Here is Dr. R's letter:
From: R... MD
Received: 08/01/2011 2:54 PM
Dear Maura:
I heard you very clearly that you wanted me, as a lead
administrator, to investigate your suspicions around dates. I've
reviewed the electronic records. Here is what I found: You saw Dr
K May 26th
Your VCUG was performed on June 15. There is plenty of
documentation stating the test was done on June 15th.
It was read by Dr G on June 20th (radiologist who formerly reads
the xrays-- this was a normal study).
The confusion I see is that Dr K signed the order June 17
to perform the VCUG
(which is why Dr A shows up as a provider who signed to get the
test done June 15 perhaps because Dr K was not available at that
moment to confirm) . In electronic medical record keeping, health
care providers "sign" orders to perform tests on other patients not
necessarily their own in the interest of time.
This is not an indication that a report was done.
So, I agree its confusing but I want to assure you no one is
trying to hide anything and we only want to implement good
medical care.
The good news is that there is nothing on the VCUG to indicate a
surgical problem.
I personally had a meeting with Dr S as well. He noted and I
confirmed that the VCUG images are not kept on the server
for viewing after a period of time
(thought the reports are available within the records)-- he had to
request from radiology that he obtain the xrays so he could
personally review them with you which he did and now you have
copies.
In conclusion, Dr K nor any doctor cannot
erase any records and replace with anything
else. That is the strength of an electronic
medical record system versus a paper system.
After careful review, I'm happy to refer you to an experienced
team of urogynecologists who are all fellowship trained in urinary
incontinence and pelvic pain. Fortunately, they are here within our
institution and I'd be happy to refer your case to them.
If its outside referral you seek, let me know and I will need to
involve member services to facilitate. I dont have that authority to
approve referrals outside of plan.
I truly hope this helps you.
Best,
Dr R
From: R... MD
Received: 08/01/2011 2:54 PM
Dear Maura:
I heard you very clearly that you wanted me, as a lead
administrator, to investigate your suspicions around dates. I've
reviewed the electronic records. Here is what I found: You saw Dr
K May 26th
Your VCUG was performed on June 15. There is plenty of
documentation stating the test was done on June 15th.
It was read by Dr G on June 20th (radiologist who formerly reads
the xrays-- this was a normal study).
The confusion I see is that Dr K signed the order June 17
to perform the VCUG
(which is why Dr A shows up as a provider who signed to get the
test done June 15 perhaps because Dr K was not available at that
moment to confirm) . In electronic medical record keeping, health
care providers "sign" orders to perform tests on other patients not
necessarily their own in the interest of time.
This is not an indication that a report was done.
So, I agree its confusing but I want to assure you no one is
trying to hide anything and we only want to implement good
medical care.
The good news is that there is nothing on the VCUG to indicate a
surgical problem.
I personally had a meeting with Dr S as well. He noted and I
confirmed that the VCUG images are not kept on the server
for viewing after a period of time
(thought the reports are available within the records)-- he had to
request from radiology that he obtain the xrays so he could
personally review them with you which he did and now you have
copies.
In conclusion, Dr K nor any doctor cannot
erase any records and replace with anything
else. That is the strength of an electronic
medical record system versus a paper system.
After careful review, I'm happy to refer you to an experienced
team of urogynecologists who are all fellowship trained in urinary
incontinence and pelvic pain. Fortunately, they are here within our
institution and I'd be happy to refer your case to them.
If its outside referral you seek, let me know and I will need to
involve member services to facilitate. I dont have that authority to
approve referrals outside of plan.
I truly hope this helps you.
Best,
Dr R
As the saying goes, "garbage in, garbage out."
To: EUGENE YOUNG RHEE MD
From: Maura Larkins
Sent: 09/27/2011 10:12 AM
You write: "With the utmost respect, I have made every effort I possibly can to accommodate your
requests and you did not show for any appointments."
With the utmost respect, Dr. Rhee, I have made every effort I possibly can to get you to look at,
or allow another urologist to look at, my VUCG images.
Two days before my last appointment I asked if the images were
available, and I received no reply.
What would you have said if I had shown up for the appt?
Without x-rays, no doctor could have made an accurate
diagnosis. You need good information to make a good decision.
As the saying goes, "garbage in, garbage out."
If you “have made every effort you possibly can to accommodate my requests” that the VUCG
images be made available, then clearly you hold a very weak position in Kaiser. Yvonne Hanzen
must have overruled your requests (if, indeed, you actually made the efforts you claim to have
made). It appears that she also overruled the VUCG request from urogynecology.
Are you still operating under the bizarre misunderstanding that I
suffer from incontinence?
To: EUGENE YOUNG RHEE MD
From: Maura Larkins
Sent: 09/27/2011 9:53 AM
Dear Dr. Rhee:
You write:
"My suggestion to you is that we...refer you to the experts in urogynecology... Please let me know so I
may expedite your care."
Have you forgotten that you and I have been down this road? You already referred me to
urogyncology, and I did make an appointment, but it was canceled
because you refused to make my VUCG images available to the
doctors in urogynecology.
You are violating professional standards by concealing my x-rays.
Also, your bizarre belief that I suffer from incontinence is helping no one. No one ever gave
you that information. You invented it yourself, apparently to avoid dealing with the
problem... The evidence suggests that you are either confused or are intentionally
confusing the issue.
You need to cough up the x-rays, Dr. Rhee.
To: EUGENE YOUNG RHEE MD
From: Maura Larkins
Sent: 09/27/2011 10:12 AM
You write: "With the utmost respect, I have made every effort I possibly can to accommodate your
requests and you did not show for any appointments."
With the utmost respect, Dr. Rhee, I have made every effort I possibly can to get you to look at,
or allow another urologist to look at, my VUCG images.
Two days before my last appointment I asked if the images were
available, and I received no reply.
What would you have said if I had shown up for the appt?
Without x-rays, no doctor could have made an accurate
diagnosis. You need good information to make a good decision.
As the saying goes, "garbage in, garbage out."
If you “have made every effort you possibly can to accommodate my requests” that the VUCG
images be made available, then clearly you hold a very weak position in Kaiser. Yvonne Hanzen
must have overruled your requests (if, indeed, you actually made the efforts you claim to have
made). It appears that she also overruled the VUCG request from urogynecology.
Are you still operating under the bizarre misunderstanding that I
suffer from incontinence?
To: EUGENE YOUNG RHEE MD
From: Maura Larkins
Sent: 09/27/2011 9:53 AM
Dear Dr. Rhee:
You write:
"My suggestion to you is that we...refer you to the experts in urogynecology... Please let me know so I
may expedite your care."
Have you forgotten that you and I have been down this road? You already referred me to
urogyncology, and I did make an appointment, but it was canceled
because you refused to make my VUCG images available to the
doctors in urogynecology.
You are violating professional standards by concealing my x-rays.
Also, your bizarre belief that I suffer from incontinence is helping no one. No one ever gave
you that information. You invented it yourself, apparently to avoid dealing with the
problem... The evidence suggests that you are either confused or are intentionally
confusing the issue.
You need to cough up the x-rays, Dr. Rhee.
People
Dr. R completely fails to explain why the date for the
procedure is consistently given as June 16, 2011 (at 11:20
a.m.) in both versions of my VUCG report. My procedure was,
indeed, on June 15. So whose report is Dr. R trying to pass off as
mine? Despite all the incorrect dates and an incorrect
name and the fact that the report was signed three says
before it was written, the head of the department told me
on July 27, 2011 that it must be my report "because it has
your name on it."
procedure is consistently given as June 16, 2011 (at 11:20
a.m.) in both versions of my VUCG report. My procedure was,
indeed, on June 15. So whose report is Dr. R trying to pass off as
mine? Despite all the incorrect dates and an incorrect
name and the fact that the report was signed three says
before it was written, the head of the department told me
on July 27, 2011 that it must be my report "because it has
your name on it."
The facts contradict Dr. R's claims
Dr. R is claiming that Dr. A signed on June 15, 2011 an
order that had already been signed by Dr. K on May 26,
2011.
Dr. R is speculating here, but there is clear documentation
that he is 100% wrong. In the record of my May 26, 2011
visit with Dr. K, under “Orders Placed This Encounter” it clearly
states “XR URETHROCYSTOGRAPHY, VOIDING.”
Dr. R is saying that the document co-signed by Dr. K two
days AFTER my VUCG was NOT a report about the
procedure, but--get this--he says it was the ORDER to have
the procedure done!
He is saying Dr. K ordered the test twice, the last time being two
days after the test had been completed!
Dr R has two signings too many here. One of these excess
“orders” is actually Dr. A’s order for someone else’s VUCG, which
was performed on June 16, 2011 at 11:20 a.m., and the other is
Dr. K’s co-signature on the vanished report for my VUCG.
I never said it was confusing, Dr. R. It's silly, pathetic and
possibly illegal, but it's not confusing.
I'm very happy that there is good news for the woman whose
VUCG report was substituted for mine.
Dr. R and Dr. S are implying that the results were on the
server at one time. They are admitting that the
results were digitized! Dr. S was telling the truth in
the above email when he wrote that he had all the digitized
images.
Apparently, "a period of time" is just the time it takes Dr. K to hide
them.
I'm guessing the images are kept on the server for years. I'm
guessing my images are still on the server. How else could
doctors appropriately diagnose and treat patients? It would be
more trouble to erase them than to leave them on the server.
Someone went out of his way to make these images unavailable.
Dr. S did not review the images with me. He gave them to me, but
we did not discuss them.
Dr. R claims that Kaiser's electronic records
can not be erased.
He knows very well that doctors can and do
erase Kaiser electronic records—and they can
do it far more easily than in the days when
records were made with ink and paper.
As proof, I possess two different versions of
Dr. G’s report of my February 9, 2011 visit.
Other patients have also noticed that Kaiser electronic records
can be changed. In the records office, I was talking to another
patient who couldn’t find the “addendum” her doctors had added
to her report. She finally realized that the doctors had rewritten
her report.
Incontinence??? I have NO incontinence!!!
Is he getting me confused with another patient? Dr. R is a
real piece of work. When I met with him on July 27, 2011 he
said he had gone over my chart in depth, but it quickly
became clear that the only thing he knew was that I had
seen Dr. K and Dr. S. I had to correct him regarding his
incontinence confusion, but even though I repeated it
more than once, it doesn't seem to have gotten through to
him.
Dr. R does not seem to have carefully examined or thought about
the facts I laid out in my letter, or the documentation I provided. It
is more clear than ever that I need a referral to an outside
urologist.
I think Dr. R truly hopes this helps HIM. If he wanted to help me,
he'd release my VUCG images.
Best,
Maura Larkins
order that had already been signed by Dr. K on May 26,
2011.
Dr. R is speculating here, but there is clear documentation
that he is 100% wrong. In the record of my May 26, 2011
visit with Dr. K, under “Orders Placed This Encounter” it clearly
states “XR URETHROCYSTOGRAPHY, VOIDING.”
Dr. R is saying that the document co-signed by Dr. K two
days AFTER my VUCG was NOT a report about the
procedure, but--get this--he says it was the ORDER to have
the procedure done!
He is saying Dr. K ordered the test twice, the last time being two
days after the test had been completed!
Dr R has two signings too many here. One of these excess
“orders” is actually Dr. A’s order for someone else’s VUCG, which
was performed on June 16, 2011 at 11:20 a.m., and the other is
Dr. K’s co-signature on the vanished report for my VUCG.
I never said it was confusing, Dr. R. It's silly, pathetic and
possibly illegal, but it's not confusing.
I'm very happy that there is good news for the woman whose
VUCG report was substituted for mine.
Dr. R and Dr. S are implying that the results were on the
server at one time. They are admitting that the
results were digitized! Dr. S was telling the truth in
the above email when he wrote that he had all the digitized
images.
Apparently, "a period of time" is just the time it takes Dr. K to hide
them.
I'm guessing the images are kept on the server for years. I'm
guessing my images are still on the server. How else could
doctors appropriately diagnose and treat patients? It would be
more trouble to erase them than to leave them on the server.
Someone went out of his way to make these images unavailable.
Dr. S did not review the images with me. He gave them to me, but
we did not discuss them.
Dr. R claims that Kaiser's electronic records
can not be erased.
He knows very well that doctors can and do
erase Kaiser electronic records—and they can
do it far more easily than in the days when
records were made with ink and paper.
As proof, I possess two different versions of
Dr. G’s report of my February 9, 2011 visit.
Other patients have also noticed that Kaiser electronic records
can be changed. In the records office, I was talking to another
patient who couldn’t find the “addendum” her doctors had added
to her report. She finally realized that the doctors had rewritten
her report.
Incontinence??? I have NO incontinence!!!
Is he getting me confused with another patient? Dr. R is a
real piece of work. When I met with him on July 27, 2011 he
said he had gone over my chart in depth, but it quickly
became clear that the only thing he knew was that I had
seen Dr. K and Dr. S. I had to correct him regarding his
incontinence confusion, but even though I repeated it
more than once, it doesn't seem to have gotten through to
him.
Dr. R does not seem to have carefully examined or thought about
the facts I laid out in my letter, or the documentation I provided. It
is more clear than ever that I need a referral to an outside
urologist.
I think Dr. R truly hopes this helps HIM. If he wanted to help me,
he'd release my VUCG images.
Best,
Maura Larkins
I agree that someone's images were read by Dr. G on June 20th,
three days AFTER Dr. K co-signed my report and then,
apparently, erased it. But Dr. G didn't write my reporton June 20;
mine had already been written days earlier.
Dr. R is claiming that two days after the test was performed,
Dr. K signed an order to do the test!
The report clearly states that Dr. K "co-signed" something
two days after the test. It could only have been a report on
the results of the test.
three days AFTER Dr. K co-signed my report and then,
apparently, erased it. But Dr. G didn't write my reporton June 20;
mine had already been written days earlier.
Dr. R is claiming that two days after the test was performed,
Dr. K signed an order to do the test!
The report clearly states that Dr. K "co-signed" something
two days after the test. It could only have been a report on
the results of the test.
Dr. Rhee's confused compendium of
illogical claims (as he defends Yvonne
Hanzen's concealment of x-rays)
illogical claims (as he defends Yvonne
Hanzen's concealment of x-rays)
Maura Larkins response:
The Kaiser Permanente Urology Department in San
Diego
Diego
Dr. Rhee seems to be trying hard to cover-up tampering with medical records
Group visits for urology
deliver efficiency,
patient satisfaction
Feb 1, 2011
Philip M. Hanno, MD, MPH
Source: Urology Times
Group shared appointments
are an increasingly popular
way to improve patient
access for busy practices.
Simultaneously giving
patients added contact with
their physician while also
allowing them to talk about
their condition with others,
group shared appointments
are applicable to a number
of urologic conditions.
In this interview, Eugene
Rhee, MD, MBA, explains
how shared appointments
work, what their advantages
are, and how they can be
applied to your practice.
deliver efficiency,
patient satisfaction
Feb 1, 2011
Philip M. Hanno, MD, MPH
Source: Urology Times
Group shared appointments
are an increasingly popular
way to improve patient
access for busy practices.
Simultaneously giving
patients added contact with
their physician while also
allowing them to talk about
their condition with others,
group shared appointments
are applicable to a number
of urologic conditions.
In this interview, Eugene
Rhee, MD, MBA, explains
how shared appointments
work, what their advantages
are, and how they can be
applied to your practice.
FDA finds U.S. drug
research firm faked
documents
Jul 26, 2011
(Reuters) - Drug companies that
had medicines tested by
contractor Cetero Research might
have to reevaluate results, U.S.
regulators warned after the firm
was found faking documents and
manipulating samples.
The Food and Drug Administration
said on Tuesday two 2010
inspections, an internal company
investigation and a third-party
audit uncovered "significant
instances of misconduct and
violations" at a Cetero facility in
Houston.
The Cary, North Carolina-based
firm does early-phase clinical
research and bioanalytics for a
number of drugmakers. The
pharmaceutical companies can
then use those studies as
supporting evidence in drug
approval applications to the FDA.
"The pattern of misconduct was
serious enough to raise concerns
about the integrity of the data
Cetero generated during the
five-year time frame," the FDA
said, warning drugmakers they
might have to repeat or confirm
any studies Cetero did in support
of their applications between April
2005 and June 2010.
It remains unclear which
drugmakers have used Cetero's
services to apply for regulatory
approvals and the FDA is asking
companies to identify such
instances. The regulators said the
measure is precautionary and the
safety and efficacy of drugs
already on the market are unlikely
to be affected.
The FDA inspected Cetero in May
and December last year and
found falsified records about
studies.
Specifically, in at least 1,900
instances between April 2005 and
June 2009, laboratory technicians
identified as conducting certain
studies were not actually present
at Cetero facilities at that time, the
FDA said in its May report.
The FDA also said at the time that
Cetero might have "fixed" studies
to get the desired result, or did not
include failed results in their
report.
"Cetero's May 2010 and
December 2010 responses are
inadequate because the scope of
their internal investigation was far
too narrow to identify and
adequately address the root
cause of these systemic failures,"
the regulators said.
Cetero was not immediately
available for comment.
(Reporting by Alina Selyukh and
Anna Yukhananov; editing by
Andre Grenon)
research firm faked
documents
Jul 26, 2011
(Reuters) - Drug companies that
had medicines tested by
contractor Cetero Research might
have to reevaluate results, U.S.
regulators warned after the firm
was found faking documents and
manipulating samples.
The Food and Drug Administration
said on Tuesday two 2010
inspections, an internal company
investigation and a third-party
audit uncovered "significant
instances of misconduct and
violations" at a Cetero facility in
Houston.
The Cary, North Carolina-based
firm does early-phase clinical
research and bioanalytics for a
number of drugmakers. The
pharmaceutical companies can
then use those studies as
supporting evidence in drug
approval applications to the FDA.
"The pattern of misconduct was
serious enough to raise concerns
about the integrity of the data
Cetero generated during the
five-year time frame," the FDA
said, warning drugmakers they
might have to repeat or confirm
any studies Cetero did in support
of their applications between April
2005 and June 2010.
It remains unclear which
drugmakers have used Cetero's
services to apply for regulatory
approvals and the FDA is asking
companies to identify such
instances. The regulators said the
measure is precautionary and the
safety and efficacy of drugs
already on the market are unlikely
to be affected.
The FDA inspected Cetero in May
and December last year and
found falsified records about
studies.
Specifically, in at least 1,900
instances between April 2005 and
June 2009, laboratory technicians
identified as conducting certain
studies were not actually present
at Cetero facilities at that time, the
FDA said in its May report.
The FDA also said at the time that
Cetero might have "fixed" studies
to get the desired result, or did not
include failed results in their
report.
"Cetero's May 2010 and
December 2010 responses are
inadequate because the scope of
their internal investigation was far
too narrow to identify and
adequately address the root
cause of these systemic failures,"
the regulators said.
Cetero was not immediately
available for comment.
(Reporting by Alina Selyukh and
Anna Yukhananov; editing by
Andre Grenon)
Do the living get better
doctors than the dead?
Probably yes, but that isn't
necessarily saying much.
The following story reminds
me of my experiences at
Kaiser. Doctors are
protected by each other from
public scrutiny.
Second Chances
Underscore Flaws in
Death Investigations
by Ryan Gabrielson
ProPublica
Feb. 1, 2011
...Gill had been forced out of
a teaching position at an
Oregon university, and then
fired for inaccurate findings
and alcohol abuse by the
coroner in Indianapolis,
Reynolds discovered.
Demoted for poor
performance as a fellow for
the Los Angeles County
Coroner, he resurfaced at a
private autopsy company in
Northern California...
The private forensics firm has
held contracts with 16
Northern California counties
to perform autopsies for local
agencies. Besides Sonoma
County, Gill has conducted
death investigations or
testified in court in eight
counties as a doctor for
Forensic Medical Group.
He had done more than
800 autopsies during a
three-year period in Yolo,
Napa and Solano counties
alone.
Forensic Medical Group cut
its ties with Gill in December
after Yolo County
Sheriff-Coroner's officials
learned of the doctor's history
from reporters and barred
him from performing its
autopsies. In a written
response to questions,
Forensic Medical Group said
that after Yolo County's
decision, it no longer had
enough cases to justify
employing Gill.
Gill's ability to resurrect
his career time and again
reflects a profound weakness
at the center of the U.S.
system of death investigation.
A chronic shortage of
qualified forensic
pathologists allows even
questionably competent
practitioners to remain
employable. The absence of
trained practitioners is so
acute that many
jurisdictions don't look
closely at the doctors they
employ. Some of the
officials who hired Gill
acknowledged they knew
about his problems but
said they had no other
viable options.
With no national oversight of
forensic pathologists or
standards that dictate who
can do autopsy work, there is
nothing to prevent Gill from
resuming his career.
In some cases, officials in
charge of death investigation
are more concerned with
costs than with competent
autopsies, said Dr. John
Pless, a director of the
National Association of
Medical Examiners and
retired forensic pathology
professor at Indiana
University.
"What the problem is all over
and why Tom Gill is accepted
is there are people running
the system who don't
understand the complexity
of the medical
determinations," Pless
said...
doctors than the dead?
Probably yes, but that isn't
necessarily saying much.
The following story reminds
me of my experiences at
Kaiser. Doctors are
protected by each other from
public scrutiny.
Second Chances
Underscore Flaws in
Death Investigations
by Ryan Gabrielson
ProPublica
Feb. 1, 2011
...Gill had been forced out of
a teaching position at an
Oregon university, and then
fired for inaccurate findings
and alcohol abuse by the
coroner in Indianapolis,
Reynolds discovered.
Demoted for poor
performance as a fellow for
the Los Angeles County
Coroner, he resurfaced at a
private autopsy company in
Northern California...
The private forensics firm has
held contracts with 16
Northern California counties
to perform autopsies for local
agencies. Besides Sonoma
County, Gill has conducted
death investigations or
testified in court in eight
counties as a doctor for
Forensic Medical Group.
He had done more than
800 autopsies during a
three-year period in Yolo,
Napa and Solano counties
alone.
Forensic Medical Group cut
its ties with Gill in December
after Yolo County
Sheriff-Coroner's officials
learned of the doctor's history
from reporters and barred
him from performing its
autopsies. In a written
response to questions,
Forensic Medical Group said
that after Yolo County's
decision, it no longer had
enough cases to justify
employing Gill.
Gill's ability to resurrect
his career time and again
reflects a profound weakness
at the center of the U.S.
system of death investigation.
A chronic shortage of
qualified forensic
pathologists allows even
questionably competent
practitioners to remain
employable. The absence of
trained practitioners is so
acute that many
jurisdictions don't look
closely at the doctors they
employ. Some of the
officials who hired Gill
acknowledged they knew
about his problems but
said they had no other
viable options.
With no national oversight of
forensic pathologists or
standards that dictate who
can do autopsy work, there is
nothing to prevent Gill from
resuming his career.
In some cases, officials in
charge of death investigation
are more concerned with
costs than with competent
autopsies, said Dr. John
Pless, a director of the
National Association of
Medical Examiners and
retired forensic pathology
professor at Indiana
University.
"What the problem is all over
and why Tom Gill is accepted
is there are people running
the system who don't
understand the complexity
of the medical
determinations," Pless
said...
Dr. Rhee’s statement to
Yvonne Hanzen, Dept
Administrator for Urology on
August 4, 2011: “…copies that
she gave me appear normal
but the patient won’t accept
this."
Dr. Rhee seemed to think that
the patient should accept that
everything as "normal" even
though:
1) most of the images
from a lengthy VUCG
procedure were
missing;
2) the few images
that had been given
to the patient were of
abysmal quality;
3) in the images,
blocking agent seems
to spread over the
bladder area;
4) EVERY SINGLE
DIGITIZED IMAGE WAS
"UNAVAILABLE";
5) and written reports of the
VUCG were tampered with.
A patient would have to be either
uninterested, of severely limited
intelligence or pathologically
compliant to accept this.
Furthermore, patient saw an x-ray
image on the computer monitor on
June 15, 2011 that is one of the
missing images.
Dr. Rhee is quite right, however,
that he needs to see ALL THE
DIGITIZED IMAGES. This is
medically necessary. But Dave
Horton and Rhianne Steins, who
run the Diagnositc Imaging
department, refuse to upload the
images to the server. They and
Yvonne Hanzen also refused to
allow an out-of-plan doctor to see
all the images.
Yvonne Hanzen, Dept
Administrator for Urology on
August 4, 2011: “…copies that
she gave me appear normal
but the patient won’t accept
this."
Dr. Rhee seemed to think that
the patient should accept that
everything as "normal" even
though:
1) most of the images
from a lengthy VUCG
procedure were
missing;
2) the few images
that had been given
to the patient were of
abysmal quality;
3) in the images,
blocking agent seems
to spread over the
bladder area;
4) EVERY SINGLE
DIGITIZED IMAGE WAS
"UNAVAILABLE";
5) and written reports of the
VUCG were tampered with.
A patient would have to be either
uninterested, of severely limited
intelligence or pathologically
compliant to accept this.
Furthermore, patient saw an x-ray
image on the computer monitor on
June 15, 2011 that is one of the
missing images.
Dr. Rhee is quite right, however,
that he needs to see ALL THE
DIGITIZED IMAGES. This is
medically necessary. But Dave
Horton and Rhianne Steins, who
run the Diagnositc Imaging
department, refuse to upload the
images to the server. They and
Yvonne Hanzen also refused to
allow an out-of-plan doctor to see
all the images.
(The first set of five images can be seen on this page.)
The second set of five images
The second set proves that Kaiser's claim was false--it turns out that more than five
images had been saved.
Kaiser bizarrely gave the patient a different set of five images. The set of five "thermal paper" images below was
provided to patient by Dr. Smiley on July 26, 2011. Patient copied them and provided them to Dr. Rhee the following day.
The second set is darker because of the setting on patient's copy machine. These images look exactly like
the ones that Dr. Rhee received.
The second set of five images
The second set proves that Kaiser's claim was false--it turns out that more than five
images had been saved.
Kaiser bizarrely gave the patient a different set of five images. The set of five "thermal paper" images below was
provided to patient by Dr. Smiley on July 26, 2011. Patient copied them and provided them to Dr. Rhee the following day.
The second set is darker because of the setting on patient's copy machine. These images look exactly like
the ones that Dr. Rhee received.
Dr. Rhee became officially involved in the "thermal paper" x-ray episode
on July 27, 2011
on July 27, 2011
Dr. Eugene Rhee emails
[to Yvonne Hanzen, Urology Department Administrator for Kaiser
Permanente in San Diego]
Is this any way to run a doctor's office? Dr. Eugene Rhee, head of urology for Kaiser
Permanente San Diego, was prevented by his Department Administrator ("DA") Yvonne
Hanzen from obtaining VUCG images for a patient.
[to Yvonne Hanzen, Urology Department Administrator for Kaiser
Permanente in San Diego]
Is this any way to run a doctor's office? Dr. Eugene Rhee, head of urology for Kaiser
Permanente San Diego, was prevented by his Department Administrator ("DA") Yvonne
Hanzen from obtaining VUCG images for a patient.
On July 27, 2010, Dr. Eugene Rhee, chief physician for urologic surgery for Kaiser Permanente in San Diego, was given
ten x-rays by a patient. She had received the first five from Diagnostic Imaging, and the second five from another doctor.
ten x-rays by a patient. She had received the first five from Diagnostic Imaging, and the second five from another doctor.
5 images provided by Dr. Smiley
numbered 1, 5, 7, 9 and 13. One
is new, two are altered, and two
are repeats of images in the first
set.
#1 is identical to an image in the first set,
but the label of “scout” has been
removed.
The other “SCOUT” has been eliminated
entirely, and no wonder. It was the most
obviously inappropriate image, wildly out of
focus. No reasonable x-ray technician would
save such an image manually since it would
have no value in helping the radiologist write
his report five days later.. Yet that is exactly
what the Diagnostic Imaging Department
claimed.
Image #5 is completely new. How could
any new images appear if they had not
been saved digitally? This question was
answered on August 19, 2011 when
Yvonne Hanzen admitted that she
"printed out" thirteen images.
Bizzarely, #7 and #9 in the Dr. Smiley set
are identical to each other, except the
label “voiding” is missing from #7.
How could printed labels be removed
from thermal paper? And what would be
the motive for removing the label?
(#7 and #9 appear slightly different in the
images at left, with more brightness in #9
than in #7, but one can see that the
picture is the same, and they have the
same time printed on them: 10:05:25 AM.
I'm thinking that the photocopy machine
may have produced a difference.)
#13 is identical in both sets.
numbered 1, 5, 7, 9 and 13. One
is new, two are altered, and two
are repeats of images in the first
set.
#1 is identical to an image in the first set,
but the label of “scout” has been
removed.
The other “SCOUT” has been eliminated
entirely, and no wonder. It was the most
obviously inappropriate image, wildly out of
focus. No reasonable x-ray technician would
save such an image manually since it would
have no value in helping the radiologist write
his report five days later.. Yet that is exactly
what the Diagnostic Imaging Department
claimed.
Image #5 is completely new. How could
any new images appear if they had not
been saved digitally? This question was
answered on August 19, 2011 when
Yvonne Hanzen admitted that she
"printed out" thirteen images.
Bizzarely, #7 and #9 in the Dr. Smiley set
are identical to each other, except the
label “voiding” is missing from #7.
How could printed labels be removed
from thermal paper? And what would be
the motive for removing the label?
(#7 and #9 appear slightly different in the
images at left, with more brightness in #9
than in #7, but one can see that the
picture is the same, and they have the
same time printed on them: 10:05:25 AM.
I'm thinking that the photocopy machine
may have produced a difference.)
#13 is identical in both sets.
Comparison of two sets of five images:
#1 34/72 9:53:45 “SCOUT” label has been removed ALTERED
#5 36/62 10:0035 NEW
#7 31/47 10:05:25 SAME AS #9 except “VOIDING"
has been removed
#9 31/47 10:05:25 "VOIDING" IDENTICAL
#13 28/56 10:08:36 "POST-VOID" IDENTICAL
1) What happened to images #2, 6, 8, 10 and 11?
2) What possessed some Kaiser administrator to plan such an incompetent hoax?
It appears Kaiser is accustomed to having patients who ask no questions, or, at
least, patients who do not demand answers.
#1 34/72 9:53:45 “SCOUT” label has been removed ALTERED
#5 36/62 10:0035 NEW
#7 31/47 10:05:25 SAME AS #9 except “VOIDING"
has been removed
#9 31/47 10:05:25 "VOIDING" IDENTICAL
#13 28/56 10:08:36 "POST-VOID" IDENTICAL
1) What happened to images #2, 6, 8, 10 and 11?
2) What possessed some Kaiser administrator to plan such an incompetent hoax?
It appears Kaiser is accustomed to having patients who ask no questions, or, at
least, patients who do not demand answers.
#1
#5
#7
#9
#13
#5
#7
#9
#13
----- Message [to Dr. S] -----
From: LARKINS,MAURA
Sent: 7/13/11 11:15 AM
To: [Dr. S] MD
Subject: Thank you for your email about my VUCG images
Does your email mean that the entire collection of digital VUCG
images taken on June 15, 2011 has been recovered and released?
If so, I am delighted.
I’m wondering if you have been able to recover the original report on my VUCG that [Dr. K]
cosigned on June 17, 2011. It must be stored in the system. I strongly doubt that the
Kaiser computer software allows a doctor to permanently erase a report, even if he is a
cosigner.
[Message from Dr. S]
RE: Thank you for your email about my VUCG images
To: Maura Larkins
From: [Dr. S] MD
Received: 07/13/2011 11:17 AM
Dear Mrs Larkin,
Yes I have all the images.
Regarding [Dr. K] note: I do not see that in your record.
Sincerely,
Electronically signed by:
[Dr. S] MD
7/13/2011 11:17 AM
Dr. S reverses himself, apparently under pressure
from Medical Records Department
July 18, 2011: Discussion with Medical Records
Kaiser Medical Records supervisor D. M. told me in a phone call that Dr. S did not have
any digital images and that he "probably didn't pay any attention" when he wrote the
above email.
She said that there are only five images available on thermal paper. She says she
doesn't know if any of the x-ray machines in urology are able to create digital images. I've
known since June 15, 2011 that my images were digitized and available to any Kaiser
doctor. Does she think that there is a single person who believes her silly story?
Perhaps not. She didn't sound very confident when she was talking to me. To her credit,
she's not talented at fabricating stories.
July 26, 2011 Appointment with Dr. S
Dr. S. said no digital images were available. He gave me five images on glossy paper.
Interestingly, three of the images were different from the five images given to me by
Medical Records. Medical Records had said that the five images they gave me were the
only images saved.
From: LARKINS,MAURA
Sent: 7/13/11 11:15 AM
To: [Dr. S] MD
Subject: Thank you for your email about my VUCG images
Does your email mean that the entire collection of digital VUCG
images taken on June 15, 2011 has been recovered and released?
If so, I am delighted.
I’m wondering if you have been able to recover the original report on my VUCG that [Dr. K]
cosigned on June 17, 2011. It must be stored in the system. I strongly doubt that the
Kaiser computer software allows a doctor to permanently erase a report, even if he is a
cosigner.
[Message from Dr. S]
RE: Thank you for your email about my VUCG images
To: Maura Larkins
From: [Dr. S] MD
Received: 07/13/2011 11:17 AM
Dear Mrs Larkin,
Yes I have all the images.
Regarding [Dr. K] note: I do not see that in your record.
Sincerely,
Electronically signed by:
[Dr. S] MD
7/13/2011 11:17 AM
Dr. S reverses himself, apparently under pressure
from Medical Records Department
July 18, 2011: Discussion with Medical Records
Kaiser Medical Records supervisor D. M. told me in a phone call that Dr. S did not have
any digital images and that he "probably didn't pay any attention" when he wrote the
above email.
She said that there are only five images available on thermal paper. She says she
doesn't know if any of the x-ray machines in urology are able to create digital images. I've
known since June 15, 2011 that my images were digitized and available to any Kaiser
doctor. Does she think that there is a single person who believes her silly story?
Perhaps not. She didn't sound very confident when she was talking to me. To her credit,
she's not talented at fabricating stories.
July 26, 2011 Appointment with Dr. S
Dr. S. said no digital images were available. He gave me five images on glossy paper.
Interestingly, three of the images were different from the five images given to me by
Medical Records. Medical Records had said that the five images they gave me were the
only images saved.
I made an appointment with a different urologist. When I went to that appointment, I was
told no images were available.
I had so much pain one night that I went to the Emergency Room. There were no VUCG
images available to the ER doctors, but those doctors said they weren't concerned since
the report (the second one on this page) assured them that all was normal. They
completely ignored me when I pointed out errors in the report. (Related story: Kaiser
retaliated against one of its emergency room physicians when he complained about
quality of care in the ER.)
I went to a new primary care doctor on July 12, and he was completely uninterested in the
missing VUCG images and the anomalies in the report. He said the report was normal,
and he "didn't have the resources" to investigate anything.
I went home and wrote emails to doctors. I noted the following:
1) Dr. K co-signed my report on June 17, but that report is missing.
2) It has been replaced by a report created on June 20 for a patient whose VUCG
was ordered by a different doctor on a different date and was done the day after
mine was done.
3) Dr. K obviously could not have co-signed the June 20 report three days
before it was written.
4) All the digitized images of my VUCG are "unavailable."
I emailed Dr. K about these discrepancies on July 12, but he has not responded as of July
17. [Update: He has not responded as of July 21. I don't think he has anything to say.]
Finally, on July 12, after I presented the above information to my new urologist, Dr. S, he
emailed me to say that he had ALL THE DIGITIZED IMAGES FROM MY VUCG, and he
would show them to me at my next appointment. Here is his reply, and the email
I wrote to him:
told no images were available.
I had so much pain one night that I went to the Emergency Room. There were no VUCG
images available to the ER doctors, but those doctors said they weren't concerned since
the report (the second one on this page) assured them that all was normal. They
completely ignored me when I pointed out errors in the report. (Related story: Kaiser
retaliated against one of its emergency room physicians when he complained about
quality of care in the ER.)
I went to a new primary care doctor on July 12, and he was completely uninterested in the
missing VUCG images and the anomalies in the report. He said the report was normal,
and he "didn't have the resources" to investigate anything.
I went home and wrote emails to doctors. I noted the following:
1) Dr. K co-signed my report on June 17, but that report is missing.
2) It has been replaced by a report created on June 20 for a patient whose VUCG
was ordered by a different doctor on a different date and was done the day after
mine was done.
3) Dr. K obviously could not have co-signed the June 20 report three days
before it was written.
4) All the digitized images of my VUCG are "unavailable."
I emailed Dr. K about these discrepancies on July 12, but he has not responded as of July
17. [Update: He has not responded as of July 21. I don't think he has anything to say.]
Finally, on July 12, after I presented the above information to my new urologist, Dr. S, he
emailed me to say that he had ALL THE DIGITIZED IMAGES FROM MY VUCG, and he
would show them to me at my next appointment. Here is his reply, and the email
I wrote to him:
Dr. S admits that the images were digitized
The head of the Urology Department fully supports
the cover-up
the cover-up
Dr. K had made clear to me that he was only giving me the VUCG to prove to me that
there was nothing wrong with me. He made no appointment to discuss the results with
me. I was to be given the results by the nurse. But I wanted to see the x-rays, so I
ordered a CD of the results. That's when things started to get very interesting.
The Records lady who said on June 30 that she'd send me the CD called me back on July
1. She said that the results of my VUCG had not
been digitized! She said that only a few images had
been saved on thermal paper, but that she'd be happy to send me
Xerox copies of the images. I received five images a few days later. None of them
included my urethra--so why did the report, supposedly based on nothing but these five
images, talk about the urethra? Luckily, as it turned out, she included a printed report
titled "Outpatient Diagnositc Imaging" (the first scanned document below). This report
shows the wrong doctor and the wrong date for the VUCG procedure. I had a faked
report and five blurry images. Kaiser said the report was created five days after my
procedure, based entirely on those five images.
I complained to Member Services that the Records Department refused to give me the CD
I order with digital images. A lady at Member Services said many X-rays were only
available on thermal paper, and, in fact, she had recently had surgery and the
only x-ray images she was able to show her surgeon were on thermal paper. I
asked her, "Didn't your doctor want a sharper image?" She said, "Well, no, he
was an older gentleman, so it was fine with him."
Then a man called me from Member Services. He said the images were never
digitized. But this time the story was that some images had been saved on
glossy paper. He said, "You're not going to get a CD!"
Why didn't they want me to have a CD of those images? After all, the CD should be quite
reassuring, since the written report came back completely normal.
there was nothing wrong with me. He made no appointment to discuss the results with
me. I was to be given the results by the nurse. But I wanted to see the x-rays, so I
ordered a CD of the results. That's when things started to get very interesting.
The Records lady who said on June 30 that she'd send me the CD called me back on July
1. She said that the results of my VUCG had not
been digitized! She said that only a few images had
been saved on thermal paper, but that she'd be happy to send me
Xerox copies of the images. I received five images a few days later. None of them
included my urethra--so why did the report, supposedly based on nothing but these five
images, talk about the urethra? Luckily, as it turned out, she included a printed report
titled "Outpatient Diagnositc Imaging" (the first scanned document below). This report
shows the wrong doctor and the wrong date for the VUCG procedure. I had a faked
report and five blurry images. Kaiser said the report was created five days after my
procedure, based entirely on those five images.
I complained to Member Services that the Records Department refused to give me the CD
I order with digital images. A lady at Member Services said many X-rays were only
available on thermal paper, and, in fact, she had recently had surgery and the
only x-ray images she was able to show her surgeon were on thermal paper. I
asked her, "Didn't your doctor want a sharper image?" She said, "Well, no, he
was an older gentleman, so it was fine with him."
Then a man called me from Member Services. He said the images were never
digitized. But this time the story was that some images had been saved on
glossy paper. He said, "You're not going to get a CD!"
Why didn't they want me to have a CD of those images? After all, the CD should be quite
reassuring, since the written report came back completely normal.
Does the Kaiser Urology Department use outdated
equipment? Or does it claim to do so in order to
cover-up incorrect diagnoses?
Either way, Kaiser's motive seems to be to save money by skimping on patient
care. At the same time, Kaiser likes to make high-profile gifts of the money it
gets from patients.
by Maura Larkins
July 17, 2011
I have discovered some things that may help explain why Kaiser Permanente
San Diego Medical Center has had worse than expected survival rates for
urology patients (see US News and World Report charts below).
I visited Dr. K in May 2011. I won't give his name here, largely because I feel that the real
problem is Kaiser itself. I'd like to think that Dr. K might have developed different habits,
attitudes and practices at a better institution.
equipment? Or does it claim to do so in order to
cover-up incorrect diagnoses?
Either way, Kaiser's motive seems to be to save money by skimping on patient
care. At the same time, Kaiser likes to make high-profile gifts of the money it
gets from patients.
by Maura Larkins
July 17, 2011
I have discovered some things that may help explain why Kaiser Permanente
San Diego Medical Center has had worse than expected survival rates for
urology patients (see US News and World Report charts below).
I visited Dr. K in May 2011. I won't give his name here, largely because I feel that the real
problem is Kaiser itself. I'd like to think that Dr. K might have developed different habits,
attitudes and practices at a better institution.
After the test, I saw the final two images of my bladder and urethra on the two
computer monitors in the x-ray room. The technician told me the images
would be available to any Kaiser doctor. (Later, Kaiser tried to convince me
that the images had never been digitized!)
computer monitors in the x-ray room. The technician told me the images
would be available to any Kaiser doctor. (Later, Kaiser tried to convince me
that the images had never been digitized!)
In February 2011, I developed a painful problem with urination. It was not an infection,
but my urine was extremely cloudy. I began using Bactine to help with the pain.
Dr. K said he'd never seen urine as cloudy as mine. He asked me, "What is
Bactine?" Obviously, he had no idea what was going on, but that didn't stop
him from making an instant diagnosis: the cloudiness was caused by the
Bactine! He either assumed that Bactine has white stuff in it rather than being clear, or
he opined that the Bactine had caused the original problem for which the Bactine was
used--or both. (He couldn't have come up with more perfect circular reasoning if he
had tried.)
A voiding urethrocystogram (VUCG), a test in which dye is injected into the
bladder, and x-rays are taken, was ordered by Dr. K on May 26. The procedure
was done at the new Garfield Specialty Center in Kearney Mesa (see photo
and story at top of this page) on June 15. (The patient whose results were
substituted for mine apparently had her test ordered on June 15, and the
procedure done on June 16--see documents below.)
but my urine was extremely cloudy. I began using Bactine to help with the pain.
Dr. K said he'd never seen urine as cloudy as mine. He asked me, "What is
Bactine?" Obviously, he had no idea what was going on, but that didn't stop
him from making an instant diagnosis: the cloudiness was caused by the
Bactine! He either assumed that Bactine has white stuff in it rather than being clear, or
he opined that the Bactine had caused the original problem for which the Bactine was
used--or both. (He couldn't have come up with more perfect circular reasoning if he
had tried.)
A voiding urethrocystogram (VUCG), a test in which dye is injected into the
bladder, and x-rays are taken, was ordered by Dr. K on May 26. The procedure
was done at the new Garfield Specialty Center in Kearney Mesa (see photo
and story at top of this page) on June 15. (The patient whose results were
substituted for mine apparently had her test ordered on June 15, and the
procedure done on June 16--see documents below.)
Garfield Specialty Center has
general and specialty offices
By Mary Kenney
San Diego Union-Tribune
June 8, 2011
Kaiser Permanente presented
the Council of Community
Clinics with a $1 million check
to administer a heart health
program...[The center] is named
for Kaiser Permanente co-founder
Dr. Sidney Garfield...
general and specialty offices
By Mary Kenney
San Diego Union-Tribune
June 8, 2011
Kaiser Permanente presented
the Council of Community
Clinics with a $1 million check
to administer a heart health
program...[The center] is named
for Kaiser Permanente co-founder
Dr. Sidney Garfield...
Kaiser urologists are lucky
they don't work for this
employer
2 Sweetwater
administrators resign
Ashly McGlone
San Diego Union-Tribune
Aug. 3, 2011
CHULA VISTA — Two
administrators in the Sweetwater
Union High School District
resigned this week.
Diego Ochoa stepped down from
his new post as principal of Bonita
Vista Middle School less than two
weeks into the new school year.
The Watchdog reported that Ochoa
signed off on the improper erasure
of 115 Ds and Fs from student
transcripts while principal at
Castle Park High School, and he
was subsequently demoted. He
said he simply used the wrong
form to enter scores from a credit-
recovery program.
“I have chosen to resign voluntarily
from the district and pursue
options elsewhere. I enjoyed my
time working in the district,” Ochoa
said.
Castle Park’s former assistant
principal of student activities,
Abram Jimenez, also resigned this
week from his new post as
assistant principal at Bonita Vista
High School. Attempts to contact
Jimenez were unsuccessful.
Jimenez oversaw the Associated
Student Body at Castle Park,
including a fund with $58,000 at
the end of the 2010 fiscal year.
As management employees,
Ochoa and Jimenez will receive 90
days of pay— Ochoa will receive
$54,000 and Jimenez $51,000 —
in addition to vacation and sick
leave pay.
No details were given on their
departure, but acting
Superintendent Ed Brand said,
“The Sweetwater district is always
looking to improve itself and we
are going to be posting these
positions and will be filling them in
the near future.”
Ochoa was set to be
promoted to executive
director of high schools
under the former
superintendent, Jesus
Gandara. When Brand was
hired in June, he changed
course.
they don't work for this
employer
2 Sweetwater
administrators resign
Ashly McGlone
San Diego Union-Tribune
Aug. 3, 2011
CHULA VISTA — Two
administrators in the Sweetwater
Union High School District
resigned this week.
Diego Ochoa stepped down from
his new post as principal of Bonita
Vista Middle School less than two
weeks into the new school year.
The Watchdog reported that Ochoa
signed off on the improper erasure
of 115 Ds and Fs from student
transcripts while principal at
Castle Park High School, and he
was subsequently demoted. He
said he simply used the wrong
form to enter scores from a credit-
recovery program.
“I have chosen to resign voluntarily
from the district and pursue
options elsewhere. I enjoyed my
time working in the district,” Ochoa
said.
Castle Park’s former assistant
principal of student activities,
Abram Jimenez, also resigned this
week from his new post as
assistant principal at Bonita Vista
High School. Attempts to contact
Jimenez were unsuccessful.
Jimenez oversaw the Associated
Student Body at Castle Park,
including a fund with $58,000 at
the end of the 2010 fiscal year.
As management employees,
Ochoa and Jimenez will receive 90
days of pay— Ochoa will receive
$54,000 and Jimenez $51,000 —
in addition to vacation and sick
leave pay.
No details were given on their
departure, but acting
Superintendent Ed Brand said,
“The Sweetwater district is always
looking to improve itself and we
are going to be posting these
positions and will be filling them in
the near future.”
Ochoa was set to be
promoted to executive
director of high schools
under the former
superintendent, Jesus
Gandara. When Brand was
hired in June, he changed
course.
I found a series of emails to Yvonne from Dr. Rhee, asking about my
VUCG images, and apparently getting no response.
HERE ARE 6 INTERESTING MESSAGES ABOUT MISSING VUCG
IMAGES:
1
Yvonne [Hanzen],
I will need your assistance to discuss with this patient her concerns and
help track down the VCUG.
This will need to involve the radiology DA as well.
Eugene Rhee, MD MBA
Chief, Department of Urologic Surgery
Otay Mesa Ambulatory Oupatient Clinic
8/2/2011 10:47 AM
2
Yvonne
I sent you a message as well
Eugene Rhee, MD MBA
Chief, Department of Urologic Surgery
Otay Mesa Ambulatory Oupatient Clinic
8/2/2011 1:41 PM
3 [from a different Urology office in San Diego]
Signed by [R] at 8/2/2011 4:00 PM
KAISER PERMANENTE PT LOMA/FORDHAM MED OFFICE U
3250 FORDHAM ST
SAN DIEGO, CA 92110-5339
Spoke with patient and scheduled for uro/gyn consult 8/5. Patient is
wanting digital image of cystogram at her appointment advised patient
needs to keep working with her ordering MD for digital image but we
would be happy to see her 8/5...
4
8/3/11 11:22 AM
Signed by Rhee, Eugene Young (M.D.) at 8/3/2011 11:22 AM
Message [from Maura Larkins] copied by RHEE, EUGENE on Wed Aug 3, 2011 11:22 AM
Message from: PERMANENTE, KAISER
Created: Wed Aug 3, 2011 10:36 AM
Regarding: I have developed more pain in the past few days
I now have to use two entire bottles of Bactine in my bath due to
increased pain. Two months ago I was using only half a bottle.
I was amazed to get a call yesterday from Urogynecology very shortly
after you said you would contact Member Services regarding an
out-of-plan referral for me. Urogynecology said Member Services
contacted them. They were under the impression that I am suffering
from incontinence. Did you intentionally misdiagnose me with
incontinence? I told you repeatedly when I met with you on July 27,
2011 that I do NOT have incontinence. You fabricated that diagnosis out
of whole cloth.
Yesterday I got the impression from Yvonne Hanzen that she supports
this foolishness. She pretended she couldn't see the date or the
referring doctor on my VUCG report. When does Kaiser plan to stop
playing games?
5
Yvonne,
I need those VCUG images tracked down so I can look at it...
Let her know
I am out of town all next week
Thanks
Eugene Rhee, MD MBA
Chief, Department of Urologic Surgery
Otay Mesa Ambulatory Oupatient Clinic
8/4/2011 4:08 PM
6
I did not send urogyn referral.
DA Yvonne Hanzen is working with me re: patient imaging request which
she states is what she wants me to pursue based on our initial visit--
administrative request not medical
I see that she has appt with me Aug 16 AND sept 8th without my
knowledge
Yvonne, please look into this scheduling as to how this is occurring.
Cancel Sept 8th.
Yvonne please give me the update as to what images we have located
during my absence last week -- if none located by Monday Aug 15th we
will need to cancel appt
Eugene Rhee, MD MBA
Chief, Department of Urologic Surgery
Otay Mesa Ambulatory Oupatient Clinic
8/12/2011 2:13 PM
It appears that Lynette Seid and Bertha Aviles of Medical Records and
Dave Horton of Diagnositic Imaging
are helping doctors cover up their mistakes.
Dave Horton of Diagnositic Imaging
are helping doctors cover up their mistakes.
How many x-ray
images end up
missing?
Apparently I'm not the
only one whose x-rays
were missing.
Kaiser Permanente
Complaint by
Nancylt723
2011-11-17
Have a lump in my
breast. Referred to
general surgery in
Kensington, Md. When I
made the appt. I said,
"hey, my mammagrams
(don't get me started on
how hard it was to get on
a schedule of 'at-risk'
patient) are at Shady
Grove, so you will
probably need to contact
them before a surgeon
sees me. Was told "oh,
don't worry, everything is
online that's the
wonderful thin about
Kaiser." Got to the appt.
Guess what?
Mammagrams NOT
online because they were
not in the same location
and the doctor was
pissed and I was pissed
because I missed 4 hours
of work for nothing and
she missed seeing other
patients for nothing and
blha blah blah.
Comments (1)
Written by Maura Larkins
on November 21, 2011
The same thing
happened to me at the
Kaiser Permanente
Urology Department in
San Diego. They didn't
upload the digitized
X-rays to the server. I'll
bet that's what happened
in your case. Why? I
believe they think we'll be
okay, but there's
something on the X-rays
they can't explain, so
they don't want to talk
about them.
Unfortunately, sometimes
people aren't okay after
Kaiser gives them the
brush-off.
images end up
missing?
Apparently I'm not the
only one whose x-rays
were missing.
Kaiser Permanente
Complaint by
Nancylt723
2011-11-17
Have a lump in my
breast. Referred to
general surgery in
Kensington, Md. When I
made the appt. I said,
"hey, my mammagrams
(don't get me started on
how hard it was to get on
a schedule of 'at-risk'
patient) are at Shady
Grove, so you will
probably need to contact
them before a surgeon
sees me. Was told "oh,
don't worry, everything is
online that's the
wonderful thin about
Kaiser." Got to the appt.
Guess what?
Mammagrams NOT
online because they were
not in the same location
and the doctor was
pissed and I was pissed
because I missed 4 hours
of work for nothing and
she missed seeing other
patients for nothing and
blha blah blah.
Comments (1)
Written by Maura Larkins
on November 21, 2011
The same thing
happened to me at the
Kaiser Permanente
Urology Department in
San Diego. They didn't
upload the digitized
X-rays to the server. I'll
bet that's what happened
in your case. Why? I
believe they think we'll be
okay, but there's
something on the X-rays
they can't explain, so
they don't want to talk
about them.
Unfortunately, sometimes
people aren't okay after
Kaiser gives them the
brush-off.
April L. Moon and Dr. Andrew Golden thumb their noses at Dr. Marianne Rochester at
Scripps--and at standard medical practice. Then Mary Ann Barnes, Paul Bernstein
and James Malone back them up.
Scripps--and at standard medical practice. Then Mary Ann Barnes, Paul Bernstein
and James Malone back them up.
(See Dr. Eugene Rhee, Yvonne Hanzen and Dr. Huathin Khaw emails below.
They were doing what their bosses wanted.)
They were doing what their bosses wanted.)
| San Diego Education Report |
| SDER |
San Diego
Education Report
Education Report
| SDER |
| SDER |
| SDER |
The first five "thermal paper" VUCG images
(mailed to patient by the Kaiser Diagnositic Imaging Department on July 5, 2011)
Kaiser Permanente claimed that these were the only images saved from the VUCG procedure.
How did Dr. Grimaldi manage to write the above report based on these five images? There is
no urethra visible at all, female or otherwise.
(mailed to patient by the Kaiser Diagnositic Imaging Department on July 5, 2011)
Kaiser Permanente claimed that these were the only images saved from the VUCG procedure.
How did Dr. Grimaldi manage to write the above report based on these five images? There is
no urethra visible at all, female or otherwise.
Kaiser tampered with medical records and created a bizarre series of paper images to hide x-rays.
Kaiser was determined to prove that the patient did not have the problem she claimed to have.
Kaiser was determined to prove that the patient did not have the problem she claimed to have.
The Diagnositic
Imaging Department
claimed that only this
image and four others
were saved from a
long series of x-rays.
Why would anyone
print this out if he
were only going to
print out a total of five
images?
Dave Horton and
Rhianne Steins are
charge of the
Diagnostic Imaging
Department at Kaiser.
Kaiser claimed that an
official medical report
was produced by
radiologist Jay
Grimaldi five days
later based only on
these five images.
The patient had been
told during her
procedure that all the
images were digitized,
and they would be
available to any doctor
in Kaiser within a few
hours. In fact, the
digitized images
were "unavailable"
to the patient's
doctor and even to
Emergency Room
doctors.
Imaging Department
claimed that only this
image and four others
were saved from a
long series of x-rays.
Why would anyone
print this out if he
were only going to
print out a total of five
images?
Dave Horton and
Rhianne Steins are
charge of the
Diagnostic Imaging
Department at Kaiser.
Kaiser claimed that an
official medical report
was produced by
radiologist Jay
Grimaldi five days
later based only on
these five images.
The patient had been
told during her
procedure that all the
images were digitized,
and they would be
available to any doctor
in Kaiser within a few
hours. In fact, the
digitized images
were "unavailable"
to the patient's
doctor and even to
Emergency Room
doctors.
| These images show the bladder, but do not show the urethra, which was the entire purpose of taking the x-rays. Is there something going on with the urethra that Kaiser doesn't want to talk about? What would the reason be to hide a diagnosis? To cover-up bad care in the past? To save money? |
| > > > This is an out-of- focus "SCOUT" image. It gives no useful information. There is no chance that a doctor who was only going to print out five images (the most significant images)--of a digital video lasting several minutes--would print out two scout images. The truth is that the whole video was saved, and these images were chosen presicely because they give no information. |
| Also a "SCOUT" image >>> |
| No urethra here, either. Yet Dr. Grimaldi's report referred to the urethra. What did he see? |
The little image of the sun in the upper right of each image is
accompanied by numbers that indicate that brightness and contrast
have been manipulated. Was this done to hide the urethra? Is there
a problem that Kaiser doesn't want the patient to know about because
it fears the patient might ask for attention, cutting into profits?
Image Brightness/
no.: contrast
#3 36/72 9:53:53 SCOUT
#4 34/72 9:53:45 SCOUT
#9 31/47 10:05:25 VOIDING
#12 29/50 10:05:31 VOIDING
#13 28/56 10:08:36 POST-VOID
accompanied by numbers that indicate that brightness and contrast
have been manipulated. Was this done to hide the urethra? Is there
a problem that Kaiser doesn't want the patient to know about because
it fears the patient might ask for attention, cutting into profits?
Image Brightness/
no.: contrast
#3 36/72 9:53:53 SCOUT
#4 34/72 9:53:45 SCOUT
#9 31/47 10:05:25 VOIDING
#12 29/50 10:05:31 VOIDING
#13 28/56 10:08:36 POST-VOID
Each image is numbered as shown in the left column
below. What happened to images #1, #2, #5, #6, #7, #8,
#10 and #11?
below. What happened to images #1, #2, #5, #6, #7, #8,
#10 and #11?
July 27, 2011 Appointment with Dr. Eugene Young Rhee, head of Urologic
Surgery for Kaiser in San Diego
Dr. Rhee speaks to the press, makes decisions for a huge health care organization that receives tax
benefits and legal protection from the public, and contracts with most, if not all, pubic entities in
California.
July 27, 2011
Chief of Urologic Surgery
Dear Dr. Rhee:
There is a serious problem in the Kaiser Urology department. It didn’t start
there, and it didn’t end there, but it reached what I hope will turn out to be its
lowest point in Dr. K’s office.
Dr. K apparently erased a report written by another doctor, and replaced it with a
report for another patient.
His motive was to support Kaiser’s [lack of action]... regarding the issue I first
brought to the attention of Dr. C on February 8, 2011..
For a time it looked like Kaiser was going to handle my urination difficulty in an
appropriate manner...Then everything stopped. The results of the biopsy were concealed
from me by Dr. G and by Dr. C... I pestered Dr. G until she relented and gave me a copy
of the February 9, 2011 biopsy results...I demanded a VUCG to get some solid proof...
On June 15, 2011 I saw the last two images of my VUCG on the computer monitors after
my test...But Dr. K wasn’t about to allow the true nature of my condition to be revealed...
He co-signed the report of my VUCG on June 17, 2011. (See attached two reports of my
VUCG.) Then Dr. K apparently erased the original report and replaced it with a report
created on June 20, 2011 for another patient.
A strong, ethical leader needs to step in and take charge of this situation.
The deception is compounded daily.... No one wants to come clean, to admit the truth, to
fix the problem.
Those involved up to this point, including Member Services and the Records Department
as well as doctors, seem to be so certain that they are somehow insulated from all
consequences of their actions that they don’t even bother to lie consistently. The
Records Department said my VUCG results were never digitized, and that only five images
were saved (on thermal paper). They mailed me these images on July 5, 2011. (See
attached.)
Then Dr. S said he had all the digitized images. (See attached email.)
Then Dr. S said that only five images were available (on glossy paper). He gave me the
images on July 26, 2011. (See attached.)
Here’s the problem. Only two of the images in each of these sets of five were matches.
That means that Kaiser printed out from a computer three new images to create the July
26, 2011 set. Obviously, everybody and his (or her) brother has known all along that
Kaiser has been misrepresenting the facts each time it said the VUCG images were never
digitized. So I suppose it makes sense that Kaiser didn’t even bother to give me the same
set of images twice. Everyone knew the story wouldn’t stand for long, so why put much
effort into defending it?
I ask that you, Dr. R, put a stop to the deceit, at least in the Urology Department. Please
find my original VUCG report. I’m sure that Kaiser’s computer system doesn’t allow a
doctor to permanently erase a report when he or she is editing it. The previous version(s)
must be in the system.
But in the meantime, please release all the digitized images from my June 15,
2011 voiding urethrocystogram. It’s long past time for Kaiser to do take this
easy, obvious first step toward solving this problem.
Yours truly,
Maura Larkins
Surgery for Kaiser in San Diego
Dr. Rhee speaks to the press, makes decisions for a huge health care organization that receives tax
benefits and legal protection from the public, and contracts with most, if not all, pubic entities in
California.
July 27, 2011
Chief of Urologic Surgery
Dear Dr. Rhee:
There is a serious problem in the Kaiser Urology department. It didn’t start
there, and it didn’t end there, but it reached what I hope will turn out to be its
lowest point in Dr. K’s office.
Dr. K apparently erased a report written by another doctor, and replaced it with a
report for another patient.
His motive was to support Kaiser’s [lack of action]... regarding the issue I first
brought to the attention of Dr. C on February 8, 2011..
For a time it looked like Kaiser was going to handle my urination difficulty in an
appropriate manner...Then everything stopped. The results of the biopsy were concealed
from me by Dr. G and by Dr. C... I pestered Dr. G until she relented and gave me a copy
of the February 9, 2011 biopsy results...I demanded a VUCG to get some solid proof...
On June 15, 2011 I saw the last two images of my VUCG on the computer monitors after
my test...But Dr. K wasn’t about to allow the true nature of my condition to be revealed...
He co-signed the report of my VUCG on June 17, 2011. (See attached two reports of my
VUCG.) Then Dr. K apparently erased the original report and replaced it with a report
created on June 20, 2011 for another patient.
A strong, ethical leader needs to step in and take charge of this situation.
The deception is compounded daily.... No one wants to come clean, to admit the truth, to
fix the problem.
Those involved up to this point, including Member Services and the Records Department
as well as doctors, seem to be so certain that they are somehow insulated from all
consequences of their actions that they don’t even bother to lie consistently. The
Records Department said my VUCG results were never digitized, and that only five images
were saved (on thermal paper). They mailed me these images on July 5, 2011. (See
attached.)
Then Dr. S said he had all the digitized images. (See attached email.)
Then Dr. S said that only five images were available (on glossy paper). He gave me the
images on July 26, 2011. (See attached.)
Here’s the problem. Only two of the images in each of these sets of five were matches.
That means that Kaiser printed out from a computer three new images to create the July
26, 2011 set. Obviously, everybody and his (or her) brother has known all along that
Kaiser has been misrepresenting the facts each time it said the VUCG images were never
digitized. So I suppose it makes sense that Kaiser didn’t even bother to give me the same
set of images twice. Everyone knew the story wouldn’t stand for long, so why put much
effort into defending it?
I ask that you, Dr. R, put a stop to the deceit, at least in the Urology Department. Please
find my original VUCG report. I’m sure that Kaiser’s computer system doesn’t allow a
doctor to permanently erase a report when he or she is editing it. The previous version(s)
must be in the system.
But in the meantime, please release all the digitized images from my June 15,
2011 voiding urethrocystogram. It’s long past time for Kaiser to do take this
easy, obvious first step toward solving this problem.
Yours truly,
Maura Larkins