CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 59 0000, ref SDS 58 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 090121 1041 Glenna called and said that progression of Millie's
040902 - cancer, most notably in the breastbone area requires UCSF to change
040903 - treatments, as ordered by Doctor Johnson at Kaiser on 081219.  Doctor
040904 - Rugo needs a list of treatments from Millie's records which UCSF has
040905 - planned to treat Millie's cancer as a chronic disease, ref SDS 6 Y67L,
040906 - further ordered by Doctor Johnson at Kaiser on 081219. ref SDS 5 V93O
040908 -  ..
040909 - On 090123 1326 Doctor Johnson confirms prior guidance that multiple
040910 - (7) relapses have mutated Millie's cancer into a very aggressive
040911 - disease that requires immediate change in treatment in order for
040912 - Millie to recover. ref SDS 8 RK6O
040914 -  ..
040915 - On 090129 0800 UCSF delayed Millie's treatment 1 week due to problems
040916 - of missed communication between Oncology and Infusion, reported on
040917 - 090130 1722. ref SDS 9 AY8Q
040919 -  ..
040920 - On 090129 1036 Doctor Rugo at UCSF notified Kaiser that Millie needs
040921 - immediate treatment to recover from 7th relapse of cancer, which is
040922 - worse in the breastbone area, and proposes treatment in UCSF Radiation
040923 - Oncology Department with hyperthermia and Doxil, reported on 090130
040924 - 1722. ref SDS 9 TZ6H
040926 -  ..
040927 - On 090201 2017 UCSF delayed treatment for Millie's 7th relapse of
040928 - cancer, because the Radiation Oncology Department needed more time to
040929 - schedule the work. ref SDS 10 GV4M
040931 -  ..
040932 - On 090202 1047 Kaiser delayed authorization for Millie's treatment
040933 - because the doctor did not fill out a form correctly referring
040934 - Millie's treatment to UCSF. ref SDS 11 9Y5I
040936 -  ..
040937 - On 090202 1353 UCSF delayed treatment again for 6 weeks to maintain an
040938 - orderly schedule. ref SDS 12 SP6H
040940 -  ..
040941 - On 090202 1932 Doctor Rugo at UCSF Oncology Department notified the
040942 - medical team that Millie needs urgent treatment quickly in time to be
040943 - effective. ref SDS 13 Y15J
040945 -  ..
040946 - On 090203 1438 UCSF Radiation Oncology Department advances Millie's
040947 - treatment 4 weeks to begin in time to be effective. ref SDS 14 XX5I
040949 -  ..
040950 - On 090204 0219 Millie's letter asks Doctor Rugo to submit proactive
040951 - planning for follow on treatment after hyperthermia and Doxil for
040952 - Millie's 6th relapse of IBC. ref SDS 15 278T
040954 -  ..
040955 - On 090204 1914 Doctor Rugo defers teamwork for practice synergy and
040956 - proactive management to plan for alternate scenarios that optimize
040957 - coprehensive care is prevented because Millie's case is very
040958 - complicated. ref SDS 16 063I
040960 -  ..
040961 - On 090205 0830 Doctor Hsu examination in UCSF Radiation Oncology
040962 - Department finds Millie's cancer has progressed significantly due to
040963 - delays starting treatment; changes treatment protocol from
040964 - hyperthermia and Doxil to radiation and hyperthermia. ref SDS 17 EY5F
040966 -  ..
040967 - On 090213 1140 Doctor Johnson notifies Millie that she has less than 1
040968 - year to live, ref SDS 19 646L, unless she gets effective treatment
040969 - quickly for cancer that has mutated into aggressive disease that will
040970 - cascade out of control. ref SDS 19 ES7I
040972 -  ..
040973 - On 090218 1205 Millie notifies Doctor Rugo again that Doctor Johnson
040974 - has authorized UCSF Cancer Center to begin planning Millie's next
040975 - treatment after radiation and hyperthremia, because she has a narrow
040976 - margin for delay getting treatment to survive. ref SDS 20 TH6U
040978 -  ..
040979 - On 090219 1315 UCSF begins treatment 4-weeks late on referral from
040980 - Kaiser for Millie to recover from 7th relapse of cancer. ref SDS 21
040981 - E57G
040983 -  ..
040984 - On 090310 0351 after 3-weeks treatment with radiation and
040985 - hyperthermia Millie notifies medical team that cancer in the
040986 - breastbone area seems worse. ref SDS 23 O56X
040988 -  ..
040989 - On 090331 2947 Millie notified medical team of possible IBC
040990 - progression on lower left arm, and asked about starting treatment to
040991 - recover from 8th relapse of cancer. ref SDS 27 Q64R
040993 -  ..
040994 - On 090401 0032 Doctor Hsu diagnosed new rash on Millie's lower left
040995 - arm as progression of IBC. ref SDS 28 R24X
040997 -  ..
040998 - On 090401 0046 Millie asks about getting treatment of IBC spreading to
040999 - lower left arm, which establishes the 8th relapse of cancer diagnosed
041000 - by Doctor Hsu. ref SDS 29 RE8P
041002 -  ..
041003 - On 090401 0121 Doctor Rugo reports Millie's wound in breastbone area
041004 - diagnosed as reaction to 4-weeks of radiation that ended on 090317
041005 - must heal before starting treatment for IBC relapse, and so defers the
041006 - meeting scheduled on 090402 0800; Doctor Rugo expects full recovery
041007 - from IBC in areas treated with radiation and hyperthermia because this
041008 - regimen to be very effective. ref SDS 30 K56O
041010 -  ..
041011 - On 090412 2241 Millie reports again to the medical team that IBC on
041012 - lower left arm is getting worse, and requests immediate treatment in
041013 - order to prevent problems cited by Doctor Johnson that delay risks
041014 - losing control and death. ref SDS 31 9S8Y
041016 -  ..
041017 - On 090510 1220 Millie reports wound in the breastbone diagnosed as
041018 - reaction to radiation looks worse; asks if this might be IBC because
041019 - of a mistake in performing radiation treatments?   Millie further
041020 - asked about doing a biopsy to test for cancer, so that treatment can
041021 - begin immediately under Doctor Johnson's warning that immediate
041022 - treatment is essential for recovery. ref SDS 33 LJ5T
041024 -  ..
041025 - On 090514 0830 Doctor Rugo prescribes treatment with MPA, ref SDS 34
041026 - D647, and submits a letter to Kaiser submitting the protocol,
041027 - ref SDS 34 DI63, as previously requested by Doctor Johnson on 081219
041028 - 1140. ref SDS 5 V93O
041030 -  ..
041031 - On 090515 0800 Doctor Rugo notifies medical team that Kaiser failed to
041032 - perform requirements for referral to pay for Millie's treatment
041033 - recommended by UCSF Cancer Center as the best evidence of care that
041034 - has the best chance for Millie to recover, which Kaiser is required to
041035 - provide under section 2 of EOC. ref SDS 35 WP6S
041037 -  ..
041038 - On 090515 1017 Millie notified medical team that Doctor Rugo's letter
041039 - was received; that Kaiser is responsible for Millie's care, and Millie
041040 - will meet with the primary care doctor at Kaiser on 090515 1140 and
041041 - request that Kaiser prescribe care for Millie's 8th relapse of cancer
041042 - based on the best evidence, ref SDS 36 6Q8W, as shown in Doctor Rugo's
041043 - letter to Kaiser on 090514 0830. ref SDS 34 DI63
041045 -  ..
041046 - On 090515 1518 Doctor Rugo responds wishing Millie "good luck."
041047 - ref SDS 38 PW7H
041049 -  ..
041050 - On 090515 1140 Millie met with Doctor Johnson at Kaiser and the doctor
041051 - said that he was told by Doctor Mason that the primary care physician,
041052 - Doctor Johnson, cannot prescribe standard of care treatment for Millie
041053 - in a clinical trial, despite patient history having prescribed prior
041054 - clinical trials 4 times previously for standard of care in oncology,
041055 - and as a result, Doctor Johnson requested a draft to assist him
041056 - preparing an appeal to file with Member Services so that Kaiser can
041057 - expedite Millie's recovery from the 8th relapse of cancer. ref SDS 37
041058 - 655R
041060 -  ..
041061 - On 090516 0858 Millie notified Doctor Rugo that Doctor Johnson is
041062 - filing an appeal for Kaiser to treat Millie with MPA protocol
041063 - recommended by UCSF to recover from the 8th relapse of cancer.
041064 - ref SDS 39 SY4J
041066 -  ..
041067 - On 090518 0017 Millie submits letter to Doctor Johnson with copy to
041068 - Doctor Rugo at UCSF, and transmitting a draft to assist Doctor Johnson
041069 - filing his appeal with Member Services to assisting Kaiser implement
041070 - Doctor Johnson's strategy to treat Millie's cancer as a chronic
041071 - disease in time for Millie to recover from the 8th relapse of cancer.
041072 - ref SDS 40 R16I
041074 -  ..
041075 - On 090519 1536 Doctor Johnson changed his mind; he sent the draft
041076 - appeal to Doctor Mason, and tells Millie to file an appeal with Member
041077 - Services, which is incorrect since at this time Millie has not been
041078 - denied medical services; and the doctor further says he is suddenly
041079 - relieved of responsibility performed continuously the past 8 years to
041080 - prescribe treatment for Millie to recover from cancer, because
041081 - Kaiser's Outside Referrals Department has a better understanding of
041082 - Medicare. ref SDS 41 5K7H
041084 -  ..
041085 - On 090519 1613 Millie responded, ref SDS 42 8V8H, to the Doctor's
041086 - letter earlier yesterday afternoon on 090519 1536, ref SDS 41 5K7H;
041087 - and, Millie asks the doctor to prescribe treatment so she can recover
041088 - from cancer, as done previously in patient history, ref SDS 42 TY3X,
041089 - and further as planned by the doctor during the meeting on 090515
041090 - 1140. ref SDS 37 655R  Millie also asked the doctor to call on
041091 - expediting treatment in time to be effective, see again on 090520
041092 - 1613, ref SDS 42 TY4W; and Millie asks Doctor Rugo for a "drop dead"
041093 - date on how soon treatment must start in order to be effective, also,
041094 - reported on 090519 1613. ref SDS 42 TX4W
041096 -  ..
041097 - Since Kaiser has delayed ordering treatment, reported on 090520 1710.
041098 - ref SDS 48 ZF4Q, then on 090521 0211 Millie's letter to Doctor Rugo at
041099 - UCSF with copy to Doctor Hsu asks about getting treatment with
041100 - hyperthermia and Doxil, while Kaiser resolves delays ordering MPA
041101 - prescribed by Doctor Rugo for Millie to recover from 8th relapse of
041102 - cancer, which Millie reports is getting worse every day, ref SDS 49
041103 - FM7Q, and since Kaiser has previosuly authorized treatment with
041104 - hyperthermia and Doxil, which Doctor Rugo recommended earlier on
041105 - 090129 for Millie to recover from the 7th relapse. ref SDS 49 6M4F
041107 -  ..
041108 - On 090521 2006, Millie received a letter from Doctor Johnson
041109 - responding to Millie's letter to the medical team on 090520 1710, and
041110 - requesting that Kaiser prescribe treatment suitable for Millie's
041111 - patient profile for recovering from 8th relapse of cancer. ref SDS 48
041112 - P65H   Doctor Johnson's letter was sent through Kaiser's Knowledge
041113 - Management System and so was not disclosed to the medical team, and it
041114 - did transmit the Doctor Johnson's medical chart for the meeting on
041115 - 090515, ref SDS 37 YT5N, and said that Millie could "choose" any
041116 - treatment she wants, and no treatment is superior for Millie's patient
041117 - profile, 090521 2006, ref SDS 51 9Q9H; the doctor noted Millie's
041118 - cancer is progressing and so she needs to start treatment by the end
041119 - of the week, which was in just 12 hours, which means today,
041120 - ref SDS 51 HC8O, and the doctor told Millie to call Medicare for
041121 - prescribing treatment to recover from the 8th relapse of cancer.
041122 - ref SDS 51 HC93
041124 -  ..
041125 - On 090522 0813 Millie responded to Doctor Johnson's letter on 090521
041126 - 2006 and submitted copies to the medical team to maintain
041127 - collaboration that has been effective treating Millie the past 8
041128 - years.  Millie also sent a copy to Jullian Kwok to notify Medicare
041129 - that Kaiser is refusing treatment. ref SDS 52 RX6L  Millie asked
041130 - Kaiser to prepare a workup and Tumor Board to evaluate Millie's next
041131 - treatment, including trade-offs comparing all of the treatments
041132 - available for Millie. ref SDS 52 7Z5Y  Millie reports having called
041133 - Kaiser numerous times to speak with the doctor on prescribing
041134 - treatment. ref SDS 52 7Z9Y  Millie notifies medical team she chooses
041135 - hyperthermia and radiation, Doxil, or other agent suitable for
041136 - Millie's patient profile. ref SDS 52 715V
041138 -  ..
041139 - On 090522 1247 Millie received a response from Doctor Johnson to
041140 - Millie's letter on 090522 0813. ref SDS 52 RX6L who sent copies to the
041141 - medical team, and saying Kaiser has performed workups, but does not
041142 - submit any works, and says Millie's patient profile is too complex for
041143 - Tumor Board to evaluate best course of treatment, and that Millie's
041144 - patient profile resists single agent treatments like Gemzar and
041145 - Navelbine, and that Millie can choose Hospice instead of treatment
041146 - with drugs which her patient profile now resists. ref SDS 53 XO5O
041148 -  ..
041149 - On 090522 1351 Millie responded to Kaiser's letter submitted by Doctor
041150 - Johnson on 090522 1247, ref SDS 53 XO5O, confirming Millie needs
041151 - urgent treatment to start quickly, reported on 090522 1351,
041152 - ref SDS 54 7R7J; Millie asks if treatment with Gemzar, Navelbine, and
041153 - possibly CTP, ref SDS 54 2T9W and ref SDS 54 2T4P, will be weeks of
041154 - agony then progression of cancer that requires another treatment
041155 - "targeted" to treat Millie's patient profile. ref SDS 54 2T4S  Millie
041156 - requested advice on treatment with a clinical trial at Kaiser, based
041157 - on patient history, ref SDS 54 2T4V, and further requested trade-offs
041158 - getting more hyperthermia and radiation and Doxil or other appropriate
041159 - agent, including vaccines. ref SDS 54 2T4Y
041160 -
041162 -  ..
041163 - Millie Over-treated Cannot Estimate Time to Progression
041164 - May Not Work at All Millie Over-treated Patient Profile Resists Chemo
041165 - Unfortunately Chemotherapy Drugs Proposed by Kaiser May Not Work at All
041166 - Targeted Treatment Essential Millie's Patient Profile to Recover 8th Relapse
041167 -
041168 - Follow up ref SDS 59 NM6J.
041169 -
041170 - On 090522 1953 Millie received a letter from Doctor Johnson responding
041171 - to Millie's letter to the medical team at Kaiser and UCSF this
041172 - afternoon, reported on 090522 1351. ref SDS 54 7R7J  For some reason,
041173 - the doctor he did not submit copies to the medical team, demonstrating
041174 - uneven case management for coordination and collaboration; the doctor
041175 - confirms that treatment with single-agent chemotherapies presented as
041176 - the only choices for care may not work at all for Millie to recover
041177 - from 8th relapse of cancer. ref SDS 55 NV4L
041178 -
041179 -
041181 -  ..
041182 - Demand for Treatment Standard of Care Millie's Patient Profile
041183 -
041184 - Follow up ref SDS 59 ON8G, ref SDS 58 ON8G.
041185 -
041186 - On 090523 0148 Millie sent a letter to Paula in the Kaiser Claims
041187 - Resolution Department with copy to medical team demanding treatment to
041188 - recover from 8th relapse applying standard of care for Millie's
041189 - patient profile. ref SDS 56 2P6J
041190 -
041192 -  ..
041193 - Kaiser Defaults Insurance Contract Millie Orders Work from Others
041194 -
041195 - Follow up ref SDS 59 UD5H, ref SDS 58 UD5H.
041196 -
041197 - On 090528 0803 called Paula for progress processing Millie's claim for
041198 - treatment with standard of care for Millie's patient profile.
041199 - ref SDS 58 T04L
041201 -  ..
041202 - On 090528 1228 Millie sent a letter to Paula confirming claim
041203 - demanding timely treatment for 8th relapse of cancer. ref SDS 59 UD5H
041204 - and saying that she will get treatment through another provider and
041205 - bill Kaiser, because her doctor at Kaiser says Millie needs immediate
041206 - treatment, and Kaiser has failed to perform. 090528 1228, ref SDS 59
041207 - 4N8X
041208 -
041209 -
041211 -  ..
0413 -
0414 -
0415 - Progress
0416 -
041601 - UCSF Asked for Treatment Mitigate Damages Kaiser Refusal to Perform
041602 -
041603 - Follow up ref SDS 59 UD5H, ref SDS 58 UD5H.
041604 -
041605 - On 090528 1334 Millie sent a letter to Doctor Rugo and Doctor Hsu at
041606 - UCSF requesting treatment, ref SDS 0 UD5H, and sent a copy to notify
041607 - the medical team she has been forced to get treatment from another
041608 - provider to mitigate damages from Kaiser's failure to provide care.
041609 - ref SDS 0 2L7P
041610 -
041611 -    1.  Subject: Treatment Plan 8th Relapse of Cancer Kaiser's Standard of Care
041612 -        Date: Thu, 28 May 2009 14:05:05 -0700
041622 -         ..
041623 -    2.  As you know, I have been discussing with Kaiser prescribing
041624 -        treatment for my 8th relapse of cancer [see patient history,
041625 -        reported on 090528 1334, ref SDS 0 CI7J].  Kaiser has discussed
041626 -        Navelbine, Gemzar, CPT [reported on 090522 1351. ref SDS 54
041627 -        2T4P], hyperthermia with radiation or other modalities,
041628 -        including chemotherapy with Doxil, bevacizumab, and with
041629 -        clinical trials [see Millie's letter to Paula in Kaiser Member
041630 -        Services Claims Resolution reported on 090528 1228. ref SDS 59
041631 -        4N5U].  However, no treatment has been prescribed [see Kaiser's
041632 -        letter to Millie failing to prescribe treatment on 090522 1953.
041633 -        ref SDS 55 NV4L, and noted in Millie's letter to Paula reported
041634 -        on 090523 0148. ref SDS 56 DQ9Q]
041636 -         ..
041637 -    3.  Communication today with Kaiser indicates performing Kaiser's
041638 -        procedures to order care will significantly delay treatment
041639 -        [reported on 090528 1228, ref SDS 59 4M6Y and ref SDS 59 4N7U].
041640 -        My last systemic treatment was on 090122, ref SDS 7 AT6N, and
041641 -        my last treatment with radiation and hyperthermia was on
041642 -        090317. ref SDS 25 9L7K  Progression was reported by Tara in
041643 -        your office on 090423, ref SDS 32 DW6F, and later by Doctor Hsu
041644 -        on the same day. ref SDS 32 UG5L  Your examination on 090514
041645 -        found that my IBC has progressed further, still mostly on my
041646 -        left arm, but beginning in other areas outside those treated
041647 -        with radiation and hyperthermia. ref SDS 34 5U4M
041648 -
041650 -  ..
041651 - Cancer Untreated 2 Months Kauser UCSF Ignore Requests for Timely Care
041652 - Millie Mitigates Damages Authorizes Payment to UCSF for Timely Treatment
041653 - Lymphedema Left Arm Worsens Because Kaiser Refused Treatment IBC
041654 -
041655 -
041656 -    4.  Right now I am feeling very good.  IBC has compounded
041657 -        lymphedema on the left arm.  Patient history shows if I do not
041658 -        get treatment soon, I will decline quickly toward death
041659 -        [notified by Doctor Johnson, primary care physician during
041660 -        meetings at Kaiser beginning on 080829, shown by case study on
041661 -        090325. ref SDS 26 L15M  On 090213, when IBC got very bad and
041662 -        the cancer marker soared to the highest level because I was
041663 -        without treatment for a month, Doctor Johnson said I had less
041664 -        than a year to live, ref SDS 19 9L7N [unless I get timely
041665 -        treatment at UCSF for cancer as a chronic disease. ref SDS 19
041666 -        WZ6K].  Doctor Hsu then advanced my treatment date, and this
041667 -        demonstrated that I can still respond well to treatment, when
041668 -        provided in time.
041670 -         ..
041671 -    5.  Since I have been without treatment now for 2 months, I have
041672 -        told Kaiser that in order to allow time for steps Kaiser needs
041673 -        to prescribe my treatment, I will personally authorize payment
041674 -        for your time to prescribe treatment and submit your bill and
041675 -        the prescription to Kaiser.  If Kaiser does not prescribe
041676 -        treatment, I will authorize UCSF to provide treatment and
041677 -        recover costs from Kaiser, as based on best evidence and
041678 -        medical necessity [Millie's letter to Paula with Member
041679 -        Services Claims Resolution reported on 090528 1228. ref SDS 59
041680 -        4N8X].
041682 -         ..
041683 -    6.  Can you please let me know what I need to do to start treatment
041684 -        as soon as possible, or as you feel is required.
041685 -
041686 -            [On 090528 1613 Doctor Rugo prescribes a new treatment
041687 -            starting next week with gemcitabine at Kaiser. ref SDS 60
041688 -            XZ4M
041690 -             ..
041691 -            [On 090528 1652 Millie responded to Doctor Rugo's letter
041692 -            notifying medical team again that she needs a prescription
041693 -            to recover from the 8th relapse of cancer, and asking for
041694 -            comparison of the new treatment proposed by Doctor Rugo
041695 -            with other treatments the team has presented. ref SDS 61
041696 -            MZ7N
041698 -             ..
041699 -            [On 090610 0122 notified Paula in Claims Resolution
041700 -            Department that UCSF medical mistakes require UCSF to
041701 -            provide treatment for Millie to recover. ref SDS 62 855G
041703 -             ..
041704 -            [On 090610 0930 Paula advised that UCSF is liable to Kaiser
041705 -            for fixing medical mistakes performing radiation services
041706 -            for Millie on referral from Kaiser. ref SDS 63 855G
041707 -
041708 -
041715 -
041716 -
041717 -
041718 -
041719 -
041720 -
041721 -
041722 -
041723 -
041724 -
0418 -