Monday, December 31, 2012

San Diego Pharmacy to Pay $11.4M to Settle Kickback Allegations

See other posts about doctors bought by insurance companies.

SD Pharmacy to Pay $11.4M to Settle Kickback Allegations
Alleged kickbacks included tickets to sports events, spa, golf and ski outings and expensive dinners
Dec 28, 2012

The U.S. Justice Department says a specialty pharmacy based in San Diego has agreed to pay about $11.4 million to resolve allegations it used kickbacks to induce doctors to write prescriptions for its products.

The Justice Department says under an agreement announced Thursday, Victory Pharma Inc. agreed to pay a criminal forfeiture of $1.4 million to resolve anti-kickback statute allegations and more than $9.9 million to resolve false-claims allegations.

The alleged kickbacks included tickets to sports events, concerts and plays, spa, golf and ski outings, expensive dinners and other events.

Authorities also say Victory encouraged sales representatives to schedule paid "preceptorships" in which they shadowed doctors in their offices to induce them to prescribe Victory's products.

A company phone listing could not be immediately located.

Friday, December 28, 2012

Kaiser sued for its common practice of releasing incorrect records

The medical records system at Kaiser is rather odd. It seems they often give the wrong records, or no records at all. I've received altered records from Kaiser, and a bizarre set of X-rays with many duplicates that Kaiser prepared in an apparent effort to hide the fact that most of my X-rays were missing from the set. Also, they gave Stutz, Artiano Shinoff & Holtz 20 years of my records illegally. It turned out that the woman at Kaiser who authorized the release was Facebook friends with Dan Shinoff's wife!

Man Claims Kaiser Screw-up Cost Him
Courthouse News Service
December 27, 2012

CLEVELAND (CN) - The Ohio National Guard rejected a man's application for Officer Candidate School because a Kaiser employee entered "intermittent explosive disorder" into a computer system, though he never had been diagnosed with that, the man claims in court.

Simon Montgomery sued Kaiser Foundation Health Plan of Ohio, Ohio Permanente Medical Group, and Constance Baker-Alden, who allegedly made the computer mistake, in Cuyahoga County Court. The National Guard is not a party to the complaint.

Montgomery claims he was diagnosed with "exercise-induced syncope" after he fainted after working out on a treadmill in February 2010. After this, his doctor had told him "that he was medically cleared for all activities and that the isolated incident should not be a cause for concern," according to the complaint.

Montgomery applied for Officer Candidate School in January 2010. To do so, he signed waivers allowing the National Guard to review his medical records.

The Guard rejected him, in a letter that said "his application for enlistment had been denied because of a permanent medical disqualification for Intermittent Explosive Disorder and exercise-induced syncope," the complaint states.

Montgomery says he appealed to the Guard, in a letter stating that the fainting episode happened just once and that the diagnosis of intermittent explosive disorder was incorrect.

He claims that Baker-Alden, "as an employee of Kaiser and/or Permanente," wrote a letter to him, which he immediately forwarded to the Guard.

"This letter explained that Baker-Alden had incorrectly entered the diagnosis of Intermittent Explosive Disorder on plaintiff's medical records," the complaint states.

The Guard rejected his appeal, "because his medical records were contradictory," Montgomery says.

As a result, he says, he applied to the Naval Reserves as an enlisted man, for monthly pay of $366 less than he would have earned as an officer in the National Guard.

He seeks punitive damages for more than $25,000 for negligence.

He is represented by Ann-Marie Ahern, with McCarthy, Lebit, Crystal & Liffman.

Friday, December 21, 2012

Kaiser Urology Department in San Diego admits truth about removing the wrong kidney

In the article below, Kaiser says that its mistakes are "rare." The truth is that it is rare for Kaiser to honestly report its mistakes, and the policy of falsifying medical records is supported at the highest levels of Southern California Kaiser Permanente Medical group and Kaiser Foundation Hospitals.

Here's a link about how Kaiser Permanente's urology department in San Diego covers up the truth: comparison of hospital urology departments.

Also see: Kaiser kidney transplant scandal

Here's a list of recent Kaiser lawsuits taken from the Courthouse News website: Kaiser Bad News.

San Diego Kaiser Hospital Fined For Removing Wrong Kidney
City News Service
December 20, 2012

A San Diego hospital was among 10 medical centers across the state that were assessed administrative penalties today for actions that caused, or could have caused, serious injury or death to patients.

According to state Department of Public Health officials, Kaiser Foundation Hospital failed to follow surgical policies and procedures in 2010, leading to a surgeon removing the wrong kidney from an 85-year-old man.

Hospital officials said that while extensive safety measures were in place, staffers acted quickly to identify the cause of the error and implemented safety measures to help ensure such an event would not be repeated.

"We sincerely regret that this error in 2010 occurred at the Kaiser Permanente San Diego Medical Center. While these types of incidents are very rare, we take the matter extremely seriously,'' according to a hospital statement. "At the time of the incident, we immediately reported the matter to the California Department of Public Health, and fully cooperated with the investigation.''

The hospital was fined $75,000 -- the second administrative penalty the medical center has received.

The hospital was assessed a $50,000 penalty after a towel was left inside a patient who underwent surgery for gallstones in 2009, U-T San Diego reported.

The CDPH issued 12 penalties to hospitals in San Diego, San Francisco, Oakland, San Rafael, Harbor City, Arcadia, Visalia, Mission Viejo, Fountain Valley and Crescent City.

Administrative penalties for incidents that happened before 2009 carried a fine of $25,000. For later incidents, $50,000 was assessed for a first violation, $75,000 for a second and $100,000 for subsequent violations. Incidents before 2009 were not included.

Hospitals were also required to provide a plan to prevent future incidents. Kaiser's plan included updated policies and procedures, and staff training "to prevent the reoccurrence of a surgical procedure being performed on a wrong body part.''

Surgeons and operating-room nurses will also ensure all relevant imaging studies are available and any surgical or invasive procedure for which an image was obtained will be available and reviewed, according to CDPH documents.

A multidisciplinary surgical safety team that meets weekly to discuss ideas for continuously promoting safe operating practices was implemented in May 2011, according to hospital officials.

Hospitals can appeal an administrative penalty by requesting a hearing within 10 days of the notification.

Monday, December 10, 2012

Flashblind: patient exposes Dr. Paul Bernstein's policy of giving lots of X-rays, but concealing the results

Dr. Paul Bernstein, left, celebrates opening of the new Garfield center in San Diego. A large series of X-rays taken at this same building two weeks later, claims Bernstein, have not been released to the patient because they were "not saved digitally or on film." Apparently patients are radiated at Kaiser, and the results are used for no purpose at all, not even research.

Dr. Paul Bernstein has scruples. He often sets them aside to pull in the big bucks as Kaiser Permanente Medical Director in San Diego, but it seems to trouble him when he harms patients in pursuit of profits.

His latest book seems to be an effort to find doctors that are worse than he is. Ironically, he relied on the Freedom of Information Act to research the book, while he supports the falsification and concealment of Kaiser medical records.

San Diego Medical Director and Author Exposes Government Experiments in New Release
Hollywood Industry
August 01, 2012

Los Angeles, California (PRWEB)

Dr. Paul Bernstein will be introducing his newest, controversial release, Flashblind, in La Jolla, discussing the grim truth behind the work of fiction, as revealed in his extensive research via the Freedom of Information Act (FOIA).

Flashblind, a medical thriller, brings to light the actual history of government sponsored radiation experiments on American citizens throughout the atomic age. Funded by the US Department of Energy--the same agency responsible for testing nuclear bombs--carefully guarded genetic research experiments were done in secret for decades.

Award-winning author and medical director for Kaiser Permenente in San Diego, Dr. Paul Bernstein will discuss this new and highly acclaimed novel, "Flashblind," at a book signing on Sunday, August 5, from 12 p.m. to 2 p.m. at Warwick's at 7812 Girard Avenue, La Jolla. Here's another story about how Kaiser handles X-rays and reports.

Tuesday, December 4, 2012

Family, Kaiser Reach Settlement in Malpractice Complaint in severe burns by antibiotic incorrectly administered

It's hard to imagine the burns this child suffered; click on the title below to see a photo of the injury.

Family, Kaiser Reach Settlement in Malpractice Complaint
Sonseeahray Tonsall
Dec. 5, 2012

FOX40 first reported what happened to little Mia Stevens back in September.

Then, her parents were fighting for recognition of what they say was an inexcusable mistake by Kaiser Roseville and help for the healing Mia will need in the future.

Now, they say they have both.

These days, Mia Stevens is learning how to be a great big sister to two-week-old Mya and she’s still learning how to deal with what happened to her last may at Kaiser Roseville.

She received third degree burns on her right arm when IV antibiotics were pumped into her tiny hand instead of a vein, scarring her from the inside out.

But now, along with a baby sister, the other new development in her life is a settlement with the hospital where she was hurt.

“They wanted to do all they can to help Mia and that’s all we wanted for Mia,” said her father, Charles Stevens.

Mia’s parents couldn’t sue the hospital in open court because they signed that right away, as all Kaiser patients do, when they enrolled for coverage.

They were allowed to seek relief through arbitration, something they say other parents shouldn’t be afraid to do.

“When we’re sick we need to go to the doctor, but no one’s perfect,” said Stevens. “Most medical malpractice cases are not pursued, they’re just forgotten. They’re swept under the rug, so I admire the Stevens family for saying, ‘We’re going to do something about this not only for our child, but to prevent it from happening to other children,’” said Moseley Collins, Stevens’ family attorney.

In their original demands, the Stevens family asked for extra training for nurses to stop another injury like this.

In statements to FOX40, Kaiser has said, “We are very sorry that this occurred and understand how distressing it is for Mia and her family. A situation like this should not occur.”

Settlement terms keep the Stevens from discussing specific monetary or educational concessions made by the hospital, but they’re confident all is being done so that Mia’s case stands alone.

When FOX 40 visited Mia Monday she was taking a break from wearing the compression glove that is part of her treatment to control scarring.

That is the big concern for her future along with maintaining function. Her recovery is far from over.

Sunday, December 2, 2012

Another naughty doctor (now congressman) wants to be in charge of women's bodies

Scott DesJarlais: 'God Has Forgiven Me' For Scandalous Past (LISTEN)
The Huffington Post
By Paige Lavender

Rep. Scott DesJarlais (R-Tenn.) told a radio host God has "forgiven" him for his scandalous past, including having an affair with a patient and later pressuring her to get an abortion.

"As far as where I stand on pro-life [issues,] I feel I have been very solid in my views," DesJarlais told conservative talk show host Ralph Bristol Saturday. "I don't think, Ralph, that I implied that there was nothing in my past. I didn’t go back and dig up all my personal shortcomings and display them. I went through this divorce a long time ago. I made a very poor decision in my first marriage. I know God's forgiven me.”

A phone call transcript first obtained by The Huffington Post revealed DesJarlais, a pro-life congressman who worked as a doctor, had slept with a women he met as a patient with a foot problem as his marriage was falling apart:

"You told me you'd have an abortion, and now we're getting too far along without one," DesJarlais tells the woman at one point in the call while negotiating with her over whether he'll reveal her identity to his wife. They then discuss whether he will accompany her to a procedure to end the sort of life the congressman now describes as "sacred."

"You told me you would have time to go with me and everything," the woman complains.

"I said, if I could, I would, didn't I? And I will try," DesJarlais says. "If I can [find] time, you're saying you still will?"

"Yeah," the woman answers.

The two bicker over when they can meet to hash out a solution, and they make clear the nature of their relationship when DesJarlais says delaying a resolution isn't fair to his wife.

"This is not fair to me. I don't want you in my life," the woman says.

"Well, I didn't want to be in your life either, but you lied to me about something that caused us to be in this situation, and that's not my fault, that's yours," the doctor responds.

"Well, it's [your] fault for sleeping with your patient," the woman fires back.

DesJarlais has acknowledged the conversation, but said he was only trying to get her to admit she wasn't pregnant. He easily won a second term despite the controversy.

More scandal from DesJarlais' past emerged when court documents revealed he and his former wife made a "mutual" decision for her to have two abortions. DesJarlais testified during divorce proceedings that the first abortion was was because she was taking an experimental drug that carried potential risks in pregnancy; the second came as the couple experienced problems in their relationship.

An American James Bond and a killer bag lady--and doctors from Stanford and U W

I recommend clicking on the title of the article below to read the entire story. It's too amazing to describe in a nutshell, and it is much longer than the clips I've provided. Along with evil doctors, it involves Ronald Reagan's CIA director William Casey, a young Chuck Schumer as investigator, and the remarkable career of a suave banker from Transylvania. It even involves the company that bankrolls Glenn Beck.

James Bond and the killer bag lady
New clues and a powerful Wall St. skeptic challenge the official story of CIA financier Nick Deak's brutal murder
DEC 2, 2012

On the morning of Nov. 19, 1985, a wild-eyed and disheveled homeless woman entered the reception room at the legendary Wall Street firm of Deak-Perera. Carrying a backpack with an aluminum baseball bat sticking out of the top, her face partially hidden by shocks of greasy, gray-streaked hair falling out from under a wool cap, she demanded to speak with the firm’s 80-year-old founder and president, Nicholas Deak.

The 44-year-old drifter’s name was Lois Lang...

New revelations about Lois Lang’s transformation from homecoming queen to homeless killer provide excellent grist for substantive speculation, if not the basis for officially reopening the Deak case.

A standout college athlete with an M.A. from the University of Illinois, Lang married in the mid-’60s and took a job coaching the University of California-Santa Barbara women’s tennis and fencing teams. An old U.C.-Santa Barbara yearbook shows coach Lang standing tall in a team photo. It was around this time that she began losing her mind, seeing “fakes” all around her, strangers whom she accused of pretending to be family members, her husband and, at an open-casket funeral, her mother’s corpse.

In 1970, the university declined to renew her coaching contract. Lang and her husband soon divorced. Her life quickly became a blur. Lang complained of “amnesia” and said that her ex-husband’s business partner moved her into an apartment in Mountain View, Calif., where she lived on “grants” and “took flying lessons.” (Moffett Field Naval Base and NASA’s Ames Research Center are located there). She told psychiatrists in 1985 that this business partner, or his “fakes,” took her to Deak’s offices at 29 Broadway in 1971. She said that “friends” taught her marksmanship at firing ranges. In August 1975, records show that Lang was discovered naked and catatonic in a Santa Clara motel room. (Neither Lang’s ex-husband nor his “business partner” could be located. Lang, who is imprisoned at a federal facility two hours north of New York City, did not respond to interview requests.)

Police responding to the motel room took Lang to nearby Santa Clara Valley Medical Center. For the next month, she was put under the care of Dr. Frederick Melges, a psychiatrist associated with the Stanford Research Institute. One of Dr. Melges’ main areas of research: drug-aided hypnosis. A few years after Lang was put in Melges’ care, the New York Times exposed the Stanford Research Institute as a center for CIA research into “brain-washing” and “mind-control” experiments in which unwitting subjects were dosed with hallucinogenic drugs and subjected to hypnosis. Melges, who died in 1988, is today remembered in the field for his research on the relationship between perceptions of time and mental illness.

Congressional hearings subsequently uncovered a large network of top-secret CIA-funded psychological warfare programs grouped loosely under the project name MK-ULTRA. These programs today sound like absurd cloak-and-dagger relics of “Twilight Zone”-inflected Cold War hysteria. But the people running these programs, which continued until at least 1979, were often leading researchers backed by the U.S. government. Enormous resources were committed to the study of how human behavior might be controlled for the purpose of interrogation and the creation of “programmed” assassins and couriers. In a detailed roundup of MK-ULRA-related operations, Psychology Today explained that the CIA “conducted or sponsored at least 419 secret drug-testing projects” at “86 United States and Canadian hospitals, prisons, universities, and military installations,” and that “by the agency’s own admission, many [experimental subjects] were ‘unwitting’.”

The Stanford Research Institute received CIA funding, and Dr. Melges published work about using drugs and hypnosis to create “disassociative states,” i.e., induced schizophrenia. One of Melges’ partners on these experiments was a doctor named Leo E. Hollister, who first dosed Ken Kesey with LSD as part of an Army experiment in 1960. He later admitted to author John Marks that he conducted drug research for the CIA. Marks’ 1979 book, “The Search for the Manchurian Candidate,” contains numerous such revelations about other government researchers.

In other words, the doctor who cared for Lang in Santa Clara was a senior figure at one of the CIA’s top institutional grantees. He worked side-by-side with a self-identified CIA collaborator, and conducted research into the kind of drug-induced behavior modification that the agency is known to have funded.

Following her release from Melges’ care, Lang began a long period as a drifter, leaving behind a record typical of such a life: petty crimes, arrests, stints in and out of psychiatric hospitals. Her only known job was at the once famously mobbed-up Harrah’s casino on the Nevada-California border (where Frank Sinatra’s son was kidnapped in 1963). By the early 1980s, Lang drifted north to her birthplace and spent her last free years lurking around the University of Washington campus wearing a feathered Robin Hood cap. Occasionally she was arrested and sent to one of the nearby mental hospitals before making her way back again. A local police officer told the New York Times after her arrest in 1985 that Lang “usually had money,” despite roaming “the [university] campus in unkempt clothes, usually wearing a green felt Tyrolean-style hat.” Once the police found more than $800 in her possession.

As with Stanford, the university employed a military-linked behavioral psychiatrist, Dr. Donald Dudley, who later became infamous for carrying out experiments in behavior modification. Dudley taught there from the 1960s through the early 1990s, and also worked at nearby mental institutions where Lang was periodically committed. The landmark lawsuit that ended Dudley’s career revealed that Dudley’s hobby was taking patients brought to him for lesser mental illnesses, pumping them full of drugs, hypnotizing them, and trying to turn them into killers.

We know this thanks to a suit brought by the family of Stephen Drummond, who entered Dudley’s care in 1989 for autism treatment. He was returned to his family in 1992 suffering from severe catatonia. According to lawsuit testimony, Dudley shot Drummond up with sodium amytal and hypnotized him with the intention of “erasing” a portion of his brain and turning him into an assassin. When Drummond’s mother confronted Dudley, the mad scientist threatened to have her killed, claiming he worked for the CIA. Dudley was arrested soon after the confrontation in a local hotel where he had shacked up to “treat” a suicidal 15-year-old drifter. Dudley had given the boy sodium amytal and several other drugs, hypnotized him, and convinced him that he was part of a secret army of assassins. Police were called in when the boy threatened hotel staff with a .44 caliber handgun. Not long after, Dudley died in state custody and his estate was forced to pay the largest psychotherapy negligence lawsuit in history. During the trial, it emerged that Dudley had possibly subjected hundreds of victims to similar experiments. Lang was not mentioned...

Friday, November 30, 2012

Samuel Shem: What I've learned from speaking out against the brutality of medical training

Samuel Shem, 34 Years After 'The House of God'
What I've learned from speaking out against the brutality of medical training, in advocacy of quality connection -- and four additional "laws" for good doctors
By Samuel Shem
The Atlantic
Nov 28 2012

For better or worse, except in real danger, I don't seem to run on fear. Guilt, yes; fear, no.

It's a good thing, because my book The House of God enraged many among the older generation of doctors. I was maligned and disliked. The book was censored by medical school deans, who often kept me from speaking at their schools. None of it really bothered me, though. I was secure in the understanding that all I had done was tell the truth about medical training.

I took this pseudonym because I was just starting my psychiatric practice and wanted to protect my patients from knowing that their therapist had written such an irreverent novel. (They all found out, and didn't care -- but "Shem" had arrived, and refused to depart.) I also felt that real writers had no place in going out and publicizing their novels. I refused all invitations. And then one day I got a letter forwarded from my publisher, which included the line:

"I'm on call in a V.A. Hospital in Tulsa, and if weren't for your book I'd kill myself."

I realized that I could be helpful to doctors who were going through the brutality of training. And so I began what has turned out to be a 35-year odyssey of speaking out, around the world, about resisting the inhumanity of medical training. The title of my talk is almost always the same: "Staying Human in Health Care."

The theme of my speaking out is simple: the danger of isolation, the healing power of good connection. And any good connection is mutual.

I base a lot of my talks on what I've learned from The House of God. About how I've come to see it, and all my novels, as a "fiction of resistance," a way of resisting the injustices of a system.

It wasn't until years into my journey that I realized the importance of the fact that I and my fellow interns were products of the 1960s. We grew up in that unique lost period of American history -- beginning with FDR and ending with Reagan -- when we learned that if we saw an injustice, and got together and took action, we could bring about change. During my college years, we helped put the Civil Rights laws on the books and ended the Vietnam War. When we entered our internships we were a generation idealistic young docs. We soon were caught in the clash between the received wisdom of the medical system, and the call of the human heart. Our patients, and we, were being treated inhumanely. As Chuck the intern put it:

"How can we care for our patients, man, if nobody cares for us?"

If we decide to walk through suffering alone -- "stand tall, draw a line in the sand, tough it out" -- we will suffer more, and spread more suffering around.

And so we took action. The novel can be read as a model of nonviolent resistance. Big hospitals, like all large hierarchies, are "power-over" systems. The pressure comes down on the ones at the bottom, and they become isolated. Not only do they get isolated from each other, but each gets isolated from his or her authentic experience of the system itself. You start to think "I'm crazy," instead of "This is crazy." In The House one of the interns does go crazy, and another commits suicide.

The crucial question is how to find mutuality -- or "power-with" -- in a "power-over" system. Historically, the only threat to the dominant group -- whether of race, gender, class, sexual preference, ethnicity -- is the quality of the connection among the subordinate group.


In The House of God there were 13 "Laws." I would now add these four:

Law 14 : Connection comes first. This applies not only in medicine, but in any of your significant relationships. If you are connected, you can talk about anything, and deal with anything; if you're not connected, you can't talk about anything, or deal with anything. Isolation is deadly, connection heals.

One of the worries in how the new generation of doctors practice medicine is their use of computers. If you have a laptop or smart phone between you and your patient, you are much less likely to create a good, mutual connection. You will miss the subtle signs of the history, of the person. With a screen between you, there is no chance for mutuality, and the connection has qualities of distance, coolness, rank, authority, and even disinterest. The "smart" digital appendages can make you, in human-connection terms, a "dumb" doctor.

This, as more and more studies suggest, can lead -- hand in hand with the tyranny of algorithms and other "quality/efficiency/cost-containers" -- to more tests, more errors and medical mistakes, lower quality care, and higher costs to all.

Law 15 : Learn empathy. Put yourself in the other person's shoes, feelingly. When you find someone who shows empathy, follow, watch, and learn.

Law 16 : Speak up. If you see a wrong in the medical system, speak out and up. It is not only important to call attention the wrongs in the system, it is essential for your survival as a human being.

Law 17 : Learn your trade, in the world. Your patient is never only the patient, but the family, friends, community, history, the climate, where the water comes from and where the garbage goes. Your patient is the world.

Some have said that The House of God is cynical. And yet in rereading, it has a constant message that I was dimly conscious of in writing: being with the patient. In the words of the hero of the novel, the Fat Man, "I make them feel that they're still part of life, part of some grand nutty scheme, instead of alone with their diseases. With me, they still feel part of the human race." And as the narrator Roy Basch realized, "What these patients wanted was what anyone wanted: the hand in their hand, the sense that their doctor could care."

And so in 1974 I came away from The House of God aware of at least one thing: The essence of medical care, and life, is connection.


Fast forward 30 years.

I have published two more novels -- Fine and Mount Misery. Also, with my wife, co-wrote the play Bill W and Dr. Bob about the founding of Alcoholics Anonymous, and a nonfiction book We Have to Talk: Healing Dialogues Between Women and Men.

Love and death. How lucky we are.

During this time, as they say, life happened. There were many life struggles, and walks through the suffering. Luckily, at the right times, I was accompanied by others.

From Mount Misery, and also from conducting gender dialogues all over the world while writing We Have to Talk, I learned the importance of shifting focus from a center on "I" or "You", to "We." As in, for physicians, "We've got all the information; let's talk about what we can." The patient will say, "I think maybe we should .. " Suddenly there is a concreteness in your approach to treatment, that you are in this together.

From Bill W. and Dr. Bob, I learned that, in Bill's words: "The only thing that can keep a drunk sober is telling his story to another drunk." Alone, an alcoholic cannot resist alcohol. The self alone -- self-will or self-discipline -- will not work. What works is asking for help from a non-self-centered perspective. AA is an astonishing mutual-help organization, because alcohol and drugs are diseases of isolation.


My latest novel, The Spirit of the Place, took me in a new direction. I had always wanted to go back to my small town on the Hudson River and join my old mentor, a family doctor, in practice. Life had taken me elsewhere, but the beauty of fiction is that you can do in a novel what you haven't in the world.

At a point toward the end of the novel, the fraught protagonist has to make a choice. He struggles with it until he hears a kind of voice in his head:

"Don't spread more suffering around. Whatever you do, don't spread more suffering around." ...

--Samuel Shem, MD, PhD, is a doctor, novelist, and playwright. He is the author of books including The House of God and The Spirit of the Place.

Kaiser Employee Reported Illicit Patient Charges, Fired

Most Kaiser Permanente management employees, including doctors, understand what is required of them: they must go along with whatever is needed to increase profits. This woman didn't understand how Kaiser and other healthcare entities do business.

Woman: Reported Illicit Patient Charges, Fired
Courthouse News
November 29, 2012

PORTLAND (CN) - Kaiser fired its director of patient access business services for reporting what she believed was patient fraud, the director says in a complaint filed in Multnomah County Court.

Aimee Mansell sued Kaiser and her boss Lisa Morrison for wrongful termination and whistle blowing.

Mansell says in her complaint that she blew the whistle on Morrison, who had "devised a policy where Emergency Department employees, including Ms. Mansell, would collect an additional 'triage' charge from Emergency Department patients, or include the triage charge on that patient's invoice for services."

Because she believed the charges to be a violation of state and/or federal law, Mansell reported these violations to defendant's complaint hotline, the court complaint says.

"On numerous occasions Ms. Mansell complained to her supervisors, human resources department, and managers at Kaiser about what she believed in good faith were different work related violations which were being committed by defendant Ms. Morrison and other Kaiser employees," her court complaint continues.

"A substantial factor in Kaiser's decision to terminate Ms. Mansell's employment was due to her fulfilling the societal obligation of reporting what she believed in good faith was patient fraud, and by protesting these triage charges which defendant Ms. Morrison had imposed or planned to impose on patient accounts," Mansell says in her complaint.

A few months before she was fired, Mansell was presented an award "In recognition of many achievements and contributions throughout the year," signed by her direct supervisor and defendant Morrison, the Patient Access Business Services Director, according to the complaint.

Plaintiff is represented by Patrick D. Angel of Portland.

Thursday, November 22, 2012

Cancer Survivor or Victim of Overdiagnosis?

It appears that over a million women who didn't have breast cancer were diagnosed with it and treated for it.

Cancer Survivor or Victim of Overdiagnosis?
New York Times
November 21, 2012

FOR decades women have been told that one of the most important things they can do to protect their health is to have regular mammograms. But over the past few years, it’s become increasingly clear that these screenings are not all they’re cracked up to be. The latest piece of evidence appears in a study in Wednesday’s New England Journal of Medicine, conducted by the oncologist Archie Bleyer and me.

The study looks at the big picture, the effect of three decades of mammography screening in the United States. After correcting for underlying trends and the use of hormone replacement therapy, we found that the introduction of screening has been associated with about 1.5 million additional women receiving a diagnosis of early stage breast cancer.

That would be a good thing if it meant that 1.5 million fewer women had gotten a diagnosis of late-stage breast cancer. Then we could say that screening had advanced the time of diagnosis and provided the opportunity of reduced mortality for 1.5 million women.

But instead, we found that there were only around 0.1 million fewer women with a diagnosis of late-stage breast cancer. This discrepancy means there was a lot of overdiagnosis: more than a million women who were told they had early stage cancer — most of whom underwent surgery, chemotherapy or radiation — for a “cancer” that was never going to make them sick. Although it’s impossible to know which women these are, that’s some pretty serious harm.

But even more damaging is what these data suggest about the benefit of screening. If it does not advance the time of diagnosis of late-stage cancer, it won’t reduce mortality. In fact, we found no change in the number of women with life-threatening metastatic breast cancer.

The harm of overdiagnosis shouldn’t come as a surprise. Six years ago, a long-term follow-up of a randomized trial showed that about one-quarter of cancers detected by screening were overdiagnosed. And this study reflected mammograms as used in the 1980s. Newer digital mammograms detect a lot more abnormalities, and the estimates of overdiagnosis have risen commensurately: now somewhere between a third and half of screen-detected cancers.

The news on the benefits of screening isn’t any better. Some of the original trials from back in the ’80s suggested that mammography reduced breast cancer mortality by as much as 25 percent. This figure became the conventional wisdom. In the last two years, however, three investigations in Europe came to a radically different conclusion: mammography has either a limited impact on breast cancer mortality (reducing it by less than 10 percent) or none at all.

Feeling depressed? Don’t be. There’s good news here, too: breast cancer mortality has fallen substantially in the United States and Europe. But it’s not about screening. It’s about treatment. Our therapies for breast cancer are simply better than they were 30 years ago.

As treatment improves, the benefit of screening diminishes. Think about it: because we can treat most patients who develop pneumonia, there’s little benefit to trying to detect pneumonia early. That’s why we don’t screen for pneumonia.

So here is what we now know: the mortality benefit of mammography is much smaller, and the harm of overdiagnosis much larger, than has been previously recognized.

But to be honest, that general message has been around for more than a decade. Why isn’t it getting more traction?

The reason is that no other medical test has been as aggressively promoted as mammograms — efforts that have gone beyond persuasion to guilt and even coercion (“I can’t be your doctor if you don’t get one”). And proponents have used the most misleading screening statistic there is: survival rates. A recent Komen foundation campaign typifies the approach: “Early detection saves lives. The five-year survival rate for breast cancer when caught early is 98 percent. When it’s not? It decreases to 23 percent.”

Survival rates always go up with early diagnosis: people who get a diagnosis earlier in life will live longer with their diagnosis, even if it doesn’t change their time of death by one iota. And diagnosing cancer in people whose “cancer” was never destined to kill them will inflate survival rates — even if the number of deaths stays exactly the same. In short, tell everyone they have cancer, and survival will skyrocket.

Screening proponents have also encouraged the public to believe two things that are patently untrue.

First, that every woman who has a cancer diagnosed by mammography has had her life saved (consider those “Mammograms save lives. I’m the proof” T-shirts for breast cancer survivors). The truth is, those survivors are much more likely to have been victims of overdiagnosis.

Second, that a woman who died from breast cancer “could have been saved” had her cancer been detected early. The truth is, a few breast cancers are destined to kill no matter what we do.

What motivates proponents to use these tactics? Largely, it’s sincere faith in the virtue of early diagnosis, the belief that screening must be good for women. And 30 years ago, when we started down this road, they may have been right. In light of what we know now, it is wrong to continue down it. Let’s offer the proponents amnesty and move forward.

What should be done? First and foremost, tell the truth: woman really do have a choice. While no one can dismiss the possibility that screening may help a tiny number of women, there’s no doubt that it leads many, many more to be treated for breast cancer unnecessarily. Women have to decide for themselves about the benefit and harms...

Tuesday, November 20, 2012

Kaiser Permanente lays off 530 Calif. workers

Kaiser Permanente lays off 530 Calif. workers
By The Associated Press
Nov. 17, 2012

LOS ANGELES — Kaiser Permanente, one of the nation's largest HMOs, has laid off 530 employees in Southern California.

The Inland Valley Daily Bulletin reports ( ) the cutbacks are spread across the company's 60,000 staff members in offices and hospitals from Kern County south to San Diego County. Doctors are not affected.

Under certain contracts, the laid-off employees who are in unions will get income and benefits for a year. Many may also get their jobs back next year, when Kaiser expects membership levels to grow, after the federal Affordable Care Act is implemented.

At least 85 positions were eliminated at the Fontana and Ontario medical centers, according to the newspaper. Exact locations of the rest of the layoffs were not available.

Monday, November 19, 2012

Anthem Blue Cross Drops Cedars-Sinai, UCLA From Health Plan

Anthem Blue Cross Drops Cedars-Sinai, UCLA From Health Plan
Bob Herman
Becker Hospital Review
September 24, 2012

Anthem Blue Cross in California is shutting out two of the largest healthcare providers in the Los Angeles area — Cedars-Sinai Medical Center and UCLA Health System — from one of its health plans because the health systems are "too expensive," according to a Los Angeles Times report.

All physicians affiliated with Cedars-Sinai and UCLA will be eliminated from Anthem's Select health plan, effective Jan. 1, which is offered to roughly 60,000 employees and dependents in Los Angeles. The city said Anthem's plan would save $7.6 million in annual premiums. It is expected that roughly 2,200 city employees and family members will lose in-network access to their physicians, according to the report.

In response to the move, the health systems said their high costs are associated with their medical research and innovative treatments that "benefit the entire community," according to the report. Cedars-Sinai and UCLA also said Anthem's maneuver will only shift costs onto those who still receive care at the facilities.

Friday, November 2, 2012

Decapitation of baby during birth by irritated doctor--part two

This case is strikingly similar to the case of Dr. Hamid Safari at Kaiser Permanente. However, in the Kaiser case, the cover-up went all the way to the top. Instead of firing the doctor who killed the babies, Kaiser fired the Chief of the OB/GYN Department for complaining about Dr. Safari! At the same time, Kaiser offered $2 million to Dr. Safari to resign.

Dr. Gilbert Kenneth Moran's lawsuit says he was fired for complaining about "Dr. X," whose negligence resulted in three deaths at Kaiser in Fresno, which is where Dr. Hamid Safari worked when his notorious misbehavior occurred.

Missouri couple sues doctors for separating baby’s head during grisly botched birth, and trying to cover it up: reports
Arteisha Betts and Travis Ammonette claim in lawsuit that their OB-GYN refused to perform a planned C-section and then detached baby's spine while trying to yank him from the birth canal.
OCTOBER 12, 2012

Arteisha Betts and Travis Ammonette, of Florissant, Mo., claimed their son, Kaden Travis Ammonette, died during birth after the delivering doctor separated his head from his neck.

A Missouri obstetrician separated a baby's head from his body during delivery and then shoved the newborn back into the mother and performed an emergency C-section to cover up the ghastly blunder, a couple claims in a lawsuit.

Arteisha Betts and Travis Ammonette, of Florissant, filed a 10-count complaint in St. Louis County Circuit Court last month claiming doctors wrongly pushed them to have a vaginal delivery, decapitated their son and then tried to cover it up, according to local Patch and Courthouse News Service.

The details of the couple's claim are horrifying.

During a February 2011 appointment, the couple claimed, Dr. Susan Moore told them their baby boy would have to be delivered by caesarian because his abdomen was too large for a normal birth, according the CNS report.

Betts went into labor on March 22, just 28 weeks into what is normally a 40-week pregnancy.

The delivering doctor at St. John's Mercy Medical Center, Dr. Gilbert Webb, refused to perform a C-section and "would only agree to deliver her baby by way of attempted trial of vaginal delivery," the complaint said, according to Patch.

Webb refused to allow them to go to a different hospital, and "Betts consented to a trial of vaginal delivery under duress and protest," the complaint said.

During the birth, the boy's head breached, but the rest of his body got stuck in the birth canal, the complaint said.

In an attempt to pull the boy loose, Webb applied traction to his head and "separated (the boy's) head from his cervical spine," the complaint said. Blood "shot out" from the newborn's neck in full view of his parents, the complaint said. Mercy Hospital in St. Louis, where Betts was brought to give birth in March 2011. The hosptial was not named in the couple's complaint. Webb then "pushed" the boy's head and body back into the birth canal and scrambled to perform a C-section, slicing into Betts before anesthesia kicked in, the complaint said.

During the procedure, Webb "surgically and completely removed" the boy's head from his body, the complaint said.

The doctor then tried to cover up the boy's wounds before handing him over to his parents — though the complaint doesn't say how he did this.

The suit, filed in late September, names Webb and Moore, along with Midwest Maternal & Fetal Medicine Services and Signature Medical Group as defendants.

The couple accused the group of wrongful death and negligence and is seeking unspecified damages...

Read more:

Asphyxia Brain Damaged Second Twin, Mom Says

Asphyxia Brain Damaged Second Twin, Mom Says
Courthouse News
November 02, 2012

SANTA ANA, Calif. (CN) - Kaiser Permanente's botched prenatal, labor, delivery and post-natal care for a pregnancy, leaving her baby brain damaged, says a newborn's mother in a complaint filed in Orange County Superior Court.

The minor plaintiff, born after his twin, who had died in utero, developed hypoxic ischemic encephalopathy, according to the complaint.

Kaiser botched "the examinations, ultrasounds, evaluations, diagnosis, care and treatment" of mother and son, her complaint says.

Kaiser also "failed to properly advise the plaintiff's mother of any possible alternative methods of diagnosis and treatment and the possible attendant risks or diagnosis or treatment thereby failing to obtain a free and informed consent," according to the complaint.

Because of his illness, the boy will need "past and future medical care, nursing care, attendant, rehabilitation, physical and occupational therapy, speech therapy, educational therapy and attendant expenses," according to the complaint. He also has lost earning capacity, and experienced severe pain and physical and emotional suffering, according to the complaint.

The woman claims in her complaint that defendants, Children's Hospital of Orange County and 10 doctors, were negligent in caring for her newborn's multiple injuries related to his hypoxic ischemic encephalopathy, including, his kidneys, his neurologic system and his heart. These defendants were negligent in failing to appropriately monitor and treat the baby's hypertension, which ultimately caused additional damage to his kidneys, heart and brain, according to the complaint.

Plaintiffs sue for medical malpractice and negligent infliction of emotional distress, and are represented by Marshall Silberberg of Irvine.

Wednesday, October 31, 2012

Trouble In Mitt Romney's Socialist Hospital Paradise

In 2010 Romney himself acknowledged the need for Obama's health care law (before he began pursuing the Republican presidential nomination):

"Look, it doesn't make a lot of sense for us to have millions and millions of people who have no health insurance and yet who can go to the emergency room and get entirely free care for which they have no responsibility, particularly if they are people who have sufficient means to pay their own way."

Trouble In Mitt Romney's Socialist Hospital Paradise
Arthur Delaney and Jamieson
Huff Post

In the early hours of May 1, D.C. bartender Mike Boone came to the aid of a young woman who was being mugged.

Boone had offered to walk her home from the bar, Trusty's on Capitol Hill, since the immediate neighborhood is not known for having the safest streets at night. A man jumped from behind some bushes and grabbed the woman's purse. Boone also grabbed it, and the two men started fighting.

"We were punching each other pretty hard," Boone recalled. It wasn't until blood gushed from his body and the woman screamed that the bartender realized what had really happened.

"He was punching me with a knife," Boone said.

Boone passed out on the sidewalk. He woke up the next day in a hospital bed, recovering from eight stab wounds and a collapsed lung.

Like nearly 50 million other Americans, Boone lacked health insurance. A pre-existing condition -- in his case, a broken back he suffered in 1993 -- prevented him from obtaining affordable coverage. President Barack Obama's health care law prohibits insurance companies from discriminating against people with pre-existing conditions, but that reform doesn't go into effect for adults until 2014.

Republican presidential nominee Mitt Romney has vowed to repeal the health care law entirely if he's elected. In America, Romney has said, we don't let people die in the street simply because they lack health insurance: Hospitals are there to care for the uninsured.

"We don't have a setting across this country where if you don't have insurance, we just say to you, 'Tough luck, you're going to die when you have your heart attack,'" Romney said in an interview with The Columbus Dispatch on Oct. 11. "No, you go to the hospital, you get treated, you get care, and it's paid for, either by charity, the government or by the hospital."

Indeed, the health care system did not let Boone bleed to death on the sidewalk. But it did bury him in life-altering debt. After four days in the hospital and two surgeries, the 39-year-old -- hailed as a hero on Capitol Hill and beyond for his actions -- is staring at $60,000 in medical bills so far. And they haven't stopped rolling in.

Well-wishers, moved by media reports of his story, have donated $17,000 to help Boone cover his expenses, and he's hoping a public fund for crime victims could defray as much as $25,000 more. But Boone, who said he expects to earn only about $15,000 this year, figures he'll still be looking at nearly $20,000 in debt, all for risking his life for a fellow human being.

His story is one that plays out with troubling regularity in the bar-and-restaurant business, where a high quotient of workers go without health coverage. Post-tragedy fundraisers are common in the industry. The events serve as vivid examples of the private sector's safety net in action.

These fundraisers can defray some of the costs of emergency care, as they have done for Boone, but often they don't provide nearly enough. Paying for health care isn't as efficient or just as Romney suggests. Instead, much of the cost is borne by health care providers and insurers and, ultimately, the insured. We all pay.

"At first, I was like, man, this is really great, this could take care of it," Boone said of the charity he has received. "And then the big bills started coming."


Douglas Zehner is the senior vice president and chief financial officer at MedStar Washington Hospital Center in northwest Washington, where Boone was treated. He said Medstar gave $22.1 million worth of care to uninsured or underinsured patients and forgave $85.1 million in debt last year. But that charity isn't free. The only way the hospital can recoup its losses, Zehner said, is by negotiating with private insurance providers for higher prices, a process known as "cost-shifting."

"I have to price my services with insurance carriers because that’s the only group I'm even in the room talking to about how much they're going to pay me for my services," Zehner said. "So the way the cost-shifting works is you basically back into how much [money] you need to run that service [for all patients] and apply it to the expected number of people that are coming in that have insurance to get that service."

The fewer people who have insurance, the greater the burden on those who do have coverage. In order to cover the costs of treating the uninsured, premiums go up. The American Hospital Association estimated that U.S. hospitals performed $39.3 billion worth of uncompensated care in 2010, the most recent year for which numbers are available. That's 5.8 percent of total expenses.

This is a problem that Obama's health care law seeks to address and one that Romney himself has acknowledged in the past, before he began pursuing the Republican presidential nomination.

"Look, it doesn't make a lot of sense for us to have millions and millions of people who have no health insurance and yet who can go to the emergency room and get entirely free care for which they have no responsibility, particularly if they are people who have sufficient means to pay their own way," he said in 2010.

In 2007, he used even starker language: "When [uninsured people] show up at the hospital, they get care. They get free care paid for by you and me. If that's not a form of socialism, I don't know what is."...

Saturday, October 20, 2012

Some drugs may remain potent long after expiration dates

Some drugs may remain potent long after expiration dates
American Council on Science and Health
October 9, 2012

When it comes to perishable food items, consumers often rely on expiration dates to determine when a product will spoil. But does the same rule of thumb hold for labeled expiration dates on medications? Not necessarily, according to a new study published in the Archives of Internal Medicine, which shows that drugs actually stay potent long after the printed expiration date.

Researchers from the California Poison Control System at the University of California San Francisco School of Pharmacy studied eight medications that had expired 28 to 40 years prior to analysis and had not been previously opened. Three tablets or capsules of each drug were analyzed, and the results showed that 12 of the 14 active ingredients in each medication tested were found in concentrations at least 90 percent of the labeled amounts, which is recognized as the minimum level of acceptable potency. The only medications tested whose efficacy had dropped below the 90 percent level were aspirin and amphetamine.

Typical drug expiration dates range from one to five years after their production, but the FDA does not require drug makers to determine how long after that date medications may remain potent. The federal Shelf-Life Extension Program does, however, check long-term stability of federal drug stockpiles and has previously extended expiration dates by more than a year. Based on these analyses and their own research, the authors support broadly extending expiration dates for many drugs.

ACSH’s Dr. Josh Bloom generally agrees and points out that “most medications found in solid (pill or capsule) form remain unchanged long past their expiration date, but this is not the case with liquid medications, since they are much more likely to spoil and lose potency. One exception to this guideline is tetracycline, which can decompose even in the solid state, forming a toxic byproduct.” He continues, “This is not carte blanche to start firing down all kinds of expired pills, but given the cost of drugs, this study is a good start to identifying old medicines that are OK to take yet are being thrown away for no good reason.”

Wednesday, October 17, 2012

Lawsuit against Kaiser Permanente: doctors did not do pathology testing on growth

Lawsuit against Kaiser Permanente: doctors did not do pathology testing on growth
Courthouse News Service
October 17, 2012

SANTA ANA, Calif. (CN) - With classic signs of basal cell carcinoma, a woman was left with a growth on her eyelid for 2.5 years, her court complaint alleges, in Orange County Superior Court.

Kaiser has "policies and procedures that instructed and ordered defendant Wong and other physicians within defendant Kaiser's physician groups to refrain, for financial and/or cost cutting reasons, from sending the material removed from plaintiff's eye-lid for pathology or biopsy testing," until the third time the growth was excised, the patient alleges in her court complaint.

Five months before a correct diagnosis, along with growth removal and reconstructive surgery of the patient's eyelid, leaving her with a deformity, Kaiser's "specialist" (italics in complaint) noted that the growth showed "characteristics of being 'thick walled,' " but still did not send the matter removed from the site to a lab for testing, the woman says in her court complaint.

Monday, October 15, 2012

Non-Partisan Kaiser Foundation Says 60% Of Seniors Would Pay More For Medicare Under Romney-Ryan Voucher Plan

It's Official: Non-Partisan Kaiser Foundation Says 60% Of Seniors Would Pay More For Medicare Under Romney-Ryan Voucher Plan
Rick Ungar

A new study out today by the non-partisan Kaiser Family Foundation confirms what many have been saying for a very long time—the Romney-Ryan Medicare plan would result in six out of ten seniors paying substantially more for the same Medicare benefits they receive today.

The premium support approach to Medicare involves the government providing seniors with a set amount of money each year—pegged to the second lowest priced private health care plan available—in an effort to turn over health care for seniors to the private insurance market. While proponents of the approach believe that this will generate more competition in health care, make seniors more responsible for how they spend their health care dollars and result in less spending on seniors by the federal government, critics have argued that the sum of money the government would pay would be insufficient to cover the rising costs of health care, leaving seniors exposed to having to pay an ever growing portion of their health insurance coverage.

According to Kaiser, the premium support approach (often referred to as a voucher plan) to Medicare—the hallmark of the Paul Ryan Medicare plan that has been endorsed and adopted by Governor Romney—would mean higher premium costs for more than half of beneficiaries currently enrolled in traditional Medicare—if such a program were in place today—while raising the costs for nearly all of those who participate in a Medicare Advantage program.

The study further found that the additional costs to seniors would vary from region to region, with areas of high per-capita Medicare spending seeing a cost boost for 80 percent of Medicare recipients.

While the Obama campaign was quick to trumpet the results of the study as further proof that the Romney-Ryan plan would mean dramatically higher costs to seniors when it comes to their healthcare, the Romney campaign fired back, noting that the Kaiser report says that it is not intend to model any specific proposal of either campaign.

The Romney troops are right to a point—but they somehow failed to fully quote what the Kaiser Family Foundation had to say, no doubt an inadvertent error that we shall seek to correct here—

“The analysis does not attempt to model any specific proposal, but is generally based on an approach included in House Budget Chairman Paul Ryan’s fiscal year 2013 budget plan (emphasis added), the proposal Chairman Ryan co-sponsored with Senator Ron Wyden of Oregon, and; in the plan put forward by former Senator Pete Domenici and Dr. Alice Rivlin. In the first two proposals, people who are at least 55 years old, including current beneficiaries, would be exempt from the new system. Republican presidential nominee Gov. Mitt Romney has supported a premium-support system along these lines. (emphasis added.)”

Here are the bullet points of the study results, including how you might be affected based on where you live:

Nearly six in 10 Medicare beneficiaries nationally could face higher premiums for Medicare benefits, assuming current plan preferences, including more than half of beneficiaries enrolled in traditional Medicare and almost nine in 10 Medicare Advantage enrollees. Even if as many as one-quarter of all beneficiaries moved into a low-cost plan offered in their area, the new system would still result in more than a third of all beneficiaries facing higher premiums.

Premiums for traditional Medicare would vary widely based on geography under the proposed premium support system, with no increase for beneficiaries living in Alaska, Delaware, Hawaii, Wyoming and the District of Columbia, but an average increase of at least $100 per month in California, Florida, Michigan, New Jersey, Nevada and New York. Such variations would exist even within a state, with traditional Medicare premiums remaining unchanged in California’s San Francisco and Sacramento counties and rising by more than $200 per month in Los Angeles and Orange counties.

At least nine in 10 Medicare beneficiaries in Connecticut, Florida, Massachusetts and New Jersey would face higher premiums in their current plan. Many counties in those states have relatively high per-beneficiary Medicare spending, which would make it more costly to enroll in traditional Medicare rather than one of the low-bidding private plans in those counties. In contrast, in areas with relatively low Medicare per-capita spending, it could be more costly to enroll in a private plan.

For those who may not follow health care policy closely, the Kaiser Family Foundation is one of the few independent think tanks that neither side of the political aisle is likely to criticize for being partisan as the organization’s record for impartiality is so well established. This would explain why the Romney campaign has chosen to attempt to distinguish the report from their plan (although there little to distinguish the Romney-Ryan Medicare plan from the model studied by Kaiser) rather than attack the findings of the Kaiser Family Foundation report.

Sunday, October 14, 2012

Kaiser charged member $4,029 AFTER Kaiser hospital bill was entirely paid

Kaiser Member Upset Over Hospital Charges
Diane Lund-Muzikant
Lund Report
October 11, 2012

Susan Chaney is convinced insurance companies are some of the highest profiting companies in America at the expense of people such as herself who deserve the right to affordable healthcare.

She spoke out after her husband, Jerry, a diabetic, was hospitalized at Kaiser Sunnyside in January for a foot ulcer that had gone undiagnosed.

After receiving the bill, Chaney realized their deductible and co-insurance hadn’t been met. That, she said, was never the issue.

Chaney became upset when Kaiser sent paperwork known as an Explanation of Benefits indicating that its medical center had billed $20,809.45 for the surgery, medical equipment and hospital stay, while the allowed amount was $28,300.65. Kaiser paid $24,644.32 toward the bill, while the Chaney’s were left owing $4,029.92.

“How does the hospital get paid $8,000 more than the cost of care?” asked Chaney who sent a complaint to the Oregon Insurance Division. “Everyone seems to think we’re trying to get out of paying, but that’s not the case. This is one reason people can’t afford healthcare is when they have to pay more than the actual cost. We’re the lucky people; we have insurance. But this is absolutely ludicrous.”

Earlier, Chaney had contacted Congressman Earl Blumenauer’s office in Portland, speaking with his casework manager Emily Hebbron who encouraged her to file a complaint with the Insurance Division.

“I want to make sure she gets an answer,” Hebbron said. “And I comment her for looking at the hospital bill so closely. Not everyone would have done so.”

The Insurance Division did look into this issue, according to a letter sent by Dennis Kuckartz, a consumer advocate. “When the allowed amount is greater than the billed charges, the benefits are calculated on the billed charges,” he wrote. “Even if Kaiser Permanente would have only allowed the billed charges, Mr. Chaney’s liability would have been the same. The claim was processed correctly.”

That explanation doesn’t satisfy Chaney. ”I still contend that this is what’s wrong with the entire system. I do not feel that a hospital or doctor or anyone for that matter should be able to negotiate a higher payment than the cost of care. Add that to the fact that then Kaiser tried to ‘strong arm’ us into making payments of nearly $400 a month on our portion when they had already received $4,000 more than the actual cost of care is absurd. After months and many, many phone calls Kaiser did finally agree to take only $175 per month until our portion is paid.”...

A Possibly Fatal Mistake

A Possibly Fatal Mistake
Daniel Stolle
New York Times
October 12, 2012

MY wife and I attended my 30-year college reunion a couple of weekends ago, but the partying was bittersweet. My freshman roommate, Scott Androes, was in a Seattle hospital bed, a victim in part of a broken health care system. Strip away the sound and fury of campaign ads and rival spinmeisters, and what’s at stake in this presidential election is, in part, lives like Scott’s.

Scott and I were both Oregon farm boys, friends through the Future Farmers of America, when Harvard sent us thick envelopes. We were exhilarated but nervous, for neither of us had ever actually visited Harvard, and we asked to room together for moral support among all those city slickers.

We were the country bumpkins of Harvard Yard. Yet if we amused our classmates more than we intended, we had our private jokes as well. We let slip (falsely) that we kept deer rifles under our beds and smiled as our friends gave them a wide berth.

Scott was there when I limped back from the Worst Date in History (quite regularly), and he and I together worked our way onto the Crimson, the student newspaper. He had an omnivorous mind: Scott may be the only champion judge of dairy cattle who enjoyed quoting Thomas Macaulay, the 19th-century British historian. Scott topped off his erudition with a crackling wit to deflate pretentiousness (which, at Harvard, kept him busy).

By nature, Scott was even-keeled, prudent and cautious, and he always looked like the mild-mannered financial consultant that he became. He never lost his temper, never drove too fast, never got drunk, never smoked marijuana.

Well, not that I remember. I don’t want to discredit his youth.

Yet for all his innate prudence, Scott now, at age 52, is suffering from Stage 4 prostate cancer, in part because he didn’t have health insurance. President Obama’s health care reform came just a bit too late to help Scott, but it will protect others like him — unless Mitt Romney repeals it.

If you favor gutting “Obamacare,” please listen to Scott’s story. He is willing to recount his embarrassing tale in part so that readers can learn from it.

I’ll let Scott take over the narrative:

It all started in December 2003 when I quit my job as a pension consultant in a fit of midlife crisis. For the next year I did little besides read books I’d always wanted to read and play poker in the local card rooms.

I didn’t buy health insurance because I knew it would be really expensive in the individual policy market, because many of the people in this market are high risk. I would have bought insurance if there had been any kind of fair-risk pooling. In 2005 I started working seasonally for H&R Block doing tax returns.

As seasonal work it of course doesn’t provide health benefits, but then lots of full-time jobs don’t either. I knew I was taking a big risk without insurance, but I was foolish.

In 2011 I began having greater difficulty peeing. I didn’t go see the doctor because that would have been several hundred dollars out of pocket — just enough disincentive to get me to make a bad decision.

Early this year, I began seeing blood in my urine, and then I got scared. I Googled “blood in urine” and turned up several possible explanations. I remember sitting at my computer and thinking, “Well, I can afford the cost of an infection, but cancer would probably bust my bank and take everything in my I.R.A. So I’m just going to bet on this being an infection.”

I was extremely busy at work since it was peak tax season, so I figured I’d go after April 15. Then I developed a 102-degree fever and went to one of those urgent care clinics in a strip mall. (I didn’t have a regular physician and hadn’t been getting annual physicals.)

The doctor there gave me a diagnosis of prostate infection and prescribed antibiotics. That seemed to help, but by April 15 it seemed to be getting worse again. On May 3 I saw a urologist, and he drew blood for tests, but the results weren’t back yet that weekend when my health degenerated rapidly.

A friend took me to the Swedish Medical Center Emergency Room near my home. Doctors ran blood labs immediately. A normal P.S.A. test for prostate cancer is below 4, and mine was 1,100. They also did a CT scan, which turned up possible signs of cancerous bone lesions. Prostate cancer likes to spread to bones.

I also had a blood disorder called disseminated intravascular coagulation, which is sometimes brought on by prostate cancer. It basically causes you to destroy your own blood cells, and it’s abbreviated as D.I.C. Medical students joke that it stands for “death is close.”... •

Thursday, October 11, 2012

In meningitis scare, charges firm misled U.S. regulators

Corruption seems to be at the heart of so many of our health care problems.

In meningitis scare, charges firm misled U.S. regulators
By Tim Ghianni
Oct 11, 2012

The deadly meningitis outbreak that has claimed a dozen lives is prompting calls for increased oversight of the nation's custom-made pharmaceutical industry, amid charges that the company at the center of the scare may have misled U.S. regulators.

On Wednesday, Idaho became the 11th state to report a case of the rare illness, which has been linked to tainted steroids produced by a specialty pharmacy in Massachusetts.

The U.S. Food and Drug Administration, whose role in the outbreak has come under criticism, said it was planning an afternoon media briefing on Thursday.

In all, 138 people have contracted meningitis as a result of the now-recalled drugs, according to the latest tally from the U.S. Centers of Disease Control and officials in 11 states where the outbreak has spread. The case in Idaho is the first discovered in the western United States.

Lawmakers have come under pressure to close what critics see as a loophole in oversight that left the New England Compounding Company (NECC), the Massachusetts pharmacy linked to the tainted steroids, largely exempt from federal regulation.

The FDA regulates only the ingredients and their suppliers, not the little-known corner of the drug world known as "compounding," which is subject to a patchwork of state oversight.

State and federal officials are now investigating NECC, which distributed thousands of vials of a contaminated steroid made at a shabby brick complex next to a waste and recycling operation in a western suburb of Boston.

The pharmacies are owned by Gregory Conigliaro, an engineer, and his brother-in-law, Barry Cadden, a pharmacist who was in charge of pharmacy operations at NECC. The waste and recycling facility is another of Conigliaro's business interests.

Compounding pharmacies such as NECC are permitted to make medications based on specific prescriptions for individual patients.

State and federal regulators are investigating why NECC shipped thousands of vials of preservative-free methylprednisolone acetate steroid to healthcare facilities in multiple states.

"It does seem like the agencies, both at the state and the federal level, may have been misled by some of the information we were given," Massachusetts Governor Deval Patrick told reporters on Wednesday.

The number of cases has grown rapidly as health practitioners contacted about 13,000 people who received injections from a potentially tainted supply of steroid medication shipped to 23 states.

In five states - Tennessee, Michigan, Maryland, Virginia, and Florida - the outbreak has claimed lives, with the latest victim a 70-year-old man in Florida.

Thousands of people received the injections to relieve back pain and other complaints and are at risk of infection...

(Writing by James B. Kelleher; Editing By Greg McCune; Desking by Vicki Allen)

Read more: In meningitis scare, charges firm misled U.S. regulators

Wednesday, October 10, 2012

Meningitis warning for those who've had spinal injections of steroids since May 21, 2012

Doctors have been having problems recognizing fungal meningitis.

Doctors Are Off Balance as Patients Show Atypical Meningitis Reactions
Wall Street Journal
October 10, 2012

The rare fungal meningitis behind a deadly national outbreak is difficult to diagnose because it can cause strokes and other reactions unlike those typically seen with the more common type of the illness.

Meningitis, a swelling of the protective membranes of the brain and spinal cord, is typically caused by bacteria that can be treated with antibiotics, or by a virus, for which there is no treatment.

Fungal meningitis, on the other hand, needs to be treated with antifungal drugs. The length of treatment isn't known but the federal Centers for Disease Control and Prevention is telling doctors that patients may need treatment for months.

Bacterial meningitis tends to attack quickly with a fever, a headache that grows worse, a stiff neck and eventually a loss of consciousness.

However, some patients who contracted fungal meningitis in the current outbreak have had just a mild headache and no fever, and "for the most part symptoms occur in a more gradual fashion," said William Schaffner, an infectious disease expert and chairman of the department of preventive medicine at Vanderbilt University School of Medicine in Nashville, which has treated four patients with fungal meningitis.

Dr. Schaffner said fungal meningitis is invading blood vessels and causing strokes in some patients affected by the current outbreak. But doctors don't typically test for meningitis when patients go to the emergency room with signs of stroke, such as weakness or loss of movement on one side of their bodies, slurred speech or sudden vision changes.

"Nobody is totally sure what these patients look like," said Trish Perl, senior hospital epidemiologist at the Johns Hopkins Health System in Baltimore, who is advising doctors about patients who might have the disease.

Because the fungal-meningitis symptoms have been so varied among patients, federal health officials have urged doctors to set a low bar in deciding whether to test patients who received a steroid injection in their backs. The test requires a spinal tap, which involves a needle inserted in the spinal column to collect spinal fluid.

The CDC has said as many as 13,000 people in 23 states have been exposed to the potentially contaminated steroid injections made by the New England Compounding Center before the products were recalled Sept. 26.
Compounding pharmacies create blends of medicines, including liquid forms of pills.

The agency said patients who have had an epidural steroid injection since May 21, 2012, and are experiencing symptoms such as headache, fever, sensitivity to light, slurred speech or numbness, should contact their doctors as soon as possible.

Officials are most concerned about spinal injections. Those given in other places, such as the knees or hips, are highly unlikely to cause meningitis, though there is the possibility of a local joint infection...

Friday, October 5, 2012

Woman self-diagnoses rare disease

I have known many people whose doctors failed to diagnose serious problems--particularly at Kaiser Permanente. It's wise to do some research oneself. Often doctors are too busy to think about unusual conditions. They rely on the sets of symptoms that they're familiar with. In fact, at Kaiser, doctors are expected to rely on fixed lists of symptoms, and to ignore everything else. This way, Kaiser is able to correctly treat a large percentage of people, while improperly diagnosing an unfortunate minority. It's medicine based on percentages, not the Hippocratic oath or professional standards.

Woman self-diagnoses rare disease
October 03, 2012
For the North County Times

To look at Chondra Hungerford today, you would never think she had ever been anything but strikingly beautiful.

And yet, last year at this time, she was gaining a pound a week, thick hair had started to sprout on her back, her skin was broken out in adult acne, and a lump of fat had started to form between her shoulders at the base of her neck.

She endured a menstrual period every two weeks, her skin bruised at the slightest touch and people stopped to ask her whether she was pregnant.

After having been a fitness model and personal trainer all of her adult life, such a body transformation was torture for Hungerford, 28. "I was training really hard, eating only fish and vegetables and nothing was working," the mother of two from Vista recalled. "I was turning into a monster."

And though she saw doctors for these and other complaints since being diagnosed with hypertension at age 19, Hungerford's primary-care physician seemed unable to correctly diagnose her condition.

That was until one day early last year, after seeing photographs of her shockingly round face, Hungerford said, "It all came together for me ... I went in to the doctor (the next week) and told him that he needed to order a cortisol lab (test). I knew I had Cushing's."

Hungerford said her doctor remained skeptical that she had the rare endocrine disease, which strikes only two or three people in a million. "I tell him 'I have Cushing's disease,' and he says to me, ‘I hope you do, because everyone who comes in her swears they do and you'd be the very first one (who did).'"

Named for the American neurosurgeon Harvey Cushing, Cushing's disease is caused by a tumor of the pituitary gland, which is located at the base of the brain. People with the disease have too much adrenocorticotropic hormone or ACTH, which in turn stimulates the production and release of cortisol.

Cortisol, the body's fight-or-flight hormone, helps maintain blood pressure, reduces the immune system's response and controls the body's use of carbohydrates, protein and fats. But in excess, it can cause upper body obesity, a full or moon face, acne, unusual purple stretch marks called striae, bone pain, weak muscles and irregular menstrual cycles...

"Chondra is a remarkable young woman," said UC San Diego endocrinologist Joseph Witztum, who recommended Hungerford for surgery. "Being aware of what is going on with you, carefully noting all the changes and using the Web in an intelligent way allowed her to make the diagnosis of a rare disease. She essentially had her doctor collect the needed laboratory data and presented an endocrinologist with the diagnosis and the supporting data. I can only imagine how surprised he was!"

...In April 2012, UC San Diego neurosurgeon Hoi U performed Hungerford's hour-long surgery to remove a 1-millimeter tumor from her pituitary gland.

...Cortisol (like cortisone) has the effect of reducing pain. Having lived with such high cortisol levels and then going to almost none, she started feeling general pain sensations almost for the first time.

Dr. U said that after the tumor is removed, it takes some adjustment for the body to return to producing normal levels of cortisol. "It can be like cold turkey for the patient," he said. "You have to give the patient some cortisone at first to achieve a soft landing. But everybody's (pain threshold) is different as you taper it down," he said with a smile. "That is like being a Chinese chef ... too much soy sauce? Not enough?"

...Indeed, this month Hungerford gave a presentation to a combined medicine/endocrinology conference at UC San Diego at which she presented, in a half-hour "mystery" narrative, the story of her illness.

Many of the young doctors were not able to diagnose Hungerford's disease until the end,
and her presentation did highlight some of the fragmentation of our current medical system, said Witztum, adding, "It was an amazing performance and I encouraged her to go into some type of medical-related profession, even consider going to medical school."

How UCLA's Millionaire Doctor/public employee David Feinberg got $1.3 million amid tuition hikes, budget cuts and a recession

Dr. David Feinberg

[Maura Larkins comment: Both Dr. Feinberg and Chancellor Gene Block are psychiatry professors. A lawsuit has been filed against yet another professor of psychiatry at UCLA. Dr. Alexander Bystritsky is accused of causing the wrongful death of a woman by giving her dangerous medications in order to make her feel happy and to believe she was cured of her illness, causing her to give a large donation to UCLA.

What kind of ethics does Dr. David Feinberg have? What's he going to do with all this money? I'm guessing it's not all going to scholarships for students who can't pay tuition at UCLA.]

UCLA's Millionaire Doctor David Feinberg
How Feinberg got $1.3 million amid tuition hikes, budget cuts and a recession
By Beth Barrett
LA Weekly
Mar 31 2011

Last year, when Stanford Hospital & Clinics was considering poaching Dr. David Feinberg from UCLA, where he is the associate vice chancellor and CEO of its public hospital system, the university brass and the powerful UC Board of Regents decided to do whatever was required to keep their golden administrator.

Things were bad at UCLA when the feverish bid to retain Feinberg broke out. It had just been slammed with $60 million in academic program cuts by the deficit-riddled state of California, and faces another $96 million bite on July 1. In a series of recent hikes, the university raised average student tuition 40 percent from about $7,000 to more than $11,000.

More tuition hikes were coming, and the university owed its employees $21.5 billion in future pension payments that it had no clear-cut way to pay.

But the vast Ronald Reagan UCLA Medical Center, a public nonprofit, had experienced a financially robust previous year under Feinberg, and the facility in 2009 enjoyed high patient-satisfaction rankings as usual. Despite California's stubborn recession, UCLA Chancellor Gene Block — like Feinberg, a psychiatry professor at the School of Medicine — decided to make his colleague a staggering offer: He would nearly double Feinberg's $739,695 base salary to $1.33 million.

That included a 22 percent pay raise of $160,300 and an annual "retention bonus" of $250,000 paid every year that Feinberg does not leave for another job. Block also decided to continue Feinberg's "incentive bonus," which had hit $210,739 in the previous fiscal year.

There was nothing else quite like Block's offer elsewhere in California's university medical schools. The next highest paid is UC San Francisco's CEO Mark Laret. San Francisco, like UCLA, is a top facility, ranked seventh in the nation by U.S. News & World Report, close behind No. 5 UCLA.

In 2010, Laret's $739,700 pay was reduced as a result of the systemwide pay cuts. But with an "incentive" bonus of $176,912 and a car allowance of $8,916, he earned $876,215. Now, suddenly Feinberg was in line to earn nearly half a million dollars more than Laret.

On June 30, Feinberg will begin getting his annual quarter-million-dollar bonus simply for not leaving for another job.

Feinberg's juicy pay package led to uncomfortable headlines for UCLA on Sept. 17, the day after the Board of Regents approved it.

Then, in late December, Feinberg earned UCLA another round of unwanted media attention. The San Francisco Chronicle obtained a private Dec. 9 letter in which Feinberg and 35 other executives in the UC system lashed out at the Board of Regents. The highly compensated group weren't demanding help for academic programs and students. They were threatening to sue the struggling California universities if the regents didn't boost the executives' long-standing $245,000 salary caps used to calculate their pensions.

The change would create a sizable pension boost, costing the universities $5.1 million per year — for just 36 government employees. In addition, the 36 executives insisted the new pension deal be retroactive to 2007, taking from the universities an additional bite of $51 million.

In the letter, Feinberg and the others wrote that it was "the University's legal, moral and ethical obligation" to hand over the pension boosts. They also threatened, "Failure to do so will likely result in a costly and unsuccessful legal confrontation," and emphasized that they were writing "URGENTLY."

The letter, which proved to be deeply embarrassing to UC officials and the regents, was widely assumed to have been leaked by a UC university system insider disgusted by the demands.

The demands from the 36 were a direct political challenge to UC President Mark Yudof, who had publicly opposed bigger pensions for university executives. The University of California system owes $21.6 billion in future pension payments to all its retirees — but it hasn't got the money, and doesn't know where it's going to get it. Yudof is pursuing fiscal reforms to raise the missing billions, including upping the retirement age for future employees from age 60 to 65 for maximum pension benefits — and, once again, raising student tuition and fees.

The leaked letter enraged students, critics of cushy government pensions and salaries and incoming Gov. Jerry Brown, who is a nonvoting member of the Board of Regents.

Brown opined in the Chronicle in December: "These executives seem very out of touch at a time when the state is contemplating billions of dollars in reductions that will affect people who are far less advantaged."

In early January, under a media spotlight, Block opposed the pension boosts, and the demand was not approved by the regents.

But three weeks later, without a formal vote, the regents — who include such notables as investment banker Richard C. Blum, husband of Sen. Dianne Feinstein, and Sherry L. Lansing, former chair/CEO of Paramount Pictures — found a way to give Feinberg and other UC system medical center executives statewide a different costly reward: "incentive" bonuses totaling $2.6 million that had been deferred from 2009.

Feinberg topped the bonus recipient list, raking in $218,728.

The popular doctor now has critics aplenty. Students, facing further tuition hikes as Gov. Brown struggles with a massive deficit, are flabbergasted at the Wall Street–like disparity between how the UC system treats its highfliers versus its students.

Student Matt Margolis, president of the Bruin Democrats, says thousands of UC, California State University and community college students "have to take quarters off, drop classes, get kicked out of their housing." For UC leaders "to respond to the need to scale back by cutting the budget and raising tuition — I don't see how that sits well with the CEO of the medical center having his salary doubled...

UCLA hospitals to pay $865,500 for breaches of celebrities' privacy

UCLA hospitals to pay $865,500 for breaches of celebrities' privacy
July 08, 2011
By Molly Hennessy-Fiske
Los Angeles Times

UCLA Health System has agreed to pay $865,500 as part of a settlement with federal regulators announced Thursday after two celebrity patients alleged that hospital employees broke the law and reviewed their medical records without authorization.

Federal and hospital officials declined to identify the celebrities involved. The complaints cover 2005 to 2009, a time during which hospital employees were repeatedly caught and fired for peeping at the medical records of dozens of celebrities, including Britney Spears, Farrah Fawcett and then-California First Lady Maria Shriver.

Violations allegedly occurred at all three UCLA Health System hospitals — Ronald Reagan UCLA Medical Center, Santa Monica UCLA Medical Center and Orthopaedic Hospital and Resnick Neuropsychiatric Hospital, according to UCLA spokeswoman Dale Tate.

The security breaches were first reported in The Times in 2008.

The violations led state legislators to pass a law imposing escalating fines on hospitals for patient privacy lapses.

After the law took effect on Jan. 1, 2009, state regulators fined Ronald Reagan UCLA Medical Center $95,000 in connection with privacy breaches that year that sources said involved the medical records of Michael Jackson, who was taken to the hospital after his death in June 2009.

The same month, the U.S. Department of Health and Human Services' Office for Civil Rights began investigating alleged violations of the federal Health Insurance Portability and Accountability Act at the hospitals, according to the settlement agreement.

Investigators found that UCLA employees examined private electronic records "repeatedly and without a permissible reason" in 2005 and 2008, including an employee in the nursing director's office, according to the agreement reached Wednesday.

The employee was not named in the agreement, and the hospital spokeswoman declined to identify who it was. But the timing and description of the alleged violations cited in the agreement suggest that it may have been Lawanda Jackson, an administrative specialist at Ronald Reagan UCLA Medical Center who was fired in 2007 after she was caught accessing Farrah Fawcett's medical records and allegedly selling information to the National Enquirer.

Jackson later pleaded guilty to a felony charge of violating federal medical privacy laws for commercial purposes but died of cancer before she could be sentenced. Fawcett died of cancer in 2009.

Federal investigators faulted the hospital system for failing to remedy the problems, discipline or retrain staff.

"Employees must clearly understand that casual review for personal interest of patients' protected health information is unacceptable and against the law," Georgina Verdugo, director of the Office for Civil Rights, said in a statement Thursday, adding that healthcare facilities "will be held accountable for employees who access protected health information to satisfy their own personal curiosity."

As a condition of the settlement, UCLA Health System was required to submit a plan to federal regulators detailing how officials would prevent future breaches. They agreed to retrain staff on privacy protections, formulate privacy policies, appoint a monitor to oversee improvements and report to regulators for the next three years.

UCLA Health System released a statement Thursday noting that, "Over the past three years, we have worked diligently to strengthen our staff training, implement enhanced data security systems and increase our auditing capabilities."

"Our patients' health, privacy and well-being are of paramount importance to us," said Dr. David T. Feinberg, chief executive of the UCLA Hospital System. "We appreciate the involvement and recommendations made by OCR in this matter and will fully comply with the plan of correction it has formulated. We remain vigilant and proactive to ensure that our patients' rights continue to be protected at all times."

Thursday, October 4, 2012

UCLA Radiology Department--Who's in charge of losing my X-rays?

I'm trying to figure out how--or why--ALL my digital X-rays got "lost" at UCLA.

[Update October 20, 2012: It seems that UCLA wants to protect Kaiser from having to answer questions about this problem at Kaiser Permanente's new Garfield Specialty Center in San Diego. My UCLA primary care doctor explained it to me, saying, "You need to forget about Kaiser." She was worried that I might "have a case against Kaiser."]

It appears that I have these people to thank for my X-rays being unavailable:


Dieter R. Enzmann, M.D.
"Leo G. Rigler" Chair and Professor (What's up with that Cheshire Cat smile? He looks like he might have swallowed my X-rays.)
Brenda Izzi, R.N., M.B.A.
Chief Administrative Officer and head of Radiology Image Library
(310) 481-7516 (310) 794-8056
(From the look on her face, I think she knows where those X-rays are.)

Brenda Jones, Director of Radiology Image Library


The head of the Medical Records Department won't even let employees give out his or her name. Perhaps the Los Angeles Times article at the bottom of this post explains the desire for anonymity.

Katherine Mair, special project manager (Her existence might be just a rumor, but I suspect she's simply too important to deal with missing X-rays.)

Erik Lozano--contractor (He had his door closed, and later was in a meeting.)

Pazzette McCray, contractor, manager 310 825 9381 (She ignored all my messages.)

Erika, contractor (She was the only one who would talk to me, but I don't think she was authorized to say much. I'm sure that's difficult for her. As far as I know, she's the only one earning her pay.)

See more information HERE.

UPDATE October 5, 2012

I got the following email this morning, but I'll believe that Ms. Izzi is sincere when I have the digital images in my possession. Erika Lee told me that the images can be burned to a CD within a day. That means they could also be sent in an email within a day. Anyone want to bet that I don't get all the digital images today? (Note to UCLA: it doesn't count if you print out an image, then scan it. You remove a huge amount of detail when you do that.)

Dear Ms. Larkins,
I am happy to look into any imaging provided by Radiology and ensure you can obtain copies of those studies. I have asked my Director of the Image Library to research your concern.
I will let you know what we uncover.
Brenda M. Izzi, RN, MBA
Chief Administrative Officer
UCLA Radiology


Dear Ms. Izzi:

It is ridiculous for your department to claim that X-rays might have gotten misplaced inside Dr. Raz's office. The Chair of the Radiology Department, Dr. Enzmann, states "the Department of Radiological Sciences is completely digital." The digital images are available on your computers, and it's simply false to say that they aren't there.

Also, please don't print out a few images, then scan them, and then call them the original digital images. You remove a huge amount of detail when you do that. By law you must provide all the videos and all the original still images. Your department has been in violation of the law for almost two weeks.

It is also shameful for your department to claim that my September 18, 2012 Request for Images was not received. I have a FAX transmission report with a photocopy of the Request to prove that you received my Request on Sept. 18.

I assume you are talking about Brenda Jones when you refer to your Director. Surely she has been researching this matter for the past three days, since Erika Lee sent a FAX on October 2, 2012 asking that my request be prioritized? Isn't Brenda Jones the person who told her subordinates to tell me that no images were available? I suggest you look into this matter yourself, Ms. Izzi.

Maura Larkins


Apparently Brenda Izzi and Katherine Mair and the mysterious head of Medical Records decided that the best response to the situation was to make up a bizarre story in which they would claim that images don't exist, and if they did, they wouldn't be able to release them.

So why would UCLA, a public entity, pay all these people in Medical Records and the Radiology Image Library to do nothing? Well, they don't exactly do nothing. They actually work very hard. It can't be easy to conduct phone calls like the following one.


On Oct. 5, 2012 at 4:50 p.m. I became part of a conference call with Ms. P. M. and the elusive Mr. E. L. of UCLA’s Medical Records office.

When I had called the office on October 2, 2012, a receptionist had gone to ask E. L. to talk to me, but then she came back and told me that his door was closed.

P. M. had ignored my messages for several days, but when I called earlier today, she had picked up the phone and talked to me.

Only P. M. spoke in the beginning of our conference call, and I began to wonder if E. L. was actually on the line. "Are you there, E.?" I asked. Then I heard his voice for the first time.

From all this I concluded that E. L. must actually be P. M.'s superior, rather than her subordinate, as I had assumed when told that P. M. was the "manager." I figure the higher-ups tell their subordinates what to say, but they don't like to actually talk to patients themselves.

In fact, I suspect that there may have been others on the line during the call who never said anything. I think B. J. was probably on the line, since she called me back just minutes after the following call. I also think that the people who were calling the shots did not speak to me at all. I think E. L., P. M. and B. J. are all following orders.

Here's my transcript of the call:

P. M.: ...I called the physician [Dr. Raz] and was told that they don't make videos in that office.

[Maura Larkins comment: I knew this statement was false. I saw the videos myself on the computer monitor as they were being taken.]

P. M.: The X-rays are the physician's product to release. We're not experts and we're not able to release it. He's a private physician.

[Maura Larkins comment: I knew that all these claims were false, too. It says on the UCLA website that the Radiology Image Library releases images on CD for free, and that it does so within 5 days of the request--because this is what is required by California law. All X-rays at UCLA are digitized, and the Radiology Image Library has access to all X-rays. In further proof, Dr. Raz's office had given me the phone number of the Radiology Image Library and told me to call that number to get copies of my images.

Also, UCLA doctors are public employees, hired by the Regents of the University of California, NOT private doctors.]

Maura: No one in your department knows California law regarding medical records?

McCray: We can not provide patient information. Erika (Lee) was being kind in trying to help you out.

Maura: (repeating the unanswered question) No one in your department knows what California law is regarding medical records?

P. M.: We know the law.

Maura: Why are you disobeying the law?

P. M.: Miss Larkins, we do not release information from a private physician.

Maura: I didn't get everything you said written down in my notes here. P. M., you said you spoke to Dr. Raz?

P. M.: E. L. called Dr. Raz's office. The number he called was 310 794 0206.

Maura: E. L., did you speak to Dr. Raz? Did he say they don't make videos in his office?

E. L.: His office said that they don't make videos.

Maura: Who was it who said that?

E. L.: I don't have her name written down. A woman said they don't make videos. If they do make videos, we don't have access.

[Maura Larkins comment: I can't believe that anyone in Dr. Raz's office would claim that they don't make videos. But it does appear that for some reason Dr. Raz's office didn't want the videos released, and Medical Records came up with this cover story. Why wouldn't a doctor want a video of abdominal X-rays released? This is all very bizarre.]

Maura: E. L., are you a contractor?

E. L.: Yes.

Maura: P. M., are you a contractor?

McCray: Yes.


UCLA hospitals to pay $865,500 for breaches of celebrities' privacy
July 08, 2011
By Molly Hennessy-Fiske
Los Angeles Times

UCLA Health System has agreed to pay $865,500 as part of a settlement with federal regulators announced Thursday after two celebrity patients alleged that hospital employees broke the law and reviewed their medical records without authorization.

...Violations allegedly occurred at all three UCLA Health System hospitals — Ronald Reagan UCLA Medical Center, Santa Monica UCLA Medical Center and Orthopaedic Hospital and Resnick Neuropsychiatric Hospital, according to UCLA spokeswoman Dale Tate...The same month, the U.S. Department of Health and Human Services' Office for Civil Rights began investigating alleged violations of the federal Health Insurance Portability and Accountability Act at the hospitals, according to the settlement agreement.

Investigators found that UCLA employees examined private electronic records "repeatedly and without a permissible reason" in 2005 and 2008, including an employee in the nursing director's office, according to the agreement reached Wednesday.

..."Our patients' health, privacy and well-being are of paramount importance to us," said Dr. David T. Feinberg, chief executive of the UCLA Hospital System. "...We remain vigilant and proactive to ensure that our patients' rights continue to be protected at all times."