Thursday, May 1, 2014

CFO Lynette Seid and Dr. Eugene Rhee, chief of urology, at Kaiser Permanente in San Diego, are up to their old tricks

See also: Finally, a Kaiser doctor, oncologist Jennifer Lycette, speaks out about doctors forced to allow harm to patients to increase profits--CLICK HERE

If Kaiser were telling the truth about the images of my VUCG, it wouldn't have gone to all the trouble of creating a hoax set of 7 images, with four images appearing twice and one image appearing three times, trying to pretend it's a set of 13 images! See the images here.

Lynette Seid, who is both CFO and chief of medical records at Kaiser Permanente in San Diego, and Dr. Eugene Rhee, chief of urology, told me a bizarre story to explain the absence of my digital X-rays on Kaiser San Diego's main computer, but the story has fallen apart.

Dr. Paul Bernstein and Dr. Andrew Golden started a review of this episode, but canceled the review within a week.

Lynette Seid is legally required to give me copies of my X-ray images. To avoid doing that, she created a CD which she claimed was scanned thermal paper images!

Much to the consternation of Seid and Rhee, the innocent underlings at Kaiser keep telling the truth. The technician who did my VUCG said my digital video would be uploaded to the main Kaiser computer. It never was. A clerk in Radiology records said that I could have a CD of the digital video for $10. I sent the money, but I didn't get the CD.

For some reason, doctors wanted to conceal the VUCG results. I assume that the reason is the typical one at Kaiser: saving money by denying care.

When I complained, Kaiser wrote to me that the digital video I had witnessed on the computer monitor WAS NOT SAVED--except that a few THERMAL PAPER IMAGES HAD BEEN PRINTED OUT DURING THE PROCEDURE.

In fact, the test had been done on a brand new digital fluoroscopy machine at the brand new Garfield Specialty Center in San Diego. The Center had had a grand opening one week earlier, and Kaiser Permanente's newsletter boasted that all X-rays were digital. In fact, the "thermal paper" images were simply digital images printed out on high quality paper.

This month, Ms. Seid's subordinate "SR" got caught flat-footed because she had no idea she was supposed to claim that X-rays were saved only on thermal paper in 2011. SR accidentally revealed information that Ms. Seid had gone to a great deal of trouble to conceal.

On April 7, 2014 I submitted a request to Radiology Records for the VUCG digital video.

Strangely, I was told by multiple individuals on April 7, 2014 that they had "still" images for a procedure done on me on June 16 2011. I did not have any procedure on June 16, 2011. My VUCG procedure was on June 15, 2011.

April 7, 2014

When I turned in my request at the radiology window, the young man who was sitting there immediately started preparing a CD. I asked if it was a digital video that he was preparing. He said it was a set of 13 still images from a procedure that was dated June 16, 2011. He was going to charge me $15 for the CD—from the wrong date! I said I wanted the digital video from June 15, 2011, not still images dated June 16, 2011.

The young man went to get someone else to talk to me. He went and sat at another desk and waited while a young woman named “V” sat down in his chair.

V asked me, “What are you going to play the CD on?

I was dumbfounded for a moment since this question seemed so bizarre. I was planning to play it on, and upload it to, my computer, but I didn’t understand why she was concerned about this. I figured I was free to do whatever I wanted with it, including using it as a bookmark or a Frisbee.

V asked me again, “What are you going to play the CD on?

I finally shrugged and said, “Whatever I feel like playing it on.”

Van said there was no video.

But then she started talking about VHS tapes. “If it’s on VHS…” she said, but then she didn’t finish her sentence. Perhaps eyebrows knitted and my mouth dropped open when she started talking about VHS tapes.

Van went to get J.

J, who said her title was “a senior”, said, “We don’t have moving videos.”

J said her supervisor is SR, and SR’s supervisor is Mary Hanshaw, who is the ADA for radiology files, but she refused to tell me who Mary Hanshaw’s supervisor is.

She said I should call the two names she gave me, but she didn’t give me phone numbers. Perhaps I was supposed to call out their names loudly?

I waited while J made a call. She wouldn’t give me SR’s phone number. Finally she said SR will call me.


SR phone call April 7, 2014

SR called me on my cell phone. She identified herself as “Manager here at Radiology Records.” I was not able to write fast enough to record every single word, but I recorded most of the conversation.

SR: Was your procedure done in urology department?
ML: Yes.
SR: What date?
ML: June 15, 2011.
SR: I have June 16, 2011. I am not aware of any moving video. I know they watch it on fluoroscopy which is like a video camera which is not actually taped.

SR: [With] fluoroscopy you can watch moving images. Those images are not saved by videotape which I think is what you are referring to. Usually they take pictures in between live video fluoroscopy. Fluoroscopy is live X-rays like a video camera. You never record moving images. For that type of procedure it’s not fully reported from beginning to end. Just spot pictures.

ML: “Spot pictures” are X-ray on a film?
SR: Correct.

ML: Do you have some films from my procedure?
SR: I’m not sure. But we don’t have moving videos. If there is anything it would be a film.
ML: Sometimes you do have plain film for people who have VUCGs?
SR: Yes, because we do it a lot on babies. I can find out if there are plain films.
ML: I’d like you to do that.

ML: So there are never any digital videos for VUCGs?
SR: For this particular exam, no. And that’s common practice, not just Kaiser. Angiograms, they tape that.
ML: You know what a VUCG is?
SR: Yes, it’s a voiding urethrocystogram.
ML: And you know for a fact that they don’t make digital videos of them?
SR: I’m 99% positive. We do babies…
ML: How about adults?
SR: I don’t even think they have the capability to do it.

ML: This is the latest technology?
SR: Correct. That’s common practice.
ML: Can you find out if anybody gets digital videos for VUCGs?
SR: I’ve been here for 20 years and it’s something I’ve never known has been done her as well as in the outside community. It’s not a standard of care.

ML: Can you find out?
SR: If it’s done at urology? I would have to call urology.
ML: You have an obligation to produce records if they exist. So you will call me when you find out?
SR: Yes, I will.
ML: Thank you. Bye-bye.

April 8, 2014

Stephanie Ritter called back.

SR: I reached out to the chief of urology and confirmed that we do not tape. You used the word video. We do not tape the full fluoroscopy for VUCGs. Your X-ray jacket is in our main warehouse up in L.A. and we’ve ordered that to be delivered and hope to have it by the end of this week so we can review if there are any images in the jacket. [Maura Larkins’ thought: why would there be an X-ray jacket if there were no images????] They can take plain film pictures between the exam.

ML: Do they use thermal paper?

[I asked this because Dr. Rhee, Lynette Seid, Andrew Golden and everyone else I talked to at Kaiser had previously told me that images from my procedure had only been saved on thermal paper. This bizarre claim was even put in writing.]

SR: No. Thermal paper hasn’t been used in a long time. Thermal paper was used in mammography more than 20 years ago.

ML: There were no digital images saved?
SR: You used the word “video”. There was no taping. That is not procedure.
ML: Are there digital images?
SR: I don’t know if they would be digital.
ML: Is there a possibility they might be digital?

SR: What do you mean by digital? [ML note: SR didn’t allow me to answer that question.] It was probably around the time we started to convert to digital in regular radiology, not necessarily in urology. Southern California, from L.A. down, did start to convert to non-film images.

ML: When you say “converting to non-film”, you mean digital?

SR: Correct. But I want to be careful about what you’re understanding. A film can be converted to digital and digital can be converted to film. [Maura Larkins’ thought: Why would anyone want to convert from digital to film????]

ML: Right now urology never uses digital X-rays or fluoroscopy?

SR: Fluoroscopy and digital are different things. We do not use video cameras.

ML: Fluoroscopy is never digital?

SR: I’m not going to say NO. Depending on type [page 6 begins here]of machine.

ML: Sometimes fluoroscopy is recorded digitally?

SR: I’m not going to answer that because it does not relate to VUCG. For a voiding urethrocystogram there is not recording of fluoroscopy.

ML: You talked to Dr. Rhee?

SR: Yes. I don’t want to mislead you.

ML: You don’t want to mislead me?

SR: Mrs. Larkins, please don’t put words in my mouth. I don’t want to miscommunicate with you.
ML: You said, “I don’t want to mislead you.”
SR: I don’t want to mislead you into something you may not understand due to dynamics of urology department.
ML: You don’t want to mislead me, do you?
SR: Mrs. Larkins, is there anything I can answer?
ML: I want you to answer this: you don’t want to mislead me, do you?
SR: I want to give you correct information. I want you to understand the dynamics of procedures. You should call Mary Hanshaw. They gave you her information.

ML: They gave me her name, but not her number.
SR: [silence]
ML: They gave me her name, but not her number.
SR: [silence]
ML: Hint, hint.
SR: Are you asking me something?
ML: I’m asking for her number.
SR: 619 528 5527. Mary is on vacation.

ML: What is her title?
SR: Director of Radiology.
ML: Who is her supervisor?
SR: Dana Gascay.
ML: What is her position?
SR: Associate Medical Group Administrator. I don’t have her information.
ML: Who is her supervisor?
SR: Jim Malone.
ML: There must be someone between her and Jim Malone.
SR: Nope, there’s not.
ML: If there is an Associate Medical Group Administrator, wouldn’t there be a Medical Group Administrator?
SR: Which is Jim Malone.

ML: I bet sometimes you don’t like your job, do you?
SR: I love my job.
ML: Surely you don’t enjoy telling me these things?
SR: I’m just telling you the truth.
ML: I hope you don’t have to do any more phone calls like this today. It really must be stressful.
SR: Well, you have a wonderful afternoon.
ML: Okay. Bye-bye.

I called Mary Hanshaw several times at 619 528 5527.

On April 24, 2014 I called but no person or machine picked up.

On April 25, 2014 I called 619 528 5527 and talked to Elsa, who transferred me to Mary Hanshaw’s answering machine. The recorded message said, “This is Mary Hanshaw, Director of Diagnostic Imaging.”

I left this message: “This is Maura Larkins. On April 7 I submitted a request to view records. 14 days have passed and I still haven’t seen records. It’s supposed to be 5 days. Please call me...”

On May 1, 2014 I called and talked to a man, who transferred me to Mary Hanshaw’s answering machine/voice mail.

I left a message:
This is Maura Larkins. I left a message on April 25 and I haven’t heard back. I made a records request on April 7. I talked to Stephanie Ritter. She said she would check my X-ray chart [I meant to say “jacket”] but she hasn’t gotten back to me. I haven’t heard from her since April 8. Please call me... And please send the records. I believe you are beyond the legal limit for this request.


On May 1, 2014 I called Stephanie Ritter at 619 528 3297. Her personal greeting on her voicemail said she’s out of the office. She continued, “If you need assistance, contact the secretary at 528 5538” or the clerk at 619 528 5417.

Then the message switched to someone else’s voice:
“Sorry, the mailbox belonging to Stephanie Ritter has an extended absence greeting in place and will not accept new messages.”


I sent an email to Lynette Seid on April 24, 2014 telling her that her subordinates were not complying with the law. She has not responded as of May 1, 2014.


Anonymous said...

Some hospital outpatient radiology departments, such as the one at Fountain Valley hospital in Orange County ask you at the time of your form filling if you would like a CD copy of your images. If you do, you have to wait up to a half hour after your procedure to get one, but, if you wait, you do go home with the copy. Unfortunately, this is an example of why everyone should make a point to ask for a copy before the procedure to avoid this happening to them.

However, if you meet with refusal upon request or end up needing the records later on, you are likely to experience what the author has. It seems that hospitals jump to the conclusion that the only possible reason you could want them is to sue them. This paranoia has caused many patients, like the author, needless unwarranted frustration.

The going in person and stating you will not leave until the images are located tactic may work. Another tactic, if you are at all friendly with your doctor is to ask his staff to order them from radiology for you. If a doctor orders something, it is amazing how records suddenly become available.

However, all this being said, getting something you own should not be such a hassle. You DO technically own those records--not the facility.

The web of incompetence the author experienced is not only possible paranoia but sheer incompetence. Forget the form the images are in. All she apparently really wanted was for them to locate the images and hand them over! But, then again, she is not the only one caught up in this kind of needless hassle!
Be forwarned and take steps to minimalize the risk of it happending to you!

Anonymous said...

CFOs certainly know what they are talking about, especially withFAR cost accounting standards.