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SUBJECTS
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0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 23 0000. ref SDS 22 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Millie notified the medical team on Sunday night that side effects of
040902 - radiation treatment which ended on 090317 continued to cause serious
040903 - problems reported on 090607 2253. ref SDS 14 KS5N  On Monday, Doctor
040904 - Hsu scheduled a meeting for yesterday morning on 090609 0900 at UCSF
040905 - Radiology Oncology, reported on 090608 1331. ref SDS 15 KS5N  Millie
040906 - notified the medical team that Doctor Hsu scheduled to meet with
040907 - Millie on 090609 about treatment for continuing side effects of
040908 - radiation treatments in the breastbone area, reported on 090608 1346.
040909 - ref SDS 16 FC3K
040911 -  ..
040912 - Yesterday, on 090609 0900 Millie met with Doctor Hsu, as requested.
040913 - ref SDS 17 TP9L
040915 -  ..
040916 - The doctor made findings that the bleeding wound in the breastbone
040917 - area was not side effects of radiation, but was caused by progression
040918 - of cancer, which occurred because UCSF failed to treat IBC in the
040919 - breastbone area with radiation during February and March, ref SDS 17
040920 - W65W, contrary to treatment ordered by Doctor Rugo, reported to the
040921 - medical team on 090130 1722, ref SDS 2 4S8O, citing the meeting with
040922 - the doctor the day before on 090129, and authorized on referral by
040923 - Kaiser, reported on 090205 1426. ref SDS 4 278T
040925 -  ..
040926 - This appears to be a medical mistake.
040928 -  ..
040929 - Doctor Hsu advised that Millie's recent breathing problems with cough,
040930 - heavy chest, and shortnes of breath, especially hiking are caused by
040931 - buildup in the lungs resulting from progression of IBC that was not
040932 - treated during the Feb-Mar radiation and hyperthermia program.
040933 - ref SDS 17 EK8J  Allowing IBC to go untreated for 6 months has enabled
040934 - spread of disease, reported initially to the medcal team on 090331
040935 - 2047. ref SDS 6 Q69V  Millie's letter to the medical team earlier this
040936 - morning presented these understandings, reported on 090610 0043.
040937 - ref SDS 21 N630  Another concern is that UCSF over-radiated the lungs
040938 - while treating IBC outside the breastbone area, shown in the radiation
040939 - treatment plan received from UCSF on 090226 1342. ref SDS 5 D452
040940 - Millie may be suffering radiation injury from failure to accurately
040941 - coorelate radiation amounts with patient history of prior radiation
040942 - treatments, which was presented to UCSF during the meeting on 090205
040943 - 0830. ref SDS 3 PN8H  Doctor Hsu advised that the best course of
040944 - treatment for Millie to recover is with the MPA protocol in the Breast
040945 - Care Clinic, ref SDS 17 1P42, proposed by Doctor Rugo to Kaiser on
040946 - 090514. ref SDS 8 D647
040948 -  ..
040949 - Doctor Hsu requested a CT test to determine if Millie has fluid on the
040950 - lungs and whether if so, it is mild enough to still permit treatment
040951 - with MPA. ref SDS 17 1P3K
040953 -  ..
040954 - Called Kaiser yesterday afternoon and reported UCSF discovering
040955 - medical mistakes performing radiation in Feb-Mar, causing Millie's
040956 - cancer to get worse, and causing breathing problems, reported on
040957 - 090609 1427. ref SDS 19 MW5H  Doctor Johnson was not aware Millie is
040958 - entitled to all reasonable and necessry medical treatment required to
040959 - recover from UCSF medical mistakes. ref SDS 19 KS3K
040961 -  ..
040962 - Early this morning, Millie notified the medical team that UCSF
040963 - reported findings of medical mistake causing Millie's cancer to worsen
040964 - and causing breathing problems, reported on 090610 0043. ref SDS 21
040965 - N630
040967 -  ..
040968 - Sent a letter to Paula notifying Kaiser Claims Department about
040969 - medical mistakes at UCSF, and requirements for Kaiser to obtain
040970 - recovery for Millie, reported on 090610 0122. ref SDS 22 855G
040972 -  ..
040973 - Called Paula this morning following up letter notifying Paula in
040974 - Kaiser Claims Department that Millie is entitled to be treated by UCSF
040975 - to recover from medical mistakes, and UCSF is responsible to Millie
040976 - and to Kaiser for reasonable and necessary costs of care for Millie to
040977 - recover. 090610 0122, ref SDS 22 855G
040979 -  ..
040980 - Paula feels that Doctor Mason in Outside Referrals Department at
040981 - Walnut Creek should be the Kaiser's lead on case management, reported
040982 - on 090610 0930, ref SDS 23 FU6L, since Outside Referrals issued
040983 - referral authorization A023141470 received on 090205 1426. ref SDS 4
040984 - 278T
040986 -  ..
040987 - Sent a letter to Doctor Mason, per telecon with Paula, and demanding
040988 - Kaiser submit a work plan for Millie to recover from medical mistakes
040989 - at UCSF providing health care services for Millie on referral from
040990 - Kaiser, reported on 090610 1032. ref SDS 0 1Q7J
040991 -
040992 -    1.  Subject: Millie's Dispute with Kaiser Resolved by UCSF Mistake
040993 -        Date: Wed, 10 Jun 2009 10:57:07 -0700
041002 -         ..
041003 -    3.  I spoke with Paula McPhail this morning in Member Case
041004 -        Resolution Center (MCRC) [reported on 090610 0930. ref SDS 23
041005 -        855G].  As you know we have been discussing expediting Millie's
041006 -        treatment for an 8th relapse of IBC [see background on 090520
041007 -        1203. ref SDS 9 9595]  Her primary care physician, Doctor
041008 -        Johnson, prescribed treatment with Gemzar on 090601 0818,
041009 -        ref SDS 10 PQ7V, and this has been scheduled by Kaiser to start
041010 -        tomorrow on 090611 1400 at Kaiser in Walnut Creek [reported in
041011 -        a telecon from Queenie with the Kaiser Pharmacy on 090603 1524,
041012 -        ref SDS 11 6W9H].
041014 -         ..
041015 -    4.  Millie disputes that Kaiser has prescribed the correct
041016 -        treatment, and [maintains] that Kaiser has a duty to prescribe
041017 -        MPA on clinical trial at UCSF, recommended by Doctor Rugo in a
041018 -        letter to Kaiser on 090514, or such other treatment that meets
041019 -        standard of care for Millie's patient profile.
041021 -         ..
041022 -    5.  Examination yesterday at UCSF indicates UCSF made a mistake
041023 -        providing medical services [reported on 090609 0900.
041024 -        ref SDS 17 W65W] on referral from authorization # A023141470
041025 -        issued by your office dated 090202 [received by Millie on
041026 -        090205 1426. ref SDS 4 278T]  Details are shown in Millie's
041027 -        letter to the medical team yesterday [on 090610 0043.
041028 -        ref SDS 21 N630]
041030 -         ..
041031 -    6.  Millie has authorized me to represent her in this matter at the
041032 -        administrative level.
041034 -         ..
041035 -    7.  Paula seemed to indicate this morning that your office has
041036 -        primary responsibility to demand that UCSF submit a treatment
041037 -        plan [reported on 090610 0930. ref SDS 23 FU6L] to correct the
041038 -        mistake that has placed Millie in severe duress with her
041039 -        survival at high risk as each day passes without a competent
041040 -        treatment plan.
041042 -         ..
041043 -    8.  Doctor Hsu who met with Millie yesterday at UCSF and discovered
041044 -        the mistake in performing radiation services advised that UCSF
041045 -        would submit a treatment plan to Kaiser for Millie to recover
041046 -        from the UCSF medical mistake [reported on 090609 0900.
041047 -        ref SDS 17 1P3K]
041049 -         ..
041050 -    9.  Millie wants a copy of the UCSF plan.  The outlines of the plan
041051 -        are in Millie's letter to the medical team shown below, however
041052 -        this should be formalized as Doctor Hsu said UCSF would do.
041054 -         ..
041055 -   10.  As noted, Millie is scheduled to get treatment tomorrow with
041056 -        Gemzar at Kaiser.  Based on the evidence yesterday, this
041057 -        treatment may be required at UCSF, as part of their
041058 -        responsibility to correct their mistake.  Kaiser should demand
041059 -        documentation from UCSF that Gemzar is the best possible option
041060 -        and what steps UCSF will perform to prevent problems cited in
041061 -        Kaiser's published guidance for patients with Millie's patient
041062 -        profile getting Gemzar.  In other words Kaiser is entitled to
041063 -        have proof that UCSF has performed planning to prevent another
041064 -        mistake.
041066 -         ..
041067 -   11.  Doctor Johnson ordered a CT test [reported on 090609 1427.
041068 -        ref SDS 19 PPVY] and this has been scheduled for Friday to
041069 -        assess whether UCSF's mistake compounded Millie's health
041070 -        problems by causing fluid on the lungs from the IBC tumor in
041071 -        the middle of chest.  Doctor Hsu requested the test to help
041072 -        UCSF develop the best treatment plan [reported on 090609 0900.
041073 -        ref SDS 17 W66T
041075 -         ..
041076 -   12.  Please confirm this is a contract issue your office will manage
041077 -        for Kaiser in securing the best care for Millie from UCSF for
041078 -        correcting their mistake.  I expect that Doctor Johnson will
041079 -        continue to provide medical oversight, as he has the past 3
041080 -        years for Millie's care at UCSF.
041082 -         ..
041083 -   13.  The immediate issue is whether Millie should get treatment with
041084 -        Gemzar tomorrow, which at this time facially conflicts with
041085 -        Kaiser's published guidance [reported on 090605 1447.
041086 -        ref SDS 12 V34K]  Or, should she wait for results of the CT
041087 -        test for UCSF to submit an alternative plan.  At this time,
041088 -        Kaiser seems positioned to demand UCSF perform on the referral
041089 -        in February, however, at all times, Millie holds Kaiser
041090 -        accountable for her care.
041092 -         ..
041093 -   14.  Doctor Hsu indicated yesterday that the MPA treatment is the
041094 -        best course of immediate treatment, and after MPA he would
041095 -        radiate the problem area that was missed previously [reported
041096 -        on 090609 0900. ref SDS 17 1P42]  However, there may be a
041097 -        problem getting MPA now that Millie may have fluid on the lungs
041098 -        caused by the mistake in radiation treatment.  So, should we
041099 -        wait for the CT test on Friday, or get Gemzar tomorrow?  UCSF
041100 -        should decide this today.
041102 -         ..
041103 -   15.  I will call you this morning to discuss Kaiser's work plan for
041104 -        this new situation.
041105 -
041106 -               [On 090611 1632 Doctor Rugo's coordinator for Millie's
041107 -               care at UCSF, sent a letter to Kaiser asking where to
041108 -               send a requisition to pay for lab work at Kaiser which
041109 -               was ordered for Millie's treatment at UCSF to recover
041110 -               from radiation medical mistakes. ref SDS 25 YU3N
041112 -                ..
041113 -               [On 090616 1240 during meeting at UCSF Doctor Rugo
041114 -               notified Millie that UCSF and Kaiser have agreed in a
041115 -               letter that everybody is on board to treat Millie's
041116 -               cancer as a chronic disease for recovering from medical
041117 -               mistakes treating Millie with radiation at UCSF, and
041118 -               that Millie's next treatment after MPA will be with
041119 -               PARP. ref SDS 26 KD6L
041121 -         ..
041122 -   16.  Thanks very much for your assistance.
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