CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 11 0000, ref SDS 10 0000.
040502 -
040503 -
040504 -
040506 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Blood Clots Doctor Fow Failure Disclose Results Ultrasound Test
040902 - Doctor Fow Failure Disclose Results Ultrasound Test Blood Clots
040903 - Ultrasound Test Blood Clots Doctor Fow Failure Disclose Results
040904 - Knee Surgery Complications Blood Clots Need Ultrasnound Test Results
040905 -
040906 - Received another call from Doctor Fow, returning call yesterday,
040907 - reported on 111115 1028, ref SDS 11 BL9J, and asking about results of
040908 - ultrasound test performed on 111114, which was ordered last Friday on
040909 - 111111, to assess complications from Bob's knee surgery.
040911 - ..
040912 - Made another mistake using the cell phone and dropped the line.
040914 - ..
040915 - Called Doctor Fow back...
040916 -
040917 - 805 473 0700
040919 - ..
040920 - Receptionist said Doctor Fow is in another room. She asked to hold
040921 - the line.
040923 - ..
040924 - Woman came online. She introduced herself as Karen. Her position
040925 - was not explained.
040927 - ..
040928 - Karen said that she placed the call a moment ago for Doctor Fow,
040929 - returning the call a second time from yesterday, per above.
040930 - ref SDS 0 M05H
040932 - ..
040933 - Karen advised that the doctor asked her to call and say that
040934 - information about Bob's condition should be obtained from Doctor
040935 - D'Amburosa at Mission View, because Doctor D'Amburosa is now
040936 - responsible for Bob's care.
040938 - ..
040939 - Explained telecon with Doctor Fow last week on Friday discussing
040940 - Mission View responsibility to provide medical services for physical
040941 - therapy to rehabilitate Bob's knee after Doctor Fow performed surgery
040942 - on 111031, reported on 111111 0802. ref SDS 9 WT4G At that time,
040943 - Doctor Fow was notified that he is Bob's attending physician for knee
040944 - surgery and any complications, reported on 111111 0802, ref SDS 9 JJ98
040946 - ..
040947 - Doctor Fow then said he would request Bob's medical chart from Mission
040948 - View to review for complications from surgery.
040950 - ..
040951 - Later that day, Doctor Fow called Mission View and asked to speak
040952 - with Rod. In that call, Doctor Fow said he is concerned that Bob may
040953 - have blood clots in his lower left leg, and he would review findings
040954 - from the ultrasound test ordered by Doctor D'Amburosa. He further
040955 - asked why the test was delayed from Friday to Monday. The doctor
040956 - planned to contact Mission View to follow up on his patient suffering
040957 - evident complications.
040959 - ..
040960 - Karen asked what complications have occurred from the surgery Doctor
040961 - Fow performed on 111031?
040963 - ..
040964 - We reviewed the list discussed with Doctor Fow on 111111 0802.
040965 - ref SDS 9 XL4P
040967 - ..
040968 - Karen seemed to insist that Doctor Fow should not be involved with
040969 - Bob's care.
040971 - ..
040972 - Explained the doctor's extensive involvement on 111111 0802.
040973 - ref SDS 9 215M
040975 - ..
040976 - Asked Karen if Doctor Fow received a copy of the report on Bob's
040977 - ultrasound test this past Monday, 111114?
040979 - ..
040980 - Karen said that Doctor Fow received a copy, but she cannot relate
040981 - information in the report, because "Rod not is listed as Bob's
040982 - contact.
040984 - ..
040985 - Explained that Kimbeny, who works in the Medical Records Department,
040986 - advised that "Rod" is listed, as Bob's authorized contact at Arroyo
040987 - Grande Community Hospital, where Doctor Fow performed knee replacement
040988 - surgery on 111031, and was attending physician during his recovery
040989 - through 111104, reported on 111114 0715. ref SDS 10 U685
040991 - ..
040992 - Karen advised that since Rod is not listed in Bob's medical chart at
040993 - Doctor Fow's office offsite from the hospital where Bob's surgery was
040994 - performed by Doctor Fow, then the doctor can only discuss Bob's
040995 - medical condition, including results of tests, when he is actually on
040996 - hospital grounds. She feels the doctor cannot rely on hospital
040997 - records to discuss patient history, diagnosis, treatment nor prognosis
040998 - in time to be effective.
041000 - ..
041001 - Thanked Karen for assistance, and asked to her to inform Doctor Fow
041002 - of my request to consult with him on Bob's care.
041004 - ..
041005 - Karen said she will advised Doctor Fow of this call.
041006 -
041007 -
041009 - ..
0411 -
0412 -
0413 - 1818
0414 -
041401 - Bob Cut Loose by Mission View Refusal Treat Surgery Complications
041402 - Mission View Refuse Treat Surgery Complications Release Bob Saturday
041403 - Bob Release Saturday Mission View Refuse Treat Surgery Complications
041404 -
041405 - Bob called.
041407 - ..
041408 - He said good news - Doctor D'Amburoso reported today that Bob has
041409 - progressed much more rapidly than expected, so Mission View is
041410 - releasing him to go home on Saturday.
041412 - ..
041413 - Bob did not explain why if he is not ready to go home today, what
041414 - basis did Mission View give for determining he will be ready for home
041415 - care on Saturday?
041417 - ..
041418 - Bob said he walked today without a walker, and he is doing better with
041419 - the walker as well.
041420 -
041421 - [...below on 111116 0959 Bob reports that taking a shower
041422 - today; feels this shows along with walking without
041423 - assistance using a walker makes him ready to go home and
041424 - care for himself. ref SDS 0 T85G
041426 - ..
041427 - [On 111118 1005 Bob called and clarified understandings
041428 - from discussion today, saying he has not walked at all yet
041429 - without the walker. ref SDS 13 EL80
041431 - ..
041432 - Bob said that Doctor D'Amburoso said today that Bob will need to see
041433 - Doctor Ritter at Arroyo Grande Community hospital for additional blood
041434 - tests and continuing treatment of infection Bob had when he entered
041435 - Mission View a few weeks ago on 111105 0853. ref SDS 7 0554
041437 - ..
041438 - Doctor Ritter is the Infectious Disease specialist who consulted with
041439 - Doctor Fow on treating Bob's infection discovered at Arroyo Grande
041440 - Community Hospital, reported on 111103 0709. ref SDS 5 OR9M Doctor
041441 - Ritter diagnosed Bob has a rare infection caused by reaction to
041442 - antibiotics, 111103 0709. ref SDS 5 OR9M, prescribed at the ER a month
041443 - earlier treating infection diagnosed at that time based on clinical
041444 - observation of scratches on his lower legs, reported on 110919 1800.
041445 - ref SDS 1 NM9M
041447 - ..
041448 - This past Friday, Doctor Fow called and urged that Mission View be
041449 - notified by the patient that doctors at Arroyo Grande Community
041450 - Hopsital have not diagnosed Bob has "infection," but rather he is
041451 - infected with a rare e-coli that is highly resistant to antibiotics,
041452 - reported on 111111 0802 at 1354. ref SDS 9 623O
041454 - ..
041455 - When Bob was released from Arroyo Grande Hospital, Jeff called and
041456 - said his temperature had dropped to normal, and that Doctor Ritter
041457 - approved transfer to Mission View, after implanting a "pic" catheter
041458 - to continue treating Bob's infection at Mission View, reported on
041459 - 111104 0952. ref SDS 6 ZF40 This appears conflicting with Mission
041460 - View reporting that on arrival from Arroyo Grande Community Hospital,
041461 - Bob's temeprature was 100.3, reported on 111105 0853. ref SDS 7 LM97
041463 - ..
041464 - Bob did not say if Mission View has or will remove the "pic" catheter
041465 - implanted at Arroyo Grande Community Hospital, when Bob was sent to
041466 - Mission View on 111104 0952. ref SDS 6 ZF40 He mentioned a few days
041467 - ago that IV antibiotic treatment was ended based on the IV pole being
041468 - removed from his room, reported on 111114 0715. ref SDS 10 U28O
041470 - ..
041471 - Why then does he need to see Doctor Ritter for continuing care of his
041472 - infection?
041474 - ..
041475 - Bob seemed to say he is getting medication for pain. Did not ask if
041476 - Bob is now receiving an oral antibiotic to treat infection and/or
041477 - blood clot problem? Did Doctor Fow increase his Coumadin, per telecon
041478 - with the doctor saying he retained responsibility for this part of
041479 - Bob's care, reported on 111111 0802. ref SDS 9 QH66
041481 - ..
041482 - Bob said he believes that the blood clot problem found by ultrasound
041483 - test on Monday, reported by Bob on 111114 0715. ref SDS 10 1Z4X, is
041484 - okay for him to go home. He indicated inflammation in his leg seems
041485 - better today. This may show good response to treatment. At this
041486 - time, there is no record of what treatment was ordered. Typically
041487 - blood clot problems can take weeks, even months to resolve.
041489 - ..
041490 - Bob did not say who will provide continuing treatment for Bob to
041491 - recover from blood clots found below the knee from the ultrasound test
041492 - this past Monday on 111114 0715. ref SDS 10 1Z4X
041494 - ..
041495 - Bob said that his brother, Allen, can stay with Bob until next
041496 - Tuesday. He asked if I can come back to Nipomo and care for him when
041497 - Allen leaves on Tuesday?
041499 - ..
041500 - Explained schedule to visit Ross and Claudia for Thanksgiving, flying
041501 - out on Tuesday, and returning a week later. Offered to cancel and
041502 - return to Nipomo, if needed.
041504 - ..
041505 - Bob said not to change those plans. He feels everything will be okay.
041507 - ..
041508 - Offered to come down to Nipomo tomorrow afternoon and stay until
041509 - Monday, if Bob feels this can be helpful.
041511 - ..
041512 - Bob said no, that is not necessary.
041514 - ..
041515 - Asked about Bob's plans to hire Terreas for rehab and to provide daily
041516 - care for Bob at home?
041518 - ..
041519 - Bob said he has decided to hire Terreas. He feels she will be all the
041520 - help he needs at the house, and that she can perform in-home
041521 - rehabilitation medical services.
041522 -
041523 - [On 111117 0017 at 2351 letter to Robin explains Bob's
041524 - efforts to arrange for home care. ref SDS 12 SO7Q
041526 - ..
041527 - Asked if he got clarification on getting reimbursed from Medicare for
041528 - the cost of hiring Terreas?
041530 - ..
041531 - Bob said he understands that Terreas is not registered with Medicare,
041532 - so he cannot get reimbursed, but he wants to hire her anyway. Terreas
041533 - lives just a few miles away, so this should be a good arrangement to
041534 - provide close order, realtime support for Bob.
041536 - ..
041537 - Previously, Bob indicated he likes Terreas, and that she did a good
041538 - job, reported on 111104 0952. ref SDS 6 HJ42, when he hired her to
041539 - clean the house, reported earlier on 111030 0916. ref SDS 2 CV9L
041541 - ..
041542 - Asked if rehabilitation is far enough along for him to feel
041543 - comfortable handling personal hygeine at home?
041545 - ..
041546 - Bob said he took a shower today. He feels this together with walking
041547 - without the walker today, per above, ref SDS 0 PY5X, shows he is ready
041548 - to go home.
041549 -
041550 - [On 111117 0017 letter to Robin transmitting this record on
041551 - Bob's plans for going home from Mission View on 111119.
041552 - ref SDS 12 EW5H
041554 - ..
041555 - [On 111117 0017 at 2200 Robin's letter reports reviewing
041556 - this record on Bob's plans for going home on Saturday,
041557 - 111119, ref SDS 12 L45P, which is his birthday. ref SDS 12
041558 - L45S
041560 - ..
041561 - [On 111118 1005 Bob called and clarified understandings
041562 - from discussion today, saying he has not walked at all yet
041563 - without the walker. ref SDS 13 EL80
041565 - ..
041566 - Bob plans to remove some of the throw rugs on the floor to make using
041567 - the walker easier around the house.
041569 - ..
041570 - Bob indicated that his progress today shows he can get around at home
041571 - to feed and provide water for Sandy. There was no discussion in this
041572 - call about risks of Sandy jumping up and causing Bob to fall, while
041573 - alone at home, which was discussed extensively with Ken, the physical
041574 - therapyst, a few days ago on Monday. At that time, Ken planned to
041575 - explain medical risks to Bob, reported on 111114 0715, ref SDS 10 HF47
041577 - ..
041578 - Bob said he appreciated help the past three weeks getting through
041579 - knee surgery, and rehabilitation.
041581 - ..
041582 - Talked about coming down for a visit in a few weeks, after Bob gets
041583 - settled.
041584 -
041586 - ..
0416 -
0417 -
0418 - 2034
0419 -
041901 - Medical Team Cutting Bob Loose Avoid Responsibility for Complications
041902 -
041903 - Bob's report that Mission View has declared him ready to go home on
041904 - Saturday, per above, ref SDS 0 PY4M, after just 2 weeks of rehab,
041905 - indicates Bob has made a "miracle" recovery from knee replacement
041906 - surgery for an 84 year-old patient.
041908 - ..
041909 - Previously,
041910 -
041911 - 1. Doctor Fow said Bob will likely need 3
041912 - weeks of rehab, reported
041913 - on....................................... 111103 0709 at 0828. ref1SDS 1 QU3I
041915 - ..
041916 - 2. Francis, nurse at Mission View Control
041917 - Station #2, reported that knee replacement
041918 - surgery patients take more time to rehabilitate,
041919 - some patients take months at Mission
041920 - View, reported on........................ 111105 0853 at 1620. ref2SDS 2 T96O
041922 - ..
041923 - 3. Bob reported that Mission View staff advised
041924 - that his care has to be extended past Thanksgiving,
041925 - because Bob's infection is delaying
041926 - rehabilitation, shown in the
041927 - record on................................ 111109 1032. ref SDS 8 U48O
041929 - ..
041930 - 4. Laurie, Medicare Administrator at Mission
041931 - View, said rehabilitation for knee replacement
041932 - patients usually takes 3 - 6 weeks, and that
041933 - Bob's infection will likely cause Bob's
041934 - rehab to take longer than most
041935 - patients, reported
041936 - on....................................... 111111 0802. ref SDS 9 W54O
041938 - ..
041939 - 5. Laura, the physical therapyst at Mission View,
041940 - said patients typically need 4 weeks to rehabilitate
041941 - after knee replacement surgery, reported
041942 - on....................................... 111111 0802 at 1822. ref4SDS 4 JR5H
041944 - ..
041945 - 6. Ken, Manager Physical Therapy at Mission View,
041946 - said Bob will require another 2 - 4 weeks of
041947 - physical therapy to be ready for living
041948 - alone at home, very concerned about
041949 - Bob's dog, Sandy reported
041950 - on....................................... 111114 0715. ref SDS 10 KL3M
041952 - ..
041953 - Suddenly, 2 days after ultrasound test, a patient profile....
041954 -
041955 - a. 84 years old
041956 - b. lives alone with large, frisky dog
041957 - c. infection resistant to antibiotics
041958 - d. low blood counts may need infusion
041959 - e. blood clots causing inflammation lower leg
041960 -
041961 - ...can now be "cut loose" to fend for himself, contrary to advice of
041962 - every provider who has seen this patient, per study. ref SDS 0 JT58
041964 - ..
041965 - Specifically, Laurie, Mission View Medicare Manager cited Medicare
041966 - requirements for standard of care must correlate to patient profile so
041967 - that risks of falling at home do not cause further injury and needless
041968 - increased medical costs, reported on 111111 0802. ref SDS 9 574F
041970 - ..
041971 - Have not seen the report on the ultrasound test, per refusal of
041972 - surgeon to even discuss, shown above. ref SDS 0 M05H
041974 - ..
041975 - Looks like Misison View is releasing Bob to avoid responsibility for a
041976 - patient with surgery complications, per above. ref SDS 0 NG5L
041978 - ..
041979 - Karen said this morning, that Doctor D'Ambruoso should be called about
041980 - results of Bob's ultrasound test. The record today indicates that
041981 - Doctor D'Ambruoso is stepping away from a complicated case.
041983 - ..
041984 - This aligns with the record of Arroyo Grande Care Center refusing to
041985 - take Bob as a rehabilitation patient, reported on 111104 0952 at 1640,
041986 - ref SDS 6 529I, and probably because they did not want responsibility
041987 - to treat surgery complications, per above. ref SDS 0 NG5L Community
041988 - Hospital shopped around to find a facility, per telecon from Jeff at
041989 - Community Hospital also on 111104 0952 at 1710. ref SDS 6 05HB
041991 - ..
041992 - May turn out that Mission View did not know Bob required care to
041993 - recover from complications after knee surgery, when he was admitted on
041994 - 111104, based on mistakes finding a rehab facility, reported on 111104
041995 - 0952. ref SDS 6 529I
041997 - ..
041998 - Additionally, the report on 111114, that Arroyo Grande Community
041999 - Hospital has no discharge document, 111114 0715, ref SDS 10 U685, may
042000 - indicate Mission View was not aware of the scope of care Bob required
042001 - when he was admitted. Francis, the nurse at Station #2, indicated
042002 - Mission View did not have a discharge document on file, during the
042003 - meeting at Mission View on 111111 0802. ref SDS 9 1W3K
042005 - ..
042006 - Bob said the other day that IV treatment for infection was stopped,
042007 - but today, Doctor D'Amburoso said Bob should see Doctor Ritter for
042008 - continued recovery from infection. This seems conflicting.
042010 - ..
042011 - On Friday, Francis said that Doctor D'Amburoso issued standing orders
042012 - for Bob to get CBC lab on Monday's, reported on 111111 0802.
042013 - ref SDS 9 MC6U This indicates that Mission View reasonably expected
042014 - Bob to need continuing rehabilitation services for weeks to come,
042015 - otherwise there was no need for a "standing order" to perform CBC lab
042016 - on Mondays, if Bob would only be at Mission View for one Monday.
042018 - ..
042019 - This record appears that Mission View seeks to avoid responsibility
042020 - for continuing Bob's care required to recover from side effects of
042021 - knee replacement surgery concurrent with providing rehabilitation
042022 - services, contrary to Doctor Fow's plan on the day of surgery,
042023 - reported on 111031 0800. ref SDS 3 CS8H
042025 - ..
042026 - Does Bob have a Medicare case officer to verify that money paid to
042027 - providers has purchased health care services that meet requirements
042028 - for standard of care?
042029 -
042030 -
042031 -
042032 -
042033 -
042034 -
042035 -
042036 -
042037 -
042038 -
0421 -