual, prolonged shortness
041731 - of breath while
041732 - hiking............................ 090331, ref SDS B6 E54L
041734 - ..
041735 - 107. Slight red blotches sprinkled on lower
041736 - left arm can signal Cellulitis; however,
041737 - concerned may be 7th relapse of
041738 - IBC............................... 090331, ref SDS B6 Q69V
041740 - ..
041741 - 108. Doctor Hsu letter asks beside fever and
041742 - chill any other symptoms? cough, pain, etc.
041743 - Did Silvadine help with the skin
041744 - pain.............................. 090401, ref SDS B7 E54L
041746 - ..
041747 - 109. Doctor Hsu letter says rash on
041748 - lower left arm likely
041749 - IBC............................... 090401, ref SDS B7 R24X
041751 - ..
041752 - 110. Millie reports to medical team temperature
041753 - came down to 97.8 with aspirin, and
041754 - drinking water; no other symptoms
041755 - of cough and pain responding
041756 - to Doctor Hsu's
041757 - inquiry........................... 090401, ref SDS B8 AE4G
041759 - ..
041760 - 111. Millie advises medical team that UCSF
041761 - instructions on 090330 to apply generous
041762 - thickness of Silvadine cream may relieve
041763 - pain slightly from radiation
041764 - side effects...................... 090401, ref SDS B8 RE6V
041766 - ..
041767 - 112. Millie more resolved to tolerate severe
041768 - side effects from radiation and hyperthermia
041769 - in order to recover from 6th relapse of
041770 - IBC because examination at UCSF shows
041771 - results; and further side effects are
041772 - subsiding in some areas; signs of recovery
041773 - helps overcome the trauma of dressing
041774 - the wound several times a day;
041775 - which is very scary to
041776 - observe............................ 090401, ref SDS B8 RE6Y
041778 - ..
041779 - 113. Millie's letter to medical team reports
041780 - UCSF has not clarified schedule for meeting
041781 - with Doctor Rugo on Thursday 090402,
041782 - which seems like a
041783 - mistake............................ 090401, ref SDS B8 RE8S
041785 - ..
041786 - 114. Doctor Rugo advises Millie will not be
041787 - ready for examination on 090402 to plan
041788 - treatment for 7th relapse of IBC; proposes
041789 - meeting at UCSF on 090416; notes Millie
041790 - suffering wound from radiation
041791 - side effects, and advises
041792 - treatment will be very
041793 - effective.......................... 090401, ref SDS B9 K56O
041795 - ..
041796 - 115. Millie's letter to medical team explains
041797 - Kaiser's schedule for medical tests on
041798 - on 090413 to support meetings at
041799 - 090423............................. 090401, ref SDS C0 R43V
041801 - ..
041802 - 116. Millie cites concern about new IBC on
041803 - lower left arm and asks UCSF to
041804 - confirm meetings on
041805 - 090423............................. 090401, ref SDS C0 R43V
041807 - ..
041808 - 117. Telecon Kaiser Outside Referral Department
041809 - advises the referral for Millie's treatment
041810 - at UCSF expires on 090602 is automatically
041811 - extended 1 year to 100202 in order
041812 - to implement Kaiser prescription
041813 - for UCSF to treat Millie's
041814 - cancer as a chronic
041815 - disease............................ 090401, ref SDS C1 KT8G
041817 - ..
041818 - 118. Kaiser Outside Referral Department lists
041819 - UCSF professionals providing services
041820 - for Millie's care to ensure
041821 - continuity of treatment to
041822 - resolve IBC........................ 090401, ref SDS C1 5W4G
041824 - ..
041825 - 119. Kaiser Outside Referral Department explains
041826 - primary care physician can amend referral for
041827 - Millie's treatment with hyperthermia and
041828 - radiation to have labs done at UCSF in order
041829 - to reduce mistakes and save lives,
041830 - time and money..................... 090401, ref SDS C1 RG5K
041832 - ..
041833 - 120. Millie's letter notifies medical team
041834 - Kaiser Outside Referrals indicates
041835 - current authorization enables continuity
041836 - of care at UCSF from Doctor Rugo in Breast
041837 - Care Clinic, and Doctor Hsu in
041838 - Radiation Oncology................. 090401, ref SDS C2 LG4G
041840 - ..
041841 - 121. Millie's letter notifies team that Kaiser
041842 - Outside Referrals authorizes continuity
041843 - of care by automatically extending
041844 - payment for 6 months until
041845 - 100202............................. 090401, ref SDS C2 WC6Y
041847 - ..
041848 - 122. Millie's letter notifies team that
041849 - referral for Millie's hyperthermia and
041850 - ratiation can be amended by primary care
041851 - physician to add labs at UCSF in order
041852 - streamline care for medical necessity
041853 - to reduce mistakes and save
041854 - time and money..................... 090401, ref SDS C2 WC7Y
041856 - ..
041857 - 123. Doctor Rugo thanks Millie for facilitating
041858 - Kaiser clarifying referral authorization
041859 - for UCSF to treat Millie's 7th relapse
041860 - of cancer as a chronic disease; and
041861 - advises information should be sent
041862 - to the UCSF authorization
041863 - person............................. 090402, ref SDS C3 LA6H
041865 - ..
041866 - 124. Doctor Rugo advises that clarifying
041867 - confusion in scheudling next meeting
041868 - should be resolved by UCSF schedule
041869 - department because UCSF has a
041870 - complex schedule system............ 090402, ref SDS C3 117O
041872 - ..
041873 - 125. Millie letter asks Doctor Rugo if Lena
041874 - who called Millie in February about
041875 - scheduling meetings with the doctor
041876 - can clarify the schedule in
041877 - April, as requested by
041878 - the doctor......................... 090402, ref SDS C4 WM8M
041880 - ..
041881 - 126. Millie sent a letter to Glenna who
041882 - coordinated Millie's treatment on pior
041883 - sunitinib clinical trial, and asking
041884 - for assistance finding who to notify
041885 - about Kaiser referral authorization,
041886 - who can assist clarifying the
041887 - schedule for meeting with
041888 - Doctor Rugo........................ 090402, ref SDS C5 WM8M
041890 - ..
041891 - 127. Glenna called and advised she coordinated
041892 - contacts at UCSF for Millie's referral
041893 - authorization, and to clarify schedule
041894 - for Millie to meet with Doctor
041895 - Rugo on planning treatment
041896 - for the 7th relapse
041897 - of IBC............................. 090402, ref SDS C6 JA6L
041899 - ..
041900 - 128. Millie letter notified medical team
041901 - elevated temperature 99.7 fever occurred
041902 - again; icing upper left arm, and is
041903 - monitoring fever to
041904 - evaluate........................... 090402, ref SDS C7 684J
041906 - ..
041907 - 129. Millie letter to medical team thanks Doctor
041908 - Rugo for Glenna's support coordinating case
041909 - management on referral authorizations,
041910 - and on scheduling a meeting to plan
041911 - treatment for recovering from 7th
041912 - relapse of IBC..................... 090402, ref SDS C7 H94R
041914 - ..
041915 - 130. Millie letter to Doctor Rugo's assistant
041916 - requests confirmation of schedule to
041917 - with the doctor at UCSF on 090423
041918 - for planning treatment of
041919 - Millie's 8th relapse of
041920 - cancer............................. 090403, ref SDS C8 375Y
041922 - ..
041923 - 131. Millie letter notifies medical team that
041924 - temperature 99.7 subsided by midnight;
041925 - cough and shortness of breath persisted
041926 - and prevented sleep; evantually
041927 - recovered about
041928 - 0400............................... 090403, ref SDS C9 XZ6I
041930 - ..
041931 - 132. Doctor Hsu letter asks Millie to get
041932 - examination at Kaiser for
041933 - pneumonia.......................... 090403, ref SDS D0 Z66M
041935 - ..
041936 - 133. Doctor Rugo letter asks Millie to
041937 - get examination at Kaiser for
041938 - shortness of breath................ 090403, ref SDS D1 3G3N
041940 - ..
041941 - 134. Millie notifies medical team that UCSF
041942 - recommends examination for pneumonia
041943 - with symptoms of shortness of
041944 - breath............................. 090403, ref SDS D2 NW4N
041946 - ..
041947 - 135. Millie notifies medical team fever occurs
041948 - for 3rd time with temperature 99.4; explains
041949 - home care has previously been
041950 - effective.......................... 090403, ref SDS D2 DX7S
041952 - ..
041953 - 136. Millie notifies medical team side effects
041954 - of radiation and hyperthermia skin "burn"
041955 - healing, and pain subsides
041956 - substantially...................... 090403, ref SDS D2 DX8R
041958 - ..
041959 - 137. Millie letter to Doctor Johnson 090403
041960 - 2012 supplements letter sent 20 minutes
041961 - earlier 1941 to explain symptoms subside
041962 - proposes monitoring and then assess
041963 - need for examination at
041964 - Kaiser............................. 090403, ref SDS D3 ZG7H
041966 - ..
041967 - 138. Letter from Doctor Johnson responds to
041968 - Mil's first letter sent 090403 1954,
041969 - ref SDS D2 NW4N, but not this 2nd letter
041970 - sent 20 minutes later, and reporting symptoms
041971 - subside, see 090403 2012, ref SDS D3 OA4R;
041972 - doctor evidently did not see the 2nd letter;
041973 - asks Millie to call Kaiser and schedule
041974 - a meeting, recommends medical team use
041975 - Kaiser's internal proprietary Knowledge
041976 - Management system for email to
041977 - increase efficiency
041978 - performing case
041979 - management......................... 090406, ref SDS D4 M19I
041981 - ..
041982 - 139. Millie letter to medical team relates
041983 - report in Millie's 2nd letter on 090403
041984 - that symptoms have not repeated, and
041985 - so proposes deferring examination
041986 - at Kaiser.......................... 090406, ref SDS D5 OC5F
041988 - ..
041989 - 140. Called UCSF talked to Roy, who advises
041990 - there is no record scheduling meeting
041991 - on 090423; Roy plans to notify Amanda,
041992 - who is another assistant for Doctor Rugo,
041993 - about scheduling meeting on 090423
041994 - 0830, which Doctor Rugo
041995 - ordered............................ 090407, ref SDS D6 PP8X
041997 - ..
041998 - 141. Amanda called, she assists Doctor Rugo;
041999 - advised UCSF cannot find Millie's letter
042000 - to medical team on 090401 1520, ref SDS C2
042001 - LG4G, and further advised that UCSF has no
042002 - record Kaiser has authorized referral for
042003 - Millie to meet with Doctor Rugo on 090423,
042004 - and so a meeting has not been scheduled;
042005 - Millie's letter on 090401 1520 was
042006 - resubmitted to Amanda
042007 - at UCSF............................ 090407, ref SDS D8 MV5K
042009 - ..
042010 - 142. Amanda called after receiving Millie's
042011 - letter on 090401 1520, and schedules
042012 - Millie for another meeting with Tara,
042013 - because Doctor Rugo will be
042014 - out of town again
042015 - on 090423 0830..................... 090407, ref SDS D8 4N3F
042017 - ..
042018 - 143. Called Kaiser CT Department Loretta confirmed
042019 - test scheduled on 090413 allows 10 days
042020 - for Kaiser to send report in time to meet
042021 - at UCSF 090423; CT Department changes time
042022 - for test from 1520 to 1500 requested by
042023 - Interventional Radiology Services to avoid
042024 - overtime for Millie's CT test; Loretta
042025 - asks Millie to coordinate with Chemotherpay
042026 - Infusion Department to change the time
042027 - for Millie's blood on 090413 from
042028 - 1500 to 1430, so that the CT Department
042029 - can make use of the nurse accessing
042030 - Millie's Power Port with a Huber
042031 - needle that can be used to
042032 - inject contrast medium
042033 - for the CT test
042034 - at 1500............................ 090407, ref SDS D9 L76N
042036 - ..
042037 - 144. Kaiser CT Department discloses the
042038 - computer indicates somebody changed
042039 - doctor's order for consolidating findings
042040 - into single report to correct mistakes
042041 - in past reports; Loretta to investigate
042042 - why doctor's order was
042043 - changed............................ 090407, ref SDS D9 1163
042045 - ..
042046 - 145. Called Kaiser Oncology Department and
042047 - changed time for blood draw from 090413
042048 - 1500 to 1430 to facilitate request by
042049 - IS to avoid overtime
042050 - expense............................ 090407, ref SDS D7 R16X
042052 - ..
042053 - 146. Kaiser CT Department called back; Katie
042054 - advised that the doctor's order for Millie's
042055 - CT test was changed by the department
042056 - to eliminate requirement for consolidated
042057 - findings because government regulations
042058 - require separate reports for scans above
042059 - the neck from scans below the
042060 - neck............................... 090407, ref SDS D9 L87J
042062 - ..
042063 - 147. CT Department called back and Katie advised
042064 - test scheduled on 090414 1500, which
042065 - conflicted with doctor's order for
042066 - test on 090413..................... 090407, ref SDS D9 YK64
042068 - ..
042069 - 148. CT Department called back and advised
042070 - an error occurred in data entry changing
042071 - the time for the test on 090413 from 1520
042072 - to 1500, resulting to scheduling the
042073 - test on 090414; Katie corrected
042074 - mistake............................ 090407, ref SDS D9 W47V
042076 - ..
042077 - 149. CT Department investigates why doctor's
042078 - order for consolidating findings into
042079 - a single report for each CT test
042080 - was changed........................ 090407, ref SDS D9 YZ95
042082 - ..
042083 - 150. UCSF notified Millie will be examined
042084 - in breast care clinic on 090423 0830
042085 - evaluate progression IBC 7th
042086 - relapse and plan for next
042087 - treatment.......................... 090408, ref SDS E0 E54L
042089 - ..
042090 - 151. Medical team notified Kaiser CT Department
042091 - changed time of test on 090413 to accomodate
042092 - IS overtime cost containment objectives;
042093 - requires coordinating with Chemotherapy
042094 - Infusion Clinic to correlate time of
042095 - blood draw with revised time
042096 - for CT test........................ 090408, ref SDS E0 QW4X
042098 - ..
042099 - 152. Fever high temperature occurred for several
042100 - days during 3 - 5 hours in late evening
042101 - but this stopped several days ago, and other
042102 - symptoms cough and shortness of breath
042103 - subside, so no need for examination at
042104 - Kaiser by primary care physician
042105 - requested by Doctor Hsu and
042106 - Doctor Rugo at
042107 - UCSF............................... 090408, ref SDS E0 QW6R
042108 -
042109 -
042110 -
042111 -
0422 -
SUBJECTS
Default Null Subject Account for Blank Record
0503 -
050401 - ..
050402 - Creatinine Needed for CT Test 1500 Requires Blood Test 1330
050403 - Blood Draw Changed to 1330 Chem Infusion Clinic for CT Test 1500
050404 -
050405 - Follow up ref SDS E0 E54L, ref SDS D3 E54L.
050406 -
050407 - Called and talked to Arlette to follow up discussion on 090407 when
050408 - she was coordinating, ref SDS D7 R16X, to change the time of Millie's
050409 - lab on 090413 from 1500 to 1430 correlated with the change requested
050410 - by IS for Millie's Ct test on 090423, and which was presented by
050411 - Loretta in the CT Department on 090407 1442. ref SDS D9 L76N
050413 - ..
050414 - Arlette said she talked to Bella in the Chemotherapy Infusion Clinic
050415 - about changing the time for Millie's lab next week on 090413. Bella
050416 - checked and found that the CT Deparment needs a current test for
050417 - Creatinine in order to perform Millie's CT test on 090413, because the
050418 - last test on 090309, ref SDS 83 8U4N, was more than a month ago, and
050419 - this does not meet standard of care. Bella therefore scheduled the
050420 - blood at 1330 to allow enough time for the lab to process the test
050421 - tubes, and report results by 1500 needed in the CT Department for
050422 - Millie's test.
050424 - ..
050425 - Arletted suggested that Millie can wait in the cafeteria for an hour
050426 - or so after the blood draw in the Oncology Chemotherapy Infusion
050427 - Clinic on the 2nd floor, and so that the lab can perform all of the
050428 - tests ordered by the doctor, and then walk to the CT Department in the
050429 - basement for that test at 1500. By that time, results for Creatinine
050430 - should be available on Kaiser's computer to the staff in the CT
050431 - Department to evaluate giving Millie the test.
050432 -
050434 - ..
050435 - Telecon Doctor Johnson Coordinate Treatment Planning at UCSF
050436 - Radiation Side Effects Subside Examination Deferred
050437 - Examination Deferred Because Symptoms Radiation Side Effects Subside
050438 -
050439 - Follow up ref SDS E0 QW6R, ref SDS D2 NW4N.
050440 -
050441 - Asked Arlettete to let Doctor Johnson know about calling today on
050442 - correcting the referral for Millie's treatment at UCSF.
050444 - ..
050445 - Arlette said that she was meeting with the doctor in his office, and
050446 - so he picked up the call.
050448 - ..
050449 - Talked to Doctor Johnson.
050451 - ..
050452 - Doctor Johnson said he received correspondence from Doctor Hsu on
050453 - 090403, and later Doctor Rugo, both transmitted by Millie's letter
050454 - notifying the medical team on 090403 1520, ref SDS D2 NW4N, of rising
050455 - symptoms on radiation side effects. He decided today that since
050456 - Millie's symptoms have subsided for several days following his letter
050457 - on 090406 asking Millie to call Kaiser to schedule a meeting for
050458 - examination, ref SDS D4 M19I, and as reported in Millie's letter to
050459 - the medical team yesterday on 090408 1113, ref SDS E0 QW6R, then
050460 - examination at Kaiser is not needed unless there is recurrence.
050461 -
050462 -
050464 - ..
050465 - Coordinate CT Department Correct Errors Publishing CT Test Reports
050466 - Consolidate Findings CT Tests Coordinating with Doctor Davidson
050467 - Doctor Davidson Reviews Consolidating Findings for Normal CT Report
050468 -
050469 - Explained progress coordinating with the CT Department requested by
050470 - Doctor Johnson during the meeting at Kaiser on 090325, to correct
050471 - problems caused by getting multiple reports for a single CT test.
050472 - ref SDS 98 P53O
050474 - ..
050475 - Doctor Johnson asked who is working the problem in the CT Department?
050477 - ..
050478 - Advised of discussions with Loretta on 090407 1442 who reported that
050479 - Doctor Johnson's order entered in the computer was changed.
050480 - ref SDS D9 M46K Katie Garcia then investigated and maintained that
050481 - Doctor Johnson did not specify a consolidated report for the test on
050482 - 090413, ref SDS D9 0254; she noted that changing the doctor's order
050483 - specifying a consolidated report, would be a very serious breach of
050484 - case management protocol. ref SDS D9 L87J Katie offered several
050485 - explanations for Kaiser changing the doctor's order and instead
050486 - issuing multiple reports for each CT test. ref SDS D9 L86F Katie
050487 - consulted with to Al Hutchins. ref SDS D9 L44L
050489 - ..
050490 - Doctor Johnson asked where the issue stands now?
050492 - ..
050493 - Reported that Katie coordinated with Doctor Davidson, who will
050494 - investigate and notify respond, hopefully in time for publishing the
050495 - report correctly for the CT test on 090413. ref SDS D9 YZ95
050497 - ..
050498 - Doctor Johnson advised that Doctor Davidson is the directory for
050499 - Radiology for the Diablo Service Area, and that Doctor Davidson
050500 - supported efforts in 2008 to upgrade the CT Department to use Power
050501 - Port and Huber needle technology for injecting contrast medium, which
050502 - Millie discussed with the department on 080711. ref SDS 32 2P3N
050503 -
050504 - [On 090409 2018 Doctor Davidson letter advises Kaiser made
050505 - a mistake publishing multiple reports for each CT test that
050506 - causes confusion and error presenting patient medical
050507 - condition, ref SDS E1 L14I; advises future tests will
050508 - consolidate findings into single report for each test that
050509 - maintains a well ordered record for efficient case
050510 - management essential to save lives, time, and money.
050511 - ref SDS E1 XZ6U
050512 -
050513 -
050514 -
050515 -
050516 -
0506 -
SUBJECTS
Default Null Subject Account for Blank Record
0603 -
060401 - ..
060402 - Labs Ordered at UCSF Facilitate Treatment 7th Relapse IBC
060403 -
060404 - Follow up ref SDS C2 WC7Y, ref SDS C1 RG5K.
060405 -
060406 - Doctor Johnson recalled Millie's letter to the medical team on 090401
060407 - 1520 about amending the referral for Millie's treatment at UCSF with
060408 - radiation and hyperthermia to include labs, ref SDS C2 WC7Y, and
060409 - citing telecon with Pam in Outside Referrals earlier on the same day
060410 - 090401 1214. ref SDS C1 RG5K
060412 - ..
060413 - Doctor Johnson asked the purpose of doing labs at UCSF?
060415 - ..
060416 - Reviewed discssion during meeting at Kaiser on 090213 1140, when he
060417 - explained doctor's need timely access to accurate lab date for patient
060418 - care. ref SDS 75 M36H At that time on 090213 1140, Doctor Johnson
060419 - explained narrowing margin for error and delay to treat Millie's 8th
060420 - relapse of cancer. ref SDS 75 ES7I Last month on 090325, this was
060421 - discussed again citing continual mistakes and delays to Millie's care
060422 - trying to perform labs at Kaiser and transmit date to UCSF.
060423 - ref SDS 98 KZ6N
060425 - ..
060426 - The doctor advised that based on evidence in patient history during
060427 - the call today he filed on Kaiser's computer an amended authorization
060428 - for Millie's treatment at UCSF to include lab work.
060429 -
060430 - [On 090415 1519 doctor frustrated by continuing delays sending
060431 - results of Millie's labs at Kaiser for Millie's care at UCSF;
060432 - expects amended referral to do the labs at UCSF will relieve
060433 - stress on Kaiser's lab and oncology staff. ref SDS E4 MJ4G
060434 -
060435 -
060436 -
060437 -
060438 -
060439 -
060440 -
060441 -
060442 -
060443 -
0605 -