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: July 27, 2009 08:12 PM Monday; Rod Welch

Millie notified Paula Kaiser and UCSF liable for damages medical mistakes.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 18 0000, ref SDS 17 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - On 090725 2017 Millie notified medical team with copy to Paul in
040902 - Kaiser's Member Services Claims Resolution Department that Millie has
040903 - suffered damages from medical mistakes, and demands recovery from
040904 - Kaiser and UCSF. ref SDS 16 R25J
040906 -  ..
040907 - On 090727 1119 called for Doctor Mason to get Kaiser's work plan for
040908 - recovering damages from UCSF for medical mistakes performing radiation
040909 - treatments on referral from Kaiser. ref SDS 17 BD5I
040911 -  ..
040912 - On 090727 1153 Millie called Paula and advised that Doctor Mason in
040913 - Kaiser's Outside Referrals did not respond to Millie's call earlier
040914 - this morning, 0n 090727 1119, ref SDS 17 BD5I, so called Paula to get
040915 - assistance. ref SDS 18 BD5I  Paula planned to investigate and call back
040916 - with report on Kaiser's progress securing Millie's rights under the
040917 - referral for medical mistakes by UCSF. ref SDS 18 J080
040919 -  ..
040920 - On 090727 2012 summary of the record Paula has reviewed on Millie's
040921 - claim for standard of care to recover from injuries caused by medical
040922 - mistakes getting radiation treatments at UCSF on referral from Kaiser.
040923 - ref SDS 18 BD5I
040925 -  ..
040926 - On 090727 2012 Paula did not call back, so Millie sent a letter
040927 - confirming demand for recovery of damages to correct medical mistakes,
040928 - including treatment to recover from 8th relapse of cancer as
040929 - previously presented to Kaiser Claims Department on 090520 1203.
040930 - ref SDS 11 9595
040931 -
040932 -    1.  Subject: Recover Medical Mistake at UCSF on Referral from Kaiser Authorization # A023141470
040933 -        Date: Mon, 27 Jul 2009 20:49:39 -0700
040940 -         ..
040941 -    2.  Confirming your telecon with Rod this morning you plan to
040942 -        investigate who at Kaiser has responsibility to obtain relief
040943 -        for me from UCSF medical mistakes [reported on 090727 1153.
040944 -        ref SDS 18 BD5I, and cited in Millie's letter to the medical
040945 -        teamm, including Paula in the Claims Resolution Department,
040946 -        submitted a few days ago on 090725 2017. ref SDS 16 R262]
040947 -        providing radiation services on referral from Kaiser under
040948 -        authorization # A023141470 dated 090202, shown in the record on
040949 -        090205. ref SDS 5 278T
040951 -         ..
040952 -    3.  Kaiser and UCSF were notified I suffered damages from
040953 -        progression of disease, and I requested treatment throughout
040954 -        April and May to prevent disease from worsening.  My concern
040955 -        was that untreated disease, like inflammatory breast cancer
040956 -        (IBC), becomes terminal.
040957 -
040958 -            [On 090730 1129 Paula in Kaiser Claims Resolution
040959 -            Department corridinating to get relief at Kaiser for
040960 -            Millie's injuries caused by UCSF medical mistakes providing
040961 -            radiation treatment on referral from Kaiser. ref SDS 19
040962 -            BD5I
040964 -         ..
040965 -    4.  On 090609 Doctor Hsu, attending physician for my radiation
040966 -        treatment, advised that UCSF made a medical mistake by failing
040967 -        to treat IBC in my breastbone area. ref SDS 12 W65W  This was
040968 -        the area where cancer was most concentrated on my body, cited
040969 -        in Doctor Rugo's letter on 090129 [reported on 090130 1722.
040970 -        ref SDS 2 TZ6H, and observed by Doctor Hsu during examination
040971 -        on 090205, at UCSF to plan my radiation traetments, ref SDS 4
040972 -        FQ8W], and it has been untreated since 090122 the date prior
040973 -        treatment with sunitinib was stopped by Doctor Rugo due to
040974 -        progression. ref SDS 1 AT6N  Doctor Hsu indicated during the
040975 -        meeting on 090609 that untreated IBC in the breastbone may be
040976 -        causing breathing problems, ref SDS 12 R24G, which later landed
040977 -        me in the ER last Monday on 090720. ref SDS 15 GE5H  He further
040978 -        observed that areas he did treat with radiation in February and
040979 -        March showed no signs of IBC on 090609, and, also, that IBC was
040980 -        suddenly spreading outside areas he treated, where it had never
040981 -        occurred previously in 8 years of disease.  Obviously,
040982 -        something caused sudden spread of disease.
040984 -         ..
040985 -    5.  A reasonable inference is that untreated IBC disease has caused
040986 -        me to suffer expanding maladies that have now become severe due
040987 -        to failure to provide timely treatment, following initial
040988 -        notice on 090331, ref SDS 7 Q64R, [and Millie's request for
040989 -        treatment on 090401, ref SDS 8 RE8P, and delayed by Doctor
040990 -        Rugo believing diagnosis that the wound in the breastbone was
040991 -        reaction to radiation, ref SDS 9 K56O, which was changed on
040992 -        090609 to untreated IBC, ref SDS 12 W65W], and follow up notice
040993 -        of worsening condition, with request for treatment on 090412.
040994 -        ref SDS 10 9S8Y
040996 -         ..
040997 -    6.  This and subsequent requests for treatment were ignored during
040998 -        April and May, because the team was not yet aware expanding
040999 -        disease was caused by IBC untreated for 6 months.  On 090609
041000 -        Doctor Hsu determined a medical mistake occurred in February
041001 -        and March doing radiation that caused my problem. ref SDS 12
041002 -        W65W
041004 -         ..
041005 -    7.  On 090609 Doctor Hsu proposed that UCSF would correct the
041006 -        problem by treating Millie with MPA in a clinical trial under
041007 -        Doctor Rugo. ref SDS 12 W66W  On 090616 Doctor Rugo advised
041008 -        "everybody" at Kaiser and UCSF is "on board" to give me
041009 -        treatment required to recover from the UCSF medical mistake.
041010 -        She described a series of treatments lined up to maintain my
041011 -        care in the event that the initial effort to recover with MPA
041012 -        was not effective. ref SDS 14 D647
041014 -         ..
041015 -    8.  However, on 090716, the doctor's assistant, Tara called late at
041016 -        night and said UCSF does not have treatments lined up for me,
041017 -        and so I was forced get treatment with Gemzar at Kaiser despite
041018 -        conflicts with Kaiser's published guidance for my patient
041019 -        profile.
041021 -         ..
041022 -    9.  I am concerned that Kaiser is forcing me to get treatment which
041023 -        the doctor says probably won't work, and conflicts with my
041024 -        patient profile, and is offering Hospice to ease transition
041025 -        toward death, when I have "ECOG performance score 0" in the
041026 -        latest examination at Kaiser on 090724, meaning that, with
041027 -        treatment, I am as healthy as you, the doctor, or anyone else
041028 -        without medical maladies.  Denying a perfectly healthy person
041029 -        essential treatment, conflicts with standard of care.
041031 -         ..
041032 -   10.  In my letter to the team on Saturday (shown below) confirming
041033 -        understandings meeting with Doctor Johnson on 090724, I cited
041034 -        standard of care for evidence-based medicine that requires
041035 -        Kaiser to...
041036 -
041037 -            "...determine which treatment methodology is going to
041038 -            result in the most positive outcome with the least cost in
041039 -            terms of suffering, time, and money." [reported on 090725
041040 -            2017. ref SDS 16 T58U]
041041 -
041043 -         ..
041044 -   11.  For several years, Doctor Johnson has known Kaiser does not
041045 -        have treatments for my patient profile.  He sent me to UCSF to
041046 -        get additional treatments.  In October of last year he began
041047 -        reminding me to ask UCSF for a list of follow on treatments to
041048 -        ensure I can remain healthy.  He called this "treating my
041049 -        cancer as a chronic disease."
041051 -         ..
041052 -   12.  Pursuant to the doctor's recommendation, I commissioned a 2nd
041053 -        opinion, and on 090204 I received a list of 10 or so possible
041054 -        treatments that fit my complex patient profile. ref SDS 3 4R3S
041056 -         ..
041057 -   13.  During the meeting on 090325 Doctor Johnson requested this list
041058 -        of additional treatments, and I submitted it to both Doctor
041059 -        Johnson and Doctor Rugo the next day on 090326. ref SDS 6 DW5S
041061 -         ..
041062 -   14.  Accordingly, Doctor Johnson and Doctor Rugo have a list of 10
041063 -        or so treatments that may be better for my patient profile than
041064 -        Gemzar, because, according to Doctor Johnson, Gemzar probably
041065 -        won't be effective for me.
041067 -         ..
041068 -   15.  At this time, there is no evidence that coordination and
041069 -        collaboration with Doctor Johnson, which Doctor Rugo described
041070 -        on 090616, has not actually occurred.
041072 -         ..
041073 -   16.  Similarly, Doctor Johnson disclosed on 090724 that no
041074 -        collaboration has occurred with Doctor Rugo since 090716, to
041075 -        coordinate my care, contrary to what was represented to me by
041076 -        Doctor Rugo's assistant, Tara, on 090716.  Why?  Because it
041077 -        seems Doctor Rugo and Doctor Johnson are working with the
041078 -        paradigm of me having received all of the treatments available
041079 -        at Kaiser and UCSF for my patient profile, and they have
041080 -        nothing left to offer.
041082 -         ..
041083 -   17.  That is not true.  Doctor Johnson and Doctor Rugo have
041084 -        expertise to provide standard of care to recommend "...which
041085 -        treatment methodology is going to result in the most positive
041086 -        outcome with the least cost in terms of suffering, time, and
041087 -        money," regardless of where that treatment is provided.  The
041088 -        duty to correct medical mistakes is not limited to remedies
041089 -        folks have on the shelf.
041091 -         ..
041092 -   18.  The next step in my care is for Kaiser to send a letter
041093 -        referencing the referral authorization and notify UCSF to
041094 -        submit a "work up" and treatment plan for correcting medical
041095 -        mistakes, and which includes a survey of all sources for my
041096 -        care, including the list submitted to Kaiser and UCSF on
041097 -        090326,  and ordering solutions according availability,
041098 -        effectiveness, side effects, and cost.
041100 -         ..
041101 -   19.  Doctor Johnson can then assist me in choosing the most viable
041102 -        course of action, as he has done all along.
041104 -         ..
041105 -   20.  This is not beyond UCSF capabilities.  Doctor Rugo's research
041106 -        partner, Doctor Benz has issued 2 such reports in my case, each
041107 -        about 10 pages in length, and each resulting in life saving
041108 -        solutions for me.
041110 -         ..
041111 -   21.  If UCSF fails to perform, then Kaiser can hire the work done by
041112 -        others, for example, MD Anderson, Stanford, etc., and send the
041113 -        bill to UCSF.  One way or the other a comprehensive review is
041114 -        required to develop a treatment plan to recover from medical
041115 -        mistakes in this case.
041117 -         ..
041118 -   22.  I assume Doctor Mason in the Kaiser Outside Referrals
041119 -        Department can take the necessary action.  He was asked to do
041120 -        this on 090610.  I have seen no evidence that Kaiser has taken
041121 -        necessary action.
041123 -         ..
041124 -   23.  Similarly, my current treatment at Kaiser should be billed to
041125 -        UCSF as the cost of recovering from medical mistakes.
041126 -        Nominally, Kaiser and UCSF can reach an accommodation on cost
041127 -        that does not diminish my chances of recovery.
041128 -
041129 -            [On 090730 1129 Paula in Kaiser Claims Resolution
041130 -            Department corridinating to get relief at Kaiser for
041131 -            Millie's injuries caused by UCSF medical mistakes providing
041132 -            radiation treatment on referral from Kaiser. ref SDS 19
041133 -            BD5I
041135 -         ..
041136 -   24.  In your call with Rod this morning, you had a hearing to
041137 -        attend, and then planned to consider my case toward reaching a
041138 -        cost effective solution.
041140 -         ..
041141 -   25.  I am getting Gemzar at Kaiser in Walnut Creek in the morning at
041142 -        0930 as a stop gap measure pending getting a treatment required
041143 -        to recover from UCSF medical mistakes.  Please call Rod in the
041144 -        afternoon after 1300; we should be home by then.
041145 -
041152 -
041153 -
041154 -
041155 -
041156 -
041157 -
041158 -
0412 -