Update June 13, 2014 : If UCSD were telling the truth about not having enough room on its hard disk to save digital colonoscopies, then it would have all the more reason to provide DVDs of the procedure. UCSD wouldn't allow me to pay extra to get my colonoscopy saved.
When I got my colonoscopy yesterday (at somewhere other than UCSD), the doctor showed me the small device for recording DVDs that attaches to the colonoscopy machine.
"How much did that cost?" I asked.
"Two hundred dollars," he said. "But you can get it for $150 on E-bay."
Ahem, UCSD? Do you want to stick to your story that prohibitive cost is the reason you (allegedly) don't save digital colonoscopies?
See all posts re UCSD.
I was scheduled for a routine colonoscopy at UCSD last month. Nothing controversial about that, right?
I had had a bizarre experience at Kaiser three years ago when I paid Kaiser $10 for a DVD of the digital video of my VUCG (or "VCUG"). Then suddenly the radiology imaging department claimed that there were no digital images of the procedure--even though the X-rays were done at the brand new Garfield Specialty Center advertised as having all-digital X-rays. Kaiser said that it only had a few odd thermal paper images of the June 15, 2011 procedure.
So naturally I wanted to make sure that the same thing wouldn't happen at UCSD. A couple of days before my colonoscopy I called to make sure that I would be able to get a DVD of the procedure.
UCSD's gastroenterology department told me that they don't save any of the digital data generated during colonoscopies.
This is what UCSD claims:
1. The patient can't get a second opinion from any doctor who wasn't watching the computer monitor during the procedure.
2. UCSD is very vulnerable to lawsuits; it can't prove that it wasn't negligent if the patient develops colon cancer that was missed.
3. UCSD can't learn from its mistakes. It can't go back and see what it was they missed so they can do a better job in the future.
4. A few seconds after the patient leaves, the doctor (and patient) are out of luck if the doctor suddenly thinks, "Hey, what was that I was looking at? Maybe that was something important. I'd like to see that again." Nope. No chance. According to UCSD, the images have been flushed from its computers.
5. UCSD says they don't save the images because it takes up too much space on the hard drive.
Yeah, right. Digital memory is getting cheaper by the month, so why would UCSD have suddenly stopped saving digital data recently? They used to give patients DVDs, and before that they gave VHS tapes of colonoscopies. Those tapes were a lot more expensive and bulky than digital memory.
I asked if I could pay extra to get my procedure saved, but they said NO. The procedure costs $1300 minimum. You'd think that would cover a bit of space on the hard drive, wouldn't you? Well, of course it does. They just don't want patients to see the images.
These days many doctors in the US are so dead set against patients seeing the images that they sedate everybody, even people who've had colonoscopies before without sedation and didn't have any problem. They'd rather take the risk of a bad reaction to drugs than to let patients see the video. I watched doctors on You Tube showing the whole process, and the first thing they asked patients when they woke up was, "Do you remember anything?" The patients all said NO.
When I suggested that I didn't believe that UCSD flushed the digital data, UCSD suggested that I go somewhere else if I wanted a DVD.
So I found a doctor who would give me a DVD of my colonoscopy.
The new doctor wants me to get some lab work done, so I went to UCSD today to get blood drawn.
The nurse who drew my blood was very sweet, but it quickly became clear that she had been tasked with finding out who had agreed to give me a DVD of a colonoscopy. Why would UCSD want to know that?
"Where are you going for your colonoscopy?" she asked.
I didn't want UCSD calling up the doctor and demanding that he not give me a DVD.
"I don't think I should say, since UCSD doesn't approve of patients getting DVDs," I told her.
"Oh, no," she said. "It's not that. It's just that we don't do DVDs."
Fine, I thought. So we're all happy and relaxed about this situation. I sat back in my chair and the nurse put a pillow on my lap.
"So are you getting it done at a hospital?" she asked. It seemed that my nurse was not so happy and relaxed about the situation after all.
I didn't want to say YES and I didn't want to say NO. I didn't want to tell the truth or tell a lie. So I didn't say anything.
I was afraid she'd be mad at me and poke me painfully with the needle, but she was very careful. I only felt a tiny pinch. And then we said friendly good byes.
Message to UCSD: she tried. She really did try. But I had planned ahead of time that I wouldn't spill the beans. So don't blame the very sweet girl who couldn't get the information out of me.
Showing posts with label concealing medical records. Show all posts
Showing posts with label concealing medical records. Show all posts
Wednesday, June 11, 2014
Tuesday, June 10, 2014
Want a souvenir DVD of your colonoscopy? So did I.
See all posts re UCSD.
I was scheduled for a routine colonoscopy at UCSD last month. Nothing controversial about that, right?
I had had a bizarre experience at Kaiser three years ago when I paid Kaiser $10 for a DVD of the digital video of my VUCG (or "VCUG"). Then suddenly the radiology imaging department claimed that there were no digital images of the procedure--even though the X-rays were done at the brand new Garfield Specialty Center advertised as having all-digital X-rays. Kaiser said that it only had a few odd thermal paper images of the June 15, 2011 procedure.
So naturally I wanted to make sure that the same thing wouldn't happen at UCSD. A couple of days before my colonoscopy I called to make sure that I would be able to get a DVD of the procedure.
UCSD's gastroenterology department told me that they don't save any of the digital data generated during colonoscopies.
This is what UCSD claims:
1. The patient can't get a second opinion from any doctor who wasn't watching the computer monitor during the procedure.
2. UCSD is very vulnerable to lawsuits; it can't prove that it wasn't negligent if the patient develops colon cancer that was missed.
3. UCSD can't learn from its mistakes. It can't go back and see what it was they missed so they can do a better job in the future.
4. A few seconds after the patient leaves, the doctor (and patient) are out of luck if the doctor suddenly thinks, "Hey, what was that I was looking at? Maybe that was something important. I'd like to see that again." Nope. No chance. According to UCSD, the images have been flushed from its computers.
5. UCSD says they don't save the images because it takes up too much space on the hard drive.
Yeah, right. Digital memory is getting cheaper by the month, so why would UCSD have suddenly stopped saving digital data recently? They used to give patients DVDs, and before that they gave VHS tapes of colonoscopies. Those tapes were a lot more expensive and bulky than digital memory.
I asked if I could pay extra to get my procedure saved, but they said NO. The procedure costs $1300 minimum. You'd think that would cover a bit of space on the hard drive, wouldn't you? Well, of course it does. They just don't want patients to see the images.
These days many doctors in the US are so dead set against patients seeing the images that they sedate everybody, even people who've had colonoscopies before without sedation and didn't have any problem. They'd rather take the risk of a bad reaction to drugs than to let patients see the video. I watched doctors on You Tube showing the whole process, and the first thing they asked patients when they woke up was, "Do you remember anything?" The patients all said NO.
When I suggested that I didn't believe that UCSD flushed the digital data, UCSD suggested that I go somewhere else if I wanted a DVD.
So I found a doctor who would give me a DVD of my colonoscopy...
This story has been moved to HERE.
I was scheduled for a routine colonoscopy at UCSD last month. Nothing controversial about that, right?
I had had a bizarre experience at Kaiser three years ago when I paid Kaiser $10 for a DVD of the digital video of my VUCG (or "VCUG"). Then suddenly the radiology imaging department claimed that there were no digital images of the procedure--even though the X-rays were done at the brand new Garfield Specialty Center advertised as having all-digital X-rays. Kaiser said that it only had a few odd thermal paper images of the June 15, 2011 procedure.
So naturally I wanted to make sure that the same thing wouldn't happen at UCSD. A couple of days before my colonoscopy I called to make sure that I would be able to get a DVD of the procedure.
UCSD's gastroenterology department told me that they don't save any of the digital data generated during colonoscopies.
This is what UCSD claims:
1. The patient can't get a second opinion from any doctor who wasn't watching the computer monitor during the procedure.
2. UCSD is very vulnerable to lawsuits; it can't prove that it wasn't negligent if the patient develops colon cancer that was missed.
3. UCSD can't learn from its mistakes. It can't go back and see what it was they missed so they can do a better job in the future.
4. A few seconds after the patient leaves, the doctor (and patient) are out of luck if the doctor suddenly thinks, "Hey, what was that I was looking at? Maybe that was something important. I'd like to see that again." Nope. No chance. According to UCSD, the images have been flushed from its computers.
5. UCSD says they don't save the images because it takes up too much space on the hard drive.
Yeah, right. Digital memory is getting cheaper by the month, so why would UCSD have suddenly stopped saving digital data recently? They used to give patients DVDs, and before that they gave VHS tapes of colonoscopies. Those tapes were a lot more expensive and bulky than digital memory.
I asked if I could pay extra to get my procedure saved, but they said NO. The procedure costs $1300 minimum. You'd think that would cover a bit of space on the hard drive, wouldn't you? Well, of course it does. They just don't want patients to see the images.
These days many doctors in the US are so dead set against patients seeing the images that they sedate everybody, even people who've had colonoscopies before without sedation and didn't have any problem. They'd rather take the risk of a bad reaction to drugs than to let patients see the video. I watched doctors on You Tube showing the whole process, and the first thing they asked patients when they woke up was, "Do you remember anything?" The patients all said NO.
When I suggested that I didn't believe that UCSD flushed the digital data, UCSD suggested that I go somewhere else if I wanted a DVD.
So I found a doctor who would give me a DVD of my colonoscopy...
This story has been moved to HERE.
Saturday, May 17, 2014
San Diego Kaiser is still refusing to release any X-ray images in response to my April 7, 2014 request
I sent this email to San Diego Kaiser Permanente's Chief Financial Officer and Chief of Records Lynette Seid today:
Dear Ms. [Lynette] Seid:
Your subordinates have come up completely empty in response to my April 7, 2014 request for radiological images.
I did receive 24 pages of paper records from my medical record today by certified mail. So it seems that the Radiology Records department is the problem.
Sincerely,
Maura Larkins
Dear Ms. [Lynette] Seid:
Your subordinates have come up completely empty in response to my April 7, 2014 request for radiological images.
I did receive 24 pages of paper records from my medical record today by certified mail. So it seems that the Radiology Records department is the problem.
Sincerely,
Maura Larkins
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.
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.
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.
Friday, April 25, 2014
Kaiser Permanente San Diego CFO Lynnette Seid personally created a hoax CD of X-ray images
UPDATE APRIL 30, 2014:
CLICK HERE for a transcript of my bizarre adventures in the Kaiser Radiology Records Department in April 2014.
UPDATE APRIL 28, 2014:
I went to Kaiser today to get medical records that I thought might be interesting. I was not disappointed. I discovered that the last doctor I visited at Kaiser wrote this:
Is that cute or what? I don't think the doctor who wrote this meant to be quite so truthful about her inability to give an honest second opinion.
ORIGINAL POST ABOUT KAISER CONCEALING TEST RESULTS:
Lynette Seid, CFO and chief administrator
for San Diego Kaiser medical records
See also: Is Kaiser Permanente violating the California Business and Professions Code with false advertising about digitized x-rays?
Lynette Seid is not only Kaiser Permanente San Diego Area's Chief Financial Officer. She's also the chief administrator in charge of medical records.
I asked for a CD of my digital VUCG X-ray images to take to an out-of-plan doctor, and in response, Lynette Seid created a CD with the following X-ray images.
It pretends to be a set of 13 images, but it actually consists of only 7 distinct images.
Four of the images appear twice, labeled with different numbers, but with the exact same time stamp:
#1 is identical to #4;
#2 is identical to #3,
#7 is identical to #9, and
#8 is identical #12.
One image appears three times!
(#10, #11 and #13 are identical).
Some of the copies have labels added (“scout,” “voiding,” and “post-void”), but the time stamped on each image identifies it precisely.
Image #6 is of particular interest; it is the one new image that Kaiser was willing to produce for an out-of-plan doctor.
See the 13 images--or rather, 7 images--here.
Nice work, Lynette! A particularly nice touch was the high-tech CD Lynetter sent me. When I open up the bizarre images, which were first printed out and THEN were scanned, and therefore provide extremely little information, I get a rapid slide show just by moving my cursor across the images. Lynette is pretending that someone might actually be looking at these images for the purpose of discerning information about the X-rays. In fact, the images only provide information about how desperate Kaiser is to conceal information about the X-rays it took.
See all posts re Lynette Seid.
CAN BAD DOCTORS CREATE GOOD KNOWLEDGE?
I believe the answer is YES. Kaiser Permanente, for example, has guidelines that require doctors to sacrifice many patients for the purpose of increasing profits. At the same time, Kaiser collects information that helps it improve the treatment of patients who can be treated without sacrificing profits.
"IN MAY 1988, Dr Robert Pozos, a hypothermia researcher at the University of Minnesota, said he planned to analyse and republish a contemporary 56-page report on infamous Dachau experiments in which almost 300 male prisoners were placed in vats of freezing water.
"The men were observed, measured and analysed, sometimes to the point of death; sometimes they were warmed up again with boiling water. Pozos said he could learn how to treat people with hypothermia better if he understood what went on at Dachau."
This sparked off a passionate debate about the ethics of knowledge. Conferences, seminars, letters and speeches the world over have struggled with what to do about Pozos's approach. Some argued the knowledge should never be used because it was gained immorally. Others asked: "Should we not look at the pyramids because they were built using slave labour?" Eventually, Pozos used the knowledge, but the debate continues. The New England Journal of Medicine, for example, does not publish citations of the work.
Contacts and staff : Information : Nature Reviews Urology
www.nature.com/nrurol/info/info_contacts.html
Nature
Chief Editor: Annette Fenner, MBBS, PhD Acting Chief Editor: Sarah Payton, PhD Senior Editor: Melanie ... PhD; David Killock, PhD Cross-Journal Associate Editors: Tim Geach, PhD Editorial Support Manager: ... Clinical Practice & Research.
CLICK HERE for a transcript of my bizarre adventures in the Kaiser Radiology Records Department in April 2014.
UPDATE APRIL 28, 2014:
I went to Kaiser today to get medical records that I thought might be interesting. I was not disappointed. I discovered that the last doctor I visited at Kaiser wrote this:
When asked how I could help her, [Maura Larkins] states that "really I just wanted to meet you because when I asked Dr. X for a transfer to another doctor, [Dr. X] said anyone except Dr. Z". Patient felt that...I would be honest and maybe go against what my supervisor's might want me to do. Discussed with the patient that this wasn't the case at all...
Is that cute or what? I don't think the doctor who wrote this meant to be quite so truthful about her inability to give an honest second opinion.
ORIGINAL POST ABOUT KAISER CONCEALING TEST RESULTS:
Lynette Seid, CFO and chief administrator
for San Diego Kaiser medical records
See also: Is Kaiser Permanente violating the California Business and Professions Code with false advertising about digitized x-rays?
Lynette Seid is not only Kaiser Permanente San Diego Area's Chief Financial Officer. She's also the chief administrator in charge of medical records.
I asked for a CD of my digital VUCG X-ray images to take to an out-of-plan doctor, and in response, Lynette Seid created a CD with the following X-ray images.
It pretends to be a set of 13 images, but it actually consists of only 7 distinct images.
Four of the images appear twice, labeled with different numbers, but with the exact same time stamp:
#1 is identical to #4;
#2 is identical to #3,
#7 is identical to #9, and
#8 is identical #12.
One image appears three times!
(#10, #11 and #13 are identical).
Some of the copies have labels added (“scout,” “voiding,” and “post-void”), but the time stamped on each image identifies it precisely.
Image #6 is of particular interest; it is the one new image that Kaiser was willing to produce for an out-of-plan doctor.
See the 13 images--or rather, 7 images--here.
Nice work, Lynette! A particularly nice touch was the high-tech CD Lynetter sent me. When I open up the bizarre images, which were first printed out and THEN were scanned, and therefore provide extremely little information, I get a rapid slide show just by moving my cursor across the images. Lynette is pretending that someone might actually be looking at these images for the purpose of discerning information about the X-rays. In fact, the images only provide information about how desperate Kaiser is to conceal information about the X-rays it took.
Lynette Seid (Mulan7224) on Twitter
Life is truly wonderful when you love what you do and you have someone very special to share your life!
[Maura Larkins response: Seriously, Lynette? You love doing stuff like this? Do you get paid a lot to do it? And get lots of appreciation from other extremely highly-paid executives? Perhaps you are blocking out the reality that life isn't truly wonderful when one's medical records are concealed by happy folks like you.]
See all posts re Lynette Seid.
CAN BAD DOCTORS CREATE GOOD KNOWLEDGE?
I believe the answer is YES. Kaiser Permanente, for example, has guidelines that require doctors to sacrifice many patients for the purpose of increasing profits. At the same time, Kaiser collects information that helps it improve the treatment of patients who can be treated without sacrificing profits.
"IN MAY 1988, Dr Robert Pozos, a hypothermia researcher at the University of Minnesota, said he planned to analyse and republish a contemporary 56-page report on infamous Dachau experiments in which almost 300 male prisoners were placed in vats of freezing water.
"The men were observed, measured and analysed, sometimes to the point of death; sometimes they were warmed up again with boiling water. Pozos said he could learn how to treat people with hypothermia better if he understood what went on at Dachau."
This sparked off a passionate debate about the ethics of knowledge. Conferences, seminars, letters and speeches the world over have struggled with what to do about Pozos's approach. Some argued the knowledge should never be used because it was gained immorally. Others asked: "Should we not look at the pyramids because they were built using slave labour?" Eventually, Pozos used the knowledge, but the debate continues. The New England Journal of Medicine, for example, does not publish citations of the work.
Contacts and staff : Information : Nature Reviews Urology
www.nature.com/nrurol/info/info_contacts.html
Nature
Chief Editor: Annette Fenner, MBBS, PhD Acting Chief Editor: Sarah Payton, PhD Senior Editor: Melanie ... PhD; David Killock, PhD Cross-Journal Associate Editors: Tim Geach, PhD Editorial Support Manager: ... Clinical Practice & Research.
Saturday, November 2, 2013
Do doctors help medical students by allowing them to practice on patients who are not considered important? CA issues fines against hospitals
The California Department of Public Health usually relies on self-reporting by doctors and hospitals, which happens rarely, I have observed.
Adverse Events Draw $775K in Fines at 9 CA Hospitals
Cheryl Clark
HealthLeaders Media
October 28, 2013
The most recent round of administrative penalties for hospital deficiencies constituting immediate jeopardy includes two patient falls resulting in deaths, a wrong-site surgery, and a retained surgical object.
>>>Slideshow: CA hospitals penalized for medical errors
At Sharp Memorial Hospital in San Diego, a surgical team took out a man's healthy left kidney instead of his cancerous right one because the hospital didn't make imaging studies viewable in the operating room and because the surgeon "forgot" how to log-in to see them before cutting into the patient.
At Antelope Valley Hospital in Lancaster, a patient returned to the emergency department three times before doctors realized they had forgotten to remove a 9 x 6-inch surgical device. According to state officials, the device was not included in the instrument count.
And at Community Regional Medical Center in Fresno, a surgeon left the OR after instructing a physician's assistant to finish the surgery, which the assistant was not trained to complete. The patient suffered major blood loss, cardiac arrest, and loss of oxygen to the brain. At the completion of a state investigation, the patient remained on life support.
These major adverse events in California hospitals are among 10 detailed in state documents accompanying $775,000 in administrative penalties to these hospitals, which state officials announced last week. The fines are assessed once state investigators determine that lapses in regulatory compliance caused or likely caused serious injury or death to a patient.
Since these penalties began in 2007, the state had issued 295 penalties to more than 155 of the state's 400 acute care facilities, according to a statement issued Thursday by the California Department of Public Health.
Including the latest round of penalties, the state has assessed $13.3 million in fines and has collected $10.1 million. Most of the $3.2 million not yet collected is under appeal by the hospitals that dispute the state's findings.
The funds are to be used for programs to improve healthcare safety.
In a phone interview Thursday, Debby Rogers, deputy director for the state Department of Public Health's Center for Healthcare Quality, refused to comment on any particular hospital's harmful event, but acknowledged that some incidents are more serious than others.
New regulations due to take effect by the end of the year, will allow the state to consider how much patient harm was done "and how widespread inside the hospital a particularly deficiency is."
"We feel strongly that publicizing these deficiencies helps hold these facilities accountable but it also empowers consumers to speak to their providers to put protections in place so something like this doesn't happen," Rogers said.
...At Community Regional Medical Center, Fresno, Fresno County, a patient admitted for ascending aortic aneurysm repair suffered massive blood loss, cardiac arrest, and loss of oxygen to the brain after the heart surgeon left the operating room prior to the closure of the patient's chest during open heart surgery.
The surgeon instead directed a physician's assistant "to be left in charge, an individual not qualified to be left in charge of the cardiovascular surgery."
State investigators said the patient's loss of blood "required reopening the chest and manual massage of the heart." The patient was subsequently placed on life support.
Asked for an explanation, the surgeon said he had allowed the physician's assistant "to practice above her privilege card as 'she was preparing for an advanced quality practice exam and for that, she needed so many cases with opening and closing the chest and to cannulate the heart." The surgeon said he had always been there when she did this procedure "until this time."
State investigators wrote that the incident was reported through "an anonymous complaint," suggesting that the hospital may not have properly reported the incident as required by law.
The penalty is $75,000. This is the hospital's second administrative penalty...
10 California hospitals fined a total of $675,000
August 15, 2013
By Ari Bloomekatz
Los Angeles Times
Ten California hospitals, including Ronald Reagan UCLA Medical Center and Hollywood Presbyterian Medical Center, were slapped with fines Thursday totaling $675,000 because they failed to follow certain licensing requirements that "caused, or was likely to cause, serious injury or death to patients."
The fines ranged from $50,000 to $100,000, according to a news release from the California Department of Public Health.
St. Jude Medical Center in Fullerton, for example, was fined $100,000 for its fifth administrative penalty, according to the release.
"Based on observation, interview and record review, the hospital failed to follow their policy and procedure to have relevant images and results properly labeled and displayed prior to a patient's surgery," according to documents provided by the public health department. "This failure resulted in the removal of the wrong kidney."
The penalty against UCLA's hospital was for not following the proper surgical policies and procedures that led to "a patient having to undergo a second surgery to remove a retained foreign object." The hospital was fined $50,000...
Adverse Events Draw $775K in Fines at 9 CA Hospitals
Cheryl Clark
HealthLeaders Media
October 28, 2013
The most recent round of administrative penalties for hospital deficiencies constituting immediate jeopardy includes two patient falls resulting in deaths, a wrong-site surgery, and a retained surgical object.
>>>Slideshow: CA hospitals penalized for medical errors
At Sharp Memorial Hospital in San Diego, a surgical team took out a man's healthy left kidney instead of his cancerous right one because the hospital didn't make imaging studies viewable in the operating room and because the surgeon "forgot" how to log-in to see them before cutting into the patient.
At Antelope Valley Hospital in Lancaster, a patient returned to the emergency department three times before doctors realized they had forgotten to remove a 9 x 6-inch surgical device. According to state officials, the device was not included in the instrument count.
And at Community Regional Medical Center in Fresno, a surgeon left the OR after instructing a physician's assistant to finish the surgery, which the assistant was not trained to complete. The patient suffered major blood loss, cardiac arrest, and loss of oxygen to the brain. At the completion of a state investigation, the patient remained on life support.
These major adverse events in California hospitals are among 10 detailed in state documents accompanying $775,000 in administrative penalties to these hospitals, which state officials announced last week. The fines are assessed once state investigators determine that lapses in regulatory compliance caused or likely caused serious injury or death to a patient.
Since these penalties began in 2007, the state had issued 295 penalties to more than 155 of the state's 400 acute care facilities, according to a statement issued Thursday by the California Department of Public Health.
Including the latest round of penalties, the state has assessed $13.3 million in fines and has collected $10.1 million. Most of the $3.2 million not yet collected is under appeal by the hospitals that dispute the state's findings.
The funds are to be used for programs to improve healthcare safety.
In a phone interview Thursday, Debby Rogers, deputy director for the state Department of Public Health's Center for Healthcare Quality, refused to comment on any particular hospital's harmful event, but acknowledged that some incidents are more serious than others.
New regulations due to take effect by the end of the year, will allow the state to consider how much patient harm was done "and how widespread inside the hospital a particularly deficiency is."
"We feel strongly that publicizing these deficiencies helps hold these facilities accountable but it also empowers consumers to speak to their providers to put protections in place so something like this doesn't happen," Rogers said.
...At Community Regional Medical Center, Fresno, Fresno County, a patient admitted for ascending aortic aneurysm repair suffered massive blood loss, cardiac arrest, and loss of oxygen to the brain after the heart surgeon left the operating room prior to the closure of the patient's chest during open heart surgery.
The surgeon instead directed a physician's assistant "to be left in charge, an individual not qualified to be left in charge of the cardiovascular surgery."
State investigators said the patient's loss of blood "required reopening the chest and manual massage of the heart." The patient was subsequently placed on life support.
Asked for an explanation, the surgeon said he had allowed the physician's assistant "to practice above her privilege card as 'she was preparing for an advanced quality practice exam and for that, she needed so many cases with opening and closing the chest and to cannulate the heart." The surgeon said he had always been there when she did this procedure "until this time."
State investigators wrote that the incident was reported through "an anonymous complaint," suggesting that the hospital may not have properly reported the incident as required by law.
The penalty is $75,000. This is the hospital's second administrative penalty...
10 California hospitals fined a total of $675,000
August 15, 2013
By Ari Bloomekatz
Los Angeles Times
Ten California hospitals, including Ronald Reagan UCLA Medical Center and Hollywood Presbyterian Medical Center, were slapped with fines Thursday totaling $675,000 because they failed to follow certain licensing requirements that "caused, or was likely to cause, serious injury or death to patients."
The fines ranged from $50,000 to $100,000, according to a news release from the California Department of Public Health.
St. Jude Medical Center in Fullerton, for example, was fined $100,000 for its fifth administrative penalty, according to the release.
"Based on observation, interview and record review, the hospital failed to follow their policy and procedure to have relevant images and results properly labeled and displayed prior to a patient's surgery," according to documents provided by the public health department. "This failure resulted in the removal of the wrong kidney."
The penalty against UCLA's hospital was for not following the proper surgical policies and procedures that led to "a patient having to undergo a second surgery to remove a retained foreign object." The hospital was fined $50,000...
Saturday, August 3, 2013
Babies die; hospital halts heart surgeries
Babies die; hospital halts heart surgeries
By Elizabeth Cohen, Senior Medical Correspondent
(CNN)
August 3, 2013
Connor Wilson was born February 13, 2012. He had his first surgery at Kentucky Children's Hospital a week later and a second surgery on May 11. On August 3, 2012, his heart stopped, but doctors got it beating again. "He never got better," says his mother, Nikki Crew. Connor Wilson was born February 13, 2012. He had his first surgery at Kentucky Children's Hospital a week later and a second surgery on May 11. On August 3, 2012, his heart stopped, but doctors got it beating again. "He never got better," says his mother, Nikki Crew.>
>
Tabitha and Lucas Rainey were beginning to get suspicious.
The staff at Kentucky Children's Hospital kept telling them their infant son, Waylon, was recovering well from surgery. There had been a few bumps in the road, to be sure, but they said that was normal for a baby born with a severe heart defect.
Months passed. Waylon remained in the intensive care unit. More complications arose.
"Is everything OK?" the Raineys would ask.
Yes, the doctors and nurses assured them. Everything was fine.
Baby heart surgery concern
Then one day, Tabitha Rainey says a cardiologist took her aside.
"She said, 'If I were you, I would move him,' " Rainey remembers. "She told me we should take him somewhere else.'"
A few days later, the Raineys arranged to have Waylon sent by helicopter to the University of Michigan. By then their son, not quite 3 months old, was in heart failure.
Secret data
If Waylon Rainey had been born 30 years ago, he almost surely would have died a few days or weeks after birth. He has a condition called hypoplastic left heart syndrome, which means the left side of his heart is so malformed it can't pump blood.
Today, surgeons perform a series of three operations on babies like Waylon. They're high-stakes surgeries -- cutting into an organ the size of a newborn baby's fist is tricky, to say the least. The blood vessels can be thinner than a piece of angel hair pasta, and one wrong move, one nick, one collapsed artery or vein can be deadly.
These children are medically very fragile, and even the best surgeons lose patients. Surgeons track their deaths and complications and take great pride in the number of babies they save. Some are so proud they publish their success rates right on their hospital websites.
Kentucky Children's Hospital is not one of these hospitals.
Instead, Kentucky Children's Hospital has gone to great lengths to keep their pediatric heart surgery mortality rates a secret, citing patient privacy. Reporters and the Kentucky attorney general have asked for the mortality data, and the hospital has declined to give it to them. In April, the hospital went to court to keep the mortality rate private.
Parents of babies treated at Kentucky Children's say the hospital's effort to keep the data a secret, coupled with troubling events over an eight-week period last year, makes them suspicious something at the hospital has gone terribly wrong...
10 ways to get your child the best heart surgeon COMMENT
Jason Simpson • 12 hours ago
− I am a pediatric cardiologist.
Pediatric heart surgery is the most delicate/complex of any surgical procedure known to man. It is a hundred times more difficult to reconstruct a baby's heart than it is to do brain surgery or colon surgery.
This is why there is such widely divergent rates of mortality and complications between hospitals and between surgeons. There are only a handful of people in the world who have the technical expertise and judgment to do these surgeries well.
There are lots of other hospitals who advertise for pediatric heart surgery programs, but they use surgeons who haven't perfected their craft yet and are still basically in training. You want one of the top flight fully trained surgeons listed at the hospitals below.
The training of a pediatric heart surgeon is the longest training pathway of any doctor. 4 years med school, 5 years general surgery, 3 years adult cardiothoracic surgery, 2-3 years pediatric cardiothoracic surgery = 14-16 years AFTER you finish undergrad. Even surgeons who have completed that pathway still have a LONG way to go in order to be fully competent surgeons and practice at the top of their craft. Many pediatric cardiothoracic surgery fellows simply arent cut out for the job and they wash out and have to pick a different medical specialty. Most of them switch from pediatric to adult heart surgery, which is much less technically complex and far easier to do.
I've worked with dozens of pediatric heart surgeons at every level of their training, and from what I've seen it is impossible to tell for sure if they are going to be good surgeons until at least 3-4 years AFTER their fellowship is completed. So never pick a surgeon who is less than 4 years out from the completion of their fellowship.
IMHO, there are only a few places in the United States who are technically capable of pulling off these highly complex surgeries:
1. Boston Childrens
2. Texas Childrens Hospital (Houston)
3. UCLA
4. CHOP (Philadelphia)
5. Univ Michigan
6. Cincinnati Childrens
There are lots of other hospitals who advertise for pediatric heart surgery programs, but they use surgeons who havent perfected their craft yet and are still basically in training. You want one of the top flight fully trained surgeons listed at the hospitals above.
Places in Kentucky and other small volume centers have NO BUSINESS opening up a pediatric heart surgery program. If you live in the middle of the country, you need to take your child to one of these elite academic medical centers in order to get good care.
By Elizabeth Cohen, Senior Medical Correspondent
(CNN)
August 3, 2013
Connor Wilson was born February 13, 2012. He had his first surgery at Kentucky Children's Hospital a week later and a second surgery on May 11. On August 3, 2012, his heart stopped, but doctors got it beating again. "He never got better," says his mother, Nikki Crew. Connor Wilson was born February 13, 2012. He had his first surgery at Kentucky Children's Hospital a week later and a second surgery on May 11. On August 3, 2012, his heart stopped, but doctors got it beating again. "He never got better," says his mother, Nikki Crew.>
>
Tabitha and Lucas Rainey were beginning to get suspicious.
The staff at Kentucky Children's Hospital kept telling them their infant son, Waylon, was recovering well from surgery. There had been a few bumps in the road, to be sure, but they said that was normal for a baby born with a severe heart defect.
Months passed. Waylon remained in the intensive care unit. More complications arose.
"Is everything OK?" the Raineys would ask.
Yes, the doctors and nurses assured them. Everything was fine.
Baby heart surgery concern
Then one day, Tabitha Rainey says a cardiologist took her aside.
"She said, 'If I were you, I would move him,' " Rainey remembers. "She told me we should take him somewhere else.'"
A few days later, the Raineys arranged to have Waylon sent by helicopter to the University of Michigan. By then their son, not quite 3 months old, was in heart failure.
Secret data
If Waylon Rainey had been born 30 years ago, he almost surely would have died a few days or weeks after birth. He has a condition called hypoplastic left heart syndrome, which means the left side of his heart is so malformed it can't pump blood.
Today, surgeons perform a series of three operations on babies like Waylon. They're high-stakes surgeries -- cutting into an organ the size of a newborn baby's fist is tricky, to say the least. The blood vessels can be thinner than a piece of angel hair pasta, and one wrong move, one nick, one collapsed artery or vein can be deadly.
These children are medically very fragile, and even the best surgeons lose patients. Surgeons track their deaths and complications and take great pride in the number of babies they save. Some are so proud they publish their success rates right on their hospital websites.
Kentucky Children's Hospital is not one of these hospitals.
Instead, Kentucky Children's Hospital has gone to great lengths to keep their pediatric heart surgery mortality rates a secret, citing patient privacy. Reporters and the Kentucky attorney general have asked for the mortality data, and the hospital has declined to give it to them. In April, the hospital went to court to keep the mortality rate private.
Parents of babies treated at Kentucky Children's say the hospital's effort to keep the data a secret, coupled with troubling events over an eight-week period last year, makes them suspicious something at the hospital has gone terribly wrong...
10 ways to get your child the best heart surgeon COMMENT
Jason Simpson • 12 hours ago
− I am a pediatric cardiologist.
Pediatric heart surgery is the most delicate/complex of any surgical procedure known to man. It is a hundred times more difficult to reconstruct a baby's heart than it is to do brain surgery or colon surgery.
This is why there is such widely divergent rates of mortality and complications between hospitals and between surgeons. There are only a handful of people in the world who have the technical expertise and judgment to do these surgeries well.
There are lots of other hospitals who advertise for pediatric heart surgery programs, but they use surgeons who haven't perfected their craft yet and are still basically in training. You want one of the top flight fully trained surgeons listed at the hospitals below.
The training of a pediatric heart surgeon is the longest training pathway of any doctor. 4 years med school, 5 years general surgery, 3 years adult cardiothoracic surgery, 2-3 years pediatric cardiothoracic surgery = 14-16 years AFTER you finish undergrad. Even surgeons who have completed that pathway still have a LONG way to go in order to be fully competent surgeons and practice at the top of their craft. Many pediatric cardiothoracic surgery fellows simply arent cut out for the job and they wash out and have to pick a different medical specialty. Most of them switch from pediatric to adult heart surgery, which is much less technically complex and far easier to do.
I've worked with dozens of pediatric heart surgeons at every level of their training, and from what I've seen it is impossible to tell for sure if they are going to be good surgeons until at least 3-4 years AFTER their fellowship is completed. So never pick a surgeon who is less than 4 years out from the completion of their fellowship.
IMHO, there are only a few places in the United States who are technically capable of pulling off these highly complex surgeries:
1. Boston Childrens
2. Texas Childrens Hospital (Houston)
3. UCLA
4. CHOP (Philadelphia)
5. Univ Michigan
6. Cincinnati Childrens
There are lots of other hospitals who advertise for pediatric heart surgery programs, but they use surgeons who havent perfected their craft yet and are still basically in training. You want one of the top flight fully trained surgeons listed at the hospitals above.
Places in Kentucky and other small volume centers have NO BUSINESS opening up a pediatric heart surgery program. If you live in the middle of the country, you need to take your child to one of these elite academic medical centers in order to get good care.
Saturday, January 5, 2013
Vast cache of Kaiser patient details was kept in private home
Kaiser won't let me see my own X-rays, and it falsified my medical records, but I'm apparently the only person Kaiser is trying to hide the information from.
Vast cache of Kaiser patient details was kept in private home
The case of Kaiser and Sure File Filing Systems underscores how patient information remains vulnerable in the hands of healthcare providers and outside contractors.
By Chad Terhune
Los Angeles Times
January 5, 2013
Federal and state officials are investigating whether healthcare giant Kaiser Permanente violated patient privacy in its work with an Indio couple who stored nearly 300,000 confidential hospital records for the company.
The California Department of Public Health has already determined that Kaiser "failed to safeguard all patients' medical records" at one Southern California hospital by giving files to Stephan and Liza Dean for about seven months without a contract. The couple's document storage firm kept those patient records at a warehouse in Indio that they shared with another man's party rental business and his Ford Mustang until 2010.
Until this week, the Deans also had emails from Kaiser and other files listing thousands of patients' names, Social Security numbers, dates of birth and treatment information stored on their home computers.
The state agency said it was awaiting more information from Kaiser on its "plan of correction" before considering any penalties.
Officials at the U.S. Department of Health and Human Services began looking into Kaiser's conduct last year after receiving a complaint from the Deans about the healthcare provider's handling of patient data, letters from the agency show. Kaiser said it hadn't been contacted by federal regulators, and a Health and Human Services spokesman declined to comment.
Kaiser said it remained confident that this patient information was never disclosed or accessed inappropriately. It said that some employees were disciplined because company policies were not followed and that it had informed regulators of the steps it had taken to ensure this type of incident didn't happen again.
"Kaiser Permanente is committed to protecting the medical and personal privacy of its patients," spokesman John Nelson said. "In retrospect, we certainly wish we'd never done business with Mr. Dean."
Even with tougher government oversight of medical privacy in recent years, this case underscores how confidential patient information remains vulnerable in the hands of big healthcare institutions and legions of outside contractors.
"Kaiser has shown extraordinary recklessness in this situation," said Beth Givens, director of the Privacy Rights Clearinghouse in San Diego. "Healthcare companies have to make sure their contractors adhere to ironclad security practices."
Federal and state laws impose strict standards on anyone dealing with patient information. The privacy rule of the federal Health Insurance Portability and Accountability Act, known as HIPAA, bans the unauthorized disclosure of individuals' medical records and requires healthcare providers and vendors, such as billing and storage companies, to protect the information.
Despite those rules, personal medical information of 21 million people nationwide has been improperly exposed since 2009, according to federal data. Last year, Blue Cross Blue Shield of Tennessee agreed to pay $1.5 million to resolve allegations it violated federal law after 57 computer hard drives with patient information were stolen from an outside facility.
In October, Kaiser sued the Deans in Riverside County Superior Court, accusing them of violating their contract by not returning all of its patient information two years ago when Kaiser picked up the paper records.
In court filings, Kaiser said the Deans put patient data at risk by leaving two computer hard drives in their garage with the door open. In response, Stephan Dean moved them to a spare room. On a recent day they sat next to a red recliner where Ziggy, the family's black-and-white cat, curled up for a nap. Dean said those hard drives contained spreadsheets on thousands of Kaiser patients, prepared at the company's request.
At one point, Dean told Kaiser he was planning to contact patients about the whereabouts of their medical information because he felt Kaiser hadn't taken proper precautions. The company sought a temporary restraining order against Dean, barring him from disclosing any confidential information. A Superior Court judge granted Kaiser's request until Thursday, when another hearing is scheduled.
Dean, 47, got his foot in the door at Kaiser from his previous work labeling paper folders for courthouses, hospitals and doctors.
But the demand for folders was slipping as hospitals and doctors used computers more. Kaiser was at the forefront of this as it invested billions of dollars in its HealthConnect system, which it bills as the largest private-sector electronic health record in the world. Kaiser, with more than 9 million customers, is the nation's largest nonprofit insurer and hospital system.
Dean said his small business, Sure File Filing Systems, got a big break when Kaiser acquired the Moreno Valley Community Hospital in 2008. The company needed to organize and clear out thousands of old patient files and it gave the job to the Deans, Kaiser records show.
In August 2008, the Deans started packing up thousands of files from Moreno Valley and moving them to the warehouse in Indio.
Hospital clerks routinely messaged Dean asking him to pull records on specific patients, emails sent by Kaiser to Sure File show. Dean said some Kaiser employees would put the patient's full name in the subject line of the email, and other messages listed the patient's Social Security number, date of birth, doctors' names and treatment dates. One message started, "Good Morning Sure File," and requested adoption records for a child.
Dean said Kaiser showed little concern for patient privacy in handling those requests. Only one out of more than 600 emails from Kaiser was password-protected with encryption, he said. Many medical providers use such technology so information isn't visible to others.
"Every one of these records is somebody's life," Dean said recently, scrolling quickly through what he said was Kaiser information on his computer screen. "We could have sold these emails to somebody in Nigeria, but Kaiser doesn't care about its patients' information."
Kaiser said that government rules don't require encryption and that "our vendors are contractually required to maintain secure environments for all records, and this includes Sure File."
The healthcare company awarded another job to Sure File in January 2010: to "deactivate" and store about 345,000 records from its West Los Angeles Medical Center for $206,000, according to Kaiser documents.
But within a few weeks, Dean said, he stopped working because he didn't have a contract yet for the West Los Angeles work. The two sides reached an accord in March 2010, and in a letter that month a Kaiser purchasing manager apologized to Dean for the confusion.
"We should have signed a contract prior to the commencement of this project," the manager wrote.
Three months later, in June 2010, Dean said, he stopped working for Kaiser again. This time, he said, he could no longer afford the insurance on the warehouse and $1,500 a month for gas for his file deliveries to Kaiser.
By July 2010, Kaiser had terminated the Deans' contract and picked up the medical records from the Indio warehouse, court files show.
The two sides signed an agreement in March 2011 to resolve their differences and Kaiser paid $110,000 to Dean, according to court documents. In its lawsuit, Kaiser said Dean was required to return or destroy "all the protected information of Kaiser members" as part of their agreements.
Dean says those agreements covered only the return of paper records. On New Year's Eve, Dean said, he deleted the Kaiser emails and other patient information on the two hard drives.
Kaiser said "this is a positive step, although based on [Dean's] behavior we will be seeking independent verification of his promised performance." In court filings, the company said it had sought access to his computers and email account for inspection by a forensic consultant.
Dean said he offered to grant that access — if the company paid him $100,000. Kaiser said it already had fully compensated the Deans, paying them about $500,000 in all...
Vast cache of Kaiser patient details was kept in private home
The case of Kaiser and Sure File Filing Systems underscores how patient information remains vulnerable in the hands of healthcare providers and outside contractors.
By Chad Terhune
Los Angeles Times
January 5, 2013
Federal and state officials are investigating whether healthcare giant Kaiser Permanente violated patient privacy in its work with an Indio couple who stored nearly 300,000 confidential hospital records for the company.
The California Department of Public Health has already determined that Kaiser "failed to safeguard all patients' medical records" at one Southern California hospital by giving files to Stephan and Liza Dean for about seven months without a contract. The couple's document storage firm kept those patient records at a warehouse in Indio that they shared with another man's party rental business and his Ford Mustang until 2010.
Until this week, the Deans also had emails from Kaiser and other files listing thousands of patients' names, Social Security numbers, dates of birth and treatment information stored on their home computers.
The state agency said it was awaiting more information from Kaiser on its "plan of correction" before considering any penalties.
Officials at the U.S. Department of Health and Human Services began looking into Kaiser's conduct last year after receiving a complaint from the Deans about the healthcare provider's handling of patient data, letters from the agency show. Kaiser said it hadn't been contacted by federal regulators, and a Health and Human Services spokesman declined to comment.
Kaiser said it remained confident that this patient information was never disclosed or accessed inappropriately. It said that some employees were disciplined because company policies were not followed and that it had informed regulators of the steps it had taken to ensure this type of incident didn't happen again.
"Kaiser Permanente is committed to protecting the medical and personal privacy of its patients," spokesman John Nelson said. "In retrospect, we certainly wish we'd never done business with Mr. Dean."
Even with tougher government oversight of medical privacy in recent years, this case underscores how confidential patient information remains vulnerable in the hands of big healthcare institutions and legions of outside contractors.
"Kaiser has shown extraordinary recklessness in this situation," said Beth Givens, director of the Privacy Rights Clearinghouse in San Diego. "Healthcare companies have to make sure their contractors adhere to ironclad security practices."
Federal and state laws impose strict standards on anyone dealing with patient information. The privacy rule of the federal Health Insurance Portability and Accountability Act, known as HIPAA, bans the unauthorized disclosure of individuals' medical records and requires healthcare providers and vendors, such as billing and storage companies, to protect the information.
Despite those rules, personal medical information of 21 million people nationwide has been improperly exposed since 2009, according to federal data. Last year, Blue Cross Blue Shield of Tennessee agreed to pay $1.5 million to resolve allegations it violated federal law after 57 computer hard drives with patient information were stolen from an outside facility.
In October, Kaiser sued the Deans in Riverside County Superior Court, accusing them of violating their contract by not returning all of its patient information two years ago when Kaiser picked up the paper records.
In court filings, Kaiser said the Deans put patient data at risk by leaving two computer hard drives in their garage with the door open. In response, Stephan Dean moved them to a spare room. On a recent day they sat next to a red recliner where Ziggy, the family's black-and-white cat, curled up for a nap. Dean said those hard drives contained spreadsheets on thousands of Kaiser patients, prepared at the company's request.
At one point, Dean told Kaiser he was planning to contact patients about the whereabouts of their medical information because he felt Kaiser hadn't taken proper precautions. The company sought a temporary restraining order against Dean, barring him from disclosing any confidential information. A Superior Court judge granted Kaiser's request until Thursday, when another hearing is scheduled.
Dean, 47, got his foot in the door at Kaiser from his previous work labeling paper folders for courthouses, hospitals and doctors.
But the demand for folders was slipping as hospitals and doctors used computers more. Kaiser was at the forefront of this as it invested billions of dollars in its HealthConnect system, which it bills as the largest private-sector electronic health record in the world. Kaiser, with more than 9 million customers, is the nation's largest nonprofit insurer and hospital system.
Dean said his small business, Sure File Filing Systems, got a big break when Kaiser acquired the Moreno Valley Community Hospital in 2008. The company needed to organize and clear out thousands of old patient files and it gave the job to the Deans, Kaiser records show.
In August 2008, the Deans started packing up thousands of files from Moreno Valley and moving them to the warehouse in Indio.
Hospital clerks routinely messaged Dean asking him to pull records on specific patients, emails sent by Kaiser to Sure File show. Dean said some Kaiser employees would put the patient's full name in the subject line of the email, and other messages listed the patient's Social Security number, date of birth, doctors' names and treatment dates. One message started, "Good Morning Sure File," and requested adoption records for a child.
Dean said Kaiser showed little concern for patient privacy in handling those requests. Only one out of more than 600 emails from Kaiser was password-protected with encryption, he said. Many medical providers use such technology so information isn't visible to others.
"Every one of these records is somebody's life," Dean said recently, scrolling quickly through what he said was Kaiser information on his computer screen. "We could have sold these emails to somebody in Nigeria, but Kaiser doesn't care about its patients' information."
Kaiser said that government rules don't require encryption and that "our vendors are contractually required to maintain secure environments for all records, and this includes Sure File."
The healthcare company awarded another job to Sure File in January 2010: to "deactivate" and store about 345,000 records from its West Los Angeles Medical Center for $206,000, according to Kaiser documents.
But within a few weeks, Dean said, he stopped working because he didn't have a contract yet for the West Los Angeles work. The two sides reached an accord in March 2010, and in a letter that month a Kaiser purchasing manager apologized to Dean for the confusion.
"We should have signed a contract prior to the commencement of this project," the manager wrote.
Three months later, in June 2010, Dean said, he stopped working for Kaiser again. This time, he said, he could no longer afford the insurance on the warehouse and $1,500 a month for gas for his file deliveries to Kaiser.
By July 2010, Kaiser had terminated the Deans' contract and picked up the medical records from the Indio warehouse, court files show.
The two sides signed an agreement in March 2011 to resolve their differences and Kaiser paid $110,000 to Dean, according to court documents. In its lawsuit, Kaiser said Dean was required to return or destroy "all the protected information of Kaiser members" as part of their agreements.
Dean says those agreements covered only the return of paper records. On New Year's Eve, Dean said, he deleted the Kaiser emails and other patient information on the two hard drives.
Kaiser said "this is a positive step, although based on [Dean's] behavior we will be seeking independent verification of his promised performance." In court filings, the company said it had sought access to his computers and email account for inspection by a forensic consultant.
Dean said he offered to grant that access — if the company paid him $100,000. Kaiser said it already had fully compensated the Deans, paying them about $500,000 in all...
Friday, October 5, 2012
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."
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:
UCLA RADIOLOGY DEPARTMENT
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
BIzzi@mednet.ucla.edu
(From the look on her face, I think she knows where those X-rays are.)
Brenda Jones, Director of Radiology Image Library
UCLA MEDICAL RECORDS DEPARTMENT
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.
Sincerely,
Brenda
Brenda M. Izzi, RN, MBA
Chief Administrative Officer
UCLA Radiology
I SENT MS. IZZI THIS EMAIL IN RESPONSE:
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.
Sincerely,
Maura Larkins
THE PLOT THICKENS ON FRIDAY AFTERNOON, OCT. 5, 2012
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.
THE CONFERENCE CALL
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.
MAYBE I SHOULD ASK THE NATIONAL ENQUIRER TO GET MY RECORDS FROM UCLA; THEY SEEM TO HAVE BETTER LUCK
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."
[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:
UCLA RADIOLOGY DEPARTMENT
"Leo G. Rigler" Chair and Professor (What's up with that Cheshire Cat smile? He looks like he might have swallowed my X-rays.)
Chief Administrative Officer and head of Radiology Image Library
(310) 481-7516 (310) 794-8056
BIzzi@mednet.ucla.edu
(From the look on her face, I think she knows where those X-rays are.)
Brenda Jones, Director of Radiology Image Library
UCLA MEDICAL RECORDS DEPARTMENT
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.
Sincerely,
Brenda
Brenda M. Izzi, RN, MBA
Chief Administrative Officer
UCLA Radiology
I SENT MS. IZZI THIS EMAIL IN RESPONSE:
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.
Sincerely,
Maura Larkins
THE PLOT THICKENS ON FRIDAY AFTERNOON, OCT. 5, 2012
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.
THE CONFERENCE CALL
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.
MAYBE I SHOULD ASK THE NATIONAL ENQUIRER TO GET MY RECORDS FROM UCLA; THEY SEEM TO HAVE BETTER LUCK
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."
Tuesday, October 2, 2012
Access to Doctors' Notes Aids Patients' Treatment
Access to Doctors' Notes Aids Patients' Treatment
By LAURA LANDRO
Wall Street Journal
October 1, 2012
Patients who have access to doctor's notes in their medical records are more likely to understand their health issues, recall what the doctor told them and take their medications as prescribed, according to a study published Monday.
The study, published online in the Annals of Internal Medicine, is the culmination of an experiment known as OpenNotes, an effort to improve doctor-patient communication by letting patients know everything their doctor has to say about them, including after a visit.
Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Danville, Pa., and Harborview Medical Center in Seattle took part in the trial, which included 105 primary-care doctors and 13,564 of their patients who had at least one note available to them during the voluntary program.
While patients legally have the right to see their entire medical record, including doctor's notes, the notes aren't automatically included in requests for records and doctors don't make it easy for patients to see them, says Tom Delbanco, a primary-care doctor at Beth Israel who is co-lead author of the study and a professor at Harvard Medical School. Some doctors were initially resistant to the idea of sharing notes, he says. According to the study, doctors who declined to participate expressed concerns that their workflow might be disrupted and that they might scare or offend patients.
But the study, based on surveys of doctors and patients taken in fall 2011 after 12 to 19 months of participation, found most fears weren't realized, and patients were enthusiastic about accessing the notes.
Close to 11,800 patients opened at least one note contained in their electronic medical record. Of 5,391 patients who opened at least one note and returned online surveys, 77% to 87% across the three sites reported that OpenNotes made them feel more in control of their care and more adherent to medications...
By LAURA LANDRO
Wall Street Journal
October 1, 2012
Patients who have access to doctor's notes in their medical records are more likely to understand their health issues, recall what the doctor told them and take their medications as prescribed, according to a study published Monday.
The study, published online in the Annals of Internal Medicine, is the culmination of an experiment known as OpenNotes, an effort to improve doctor-patient communication by letting patients know everything their doctor has to say about them, including after a visit.
Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Danville, Pa., and Harborview Medical Center in Seattle took part in the trial, which included 105 primary-care doctors and 13,564 of their patients who had at least one note available to them during the voluntary program.
While patients legally have the right to see their entire medical record, including doctor's notes, the notes aren't automatically included in requests for records and doctors don't make it easy for patients to see them, says Tom Delbanco, a primary-care doctor at Beth Israel who is co-lead author of the study and a professor at Harvard Medical School. Some doctors were initially resistant to the idea of sharing notes, he says. According to the study, doctors who declined to participate expressed concerns that their workflow might be disrupted and that they might scare or offend patients.
But the study, based on surveys of doctors and patients taken in fall 2011 after 12 to 19 months of participation, found most fears weren't realized, and patients were enthusiastic about accessing the notes.
Close to 11,800 patients opened at least one note contained in their electronic medical record. Of 5,391 patients who opened at least one note and returned online surveys, 77% to 87% across the three sites reported that OpenNotes made them feel more in control of their care and more adherent to medications...
Wednesday, June 6, 2012
Parents assail malpractice caps after daughter's death at UCLA hospital
Parents assail malpractice caps after daughter's death at UCLA hospital
Center for Justice and Democracy
Los Angeles Times
JANUARY 22, 2011
Two years ago last week, Olivia Cull, 17, was taken off life support. The standout student — who planned to study classics at Smith College — had slipped into a coma during a routine, outpatient procedure at Mattel Children's Hospital UCLA in Westwood.
The story of her death was presented to Congress a few days ago, among cases cited by patient advocates pushing to lift the caps on damages for medical malpractice lawsuits.
As lawmakers search for ways to trim healthcare costs, debate continues over the country's medical malpractice laws. Physician groups say caps limit frivolous lawsuits that can drive good doctors out of business. But patients and their families argue that limits on payouts diminish accountability, making it hard to find lawyers to take cases and force full disclosure from doctors.
... "It's confusing," Joy Cull said. "I could imagine this happening over and over again because families don't have the resources to find out how their loved one passed away. We had to claw our way through the system."
To get more information, the Culls decided to sue the hospital. But like others, they had trouble finding a lawyer willing to take the case. Given the state cap on damages, they said, many lawyers did not consider their case worth pursuing.
Although doctors groups complain of frivolous malpractice lawsuits, the number of malpractice claims has actually decreased in recent years as families have had difficulty pursuing claims, Joanne Doroshow, executive director of the Center for Justice & Democracy, a New York-based advocacy group, told Congress at a hearing Thursday, the second anniversary of Olivia's death...
Center for Justice and Democracy
Los Angeles Times
JANUARY 22, 2011
Two years ago last week, Olivia Cull, 17, was taken off life support. The standout student — who planned to study classics at Smith College — had slipped into a coma during a routine, outpatient procedure at Mattel Children's Hospital UCLA in Westwood.
The story of her death was presented to Congress a few days ago, among cases cited by patient advocates pushing to lift the caps on damages for medical malpractice lawsuits.
As lawmakers search for ways to trim healthcare costs, debate continues over the country's medical malpractice laws. Physician groups say caps limit frivolous lawsuits that can drive good doctors out of business. But patients and their families argue that limits on payouts diminish accountability, making it hard to find lawyers to take cases and force full disclosure from doctors.
... "It's confusing," Joy Cull said. "I could imagine this happening over and over again because families don't have the resources to find out how their loved one passed away. We had to claw our way through the system."
To get more information, the Culls decided to sue the hospital. But like others, they had trouble finding a lawyer willing to take the case. Given the state cap on damages, they said, many lawyers did not consider their case worth pursuing.
Although doctors groups complain of frivolous malpractice lawsuits, the number of malpractice claims has actually decreased in recent years as families have had difficulty pursuing claims, Joanne Doroshow, executive director of the Center for Justice & Democracy, a New York-based advocacy group, told Congress at a hearing Thursday, the second anniversary of Olivia's death...
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