CONTACTS 

SUBJECTS
EGD Test Move VA Medical Center San Francisco for Driver Requirement

5803 -
5803 -    ..
5804 - Summary/Objective
5805 -
580501 - Follow up ref SDS 15 0000. ref SDS 14 0000.
580502 -
580503 -
580504 -
580505 -
580507 -  ..
5806 -
5807 -
5808 - Progress
5809 -
580901 - Put c16 and the keyboard in the suitcase Pam left to test for making
580902 - the trip next Tuesday going to New York.  The suitcase has been open
580903 - on the bed since planning for the trip on 101110 2013. ref SDS 12 954O
580905 -  ..
580906 - The suitcase has provisions for a carrying strap, but no strap, so
580907 - took the strap from the computer case for c15, and connected to the
580908 - suitcase.  Picked this up, but when the strap was placed on the
580909 - shoulder, the strap connection tore loose from the suitcase.  Thought
580910 - it might be defective design or manufacture.
580912 -  ..
580913 - Removed the strap and picked up the suitcase by the two handles, and
580914 - started to enter the garage to leave for San Francisco.  The handles
580915 - both tore loose from the suitcase.  This indicates the suitcase is
580916 - very old, and so even the nylon woven connections have rotted.
580917 -
580918 -            [On 101117 1041 asked Pam about borrowing suitcase again
580919 -            for Thanksgiving travel to Connectiut to visit Ross and
580920 -            Claudia. ref SDS 16 4P8L
580922 -             ..
580923 -            [On 101118 1741 Pam loaned suitcase used for the September
580924 -            trip. ref SDS 17 OP5H
580926 -  ..
580927 - Put the computer in the carrying case, and left.  Decided not to take
580928 - the keyboard.
580929 -
580931 -  ..
5810 -
5811 -
5812 - 0613
5813 -
581301 - Arrived at VA Medical Center in San Francisco.  Forgot can take
581302 - Fulton to 42nd street, and the VA is on Clement.  Found the VA by
581303 - driving through the golf course streets, including the Palace of Fine
581304 - Arts, until reaching Clement, then remembered the location.
581306 -  ..
581307 - Waited in the lobby near the Emergency Department and worked until
581308 - staff began arriving.
581309 -
581311 -  ..
5814 -
5815 -
5816 - 0738
5817 -
581701 - Visited Module #1, where met previously with the CT surgery team on
581702 - 091119. ref SDS 6 0001
581704 -  ..
581705 - The attendant advised that Neil no longer works with the CT surgery
581706 - team.
581708 -  ..
581709 - The attendant called Ramone.  He recalled receiving correspondence
581710 - reporting possible a-fib events.  Ramone forwarded patient
581711 - communication to Michael Byrd in general surgery.  Michael has not had
581712 - time to respond.
581713 -
581714 -
581715 -
581716 -
581718 -  ..
5818 -
5819 -
5820 - 0757
5821 -
582101 - EGD Test Move Medical Center San Francisco No Driver Stay Overnight
582102 -
582103 - Follow up ref SDS 15 RO74.
582104 -
582105 - Met with Tricia in the GI Department on the 2nd floor of Building 2,
582106 - which is where surgery was performed on 091022. ref SDS 4 01F9
582108 -  ..
582109 - Explained background of Jennifer's telephone message saying Doctor
582110 - Lee proposed doing the EGD test at the Medical Center in order to
582111 - solve the driver problem by staying over night at the Hoptel.
582113 -  ..
582114 - Tricia called the GI Clinic at the VA in Martinez and requested a
582115 - referral for doing the EGD test at the Medical Center.
582116 -
582117 -            [On 101124 1625 telephone message confimrs EGD test
582118 -            scheduled GI Department VA Clinic Martinez CA, does not
582119 -            report solution for driver requirement. ref SDS 18 PS4O
582120 -
582121 -
5822 -

SUBJECTS
Atrial Fibrillation A-fib Causes Strokes Death VA Notified 101105 Re

A503 -
A504 - 0811
A50501 -  ..
A50502 - Cardiology Evaluates A-fib Symptoms
A50503 - Patient Sympoms Different from A-fib Cardiology Issue
A50504 -
A50505 - Follow up ref SDS 14 S070.
A50506 -
A50507 - Met with coordinator in Module 1 on the ground floor across from the
A50508 - Emergency Department.  This is where Cardiothoracic team meets with
A50509 - patients to assess recovery from surgery.  On 091119 met with Niel and
A50510 - Mark following up cabg. 091119 1000, ref SDS 6 0001
A50512 -  ..
A50513 - Explained notice to the medical team of possible a-fib events reported
A50514 - on 101105 2223. ref SDS 9 755I  Follow up was sent a week later on
A50515 - 101110 1216. ref SDS 11 W54S  On 091219, Neil said to submit
A50516 - communictions with the team through Ramone. ref SDS 7 3M6N
A50518 -  ..
A50519 - The coordinator advised that Neil has left the Cardiothoracic surgery
A50520 - team.
A50522 -  ..
A50523 - The coordinator called Ramone.  He advised that notice of possible
A50524 - a-fib events in recent weeks and which was submitted to the team on
A50525 - 101105, and again on 101110, were forwarded to...
A50526 -
A50527 -                      Michael Byrd............ ext 4704
A50528 -                      Bldg 203
A50529 -                      3rd Floor Room 3B30
A50530 -                      General Surgery
A50532 -             ..
A50533 -            [...below Cardiology had not received patient
A50534 -            correspondence submitted by Ramone. ref SDS 0 5B8I
A50536 -  ..
A50537 - After meeting with Tricia in GI Department on the 2nd floor, per
A50538 - above, ref SDS 0 0P71, noticed the Cardiology Department is down the
A50539 - hall, so stopped there before going to the 3rd floor to meet with
A50540 - Michael, per above. ref SDS 0 OS6G
A50542 -  ..
A50543 - Met with receptionist in Cardiology office.
A50545 -  ..
A50546 - Explained background notifying medical team of possible a-fib events
A50547 - reported on 101105 2223. ref SDS 9 755I  Follow up was submitted a
A50548 - week later on 101110 1216. ref SDS 11 W54S  Research on 101115
A50549 - indicated a-fib can cause stroke, ref SDS 14 S070, so called Karen to
A50550 - facilitate feedback on need for examination. ref SDS 14 RJ6N
A50552 -  ..
A50553 - Doctor Jeff Zimmet heard this discussion from his office in back of
A50554 - the reception area.  He came forward and discussed a-fib.
A50556 -  ..
A50557 - Jeff is identified on the Internet....
A50558 -
A50559 -                Jeffery Zimmet, MD
A50560 -                Interventional Cardiologist
A50561 -                UCSF Medical Center
A50562 -                SFVAMC
A50564 -  ..
A50565 - Initially, Jeff advised that a-fib symptoms post-surgery, as in this
A50566 - case, reported a year after surgery, should be reviewed by Cardiology,
A50567 - and not the surgery team.
A50569 -  ..
A50570 - Explained that Karen was called on 101115 to facilitate communication
A50571 - with Cardiology. . ref SDS 14 RJ6N  Called again yesterday and advised
A50572 - would visit the Medical Center today for coordinating review of this
A50573 - new matter.
A50575 -  ..
A50576 - Karen has not arrived, but is expected shortly.
A50578 -  ..
A50579 - Jeff had not received correspondence from Michael, per Ramone's call
A50580 - this morning, reported above. ref SDS 0 OS6G
A50582 -  ..
A50583 - Jeff explained a-fib events result from the heart beating faster than
A50584 - normal, and irregularly, causing in some cases chest pain, fainting,
A50585 - loss of energy, shortness of breath, and stroke.  This aligns with
A50586 - research on 101115 1624. ref SDS 14 KM6M
A50588 -  ..
A50589 - Jeff seemed to indicate that rocking/swaying chest motion reported to
A50590 - the VA on 101105, ref SDS 9 G68X, is not a documented symptom of
A50591 - a-fib.  We reviewed the record on 091024 reporting patient treated for
A50592 - a-fib, and at that time experienced rocking/swaying chest motion.
A50593 - ref SDS 5 HR7G
A50595 -  ..
A50596 - Jeff asked if the primary care physician was notified?  He feels
A50597 - Doctor Egan at the VA Cardiology Clinic in Martinez should evaluate
A50598 - a-fib report on 101105. ref SDS 9 G68U  Jeff feels Doctor Eagan is
A50599 - excellent assessing cardiology issues.  This aligns with review of
A50600 - Doctor Eagan's medical chart applying evidence- based care for the
A50601 - meeting at the VA on 091002 0900. ref SDS 1 7S8M  On 091021, Doctor
A50602 - Eagan was commended for excellence to the cardiothoracic surgery team,
A50603 - reported on 091021 0716. ref SDS 3 FB5N
A50605 -             ..
A50606 -            [On 101223 1030 not enough time for primary care physician
A50607 -            to review afib episodes reported to medical team on 101105,
A50608 -            and notified again on 101110. ref SDS 19 JF5N
A50610 -             ..
A50611 -            [On 110304 1126 scheduled meeting Doctor Egan on 110309 in
A50612 -            Cardiology Department VA Martinez. ref SDS 20 MY9V
A50614 -             ..
A50615 -            [On 110406 1230 treadmill stress test performed; initial
A50616 -            indications are 100% performance, with one node showing
A50617 -            possible slight irregularity. ref SDS 22 OF8F
A50619 -  ..
A50620 - Explained that Doctor Sandhu is the primary care physician.  He was
A50621 - notified on 101105, of possible a-fib events. ref SDS 9 755I  Notice
A50622 - was submitted with email for efficient, clear, concise, complete
A50623 - communication, reported to the VA on 091228 1049, ref SDS 8 JN4V, and
A50624 - implementing evidence-based work practice discussed with Doctor
A50625 - Ratcliff and the CT team at the VA on 091219 0600. ref SDS 7 6R6G
A50627 -  ..
A50628 - Subsequently, the earliest Doctor Sandhu can meet is on 101223,
A50629 - reported in a meeting last week at the VA on 101112 0952. ref SDS 13
A50630 - PP8W
A50632 -  ..
A50633 - Jeff seemed to indicate a-fib events are not always medically
A50634 - significant, but can sometimes cause stroke, as reported on
A50635 - television, shown in the record on 101115 1624. ref SDS 14 S070
A50637 -  ..
A50638 - He explained that testing is required to collect data for thorough
A50639 - assessment of diagnosis and treatment, if any is needed.
A50640 -
A50641 -            [On 110304 1126 scheduled meeting Doctor Egan on 110309 in
A50642 -            Cardiology Department VA Martinez. ref SDS 20 MY9V
A50643 -
A50644 -            [On 110309 0900 Doctor Egan ordered heart monitoring test
A50645 -            to assess possible afib exosure. ref SDS 21 MY9V
A50646 -
A50647 -
A50648 -
A50649 -
A50650 -
A50651 -
A50652 -
A50653 -
A50654 -
A50655 -
A507 -