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.



TRANSCRIPT OF PHONE CALL FROM KAISER RADIOLOGY DEPARTMENT

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.
FOLLOW-UP PHONE CALLS TO MARY HANSHAW

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.

FOLLOW-UP CALL TO SR:

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.”

EMAIL TO LYNETTE SEID:

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.

My doctor said I was paranoid to doubt medical report--but I was proved right

My primary care doctor, Jae Kyo Lee of Kaiser Permanente in San Diego, said that I was paranoid when I didn't believe that a medical report could be signed three days before it was written. It turned out I was right. My urologist, Dr. Huathin Khaw, had supposedly co-signed a report on June 17, 2011. The report had supposedly been written by Dr. Jay Grimaldi on June 20, 2011. I was also suspicious because the date of the X-ray procedure was wrong and the name of the referring doctor was wrong.

It turned out I was right. The original report had actually been written on June 16, 2011 by a completely different doctor. That's the report Dr. Khaw co-signed. Then somehow large parts of it got erased. NONE of my digitized X-rays were ever made available on the Kaiser server--not even Emergency Room doctor could see them.

Dr. Jae Kyo Lee and Dr. Eugene Rhee told me I should accept the report "because it had my name on it." Why would they both make the same bizarre statement? They must be trained to say that when documents are obviously compromised.

Dave Horton, who is in charge of Radiology and Radiology Files, has refused to respond to a letter and an email. His underlings obediently spout a ridiculous story about my X-rays, taken at the brand new Garfield Specialty Center, having been saved only on thermal paper. But Kaiser's own newsletter says all X-rays at the new center are digitized. Is Kaiser guilty of false advertising? I don't think so. I think they're guilty of covering up incorrect diagnoses.

My digitized X-rays remain "unavailable". Why the cover-up, guys? (Well, I shouldn't say "guys" since Lynette Seid and Mary Ann Barnes have supported the cover-up.) I'd say these folks are a bit paranoid if they're afraid of a few X-rays.

Group visits for urology deliver efficiency, patient satisfaction

Group visits for urology deliver efficiency, patient satisfaction
Feb 1, 2011
Philip M. Hanno, MD, MPH
Source: Urology Times

Group shared appointments are an increasingly popular way to improve patient access for busy practices. Simultaneously giving patients added contact with their physician while also allowing them to talk about their condition with others, group shared appointments are applicable to a number of urologic conditions.

In this interview, Eugene Rhee, MD, MBA, explains how shared appointments work, what their advantages are, and how they can be applied to your practice.

Dr Rhee is chief of urologic surgery at Kaiser Permanente, San Diego. He was interviewed by Urology Times Editorial Consultant Philip M. Hanno, MD, MPH, professor of urology at the University of Pennsylvania, Philadelphia...

Falsifying records and hiding x-rays in the Kaiser Permanente Urology Department?

See two more pages related to this report HERE.

UPDATE OCT. 15, 2011
Kaiser publishes newsletter contradicting repeated statements that x-rays were saved only on thermal paper.







Click HERE (and then go to bottom of new page) to see US News and World Report statistics comparing urology departments in San Diego hospitals.

What's going on in the Kaiser Permanente Urology Department?
by Maura Larkins

I have discovered some things that may help explain why Kaiser Permanente San Diego Medical Center has worse than expected survival rates for urology patients.

I visited Dr. K in May. (I won't give his name here, largely because I feel that the real problem is Kaiser itself. I'd like to think that Dr. K might have developed different habits, attitudes and practices at a better institution.

In February 2011, I had developed a painful problem with urination. It was not an infection, but my urine was extremely cloudy. I began using Bactine to help with the pain. Dr. K said he'd never seen urine as cloudy as mine. He later asked me, "What is Bactine?" Obviously, he had no idea what was going on, but that didn't stop him from making an instant diagnosis: the cloudiness was caused by the Bactine! He either assumed that Bactine has white stuff in it rather than being clear, or he opined that the Bactine had caused the original problem for which the Bactine was used (he couldn't have come up with more perfect circular reasoning if he had tried.) Or maybe he was thinking both things.

A urethrocystogram (VUCG), a test in which dye is injected into the
bladder, and x-rays are taken, was ordered by Dr. K on May 26. The
procedure was done on June 15. (These two dates will become
important later on in this story.)

After the test, I saw the final two images of my bladder and urethra
on the two computer monitors in the x-ray room. The technician
told me the images would be available to any Kaiser doctor. (These
facts will also become important later on.)

But Dr. K had made clear to me that he was only giving me the VUCG to
prove to me that there was nothing wrong with me. He made no
appointment to discuss the results with me. I was to be given the results by
the nurse. But I wanted to see the x-rays, so I ordered a CD of the results.
That's when things started to get very interesting.

The Records lady who said on June 30 that she'd send me the CD called
me back on July 1. She said that the results of my VUCG had not
been digitized! She said that only a few images had been saved on
thermal paper, but that she'd be happy to send me Xerox copies of the
images. I received five images a few days later. None of them included my
urethra. Luckily, as it turned out, she also included a printed report titled
"Outpatient Diagnositc Imaging." That report was the key to exposing Dr. K's bizarre antics.

I complained to Member Services. A lady at Member Services said
X-rays were often available only on thermal paper, and, in fact,
she had recently had surgery and the only x-ray images she was
able to show her surgeon were on thermal paper. I asked her,
"Didn't your doctor want a sharper image?" She said, "Well, no, he
was an older gentleman, so it was fine with him."

Then a man called me from Member Services. He said the images were
never digitized. But this time the story was that some images had
been saved on glossy paper. He said, "You're not going to get a CD!"

Why didn't they want me to have a CD of those images? After all, the CD
should be quite reassuring, since the written report came back completely
normal.

Two very odd--and oddly different--printed reports

Perhaps a clue as to why I was not given the CD of the VUCG can be found
by looking at the following written report(s):

Click HERE to see the Kaiser VUCG reports.

I made an appointment with a different urologist. When I went to that
appointment, I was told no images were available.

I had so much pain one night that I went to the Emergency Room.
There were no VUCG images available to the ER doctors, but those
doctors said they weren't concerned since the report assured
them that all was normal. They completely ignored me when I
pointed out errors in the report. (Related story:
Kaiser retaliated against one of its emergency room physicians
when he complained about quality of care in the ER.)

I went to a new primary care doctor on July 12, and he was completely
uninterested in the missing VUCG images and the anomalies in the
report. He said the report was normal, and he "didn't have the
resources" to investigate anything.

I went home and wrote emails to doctors. I noted the following:

1) Dr. K co-signed my report on June 17, but that report is
missing.

2) It has been replaced by a report created on June 20 for a
patient whose VUCG was ordered by a different doctor on a
different date and was done the day after mine was done.

3) Dr. K obviously could not have co-signed the June 20 report
three days before it was written.

4) All the digitized images of my VUCG are "unavailable."

Finally, on July 12, after I presented the above information to my new
urologist, he emailed me to say that he had ALL THE DIGITIZED
IMAGES FROM MY VUCG, and he would show them to me at my
next appointment.

I emailed Dr. K about these discrepancies on July 12, but he has not
responded as of July 17.

I wonder if I will actually see these mysterious images.

Update August 1, 2011
No, I didn't see the images--even after talking to the head of the Urologic Surgery Department, Dr. Eugene Young Rhee. See full story HERE.


Kaiser Permanente San Diego Medical Center
Urology Score Card 2010-2011

U.S. News Hospital Score
16.0/100

Survival
Worse than expected


Patient safety
Low


Patient volume
Medium

Level of nurse staffing
Lowest

Nurse Magnet hospital
No

Number of important technologies available in this specialty
Low