CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 21 0000. ref SDS 4 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 010427 0830 meeting at Kaiser - Doctor Johnson notes Millie looks
040902 - so good nobody can believe she has such severe cancer, ref SDS 2
040903 - OJ6I; the doctor explained again Millie's cancer has mutated through
040904 - 11 relapses to resist chemotherapy.  The doctor advised that Kaiser
040905 - has a new strategy prescribing therapy that is effective for treating
040906 - cancer as a chronic disease by "targeting" the genetic profile of
040907 - cancer that has mutated in patients, like Millie, to resist
040908 - chemotherapy. ref SDS 2 SJ6N
040910 -  ..
040911 - On 100501 1037 Millie letter to medical team confirms Kaiser's new
040912 - strategy to treat Millie's cancer with "targeted therapy." ref SDS 3
040913 - F25O  Millie requests Kaiser immediately switch from Abraxane
040914 - chemotherapy that has failed, and implement Doctor Rugo's plan at UCSF
040915 - on 090616, to treat Millie with PARP that is "targeted" to Millie's
040916 - rare patient profile of "triple negative" and avoids pain and
040917 - suffering from chemotherapy side effects, and for the purpose of
040918 - recovering from UCSF medical mistakes. ref SDS 3 U47P and ref SDS 3
040919 - U49V
040921 -  ..
040922 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040923 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040924 - of cancer caused by UCSF medical mistakes. ref SDS 4 HH4I
040926 -  ..
040927 - On 100502 2143 Kaiser confirms that some patients respond well to new
040928 - "targeted" therapies. ref SDS 5 YX8L  Kaiser contends that all of the
040929 - strategies for "targeted" therapies have been executed for Millie,
040930 - which seems conflicting with the record in this case. ref SDS 5 MZ4N
040932 -  ..
040933 - On 100503 1522 Millie notifies medical team that time of the essence
040934 - to get the next treatment going. ref SDS 6 TD5W
040936 -  ..
040937 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040938 - with Abraxane chemotherapy that seems to be failing, and then after 3
040939 - more weeks without treatment, following a trip abroad, the doctor will
040940 - discuss "next steps." ref SDS 7 YL5N
040942 -  ..
040943 - On 100503 2338 Millie reports to medical team that she will implement
040944 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040945 - letter on 010503, as assurance that recovery will be equal to changing
040946 - treatment immediately on 100505. ref SDS 8 6X7S
040948 -  ..
040949 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040950 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040951 - communicate with Doctor Johnson, or had already done so, to coordinate
040952 - with Kaiser on planning Millie's next treatment to recover from the
040953 - 11th relapse of cancer. ref SDS 9 NT5N
040955 -  ..
040956 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040957 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040958 - ref SDS 10 KE4K
040960 -  ..
040961 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040962 - seemingly on an accelerating rise, which threatens to cascade out of
040963 - control, because Abraxane chemotherapy is not effective. ref SDS 11
040964 - L54I
040966 -  ..
040967 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040968 - Abraxane. ref SDS 12 KE4K
040970 -  ..
040971 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 13 PK9O
040973 -  ..
040974 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040975 - Department for standard of care to recover from 11th relapse of cancer
040976 - caused by medical mistakes getting radiation treatments at UCSF on
040977 - referral from Kaiser. ref SDS 14 IZ7N
040979 -  ..
040980 - On 100528 0322 Millie requests support from Medicare to separate
040981 - recovery for medical mistakes getting radiation from UCSF, from health
040982 - care benefits limited by Medicare insurance coverage. ref SDS 15 QQ6N
040984 -  ..
040985 - On 100528 1031 called Medicare they have formed a team to review
040986 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040987 - response to Millie's claim. ref SDS 16 4W5F
040989 -  ..
040990 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040991 - collaborate with UCSF on treatment for Millie to recover from UCSF
040992 - medical mistakes.  He discussed treating Millie with MPA, but this was
040993 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040994 - ended the treatment due to fears about blood clot side effects, which
040995 - were believed to cause breathing problems Millie had, though later
040996 - breathing problems were discovered to be caused by defective radiation
040997 - treatment.  Since Doctor Johnson said Kaiser has no more treatments
040998 - for Millie, the only way Millie can get relief from pain caused by
040999 - cancer that is progressing without treatment is get treatment in
041000 - Hospice.  Since Hospice is the only choice of care offered today,
041001 - Millie accepted this.
041003 -  ..
041004 - On 100601 1531 Sharon called to schedule starting Hospice medical
041005 - services beginning tomorrow between 0900 - 1000. ref SDS 3 036C
041007 -  ..
041008 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041009 - Sharon's report yesterday, that if Kaiser performs on the insurance
041010 - agreement to provide standard of care for Millie's patient profile,
041011 - than Millie can elect to recover from 11th relapse of cancer, rather
041012 - than continue with Hospice support for dying peacefully. ref SDS 4
041013 - 036C
041015 -  ..
041016 - On 100602 1046 Diane received notice from Medicare to file claim for
041017 - Millie to get treatment for recovering from UCSF medical mistakes; she
041018 - is preparing a statement of claim. ref SDS 21 036C  Advised Diane to
041019 - use Millie's statement of claim submitted to Kaiser on 100527.
041020 - ref SDS 21 MZ5H  Eileen called later and reported that Kaiser denied
041021 - Millie's claim on the grounds that Medicare does not authorize payment
041022 - for treatment to recover from cancer, after a patient starts Hospice.
041023 - ref SDS 21 UN4M  Requested that Eileen read he claim and then make a
041024 - good faith determiantion. ref SDS 21 I33H  Eileen called back after
041025 - reading the claim and advised the denial of claim has been withdrawn,
041026 - and the matter is referred to Claims Resolution Department.
041027 - ref SDS 21 UN5P
041029 -  ..
041030 - On 100603 0449 Millie submits record to medical team confirming
041031 - understandings, ref SDS 0 036C
041032 -
041033 -
041034 -
041035 -
041037 -  ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Millie sent the following letter to the medical team...
041402 -
041403 -    1.  Subject: Cancer 11th Relapse Work Plan - Hospice Started
041404 -        Date: Thu, 03 Jun 2010 05:27:34 -0700
041417 -         ..
041418 -    3.  Thanks very much for fast work on Tuesday, getting me started
041419 -        in Hospice. ref SDS 18 4F5J
041420 -
041421 -            [On 100605 1817 Doctor Johnson reported he received
041422 -            Millie's letter today, transmitting the record meeting with
041423 -            him at Kaiser on 100601, when he signed Millie up for
041424 -            Hospice. ref SDS 23 FT4G
041426 -         ..
041427 -    4.  Sharon called yesterday afternoon to implement the e-consult
041428 -        ordering Hospice that was fast and easy to do on the computer
041429 -        during your examination. ref SDS 19 036C
041431 -         ..
041432 -    5.  I met at home today with Liz from the Hospice Department; she
041433 -        was terrific explaining all the details getting relief from
041434 -        pain and suffering from chemo the past 8 months. ref SDS 20
041435 -        036C
041437 -         ..
041438 -    6.  I don't yet have communication with Hospice, so if time permits
041439 -        can you forward the record.  Liz was very complementary of your
041440 -        stewardship as former Chief of Hospice, so hopefully it is fast
041441 -        and easy to make distribution to former colleagues.
041442 -
041443 -            [On 100604 1350 Hospice Case Manager Linda reported she did
041444 -            not get a copy of the record on Millie's patient history.
041445 -            ref SDS 22 XU7H
041447 -         ..
041448 -    7.  My only concern about medication is to balance pain at a higher
041449 -        level (5 or 6) than Hospice standards (< 4), in order to avoid
041450 -        being totally zonked out in bed all day by higher doses.
041451 -        ref SDS 20 3W4O
041452 -
041453 -            [On 100604 1350 Linda orders increasing morphine to 2 pills
041454 -            at once, twice a day, doubling morphine. ref SDS 22 PC65
041456 -             ..
041457 -            [On 100605 1838 Millie notified Doctor Johnson at Kaiser
041458 -            that she was emotional because nobody seems to be listening
041459 -            to patient requests for pain relief. ref SDS 24 CG6W
041461 -         ..
041462 -    8.  During the meeting Liz called your office and left a message
041463 -        for comment on adjusting pain meds [reported on 100602 0913.
041464 -        ref SDS 20 U53N].  Daniel called in the evening from Hospice
041465 -        After-hours Advice and asked about my pain level again.
041466 -        ref SDS 20 3W5H  You are right about Hospice - they seem very
041467 -        efficient and totally patient oriented.
041469 -         ..
041470 -    9.  I also received calls today from various Kaiser offices on
041471 -        clearing the way to recover from UCSF medical mistakes
041472 -        providing radiation treatments on referral from Kaiser. 100602
041473 -        1046, ref SDS 21 036C  Since I was meeting with Liz, Rod talked
041474 -        to the claims folks.  I was encouraged by the last call from
041475 -        Eileen.  She had called earlier and said Kaiser sent a letter
041476 -        denying the claim, because I started Hospice today. ref SDS 21
041477 -        9N62  She called back later, and said that, after reading the
041478 -        claim, Kaiser has withdrawn the denial letter, because the
041479 -        claim has nothing to do with Medicare, and so forwarded the
041480 -        matter to Paula's office in Claims Resolution. ref SDS 21 UN5P
041482 -         ..
041483 -   10.  Since Paula is familiar with the case from getting the record
041484 -        for the past year, her support can significantly expedite
041485 -        resolution in time for recovery efforts to be effective.
041487 -         ..
041488 -   11.  I want to especially thank Jullin Kwok at Medicare.  Even
041489 -        though she no longer handles the Kaiser account, after getting
041490 -        my letter sent at 0330a [reported on 100527 0217, ref SDS 14
041491 -        IZ7N], she responded a few hours later at something like 0630a
041492 -        in the morning, assembling a team, and starting machinery for
041493 -        getting things done. 100528 1031, ref SDS 16 QQ6N  This fits
041494 -        Doctor Rugo's work ethic of "24-7" support, sending me letters
041495 -        at 1000pm, 1am, 3am, Tuesday, Friday, Sunday, rain or shine
041496 -        she's always on the job.
041498 -         ..
041499 -   12.  As you can imagine the past few months have been extremely
041500 -        stressful, beginning with shingles in January, and not knowing
041501 -        what is going to happen.  Of course, nobody knows what the
041502 -        future holds.  I am relieved and grateful to have a strong team
041503 -        moving forward.
041511 -         ..
041512 -   15.  PS.  Please submit CA 15-3 for the lab this past Saturday on
041513 -        100529.  Hoping its not too depressing [Millie's letter on
041514 -        100601 worried cancer marker increased to over 1000.
041515 -        ref SDS 17 1Q3P]
041516 -
041517 -            [On 100605 1817 Doctor Johnson's letter does not report
041518 -            results of cancer marker. ref SDS 23 036C
041520 -             ..
041521 -            [On 100605 1838 Millie asks Kaiser again for results of
041522 -            cancer marker on lab test 100529. ref SDS 24 CG8V
041524 -             ..
041525 -            [On 100606 1604 Doctor Johnson reports Millie's cancer
041526 -            marker for lab on 100529 was CA 15-3 606, ref SDS 25 8H5I,
041527 -            considerably less than expected in Millie's letter on
041528 -            100601 0136. ref SDS 17 1Q3P
041530 -             ..
041531 -            [On 100606 1638 Millie thanks Doctor Johnson for submitting
041532 -            results of lab on 100529, showing less increase in cancer
041533 -            marker than exptected, even after 3 weeks without
041534 -            treatment, ref SDS 26 036C, and indicating there is still
041535 -            no internal involvement. ref SDS 26 PQ6V
041536 -
041537 -
041538 -
041539 -
041540 -
041541 -
041542 -
0416 -