CONTACTS 
020304 -

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 59 0000. ref SDS 57 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 090423 Millie met with Tara in the Breast Care Clinic at UCSF for
040902 - examination, which showed recovery from side effects of radiation and
040903 - hyperthermia treatments during February and March 2009. ref SDS 32 QR3M
040904 - This was confirmed in Millie's letter to the medical team later that
040905 - day on 090423. ref SDS 33 ZL6T  Tara also found expanding IBC on the
040906 - lower left arm, ref SDS 32 DW6F, also confirmed in the letter to the
040907 - medical team. ref SDS 33 ZL7P
040909 -  ..
040910 - At that time, on 090423 Tara planned to discuss with Doctor Hsu in the
040911 - UCSF Radition Oncology Department concerns about slow healing of
040912 - radiation side effects in Millie's breastbone area. ref SDS 32 R15K
040913 - Collaboration plans were further confirmed in Millie's letter to the
040914 - medical team on 090423. ref SDS 33 ZL7V
040916 -  ..
040917 - In the afternoon on 090423 1315 Millie met with Doctor Hsu to check on
040918 - recovery from radiation side effects. ref SDS 32 4H5G  Doctor Hsu gave
040919 - Millie a "thumbs up" that she was well enough to take time from
040920 - treatment to go on a 2-week vacation, ref SDS 32 FJ6K, and despite
040921 - confirming diagnosis of IBC relapse on the lower left arm, ref SDS 32
040922 - 5G4G, and despite growing doubts about vertical line of sking infected
040923 - either by IBC or radiation side effects. ref SDS 32 EX4I  The doctor
040924 - recommended against taking a biopsy because the skin was thought to be
040925 - radiated, and surrounding tissue was radiated, and so this would delay
040926 - and prevent normal recovery from a biopsy wound. ref SDS 32 456H
040928 -  ..
040929 - On 090423 2337 Millie's letter to medical team reports Doctor Hsu's
040930 - favorable report that IBC cannot recur in treated areas, because
040931 - nothing can grow in treated areas. ref SDS 33 ZL9V  The letter further
040932 - confirms UCSF plans to treat IBC recurrence on the lower left arm as a
040933 - chronic disease with systemic agents prescribed by Doctor Rugo in the
040934 - Breast Care Clinic, ref SDS 33 ZL4X, and notes the meeting scheduled
040935 - with Doctor Rugo on 090514. ref SDS 33 ZL5Q
040937 -  ..
040938 - Yesterday on 090510 1553, Millie submitted an agenda for the meeting
040939 - on 090514 to start treatment of the 8th relapse. ref SDS 34 QH9J  The
040940 - letter was hurried to fit commitments for attending Mother's Day
040941 - family event.  In the afternoon on 090510 1953, after retrurning home,
040942 - Millie sent a second letter to further explain the agenda for meeting
040943 - on Thursday 090514 at UCSF with Doctor Rugo. ref SDS 35 FJ3G
040945 -  ..
040946 - This morning, called and talked to Amanda about coordinating to
040947 - facilitate the agenda for meeting with Doctor Rugo on Thursday,
040948 - 090514, particularly on requirements for blood tests at Kaiser, as
040949 - discussed in Millie's letter on 090510 1953. ref SDS 35 LJ7X
040951 -  ..
040952 - Amanda requested a copy of Millie's letter to the medical team that
040953 - explains details about getting a lab.  Millie sent the letter to
040954 - Amanda and requested clarification on requirements for a lab.
040955 - ref SDS 36 YN33  After sending the letter to Amanda this afternoon,
040956 - Kaiser notified Millie on 090511 1427 that Doctor Johnson has a
040957 - standing order at Kaiser for Millie to get a monthly blood test,
040958 - ref SDS 37 FJ5L; so, Millie then sent a letter notifying the medical
040959 - team that the blood draw will be done on 090512, so that people can be
040960 - prepared for a productive meeting at UCSF on 090514. ref SDS 37 FJ6G
040962 -  ..
040963 - On 090511 2013, Doctor Rugo sent a letter saying that scope for labs
040964 - at Kaiser performed to support examinations at UCSF should be
040965 - determined by Kaiser rather than by UCSF. ref SDS 38 RF4J
040967 -  ..
040968 - On 090511 2313, Millie notified Doctor Rugo that case study on 090325,
040969 - ref SDS 23 KZ6N, shows UCSF has been setting the scope on labs at
040970 - Kaiser for the past 3 years that are used to guide the work for
040971 - Millie's care at UCSF on referral from Kaiser, ref SDS 39 YN4L
040973 -  ..
040974 - On 090512 Millie went to Kaiser for the lab.  ref SDS 40 6Z4F
040976 -  ..
040977 - On 090513 1654 Millie submitted results of Kaiser's lab to UCSF,
040978 - ref SDS 41 N54I, and notifies Doctor Mason at Kaiser's Outside
040979 - Referrals Department about more mistakes at Kaiser that causes poor
040980 - coordination of Millie's care at UCSF on referral from Kaiser.
040981 - ref SDS 41 ZH6W, and follows up Doctor Mason's plan on 090420 for
040982 - Kaiser to work harder with greater diligence to avoid mistakes in
040983 - order to continue doing labs at Kaiser rather than include labs for
040984 - referral at UCSF for Millie's treatments at UCSF. ref SDS 31 8G3N
040986 -  ..
040987 - Millie received a letter from Pam who works for Doctor Mason in
040988 - Kaiser's Outside Referrals Department, and asking why the Outside
040989 - Referrals Department was notified about mistakes at Kaiser performing
040990 - labs required for Millie's care at UCSF on referral from Kaiser.
040991 - ref SDS 42 2T5L
040993 -  ..
040994 - Millie replied to Pam's letter explaining patient history assists
040995 - Doctor Mason evaluate requirements for effective coordination because
040996 - chronic mistakes at Kaiser can be avoided by performing labs at UCSF
040997 - for Millie's care at UCSF. ref SDS 43 PQ5N
040999 -  ..
041000 - On 090514 0830 Millie met with Doctor Rugo, ref SDS 44 TP9L, and the
041001 - doctor prescribed treatment in the MPA clinical trial to help Millie
041002 - recover from the 8th relapse of cancer. ref SDS 44 A13N  The doctor
041003 - was encouraged about powerful new treatments becoming available to
041004 - treat Millie, ref SDS 44 3F7M, but was very discouraged saying Kaiser
041005 - would never get on board to treat Millie's cancer as a chronic
041006 - disease. ref SDS 44 3F82  As a first step to order treatment, Doctor
041007 - Rugo sent a letter to Kaiser recommending treatment for Millie with
041008 - the MPA protocol that is targeted to Millie's patient profile.
041009 - ref SDS 44 DI63
041011 -  ..
041012 - On 090514 2346, Millie sent a letter notifying the medical team,
041013 - ref SDS 45 LF3H, about the new MPA treatment prescribed by UCSF, and
041014 - cited the letter Doctor Rugo sent to Kaiser explaining prospects for
041015 - recover, ref SDS 45 WF9V; and Millie's letter further submitted the
041016 - agenda for meeting tomorrow with Doctor Johnson at Kaiser to perform
041017 - oversight review. ref SDS 45 WF9Y
041019 -  ..
041020 - On 090515 0952, Doctor Rugo sent a reply this morning to Millie and
041021 - the medical team saying that Kaiser notified UCSF that Kaiser refused
041022 - to treat Millie for recovering from the 8th relapse of cancer.
041023 - ref SDS 46 GR4O
041025 -  ..
041026 - On 090515 1017, Millie notified the medical team that Kaiser is
041027 - responsible for her care, must prescribe treatment based on the best
041028 - evidence, and that Millie will meet with the primary care physician
041029 - today at 090515 1140 and support review for ordering treatment
041030 - recommended by Doctor Rugo, and in time to effective. ref SDS 47 EY5L
041032 -  ..
041033 - On 090515 1140 Millie met with Doctor Johnson, primary care physician
041034 - at Kaiser to prescribe treatment for Millie's 8th relapse of cancer.
041035 - ref SDS 48 J47M  The doctor asked Millie to assist him preparing an
041036 - appleal to Memeber Services for clarification of incorrect guidance he
041037 - received from Doctor Mason. ref SDS 48 655R
041039 -  ..
041040 - On 090515 1518 Millie received a letter from Doctor Rugo wishing
041041 - Millie "good luck" assisting Kaiser perform the agreement to prescribe
041042 - standard of care treatment for Millie's 8th relapse of cancer.
041043 - ref SDS 49 PW7H
041045 -  ..
041046 - On 090515 1140 Doctor Johnson confirmed prior notice that Kaiser has
041047 - not treatments for Millie's patient profile, and he would get in
041048 - trouble if an audit shows he prescribed Gemzar or Navelbine for
041049 - Millie's 8th relapse of cancer. ref SDS 48 658J
041051 -  ..
041052 - On 090516 0858, Millie notified Doctor Rugo that Doctor Johnson was
041053 - going to bat for Millie at Kaiser to prescribe treatment by filing an
041054 - appeal with Memeber Services. ref SDS 50 SY4O
041056 -  ..
041057 - On 090518 0017 prepared a draft appeal for Doctor Johnson to file with
041058 - Member Services on requirements for prescribing Millie's treament to
041059 - recover from the 8th relapse of cancer. ref SDS 51 R16I
041061 -  ..
041062 - On 090519 1536 Doctor Johnson responded to Millie's letter submitted
041063 - to Kaiser yesterday on 090518 0017, ref SDS 51 R16I, and telling
041064 - Millie he changed his mind and so would not expedite treatment by
041065 - sending an appeal to Member Services, and instead tells Millie to
041066 - submit an appeal for treatment to recover from Millie's 8th relapse of
041067 - cancer. ref SDS 52 5K7H
041069 -  ..
041070 - On 090519 1613 Millie responded, ref SDS 53 8V8H, to the Doctor's
041071 - letter earlier yesterday afternoon on 090519 1536, ref SDS 52 5K7H;
041072 - and, Millie asks the doctor to prescribe treatment so she can recover
041073 - from cancer, as done previously in patient history, ref SDS 53 TY3X,
041074 - and further as planned by the doctor during the meeting on 090515
041075 - 1140. ref SDS 48 655R  Millie also asked the doctor to call on
041076 - expediting treatment in time to be effective, see again on 090520
041077 - 1613, ref SDS 53 TY4W; and Millie asks Doctor Rugo for a "drop dead"
041078 - date on how soon treatment must start in order to be effective, also,
041079 - reported on 090519 1613. ref SDS 53 TX4W
041081 -  ..
041082 - On 090520 1113 Millie received a letter from Doctor Johnson,
041083 - ref SDS 56 UC9G, responding to Millie's letter yesterday requesting
041084 - that Kaiser prescribe treatment for the 8th relapse of cancer.
041085 - ref SDS 53 TY3X
041087 -  ..
041088 - Today, on 090520 1137 Millie responded to Doctor Johnson with copies
041089 - notifying the medical team of Kaiser's treatment plan for Millie's 8th
041090 - relapse of cancer. ref SDS 57 5K9M
041092 -  ..
041093 - Today, on 090520 1153 called Paula and asked Member Services to
041094 - assist the Oncology Department prescribe urgent treatment
041095 -
041097 -  ..
041098 - On 090520 1703 Millie received a letter from Doctor Johnson saying
041099 - Gemzar and Navelbine are viable options for treating Millie's patient
041100 - profile, ref SDS 59 HN4I, contrary to having told Millie in a meeting
041101 - on 090515 that he would get in trouble from a practice audit for
041102 - prescribing these treatments at this stage of Millie's care, reported
041103 - 090515 1140, ref SDS 48 658J
041104 -
041105 -
041107 -  ..
041108 - Treatment Plan After Gemzar What Will Kaiser Prescribe Next?
041109 -
041110 - On 090520 1710 Millie asked Kaiser to perform a work up, including a
041111 - Tumor Board to evaluate treatment options available at this time...
041112 -
041113 -    1.  Subject: Treatment Plan 8th Relapse of Cancer Kaiser's Standard of Care
041114 -        Date: Wed, 20 May 2009 17:19:29 -0700
041127 -         ..
041128 -    2.  Thanks for clarifying in your letter today that Navelbine and
041129 -        Gemzar meet Kaiser's standard of care for my patient profile
041130 -        [reported on 090520 1703. ref SDS 59 HN4I]
041132 -         ..
041133 -    3.  You seemed concerned when we met last Friday on 090515 that I
041134 -        could not tolerate these drugs, and that my cancer would resist
041135 -        these drugs [reported on 090515 1140. ref SDS 48 658J  If we
041136 -        proceed with these drugs, and discover my cancer progresses in
041137 -        a week or a month, what will Kaiser prescribe?
041138 -
041139 -
041141 -  ..
041142 - Millie Needed Treatment on 090331 and Kaiser Has Not Prescribed Care
041143 - Claim Millie Demands Kaiser Prescribe Treatment Expedited Review
041144 - Expedited Claims Reviewing Millie's Demand Kaiser Prescribe Treatment
041145 -
041146 -
041147 -    4.  Pamela Powell was called today in Kaiser's Expedited Claims.
041148 -        She would not accept written explanation of patient request for
041149 -        medical services, and insisted Kaiser likes to work by
041150 -        conversation [reported on 090520 1203. ref SDS 58 PQ8P]
041152 -         ..
041153 -    5.  In the call, Pamela was told that you have done an excellent
041154 -        job prescribing my care the past 8 years.  There have been
041155 -        problems, but these have been overcome with your diligence and
041156 -        skill, for which I am grateful.
041158 -         ..
041159 -    6.  My concern today is that I suffered progression of cancer on
041160 -        090331 [2047, ref SDS 24 Q69V].  Kaiser has not prescribed
041161 -        treatment due to administrative issues.
041162 -
041163 -            [On 090521 0211 Millie's letter to Doctor Rugo at UCSF with
041164 -            copy to Doctor Hsu asks if hyperthermia and Doxil can treat
041165 -            Millie for 8th relapse of cancer until Kaiser resolves
041166 -            delays authorizing treatment with MPA prescribed by Doctor
041167 -            Rugo as the best course of care for Millie to recover from
041168 -            8th relapse of cancer. ref SDS 60 FM6R
041169 -
041170 -
041172 -  ..
041173 - Standard of Care Prescribe Treatment Millie's Patient Profile
041174 - Workup Millie's Patient Profile Treatment Plan Recover 8th Relapse
041175 - Trade-offs Treatment Plan for Alternative Modalities and Protocols
041176 - When Must Treatment Start in Order to Have Chance of Being Efective
041177 -
041178 -
041179 -    7.  Pamela was asked to work with you on submitting a written
041180 -        workup and treatment plan for my 8th relapse of cancer that
041181 -        follows Kaiser's Standard of Care [reported on 090520 1203.
041182 -        ref SDS 58 9595] for my patient profile [shown in the record on
041183 -        090213 1140. ref SDS 20 ES7I
041184 -
041185 -            [On 090521 2006 Doctor Johnson notifies Millie without
041186 -            notice to medical team and saying Millie can "choose" which
041187 -            next treatment regimen that Millie wants, and that no
041188 -            treatment would be considered more superior than another,
041189 -            ref SDS 61 UD5H; the doctor says Millie needs urgent
041190 -            treatment and so should notify Kaiser which treatment
041191 -            Millie chooses by the end of the week, which is the next
041192 -            day in roughly 12 hours, ref SDS 61 HC8O; the doctor
041193 -            further tells Millie to call Medicare for prescribing
041194 -            treatment suitable for Millie's patient profile, rather
041195 -            than call Kaiser Oncology. ref SDS 61 HC93
041197 -             ..
041198 -            [On 090531 1544 Millie notified the medical team that she
041199 -            demands standard of care for treatment of her patient
041200 -            profile. ref SDS 63 IH6S
041202 -         ..
041203 -    8.  Additionally, I asked [Doctor Rugo with a copy to] Kaiser for a
041204 -        medical opinion on how soon I must start treatment in order to
041205 -        maintain local control [reported on, 090519 1613, ref SDS 53
041206 -        TX4W], and I asked for medical opinion on trade-offs between
041207 -        Navelbine and Gemzar, Doctor Rugo's clinical trial, and
041208 -        hyperthermia and associated modalities [presented in Millie's
041209 -        letter to the medical team on, 090520 1137, ref SDS 57 SS3W]
041210 -
041211 -            [On 090521 0211 Millie's letter to Doctor Rugo with copy to
041212 -            Doctor Hsu at UCSF asks if hyperthermia and Doxil can treat
041213 -            Millie for 8th relapse of cancer until Kaiser resolves
041214 -            delays authorizing treatment with MPA prescribed by Doctor
041215 -            Rugo. ref SDS 60 FM6R
041217 -             ..
041218 -            [On 090605 1447 Kaiser documentation dislcoses high risks
041219 -            of Gemzar that require "extreme caution" for Millie's
041220 -            patient profile. ref SDS 64 V34K
041222 -         ..
041223 -    9.  I've tried to call several times, but have not been able to get
041224 -        through [reported on 090519 1643, ref SDS 54 9G57, and again
041225 -        this morning on 090520 1052, ref SDS 55 IW6O].  Thanks very
041226 -        much for continuing to work this problem.
041227 -
041228 -            [On 090528 1228 Millie notifies Kaiser Member Services
041229 -            Claims Resolution Department that email is the only means
041230 -            of communication with Kaiser, because everybody is too busy
041231 -            to return calls. ref SDS 62 4N8U
041232 -
041238 -
041239 -
041240 -
041241 -
041242 -
041243 -
041244 -
0413 -