THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
S U M M A R Y
DIARY: June 30, 2010 03:37 PM Wednesday;
Millie notifies medical team of right to choose life rather than Hospice.
Click here to comment!
1...I am therefore concerned about Kaiser delaying response to my
Default Null Subject Account for Blank Record
0403 - ..
0404 - Summary/Objective
040501 - Follow up ref SDS B0 0000. ref SDS A9 0000.
040507 - ..
0408 - Background
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 53
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 53 SJ6N
040910 - ..
040911 - On 100501 1037 Millie letter to medical team confirms understanding of
040912 - new strategy to treat Millie's cancer with targeted therapy.
040913 - ref SDS 54 F25O
040915 - ..
040916 - On 100501 2017 Doctor Rugo reports plans to collaborate with Doctor
040917 - Johnson at Kaiser on work plan for Millie to recover from 11th relapse
040918 - of cancer caused by UCSF medical mistakes. ref SDS 55 HH4I
040920 - ..
040921 - On 100502 2143 Kaiser confirms that some patients respond well to new
040922 - "targeted" therapies. ref SDS 57 YX8L Kaiser contends that all of the
040923 - strategies for "targeted" therapies have been executed for Millie,
040924 - which seems conflicting with the record in this case. ref SDS 57 MZ4N
040926 - ..
040927 - On 100503 1522 Millie notifies medical team that time of the essence
040928 - to get the next treatment going. ref SDS 58 TD5W
040930 - ..
040931 - On 100503 1945 Kaiser notifies Millie to get remaining 2 treatments
040932 - with Abraxane chemotherapy that seems to be failing, and then after 3
040933 - more weeks without treatment, following a trip abroad, the doctor will
040934 - discuss "next steps." ref SDS 59 YL5N
040936 - ..
040937 - On 100503 2338 Millie reports to medical team that she will implement
040938 - Kaiser's guidance to delay changing treatments, and takes Kaiser's
040939 - letter on 010503, as assurance that recovery will be equal to changing
040940 - treatment immediately on 100505. ref SDS 60 6X7S
040942 - ..
040943 - On 100504 1609 Sara, Practice Manager for the UCSF Oncology Breast
040944 - Care Clinic, called and notified Millie that Doctor Rugo will soon
040945 - communicate with Doctor Johnson, or had already done so, to coordinate
040946 - with Kaiser on planning Millie's next treatment to recover from the
040947 - 11th relapse of cancer. ref SDS 61 NT5N
040949 - ..
040950 - On 010505 0730 Millie received the 2nd treatment at Kaiser for the 3rd
040951 - cycle of Abraxane chemotherapy, as ordered by Doctor Johnson.
040952 - ref SDS 62 KE4K
040954 - ..
040955 - On 100511 0900 cancer marker CA 15-3 520 increased another 100 points,
040956 - seemingly on an accelerating rise, which threatens to cascade out of
040957 - control, because Abraxane chemotherapy is not effective. ref SDS 63
040958 - L54I
040960 - ..
040961 - On 100512 0730 Millie received 3rd treatment for 3rd cycle of
040962 - Abraxane. ref SDS 64 KE4K
040964 - ..
040965 - On 100515 1415 Millie departed 2-week trip to Europe. ref SDS 65 PK9O
040967 - ..
040968 - On 100527 0217 Millie files claim with Kaiser Claims Resolution
040969 - Department for standard of care to recover from 11th relapse of cancer
040970 - caused by medical mistakes getting radiation treatments at UCSF on
040971 - referral from Kaiser. ref SDS 66 IZ7N
040973 - ..
040974 - On 100528 0322 Millie requests support from Medicare to separate
040975 - recovery for medical mistakes getting radiation from UCSF, from health
040976 - care benefits limited by Medicare insurance coverage. ref SDS 67 QQ6N
040978 - ..
040979 - On 100528 1031 called Medicare they have formed a team to review
040980 - Millie's case, and contacted Kaiser's Claims Resolution Department for
040981 - response to Millie's claim. ref SDS 68 4W5F
040983 - ..
040984 - 100601 0830 Doctor Johnson reported that Kaiser has not had time to
040985 - collaborate with UCSF on treatment for Millie to recover from UCSF
040986 - medical mistakes. He discussed treating Millie with MPA, but this was
040987 - not prescribed because Millie was treated with MPA in 2009, and UCSF
040988 - ended the treatment due to fears about blood clot side effects, which
040989 - were believed to cause breathing problems Millie had, though later
040990 - breathing problems were discovered to be caused by defective radiation
040991 - treatment. Since Doctor Johnson said Kaiser has no more treatments
040992 - for Millie, the only way Millie can get relief from pain caused by
040993 - cancer that is progressing without treatment is get treatment in
040994 - Hospice. Since Hospice is the only choice of care offered today,
040995 - Millie accepted this.
040997 - ..
040998 - On 100601 1531 Sharon called to schedule starting Hospice medical
040999 - services beginning tomorrow between 0900 - 1000. ref SDS 54 036C
041001 - ..
041002 - On 100602 0913 Liz provides orientation on Hospice care; she confirms
041003 - Sharon's report yesterday, that if Kaiser performs on the insurance
041004 - agreement to provide standard of care for Millie's patient profile,
041005 - than Millie can elect to recover from 11th relapse of cancer, rather
041006 - than continue with Hospice support for dying peacefully. ref SDS 55
041007 - 036C
041009 - ..
041010 - On 100602 1046 Diane received notice from Medicare to file claim for
041011 - Millie to get treatment for recovering from UCSF medical mistakes; she
041012 - is preparing a statement of claim. ref SDS 73 036C Advised Diane to
041013 - use Millie's statement of claim submitted to Kaiser on 100527.
041014 - ref SDS 73 MZ5H Eileen called later and reported that Kaiser denied
041015 - Millie's claim on the grounds that Medicare does not authorize payment
041016 - for treatment to recover from cancer, after a patient starts Hospice.
041017 - ref SDS 73 UN4M Requested that Eileen read he claim and then make a
041018 - good faith determiantion. ref SDS 73 I33H Eileen called back after
041019 - reading the claim and advised the denial of claim has been withdrawn,
041020 - and the matter is referred to Claims Resolution Department.
041021 - ref SDS 73 UN5P
041023 - ..
041024 - On 100603 0449 Millie notified medical team that Kaiser called today
041025 - about moving forward to resolve medical mistakes getting radiation
041026 - treatment at UCSF on referral from Kaiser. ref SDS 74 IX9Q
041028 - ..
041029 - On 100606 1604 Doctor Johnson notifies Millie that her cancer marker
041030 - has remained fairly stable the past 3 weeks since ending treatment
041031 - with Abraxane on 100512; actually went up less without Abraxane, than
041032 - with it, because Millie's cancer resists chemotherapy. ref SDS 75 036C
041034 - ..
041035 - On 100606 1638 Millie thanks Doctor Johnson for submitting good news
041036 - cancer marker CA 15-3 606 much smaller rise than exptected after
041037 - ending treatment for 3 weeks. ref SDS 76 036C; asks if Doctor Rugo ever
041038 - returned Doctor Johnson's call from Kaiser, as planned in Doctor
041039 - Rugo's letter on 100501?
041041 - ..
041042 - On 100606 2317 Millie receives letter from Doctor Johnson reporting
041043 - that Doctor Rugo has never returned his call asking UCSF for Millie's
041044 - treatment plan, which demonstrates failure to perform on Doctor Rugo's
041045 - commitment in UCSF letter sent to the medical team on 100501.
041046 - ref SDS 77 036C
041048 - ..
041049 - On 100607 0932 called Cherry at Medicare about progress on contacting
041050 - Kaiser to process Millie's claim filed on 100527, and planned in the
041051 - call with Medicare (Cherry and Beth) as action item #8, planned the
041052 - next day on 100528 1031, ref SDS 68 PE6P; today, Cherry did not have
041053 - time to return the call. ref SDS 78 036C
041055 - ..
041056 - On 100607 1021 called Paula at Kaiser - she said someone else is
041057 - handling Millie's claim, because the claim has not been denied, and
041058 - Paula only handles denied claims. ref SDS 79 036C; Paula further
041059 - reported that Kaiser no longer objects to demaning UCSF correct
041060 - medical mistakes, so Millie's claim should be easy to resolve.
041061 - ref SDS 79 QN9F
041063 - ..
041064 - On 100607 1117 letter to Paula confirming Kaiser's work plan to
041065 - process Millie's claim for care promptly in order to save her life.
041066 - ref SDS 80 036C
041068 - ..
041069 - On 100608 1521 called and talked to Cherry and Beth about expediting
041070 - Millie's claim at Kaiser. ref SDS 81 036C Developed work plan to have
041071 - a conference call with Kaiser tomorrow. ref SDS 81 C354 Submitted
041072 - letter to Kasier and CMS Medicare confirming work plan for tomorrow.
041073 - ref SDS 81 G84Q
041075 - ..
041076 - On 100609 1114 called CMS to expedite conference call on expediting
041077 - Millie's care. ref SDS 82 036C Cherry called and schedule telecon with
041078 - Kaiesr and CMS today 1300. ref SDS 82 8O4H Received letter from Cherry
041079 - at CMS confirming work plan for conference call at 1300. ref SDS 82
041080 - PRXY
041082 - ..
041083 - On 100609 1232 letter to CMS and Kaiser submitts agenda for conference
041084 - call to review progress on Kaiser resolving Millie's claim for
041085 - recovery from UCSF medical mistakes. ref SDS 83 036C
041087 - ..
041088 - On 100609 1300 CMS and Kaiser conference call to report progress on
041089 - reviewing Millie's claim for treatment to recover from UCSF medical
041090 - mistakes in time to be effective. ref SDS 84 036C
041092 - ..
041093 - On 100609 1522 Jennifer called for assistance processing Millie's
041094 - claim to recover from medical mistakes getting radiation treatment at
041095 - UCSF on referral from Kaiser. ref SDS 85 036C
041097 - ..
041098 - On 100611 1451 Jennifer advised Kaiser extended the date for
041099 - responding to Millie's claim from 100610 to 100624, based on Millie
041100 - filing updated statement of authorized representative. ref SDS 89 036C
041101 - Jennifer reported she reviewed 6-issues discussed on 100609, and will
041102 - address these issues responding to Millie's claim. ref SDS 89 FQ4G
041103 - Jennifer asked how Kaiser can treat Millie to recover from UCSF
041104 - medical mistakes, if Millie refuses chemotherapy and has entered
041105 - Hospice. ref SDS 89 FQ4M
041107 - ..
041108 - On 100611 2326 Millie received Jennifer's letter confirming the date
041109 - for Kaiser to respond to Millie's claim has been extended to 100624,
041110 - ref SDS 90 CV4O, and further advising that issues Kaiser will determine
041111 - responding to Millie's claim for recovering from UCSF medical
041112 - mistakes, ref SDS 90 036C, are as set out in the record for telecon on
041113 - 100609. ref SDS 85 XK50 Jennifer will call on 100615, to report
041114 - progress on respnding to Millie's claim. ref SDS 90 6P53
041116 - ..
041117 - On 100614 0257 letter to Kaiser Medicar CMS claim team requests
041118 - immediate written proposal evaluating treatment options for Millie to
041119 - consider. ref SDS 91 036C
041121 - ..
041122 - On 100616 0832 called Jennifer about her plan to call yesterday on
041123 - Tuesday to report progress Kaiser responding to Millie's claim, as set
041124 - out in Jennifer's letter on 100611. ref SDS 92 036C Jennifer called
041125 - back to ask if Millie wants UCSF or Kaiser to pay for her damages
041126 - caused by UCSF medical mistakes. ref SDS 92 PSSV Jennifer reported
041127 - delays communicating with Millie's medical team have delayed making
041128 - arrangements for Millie to start treatment recovering from UCSF
041129 - medical mistakes. ref SDS 92 OY4T She plans to call on Friday, 100618,
041130 - to report progress responding to Millie's claim. ref SDS 92 1K5J
041132 - ..
041133 - On 100618 0843 called Jennifer at Memeber Case Resolution Department
041134 - about progress responding to Millie's claim. ref SDS 93 036C
041136 - ..
041137 - On 100620 1112 letter to Kaiser claim team with copy to Medicare, and
041138 - the medical team requests call on Monday 100621, planned for previous
041139 - Friday, 100628, to report progress getting Millie treatment.
041140 - ref SDS 94 036C Recommends that delay communicating with medical team
041141 - that has delayed Millie starting treatment in time to be effective,
041142 - ref SDS 94 L59P, can be solved by hiring MD Anderson. ref SDS 94 L59X
041144 - ..
041145 - On 100621 0853 called for Jennifer and left several messages,
041146 - including for her team lead. ref SDS 96 036C Nobody had time today
041147 - for calling back. ref SDS 96 OP3N
041149 - ..
041150 - On 100622 1027 Jennifer called and advised that Doctor Johnson
041151 - responded to request for comment on Millie's claim saying he cannot
041152 - provide care for Millie because she entered Hospice on 100601,
041153 - ref SDS 98 036C; recommended Jennifer check Kaiser's medical chart for
041154 - Millie meeting with Doctor Johnson to see Millie was given no choices
041155 - except to enter Hospice in order to avoid further pain and suffering.
041156 - ref SDS 98 NX68
041158 - ..
041159 - On 100622 1511 letter to claim team and Medicare, and to Millie's
041160 - medical team confirming understanding in Jennifer's call that Millie's
041161 - medical team at Kaiser seems to refuse Millie standard of care to
041162 - recover from UCSF medical mistakes, because she was forced to enter
041163 - Hospice to get relief from pain caused by UCSF medical mistakes.
041164 - ref SDS 99 036C UCSF delays compounded Millie's injuries, pain, and
041165 - suffering; caution must be exercised to enable recovery, based on
041166 - Millie's right to life. ref SDS 99 575U Millie's patient history
041167 - shows the doctor's only issue, ref SDS 99 576V, is having time to
041168 - providing standard of care for Millie to recover from medical
041169 - mistakes, and if not, then Kaiser should assign someone who does.
041170 - ref SDS 99 583Y Kaiser has violated Millie's human rights; a woman's
041171 - right to choose life for herself, should be no less than the right to
041172 - choose for her unborn child, since the right to life and due process
041173 - are protected by the US Constitution. ref SDS 99 584W Kaiser can
041174 - easily solve the time problem by hiring other people to do the work,
041175 - and charging UCSF. ref SDS 99 585P
041177 - ..
041178 - 100624 1616 Jennifer called and asked to extend Kaiser's response to
041179 - Millie's claim another day or so, for review with her boss, and with
041180 - the customer. ref SDS A0 036C Jennifer the original date for Kaiser to
041181 - respond on 100610, required by statute, and then amended to today on
041182 - 100624, can be further amended, and cited unclear authority about 30
041183 - days instead of 14. ref SDS A0 EG5P Agreed that extending Kaiser's
041184 - response another few days until tomorrow, or Monday, is an acceptable
041185 - risk, even though Millie's cancer markier has increased significantly
041186 - to over 1000, and so that an equitable solution can be implented that
041187 - allows treatment in time to be effective for Millie. ref SDS A0 EG73
041188 - Jennifer will submit her draft response, and call tomorrow for
041189 - discussing Kaiser's solution. ref SDS A0 H98M
041191 - ..
041192 - On 100625 0852 letter to Kaiser and Medicare claim teams confirming
041193 - Kaiser's request to extend date for responding to Millie's claim
041194 - another few days until Monday in order to get comprehensive solution.
041195 - ref SDS A1 036C
041197 - ..
041198 - On 100626 0917 received letter from Cherry at Medicare, ref SDS A2
041199 - 036C, submitting CMS regulations, that control due date for Kaiser to
041200 - respond to Millie's claim. ref SDS A2 N64I
041202 - ..
041203 - On 100628 0228 letter to claim teams at Medicare and Kaiser asking how
041204 - CMS regulations received on 100625, apply to extend Kaiser's response
041205 - date for expediting Millie's recovery. ref SDS A3 036C
041207 - ..
041208 - On 100628 1033 called CMS Medicare for Beth Simone on regulations for
041209 - Kaiser to respond to Millie's claim.
041211 - ..
041212 - On 100628 2318 submitted record of telecon with CMS, ref SDS A5 036C,
041213 - and that CMS learned today that Kaiser changed Millie's claim to a
041214 - Grievance, and notified CMS that Kaiser intends to delay response
041215 - until 100710, to Millie's claim filed on 100527.
041217 - ..
041218 - On 100629 00003 received letter from Cherry transmitting Grievance
041219 - procedures, cited in the telecon yesterday as a change Kaiser made to
041220 - delay responding until 100710, to Millie's claim filed on 100527.
041221 - ref SDS A6 036C Review of Grievance regulations show Kaiser required
041222 - to make timely response based on patient health. ref SDS A6 PN5S
041224 - ..
041225 - On 100629 0013 letter thanks CMS for submitting regulations on
041226 - Grievance procedures, and notes requirements for Kaiser to respond
041227 - prior to maximum allowed of 30 days, based on patient health.
041228 - ref SDS A7 036C
041230 - ..
041231 - On 100629 1631 called Medicare (CMS) on results of their
041232 - teleconference with Kaiser on expediting response to Millie's claim.
041233 - ref SDS A8 036C
041235 - ..
041236 - On 100630 0027 Millie thanks Doctor Johnson for reporting on 100606,
041237 - that UCSF did not call Kaiser to provide care for Millie to recover
041238 - from UCSF medical mistakes. ref SDS A9 036C; she reports blood counts
041239 - are good, but cancer progressing because treatment was stopped on
041240 - 100601, for pain relief from chemotherapy. ref SDS A9 V83U Kaiser has
041241 - deferred responding to Millie's claim, ref SDS A9 V87S, and needs to
041242 - know how soon her health status requires Kaiser to make a response.
041243 - ref SDS A9 V88T Millie asks about deferring the meeting with Doctor
041244 - Johnson tomorrow, until Kaiser responds to Millie's claim, or, Millie
041245 - would love to meet, if Doctor Johnson has communicated with Doctor
041246 - Rugo on a work plan for Millie to recover from UCSF medical mistakes.
041247 - ref SDS A9 V89X
041249 - ..
041250 - On 100630 1148 Doctor Johnson notfies Millie, and the Kaiser claim
041251 - team that he is confused about Millie's case, because Kaiser has
041252 - deferred determination on urgent requirement for care. ref SDS B0 036C
041253 - Doctor Johnson notes Millie is in Hospice and states that Millie's
041254 - disease is resistant to all forms of therapy, and that entering
041255 - Hospice is based on patient desire to forego therapy. ref SDS B0 PY4J
041256 - He asks if Millie wants to dis-enroll from Hospice. ref SDS B0 OY5G
041257 - Doctor Johnson further notes that public domain email conflicts with
041258 - HIPAA regulations. ref SDS B0 0W5U
041260 - ..
041261 - On 100630 1537 Millie notified medical team and claim team, thanking
041262 - Doctor Johnson for his letter commenting on Millie feeling better
041263 - after ending chemotherap. Confirms Doctor Johnson's intent to defer
041264 - meeting scheduled for tomorrow until after Kaiser responds to Millie's
041265 - claim, and further confirms Doctor Johnson has still not communicated
041266 - with Doctor Rugo on UCSF providing care for Millie to recover from
041267 - UCSF medical mistakes. ref SDS 0 M86X Advises that Doctor Johnson's
041268 - assertion that Millie's cancer now resists all forms of therapy
041269 - conflicts with the record; Doctor Johnson advised that finding
041270 - effective treatment requires experimentation; Millie's first treatment
041271 - failed, and had to be switched. ref SDS 0 M87Q When UCSF discovered
041272 - medical mistakes, UCSF failed to provide necessary and reasonable care
041273 - for Millie to recover, and instead prescribed chemotherapy, which was
041274 - not effective and caused unbearable pain and suffering, causing Millie
041275 - to enter Hospice. ref SDS 0 M84P The only evident purpose for
041276 - Millie's death is to avoid accountability from medical mistakes and
041277 - avoid cost of recovery, by making Millie suffer, and making Medicare
041278 - pay, while Millie is actually innocent, and Medicare is innocent.
041279 - ref SDS 0 M84S Millie sent 44 letters to medical team requesting
041280 - targeted treatment to recover from UCSF medical mistakes, and
041281 - reporting pain and suffering from chemotherapy; so, on 100601, Millie
041282 - entered Hospice for pain relief for chemotherapy. ref SDS 0 M84Y
041283 - Millie cannot dis-enroll from Hospice providing pain medication until
041284 - Kaiser provides standard of care to recover from UCSF medical
041285 - mistakes. ref SDS 0 M93V Millie explains benefits to saving lives,
041286 - time, and money using public domain email. ref SDS 0 M94W Millie
041287 - notes Doctor Johnson's report today shows Kaiser has violated Medicare
041288 - regulations by delaying response to her claim longer than justified by
041289 - Millie's health status. ref SDS 0 M96P
041293 - ..
0415 - Progress
041601 - Doctor Johnson's letter to Millie and Kaiser's claim team says...
041603 - 1. Subject: Work Plan Recover UCSF Mistakes - Defer Meeting Jul 1 Pending Claim Response
041604 - Date: Wed, 30 Jun 2010 22:55:40 -0700
041620 - ..
041621 - 2. Thanks very much for timely response to my letter this morning,
041622 - commenting on my improved condition since ending chemotherapy.
041624 - ..
041625 - 3. I asked in my letter about deferring the meeting tomorrow until
041626 - Kaiser responds to my claim filed on 100527, requesting relief
041627 - from UCSF medical mistakes. I assume you agree, though you did
041628 - not say this in your letter. I further assume that you still
041629 - have not heard from UCSF, and thus, UCSF has defaulted on its
041630 - referral obligations to correct medical mistakes.
041632 - ..
041633 - 4. Your report this morning that my cancer is resistant to all
041634 - forms of therapy [...reported on 100630 1148, ref SDS B0
041635 - PY4J...], seems conflicting with the record. You explained on
041636 - 030606, that resistance/response to therapy is a genetic
041637 - variable that can only be determined by experimentation.
041638 - ref SDS 2 RY5J [...shown by Millie's patient history - her
041639 - first treatment regarded as the best cure for cancer was
041640 - resisted, and had to be switched immediately to another
041641 - regimen, reported on 020603 1115. ref SDS 1 WO4O...].
041643 - ..
041644 - 5. On 041130, you explained that Kaiser has a limited number of
041645 - chemotherapy agents for treating my cancer, and you submitted a
041646 - list of 5 or 6 agents scribbled on tissue torn from the
041647 - examination table, saying my care is a simple matter of going
041648 - through the list. ref SDS 4 763L
041650 - ..
041651 - 6. On 070105, you prescribed cetuximab treatment on referral at
041652 - UCSF, which you described as a new kind of [...targeted...]
041653 - care for cancer that improves chemotherapy for survival and
041654 - quality of life, thus expanding the list you provided on
041655 - 041130. ref SDS 6 JE7N
041657 - ..
041658 - 7. You were correct. Cetuximab therapy "targeted" to cancer
041659 - lasted nearly 2 years, about 10 times longer than chemotherapy
041660 - treatments I have had. Not only was survival increased by
041661 - orders of magnitude, quality of life was 1000 times better than
041662 - with chemotherapy. Rather than being a zombie in constant
041663 - pain, I lived a vigorous, normal life-style without a hint of
041664 - pain and suffering.
041666 - ..
041667 - 8. On 080829, you asked me to get a list of targeted treatments
041668 - from Doctor Rugo for extending my care at UCSF, because Kaiser
041669 - didn't have anything but 2 chemotherapy agents, and you advised
041670 - that my cancer has mutated to resist chemotherapy. Doctor Rugo
041671 - said UCSF had new "targeted" treatments lined up for after
041672 - cetuximab. You prudently kept asking for the list, just as I
041673 - asked you for a list on 041130. On 090121, Doctor Rugo's
041674 - assistant Glenna called and said UCSF lost their list, and
041675 - asked me (Rod) to cull the record of meetings the past few
041676 - years and submit a list of treatments discussed during
041677 - examinations. This was done. The team has a list. I asked
041678 - you to collaborate with Doctor Rugo on figuring out which of
041679 - many treatments would be tried next, and then after that, just
041680 - as you explained on 041130. Your letter on 090326. said that
041681 - you would do this, all as shown in case study on 090213.
041682 - ref SDS 10 PT3N
041684 - ..
041685 - 9. On 090401, I requested treatment. Doctor Rugo sent a letter to
041686 - the team saying treatment for cancer had to be delayed until
041687 - the wound in my chest healed, which was diagnosed as reaction
041688 - to radiation. ref SDS 14 4J4F On 090609, Doctor Hsu discovered
041689 - this was a mistake, because the wound in my chest is cancer
041690 - that UCSF failed to treat providing radiation services on
041691 - referral from Kaiser (you), and so cancer untreated for 6
041692 - months had spread everywhere, but mostly to my right side.
041693 - ref SDS 21 W65W
041695 - ..
041696 - 10. On 090616, Doctor Rugo said "everybody is on board" at Kaiser
041697 - and UCSF for me to recover from medical mistakes, ref SDS 23
041698 - D647, with therapy targeted to cancer, starting with MPA and
041699 - then PARP, going down the list provided to the team at your
041700 - request and requested by Doctor Rugo, for experimenting to find
041701 - a treatment that works for me. ref SDS 23 KD6L
041703 - ..
041704 - 11. The problem has been that UCSF defaulted on referral
041705 - obligations to provide necessary and reasonable care for me to
041706 - recover from medical mistakes. Instead of experimenting with
041707 - "targeted" treatments on the list, UCSF prescribed chemotherapy
041708 - ...[reported on 090716 2106. ref SDS 25 EE5W...], which you
041709 - determined on 080829, is resisted by my cancer, and conflicts
041710 - with my patient profile exposing me to fatal infection, and
041711 - unbearable pain and suffering. Treatment ineffective against
041712 - cancer, and which makes life unbearable forces patients to
041713 - enter Hospice and die.
041715 - ..
041716 - 12. The only evident benefit of forcing this end game is to avoid
041717 - accountability for medical mistakes, including cost of care by
041718 - charging Medicare instead of UCSF. I have notified the claim
041719 - team that Kaiser can certainly hold UCSF harmless from medical
041720 - mistakes, if it wishes, but I should not suffer.
041722 - ..
041723 - 13. I am innocent. So is Medicare. UCSF made the mistakes.
041725 - ..
041726 - 14. Case study on 100622, shows I asked the medical team
041727 - consistently (44 times) in writing to provide standard of care
041728 - for the work plan UCSF presented on 090616, using some 20
041729 - treatments targeted to my cancer [...and which do not cause
041730 - unbearable pain and suffering...] for recovering from UCSF
041731 - medical mistakes. ref SDS 99 LQ7G
041733 - ..
041734 - 15. My letter to you on 100601, submitting an agenda for our
041735 - meeting later that day at Kaiser requests treatment targeted to
041736 - my cancer, and says I cannot tolerate more chemotherapy.
041737 - ref SDS 69 1P6U
041739 - ..
041740 - 16. During the meeting later that day on 100601, you reported
041741 - communication with UCSF failed using email and the telephone
041742 - for a month, ref SDS 70 4F6I, and as a result, you could not
041743 - implement UCSF's work plan for my next treatment with PARP, nor
041744 - with any of the other 20 or so treatments submitted at your
041745 - request to the medical team. ref SDS 70 4G6G
041747 - ..
041748 - 17. This record provides clarification requested in your letter
041749 - today saying in part...
041751 - ..
041752 - "Enrollment in Hospice is based on a patient's desire to forego
041753 - any additional aggressive therapies." [...reported on 100630
041754 - 1148, ref SDS B0 PY4J...]
041756 - ..
041757 - 18. This construction confuses "therapy" with "chemotherapy."
041759 - ..
041760 - 19. My desire is to forgo "chemotherapy," as stated in 44 letters
041761 - to Kaiser for an entire year. If there is a "targeted" therapy
041762 - that works like cetuximab, my desire is to have quality of life
041763 - for 2 years, then experiment further to find another solution,
041764 - implementing your prescription to treat my cancer as a chronic
041765 - disease. [...discussed with Doctor Johnson at Kaiser on 090213
041766 - 1140, ref SDS 10 863H and also in the same meeting. ref SDS 10
041767 - GC6N
041769 - ..
041770 - 20. Your review of PARP on 100112, sounds promising, ref SDS 45
041771 - 1D4G, but like AC [...Millie's first cancer tratment failed in
041772 - 2002, discussed in the record analyzing Doctor Johnson's letter
041773 - received earlier today on 100630 1148. ref SDS B0 K57M...], I
041774 - am aware we have to experiment further to find effective care,
041775 - and that the journey may fail, i.e., nothing may work, as
041776 - stated in your letter today. I am asking in my claim for the
041777 - right to choose life, equal to the right for a woman to choose
041778 - for her unborn child.
041780 - ..
041781 - 21. On 100601, I was not given a choice of targeted treatment
041782 - without pain and suffering necessary and reasonable to recover
041783 - from UCSF medical mistakes. My only choice was Hospice or more
041784 - pain and suffering. ref SDS 70 4H4J
041786 - ..
041787 - 22. Accordingly, I want to dis-enroll from Hospice [...responding
041788 - to Doctor Johnson's letter on 100630 1148. ref SDS B0 OY5G...],
041789 - based on Kaiser providing standard of care for me to recover
041790 - from medical mistakes, as set out in my claim filed on 100527,
041791 - a copy was sent to you. ref SDS 66 IZ7N
041793 - ..
041794 - 23. Clearly, I cannot possibly give up pain medication in Hospice
041795 - until there is a viable written work plan showing the medical
041796 - team is ready, willing, and able to provide standard of care
041797 - for the list of treatments in my claim [...reported on 100527
041798 - 0217. ref SDS 66 X77U...], and presented at your request to you
041799 - and UCSF on 090326. ref SDS 12 DW5S
041801 - [On 100701 0915 received call from Carol saying she is
041802 - Chief of Hospice, and that she was told Millie wants to
041803 - dis-enroll from Hospice, ref SDS B1 Q85S, which conflicts
041804 - with the record of notice to Kaisre in this letter today,
041805 - on 100630 1537. ref SDS 0 M93Y
041807 - ..
041808 - 24. Your request to use secure email conflicts with the record in
041809 - this case [...reported on 100630 1148, ref SDS B0 0W5U...].
041810 - You reported on 100601, that Doctor Rugo sent you a secure
041811 - email. You couldn't open it. You sent her a secure email
041812 - which she could not open, so she sent you a public domain email
041813 - asking you to call her. ref SDS 70 OK91 You called and she
041814 - never called back. This scenario has been repeated several
041815 - times over the past 5 years, where you have sent me secure
041816 - email, which I couldn't open. One time I had to get in the
041817 - truck and drive to your office just to get a once sentence
041818 - letter. Moreover, secure-email eviscerates productivity
041819 - communicating across organizational boundaries, and has
041820 - constant breakdowns that require technicians to restore
041821 - service. My care cannot withstand these limitations.
041823 - ..
041824 - 25. Public domain email fully complies with HIPAA which vests
041825 - patients with a right of confidential medical records, as set
041826 - out in my letter to the medical team on 100502. ref SDS 56 CO3W
041828 - ..
041829 - 26. Note that Doctor Rugo's practice manager, Sarah, called and
041830 - inquired about my right to give up some measure of
041831 - confidentiality to benefit from increased efficiency and
041832 - accuracy communicating with public domain email. Sarah planned
041833 - to check with UCSF legal department, and notify the team of any
041834 - grounds that prevent communicating quickly and accurately with
041835 - the medical team using public domain email [...reported on
041836 - 100504 1609. ref SDS 61 ZV6M She hasn't called.
041838 - ..
041839 - 27. My letter this morning asks your opinion on how soon Kaiser
041840 - must respond giving you authority to provide standard of care
041841 - for necessary and reasonable treatment to recover from UCSF
041842 - medical mistakes, in order for treatment to be effective.
041843 - 100630 0027, ref SDS A9 V87Y Your letter today, could be
041844 - interpreted to mean that Kaiser has already delayed response
041845 - too long for me to have a chance to recover, ref SDS B0 PY4J,
041846 - and so every day of additional delay makes failure a
041847 - self-fulling prophecy.
041849 - [On 100702 1424 Millie received a letter in the mail dated
041850 - 100624, from Doctor Johnson transmitting Kaiser's lab
041851 - report for Millie's blood test on 100622. The doctor
041852 - provides no analysis, nor comment of any kind except "CA
041853 - 15-3 1116" is circled in ink. ref SDS B2 NC3F
041855 - ..
041856 - 28. I am therefore concerned about Kaiser delaying response to my
041857 - claim beyond the agreed date of 100624 (see Jennifer's letter
041858 - on 100611. ref SDS 90 6P53
041860 - ..
041861 - 29. By copy I am asking the Kaiser claim team to present evidence
041862 - showing how further delay enhances my prospects for recovery,
041863 - since patient health is the only criteria in the regulations
041864 - for delaying response to a claim for medical care beyond the
041865 - time that reduces the chance for effective care.
041867 - ..
041868 - 30. Based on this record, we can defer the meeting scheduled for
041869 - tomorrow, until delays with the claim team are resolved. I am
041870 - disappointed because Arlette called and we planned to say hello
041871 - tomorrow. Hope we can do this soon.