THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: August 12, 2016 04:26 PM Friday; Rod Welch

VA GI Doctor Lee called schedule EGD 160816 and request interim Peer Reviewed report.

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 24 0000. ref SDS 23 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040507 -  ..
0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040901 - Doctor Lee related discussion with Doctor Massa yesterday.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040902 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040903 - Mentioned Doctor Massa's letter setting out understandings from the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040904 - call with Doctor Lee and efforts to advance the next EGD Dilation to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040905 - address rising achalasia symptoms. 160811 1546, ref SDS 23 OT3H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040907 -  ..
040908 - Doctor Lee said he has not had time to check his mail, and so has not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040909 - read Doctor Massa's letter yesterday, nor the letter sent earlier this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040910 - morning to the team asking for an interim release on progress so far                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040911 - performing Peer Review, 160812 1119, ref SDS 24 1W40, ordered by                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040912 - Doctor Lee on 160714, following telecon and confirmed in a letter on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040913 - 160714 0814. ref SDS 4 SG67                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040915 -  ..
040916 - Doctor Lee said that he discussed possible causes for stroke symptoms                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040917 - following the last EGD dilation on 160617.  Doctor Massa wants to do                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040918 - another MRI after the next EGD procedure to continue testing for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040919 - adverse neurology conditions following the procedure, as occurred                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040920 - previously.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040922 -  ..
040923 - Doctor Lee said he has scheduled the next EGD dilation for next                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040924 - Tuesday on 160816 0800.  He will notify Doctor Massa of this schedule,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040925 - so that the doctor can order another MRI the next day at the VA                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040926 - Medical Center in San Francisco, as he and Doctor Massa discussed in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040927 - their call yesterday, reported on 160811 1546. ref SDS 23 1I8N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040929 -  ..
040930 - Requested interim report on Peer Review, which he ordered on 160714,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040931 - as set out in the letter to Doctor Massa earlier this morning on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040932 - 160812 1119. ref SDS 24 1W40  The Peer Review order was noticed by                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040933 - Doctor Yoo accessing Doctor Lee's Progress Notes for 160714, when we                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040934 - met for Neurology Clinic the next day on 160715 1630. ref SDS 5 8Q48                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040936 -  ..
040937 - Doctor Lee said the report is not completed yet.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040939 -  ..
040940 - Explained interim report on what has been done so far, aids assessment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040941 - of viability doing the next EGD procedure, now scheduled in just 5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040942 - days on 160816.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040944 -  ..
040945 - Doctor Lee said the Peer Review process is performed by someone else,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040946 - so he does not control the speed of the process.  He said there is a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040947 - meeting of the GI Clinic doctors to discuss the case, before the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040948 - report is finalized.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040950 -  ..
040951 - We reviewed urgency of gathering available evidence to avoid                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040952 - repetition of stroke symptoms or worse, as set out in the letter to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040953 - the team this morning. 160812 1119, ref SDS 24 1W43                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040955 -  ..
040956 - Doctor Lee said he would speak with the person leading the Peer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040957 - Review process about getting an interim report on their work product                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040958 - to date.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040960 -  ..
040961 - Asked Doctor Lee if he feels confident doing another EGD dilation                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040962 - procedure will not result in further stroke symptoms?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040964 -  ..
040965 - Doctor Lee said he is very confident, otherwise he would not do the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040966 - procedure.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040968 -  ..
040969 - Based on patient history doing 19 prior procedures with Doctor Lee,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040970 - agreed to procede.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040971 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040972 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
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040976 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
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040978 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040979 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040980 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040981 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040982 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040983 -