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Medical Industry’s Death Panels Medical Industry’s Death Panels are Here: Greek Tragedy of a Lady Named Glenda. Silverpeak Publisher PO Box 4, Alamo, CA 94507 www.silverpeak.org Copyright by Rodney Stich, April 1, 2012. All rights reserved. But any part of this book may be reproduced in an effort to expose the corruption in America’s health industry and bring about corrective actions. Make reference to this title. Because of the dynamic nature of the Internet, any Web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher. The publisher hereby disclaims any responsibility for them. Stich, Rodney. Medical Industry Death Panels: Greek Tragedy of a Lady Named Glenda. ISBN for print book 978-0-932438-73-7 ISBN for e-book 978-0-932438-74-4
c Table of Contents Medical Industry’s Death Panels: Greek Tragedy of a Lady Named Glenda Chapter 1. Glenda’s Early Life in Oklahoma____________________1 2. Two Seniors, Pilots, Joining Together________________5 3. First Medical Crisis: Glenda About to be widowed______15 4. Next Pastime Following Aviation: Recreation Vehicle___18 5. Glenda Diagnosed with Stage IV Esophagus Cancer_____22 6. Cancer Became a Family Affliction__________________28 7. Glenda’s Cancer Drug Unavailability________________31 8. Nearing the End of a Four Year Cancer Battle_________59 9. Hospital Admission for Treatable Breathing Problem____65 10. Glenda’s Arrival at SNF Lacking COPD Unit______73 11. Sham Certification of Terminal Illnesses______________102 12. Ineligible Glenda Transferred to Hospice Facility_______114 13. Hours Later: Suspicious End of Glenda’s Active Life____119 14. Major Medical Secret: Morphine Overdose_________129 15. Funeral Services for a Great Lady___________________132 16. Prevalence of “Homicide” in America’s Medical Industry 17. Last in Series of Fighting Corruption_________________148 18. Physician Fraud and Euthanasia (homicide!)___________186 19. Hospice: the Good, the Bad, and the Deadly___________193
Medical Industry’s Death Panels 20. The Guilty, the Complicit, and the Enablers___________200 21. Sampling of Glenda in Happier Times________________207
This is the story of two lovers, seniors, both pilots, whose eventfilled life came apart due to a series of corrupt acts by physicians in America’s medical industry. The joining of Rodney Stich, a former naval aviator, airline pilot, and federal airline safety inspector, with Glenda, was followed by years of flying trips throughout the Southwest. Illness brought their flying activities to an end. This is primarily a story of Glenda and her torturous path through cancer. But, it is also an indictment of the cavalier, indifferent, and possibly criminal conduct by certain physicians, and may be one of the reasons for the reported 30,000 deaths a year due to medical "errors." People talk about the possible death panels for seniors in the politically charged attention on health care changes. But death panels are already active in the United States. And as usual, the American public has been kept in the dark about these corrupt medical activities. With touches of a Greek tragedy, this is the story of a beautiful and talented woman and the problems she faced after being diagnosed in early 2008 with Stage IV esophagus cancer. It provides examples of arrogance and corruption in segments of America's medical industry. This story is about Glenda Guilinger and her interesting life, and the premature ending of that life in America’s medical industry. What Glenda experienced should be a warning for any senior person or one experiencing a serious illness. And, a warning to younger people about perils ahead.
Medical Industry’s Death Panels There are multiple purposes for this site. This site is in two parts. The first part is about the life of a great lady, Glenda, and seeks to keep her memory alive. The second part is about her suffering and premature death at the hands of the sordid culture among some physicians and management personnel in America's medical industry. It is information people must know if they are to avoid and protect themselves and their loved ones when illness strikes. The medical industry has the same sleazy characters as most any other industry. The 30,000 reported deaths from medical mistakes in hospitals is only part of the story. Glenda and her partner, Rodney Stich, never formally married for various reasons. One reason being Rodney’s attempts to expose high-level corruption that made him vulnerable for lawsuits, which could then impact Glenda's assets if they were legally married. The focus is on the last four years of Glenda's life as she fought an early 2008 Stage IV esophagus cancer. In early 2011, Glenda's then-three-difficult years of fighting cancer was joined by Rodney being diagnosed with Stage III kidney cancer, and their encounter with physician arrogance and misconduct in the American medical industry. Together, they battled elements in the medical field that are similar to the rampant misconduct throughout the United States. Glenda experienced a form of medical treatment abuse that precipitated a premature death, despite having medical coverage under Medicare, Healthnet PPO, and ChampVa insurance (all of which performed admirably).
Medical Industry’s Death Panels
He also filed federal lawsuits under the federal crime reporting statute. which are described in various books. As one of the most highly qualified inspector in the FAA. he was given the task to correct the conditions resulting in the greatest number of airline disasters. he left government and proceeded to expose what he had discovered. Boeing Stratocruiser. Title 18 U.C. In 1962. C-46. starting in 1978.S. Section 4. He was a Naval Aviator during World War II. believed serving as the youngest Patrol Plane Commander in 4-engine Privateer and Liberator aircraft during that war. and eventually several jets. including History of Aviation Disasters: 1950 to 9/11. Martin 202. After attempts to correct these conditions. including the Convair 880 and Douglas DC-8. Corruption. Lockheed Constellation. and deadly tragedies became routine discoveries in the aviation environment. cover-ups. As a result of these efforts. he left airline flying and became a federal airline safety inspector for the Federal Aviation Administration (FAA) during the time when airline crashes were occurring seemingly every few months. DC-4. including the DC-3. After the end of World War II. These efforts included publishing books based on personal insider knowledge and appearing on hundreds of radio and TV shows.i About the Author Rodney Stich had a colorful background. he was an international airline captain in various types of aircraft. which played enabling roles in many of America'- . It was in this capacity that he discovered areas of corruption that would shape his life thereafter. Convair 340. and instructor in PBY Catalina aircraft. a continuing series of other former federal agents and other insiders provided him information on hardcore corruption of people in other areas of overt and covert government operations. in an attempt to change the corrupt cultures through citizen outrage.
is based upon what he personally experienced as he and his partner. Stich used this information in a series of other not-for-profit books that he wrote. This present book. again seeking to inform the people and bring about outrage to halt the various areas of corruption. I write about Russbacher in such books as Defrauding America and Drugging America. One of Rodney’s firsts major sources for information on misconduct in covert government operations was a very unusual agent of the Central Intelligence Agency (CIA): Gunther Russbacher. Russbacher received his initial flight training from the same flight instructor that had given Glenda her pilot training. Medical Industry’s Death Panels. Ironically. Glenda. both endured the hardships of cancer. .Medical Industry’s Death Panels s great tragedies.
The important need to understand the pros and cons of hospice. The need to cross check surgical or medical advice being given.k The Purpose of the Book Medical Industry’s Death Panels provides the actual experience and other information about the rarely publicized misconduct in the medical field that result in thousands of deaths a year. The need to research the effects of certain medication being prescribed for home use or in medical facilities. As shown by the personal story of the author. bringing a loved one to the hospital for a relatively modest treatable pulmonary problem . or arrange for such care for a loved one. The need to understand that for many doctors you or a loved one is merely a business commodity and that death can easily occur when profit is the physician’s primary interest. and how failure to understand can result in needless suffering and death for yourself or a loved one. Failure to recognize the inherent problems in the medical field can easily bring about a deadly outcome. which sometimes can lead to tragic or deadly consequences. Discover. Everyone will experience at some time in their life the need for medical attention for themselves. • • • This information must be known by everyone. for instance: • • The need to research and become familiar with certain medical conditions that are being addressed.
or a loved one that you are arranging medical care. This could happen to you.Medical Industry’s Death Panels resulted in needless suffering and premature death. .
using insider information on the relationship between corruption and great tragedies. It is also dedicated to the memory of the thousands who have already been victimized by a culture in the medical industry that has the same areas of corruption as in virtually every other area of activity in the United States. as with every other book written by Rodney Stich. he tried. Medical Industry’s Death Panels will suffer the same indifference.m Dedication This book and the efforts behind it are in remembrance of a great lady whose life was brutally and prematurely brought to an end by misconduct in America’s medical industry. Unfortunately. . At least.
Glenda’s father worked for Sinclair Oil Company. More than once she was rushed to hospitals due to breathing problems from that allergy. Glenda also had strong attachment to horses and was an excellent rider. In those days it was rare to see a young woman who was willing to take such extraordinary measures to achieve their life-long dream. 1933.. In 1951.. Eventually she had to disassociate herself from horses due to a strong allergy to them.flying. often riding without a saddle. More than once she was near death. She was an avid reader of non-fiction and fiction. Her parents didn’t find out about her secret activities until an article appeared in the local newspaper announcing the licensing of a young local high school girl as a pilot. in Oklahoma during the Great Depression..CHAPTER ONE Glenda’s Early Life in Oklahoma Glenda Guilinger was born on January 24. Glenda attended Bow Legs High School. where she was voted homecoming beauty queen in 1950. at the age of 17. Glenda secretly saved her lunch money and used it to take flying lessons in a Cessna 140 at the Seminole airport.. . Glenda had a keen interest in aviation.
known for the quilts she made. and much more. Glenda at the age of 16 . held a master's degree in criminal justice.Medical Industry’s Death Panels a fabulous cook.
she became a Correctional Case Manager for the Department of Corrections in Oklahoma. receiving a degree in Business Administration.3 Glenda’s Early Life in Oklahoma Glenda crowed Homecoming Queen in 1950 Glenda attended Central State College and the University of Oklahoma. . After receiving a Master’s Degree in Criminal Justice.
when they were spotted living on a chicken ranch in Campti. Guilinger. Edwin L. Glenda married a World War II Army soldier. She had three sons and a daughter from that marriage. Texas. Glenda moved to the Bay Area of Northern California in 1987 and was employed at the Naval Weapons station in Concord. . In 1953. from 1986 to 1992. Along with her love of reading. Randolph Franklin Dial. She traveled extensively throughout the world. In 1979. Glenda loved cross word puzzles. left with one of the prisoners. They were not discovered for many years until 2005. Bobbi Parker. who had been wounded during a major battle in Europe. her husband died from his World War II wounds. California. leaving behind her children.Medical Industry’s Death Panels She was employed as a case worker at the prison where the warden’s wife.
I had been in aviation since 1941. I had been fighting high-level corruption for many years and had become the head of a coalition of former government agents and other insiders exposing corruption that was resulting in a continuing series of major national disasters.CHAPTER TWO Two Seniors. Pilots. I had been under heavy attack from government and non-government sources seeking to halt my exposure of nation--effecting high-level corruption. I claim to have met Glenda in front of the prune counter at Safeway. and FAA airline safety inspector. We hit it off right from the start. international airline captain. Navy Patrol Plane Commander. first as a radio operator in Navy PBY patrol planes and then later as a Naval aviator. . Joining Together I met Glenda in 1994. At the time I met Glenda. Occupied with Fighting High-Level Corruption And Fighting Massive Retaliation When Glenda and I joined in 1994. For laughs. I soon learned that Glenda had obtained her pilot’s license in 1951 at the age of 17.
the next in a series of books on these subjects was called Defrauding America. She loved flying above the clouds in the San Francisco area. we rented either single or twin-engine aircraft and flew throughout the Southwest. After about 20 minutes I managed to get the needed altitude to safety cross the Sierras. as my many sources provided me with information on corruption in other areas. From 1995 until 2003. Glenda had to go to the restroom. Reigniting Our Love for Flying We started renting small single engine and sometimes twin-engine aircraft and monthly had Glenda do about thirty minutes of touch and go landings. History of Aviation Disasters: 1950 to 9/11. going from about 13. I told Glenda I would look for updrafts to get the needed altitude. or else we would have to divert southward where the mountains were lower. with an occasional first stop at Death Valley. The aircraft just didn’t have enough power to get the altitude.) From that moment on. two senior lovers experienced 18 years of eventful living. We were in a single-engine aircraft flying over the Sierras on a hot day and trying to get a thousand feet clearance to get over the pass at the end of Kings Valley. That brought back her flying proficiency.000 feet to below sea level at the Death Valley airport. Flying the length of the Grand Canyon and Lake Powell was one of her favorites. One landing at Death Valley was unplanned. I then put the nose down and headed for Death Valley. (Details in book. Our first stop was always at Las Vegas International Airport. ..Medical Industry’s Death Panels My first book on this subject was published in 1978 and was the first of multiple editions of Unfriendly Skies. Later. But by the time we made it across.
Grand Canyon. Bryce Canyon. flying over the Sierras. and other western states. Zion. Pilots. Joining Together We took many special trips. Glenda at Sedona Airport . Sedona.7 Two Seniors.
Bruce. Las Vegas 1998 .Medical Industry’s Death Panels Glenda's son.
9 Two Seniors. Pilots. Joining Together Simultaneous Continuation of .
Once. Security informed me that was normal of gamblers. was a former New York City Mafia figure: Gregory Scarpa. I had been battling corruption that I first discovered while I was a federal airline safety inspector. But I sometimes lost Glenda. She usually came out ahead and rarely lost. explaining my problem about not having heard from Glenda for hours.Medical Industry’s Death Panels Crusade against High-Level corruption When I first met Glenda in 1994. I described the car she was driving. the mastermind behind the 1993 bombing of the World Trade Center. who always mentioned Glenda in his letters. Glenda loved traveling to Reno for her favorite hobby: the slot machines. The subject is too complex for what is being discussed here. That was Glenda. I didn’t hear from Glenda and it was almost midnight. giving speeches. Ramzi Yousef. One unusual source. Scarpa obtained advance information about . I called security personnel. while staying at the Atlantis. Jr. I knew she went to the Silver Legacy to gamble. Scarpa had “befriended” a key al Qaeda figure. With this relationship. and writing books. Glenda was also the proof reader for some of the books that I wrote on covert activities in various government operations. Glenda became acquainted with many of my sources in the intelligence community and also insiders who provided me a wealth of highly sensitive information. Part of my crusade or activist activities involved appearing as guests on radio and TV programs. Major national tragedies resulted from this problem. and before ending the conversation—this was around midnight—security stated there was a car matching that description leaving the parking area at that time. Glenda often appeared with me when I appeared before groups in out-of-town events throughout California.
S. Overall. The information I obtained from Scarpa. Glenda was a fabulous cook. Why that information was not acted upon is one of the country’s biggest scandals that have yet to be exposed. are found in the book that Glenda helped proofread: Crimes of the FBI-DOJ.11 Two Seniors. as given to me by Scarpa.S. Section 4 federal action in the federal courts in New York City. and al Qaeda. and while residing in the senior community of Rossmoor in Walnut Creek. Court of Appeals to give verbal argument on an appeal that I had filed in a federal action that was related to the 9/11 attack. Title 18 U. Details are in the book. California. She was fabulous at making quilts. That is another subject that is too complex to discuss here. including 9/11. Crimes of the FBI-DOJ. she taught others in quilt making. caused me to file a lawsuit under the federal crime reporting statute. and al Qaeda. Joining Together several major terrorist attacks upon U. Pilots. . Glenda went with me to New York City when I appeared before the U. targets. In 2005. Mafia.S. our 18 years together were full of unusual and enjoyable events.C. Mafia. Details. and other sources.
Medical Industry’s Death Panels Flying over the Rainbow Bridge Flying over Lake Powell .
Joining Together Glenda at Sedona Airport Flying over the Grand Canyon .13 Two Seniors. Pilots.
Medical Industry’s Death Panels Glenda at Grand Canyon Glenda loved flying over the Clouds .
Joining Together One of dozens of quilts made by Glenda .15 Two Seniors. Pilots.
This research was somewhat natural for me since I was a pharmaceutical company representative for a number of years after leaving the Navy and before going with the airlines. Several cardiologists stated there was nothing they could do since my coronary vessels were too small for stents or another open heart surgery. . Several times she had to rush me to the hospital because of the chest pains. which I had in 1985. I was near death after that happened. One of my six coronary bypasses failed and I experienced heavy angina.CHAPTER THREE First Medical Crisis: Glenda about to be "Widowed" Our flying came to an end in 2003. especially specialists. None of the heart medications were working to halt the intense angina. I would again learn the value of doing medical research and not to rely totally on physicians. I then made final funeral arrangements so that Glenda would not suddenly have to make all the arrangements from scratch. That position required me to do considerable medical research to help me promote certain fairly sophisticated medications to physicians.
The theory is that these surges cause the formation of tiny blood vessels around coronary blockage. my angina was gone." said Dr. "This study is significant. This study was the impetus for the larger controlled prospective PEECH(TM) trial (Prospective Evaluation of EECP in Congestive Heart Failure). I couldn’t believe it. and encourages the formation of coronary arterioles or collaterals that circumvents blocked coronary arteries. sending a surge of blood to the heart. The treatment is known as EECP or Enhanced External Counterpulsation. In this way the treatment restores or improves the blood circulation to organs and tissues that have been affected by blockage in the normal blood supply.info. Death was no longer at my doorstep. the cuffs contract. in that it is the first to show improvements in specific symptoms of heart failure. which is studying the efficacy of EECP in a larger number of patients. Soran. lying on a table with cuffs wrapped around your legs and abdomen. Every time your heart beats. to provide additional pathways for blood flow to the heart that circumvents blocked arteries. I was so impressed that I put up a web site to inform people about this treatment. to authorize an out-of-medical plan referral to try it out. called arterioles or collaterals. I was able to convince my cardiologist. Michael Forrest. .heartsurvival. "Previous studies have shown that EECP therapy can relieve symptoms of angina in heart failure patients. Dr. It consisted of 35 one-hour treatments. The treatment creates additional paths for blood flow. After 35 treatments.17 First MedicalCrisis: Glenda About to be Widowed I discovered a Medicare-approved non-invasive treatment that had worldwide use and was being used in some of the nation’s top medical centers. www.
There isn't that much profit in the selling of a machine as there is in having doctors prescribe certain medication. Often times. This near-death experience again showed me the importance of not counting solely on medical help from an individual. there is medical help from other sources that a particular doctor or group of doctors don’t know about. most doctors are unfamiliar with this treatment. or a group of doctors.Medical Industry’s Death Panels Despite the fact that EECP is well proven and used by top medical centers. There is virtually no profit in referring a patient to a location that has the machine necessary for EECP treatment. One reason for this is that the people selling the machines do not have detail people making periodic calls on physicians. Another reason for resistance is that there is far more profit in insertion of stents or open-heart surgery. . as is done by the pharmaceutical companies.
we took many short trips to campsites in Northern California. Glenda loved traveling with a “small one-bedroom” apartment. cooking stove. I said we will take it. TV. I was impressed with it. With the purchase of a 27-foot Class A motor home. and all the comforts of home. including nearby Bodega Bay. I saw an RV listed for sale that had a very low price. I called the number and the person drove the RV to the Reno Hilton where we were staying. I occupied myself looking at the classified section of the Reno Gazette. which caught my eye. on wheels. we developed an interest in recreation vehicles. we purchased a used 27-foot Dolphin motor home. but I felt that was not practical. especially along the ocean. including a shower. and while Glenda was gambling. During one of our monthly trips to Reno. That started a new life for us. Glenda wanted to wait and think about it. In 2004.CHAPTER FOUR Next Pastime Following Aviation: Recreation Vehicle With the end to our flying activities. replacing our aviation activities. .
and an endless number of other things. The meals prepared by Glenda on the four-burner stove or microwave appeared to taste even better than at home while in a spectacular view area. Glenda by the 27-food Dolphin RV .Medical Industry’s Death Panels Where else can you have the comforts of home while parked within a few hundred feet of the ocean. It greatly helps to have mechanical skills to keep a used 27-foot “house on wheels” operational. Or other panoramic areas. the air conditioner. the space heater. Or parking in the wilderness. Problems were common with the refrigerator. the hot water heater.
.21 Next Pastime Following Aviation: Recreation Vehicle Camping along the Pacific Ocean north of San Francisco.
Medical Industry’s Death Panels Glenda: Eating time in the RV World .
.23 Next Pastime Following Aviation: Recreation Vehicle Our RVing days would shortly end.
CA) difficulty in swallowing. Glenda was diagnosed with Stage IV esophagus cancer. Glenda was then given the phone number of a surgeon and an oncologist on a handwritten note pad. then a youthful 75. Vona Lorenzana (Walnut Creek. No other instructions were given. I discovered the enormous responsibilities of a caregiver for someone with a serious and event-plagued illness. Glenda. with a survival prognosis of less than one year.CHAPTER FIVE Glenda Diagnosed with Stage IV Esophagus Cancer Our lives changed in early 2008. This physician immediately referred Glenda to specialists. Glenda would lie motionless. Glenda was near-death several times. Dr. . sleeping. reported to her primary care physician. much of the time. where the diagnosis was made of esophagus cancer. causing me to rush her to the hospital several times. That first year was very rough for Glenda and I. In early 2008. The tests revealed that Glenda had cancer of the esophagus and that it had already spread to other organs: Stage IV esophagus cancer.
Starting With an Oncologist The other name on the notepad paper was that of the Diablo Valley Oncology Center. never mentioned this important life-affecting matter. I found that surgical removal of the esophagus when the cancer had already spread beyond the esophagus would not prolong life and would greatly deteriorate the quality of life.25 Cancer Became a Family Affliction Being new to the area of cancer treatment. Dr. Medical supply companies delivered food and a feeding pump to the residence. While being seen by Dr. Robles. who then made an opening into her stomach and the placement of a feeding tube so that Glenda could feed liquid food directly into the stomach. the surgeon. But this discovery would be only the first of others as to the culture among some physicians in the medical field. created a newdeath condition for Glenda. and the oncologist. That condition required referral to a surgeon. At that point I started researching the many cancer treatment sites on the internet. which were not responded to. Glenda and I went to the surgeon whose name was on the slip of paper. Several problems for which this writer sought help from Diablo Valley Oncology. who certainly knew of these many reports against surgical removal of the esophagus when the cancer was already metastasized to other organs. but no one took the effort to describe how to use it. That near-death experience brought on by the cavalier indifference of Diablo Valley Oncology caused Stich to request urgent help from the executive offices of John Muir Hospital. They established . Robles. He obviously was more interested in the money from the surgery that would have made life more miserable for Glenda. He recommended surgical removal of the esophagus. Disturbingly. Surgery was therefore out of the question. Glenda's esophagus eventually closed to where she could not eat or drink.
. For the first year the cancer treatment consisted of radiation. I might have detected the problem earlier. Michael Sherman. A one-year maximum survival is often the case with the discovery of Stage IV esophagus cancer. possibly due to the effect of the cancer drugs. There then followed months of radiation treatment at the John Muir Hospital campus at Concord. Seeking additional guidance. And the plan worked very well for Glenda during her four years of cancer treatment. It was the opinion of the Stanford physicians that the cancer treatment that Glenda needed. Fortunately for Glenda. the cancer appeared to be in remission. I took Glenda to the prestigious Stanford Medical Center in Palo Alto California. That failure of the Diablo Valley Oncology group to respond.Medical Industry’s Death Panels treatment for Glenda with Contra Costa Oncology's Dr. It wasn't until Glenda's dehydrated appearance was obvious that I rushed her to the emergency section of John Muir Hospital in Walnut Creek. The treatment there was generally good. The first year was very hard on Glenda. and on her life companion and caregiver. cancer drug infusions. could be done as well by the facilities in the Walnut Creek area as at Stanford. While I was caring for Glenda who slept most of the time. weeks of radiation and endless chemo. caused cancer treatment to be changed to the Contra Costa Oncology group in Walnut Creek. It looked as if Glenda would survive the cancer as the cancer drugs kept the cancer under control. California. Beating the normal maximum one-year survival from Stage IV esophagus cancer. she had not only Medicare to pay the bills. If the cancer experience was not a new experience. I was not aware of the problem. but also a PPO supplemental insurance issued by Healthnet. enabling her to go to virtually any doctor. and continual tests. and a prior problem. but a common problem was experienced of physicians refusing to respond to the caregiver responsible for arranging medical treatment.
Glenda and I then . and spending much of her time in bed. as I ended up rushing her to the hospital in a near-death condition. and that whatever she wanted to do. deathly sick from radiation and cancer drugs. through the feeding tube. The normal life expectancy of someone diagnosed with Stage IV esophagus cancer is one year. I would go to our Allen theatre organ and play quiet soothing songs from the thirties.27 Cancer Became a Family Affliction Rough First Year of Esophagus Cancer The first year was the most difficult for Glenda. I felt so sorry for Glenda. Glenda went way beyond that. even for a few hours. Ted Gunderson. former FBI chief of the Los Angeles office. Sherman's selection of oncology drugs appeared to stabilize Glenda's cancer. thinking it might make her feel better. Once she started feeling better. The surgeon that inserted the feeding tube directly into Glenda's stomach responded to a question. Sometimes when she lay motionless in bed. I told Glenda that we have to make every day as pleasant for her as possible. The closing of the esophagus. I was a scheduled to be a speaker before a group of about 700 in the Los Angeles area and had to cancel so as not to leave Glenda alone. Gunderson died of cancer. don’t hesitate for a moment to tell me. or wherever she wanted to go. stating that the esophagus would never again reopen. It was good that I didn’t leave Glenda during those few hours. A friend of mine took my place. and that she would need to feed herself for the remainder of her life. being forced to feed herself through a stomach tube. Less than four years later.
Minnesota. Martin who lived in Tulsa. pain. Glenda suffered less. with repeated treatment at Contra Costa Oncology with infusions of cancer drugs. who lived in Big Lake. Cancer treatment continued for several years. PET scans. but medical visits continued in order to keep the cancer in remission.Medical Industry’s Death Panels planned to again visit Stanford where physicians would reopen Glenda's esophagus that had previously closed. Without that. near-death experiences. It never ended. Bruce. Glenda beat the odds by living beyond the one-year life-expectancy of a person diagnosed with Stage IV esophagus cancer. all of whom lived out of state. . but still needed a full time caring caregiver. when the cancer had spread beyond its initial place of origin. But before this came about. and was a nearly daily occurrence for almost four years. Anyone going through something like that urgently needs a loving person there all the time. and blood tests. CT scans. Glenda's Distant Biological Family Glenda had three sons and one daughter. Glenda beat the odds by living beyond the first year. the esophagus did reopen. Mike who lived in New Jersey. and who had Multiple Sclerosis (MS). After surviving the first year. and became confined to a wheel chair. constant trips to hospitals and other medical facilities. the near-death experiences did not occur. Oklahoma. about a year after it had closed and Glenda thereafter was able to eat and drink normally. and had himself been diagnosed in early 2011 with liver cancer that had already spread to another organ. the suffering and premature death is sure to occur. The Enormous Load for Caregivers The first year of Glenda's cancerous life was an endless series of tragic moments.
Glenda not only survived that first year. such as over the Grand Canyon and the Sierras. As Glenda approached the end of the fourth year. the altitude started affecting Glenda in early 2011 at Reno's 4500 feet elevation. (Glenda was an avid slot machine player.000 altitude. her cancer was apparently in remission and she felt fine. but survived three additional years. Where formerly Glenda had no breathing problems while she and I flew small aircraft at 14. except for occasional episodes of breathing problems from the years of COPD.) .29 Cancer Became a Family Affliction As I sat with Glenda in the cancer drug infusion sections I often felt sorry for single people getting infusions. having to go through cancer treatment without someone by their side.
sometimes emergency reactions. . California. At most other times. refused to order tests. my primary care physician at Kaiser Permanente HMO in Walnut Creek. Cancer then became a dual family matter. That was an outrageous statement since I had a contract with Kaiser Permanente for medical care. It was medical fraud to now deny me that contractual care because I was older than the unwritten guideline by this for-profit physician medical group. primarily a CT scan.CHAPTER SIX Cancer Became a Family Affliction In May 2011. when I was in need of caregiver help. and provided the help. I was diagnosed with Stage III kidney cancer. When I first experienced multiple symptoms that something was radically wrong. He stated that it was against Kaiser Permanente policy to order such tests for a health plan member of my age. Events leading up to that diagnosis revealed a sordid side of physician conduct in America’s HMO health industry. when Glenda needed help. I was able to respond. Glenda was in remission and relatively free of symptoms. Fortunately.
I then provided Kaiser physicians copies of numerous medical reports showing their excuses to be false. the cancer would most probably be incurable and hospice would be the only avenue remaining for me. including a urologist and the primary care physician. Kaiser physicians then used sham arguments to dissuade me from surgery. I then provided the report and copy of the disk to several Kaiser physicians. which was immediate surgical removal of the right kidney and lymph node. That was insane. That scan showed advanced Stage III kidney cancer in the right kidney and fully engulfing the related lymph node —ready to spread to a deadly Stage IV kidney cancer. The curative or remission-causing benefits of cancer drugs would be lost and by the time additional symptoms became evident. . I had a stent that required blood thinning drugs such as aspirin. After nearly two months delay—wherein the cancer may have then spread to other parts of the body—the surgery was finally performed. Upon describing my symptoms. he immediately ordered a CT scan. I was then subjected to coordinated pressure urging me to do nothing and wait until I personally experienced symptoms as the cancer spread to other parts of the body. and that increased the risk of bleeding. for instance: • • I was too old. and presented Kaiser physicians with evidence of the universally recognized treatment at that stage. It was a death decree! I objected repeatedly.31 Glenda’s Cancer Drug Unavailability I was then forced to go to a physician outside of the Kaiser Permanente group. These arguments included.
may have forced a thinking change at Kaiser. the misconduct by the Kaiser physicians made life more difficult for me and for Glenda. being a very busy caregiver taking care of Glenda’s cancer emergencies and around-the-clock needs. The first one said that the contrast used in CT scans was too dangerous for people with only one kidney. By that time. I am still waiting for the cancer to be discovered at some other part of the body. Again I had to provide copies of medical reports showing the urgent requirement of such tests. wherein one oncologist.defraudingamerica. . Kaufman. Obviously. An appeal under Medicare was also a farce. The standard practice is to perform the CT scans without contrast. Dr. Complaints to medical regulatory bodies in California were a waste of time.Medical Industry’s Death Panels After surgery.com/kaiserpermanente. possibly the web site I put up. stated he would order the tests. The third Kaiser oncologist simply walked out of the examining room when I questioned his excuse. At the time of this writing. The second Kaiser oncologist stated that cancer drugs do not delay the spread of cancer. The logistics of the appeal process is such that the patient has no information on what the physician is providing and therefore has no way to correct any falsehoods. www. which was totally false. Kaiser physicians returned to sham arguments to deny to me the universally recognized post-nephrectomy blood tests and CT scans. Three Kaiser Oncologists provided sham arguments.html.
33 Glenda’s Cancer Drug Unavailability .
The unavailability of the cancer drug.S. of cancer fighting drugs in the United States. Obviously. Because of this shortage.CHAPTER SEVEN Glenda’s Cancer Drug Unavailability During 2011. which had worked so well for Glenda. One such drug is Taxol. Greedy and Indifferent U.S. many are dying as a result. Taxol. That cancer drug brought about uncomfortable side effects. had to be replaced with Taxotere. cancer patients are suffering and dying of cancer because of drug shortages or unavailability due to what seems to be no end to the sordid conduct inflicted upon the American people. Pharmaceutical Companies And U. vulnerable cancer patients are needlessly suffering the advance of cancer metastasis. Vulnerable Cancer Patients are Suffering--and Dying— Because Of Profit-Related Shortage of Cancer Fighting Drugs For many months there has been a worsening shortage. Glenda was doing well. Pharmacies Versus U. and her cancer appeared to be in remission.S. or total unavailability. Cancer Patients Numerous media reports blame the unavailability or shortages on the refusal of pharmaceutical companies to produce the drugs be- . In what was once the most advanced nation in the world.
35 Neda’s Cancer Drug Unavailability cause of a low profit level. The speaker said the government [bureaucrat] takes the view this violates FDA regulations and probably Medicare billing law as well. billing Medicare or other payors as if the drugs had been purchased in the U. it is OK to spend tens of millions on advertising drugs like Viagra and Cialis. Government Bureaucrats Barring Importing Cancer Drugs from Canadian Approved Drug Suppliers Glenda’s oncology clinic was unable to obtain the Taxol cancer treatment drug that had been keeping Glenda’s cancer in remission. The feds are apparently all over this issue.S. that seek to increase sale of profitable drugs through continuous TV segments showing everything but the penis entering the vagina. But for reasons still being investigated. these cancer centers do not order the life-saving cancer drugs. I asked the purchasing agent at the cancer clinic where Glenda was receiving cancer drugs if they would use Taxol that I obtained from drug suppliers approved by the Canadian government. In their eyes. He replied: I was at a conference recently. Most won't even use these cancer drugs if the cancer victim buys the drugs themselves. where one of the speakers talked about a big federal enforcement push against oncologists who purchase chemotherapy drugs from outside the US (mainly Canada). But they have no money for dying cancer patients. such as Taxol. Politician's Legislation Barring Reimportation Of Cancer or Other Drugs Produced in the United States . despite the suffering and deaths that could be avoided. and use them for patients. The cancer drugs are easily available from government-licensed pharmacies in Canada by oncology clinics and hospitals in the United States. On August 29. 2001.
The Obama White House has acted for the prior two years to bar Americans and U.S. even though they had been saving lives and were unavailable in the United States. politicians wrote into law the Federal Food.S. and resulting in worsening of their cancer and early death.S.Medical Industry’s Death Panels U. In 2010. medical providers from access to governmentlicensed pharmacies in other countries. That legislation has been followed by an even more draconian denial of treatment to cancer and other patients. President Obama supported a law known as COICA that would shut down websites of international pharmacies. That would enable U. The carrying out of this political stunt by government bureaucrats has now resulted in cancer patients deprived access to needed treatment. That legislation had been given the somewhat bizarre name. pharmaceutical manufacturers with yearly sales in the billions to continue to fleece the public. The Obama “deal” made it illegal to reimport these drugs. or inspected and approved by major nations. U. Politicians Protecting Cancer Drug Shortage Schemes! In 2009 President Barack Obama made a deal with major pharmaceutical companies to prevent reimportation of pharmaceuticals into the United States from Canada and other countries. Even though government licensed pharmacies in countries such as Canada and throughout Europe could provide life-saving drugs in . Preventing Real Online Threats to Economic Creativity and Theft of Intellectual Property Act of 2011 (PROTECT IP Act). even though the pharmaceuticals were either originally manufactured in the United States.S. Drug and Cosmetic Act (FD&C Act) that bars prescription drugs that are made in the United States and exported to a foreign country from being reimported into the United States. the ones making available such lifesaving cancer drugs as Taxol and others.
the public would be none the wiser. That legislation would reduce the price of drugs in the United States and also enable cancer or other important drugs to be obtained when not available in . provided that prescription drugs manufactured in the United States and exported to certain foreign countries. Revolving-Door Bureaucrats Blocking Access to Cancer and Other Drugs Unavailable in U. And as usual. In 2000. The Obama administration in December 2010. supported legislation to legalize the importation of prescription drugs from Canada and other nations. They acted to protect the huge and obscene billion-dollars-a-year profits of many large pharmaceutical companies. As Barack Obama was campaigning to be President of the United States. even death. These companies include Google. reversed their position. After Obama became President. his Chief of Staff. the Obama administration and many members of Congress.37 Neda’s Cancer Drug Unavailability short supply or unavailable in the United States. and others. he promised to support legalization of imported drugs from government-licensed pharmacies and suppliers in Canada and other nations.S. But after bribe-taking members of Congress and bribe-giving corporations applied pressure. he and Rahm Emanuel. MasterCard. the Medicine Equity and Drug Safety Act (MEDS). and suffer the health consequences. companies. through the White House Intellectual Property Czar. VISA. stated the administration planned to order the complete shutdown of reputable Canadian and international online pharmacy sites by pressuring U.S. Victoria Espinel. American citizens would be deprived of obtaining such drugs. so bribe-taking politicians in the United States can chalk up one more win for their politician-corporation relationship. be reimported from those countries for sale to American consumers.
Medical Industry’s Death Panels the United States. which is long overdue here in the United States.gov/Drugs/ResourcesForYou/Consumers/u cm143561.fda. The FDA's own internet site admits that it has the authority to approve these drugs from Canada. life saving for some. starting with Secretary Tommy G. Thompson. while he believed strongly in access to affordable drugs. But former Health and Human Services Secretary Tommy G. enacted in 2000. That protection. . Thompson responded by saying that. and are dying. One provision in the legislation required that the benefits of the legislation be subject to the approval of Health and Human Services who would decide by themselves whether adequate safety could be maintained and whether costs could be reduced significantly. where people must die. Here are a few excerpts from that link: The Medicine Equity and Drug Safety Act (MEDS). Supporters of the bill hoped that lower drug pricing in other countries would be passed along to consumers. and is now escalating. he could not implement the act because it would sacrifice public safety by opening up the closed distribution system in the United States.htm. • http://www. Health and Human Services bureaucrats. As a result of a revolving door bureaucrat action. claimed that this reimportation was not safe. Subsequent shortages and non-availability of life-saving cancer drugs then took its toll. was blocked by revolving door bureaucrats. would have allowed prescription drugs manufactured in the United States and exported to certain foreign countries to be re-imported from those countries for sale to American consumers. it is illegal to import cancer drugs which are unavailable in the United States.
• If the product is for personal use and is a three-month supply or less and not for resale. since larger amounts would lend themselves to commercialization. • If there is no known commercialization or promotion to U. residents by those involved in distribution of the product. The current policy [of denial] is not a law or a regulation.S. Donna Shalala. one provision requires that the HHS secretary determine whether adequate safety could be maintained and whether costs could be reduced significantly. That means if you buy your high blood pressure or other medication from a foreign country because it's cheaper—even though a drug with the same name is approved for sale in the United States . Both Thompson and his predecessor. but serves as guidance for FDA personnel. • If the individual seeking to import the drug affirms in writing that it is for the patient's own use and provides the name and address of the U. • If the product is not considered to represent an unreasonable risk.39 Neda’s Cancer Drug Unavailability Though the law was enacted in 2000. concluded that these conditions could not be guaranteed. before the bill can take effect. The importation of certain unapproved prescription medications for personal use may be allowed in some circumstances if all of these factors apply: • If the intended use is for a serious condition for which effective treatment may not be available domestically.-licensed doctor responsible for his or her treatment with the drug or provides evidence that the drug is for continuation of a treatment begun in a foreign country.S.
Medical Industry’s Death Panels —generally the drug will be considered unapproved and the FDA's personal use guidance will not apply. The Drug Enforcement Administration has additional requirements for controlled drugs. $500,000 Fine In August 2011, pressure by bureaucrats in the U.S. Department of Justice caused google.com to pay a huge fine of $500,000 to the government for not succumbing to the political pressure barring Americans access to drugs from online Canadian pharmacies, which included those that were government-licensed, and capable of providing life-saving cancer drugs that U.S. drug companies had created a shortage in the United States. The threat to any U.S. company from the power wielded by U.S. politicians and bureaucrats can quickly silence anyone. Department of Justice personnel claimed that the sale of pharmaceuticals from government-licensed pharmacies in Canada violated the federal Food, Drug, and Cosmetic Act and the Controlled Substances Act. The argument they used was that the importation of prescription drugs from Canada was illegal and that the Food and Drug Administration could not ensure the safety and effectiveness of the drugs from government-licensed sources. Google had blocked ads for many foreign online pharmacies but continued allowing government-licensed Canadian Internet pharmacies to place ads. In 2009, Google blocked pharmaceutical ads from non-government-licensed firms, requiring online pharmacy advertisers to sign up for a certification program run by the National Association of Boards of Pharmacy. This retaliation against vulnerable corporations is not much different than the decades of retaliation against corruption-exposing whistleblowers. The new legislation, Protect Ip Act, would require Internet Service Providers and search engines to block access to all non-U.S. based online pharmacies, and prevent credit card issuers from accepting
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charges made from any pharmacy other than those in the United States. Legislation by bribe-taking members of Congress that makes it a felony to reimport life-saving drugs for Americans which are unavailable in United States because of industry-caused shortages. Protests Based Upon Free Speech Violation Many protests were raised about the legislation's effect upon free speech, and call legislation such as COICA “a dangerous new encroachment of the government into our lives.” It is also another form of censorship. Protests Should Be on People's Suffering and Deaths! Made possible by the above conduct are endless series of premature deaths, as well as enormous pain and suffering by cancer victims. These consequences can only be felt by the victims themselves who can't defend themselves against this outrage, and by the family and friends of those that are needlessly suffering because of this misconduct. Protection Against Drug Counterfeiters Available Without Denying Cancer Patients Life Saving Drugs Bribe-taking U.S. politicians and major pharmaceutical companies spin the truth about what is being done by claiming they only want to keep the American public safe from counterfeit drugs peddled by unlicensed Canadian and international companies. But this protection can be achieved by other means, such as blocking the purchase of, importation of, and internet listing of non-licensed companies. In Canada, for instance—certainly not a third world country— drugs imported for sale in Canada or for subsequent export must be approved by Canada's health department. The Canadian requirements for approval under Canada’s Food and Drugs Act and Regu-
Medical Industry’s Death Panels lations are rigid. These requirements are reportedly equal to or more stringent than that of the U.S. FDA requirements. Each drug is labeled with an Identification Number (DIN) and must be manufactured at a plant that meets the approval of Canada’s GMP Regulatory Requirements. Defend Your Right to Affordable and Life-Saving Medications This writer is investigating these issues. He strongly suggests that people contact their members of Congress, demanding that they conduct an immediate investigation. Any delay results in more people dying needlessly. Please pass any information on to this writer to help his attempt to correct this outrageous situation. If you know someone who has cancer, or has died of cancer, you know the importance of this issue. email@example.com. Sampling of Internet Sites Addressing This Hoax Against the American People Government Censorship Campaign to Block Affordable Access, RxRights.org. “The White House has initiated a Draconian crackdown on online pharmacies that puts the health of a millions of Americans in jeopardy. American consumers’ access to sources of safe and affordable prescription drugs has been endangered before, but never before like this. Last month, Intellectual Property Czar Victoria Espinel, announced the government’s plans to completely shut down online pharmacy sites as an extension of the proposed Combating Online Infringement and Counterfeits Act (COICA).” Obama And Rahm’s Flip-Flop On Drug Importation, IntoxiNation. “When they were members of Congress, President Obama and Chief of Staff Rahm Emanuel strongly backed measures to legalize the importation of cheaper prescription drugs from Canada and other nations. On Tuesday, the Obama administration--siding with the drug industry--thwarted a bid by a
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bipartisan group of Senators to add the provision to the Democratic health care bill when it was clear the amendment threatened to derail the overall legislation, a top Obama priority.” Huffington Post. Pharma Deal Shuts Down Senate Health Care Debate. “The White House, aided by Sen. Tom Carper (D-Del.), is working hard to crush an amendment being pushed by Sen. Byron Dorgan (D-N.D.) to allow for the reimportation of pharmaceutical drugs from Canada, Senate sources tell the Huffington Post. As a result, the Senate health care debate has come to a standstill: Carper has placed a "hold" on Dorgan's amendment and in response, Dorgan tells HuffPost, he'll object to any other amendments being considered before he gets a vote on his.” • Online Pharmacies, the Obama Administration and Public Health, PharmacyChecker.com. “The Obama administration is taking actions to address the illegal sale of counterfeit prescription drugs online. These efforts can benefit patients who could fall victim to rogue online pharmacies, but may also limit access to safe and affordable medication provided by non-U.S. international online pharmacies, many based in Canada. Millions of uninsured and under-insured Americans have purchased prescription drugs through, and relied on, such websites to afford medicine.” • US IP Czar Gets Companies To Cut Off Unlicensed Online Pharmacies, TechDirt. “It's for "unlicensed web pharmacies," and everyone plays up the spam and the fake (potentially dangerous) drugs. Those are a serious problem. But they also lump in the (quite common) grey market pharmacies as well -- which often allow people to get drugs from outside the country at much more affordable rates. Shutting down fake drug sellers is fine. Shutting down the grey market drug
First.com/033361_FDA_conflicts_of_interest.html. U.” • http://www. a group called PhRMA.html. the FDA and the monopoly pharmaceutical industry in the United States won't stand for anything resembling the free market.S. “When it comes to blocking the importation of prescription drugs from Canada.naturalnews.com/019406_business_ethics_big_pharma. a columnist for the New York Daily News. says that the pharmaceutical lobby in the United States. actually commissioned the writing of a fiction novel designed to scare Americans into avoiding prescription drugs from Canada. At a time when drug industry corruption is reaching a pinnacle of public exposure. they sited . The book was supposed to tell a story of terrorists who altered prescription drugs from Canada in order to kill Americans who were buying them over the internet or crossing the border to buy them at lower prices. “NaturalNews.com/019406_business_ethics_big_pha rma. but god forbid should we try to purchase prescription drugs from Canada.naturalnews. And that's what this issue is all about―in America.html#ixzz1rwEJq600. we can purchase dishware made in China. “But of course.” • How pharmaceutical industry scare tactics adversely affects American lives. pharmacies oppose access to Canadian drugs on basis of jobs.” • http://www. clothing made in Mexico.html. “Sometimes truth is stranger than fiction. especially in this case. especially cancer patients: http://www. automobiles made in Japan.naturalnews.” http://www.com/drugs_from_Canada. Lloyd Grove.sellers • is Medical Industry’s Death Panels a bit of a bigger issue.naturalnews. the US Food and Drug Administration (FDA) is actually proposing eliminating one of the few pseudo-effective measures in place that restricts the agency from becoming a full-blown Big Pharma "rubber stamp" consultant. pharmacists are a creative bunch.
meaning that it might be impossible to tell which customers were killed by the drugs vs.html #ixzz1rwFqJ5aa FDA warns of deaths from Canadian pharmacies while ignoring far more deaths due to mistakes or deliberate acts by U. either.S.html “The FDA is getting desperate in the war to monopolize the U. pharmaceutical industry and prevent citizens from purchasing prescription drugs at lower prices from Canada and elsewhere. pharmacies.45 Neda’s Cancer Drug Unavailability safety concerns.html.com/001894_terrorism_the_FDA. FDA commissioner Lester Crawford is now saying that prescription drugs from Canada are a threat to U. but ignored the statistics that show U.com/001893_pharmacies_Walgreens. pharmacies responsible for far more American deaths from terrorists. since most prescription drugs are already toxic (they are now the third leading cause of death in the United States). consumers because terrorists might be attacking us through those prescription drugs. They've now invoked the "terrorism" label in the fight to suppress consumer free choice.S.” • http://www.” • Errors by U.naturalnews.naturalnews. http://www. Then they backed the ridiculous position of the FDA that terrorists were going to attack the United States by somehow lacing prescription drugs from Canada with toxic chemicals. This idea is so ridiculous as to be laughable.S. pharmacies are just as likely to improperly fill prescriptions as Canadian pharmacies. That didn't make any sense.S. .S. • http://www.com/001894_terrorism_the_FDA. Unbelievably. which customers were killed by "terrorist" contaminated drugs.naturalnews.
Montgomery County says it could save $6 million to $10 million a year by giving its employees the choice of filling their prescriptions through certified Canadian pharmacies..Medical Industry’s Death Panels “The point here is that U. borders. “The state of Maryland joins a growing list of cities and states attempting to import prescription drugs from Canada. drug monopoly -.S. “4/21/2008 . http://www.” • Drug racketeers.com/001573_the_FDA_drugs_from_C anada.html.naturalnews. and even though the FDA is fond of pointing out the dangers of pharmacies located outside U. pharmacies are just as dangerous as pharmacies in Canada or the UK or any other developed nation. “Boston has now done the math and realized that buying prescription drugs from Canada -.html. This latest revelation of scientific fraud exposes. it neglects to mention that those exact same dangers exist at pharmacies right here in the United States.” • Maryland joins list of states wanting to obtain drugs from Canada.S.naturalnews.S. More and more U.” • Boston joins list of those wanting to buy drugs from Canada.naturalnews. then paying (bribing) doctors and high-level academics to pretend they were the author of the article is making shockwaves across conventional medicine..The discovery that drug companies have been ghostwriting scientific studies using in-house writers. http://www. There's nothing sacrosanct about the safety of pharmacies just because they happen to be geographically located in the United States.com/drug_racket.com/001500_the_FDA_drugs_from_C anada. cities are doing the same thing: making . http://www.S.html.will save it millions of dollars each year.rather than paying sky-high prices under the U.
And it's working.S. Both sell products .” • Drug advertising in United States.” • Big tobacco and big pharmaceutical companies: similar tactics. U. “The great direct-to-consumer prescription drug advertising con: how patients and doctors alike are easily influenced to demand dangerous drugs. claiming their sole reason for doing so is to "protect the health of American consumers. Canada). pharmaceutical industry. http://www. “The situation is even worse than we feared: not only is the Bush Administration conspiring with pharmaceutical companies to defraud American consumers by banning the importation of lower cost prescription drugs from other countries (notably. President. It's more like protecting their distribution lines in the same way a Miami cocaine dealer protects his: by taking out the competition. http://www.” • Monopoly drug racket in United States. Calling this system a global drug cartel is no longer an exaggeration." Yeah.html.naturalnews. “Have you ever thought about the similarities between pharmaceutical and tobacco companies? They're striking. right.html. pharmaceutical companies are strongly backing this political play by the U.html. but the administration is actually forming trade agreements with other countries that would make it illegal for those countries to import lower cost medications as well! It's all part of the Republican/pharmaceutical drug racket designed to control the world drug market and exploit consumers for every last dollar.S.47 Neda’s Cancer Drug Unavailability deals with Canadian pharmaceutical companies to deliver prescription drugs at prices that undercut the monopoly prices of the U.naturalnews.com/008291_Big_Pharma_Tobacco.naturalnews.com/001345_bad_medicine_drug_racket.com/010315_direct-to-consumer_advertising_drug_ads.S. http://www.
Introduced by Sens.com/news/. Many times taxpayer money funds the initial discovery.aarp. the new bill is cosponsored by leading sena- . GOP Support New Bill to Allow Lower-Cost Drugs From Canada Americans could save billions of dollars by: Patricia Barry | from: AARP Bulletin | March 30. which makes tobacco products that are partly responsible for hundreds of thousands of cases of cancer in the United States each year. which derailed similar legislation in the past.” Canada drug talk: http://www. Industry critics (such as myself) would argue that those numbers are actually much higher. and Big Tobacco. • Actual Cost of Producing Drugs. Once again.html. GOP Support New Bill to Allow Lower-Cost Drugs From Canada. a bipartisan group of senators is attempting to give American consumers and pharmacies the right to import lower-cost prescription drugs from abroad.Medical Industry’s Death Panels that kill people when used as directed.). a bipartisan group of senators is attempting to give American consumers and pharmacies the right to import lower-cost prescription drugs from abroad. with a new focus on safety issues. Americans could save billions of dollars. “Dems.canadadrugtalk. which kill around 100. Olympia Snowe (R-Maine) and Debbie Stabenow (D-Mich.org/health/drugs-supplements/info-03-2011/lowercost-drugs-from-canada. with a new focus on safety issues. which derailed similar legislation in the past. 2011 Once again.000 Americans each year according to the Journal of the American Medical Association.” Dems. These are the facts from industry. The statistics are readily available for pharmaceuticals. Obstructive Legislation Efforts in United States The following reference to importing drugs from Canada appeared in an AARP web article: http://www.
41 through the mail-order pharmacy of the American company Costco.). opening the way for health insurance companies and government programs like Medicare and Medicaid to lower their drug costs. law to seek cheaper prices from Canada. Chuck Grassley (R-Iowa).S. when the general inflation rate fell by 0. Michigan families have been forced to pay outrageous costs or cross into Canada to get reasonably priced prescriptions. .3 percent in 2009." The new bill would permit pharmacies and registered wholesalers to buy drugs from Canada and other selected countries. compared with $48. "The fact that the exact same FDAapproved drugs are a fraction of the price in Ontario defies common sense.) and Sherrod Brown (D-Ohio). it's more important than ever to do whatever we can to keep drugs available and affordable. "For years. AARP announced its support for the bill yesterday." Stabenow said in a statement.20 to $69. is $156. John Kerry (D-Mass. widely used for high cholesterol. The Congressional Budget Office estimated that a similar bill introduced last year would save federal taxpayers more than $19 billion.3 percent.86 from licensed online pharmacies in Canada and some other countries." says AARP Senior Vice President John Rother. AARP's latest Rx Price Watch report found American retail prices for the most widely used brand-name drugs jumped by 8. for example. the price for a 30-day supply of Lipitor 20 mg." Over the past decade millions of Americans have ignored U. "With drug prices continuing to substantially outpace inflation. "That includes making sure that Americans are not paying much higher prices than the rest of the world. including John McCain (R-Ariz. Currently.49 Neda’s Cancer Drug Unavailability tors on both sides of the aisle. according to a price-comparison website. most often by mail order.
The new bill proposes more ways to ensure the safety of imported drugs. experts say. during the presidencies of Bill Clinton and George W. But they never went into effect because the health secretaries in those administrations declined to guarantee the safety of imported drugs as each law required. as some have done in recent years by cutting off supplies to Canadian pharmacies that sold lower-cost drugs to Americans. They include allowing imports only from FDA-inspected manufacturing plants in specific industrialized countries that have tough safety standards. Bush. was attached as an amendment to health care reform legislation. requiring tamperproof packaging. Even if this legislation passes the Senate. but failed to garner the 60 votes needed to overcome a filibuster. Legislation to legalize drug importation has been signed into law twice previously. its fate would be uncertain in the House. [Standard payment of bribes to members of Congress still does not result in public outrage!] Senators Voting on Allowing Reimportation of Cancer Treating and Other Pharmaceuticals Legislation had been proposed to circumvent the government rules against reimporting drugs made in the U. The bill also includes measures to prevent pharmaceutical companies from impeding importation.S.D. introduced by then-Senator Byron Dorgan (D-N. Previous drug importation bills have fallen to parliamentary procedures or political maneuvering. A bill very similar to the current one.Medical Industry’s Death Panels Medications at half the cost This means that consumers could not only legally import drugs for their own use but also buy them from their local pharmacies at prices estimated by the bill's sponsors to be 35 to 55 percent lower than they are now. and shipped to Canada .) in 2009. and enforcing rules to verify the "chain of custody" — all the stages a drug goes through between manufacturer and consumer.
That would have made available life-saving cancer drugs and others that are now unavailable. Senate Roll Call Votes 109th Congress – 2nd Session. The article stated in part: Behind Google’s $500 Million Settlement with U.S. These advertisements saved Americans huge amount of money by buying identical overpriced medications sold in the United States.51 Neda’s Cancer Drug Unavailability (and elsewhere) to be reimported into the United States. Department of Justice for having allowed Canadian pharmacies (most of whom were government licensed) to place advertisements appearing in Google search engines.com shows the senators that sided with power money interests against the American people.000 DOJ Fine for Helping Cancer Victims Get Life-Saving Medication. and especially against cancer victims: Statement of Purpose: To prohibit the United States Customs and Border Protection from preventing an individual not in the business of importing a prescription drug from importing an FDA-approved prescription drug. The following excerpts from www.canadadrugtalk. companies to Canada at prices much lower than Americans had to pay. According to the Vote Summary of U.000 paid by Google to settle the charges made by employees of the U. those who voted for the amendment outnumbered those who opposed it by over two to one.S. 2011) in Dealbook by Peter J. . and Others An article (August 30.S.S. Vote Counts: YEAs: NAYs: 32 68 $500. in many cases simply reimporting drugs shipped from U. Henning addressed the $500.
Instead. but Google was not involved in any way in their actual transfer into the United States.S. That law prohibits causing the “introduction or delivery for introduction into interstate commerce of any food. In some cases.Medical Industry’s Death Panels The Justice Department’s settlement of a criminal investigation of Google for allowing Canadian pharmacies to advertise drugs for distribution in the United States reflected an effort by prosecutors to extend the reach of federal drug laws. drug. or cosmetic that is adulterated or misbranded. representing both its advertising revenue from the Canadian pharmacies and the revenue the pharmacies received from American customers buying controlled drugs. 21 U. The statute prohibits the “introduction or delivery” of the drugs.” Google agreed to forfeit $500 million. tobacco product. The Canadian prescriptions sold to American customers were considered “misbranded” under the statute because they were not approved by the Food and Drug Administration. Google entered into a nonprosecution agreement with the government last week over the use of its AdWords program by Canadian pharmacies that helped them sell prescription drugs in the United States in violation of a federal law. § 331(a). The company also agreed to enhance its compliance program for drug advertising.C. the drugs were obtained from countries other than Canada that lacked adequate regulation of pharmacies. Can a search engine be held responsible for how consumers use the products or services allowed to be advertised on it? That question . which is the usual means of proving a violation of the statute. This may present future challenges to Internet search companies over their advertisements. the Justice Department viewed Google as an accomplice to the crime by enhancing the ability of the Canadian pharmacies to reach American consumers. device.
the law further requires that the accomplice be aware of the user’s intention to commit a crime and intend to give some assistance or encouragement in its completion. which can include counseling or encouraging the offense. the Justice Department’s nonprosecution agreement with Google involved an assertion that the company aided a criminal violation — i. the prosecution must show the defendant provided some assistance in the commission of the crime. Google was not involved in the actual movement of the prescriptions. With that ability comes the growing possibility that the Justice Department will view search engines as . that it was an active participant in a crime. To prove accomplice liability.. not a criminal fine or civil monetary penalty. Unlike a private lawsuit alleging negligence.e. Even if one does furnish some measure of assistance. Google’s $500 million payment was labeled as a forfeiture of the revenue that both the company and the Canadian pharmacies received. it did not experience any additional monetary punishment for its conduct.53 Neda’s Cancer Drug Unavailability goes to a core issue in the criminal law regarding the responsibility of suppliers for the use of products they sell. but the government viewed its role as sufficiently important to the success of the Canadian pharmacy sales that it was similar to someone who actually supplied or shipped misbranded drugs. While Google paid out that money. There is a fine line between supplying goods that are later used for the commission of a crime and actually assisting in its completion. The Internet allows messages to be better focused on particular groups of potential customers.
com) The June 24. Henning.S. While importing Canadian medications is against U. director of the group's practice development division. paclitaxel joined 196 other drugs on a shortage list compiled by the American Society of HealthSystem Pharmacists in Bethesda." said Cynthia Reilly. policy. demonstrates once again how vulnerable U. is a professor at Wayne State University Law School. a chemotherapy workhorse for ovarian.S. leaving patients at risk. warning that these sales pose serious safety problems. the FDA has said that it will not prosecute individuals who import small amounts (three months or less) for personal use. Peter J. and colon cancers. 2011 article stated: A shortage of paclitaxel (Taxol). . Last month. Md. The U. lung. breast. the lengthy list underscores that the country is in the midst of a "public health crisis of drugs overall.Medical Industry’s Death Panels more than mere passive conduits of information. Food and Drug Administration (FDA) opposes foreign drug purchases. and instead as potentially active participants in conduct that may violate the law." Drug Shortages Leave Cancer Patients at Risk (www.Medpagetoday. Although no one has been able to quantify the number of lives jeopardized by the shortages. who writes White Collar Watch for DealBook. hospitals and clinics are to an increasingly unreliable pharmaceutical supply chain. Miscellaneous Related Articles John Hopkins Medicine Health Letter states of drugs imported from Canada: "One way to purchase medications at a reduced cost is to buy them online or by phone from Canadian pharmacies.S.
medpagetoday.) Cancer drug shortage articles: http://www. Cytarabine is a key ingredient in the drug cocktails given to such children. Maugh II. chief mission officer of the Leukemia & Lymphoma Society. with some hospitals rationing supplies of the drug and others turning away new patients. told Bloomberg News. carboplatin. A shortage of the chemotherapy drug cytarabine is threatening the treatment of acute myeloid leukemia (AML) in children around the country. Los Angeles Times. More than 400 generic drugs were back-ordered for more than five days. which was released in a press call with reporters on Monday. ciprofloxacin and gentamicin. there were more than 240 drugs either in short supply or not available at all. (Remainder of article at http://www. according to the report. according to a new report from Premier Healthcare Alliance." Louis J.com/ProductAlert/Prescriptions/ 25585. In 2010.” Children Threatened HEALTH WORLD April 15.medpagetoday. as well as the quick-acting anesthetic propofol. vincristine and cytarabine. daunorubicin. “WASHINGTON―The number of prescription drugs in short supply has more than tripled since 2005 and shortages are now more frequent than ever. Additions in the last month include such chemotherapy mainstays as doxorubicin. DeGennaro. "Without it. with a June 16 update. "There's really no substitute for cytarabine in those chemotherapy regi- .com/HematologyOncology/Chemotherapy/27249. most patients die. 2011|By Thomas H. the injectable painkiller Fentanyl injectable forms of several powerful antibiotics: clindamycin.55 Neda’s Cancer Drug Unavailability Paclitaxel made the list May 13.
breast and ovarian cancers. has been added to a list of 196 other major drugs considered to be in short supply.Medical Industry’s Death Panels mens. said that the shortage in leukemia medication has put him and his staff at risk of making some difficult choices. Dr. Public Health Crisis Charged Chemotherapy Drug Shortage Puts Patients at Risk July 5.” The lack of available medications has become a nationwide problem. lung. antibiotics.” The shortage also extends to many generic drugs. Cynthia Reilly. pain medications and chemotherapy drugs for leukemia. but it is apparently not as critical in such drug regimens and it is primarily adults that are being denied access to the drug now. “There are cancer patients who will die because of this (shortage). 2011 A report from the American Society of Health-System Pharmacists (ASHSP) shows a growing number of vital chemotherapy drugs are in short supply. The drugs on the shortage list include anesthetics. but the shortages have disproportionately affected smaller fa- ." The drug is also used in the treatment of adults with acute lymphocytic leukemia. “We’re hoping to get more so we don’t face that awful crisis.” Reilly said. a drug used extensively in patients with colon. are also in short supply and do not have effective substitutes. The shortage has forced some hospitals and cancer centers to select which patients have greater need for their life-saving medication. called the shortages a “public health crisis”. which offer a cost-effective alternative for patients over the brand-name prescriptions. Other practices have. “This could change their survival. a pediatric oncologist at Stanford University’s Lucile Packard Children’s Hospital. Some chemotherapy drugs. such as cytarabine and daunorubicin for leukemia. Michael Link. director of the ASHSP’s practice development division. Paclitaxel (brand name: Taxol).
The Cancer Therapy and Research Center at the University of Texas Health Sciences Center in nearby San Antonio reported “rationing the use of” paclitaxel. Ochsner’s chairman of oncology. Bedford Laboratories of Bedford. He noted that larger facilities and hospitals that have access to multiple suppliers tend to have less of an issue with shortages. one of the largest cancer treatment facilities in the country. The Beaumont Hospital in suburban Detroit is currently paying more than three times its normal rate for paclitaxel. Dr. announced that they had numerous backorders for the drug. but smaller treatment centers and oncology practices “tend to operate more on an order-asneeded basis. Link.57 Neda’s Cancer Drug Unavailability cilities. several patients have had to drive to other states to get the medication they need.” Even the bigger hospitals are not immune to these shortages. A spokesman announced that the company hopes to have a supply of the drug ready for market by 1 July. Some hospitals are taking emergency measures to insure that they have an adequate supply of paclitaxel on hand. The MD Anderson Cancer Center in Houston. Texas. said that he had never seen shortages this severe in his 25-year career in cancer treatment. Jay Brooks. . At the Ochsner Clinic Foundation and Hospital in New Orleans. According to Dr. doctors work together to move available drugs from one physician’s patient to another’s in greater need. reported that their stockpiles of at least four different chemotherapy drugs are at severely depleted levels. One paclitaxel supplier. A spokesperson with the US Food and Drug Administration (FDA) said that some of the makers of generic-label paclitaxel have some of the drug on hand and that the shortage was “not a complete national outage”. with another twenty also in short supply. Ohio.
lung and colon cancers." said Dr. director of the group's practice development division. This has been going on for some time now. a Stanford University pediatric oncologist who serves as president of the American Society of Clinical Oncology. He called the paclitaxel crunch "another add-on. Although no one has been able to quantify the number of lives jeopardized by the shortages.go. Link.Medical Industry’s Death Panels Sources: http://abcnews. joins 196 other drugs on a shortage list compiled by the American Society of HealthSystem Pharmacists in Bethesda. hospitals and clinics are to an increasingly unreliable pharmaceutical supply chain. By JANE E. "we've been having a crescendoing of drugs that are in short supply. 2011. Paclitaxel. leaving patients at risk. breast. Michael P.com/Health/CancerPreventionAndTreatment/che mo-drug-taxol-shortage-leaves-doctors-scrambling-cancer/story? id=13906891.S. regimens that use paclitaxel often lack equally effec- . ABC News Medical Unit June 23." Although some drug shortages can be eased with simple substitutions. the generic version of Taxol. ALLEN @JaneEAllenABC) ." said Cynthia Reilly. For more than a year. “A shortage of Taxol. an intravenous chemotherapy workhorse for ovarian. demonstrates once again how vulnerable U. Md. the lengthy list underscores that the country is in the midst of a "public health crisis of drugs overall.
This could change their survival.com/b/2011/06/23/taxol-shortage-may-affect-ovarian-and-breast-cancer-patients. the original sellers of Taxol. seniors still struggle to afford the drugs they need. like to make the point that our nation’s seniors no longer need access to lower cost foreign medication because they now have new and improved Medicare drug plans. but all of the chemotherapy shortages significant." • http://cancer. “For some clinics across the nation.medpagetoday. The logic behind this theory is.about. Doctors and patients are experiencing a shortage of the chemotherapy drug used to treat ovarian and breast cancer in women.” Scandals at Bristol-Myers Squibb Pharmaceutical Company. While no official cause of the shortage has been released. why produce a large amount of a drug when profits are low?” • http://www.htm.' Put simply. More information on what politicians are doing to harm ill Americans as they pander to bribe-giving special interests. the data indicates that even with the improvements and savings offered by Part D of Medicare (Medicare’s drug benefit).com/HematologyOncology/Chemotherapy/27249. . and their political allies.59 Neda’s Cancer Drug Unavailability tive substitutes.rxrights. www. Taxol is a generic drug. “Some pharmaceutical industry folks. "That's what makes not just this. which equals a low profit margin. many doctors and patients are placing the blame of corporate economics. But a new report by IMS indicates that drug costs are having a negative effect on public health." Reilly said. the supply of Taxol is running low. including for our seniors.org. Accounting scandal in 2002. "There's cancer patients who will die because of this.
2004A 2003 FTC consent order involving Bristol Myers Squibb stated that the company: “Engaged in a series of anticompetitive acts over the past decade to obstruct the entry of low-price generic competition for three of Bristol's widely-used pharmaceutical products: two anti-cancer drugs. Bristol avoided competition by abusing federal regulations to block generic entry. in July 2006.” Several State Attorneys General Sued to recover monetary damages. were indicted for federal securities violations. But in early 2011.S. the former head of the Pharma group. was placed under a monitor oversight appointed by the U. FBI agents. Glenda’s Cancer Drug Shortage Glenda's cancer tests showed the cancer in remission while taking the cancer drug Taxol. . Richard Lane. Attorney General settlement with Bristol Myers Squibb over conduct delaying generic for Taxol being available. and the anti-anxiety agent BuSpar. deceived the U. like many other low-cost. Patent and Trademark Office (PTO) to obtain unwarranted patent protection. paid a would-be generic rival over $70 million not to bring any competing products to market.Medical Industry’s Death Panels Scheme involving two anti-cancer drugs. all executives involved in the "channelstuffing" and generic competition scandals have since left the company. Attorney in New Jersey. The company. that lowprofit generic cancer drug was unavailable in the United States. raided the company's corporate offices following an investigation into collusion surrounding the distribution of Plavix.S. by infusion. former CFO. and filed baseless patent infringement lawsuits to deter entry by generics. as part of a Deferred Prosecution Agreement. Taxol and Platinol. Eventually. low-profit cancer drugs. and Fred Schiff.
. On June 24. the oncologist could no longer get Taxol and had to substitute another cancer drug.61 Neda’s Cancer Drug Unavailability Obstacle to Cancer Remission Status: America's Drug Shortage The cancer drug Taxol appeared to be keeping the cancer under control. Taxotere. But then. That caused Glenda to suffer more side effects. 2011. a PET scan showed the cancer had spread to her lungs.
They adopted Glenda.CHAPTER EIGHT Nearing the End of a Four Year Cancer Battle Glenda's Adopted Family Living near Glenda and I were my daughter. Glenda’s Long Standing COPD For many years Glenda had pulmonary problems which required occasional hospital visits. A COPD exacerbation can easily be caused by the need to change medication. and pulmonary rehabilitation sessions. allergy. Stephanie. fungicides. infection. attended by over a dozen members of the clan. or won’t take the time to understand the patient’s problems. Jerry. can easily bring about a preventable breathing crisis. change in type of bronchodilators. or one without a strong feeling to help a COPD patient. . and contributed greatly to Glenda's quality of life. failure to follow instructions. treated her like a queen. Lack of competency by a physician. or need for a more qualified pulmonary specialist. They hosted almost monthly family events. Many doctors don’t stay up on the latest treatment. and her husband. Among the treatments for pulmonary exacerbations are antimicrobials for possible infection. improper use of an inhaler.
In late 2010. Glenda had developed a fungus infection of the lungs that impaired her breathing. requiring use of oxygen during exertion and it appeared to be coming back. and Flovent play a key role in improving acute COPD breathing problems. such as Prednisone. cancer-in-remission and breathing easily. Glenda and Rodney sitting with the “clan.” . Solumedrol.63 Hosp Corticosteroids. That fungus infection appeared to be also occurring with other residents in the San Francisco area.
Medical Industry’s Death Panels Stephanie-Rodney-Glenda Round Hill Country Club. Alamo. CA 12-9-11 .
But she was able to attend a Christmas party and a New Year's eve party hosted by my daughter. Glenda started having to use oxygen more frequently. she would easily go for 25 minutes at about 2. With the help of oxygen. I was lucky to go five minutes at 2. 2011 In November 2011.2 miles-perhour speed.65 Hosp Glenda at home on December 23.7 mph! . Glenda looked forward to warm weather and taking short trips. Despite the need for using oxygen. Glenda regularly exercised on the treadmill. including a sea cruise to Alaska. Jerry Stadtler. Stephanie and her husband.
the indifference. 2011 On January 5." or plain arrogance and misconduct. The events. described in part here. met the definition of a double "Greek tragedy. and corrupt conniving conduct.Medical Industry’s Death Panels Christmas Party at the Stadtler’s. California." Glenda was about to suffer the painful consequences of cavalier physicians’ attitudes. . 2012. one of Glenda's shortness of breath episodes caused me to admit Glenda into John Muir hospital in Walnut Creek. A series of improper acts by physicians changed Glenda from a smiling and active person into one racked with pain and then a premature death. This is another tentacle to the thousands of needless suffering and deaths every year from hospital and physician "errors. December 25.
67 Hosp Glenda was nearing the end of the fourth year since the early 2008 diagnosis of Stage IV esophagus cancer. . She was well on the way to having either experienced a cure. or repeated remissions from a deadly form of cancer.
Glenda experienced shortness of breath. Patty and Stephanie. were visiting Glenda at John Muir hospital on January 12. Hospital physicians reported that Glenda had fluid on her lungs and a possible fungus infection—which she previously had a year or two earlier. . While my daughters. Nurse's Concern about Glenda's Untreated Pressure Wound on Glenda’s Back While in the hospital. causing me to rush her to John Muir hospital in Walnut Creek." That was a correctable problem. one of the nurses expressed concern about the wound on Glenda's back that wasn't being given adequate treatment. hospital report stated in part: "Moderate bilateral pleural effusions are noted. 2012. the January 5.CHAPTER NINE Hospital Admission For Treatable Breathing Problem On January 5. 2012. Glenda developed a pressure wound on her back that was causing her increasing pain. Addressing the reason for Glenda's shortness of breath.
enzymatic. Determining the size and depth of the ulcer. and the cause of much of Glenda’s pain. Pressure Wound is a Serious Medical Problem A pressure wound is a serious medical problem. • • • • . In Glenda’s case. it is standard to have the patient kept in bed lying on the patient’s side. Treatment by a physician dealing in wound care. mechanical. Since the pressure wound was on Glenda’s back. This seemingly minor oversight would have deadly consequences. or autolytic debridement of dead tissue. Surgical. keeping the wound from healing. Tissue cultures to check for cancerous tissue needing surgery. worsening the problem. The most basic of such treatment is to keep pressure off the wound by lying on the side rather than the back.mayoclinic. a wound specialist. something not done for a routine and relatively minor problem. and also putting a protective boot over the area.com/health/bedsores/DS00570): • Tests. Pressure wounds and their treatments are described at a Mayo Clinic site: (http://www. such as tissue cultures to diagnose a bacterial or fungal infection.69 Hospital Admission for Treatable Breathing Problem They later told me that the nurse showed a serious concern about the wound on Glenda’s back and then took a picture of the wound. Subsequent doctor visits did not even look at Glenda’s back. she was constantly kept lying on her back. requiring the care of a wound specialist and special treatment.
They ordered that this treatment be given to Glenda at a skilled nursing facility (SNF) and selected Manor Care Rossmoor Parkway in Walnut Creek. John Muir hospital physicians determined that Glenda’s shortness of breath could be improved with pulmonary rehabilitation treatment. Topical rather than systemic pain medication would be indicated. Avoidance of hospital bed positions that result in a shearing effect as the patient slides and irritates the bed ulcer. • None of these actions were taken. . California. Special cushions to take the weight off of the ulcer area.• • • Medical Industry’s Death Panels Constant repositioning in bed. Pain management that does not adversely affect pulmonary efficiency. This means avoidance of morphine sulfate or other morphine containing drugs that were used around the clock on Glenda.
That final report indicated Glenda was doing well. The following is a relevant section of that final January . CA For Shortness of Breath Treatment. 2012.71 Hospital Admission for Treatable Breathing Problem Glenda at John Muir Hospital. Walnut Creek. John Muir hospital physicians prepared a final report before transferring Glenda to Manor Care SNF for pulmonary rehabilitation. On January 13.
Asymptomatic on 2 L of oxygen. Clinically. For Medicare to pay for medical care in a skilled nursing facility certain conditions must be met: • The patient must have spent at least three days in the hospital as an in-patient and not under observation. She then had a totally different outlook on life. Vital signs have been relatively stable with 02 saturations 97% to 100% on 2 L per nasal cannula. Patient should check with the hospital physician to confirm that the hospital . Different SNFs have specific units addressing certain medical conditions. the date the patient is to be discharged to a skilled nursing facility. She wanted treatment and she wanted to live! Skilling Nursing Facility A skilled nursing facility is a medical facility that provides specific medical care for certain medical conditions. She looks comfortable without any shortness of breath or tachypnea. Walnut Creek) unless she accepted pulmonary improvement treatment rather than palliative treatment. George Slater's interim summary dictated on 01/12 for details. she is doing relatively well. Briefly.] The increasing pain from the inadequately treated back wound caused Glenda to just give up. 2012 report by John Muir hospital physicians showing Glenda's breathing problems to be under control and not at a critical stage: Please refer to Dr.Medical Industry’s Death Panels 13. [emphasis added. the patient was admitted to the hospital with shortness of breath. I explained to Glenda that she could not be transferred to the Manor Care SNF (Rossmoor Parkway. She wanted to be transferred to nearby Manor Care Rossmoor Parkway skilled nursing facility and just give up on treatment. I assumed care from Dr. George Slater on 01/13.
It is therefore extremely important.73 Hospital Admission for Treatable Breathing Problem stay is not in the hospital only for observation. Jan 11. that anyone going to a SNF goes to one that has the . A doctor must sign an order admitting the patient to a skilled nursing facility. • The hospital must state that the patient needs skilled medical care for a particular medical condition. • The patient must go to a Medicare-certified skilled nursing facility. John Muir Hospital Different Specialties at Skilled Nursing Facilities (SNF) Different skilled nursing facilities focus on different types of rehabilitation. 2012. Glenda. with life-affecting consequences.
Stengel explained that without such necessary facilities Glenda could not be expected to show improvement and Medicare would not pay for their services. . to inquire whether the facility would take Glenda. Prior to Glenda's Transfer to Manor Care. Stengel again stated that Manor Care did not have any COPD treatment or pulmonary physicians and therefore would not accept Glenda.nhlbi. When I heard this. But only one had a pulmonary rehabilitation unit. Admitting to Absence Of Pulmonary Rehabilitation Unit And Refusal to Accept Glenda Several days earlier. http://www. arrived at Manor Care on the afternoon of January 12.nih. Stengel stated that Manor Care did not have a pulmonary rehabilitation unit and would not accept Glenda. my daughters Stephanie Stadtler and Patty Milam." Site referring to the pulmonary rehabilitation program that Manor Care did not have. By transferring Glenda to a skilled nursing facility (SNF) that did not have the treatment they were ordering would set in motion a series of medical frauds and quickly result in a double "Greek tragedy. Admissions Director Laura Stengel stated Glenda would not be admitted. 2012. 2012. Kindred skilled nursing facility. John Muir hospital personnel should have known that Manor Care did not have such a program. That occurred on January 13.gov/health/health-topics/topics/pulreh/. In the Walnut Creek area. but available at Kindred Rehabilitation facility (SNF). my daughter Stephanie and I returned to Manor Care and discussed Glenda's admission with Laura Stengel to confirm that Manor Care would accept the transfer of Glenda from John Muir hospital.Medical Industry’s Death Panels personnel and equipment to rehabilitate their particular medical problem. there were two major skilled nursing facilities: Manor Care Rossmoor Parkway and Manor Care Walnut Creek and a medical care competitor.
That deception would shortly prove tragic for Glenda.75 Hospital Admission for Treatable Breathing Problem Kindred SNF Stephanie and I then went to another skilled nursing facility nearby. I gave the approval for Glenda to be admitted. Manor Care accepted Glenda for COPD treatment despite the fact they had no facilities or pulmonary specialist to address COPD problems. it was discovered that John Muir hospital had already made arrangement for Glenda's transfer to Manor Care. and showed a room that Glenda could be transferred to immediately. . Upon doing so. Kindred SNF. Kindred personnel then called the case worker at John Muir hospital to arrange for Glenda's transfer. The admission personnel bragged about their special pulmonary rehabilitation unit and pulmonary physician.
but felt good that she would receive treatment for her COPD and the wound. Manor Care personnel notified Glenda that she would have to leave and that she . Medicare would soon question her presence at Manor Care for pulmonary rehabilitation. which required improvement for continued payment. That risk of being exposed was quickly addressed by Manor Care personnel. which would increase the risk of being sanctioned by Medicare. Glenda was still suffering pain from the raw wound on her back. Glenda would of course not be showing any improvement. By accepting Glenda for pulmonary rehabilitation treatment. possibly for fraud. Glenda arrived at Manor Care. 2012. She was delighted. Within 24 hours of receiving Glenda. She didn't know that Manor Care did not have a pulmonary rehabilitation facility or pulmonary doctor.CHAPTER TEN Glenda’s Arrival at SNF Lacking the Treatment Ordered for Glenda’s COPD Breathing Problem On January 14. Manor Care risked being cited by Medicare and California regulators. when in fact Manor Care does not even offer this form of rehabilitation. had a smile on her face. when Manor Care had no such program or pulmonary specialist. and now wanted to live.
was a lie to cover up for the decision to accept her when John Muir hospital incorrectly transferred her to Manor Care. That meant abandoning the pulmonary rehabilitation that American- . That statement. Glenda Jan 15. holding a teddy bear made for her by grandchildren of her adopted family.77 Glenda’s Arrival at SNF Lacking COPD Unit was not capable of having her breathing problems improved upon. Smita Chandra. and no time to start pulmonary rehabilitation (which they didn't have). Dr. came into the room while I was visiting Glenda. and started talking palliative care. of course. Chandra told Glenda that she would be discharged. With no time to have assessed Glenda's medical condition. 2012 Manor Care. Manor Care's Immediate Decision to Discharge Glenda Glenda was at Manor Care less than 24 hours when a physician. not competent in pulmonary conditions. Looking and Feeling Good —wanting to live.
she was being thrown out of the facility that she set her heart on. Glenda's spirits plummeted. Dr. She said that Glenda must go . The probable reason was that Manor Care had engaged in fraud when they admitted Glenda for treatment that they were not qualified to give. After four years of cancer and COPD treatment. Chandra became argumentative while Glenda appeared ready to cry. and now had to engage in a cover-up. not palliative care. I stated that this may be the practice in India.Medical Industry’s Death Panels trained doctors at John Muir hospital had ordered for Glenda. Chandra. Smita Chandra during my first discussion that there is no pulmonary doctor on the staff or one that comes to Manor Care. including information about the treatment Manor Care doctors were providing to Glenda. Dr. which had already been admitted several times by Manor Care admissions director Laura Stengel. I faxed my objections to Manor Care (January 16. Glenda was grief stricken. I resented the doctor causing a confrontation in front of a very frail patient. Pertinent parts of that fax stated: I was told by Dr. I stated that John Muir Hospital doctors would not have sent her to Manor Care for rehabilitation if they did not think her condition was suitable for it. 2012) about the immediate dismissal plans before Glenda had any pulmonary rehabilitation. This surprised me. and now looking for relief. I was outraged at this blunt talk to a frail lady within 24 hours of her arrival! I protested. trained in India. As with every other communication request. stated that Manor Care had no pulmonary rehabilitation facilities. I protested that Glenda was looking for treatment. stating that Glenda had been sent by John Muir Hospital doctors for pulmonary improvement treatment and that Manor Care had accepted her on that basis. but totally unacceptable here in the United States. none were ever answered.
S. The conduct was certainly out of character for your fine institution. Assuming Chandra was from India. stating she was here for rehabilitation care to improve her serious breathing problems. which is the worst I have ever encountered. Glenda is in my estimation in no condition to do so. Chandra was emphasizing discharging her into palliative care at home. Unless you have some suggestion. in front of the frail patient. In front of the patient who had just been admitted two days earlier from John Muir Hospital. I stated to her that her type of confrontational attitude in front of . Chandra then. etc. or my many years as caregiver. and despite the fact that I am responsible for arranging for Glenda’s care. which she felt would be a death decree. and first check with her primary care physician. he refuses to respond. Dr. the culture in their country. I will have to try to find a pulmonary doctor that will come to Manor Care. Vona Lorenzana. Ramin Khashayar. Despite several faxes requesting the medication that Glenda is taking. (Her regular pulmonary doctor is an Iranian. accused me of being confrontational. Smita Chandra. On Sunday morning. Dr. I found Dr. either during my years in the medical field. I made the following memorandum of that problem: As caregiver for a very frail lady suffering breathing problems from an apparent lung infection on her COPD status. I had a response from your staff doctor. The patient was then in emotional distress fearing she would be discharged from the rehabilitation facility. I objected. Smita Chandra arrogant during a visit at the Manor Care facility (Rossmoor Parkway).79 Glenda’s Arrival at SNF Lacking COPD Unit to her pulmonary doctor as a regular patient. the treatment options.) Possibly these foreign doctors are bringing to the U. nor should she be put through that stress.
Manor Care management and physicians: • Fraudulently. 2012. with Glenda paying the tragic consequences.Medical Industry’s Death Panels a frail patient may be the norm in India. Manor Care. Glenda January 15. I found everyone else I came in contact with at Manor Care to be very considerate (referring to the working personnel). with the Stich Clan Manor Care Management and Physicians Engaging in Life-or-Death Fraud upon Glenda Manor Care personnel had engaged in fraud. accepting Glenda for . and now were trying to extricate themselves from the consequences. accepted the referral by John Muir hospital personnel. and with deadly consequences. but it was not tolerated here in the United States.
was Dr. Martin Jimenez. the total denial of pulmonary rehabilitation was combined with heavy dosing of drugs that worsened her pulmonary breathing problems. Dosing Glenda with Round-the-Clock Drugs That Decreased Pulmonary Function From Glenda's arrival at Manor Care. Rather than bringing in a wound specialist to treat the wound. Lacked a pulmonary specialist. And then. That dangerous medical practice was . besides supervisory physician Dr. and then upon Glenda's arrival. Glenda was given round-the-clock drugs that were either contraindicated for people with breathing problems.81 Glenda’s Arrival at SNF Lacking COPD Unit pulmonary improvement when they knew they did not have the facilities. knowing their conduct would create great stress and possibly death. which worsened her breathing. within 24 hours. Smita Chandra. And even more abuse on this great lady was to come! Manor Care Ignoring Glenda’s Worsening Pressure Wound The pressure wound that developed at John Muir hospital became progressively worse at Manor Care. moved to discharge her. or change any of her medications that would be normal actions by a competent pulmonary specialist. • • • Lacked a pulmonary rehabilitation program. took action to discharge the frail and under stress woman that had already been subjected to other forms of stress. round-the-clock morphine-related pain killers. Manor Care physicians dosed Glenda with. or had side effects worsening such problems. Among the doctors ordering such drugs. Did not provide pulmonary breathing exercise sessions.
confusion) … slow/fast heartbeat. … mood changes (such as agitation. face. chronic . .Medical Industry’s Death Panels due to gross lack of medical competency or arrogant disregard for the consequences Glenda would suffer. Anxiety." Duramorph (morphine injection) is a systemic narcotic analgesic for administration by the intravenous. The warnings associated with that drug state: “Emergency type of side effects” (each of which Glenda experienced.com. lips. swelling (especially of the face/tongue/throat) … trouble breathing. slow heartbeat At www. or tongue... as reported in Manor Care records): • • • • • • • Swelling in mouth. Shallow breathing. Heavy Morphine-Related Dosing by Physicians One such drug was Norco (hydrocodone-Acetaminophen). Airway constriction (bronchospasm) and wheezing. It causes serious side effects: slow/shallow breathing. This medicine should not be used in … lung diseases (such as asthma. The following is a partial list of such drugs. Loss of appetite.ehealthme. The study is created by eHealthMe based on 33 reports from FDA and user community. Causing serious breathing problems. epidural or intrathecal routes.. hallucinations. the following warning is stated: "This is a post-marketing study of COPD (Chronic obstructive pulmonary disease) among people who take Norco.. . Dry mouth.
If the dosage of morphine is too high for what the patient is accustomed to. very inefficient breathing. i. A sampling of the warnings stated in that article: “One of morphine's main adverse effects is slowing down the respiratory rate. • http://www. the respiratory depression can become severe and actually stop the breathing periodically for a few seconds or many seconds. Because COPD patients have compromised breathing already.83 Glenda’s Arrival at SNF Lacking COPD Unit obstructive pulmonary disease-COPD). .. If the breathing is stopped completely without restarting. Morphine's Adverse Effect on COPD One of morphine's main adverse effects is slowing down the respiratory rate. i. respiratory depression.. This pattern of breathing where the patient stops breathing (skipping breaths) and then starts breathing again is termed "apnea. when certain metabolic changes occur in the patient's body." Apnea commonly occurs as a result of the terminal illness and the dying process.hospicepatients. the patient dies...e.. very inefficient breathing..html: . breathing problems (such as slow/shallow breathing.. Because COPD patients have compromised breathing already. If the dosage of morphine is too high for what the patient is accustomed to. overly high doses of morphine can quickly cause these patients to stop breathing.” At http://seniors. .kaiserpapers.html.org/no-prn-morphinecopd..org/hos.e. the respiratory depression can become severe and actually stop the breathing periodically for a few seconds or many seconds. sleep apnea) . respiratory depression. overly high doses of morphine can quickly cause these patients to stop breathing.
That treatment kept the pain under control. Because COPD patients have compromised breathing already.. also known as Ativan.. To use morphine for treatment for shortness of breath is LETHAL. Glenda was under the care of a wound specialist in the Wound Center of Walnut Creek. . It also sedates the patient and creates noisy breathing as the tongue relaxes back in the throat. Prior to Glenda's entry into Manor Care. was given to Glenda round the clock. If the breathing is stopped completely without restarting. Lorazepam." Apnea commonly occurs as a result of the terminal illness and the dying process. A typical Ativan warning is the following: Ativan injection is contraindicated in patients with severe respiratory insufficiency. Morphine for Pain Relief from Back Wound Instead of Treatment! The morphine was primarily for the pain arising from the open wound on Glenda's back that should have been under the attention of doctors specializing in wound care. That was the exact opposite to what Glenda needed. when certain metabolic changes occur in the patient's body." • • This pattern of breathing where the patient stops breathing (skipping breaths) and then starts breathing again is termed "apnea. the patient dies.• Medical Industry’s Death Panels "Morphine suppresses the patient's drive to breath and creates the appearance of inadequate breathing. very inefficient breathing. overly high doses of morphine can quickly cause these patients to stop breathing. That drug is known to reduce pulmonary function. and more so in elderly people. .
A long-time movie producer friend of mine. heard about my problems with Khashayar and contacted the executive offices at John Muir hospital. Martin Jimenez. if he had responded and acted responsibly. Also. Hospital personnel apparently contacted Khashayar. I sent a complaint to the California medical board on January 18. he should have arranged for Glenda’s transfer to a skilled nursing facility where such medical care was available. Norco 10-325 MG tablet (and morphine). concerning Khashyar’s refusal to respond to Glenda’s breathing problems. Ramin Khashayar. the harm inflicted upon Glenda by Manor Care physicians. treated me with contempt despite the fact that I was the person responsible for Glenda's medical treatment. . Donnelly. He and other Manor Care personnel connived to turn Glenda against the person primarily responsible for the prior four years of selecting the medical care that helped her beat the one-year cancer survival rate.J.85 Glenda’s Arrival at SNF Lacking COPD Unit As if that was not bad enough. had literally abandoned Glenda during these difficult days. Glenda's Pulmonary Doctor Abandoning Critically Ill Patient Glenda's pulmonary doctor. 2012. Manor Care's physician in charge. D. Manor Care's Head Physician Withholding Information from Person Responsible for Arranging Glenda's Medical Treatment During all this time. the respiratory decreasing effect of Ativan was then combined with another respiratory decreasing drug. continued throughout the period Glenda was a patient. Dr. In this way. who then called me on the phone and accused me of blackmail.
Glenda. I sent multiple faxes to Dr. • • Khashayar January 6. 2012.) My complaint to the Medical Board of California concerned the refusal of Dr. Khashayar stated he did not visit Glenda because he did not have a contract with John Muir hospital. Glenda's pulmonary doctor. • Blackmailing Phone Call from Glenda's Pulmonary Doctor On the evening of January 17. Khashayar to provide any information about Glenda’s pulmonary problems and the doctor’s abandonment of a person near death. Khashayar's conversation was so bizarre and indicative of the abandonment of Glenda in her near-death condition that I . Khashayar stated that Glenda's primary care physician had asked him to check on his pulmonary patient. 2012. (That was a lie. Khashayar seeking information on Glenda's care. Anyone suffering great pain is in no position to be inquiring of her not-present physicians about these matters. I received an obviously hostile phone call from Dr. Khashayar. January 6. and before Glenda's transfer to Manor Care. and any physician has enough common-sense intelligence to realize an informed caregiver must be kept informed. all of which were ignored.Medical Industry’s Death Panels Blackmail for complaining about abandoning a dying patient? I repeatedly tried to obtain information from Khashayar. He accused me of blackmailing him by complaining about his conduct. about her treatment and what he was doing for her condition. as he later had Glenda brought back to John Muir for the removal of the fluid from on her lungs that he should have removed earlier while she was in the hospital. Khashayar January 12. 2012 Another fax the same day. 2012.
Dr. I can’t see her anymore. Dr. I am not going to see her. Glenda’s primary care physician. I’m desperate to find someone to see her. a caregiver for a dying patient is a blackmailer if he objects to the abandonment of his loved one by an irresponsible physician. Khashayar: I was going to see her.] Rodney: You won’t see and treat her. But because you are blackmailing me. Khashayar: What do you want me to do? [Take care of his patient! who he had abandoned.] Dr. [Rodney had complained to Dr. … Glenda is upset. Khashayar: The path that you have taken. [In Khashayar’s mentality. A partial transcript of Khashayar phone call follows: Rodney: [Because of your refusal to communicate with me]. and this is not the way to go. Khashayar: I don’t like people blackmailing me.] Dr. [Filing complaint with medical board about his abandonment of his patient and refusal to respond to the person responsible for arranging Glenda’s medical care and to check that no neglect is occurring. she is a lovely woman. about Khashayar’s abandonment of Glenda during the critical breathing problem. Khashayar: Dr. Khashayar: Do you want me to go and see her? Rodney: Why can’t you write some type of report on Glenda and state what should be done? Dr. I am in the dark about Glenda’s treatment and condition and don’t know what to do. Lorenzana. The . Lorenzana called me and asked me as a favor to see Glenda.] Dr.87 Glenda’s Arrival at SNF Lacking COPD Unit pressed the record button on a recorder halfway through his call.
and you ask me nicely to go see her. Khashayar: I have no obligation to see her. I will do it. …If you want me to go see her. I will see her tomorrow. Rodney: I’m not sure about the law. The only way I am going to go there is if you write a letter. she can come to see me in my office. Iranian Doctor Compounding Abandonment With Inflicting Stress Upon Suffering Patient Not satisfied with the harm inflicted upon Glenda. [Khashayar’s form of reverse blackmailing!] Dr. And if I get a fax from you withdrawing all of your comments. but by abandoning a patient there may be some criminal aspect to it. Khashayar inflicted more stress upon her. all of your accusations … Once I get that fax. hand delivered to Glenda complaining about my conduct in complaining about his neglect of se- . there is no way nobody can make me see her. and ask me to go see her. Following that phone call.Medical Industry’s Death Panels only way that I am going to see her is if you send me a fax and rescind what you have told me. End of reverse blackmailing call from Iranian physician. Khashayar: Because of your attitude. Dr. 2012. all you have to do is write a fax rescinding what you said and ask me to go see her. Khashayar: Do you want me to see her? Send a letter and essentially rescind. [The doctor's responsibility to his critically-ill patient cannot be predicated on rescinding medical misconduct complaint to the California medical oversight board!] Dr.] Dr. If I don’t get it. There is no law that says I have to see her. and rescind all the complaints and everything you have said. I am not going to go there. send a fax as you have done before. Khashayar: I have no responsibility to go to that nursing home. Khashayar had a letter dated January 20. [Glenda was critically ill.
she would have been sent to John Muir Hospital. on January 21. The physician conduct described in the Bill of rights stated by American Hospital Association was trampled repeatedly as Glenda was victimized at every turn. Normally. the nearest hospital was selected. 2012. 2012. Finally Returning Glenda to John Muir Hospital For Removal of Fluid on the Lungs The following day.89 Glenda’s Arrival at SNF Lacking COPD Unit riously ill patient. arranged for Glenda's transport from Manor Care to John Muir hospital for the thoracentesis removal of the fluid on her . Khashayar then required that Glenda sign the bottom of the letter acknowledging that she received it. the next day. On January 23. Plus. the harmful effects of the round-the-clock dosing with harmful medication and the mind-altering drugs. Glenda was transported back to Manor Care. Doctors at Kaiser Permanente hospital found the fluid on the lungs that had gone uncorrected for weeks. 2012. January 24. possibly due to pressure. but because of her near-death condition. Rushing Glenda to the Nearest Hospital because of Critically Low Body Oxygen Level Possibly due to the stress caused by Khashayar’s conduct. That stunt was pulled on a frail senior suffering pain from the inadequately treated wound on her back. suffering breathing problems from the untreated pulmonary problem that was ordered by hospital personnel. the fraudulent conduct by Manor Care management and physicians. a possible pneumonia or fungus infection. Khashayar. The abuse Glenda was suffering from physicians in the medical industry should have received national headlines. Glenda was rushed to nearby Kaiser Permanent hospital in Walnut Creek because of a dangerously low oxygen level. Also.
Medical Industry’s Death Panels lungs. Caregiver Pleading with Glenda's Primary Care Doctor for Help Pressure was building as Manor Care threated to evict Glenda. [Emphasis added. … When her esophagus totally closed during radiation. Glenda's pain and depression would most probably have improved and changed Glenda's wish to just give up. physicians considered she would not be alive beyond a year. It reopened. I sent a fax with an urgent message to Dr.] Since the removal of fluid from her lungs a few days ago. 2012. Khashayar. I briefly explained part of the problems and asked her for help. Lorenzana. In that message I stated: If you have any suggestions. Glenda has shown improvement. who had not seen Glenda for some time. the physician said it would never reopen. that he did not have a contract to perform at John Muir hospital. arranged for Glenda's transfer to that same hospital to perform the removal of fluid from Glenda's lungs. If that fluid had been removed earlier. during the January 19. … As for physicians’ estimate of Glenda’s remaining life. Manor Care wants to discharge Glenda on the doctors’ assumption that she has reached a plateau or unable to improve further. and paved the way for her transfer to Kindred where the facility had a major pulmonary unit. Manor Care records indicated that Glenda was feeling much better after the removal of that fluid. On January 26. having previously stated to me. which should have been done weeks earlier. when she was diagnosed with Stage IV esophagus cancer four years ago. The earlier removal of that fluid would very probably have improved Glenda's wellbeing. Glenda can sure use them now. Glenda's primary care physician. 2012 phone call. A year ago medical personnel said .
If I had. • • • • Indifferent to what Dr.91 Glenda’s Arrival at SNF Lacking COPD Unit Glenda only had a few weeks to live. they wish to discharge her from the skilled nursing facility because they think she cannot improve any further. January 27. Lorenzana’s doctor associates were doing to Glenda. I did not recognize the enormity of the physician misconduct that was occurring. . 2012: Dear Rodney: I am so sorry to hear about Glenda's plight. The unfilled pulmonary rehabilitation treatment ordered by John Muir hospital. Lorenzana. It is unfortunately an insurance problem. They are the ones that make a determination of how long a patient can be in a skilled nursing facility. The fraudulent acceptance of Glenda by Manor Care when the SNF lacked that form of treatment. being a doctor. Lorenzana faxed back a reply the following day. Dr. 200 feet from her office building. However. would have recognized at that time what I would later recognize. Now. At that time. that did have the pulmonary rehabilitation treatment ordered for Glenda. The around-the-clock dosing with drugs that should not be given to a patient with COPD. that letter would have been far stronger. Among the serious problems affecting Glenda that Lorenzana surely recognized including the following: • Glenda’s problems were the untreated shortness of breath and inadequately treated painful wound on Glenda’s back. Dr. The availability of Kindred SNF.
Her cancer was in apparent remission. Lorenzana explained to her the absence of a pulmonary rehabilitation unit at Manor Care— which automatically signaled that Glenda was not receiving the pulmonary improvement that was intended. I would have given her the remainder of the problems that the doctor did not know about. If Dr. Dr. the shortness of breath and the pain from the open wound on her back and on her ankle. and must investigate and correct any shortcomings.Medical Industry’s Death Panels What Dr. were not being seen by physicians competent and specializing in these problems. 2012 fax to Dr. 2012. For instance: • A January 20. As Glenda's primary care physician. Lorenzana went into problems more deeply. • It is recognized in the medical industry that a primary care physician serves as the patient's first point of entry into the health care system and as the continuing focal point for all needed health care services. that the two problems that had given Glenda so much grief. and that Manor Care was not capable of evaluating whether she was capable of showing improvement. Since then. a careful diagnosis often relies on the . Lorenzana described the abandonment of Glenda by her pulmonary physician since she first entered John Muir hospital on January 4. especially since prior faxes to Dr. Lorenzana had contacted me. Lorenzana had responsibility for overseeing Glenda's medical treatment by other doctors and medical facilities. She knew. A January 16. and earlier. In any difficult medical condition. 2012 fax to Dr. That was Glenda's primary medical problem. or should have known. Lorenzana’s physician colleagues were doing to Glenda wasn’t any insurance problem! That answer did not address the problems. she had no pulmonary specialist to address her shortness of breath problems.
I sent faxes to the Manor Care facility seeking information about the treatment being provided to Glenda.93 Glenda’s Arrival at SNF Lacking COPD Unit patient's history of symptoms. and this is why it is so important that physicians communicate with the patient's close family or caregiver. were also ignored. to where she should have sought further information. 2012 Memorandum justifying transfer to Kindred. and a member of the John Muir hospital physician group. or denial of treatment. Glenda's pain. Every request went unanswered. • • The following are some of the faxes that I sent: January 16. and reference to pulmonary physician abandonment. Glenda's medical treatment. 2012 Caregiver complaining about immediate discharge following Glenda's arrival at Manor Care. January 20. Faxes sent to Glenda's pulmonary physician. Dr. Manor Care physicians were providing. That failure would have tragic effects for Glenda within a few days! Systematic Withholding of All Information from Glenda's Caregiver Throughout this period. Every request was ignored. However. sufficient information was provided to Dr. despite the fact that I had sole responsibility for arranging for Glenda's treatment and was responsible for determining if the treatment was adequate. Martin Jimenez. left her vulnerable to whatever conduct. Lorenzana. Khashayar. a grave violation of responsibility to the person responsible for arranging for. and overseeing. January 17. • • . Manor Care's physician-in-charge was Dr. and Glenda's life was involved. 2012 Message left at nurses' station. and inability to check medical sources for information.
copies of medical reports that they repeatedly withheld. again. • • • • • • • Glenda Desperately Asking Stephanie To Seek Help From Glenda's Oncologist During a conversation between Glenda and Stephanie. I told him that Glenda has asked that I call him to get his advice as Manor Care was discharging her next week (possibly). Stephanie called Dr. 2012 Notifying Manor Care about rescinding all signed copies for failure to return copies. Sherman (Jan 26. 2012 demanding. January 30.• Medical Industry’s Death Panels January 25. I said. 2012 Enlargement on the above matter. February 17. In an email to me. "No. they are not releasing her because . 2012). January 30. jeopardizing Glenda's life. Glenda asked Stephanie to call her cancer doctor. Dr. of Contra Costa Oncology. January 26. 2012 Addressing Glenda's deteriorated condition induced by Manor Care misconduct. It was a strange conversation. 2012 Requesting copies of all medical records pertaining to Glenda before her discharge. January 25. "Well. Fax sent to Manor Care about Glenda's pain preventing major medical decisions. 2012 Relaying Glenda's report of pain medication and withholding of pain medication. He said. she can now go home with Rodney" and that is good. 2012. January 29. January 28. Michael Sherman. seeking his help. Sherman. 2012 Suggesting steam inhalation for Glenda's breathing problems. Stephanie wrote: I actually did talk to Dr.
95 Glenda’s Arrival at SNF Lacking COPD Unit her condition has improved. . Not so here! Glenda was simply a commodity! Glenda at Manor Care. Dad. That was his job responsibility. Sherman is that he really isn't much help right now and obviously doesn't realize the condition that Glenda is in. That is what she told me she wants more than anything. Dr. and being a part of the care. At the end of her life. "Does she want to live or die" which was strange. Glenda still looked good and had a wish for recovery and going home. January 26. But his repeated refusal to respond to my questions was a serious lack of responsibility. She told me that she really just wants to die. I said that what she really wants to do is to get treatment. for which I am grateful. the oncologist would be carefully following their client's progress and treatment. He said to call back tomorrow to his office and his office will give me the phone # for Provident Care. she is extremely weak and they feel there is nothing else they can do for her". Each one is just doing their "own thing". My feeling from talking to Dr. or at any oncology group. He then asked. With Hope of Transfer to Kindred SNF Despite the harmful effects of heavy dosing with Ativan and narcotics that worsened Glenda's pulmonary condition. At major cancer centers. 2012. The lack of a real doctor overseeing all other doctors bothers me. I am so worried about all of these moves. Sherman’s cancer treatment extended Glenda’s life. and despite the heavy pain from the large open wound on her back. she needs to have the least stress possible.
Manor Care management and physicians had sought to cover their own misconduct by stating Glenda was not capable of having her breathing problems improved upon. Manor Care. January 26. that there was an outstanding order from John Muir hospital for Glenda to receive pulmonary rehabilitation. But the wrongdoing was so obvious to Kindred from looking at the records to where they surely recognized the gravity of the misconduct. 2012 Glenda Rejected by Kindred Admission Personnel I contacted Kindred admission personnel to arrange for Glenda’s transfer into their facility. Pro- .Medical Industry’s Death Panels I told Glenda not to worry about being discharged from Manor Care as Kindred SNF would take her. that it had never been provided. and that the cost would be fully covered by Medicare and Healthnet PPO insurance. Apparently. Glenda. I notified them of what they already knew.
she could go back on cancer therapy. Can you advise? After I learned that Kindred’s admission personnel had refused to accept Glenda. if needed. But then when John Muir Hospital notified them that Glenda would be sent there. and sent a January 29. She and I thought that the pulmonary rehabilitation unit that Kindred has may improve her COPD enough to where. stating they were not set up for pulmonary cases. they must have felt obligated to take her. Glenda and I wondered if transfer from Manor Care to Kindred could be done now. but when the fluid that the hospital knew was on her lungs prior to her transfer was finally removed. Glenda was doing marginally until a few days ago. I was angry. I immediately faxed a protest to Kindred. especially if you had a single room available. stating in part: January 26. they rejected Glenda’s admittance to their facility. fax to Stephanie and Jennifer: Hello Stephanie and Jennifer. Having written many books on great misconduct at the national level in the past. 2012. 2012 to Stephanie and Jennifer: After careful research. etc. she greatly improved. I feel another one must be done on the prob- . She looks much better now. she flat-out refused to accept Glenda.97 Glenda’s Arrival at SNF Lacking COPD Unit fessional courtesy possibly caused them to ignore Glenda’s plight. I think I know why Manor Care wants to discharge Glenda Guilinger: When I first contacted the admissions director at Manor Care.
indicates some other problem which has yet to be understood. Since their physicians. The suspicious pattern of trying to discharge Glenda. have repeatedly refused to turn the physician reports over to me—despite the fact that I make the decision as to Glenda’s care. I have no knowledge of what was in those reports. possibly by mistake. has so greatly upset Glenda that she now wants . there were some kind of “irregularities” with Manor Care’s conduct relating to Glenda. long before the attending physician or any pulmonary specialist could have made an intelligent decision about Glenda’s progress. Kindred had agreed to admit Glenda until. What I’ve seen in the last four years demands that certain information be made known. In my opinion. John Muir Hospital sent her to Manor Care. Walnut Creek. and the refusal by Kindred to now admit Glenda. The efforts of Manor Care. and Glenda Guilinger. they accepted her. When we tried to have Glenda transferred to Kindred. There is one area I am writing about that involves Manor Care. This must have been done on the basis of Manor Care’s decision and whatever reports their physicians made. But within 24 hours. Laura Stengel at Manor Care had already told me that they did not have a pulmonary rehabilitation unit and therefore would not take Glenda. despite the fact that she has shown visual improvement. the prior willingness to admit her was rescinded. the talk by Manor Care physicians was to discharge Glenda. I informed you of these questionable tactics. when John Muir Hospital advised them that Glenda was on her way. Kindred Transitional Care.Medical Industry’s Death Panels lems of people with serious illnesses receiving care from medical providers. However. and Manor Care itself. The politics behind that tactic are unknown to me—at this time.
and her appearance improved. and explained the problem. her mind clouded with mind-altering drugs. Depressed by It All. and pressure from all sides to select hospice.99 Glenda’s Arrival at SNF Lacking COPD Unit to die. Glenda finally said. One problem. but events were snowballing rapidly and the appeal was never filed. and now her will to live has been taken from her. Manor Care said they would refuse to recognize me as having any control over Glenda’s decision to abandon treatment and select hospice. She stated that I should file an appeal of the discharge order. as they had previously stated they would. would take her. But this bright spot would be undermined by another problem. which would provide several extra days to find a suitable facility. Glenda's spirits then changed. Glenda didn’t know she had treatable medical conditions and that her problem was medical misconduct denying her the available treatment. (coming shortly). During all these events. Outraged County SNF Ombudsman Suggested Filing an Appeal My daughter Stephanie and I were frantically seeking to find a suitable facility upon Glenda's removal by Manor Care. I told Glenda that nearby Kindred's SNF. Manor Care management then told me they would not process my appeal since Glenda. Upon being told of this transfer. I want to detail this outrageous matter on my Internet sites and in the not-for-profit book I am now writing. They had encouraged Glenda to state that I no longer had any control over her decision to go to hospice. I planned to do that. racked with pain from the pressure wound. We called the county ombudsman (Nancy at 925-685-2070) with oversight for skilled nursing facilities. . which had a pulmonary improvement unit and a pulmonary specialist that regularly visited. Her spirits were formerly high.
Manor Care Physicians Encouraged Glenda To Exclude Me from Her Decision to Die Glenda refused to listen to me that there was treatment out there and I would get it for her. dying or suicide.. The Mayo Clinic Staff website says of Depression: Depression is a medical illness that causes a persistent feeling of sadness and loss of interest.Medical Industry’s Death Panels "I Just Want to die"! The obstacles faced by Glenda and I as her caregiver were overwhelming. now wanted to die. who had wanted to live." Glenda said. and that was to go to hospice. the rejection by Kindred. Glenda. and finally. Depression can lead to a variety of emotional and physical problems. the scheme by Manor Care physicians and management. Depression can cause physical symptoms. She didn’t understand what was going on. Physician obligations required that Glenda be informed of such material matters as: . She finally succumbed to the pain. . She stated to Manor Care physicians and management that she alone would make the decision. "I want to die. and unaware of pulmonary treatment that was out there. but denied to her. … Symptoms … Frequent thoughts of death. the connivance of key people in the healthcare industry. Intense pain from raw pressure wound.. the abuses. the physician’s abuses and deliberate infliction of stress. may make you feel as if life isn't worth living. Glenda's judgment was further affected by the mind-altering drugs. the lack of knowledge about the pros and cons of hospice. The final straw was the combination of the Manor Care fraud and Kindred's refusal to accept her.
caused Glenda to give up . The combination of denial of pulmonary care by the deception of Manor Care physicians and management. • • • • • Glenda had two medical problems at issue. The intense pain from the infected wound/ulcer on her back could be addressed by physicians specializing in such medical problems. Manor Care management and physicians had engaged in fraud by accepting her for pulmonary rehabilitation when they did not have that type of medical care. was known to cause deterioration in her breathing difficulties. and the dosing with drugs that depressed pulmonary function. A series of physicians were engaging in medical fraud against her. Medication given to Glenda round-the-clock. while a patient at Manor Care. Hospice is for people whose medical problem is untreatable and where the patient simply wants relief from pain.101 • Glenda’s Arrival at SNF Lacking COPD Unit She had never received the pulmonary rehabilitation that was ordered by John Muir hospital physicians and therefore her ability to have her breathing improved was never determined. was the wound/bed sore/ulcer on her back that needed treatment by a wound specialist that was never provided to her. and caused suicidal thinking. The other problem. One was the shortness of breath for which John Muir hospital physicians ordered pulmonary rehabilitation treatment—that by fraud was denied to her. Glenda never belonged in hospice. the primary reason for giving up. the denial of pulmonary rehabilitation.
As if I didn’t have enough problems from the series of corrupt physicians. it is often a death sentence. that once hospice is selected. A little knowledge can be dangerous. All of these death-accelerating problems could be avoided by getting Glenda into the medical treatment that had been ordered and was universally recognized. • Corrective treatment for shortness of breath would not occur. Glenda was pushed to go for hospice by members of her own family during numerous phone conversations. pushed for hospice. Deadly Consequences of Electing Hospice There are pros and cons about hospice. . For many people with treatable medical conditions. Pressure to Accept Hospice from Glenda’s Family A granddaughter in Oklahoma. that Glenda had two treatable conditions. studying to be a nurse. • The morphine used to deaden the pain from treatable pressure wound or any other treatable medical problem will hasten death due to the adverse effect upon a person’s breathing.Medical Industry’s Death Panels and want to die. She never knew the factors that put her in that position. pain medication replaces curative treatment. Still More Obstacles! I was under heavy pressure to find a nursing home that would admit Glenda. Glenda’s decision to go with the pressure for hospice had the following consequences. which would give me time to obtain the medical treatment that had been denied to her. which she did not understand: • Curative treatment for the pressure wound would not occur. • Any new treatable medical problem goes untreated. Her granddaughter didn’t know that Glenda did not have a terminal medical problem.
103 Glenda’s Arrival at SNF Lacking COPD Unit Another obstacle came from Glenda's daughter. Glenda's daughter worked for a pharmaceutical company at their Seattle office. At a later date. but if you force us we will do so. If Glenda chose hospice. I never heard of Glenda's daughter offering any help with Glenda's pulmonary problems. that the money in a trust account that Lisa would receive upon Glenda’s death would instead be used for nursing home care when another source of funds was used up. sick. the trust would not . Lisa. That was the daughter who never visited Glenda once while I was caring for Glenda during the prior four difficult years until Glenda’s cancer went into remission. While I am working to divert Glenda from her desire to give up and instead get her the medical treatment that had been denied to her. Only once did she visit her mother. and that was in December 2011—as a side trip while the daughter was displaying her two water dogs in a dog show at Sacramento. man. The website for that company stated it specialized in developing improvement for pulmonary conditions. Please stop torturing the person you claim to love. Get off the goddamn internet. A sampling of her emails to me at this critical time included the following samples: You are a sick man. Lisa Kinney. she managed to travel the few extra miles to finally visit her mother. who worked for a pharmaceutical company in Seattle. go spend her last days with you and stop indulging your paranoid fantasies. We don't want to have to get the court to get you away from her. Being close. You are a sick. I saw where Glenda was advising her daughter. looking over Glenda’s emails on her computer. her daughter is sending me ugly emails for opposing Glenda’s desire to abandon treatment and go for a premature death.
the rejection by Kindred skilled nursing facility. But in most cases. and that she was a victim of massive medical fraud by a group. once hospice is elected. It is of course unknown as to what role this had in encouraging her mother to go for hospice and not to listen to my request to abandon that decision. including subsequent treatable medical conditions. the treatable medical conditions remain untreated. The combination of events was too much for Glenda. The stunt pulled by Manor Care management and physicians.of doctors belonging to the John Muir Physician Group. the pain from the untreated pressure wound. The pain will get worse. and everything else.Medical Industry’s Death Panels be exhausted and death would come sooner. and in many cases require fatal dosage of morphine. the support by her family for hospice. Glenda thought hospice would relieve the pain. . Glenda did not know that the pain she was suffering was from untreated medical problems.
and the other was Dr. Their Certification of Terminal Illness required that • The medical condition for which Glenda was in Manor Care skilled nursing facility (shortness of breath) was untreatable and that she would die of that medical condition within six months. [Manor Care had no such • . Vona Lorenzana. Two physicians had to sign a legally required Certification of Terminal Illness (CTI). and not being treated at that time. One was Glenda’s primary care physician. [Glenda’s two medical conditions for which she was in the hospital were the untreated COPD and the inadequately treated wound on her back. who’s only known medical practice was as a consulting physician with Hospice of the East Bay. The underlying esophageal cancer was still being treated and in apparent remission. Walnut Creek.CHAPTER ELEVEN Sham Certification of Terminal Illness The complicity of two physicians was needed to remove Glenda from Manor Care. Dr. abandon the pulmonary treatment that had been denied to her.] That the pulmonary rehabilitation treatment ordered by John Muir hospital to improve her shortness of breath had been given to Glenda and found ineffective. and settle for a premature death. Jay Spencer.
2012. and Glenda’s oncolo- . That the intense pain from the ulcer/wound/bed sore was not treatable. Obviously. That a narrative be stated to support the CIT terminal illness. fraudulently held to have a pulmonary condition that could not be improved upon. signed the CTI on January 31.] • The pulmonary rehabilitation treatment was not effective. the conditions to bring about improvement had not yet occurred. and case law requirements for hospice had been met for you to legally sign the Certification of Terminal Illness. and stated death would be from esophageal cancer. regulatory. and that Glenda’s condition had worsened to where her death from the shortness of breath condition would occur any time within six months. and have supporting medical reports. But Glenda wasn’t being treated for esophageal cancer. That the drugs given to Glenda at Manor Care did not worsen her breathing problem. That the statutory.Medical Industry’s Death Panels unit and therefore Glenda never received the pulmonary rehabilitation treatment. And the non-pulmonary doctors lacked the experience to make such determination. Vona Lorenzana. MD. That there were no irregularities or fraud in the medical care for Glenda while at Manor Care that contributed to the expected death within six months. and the only decision for her was to accept palliative treatment and die. That Glenda was made fully aware of the above irregularities. • • • • • • Dr. knew that she had been fraudulently denied the pulmonary rehabilitation treatment.
Please send pt demographics. I agree to an initial plan of care (POC) as determined by the Interdisciplinary team (IDT) and patient/family. if the illness runs the normal course. Revisions to the POC will be made as indicated by changes in patient/family needs. Preliminary Hospice Diagnosis: Metastatic esophageal cancer (per referring physician) (Single diagnosis most likely the life expectancy) Final Hospice diagnosis to be determined by Hospice of the East Bay Physician and Interdisciplinary Team based on Local Coverage Determination (LCD) guidelines. Physicians progress notes and Discharge Summary. H&P.107 Sham Certification of Terminal Illness gist wasn’t involved while Glenda was in the hospital and Manor Care SNF. 2. Vona Lorenzana Attending Physician Certification of Terminal Illness This is to certify that the above named patient has a prognosis of six (6) months or less. Martin Jimenez Dr. fact sheet. 2012. Glenda P# 14286 Pt Name Attending Physician: Dr. evaluate and admit to Hospice Care as appropriate. I recommend this patient be admitted to hospice services. The attending physician will be informed of POC revi- . Physician Orders and Initial Plan of Care: 1. CTI stated: Hospice of the East Bay Guilinger. Her January 31. Hospice RN to assess. Glenda’s medical problems were the untreated shortness of breath and the excruciating pain from the wound on her back.
Medical Social Worker will assess and evaluate psychosocial needs. Attending Physician to follow patient for pain/symptom management. 4. the attending physician will be notified if systolic blood pressure is less than 90 mm HG or if the systolic blood pressure exceeds the baseline by 30 mm HG or greater. If attending Physician is unavailable. 7. If Patient is on cardiac medication or diagnosed with hypertension or hypotension. 8. Spiritual Care Counselor to assess and evaluate patient for spiritual and emotional care needs. Remain available but allow Hospice Physician to consult as needed for end of life symptom management. • . Volunteer per patient/family request.Medical Industry’s Death Panels sions. Current medication and care orders will be continued until changed by attending Physician or the Hospice of the East Bay Physician. 6. 3. Hospice of the East Bay to report changes in level of care to the attending Physician. I want to follow my patient in the following capacity: • Continue to be the attending Physician while my patient is in Hospice. 5. Comfort Medications Orders and Wound care per attached guidelines until changed by attending Physician or a Hospice of the East Bay Physician. Hospice of the East Bay may call MD Group or Hospice of the East Bay Physician about this patient. per Plan of Care to be established.
Dr. Effective 1/31/12. if the illness runs its normal course. Glenda Address: 2849 Miranda Avenue. and copies of supporting medical records. I recommend this patient be admitted to hospice services. Brief Rubber Stamp by Dr. Alamo.Medical Director Note: Hospice Physician Certification of Terminal Illness This is to certify that the above named patient has a prognosis of six (6) months or less. wasn’t dated until February 2. Spencer’s Certification of Terminal Illness stated: Charts/Clinical Notes Period: 01-31-2012 through 02-01-2012 Hospice of the East Bay –Bruns House Patient: P142896 Guilinger.109 Sham Certification of Terminal Illness • • Keep me informed of major changes. Although reference is made to coordinating with family. Notify me of patient’s death. 2012. Joy Spencer The record shows that the CT by Dr. a physician consultant at Hospice of the East Bay. Attending Physician: Dr. She cavalierly stated nothing to support her short off-theshelf death decree. Joy Spencer. Vona Lorenzana 1/31/12 Regulations relating to Certification of Terminal Illness require a narrative to support the statement. CA 94507 Use Code: N Effective Date: 01-31-2012 Discipline: MD . Terminal Diagnosis* metastatic esophageal cancer . I was the only person involved with Glenda’s care and every physician involved in this group refused to provide me any information or control over what they were doing to Glenda.
her oncology physician was not involved during Glenda’s stay at Manor Care SNF or the two hospital visits for shortness of breath. Treatment had put that cancer in remission. and there was no • . Major falsehoods arose with those two certifications: There were no reports in any of the medical facilities that cared for Glenda between January 5. and based solely on Manor Care requests. addressing Glenda’s underlying cancer. including what has already been stated. • The certification of terminal illness had to cover up for the prior misconduct inflicted upon Glenda.Medical Industry’s Death Panels (*single diagnosis most likely limiting the life expectancy) 78 yo woman with metastatic esophageal cancer and history of DM11 and CAD …. Jan Spencer. 2012. The reports throughout that period focused on Glenda’s shortness of breath. MD Hospice Physician 2/2/12 Signature: Glenda was not being treated for esophageal cancer. • Glenda was diagnosed four years earlier with Stage IV esophagus cancer. Attestation: I confirm that this narrative is based on my review of the patient's medical record and/or examination of the patient. and January 31. her oncologists had scheduled Taxol cancer treatment for Glenda prior to her shortness of breath problem and had planned to start that as soon as Glenda returned home. 2012. John Muir hospital physicians believed that Glenda’s breathing problems could be helped by pulmonary rehabilitation treatment (which Manor Care physicians denied to Glenda).
and the nearby Kindred SNF had that treatment. by deception. Neither doctor was a cancer specialist. • Their CTI allowed or encouraged Glenda to abandon the pulmonary rehabilitation treatment that unknown to her. and sentenced Glenda to a premature death by their sham Certification of Terminal Illness. Instead. that she had never received that treatment. • Neither of the two physicians made any effort to inform Glenda of these matters when in desperation she decided to give up the available medical treatment that was unknown to hers.111 Sham Certification of Terminal Illness involvement of her oncologist in Glenda’s medical treatment or any contacts throughout the period from January 5. • Their CTI assisted in covering up for the major medical misconduct occurring while Glenda was at Manor Care. to die. and resulted in her premature death. 2012. she never received. • Their certification contradicts everything written by physicians at John Muir Hospital and Kaiser Permanente hospital during the prior several weeks of treatment. a unit of Hospice of the East Bay. • They both knew that the John Muir order for Glenda to receive pulmonary rehabilitation still existed. 2012. and instead go to Bruns House hospice. Instead of arranging for Glenda to receive that fraudulently denied treatment. they both covered up for the medical crimes and became accomplices. to January 31. cover-up. • Both physicians played major roles in denying to Glenda the pulmonary rehabilitation that could have extended her life. Both physicians signing the Certification of Terminal Illness stated that death would come from esophageal cancer. • .
and easy to bring to an end. The COPD that she had lived with for years was giving her problems. 2012—just over a week prior to Glenda's death. A key January 13.Medical Industry’s Death Panels To this sordid coterie of physicians. A portion of two John Muir hospital reports stated: Clinically she is dong relatively well. 2012. The John Muir hospital physician reports. Glenda's Hospital Records State Favorable Pulmonary Status Although the hospital records did not reflect the favorable pulmonary status of a 21-year person. California. were normal and common for a COPD patient. Glenda’s life was cheap. dated January 22. Other additional comorbidities [effect of all other diseases] include a history of allergic bronchopulmonary aspergilosis [diseases caused by fungus. Asymptomatic on 2 L of oxygen. were also normal and common. arriving about 2 pm on January 31. Martinez wrote: Glenda was transported to Bruns House. The Kaiser Permanente hospital physician records. They indicated the status of a normal person with COPD. She looks comfortable without any shortness of breath or tachypnea [Abnormally fast breathing] Vital signs have been relatively stable with O2 saturation 97% to 100% on 2L per nasal cannula. the latest being January 13. Her cancer was in remission. they did not indicate a neardeath condition. Martin Jimenez. but she wasn't on death's doorsteps. A Manor Care memorandum dated 1/31/12 by Manor Care's physician in charge. John Muir hospital promptly provided the records that I requested that related to Glenda's January hospitalization. about two weeks before Glenda's suspicious death at Bruns House hospice. showed him arranging for Glenda's transfer to Bruns House hospice facility in Alamo. 2012 discharge report showed Glenda to be far from a hospice case. a difficult-to-treat condi- . 2012.
will start abx including coverage for MRSA. Physical exam: General appearance—Alert with mild distress due to dyspnea on O2... DYSPNEA: possible cause including COPD exacerbation triggered by pneumonia.. which she had a year earlier]. treated with possible influenza. continue bipap with breathing treatment. Respiratory ROS [review of system]: positive for cough. Pt had long hix [history] of severe COPD and allergic bronchopulmonary aspergillosis [allergic reaction/infection due to fungus. 2012: Kaiser Permanente: Assessment and Plan: History of present illness: Glenda A Guilinger is a 78 Y very pleasant female . pul[monary] consult[ant] due . presented to ER with worsening dyspnea and productive cough for last week.. sputum changes and tachypnea.] Kaiser Hospital Reports No End-of-Life Problems Segments of Kaiser Hospital physicians’ reports stated a medical condition that in no way indicated a hospice situation. Cardiovascular ROS: no chest pain or dyspnea on exertion. complained of worsening dyspnea at exertion with dry cough for last week after she was discharged back to Manor Care . and a condition amenable to competent medical treatment: Jan 21.113 Sham Certification of Terminal Illness tion Glenda initially acquired approximately a year earlier.. Pt denied chest pain but continued to have both legs swelling as she had for years. had few hospitalizations in John Muir for dyspnea and last hospitalization was on 1/5 and was discharged to Manor care on [Jan] 13 for similar symptoms and was treated with steroid and abx [antibiotics]. and might still exist. start steroid.
. Difficult to treat. Assessment: stable. D/C summary from 1/15/12 from John Muir reveal normal echo.] Assessment and Plan: Dyspnea in a patient with COPD. . Right now she is saturating at 99% on 2 lits. ABPA previously treated with itraconazole and metastatic esophageal cancer admitted for SOB.. [Note: ABPA is a disease in which the fungus grows in mucus (evoked by inflammation). She had a recent echo which showed normal LVF..] . treated with possible influenza. she'll need thoracentesis. Pt had recent angiogram of chest done recently which was negative. and causes intermittent bronchial obstruction. try diuresing with Lasix and repeat CXR [chest x-ray]. Right now she is saturating at 99% or 2 lits. Jan 22. Glenda originally diagnosed with this a year earlier. Chest CXR looks b/l effusions. Plan: Lasix. start steroid.Medical Industry’s Death Panels to hix [history] of allergic bronchopulmonary aspergillosis. Dyspnea in a patient with COPD. If effusion is not decreasing she'll need thoracentesis [removing the fluid on her lungs]. [Fluid on lungs.. metastatic esophageal and b/I pleural effusion likely from COPD exacerbation and anxiety.. will start abx including coverage for MRSA.. COPD exacerbation and possible pneumonia.. continue bipap with . . 2012: Kaiser Permanente Progress Note: Hospital Day 1: HP1: Patient with Hx of COPD. . metastatic esophageal and b/I pleural effusion likely from COPD exacerbation and anxiety. Disposition: transfer patient to John Muir of d/c back to SNF in 2-3 days. COPD exacerbation and possible pneumonia.. possible cause including COPD exacerbation triggered by pneumonia. with small b/l effusions.
At that time. and judgment. It was as if a group of people in the medical industry were determined to put Glenda to death. and the possible fungus infection in her lungs may have still existed. Admission to Bruns House Hospice for People with Maximum of Seven to Ten Days to Live Bruns House hospice had only six beds. because of frequency of altering behavior and emotions. On January 23. This drug was repeatedly given to Glenda from that point on. Glenda was transferred back to Manor Care. Pt had recent angiogram of chest done recently which was negative. 2012) still had not been done. It operated on a very short admission time. January 25. which had first been detected during her initial John Muir hospital stay (Jan 4. She also complains of chronic back pain. 14.2012 Manor Care report showing breathing improvement after delayed thoracentesis. the thoracentesis procedure to remove fluid on her lungs. they would succeed. General appearance: alert. Ativan. and certainly not seven to ten days! This was bizarre. Its admission policy was limited to people with a maximum time remaining before their estimated death of ten days. 2012 to Jan. and in mild respiratory distress. and was the only hospice facility in that area. pul[monary] consult[ant] due to hix of allergic bronchopulmonary aspergillosis. Pictures I took of Glenda at Manor Care definitely didn’t reveal anyone with a terminal illness.] Subjective: patient still complains of SOB with dry cough. 2012. Unfortunately. Psychotropics consent and treatment [Patient approval needed before using the psychotropic drug.115 Sham Certification of Terminal Illness breathing treatment. with people dying every few days. with many enablers! A Medical Horror Story .
The plight of a vulnerable senior being defrauded out of her life by a group of physicians protecting each other’s medical misconduct should be the center piece of America’s medical discussions. . plus treatment for the pressure wound. She just needed the care that had been ordered for her shortness of breath. or six months.Medical Industry’s Death Panels Glenda was certainly far removed from dying within ten days. and elimination of the morphine drugs adversely affecting her breathing.
She didn’t understand that she had been defrauded by physicians seemingly acting in unison. Visiting Glenda an hour later. Glenda also did not understand all of the physician misconduct that kept her from receiving corrective statement for her breathing problem and the painful wound on her back. arriving at 2 PM. Glenda was transported to Bruns House hospice in Alamo. she trusted the physicians. 2012. California.CHAPTER TWELVE Ineligible Glenda Transferred to Hospice Facility On the afternoon of January 31. Bruns House is a unit of Hospice of the East Bay. or that she had just given up the opportunity for treatment of her two problems. Like most people who don’t read about such things. I . and on the phone. smiling. The group is supported by donations that provide an income for those who cooperate. Her spirits were up. She didn’t understand how hospice works. headquartered in nearby Pleasant Hill. doing her crossword puzzles. reading the newspaper. She thought that she would get pain-relieving treatment and live out her remaining life comfortably. Glenda was unaware of the negatives in hospice. I found Glenda in a good mood.
for which only pain medications available. Only pain drugs would be made available. California . Bruns House Hospice. Alamo. But adverse events would happen too soon for those events to occur. Also. The medical care for her treatable and painful wound on her back would not be given. The treatable medical care for her shortness of breath would not be available. That broken leg continues to inflict pain. to obtain the services of a wound specialist to treat the back wound responsible for her pain. Consider this sample scenario for understanding. A patient with a broken leg in the hospital abandons medical care and instead elects hospice.Medical Industry’s Death Panels was set to find a medical facility that would provide the pulmonary rehabilitation treatment that John Muir hospital physicians had ordered for her and then blocked.
2012 Glenda was already feeling better when she arrived at hospice on January 31. She certainly didn’t look like a patient with less than ten days to live. But that was not to be! Bruns House hospice is intended for those patients with a very short time to live.119 Ineligible Glenda Transferred to Hospice Facility Glenda didn't belong in a hospice. especially by the physicians and management staff of John Muir Rossmoor Parkway. that being an admission requirement for Bruns House Hospice. and it was my intent to find a facility that would provide her the pulmonary treatment that she had been denied. and it was my intent to do that once the intense pressure was off. 2012. Admission is based on estimated survival of days. Away From the Stress: January 31. That improvement may have been due to the final removal of the fluid on Glenda's lungs four days earlier. and then Kindred SNF. far less than six months. A person can opt out of hospice at any time. Glenda obviously did not meet that criteria! Glenda Looking and Feeling Well. .
She was the doctor from Manor Care who played a key role in denial of pulmonary rehabilitation treatment for Glenda. 2012 Hostile India-Trained Manor Care Doctor Taking Over Glenda's Morphine Dosage and Other Drugs As I sat by Glenda's bed. January 31. Smita Chandra. Late afternoon. This disturbed me greatly! My daughter Stephanie joined me and we spent most of the remainder of the day with Glenda. Glen- . When we left that evening. That doctor would now be in charge of the pain-relieving drugs given to Glenda and her care. I now wondered what role this doctor would now have affecting Glenda's life.Medical Industry’s Death Panels Glenda. I was shocked to see entering the room Dr.
made it difficult for me to understand what Glenda was saying. By that time. Glenda stated that during telephone conversations between Glenda and her daughter that the daughter harshly criticized me and made derogatory comments for attempting to change Glenda’s decision to select hospice instead of treatment. I walked over to the window where Glenda was lying. a combination of my poor hearing from years of airline piloting and Glenda’s weakened vocal cords. talkative and showing no sign of any personal distress. and she waved us back. My daughter later conveyed to me what happened. . That would shortly change. Glenda was visibly upset. Added Stress for Glenda When Stephanie and I started out the door of the Bruns House.121 Ineligible Glenda Transferred to Hospice Facility da was still smiling.
She also had respiratory distress. That would explain Glenda’s comatose condition and difficulty breathing. to a comatose condition. and had the right connections in the medical industry. At the moment I could not understand the ongoing events. Instead of a smiling and active Glenda. Undoubtedly Glenda was Given a Fatal Dose of Morphine The only explanation for this sudden and unnatural transformation was a deliberate overdose of morphine. She was transformed into a totally different woman from when I had left the night before. and writing notes. she was in a good mood when Stephanie and I left her about 12 hours earlier. Something wasn't right.CHAPTER THIRTEEN Hours Later: The Suspicious End of Glenda’s Active Life Upon arriving at Bruns House early the following morning I couldn’t believe my eyes. In fact. If I had been smarter. possibly I could have had Glenda quickly moved and . she was comatose. Glenda hadn't been in significant pain when last seen. Glenda went quickly from looking good.
.123 Hours Later: Suspicious End of Glenda’s Active Life treatment given to counteract the deadly morphine overdose. But no one can be expected to know what was being done to Glenda.
but they felt that she could hear them. The phone would be placed next to Glenda's ear while people told her how much they loved her. Glenda Dying Unknowingly Watching a Loved One Put to Death! Throughout the day on February 1. people were calling on the phone from Glenda’s birthplace in Oklahoma and elsewhere. I thought. It was a tragic sight! How this could be. 2012. Glenda was comatose. This was not natural! . I brought Glenda to the hospital a short three weeks earlier for a relatively modest breathing problem and now she was comatose.Medical Industry’s Death Panels Early Morning February 1. 2012.
125 Hours Later: Suspicious End of Glenda’s Active Life .
such as morphine. It was strange that Glenda was looking and feeling good the evening that Stephanie and I had left her. Medical Fraud. In early . It is not the sight one wants to view of a loved one! Signs of opiate overdose that I observed shortly before Glenda died included respiratory depression. thinking of the many great moments we shared together. occasionally holding her hand.Medical Industry’s Death Panels Denial of treatment. shallow. Twelve hours later she was comatose and having trouble breathing and her body was twitching. Compounded by Rat Pack Medical Industry Complicity Spelled Premature Death for Glenda A coma—or death—can be induced by heavy opiates. and body twitching. precise signs of opiate over dosage! I sat by Glenda's bed all day. breathing.
m. A double Greek tragedy! I had been in almost daily email contact with Bruce for several years. Glenda started myoclonic jerking. Probably a suicide. But no sooner had I arrived home. apparently after being told of his mother's death. which is often the side effect of heavy opioid administration. Rushing back. February 1. the 15 minutes it took me to arrive was not quick enough.127 Hours Later: Suspicious End of Glenda’s Active Life evening. thinking that Glenda would survive the night. at eight p. It is a disturbing sight to watch. and emotional. they had the police in Big Lake. Minnesota check his residence. Their phone calls to Bruce went unanswered. He didn’t think enough to even respond. Sean Rifenberick. a call from Bruns House said Glenda was near death. it was preposterous to realize that I brought Glenda to the hospital for a relatively modest treatable shortness-of-breath problem and now three weeks later Glenda was dead! And she only had an easily treatable condition. How could such a tragedy occur? Where were the medical regulators? Where was the media? . Martin and Mike. Martin and Mike knew that Bruce was very close to Glenda.m. Finally. I offered to provide information that could help find a reason for Bruce’s death. Incredible Series of Events Looking back. Fearing that something may have happened.. causing me to write to the police chief in Big Lake. That check found that Bruce had died.. Compound Greek Tragedy: Another Death in the Family! Upon Glenda's death at 9 p. I immediately e-mailed to Glenda's sons news of Glenda's death: Bruce. I left for home so as to get enough sleep for the next day's vigil. 2012. A beautiful life was over for Glenda. Wednesday.
These statements. I know this is hard on you. I found by examining the emails from Bruce that Glenda's daughter. and also the emails on Glenda’s computer between Bruce and his mother. Since he lived alone in Minnesota. I started looking over the emails that Bruce had sent to me. Hopefully she can get over this pneumonia. caused Bruce considerable stress. . Lisa Kinney.] (another at 10:37 PM) Rodney. had multiple sclerosis (MS). was making ugly statements about me. was often in pain.Medical Industry’s Death Panels Examining Bruce's Emails for Possible Clues After the funeral services had occurred. which Bruce shared with Rodney. Bruce's emails repeatedly thanked me for providing care for his mother and extending her life. 2012 from Bruce: You two can end the great love story where you two lived it! [Referring to Glenda returning home. They all showed a deep love for his mother and discussion of personal matters. The following are excerpts from some of the emails Bruce sent to me: Some of the messages had this to say about his sister: • January 21. and between his periods of grief. I can only imagine how hard this is for YOU. • January 22. I felt the need for almost daily communication to improve Bruce's spirits. 2012 from Bruce) Thanks for keeping us updated.
2012 from Bruce. I know this is very hard on you.com to Bruce: Subject: Fwd: Re: Pompous. Glenda's daughter had been criticizing me for years—while I was taking care of her mother. Thanks to you and the "Stich" Clan for making her as comfortable as possible! She knows I love her. and there is no need to make it more complicated and stressful. 2012 from Bruce: I would SUGGEST NOT including my sister "Lisa's e-mail address in this fight. maudlin. she would have died a long time ago. very little to do with her. Something is left insider her to fight. Spring is coming. forwarding an email to him from Glenda's daughter. HE is unfairly and gratuitously alienating her health care providers to satisfy a selfish wish that has very. January 26. You have my deepest sympathies. and hopefully will be able to speak better.] . Nothing more to say here.] • • Another January 26. [Unknown to me. [These comments were made while I was taking care of her mother during very difficult times. but without you. The man is insane. That I know. very.129 Hours Later: Suspicious End of Glenda’s Active Life and it will bring back the fight in her! Hang in their Rodney! I know this is SUCH a hard time for you. and that would give me a chance to come see her! I hope she can hold on till then. He's a moron who thinks he is. arrogant asshole .. Lisa. Lisa: From Lisa Kinney (fetchinketch@yahoo. 2012 from Bruce: I have never stopped believing Mom can beat this. a genius. and longer. • January 24.
] • Glenda's Explanation of Her Daughter's Problems Glenda sent two emails to my daughter. Then last Thanksgiving. Stephanie. although others would want to walk with her. Lisa has a type of autism that makes it difficult for her to carry on conversations.an anti-social problem that she has and has been totally aware of for years. From Lisa Kinney to Bruce Guilinger. 2012. January 26. seeking to explain her daughter's problems: Lisa was very aware of her anti-social tendencies and didn't want to work in a physician's office. she moved to Seattle to work for Seattle Genetics.net to Lisa Kinney: Subject: Re: Hi Lisa: How much time have you spent in her hospital room holding her hand? But if she makes it another year. [Sent at the time I was seeking to transfer Glenda to a pulmonary rehabilitation facility and delaying the discharge by Manor Care personnel. . and Mike Guilinger: Subject: Re: A crisis against Glenda. Martin Guilinger. This man is criminally delusional! He's the one who needs to be stopped. We moved a lot. choosing clinical trials for the drug company Gilead in Foster City. 2011. it would be considered "Torture to You"? God Bless Sis. the first one on August 16. she would walk to school alone. and she would usually have only one friend. When she was small.• Medical Industry’s Death Panels From cbrucski@izoom. Lisa.
131 Hours Later: Suspicious End of Glenda’s Active Life .
Medical Industry’s Death Panels .
This pattern of breathing where the patient stops breathing (skipping breaths) and then starts breathing again is termed "apnea.. the patient dies.org/no-prn-morphine-copd.e. If the breathing is stopped completely without restarting." Apnea commonly occurs as a result of the terminal illness and the dying process. Because COPD patients have compromised breathing already. One internet article warning against the consequences of giving morphine related drugs to patients with COPD breathing problems contained the following warnings: One of morphine's main adverse effects is slowing down the respiratory rate. the respiratory depression can become severe and actually stop the breathing periodically for a few seconds or many seconds.CHAPTER FOURTEEN Cause of Glenda’s Death: Morphine Overdose It is well known in the medical community that morphine and morphine-containing drugs decrease a person's breathing capabilities. http://www.html. respiratory depression.. .. i. when certain metabolic changes occur in the patient's body. If the dosage of morphine is too high for what the patient is accustomed to.hospicepatients. .
org/hos. I starting researching and finding articles on the deliberate killing of patients by physicians in America’s medical industry that is virtually unknown by the normally uninformed American public.the pain had been treated: the pressure wound on her back. "Morphine can seriously interfere with a patient's ability to breathe. its medical director and its nurses: involuntary euthanasia. It also sedates the patient and creates noisy breathing as the tongue relaxes back in the throat. In fact. “Note: the following is the account given by a daughter showing how her mother was medically killed by a hospice.” Morphine contraindicated for patients with COPD: http://www. may stop • .kaiserpapers.html.Medical Industry’s Death Panels More warnings about morphine usage: "Morphine suppresses the patient's drive to breath and creates the appearance of inadequate breathing. To use morphine for treatment for shortness of breath is lethal." http://seniors.html.hospicepatients. In Glenda’s case.hospicepatients. the morphine related drugs would not have been even a matter of consideration if the source of . anyone who is given a dosage of morphine which is much higher than they are accustomed to. For any doctor to give Glenda round-the-clock morphine drugs in Glenda’s modest breathing condition would be criminal.html. and apply to those doctors and other medical personnel who knew what was being done and remained quiet about it. Routine Physician-Ordered Euthanasia (Homicide!) in the United States Medical Industry At a later date. • http://www.org/euth-acct-three.org/no-prn-morphine-copd.
Hospice Patients Alliance has received many.135 Cause of Glenda’s Death: Morphine Overdose breathing.. Most of those patients were given these dosages of morphine by nurses in the hospice setting." . .. who died shortly after getting those morphine dosages. the physician had ordered that the morphine might be given "as needed" or "PRN" within a certain range and at a certain frequency of time intervals between doses given. In all the cases reported. many reports from families about patients with COPD who were given morphine in dosages higher than they were accustomed to receiving.
Lisa Kinney. California. A loving and caring Pastor Cherie Reid conducted the services. a paper for the 8. An obituary was sent to the Contra Costa Times for a threeday placement. Martin from Tulsa. did not appear. with Pastor Cherie Reid of the Grace Presbyterian Church conducting the services.000 member retirement community where Glenda was well known for her sewing and quilt activities.CHAPTER FIFTEEN Funeral Services for a Great Lady There are hectic necessities to be done upon the death of a loved one. . Several members of this writer's family spoke of their love for Glenda. living closer than any of Glenda’s other children. who was found dead after being informed of his mother's death. From Glenda's family. Glenda's daughter. at Hull's Mortuary in Walnut Creek. Glenda is buried at the Alamo-Lafayette cemetery in Lafayette. there appeared at the funeral services two of the sons. The funeral services were held on February 8. Missing was Bruce. Oklahoma. and an obituary to the Rossmoor News. 2012. and Mike from New Jersey.
A brief summary follows: Manor Care physicians and management accepting Glenda for COPD rehabilitation that they knew she needed. • . But when a person seeks treatment for a modest medical problem and then is subjected to the massive amount of physician misconduct that was inflicted upon Glenda. and they did not have.137 Funeral Services for a Great Lady Glenda Didn’t Die of an Illness: She was Put to Death. And the need for prosecution. With Many Enablers in America’s Medical Industry It is tragic enough when a wonderful person like Glenda dies of an incurable illness. there is a national scandal. with no concern for the possible fatal consequences.
• Kindred personnel knew that their refusal would lead to Glenda's premature death in a hospice facility. 2012 letter to Kindred SNF management making reference to their role in Glenda's wanting to die—two days before Glenda's suspicious premature death. knowing this would adversely affect her life. and treatment they were not providing.Medical Industry’s Death Panels • Manor Care physicians. Support for nearby Manor Care management and physicians superseded responsibility to a patient in need of the pulmonary rehabilitation treatment that they had. January 30. despite an existing order for pulmonary rehabilitation treatment and an ability to pay. Jimenez. Manor Care physicians ordering round-the-clock drugs for Glenda that decreased pulmonary functions. Smita Chandra. • Manor Care physicians and management repeatedly withholding from Glenda's caregiver information about the drugs and treatment they were providing. Dr. and another Manor Care employee. Martin Jimenez and India-born Dr. including a suicidal desire—a desire to die. Also. • . in a patient already suffering from breathing problems. • Kindred SNF management refusing to accept Glenda for COPD care. manipulating the drugged Glenda into denying her caregiver any role in her desire to abandon treatment and elect a desire to die. moving immediately upon Glenda's arrival to discharge Glenda. and especially Dr. drugs that bring about mental problems. • Manor Care physician-in-charge.
Chandra's care! • Glenda’s pulmonary physician’s neglect of Glenda at a critical time.139 Funeral Services for a Great Lady Glenda’s unnatural and highly suspicious sudden death within hours of arrival at Bruns House. • . with death hours later and under Dr. The sudden transformation of a smiling and writing Glenda at Bruns House hospice into a coma. that facility did not have a COPD rehabilitation operation and did not have a pulmonary specialist. • John Muir hospital personnel discharging Glenda to Manor Care SNF for pulmonary improvement when the hospital knew. or should have known.
An article about criminal prosecution for denial of medical treatment by HMO medical groups was written by law professor John A. Excerpts of his article. however. White Plains. His article was about the criminal aspect of denying medical treatment when there is a responsibility to act.1 There is. In Glenda’s case. Humbach. making it possible for multiple medical crimes far worse than simple withholding of medical treatment or medical error. the omitter must have had a legal duty to act. denial of medical treatment was compounded by criminal fraud.D.CHAPTER SIXTEEN Prevalence of “Homicide” In America’s Medical Industry Medical homicide can occur from denial of medical treatment. follows: Homicide can be committed by commission or by omission—by affirmatively doing a lethal act or by omitting to do an act that is necessary to preserve another's life. an important legal difference between the two: In order for a fatal omission to be considered a crime. 11:147. summa cum laude. Ohio State University (1966).2 and the victim’s death must re- . Many articles have been written about this subject. Health Matrix. Vol. J. at Pace University School of Law. New York.
. 141 S.2d 1054 (Md. Beardsley. People v. 1948). Territory v.E. 1989) (noting that there is no legal duty to render aid in absence of a special relationship). UNDERSTANDING CRIMINAL LAW 89 (2d ed. App.01(1). State. 280 So. see also Commonwealth v. 4 For example. 1986). Burden. Hall. 282.2d at 310 (describing "at least four situations in which the failure to act may constitute breach of a legal duty. and the omission to perform the duty must be the immediate and direct cause of death"). Biddle v. 311 (D. Albright v. 190-91 (Ala.W. at 86-89. 138. 387. JOSHUA DRESSLER..E. Oliver. 1977).2d 307. 113 N. Rptr.6 Consider the following case: 1 See People v. 1965) (collecting numerous cases and treatises). 2 See. 1995) (providing an overview of liability by omission). 2d 186. 1979). Rptr." . 1129 (Mich. 1888). JR. 308 F. 396 A. 258 Cal. Manton. 3 See DRESSLER. for example when a person agrees to provide care for another. 140 Cal.C. CRIMINAL LAW 202-12 (2d ed. 1128. a legal duty to provide care is imposed on the parents or legal guardian of a child.5 Such a legal duty may also be created by contract. see also MODEL PENAL CODE §§ 2. see also Pope v. 1973) (upholding demurrer to indictment that failed to allege the status relationship giving rise to the duty).2d 644.g. State. Commonwealth. Crim. Cir. 1907) (stating that "the duty neglected must be a legal duty. 78 N. supra note 1.2d 710. App. It must be a duty imposed by law or by contract. 308 F. People v. 19 P. 714-15 (Va. 142 (Ct. See generally WAYNE R.3 Such legal duties may arise in various ways. and not a mere moral obligation. e. United States. (3)(b) (Official Draft 1962) (commenting that "a duty to perform the omitted act is otherwise imposed by law"). 1962) (requiring proof of the legal duty). App. Jones v.141 Prevalence of “Homicide” in America’s Medical Industry sult from a breach of that duty. SCOTT. 289-92 (Ct. 647 (Mass. 4 See Jones. LAFAVE & AUSTIN W. 392-93 (Mont.
E. Rptr. Ct. 553 N.E. 617 A.Medical Industry’s Death Panels namely. if timely provided. Ct. People v. Commonwealth v. Ct. 1991) (upholding manslaughter conviction for parent who failed to perform legal duty to care for his son). 523 N. Flayhart. 1993). see also DRESSLER. Commonwealth. the subscriber dies as a result. 153-54 (Ill. Jones. and a voluntary assumption of care while secluding the victim). 629 N.2d 375. e. 140 Cal. 617 N.. 1985) (holding that defendant accepted sole responsibility for the total care of her mother and that she had a legal duty to provide the care). App.g. 152 P.2d 148. Twitchell. Pestinikas. Norman. 1993) (sustaining convictions for murder and aggravated battery based on parent’s failure to take affirmative action to protect children from an abusive live-in boyfriend).E. a contractual duty of care. a statutory duty of care.2d 225 (App. 613 (Mass. (Is it not murder?) . App. Ct. Montecino. 1944) (finding that the legal duty to care for another may be created by contract or moral duty). Davis v.E. have preserved the subscriber’s life.2d at 310-11. App. a status relationship to another.2d 1159 (Wash. status relationship. 13 (Cal. State v. Super. 308 F. knowing he had no other way to get food).Y. supra note 1.S. Burden.2d 609. People v. 6 See People v. Abraham. at 89-91 (describing legal duties arising from statutory duty. Dist. 1344 (Pa. aff’d. 282 (Ct. 1991) (holding defendant guilty of murder for agreeing to provide for a 92-year old and then letting him starve to death. 1977) (sustaining a murder charge based on a parent’s failure to feed an infant). If an HMO breaches a legal duty to one of its subscribers by wrongfully denying treatment benefits that would. and contractual obligations). Div. 5 See. 335 S.) (holding that guardians were guilty of criminal negligence for failing to care for the retarded brother decedent). 808 P. 378 (Va.2d 657 (1988). App.2d 5. Commonwealth v.2d 1339. People v.
People v. State v. the lethal omission was inspired by a motive to secure a financial advantage.E.143 Prevalence of “Homicide” in America’s Medical Industry There has been a deliberate breach of a legal duty to provide essential care. provided only that he was saved from drowning. 7 See sources cited supra notes 1-6. 1989). There may. see also Pinkerton v. State. In both cases. or the fact that the victim was going to die anyway. 1992) (noting that parents have an affirmative duty to protect their children from threat of murder and holding that neglect of this duty imposes liability by reason of accountability). even with all possible care. given the inevitability of eventual death. 1211 (Ill. the defendant’s wrongful failure to avert such other causes. however. App. In both cases. This is. . someone has died due to the breach of duty.2d 671. 784 P. For example.2d 147.2d 1201. a difference without a legal distinction. even at the expense of human life. Wyatt. 1996) (finding that "knowing failure to take reasonable steps" to prevent deprivation that resulted in a child’s death constitutes murder). Stanciel. 8 "Life at best is but of short duration"9 and. Criminal liability for causing death is not relieved by the victim’s pre-existing health condition.E.Va. the law is clear that "murder is never more than shortening of life. What makes fatal omissions into crimes is. also be salient factual differences between the two cases. 482 S. 677 (Alaska Ct.11 It is. the case of the avaricious uncle seems to presuppose that the young nephew had a long life ahead of him. By contrast. medical patients who are so ill that they die from lack of treatment are often so close to death that they would soon die anyway. 606 N. precisely. 153 (W. always a characteristic of omission-homicide cases that there are other causes of death than the omission alone. of course."10 even if only by a day. moreover.
601-02 (Iowa 1887). It may. Superior Court. once it is shown that the duty has in fact been breached. 1966). 1884) (stating that it is homicide even if the victim has "a tenure upon life that cannot possibly continue for a day") that results. 10 People v. App. 487 (Ct. State v. 1969) (holding appellant guilty of murder for causing the victim to die of a heart attack). 195 Cal. no HMO entity or personnel have ever yet been criminally prosecuted for wrongful delay or denial of treatment authorization.Medical Industry’s Death Panels The HMO’s duty is contractual and is subject to stipulated exceptions while the uncle’s duty is rooted in a status relationship and is relatively unconditional. the HMO and its decision making personnel would seem to be in exactly the same legal position as the avaricious uncle—criminally liable for the death. 11 See People v. Rptr. 484. 9 State v. 548 (Cal. 913-14 (Ct. 873 (Mont. Moan. 597.2d 545.2d 353. despite these differences in the origin and scope of the legal duty. 366 P. Malley. 911. Barber v. the cases would seem legally the same. however. 358 (Cal. cf. 79 Cal. To my knowledge. Morgan. App. 4 P. considerable disquiet about the federal limitations on HMO . relying on HMOs. 1983) (referring to superior court judge’s conclusion that homicide is the shortening of life since everyone sooner or later will die). moreover. 34 N.2d 868. However.W. be only a matter of time before such prosecutions are attempted. 8 See People v. Already there is a growing interest in civil actions for the harms that ensue when people. Phillips. That is.12 Death-by-omission should be the same thing legally no matter who happens to be the omitter. 1961) (allowing conviction if the "spark of life is extinguished by a wrongful act"). suffer or die because benefits are denied. assuming the HMO breached its contractual duty by refusing to authorize timely care. Rptr.13 There is. 414 P. Smith.
J.15 In many cases. in the form of higher premiums. Cost-Cutting Consequences: An HMO Liability Case is Being Closely Watched by the Lawyers Who Targeted Tobacco Companies. The Legal Implications of . In any case. criminal prosecutions may therefore be the only effective avenues of redress. Richard A. See also Chad Bowman. 1 (1990) (discussing potential liability for HMOs and PPOs with regard to provider selection and utilization management). Tiano. 12 See infra Parts III and IV.L.14 However. 68 U. the amounts paid out as damages in lawsuits become just another cost of doing business. For the HMO. criminal sanctions may actually work better than mere civil damages to motivate HMOs to authorize the medical treatments that their subscribers are contractually entitled to. Linda V.145 Prevalence of “Homicide” in America’s Medical Industry liability that were enacted by Congress in the Employee’s Retirement Income Security Act (ERISA). 2411-12 (2000) (observing that "the common law is evolving to allow patients to receive compensation for injuries caused by HMOs" and that "liability protection for managed care continues to be the battleground for the coming year"). 14 SETON HALL LEGIS. Feb. at 30. Special Report: Health Care Outlook 2000. Savage. 2411. civil damages for wrongful treatment denials may actually work against the interests of the HMO’s subscribers and patients. 2000.B.. the ERISA exemptions do not apply to criminal laws. Elden. J. As a result. increasing premiums and diverting scarce resources away from medical care into judgments and lawyers’ fees. Hinden & Douglas L.W.S. Liability Issues for Managed Care Entities. A." see David G. One of the biggest disadvantages of allowing civil damages against HMOs is that the companies can simply shift the burdens of those "penalties" back to the subscribers. 13 For a prediction that "HMOs may replace big tobacco companies as the prime target of the nation's trial lawyers.A.
14 See 29 U. A civil defendant may shift the cost of a monetary judgment. § 1144(b)(4) (1994) (specifying that ERISA does not supersede "any generally applicable criminal law of a State"). it may never be possible to minimize the number of wrongful HMO denials. not a right to get cash "compensation" after the fact.C. the fact remains that it is the response prescribed by law for cases where people’s conduct proves deadly or causes .S. laws relating to any employee benefit plan are superseded by ERISA). This is. Although criminal punishment is a dramatic response to administrative errancy.C. 14 SETON HALL LEGIS. § 1144(a) (1994) (stating that.Medical Industry’s Death Panels HMO Cost Containment Measures. The due performance of these agreements can be vital to life itself. as needed. the classic function of the criminal law—to impose costs on bad behavior that offenders cannot shift. 79 (1990) (describing liability theories that can arise when HMOs deny benefits causing patients’ injury or death). but a criminal defendant cannot "shift" a prison sentence. J. of course. 15 See 29 U. which it can pass on to subscribers. when life-or-death treatments have been denied. When people subscribe to HMOs.S. The only way to prevent HMOs from shifting the penalties for wrongful denials is to impose a cost on wrongful denials that the HMO cannot shift.17 The legal agreements that people make with HMOs are no ordinary commercial contracts. instead of delivering the benefits it has promised in its contract. It little serves the person denied benefits. As long as HMOs are able to shift the costs of their breaches. or his surviving family and loved ones. to let an HMO get off with merely paying damages. what they are primarily seeking is quality medical care.16 Money is a poor recompense for a permanently impaired quality of life or the loss of life itself. with certain exceptions.
1995). the idea "stinks in the nostrils" that a person who makes a promise need feel no compulsion to perform. consumers say that quality of care is their greatest concern .org/firstpage. 171 (Joel Feinberg & Hyman Gross eds.18 In the social debate about the role of HMOs.html." Report to Congressional Requesters. Consumer Health Care Information: Many Quality Commission Disclosure Recommendations Are Not Current Practice. GAO Rep. 1998) (report of Bernice Steinhardt. 38 states and the federal government currently prescribe the death penalty for lethal conduct under certain aggravating circumstances. Director. the deterrent impact of criminal penalties can scarcely be doubted: A potential for criminal prosecutions would give HMO decisionmakers a strong incentive to treat subscribers right. the public could feel much more secure against wrongful medical care denials in any situation where the patient’s life might be shortened or health seriously compromised. 3. 18 Indeed.. . at 18 (Apr. The Path of the Law. Health Issues).147 Prevalence of “Homicide” in America’s Medical Industry serious bodily harm. our nation’s commitment to criminal punishment as a tool of social policy must be recognized as part of the background. avoiding delays and unwarranted denials of treatment authorization. 16 "In choosing a health plan. O. In any case. 17 As stated piquantly by Oliver Wendell Holmes. See State By State Death Penalty Information (visited Nov. . (Death Penalty Information Center. Quality & Pub. GAO/HEHS 98-137. 30. with prosecutions a possibility. . provided the person is willing to pay legal damages. In addition. Jr.) . such as when multiple victims occur. No. in PHILOSOPHY OF LAW 169. 5th ed. Health Serv. Holmes.deathpenaltyinfo.. 2000) http://www. W.
9 HEALTH MATRIX 79. Finally. that regulatory measures can have much effect since they are "always a step behind the latest business . It is doubtful. Jacobi. offering leniency to subordinates in exchange for testimony against their superiors. and it may be almost impossible for a civil plaintiff to demonstrate in an individual case that economic considerations played a role.21 In a criminal prosecution. Did the HMO refuse to authorize treatment benefits in a situation where there was a legal duty to approve and provide them promptly? Were the HMO’s decision-makers aware of the risks imposed 19 See John V. much less an improper role. in an HMO’s decision to deny benefits. as will be described below. the rules to which our society turns routinely to address a wide range of harmful activities. Canaries in the Coal Mine: The Chronically Ill in Managed Care. Medical decisions and judgments are necessarily discretionary. Third. the individuals directly responsible for forming HMO policies. by contrast. the criminal law is not superseded by ERISA. Second. so the current federal barriers to civil lawsuits would not stand in the way. the needed evidence can be obtained by such well-tested prosecutorial techniques as.Medical Industry’s Death Panels In sum.19 the most straightforward approach may be simply to enforce the rules we already have. The only real questions seem to be factual. the existing rules of criminal law.20 criminal prosecutions offer advantages with respect to proof. however. 106-26 (1999) (summarizing a variety of proposed and enacted regulatory measures). while there are many possible approaches to the regulation of HMOs. First. for example. as will also be outlined below. the criminal law has the advantage of subjecting wrongful treatment denials to a penalty that cannot be shifted back to subscribers. the criminal law on lethal and other injurious activities is rather clear.
(Oct. Was the patient’s life shortened or health impaired as a result? This article will. in Part II. a short Postscript will consider some further policy implications of HMO homicide prosecutions. on Health & Env’t of the House Comm. on Commerce. .). lawyers find that obtaining critical information from a plan is akin to getting gold bars out of Fort Knox. particularly in the cases of elderly and chronically ill patients. 28. after concluding that the criminal law provides. News Serv. Finally.)." while HMO cost containment methods "are simply too complex and subtle to be easily addressed by rigid regulations. The objective is to show how the natural effect of normal market forces is to exert a constant pressure towards treatment delays and denials. 21 "Even in those few cases in which there have been legal claims [against HMOs]. 1997) [hereinafter Menace of Managed Care] (prepared statement of Linda Peeno. Denial and Control Can Result in Patient Harm.C. 20 See infra Part IV." The Menace of Managed Care: A Guide to How Avoidance.D.149 Prevalence of “Homicide” in America’s Medical Industry practice. Part III will provide an overview of the existing criminal law as it applies to situations in which death results because someone has violated a legal duty to provide medical treatment. first provide a brief examination of the economic pressures that market forces bring to bear on HMOs and their decision-making personnel. available in LEXIS ( Fed. Before the Subcomm. M. at 120. In Part IV." Id. a rather clear basis for homicide prosecutions of HMO personnel who authorize lethal treatment denials. in its present state. the question of the requisite mental culpability will be discussed. 105th Cong.
Ct. . 23 See. However. et al. Crum & Forster Ins. See John E.g. N. with forprofit HMOs now accounting for nearly two thirds of the total HMO market. Supp. 282 JAMA 159. these corporations have acquired the power to make essentially final decisions about who receives medical care. Quality of Care in Investor-Owned vs Not-for-Profit HMOs. . Herdrich. MGMT. Managed Care Ethics: The Close View (last modified May 30. 2149 (2000). 2143. 530 U.23 22 "Between 1985 and 1998 the proportion of HMO members enrolled in investor-owned plans increased from 26% to 62% ." Pegram v.S. Aug. Linda Peeno. 131. her parents’ HMO has denied approval for the treatment that she needs. 1039 (1996).. 1989) (noting that the Plan Administrator "retains ultimate authority to grant or withhold benefits"). HEALTHCARE FIN. Nelson. . what kinds of care they receive. supra note 21.. Chronically Ill Patients Treated in HMO and Fee-forService Systems.. 211. THE PROBLEM OF |"NET-NEGATIVE" PATIENTS In the past couple of decades. Himmelstein et al. Customers Demand Managed Care.. 134 (D. 716 F." David U. "The defining feature of an HMO is receipt of a fixed fee for each patient enrolled under the terms of a contract to provide specified health care if needed. HMOs and other managed care firms have taken on a dominant role in the health care field. 159 (1999). Half or more of privately insured Americans are enrolled in HMOs. Co. 1996) A child is seriously ill. e. Dozsa v.22 Typically.. 1995. and when they can receive it.J. Jr. .Medical Industry’s Death Panels II. at 38 (stating that "about 66 percent of insured Americans are enrolled in HMOs and other forms of managed care plans"). see also William H. According to her doctor. Ware. Menace of Managed Care. 120 S. Differences in 4-Year Health Outcomes for Elderly and Poor. 276 JAMA 1039. She will not live much longer if steps are not promptly taken. discussed infra text accompanying notes 24-29.
So. The treatment is. a few days from now—maybe less—she will lapse into unconsciousness and. somebody ought to pay. expensive. however. It could extend her life by months or even years. she will pass away. more than her parents can pay. If she dies now. soon after. Her parents ponder this and think: "We’ve paid premiums to that HMO for years. the law should make somebody pay for letting our daughter die. As long as the child lives she will need expensive care. because of this denial. Also." . the initial cost is just the beginning. It is a burden that the HMO does not want to take.151 Prevalence of “Homicide” in America’s Medical Industry the treatment has a good chance of helping.
cover-ups by mainstream media. cover-ups by lazy or complicit regulators. and indifference by the public. Similar to prior cause and effect. I was determined to at least make public the corruption responsible for Glenda’s suffering and premature death. my investigations expanded to other areas of corruption by key people in covert government operations. In May of 2011. I foolishly chased “windmills. I was a key federal airline safety inspector.CHAPTER SEVENTEEN Last in Series of Fighting Corruption Starting in the mid-1960s. a cancer for which cancer treatment drugs have even more severe side effects than the drugs used for esophagus cancer. The horrors that Glenda experienced during her four-year battle with cancer and COPD. Later. there was no understanding among the public. That culture would affect others among the American public. The arrogance and corrupt conduct I encountered from rogue physicians at HMO Kaiser Permanente medical group has further . I was diagnosed with Stage III kidney cancer. investigating and exposing criminal misconduct that enabled a long series of brutal airline disasters to occur.” Despite facing the same obstacles. were experienced personally to some extent.
• There is a reason for the reported 30.153 Last in Series of Fighting Corruption shown the sordid depths to which certain members of the medical fraternity have sunk in the United States.com/list_of_books. caused me to suffer enormous personal and financial harm.com. The attacks upon me.000 medical-error deaths a year in hospitals. Medically-related deaths outside of hospitals are not defined. corruption again affected me personally. While fighting the death panel and arrogance of certain physicians at Kaiser.defraudingamerica. Now. Sampling of informative sites: • www.html for a list of the heavily documented books on multiple areas of high-level corruption discovered by me and my coalition of other former government agents and insiders.defraudingamerica. but the thug-like physician misconduct that made Glenda's last days on earth so brutal should be an eye-opener even for the most naive among the masses! Rampant Physician Misconduct That Meet Definition of Criminal Conduct The need for. and the laws permitting. I had fought off for several decades attacks to halt my exposure of high-level corruption in the federal government which continue to cause or enable to occur great American tragedies. • Denial of health care by Kaiser Permanente senior Medicare plan.where over a thousand files provide evidence that is never made available to the trivia-obsessed masses. seeking to silence me. toward the end of my life. www. criminal prosecutions of HMO denial of care decisions are addressed in an article written by . I had to deal with the many problems confronting Glenda.
however. an important legal difference between the two: In order for a fatal omission to be considered a crime.’’ James said in an interview. Such a legal duty may also be created by contract. as well as the fact that the support that should have been in place for her was not in place.boston. where Jeremy was treated. for example when a person agrees to provide care for another. said yesterday that the jury apparently did not understand the burden his client experienced in caring for an autistic son who developed cancer. Such legal duties may arise in various ways.defraudingamerica. a legal duty to provide care is imposed on the parents or legal guardian of a child.com (April 13.Medical Industry’s Death Panels Ohio State University professor. . the omitter must have had a legal duty to act." stated: LaBrie’s attorney. "Woman who withheld son’s cancer drugs found guilty. John A. He had also argued that social workers and doctors at Massachusetts General Hospital. There is.com/hmo_criminal_prosecution. 2011) under the heading. "What we wanted to get across to the jury is the tremendous burden my client had to carry. should have done more to make sure she was fit to care for her child and administer the medications. and the victim’s death must result from a breach of that duty. For example. • www. Kevin James.html. Included in that article was the following statement: Homicide can be committed by commission or by omission— by affirmatively doing a lethal act or by omitting to do an act that is necessary to preserve another's life. Humbach with dozens of legal citations showing criminal offense from HMO withholding of life-affecting treatment. A Boston Globe article at www.
’’ O’Keefe said. said she understood jurors were required to follow the legal directives given to them. “It’s too hard for them to know what my sister was going through at that time. David and Ginger Twitchell. LaBrie’s sister. were Christian Scientists and believed the boy could be healed by spiritual treatment. but who understand the difficulties of raising a developmentally disabled child with cancer. then of Hyde Park. never. said LaBrie’s case was troubling in that she was portrayed as a mother who was overwhelmed.155 Last in Series of Fighting Corruption James said he asked for the sentencing to be postponed at least until Friday in part so that he could gather evidence of support his client has received from many people who never met her. The state Supreme Judicial Court. in reviewing that case. . determined in a landmark decision that parents have a legal duty to provide medical care for gravely ill children.W. but that her sister never sought to hurt Jeremy. once it became obvious that she was not administering medications. holding back tears.’’ Legal analysts said yesterday that the case was the most unusual since prosecutors brought manslaughter charges two decades ago against a couple who refused to authorize surgery for their toddler. Carney Jr. He said the case should have also focused on the failure of LaBrie’s doctors to intervene quicker. of Carney & Bassil. “I don’t think my sister had any intentions of hurting Jeremy. O'Keefe. The couple.. who was suffering from a treatable bowel condition. regardless of religious faith. He died within several days after his diagnosis in 1986. ever. Boston attorney J. I never will believe that in my life.
One of the aggravating factors is you have a vulnerable victim with a disability in this case. who could consider outside factors. Ballou at bballou@globe. Under state sentencing guidelines. with mitigating factors.com/2011-04-13/news/29414342_1_hospicecare-medication-young-son/2.’’ Carney said. LaBrie — who does not have a criminal record — could face up to 7 ½ years in prison. “A judge is authorized to go downward.’’ he said.com.’’ Valencia can be reached at www. Compassion and Coordination with Caregivers Alien to These Medical Industry Physicians What Glenda and I experienced together in our cancer journeys were in key areas the exact opposite of what is expected as a practical manner and what is claimed at major medical centers. “I think there are mitigating factors and aggravating factors in this case. That determination will be made by Judge Richard Welch. Boston-based defense attorney Randy Gioia added. according to legal analysts. “It is cruel to add to that burden a diagnosis of cancer and a requirement that the mom administer medicine that will cause the child even more pain. or depart upward if there are aggravated factors.boston. and what I am experiencing at my HMO type medical group at Kaiser Perma- . That is one of the factors the judge is going to take under consideration. nonverbal. and developmentally delayed.mvalencia@globe. Article at the following address: http://articles.com.Medical Industry’s Death Panels "It can be so overwhelming for a single parent to deal with a child who is autistic. The consequences were felt by Glenda in her cancer ordeal under the fee-for-service Medicare and Healthnet PPO." The attempted murder conviction carries a maximum penalty of 20 years in prison.
who was going. 2012. Honest Medical Care and Compassion: Missing in Much of America’s Medical Industry The universally recognized requirement of care requires physicians to keep caregivers and family members fully informed of a patient's condition and treatment. Vona Lorenzana. I consider these to be outrageous criminal acts that led to Glenda's needless suffering and premature death! I notified Glenda's cancer doctor of Glenda's death. Glenda and I encountered a constant pattern of indifference. February 3. At Manor Care. to do it.157 Last in Series of Fighting Corruption nente in Walnut Creek. and whether it met the standards that can often be found through an intelligent Google search. A subsequent letter requesting important information also went without a response. being treated like a commodity. The only one of Glenda's physicians that responded after Glenda's death was Glenda's primary care physician. I was unable to discover the plans for the removal of the fluid from the lungs. the cooperation with caregivers. I believe that the quality of care. even when repeatedly requested and demanded. being denied details of the treatment and medical condition. This denial made it impossible for me to know what treatment was being given. the compassion. and when. But I would soon learn that it was Glenda’s primary care physician that put the final nail in Glenda’s coffin. In Glenda's case. No response. and couldn't get any details about what if anything was being done. is far superior at the major medical centers. I was unable to find out what the pulmonary rehabilitation consisted of (They didn't have a professional pulmonary unit!). California. and contributed to Glenda's premature death from breathing problems. But there were physicians affecting . Since they had a moral and legal responsibility to do these things.
The Enablers Since the 1960s. as a federal airline safety inspector. January 24. in pain from denial of treatment. 2012. and the American public did suffer. with complaint against Iranian born doctor. Life in the United States would be totally different if these areas of corruption did not exist. 2012. Medical Board of California Complaints to the California Medical Board resulted in the standard do-nothing that is the culture in state and federal regulators. Ativan. February 20. enlarging on Khashayar's conduct and Glenda's death. to deny to me any say in her treatment. For four years. while drugging Glenda with the mind-altering Ativan drug. and under the effect of the mind-altering drug. Fax sent to Medical Board of California. that possibly .Medical Industry’s Death Panels Glenda's life doing the very opposite. because of the enablers that covered up. too indifferent. alleging abandonment of Glenda at critical time. Examples of the many documented areas of corruption and consequences can be found at www. Ramin Khashayar. They kept me totally in the dark while they used Glenda in the business-related scheme. I have uncovered multiple areas of major misconduct that caused or enabled to occur some of America's worst tragedies. The following are two of many examples: Prior to Glenda’s death I sent a fax to the Medical Board of California. Then they encouraged Glenda. No response. and continues to do so more than ever. But they did exist.defraudingamerica. I maneuvered under difficult circumstances to arrange for treatment that greatly assisted her living four years instead of the normal one year after a Stage IV esophagus cancer diagnosis.com. and more interested in their own self. And that includes well-paid government regulators who were too lazy. to perform the duties they were paid and entrusted to do.
ever be reported as medical errors or medical corruption? Was Glenda's sudden death a result of excessive opiate administration? See one article on the internet relating to the deliberate administration of excessive opiate and resulting death: http://www. die because of the indifference. • • • . And publicizing these problems. and the needless sufferings and deaths that occur.159 Last in Series of Fighting Corruption could have been prevented if they had acted instead of covered up.org/euth-acct-four. Neither she nor her caregiver wanted her murdered by the conditions inflicted upon her. Thousands of people reportedly die every year in the United States from medical errors. Glenda had earlier wanted to die only because of the inadequately treated pain and COPD problems.html. But those who die from physician misconduct. They now have a primary reason to cover up and protect Khashayar. self-interest.000 people die each year from errors in hospitals. • Questions Needing Answers A reported 30. I have experienced the do-nothing complicity of California and federal healthcare regulators. cowardice. of state and federal regulators. And so it is in the medical field. and many others. as described at this and other sites. How many of those "errors" are due to outright medical corruption? How many are the unreported deaths outside of hospitals due to medical personnel misconduct? Will Glenda's premature death.hospicepatients. who are complicit and enablers. considering my age and cancer. will be the final efforts in 50 years of doing these foolish things.
2. You implied by your Certification of terminal illness that: • The medical condition for which Glenda was in Manor Care (shortness of breath) was untreatable and that she would die of that medical condition within six months. fax to Dr. that Glenda had less than six months to live and would die of esophageal cancer and that you would act as attending physician while Glenda was at Bruns House hospice. and will change my report if you provide facts that indicate otherwise.defraudingamerica.defraudingamerica.com/medical_care_minefield. Addressing Dr. The following is my interpretation of the evidence. 2012. Lorenzana stating the sham nature of her Certification of Terminal Illness. You were the primary physician needed to issue and sign the certification of terminal illness (CTI) on January 31. • That the pulmonary rehabilitation treatment ordered by John Muir hospital to improve her pulmonary shortness of breath had been given to Glen- . I am putting this letter on the internet with my interpretation of your conduct. which I am presenting to different government entities: 1. 2012.html. just as government oversight personnel have allowed to continue the corruption that enabled to occur many of America's worst tragedies. See: www.com. www.Medical Industry’s Death Panels Government medical oversight personnel will not act on these corrupt acts. Lorenzana’s Sham Certification of Terminal Illness “Death Decree” I sent a March 22.
and that the only decision for her was to accept palliative treatment and die. fraudulently held to have a pulmonary condition that could not be improved upon. and that Glenda’s condition had worsened to where her death from the shortness of breath condition would occur any time within six months. if the medical conditions were in fact treatable and did not indicate a fatal ending within six months. • It would be a criminal offense to sign a certification of terminal illness if any of the above conditions existed. • That the intense pain from the ulcer/wound/bed sore was not treatable.161 Last in Series of Fighting Corruption da. • The pulmonary rehabilitation treatment was not effective. • The esophageal cancer that your Certification of Terminal Illness stated as Glenda’s expected cause of death appears nowhere on any of the medical records pertaining to Glenda’s recent hospitaliza- . • That there were no irregularities or fraud in the medical care for Glenda while at Manor Care that contributed to the expected death within six months. • That Glenda was made fully aware of the above irregularities. and knew that she had been fraudulently denied the pulmonary rehabilitation treatment. • That the drugs given to Glenda at Manor Care did not worsen her breathing problem.
8. John Muir hospital. 7. 2012. 5. notified Manor Care that Glenda was to be transferred to their facility for treatment (that they did not have). 2012. and deprive Glenda of the medical treatment and pulmonary rehabilitation. I notified you by faxes of serious medical problems including medical misconduct that was causing Glenda to needlessly suffer pain. and case law requirements for hospice had been met for you to legally sign the Certification of Terminal Illness. regulatory. for that treatment. where physicians ordered Glenda to be treated at a pulmonary rehabilitation unit. 4. January 16. You knew that Manor Care did not have a pulmonary rehabilitation unit and that treatment was never provided to Glenda. That the statutory. You did nothing about the medical misconduct being inflicted upon a patient that you had oversight responsibili- . 2012. 6. 2012. January 20. 2012. Glenda was sent to Manor Care Rossmoor Parkway on January 14.Medical Industry’s Death Panels tion. and January 26. 3. at John Muir hospital. 9. I stated to you in several faxes serious misconduct that was adversely affecting Glenda’s medical condition. 2012. that was ordered by John Muir hospital physicians. That Manor Care fraudulently accepted Glenda for that treatment when Manor Care’s key source of patients. You certified that you read the medical reports relating to her medical problems for which she first sought treatment on January 5. including those dated January 11.
11. when Manor Care had no such facilities and that the fraudulent acceptance was probably to continue an uninterrupted flow of patients from John Muir hospital. she was dead! . or should have known. that it was not an insurance matter. 10. that Medicare and Healthnet PPO would pay for the pulmonary rehabilitation treatment that Manor Care was withholding from Glenda. omitting information about denial of ordered medical treatment and the medical misconduct occurring while Glenda was at Manor Care. You knew. you became complicit through covering for these medical crimes that could be expected to have fatal consequences. That as a result of your actions. smiling. you knew when you heard that Glenda was being transferred from John Muir hospital to Manor Care for pulmonary rehabilitation that Manor Care did not have such medical facilities and arranged for prompt transfer to a skilled nursing facility that did have: the Kindred SNF located about 300 feet from your office. doing her crossword puzzles. reading the newspaper. Worse. you falsely stated that this was an insurance problem. Glenda arrived at Bruns House hospice. When I notified you that Manor Care was discharging Glenda on the sham argument that her pulmonary condition did not show any improvement. that Manor Care had fraudulently accepted Glenda agreeing to provide such treatment. 13. 12. Under your primary care physician responsibilities. But within hours. and on the telephone.163 Last in Series of Fighting Corruption ties as her primary care physician. Glenda was dead within a matter of hours. You then insured Glenda’s premature death by covering up for these medical crimes by falsely signing the Certification of Terminal illness.
John Muir hospital personnel selected Manor Care Rossmoor Parkway to provide the pulmonary rehabilitation treatment. Prior to that transfer. from what I brought to your attention and partly from your examination of the records. 15. 2012. 17. Laura Stengel. John Muir hospital physicians determined that Glenda’s shortness of breath could be improved with pulmonary rehabilitation treatment. and would not accept Glenda as a patient.Medical Industry’s Death Panels 14. John Muir hospital physicians reported that Glenda had fluid on her lungs and a possible fungus infection— which she previously had a year or two earlier. Admissions Director at Manor Care. She was transported there on January 14. You were aware of all of the above. I brought Glenda Guilinger to John Muir hospital in Walnut Creek because of shortness of breath. 18. 20. It appears that your clubbiness with the physicians involved in the medical misconduct against Glenda gravely affected your responsibilities to her. 19. History of Glenda’s Medical Problem and the Medical Frauds Known to You: 16. and the following facts. When John Muir hospital personnel. during two separate discussions with three different people. They ordered that this treatment be given to Glenda at a skilled nursing facility (SNF). On January 5. a major source of Manor Care’s business. stated that Manor Care did not have a pulmonary rehabilitation program or pulmonary specialist. notified Manor Care that they were sending Glenda to their facility for pulmonary rehabilita- . 2012.
when Manor Care had no such program or pulmonary specialist. 23. They showed us the room Glenda would be in and confirmed that they would accept her. 21. Within 24 hours of receiving Glenda. this transfer was cancelled after Kindred admission personnel called the case manager at John Muir hospital to arrange for transfer and was told that Glenda was already being transferred to Manor Care. That risk of being exposed was quickly addressed by Manor Care personnel. was the first to state to Glenda. However. on January 15. Dr. 2012. Manor Care personnel notified Glenda that she would have to leave and that she was not capable of having her breathing problems improved upon. Manor Care’s nearby competitor in the skilled nursing facility business did have a pulmonary rehabilitation unit. That was of course a deliberate lie to get Manor Care out of the predicament that Manor Care got themselves into by fraudulently accepting Glenda when . By accepting Glenda for pulmonary rehabilitation treatment. that Glenda was not capable of having her shortness of breath improved and that she would be shortly removed from Manor Care. Kindred’s admission personnel had earlier stated to me and my daughter that Kindred did have a pulmonary rehabilitation unit. possibly for fraud. the day after arriving at Manor Care. one of your associates at 1220 Rossmoor Parkway. 24. Their facilities were about 300 feet from your office building. 22. including you in your position as chief physician. Manor Care risked being cited by Medicare and California regulators.165 Last in Series of Fighting Corruption tion treatment—Manor Care management remained silent about not being able to provide that treatment for Glenda. Smita Chandra.
some of which had published warnings not to be used on patients with pulmonary breathing problems. 2012. 26. 24 hours since arriving at Manor Care could not have enabled anyone from making such judgment. My January 16.Medical Industry’s Death Panels John Muir hospital notified Manor Care that they were having Glenda transported to Manor Care for pulmonary rehabilitation treatment. letter to Manor Care addressing India-trained Dr. • Attempting to cover up for that first fraudulent act by immediately stating to an ill patient that she would be evicted from Manor Care and that she was not capable of having her breathing problems improved upon. Obviously. The harmful round-the-clock dosing of Glenda with drugs. your cruel statement to Glenda. Chandra’s misconduct to an ailing patient that included: • Withholding from a senior patient the fraudulent accepting of a patient transfer from John Muir hospital under an order for pulmonary rehabilitation treatment when Manor Care had no such program. even if there had been such a program— which there wasn’t. That was a lie: Glenda didn’t yet have the ordered pulmonary rehabilitation treatment and there was no way that you could contradict the physicians at John Muir hospital that stated she could have her breathing improved. who was leading an active life and who wanted to live. 25. and others worsened her breathing problems and created other medical problems. Sampling of these drugs included: . and for argument. created great stress and anxiety upon the woman.
depression. allergic reaction causing swelling of the airways— which Glenda experienced. mental depression. and hoarseness—which Glenda experienced. change and irregular heartbeat—which Glenda experienced.) • Protonix/Pantoprazole (Published side effects included difficulty breathing. hoarseness. all of which depresses lung function.) • Metoprolol Succinate (Published warning side effects include breathing problems. Oxycodone HCL round the clock. accumulating in the body.) • Bisacodyl (Published warning side effects include difficulty breathing and swelling of the mouth —which Glenda experienced. resulting in difficulty swallowing—which Glenda experienced. with each dose being cumulative.) • Haloperidol Lactate (Published side effect includes shortness of breath and swelling of the mouth. and musculoskeletal pain—which Glenda experienced. bone pain.) • Diltiazem (Published side effects include difficulty in breathing. swelling.) . Duramorph. swelling of the mouth. swelling of the mouth. swelling of the mouth. (Published strong warnings state these drugs are contraindicated in patients with breathing difficulty.167 Last in Series of Fighting Corruption • Morphine sulfate. shortness of breath. Norco.) • Digoxin (Published warning side effects include difficulty breathing.
Iranian Dr. 2012. As her oxygen level improved. . dryness of the mouth. depression. and compounded by the misuse of round-the-clock drugs that worsened the breathing difficulties. 2012.) • Prednisone. depression. Glenda was transported to John Muir hospital for the thoracentesis procedure to remove the fluid on her lungs that was first discovered nearly three weeks earlier when she was admitted to the hospital for shortness of breath. On January 24. pain in back—which Glenda experienced.Medical Industry’s Death Panels • Ativan/Lorazepam.) 27. Similar to John Muir hospital reports. hinders wound healing. That delayed thoracentesis procedure was done by Glenda’s pulmonary doctor. 2012. (Published warning side effects include breathing difficulties. Manor Care records reported that Glenda showed improvement in her breathing after that procedure was done. Ramin Khashayar. Kaiser Permanente. 29. 28. increased blood pressure. she was discharged to Manor Care on January 23. irregular heartbeat. Glenda’s oxygen level plummeted. This could be due to the failure to provide the John Muir hospital ordered pulmonary rehabilitation treatment. swelling of the throat. This improvement may have been due to removal from the breathing-impairment drugs given to Glenda at Manor Care. especially to seniors. Glenda was rushed to the nearest hospital. Various events interfered with Manor Care’s efforts to evict Glenda. delusions—which Glenda experienced. shortness of breath. water retention. (Published warning side effects include strong warnings not to give to patients with COPD breathing problems. no terminal illness was stated. On January 21.
you and other Manor Care physicians ordered round-the-clock morphine and morphine-containing drugs to be given to Glenda. and the role you played by ignoring your responsibilities to intervene—and then to order the sham Certification of Terminal illness—include the following: • Fraudulent admission of Glenda into Manor Care for an ordered medical treatment that Manor Care knew it did not have. 30.169 Last in Series of Fighting Corruption after I reported to the medical board of California that he had abandoned his patient at a life-critical period. Instead of obtaining medical care from a wound specialist. and then dosing her with round-the-clock morphine and morphine related drugs that worsened . including Manor Care’s nearby competitor. • Refusal to obtain a wound specialist to treat Glenda’s worsening wound/ulcer/bed sore on her back. especially among seniors. That attempt was vocalized by Dr. Highlights of the life-affecting abuse of Glenda. • Fraudulent attempts to evict Glenda from Manor Care by Manor Care physicians. Kindred SNF. using the sham argument that Glenda did not display an ability to improve her pulmonary function. Those drugs were known to worsen a person’s breathing capabilities. who acted under your supervision. within 24 hours of her arrival. • Refusal to transfer Glenda to a SNF that had the pulmonary rehabilitation treatment. While at Manor Care. Glenda experienced increasing pain from a wound/bed sore/ulcer on her back. Smita Chandra. 31.
in pain. Dr. Further cause for Glenda’s anxiety was the misconduct by pulmonary specialist.Medical Industry’s Death Panels her breathing problems. Manor Care management and physicians refused to respond to my faxes asking for information about Glenda’s treatment. 32. 34. and waiting to be evicted. Manor Care personnel falsely stated that Glenda was not capable of . and forced Glenda to sign that she received the letter complaining of these matters. compounding her anxiety. 33. Ramin Khashayar. That misconduct occurred while Glenda was lying at Manor Care. He refused to treat Glenda unless I signed a statement that the facts in my complaint were false. and some that caused anxiety. Dr. and during one phone call accused me of blackmailing him for complaining to the Medical Board of California. where the pulmonary rehabilitation facility did exist. Shortly before Glenda’s removal from Manor Care. Khashayar compounded that by having a letter delivered to Glenda complaining about my conduct [seeking to have him attend his seriously ill patient]. as I sought to transfer Glenda to nearby Kindred SNF. some that were not to be used on COPD patients. I had power of attorney over her medical care and authorized to be kept informed. worsening Glenda’s anxiety arising from all the other wrongs inflicted upon her by physicians. He repeatedly refused my requests to examine Glenda. and I was her partner for the past 18 years. • Compounding the harm to Glenda’s breathing problem with round-the-clock dosing with drugs. or elderly patients. Possibly to insure that these medical frauds by multiple physicians went unaddressed. despite the fact that I had been arranging and overseeing her medical care for the prior four years.
This rejection. and January 31. John Muir hospital physicians held that Glenda’s breathing problems could be helped by pulmonary rehabilitation treatment (which Manor Care physicians denied to Glenda). The complicity of two physicians was needed to remove Glenda from Manor Care. addressing Glenda’s underlying cancer. a physician consultant at Hospice of the East Bay. causing her to just give up and want to die. 2012. Joy Spencer. added to the medical abuses already inflicted upon Glenda. The reports throughout that period focused on Glenda’s shortness of breath. and the routine off—the-shelf statement by Dr. 36. her oncologists had scheduled . • Glenda was diagnosed four years earlier with Stage IV esophagus cancer. • The certification of terminal illness had to cover up for the prior misconduct inflicted upon Glenda. You knowingly signed a certification of terminal illness falsely stating that Glenda had less than six months to live. This was done on January 31. 2012. who cavalierly stated nothing to support her short off-the-shelf one sentence death decree. and that her death would come from esophageal cancer. including what has already been stated. Treatment had put that cancer in remission. Kindred refused to accept Glenda. Several falsehoods arose with those two certifications : • There were no reports in any of the medical facilities that cared for Glenda between January 5.171 Last in Series of Fighting Corruption showing pulmonary improvement. 35. 2012. Based upon this false information. These two physicians included yourself.
or encouraged. cover-up. were cancer specialists. and instead go to Bruns House hospice. 41. 2012. that she had never received that treatment. 37. 39. with death from esophageal cancer. and there was no involvement of her oncologist in Glenda’s medical treatment or any contacts throughout the period from January 5. • Neither you nor your rubber stamp accomplice signing the certification of terminal illness. Glenda to abandon the pulmonary rehabilitation treatment that unknown to her. The facts indicate that you and your “rubber-stamp accomplice” fabricated the certification of terminal illness. Your certification contradicted everything written by physicians at John Muir Hospital and Kaiser Permanente hospital during the prior several weeks of treatment. You allowed. Instead of arranging for Glenda to receive that fraudulently denied treatment. and omission. 38. by deception. You made no effort to inform Glenda of these matters when in desperation she decided to give up the available .Medical Industry’s Death Panels Taxol cancer treatment for Glenda prior to her shortness of breath problem and had planned to start that as soon as Glenda returned home. a unit of Hospice of the East Bay. which assisted in covering up for the major medical misconduct occurring while Glenda was at Manor Care. she never received. You knew that the John Muir order for Glenda to receive pulmonary rehabilitation still existed. 40. to January 31. and the nearby Kindred SNF had that treatment. you sentenced Glenda to a premature death by your sham Certification of Terminal Illness. 2012.
you covered up for the medical crimes and became complicit. 44. Make Guilinger. Bruce. If a group of physicians had set out to bring about Glenda’s death. 43. Rodney Stich cc: Medical Board of California The copy sent to the Medical Board of California was a waste of time. starting with Glenda’s arrival at Manor Care on January 14. and resulted in her premature death. 42. but I wanted the record to show their continued cover-up of these corrupt acts by physicians over whom they had oversight re- . You played major roles in denying to Glenda the pulmonary rehabilitation that could have extended her life. She was put to death! The records and personal observation strongly indicates Glenda would be alive today but for the joint misconduct of multiple physicians and your final certification to rid yourselves of the woman defrauded out of her life! 46. it would arguably also have played a role in the death of her son. either committed suicide or her death caused his death. The evidence indicates that Glenda didn’t die of any illness. upon hearing of Glenda’s death. Glenda’s son. If your conduct did play a role in Glenda’s death. Instead. 45. 2012. the physician misconduct inflicted upon Glenda could be expected to result in success: Glenda’s death within about two weeks.173 Last in Series of Fighting Corruption medical treatment that was unknown to hers.
It appears that’s Dr. Two deaths were made possible by your final act of preparing a Certification of Terminal . The responsibility to provide me with information arises in part from my position as trustee over the estate of Glenda Guilinger. or her medical records. No one looking at Glenda. 2012. Spencer was protecting the rear ends of the other physicians that had used Glenda in a bizarre medical game. her caregiver during the last four years of her life and illness. the second physician signing what amounted to a death decree for Glenda. Spencer: I am providing details to government entities and putting the details on the Internet about your role in events leading to the highly suspicious death of Glenda Guilinger association with your signing of a Certification of Terminal Illness. Fax to Second CTI Physician. Jay Spencer I also sent a March 22. let me know in writing and I will consider changing it. a unit of Hospice of the East Bay. As a consulting physician for Hospice of the East Bay. she knew that admission was limited to people with an estimated remaining life of ten days. Jay Spencer to Hospice of the East Bay. the power of attorney for me to make medical decisions while Glenda was alive. and eventual death within hours of arriving at Bruns House. where you are a medical consultant. You have a responsibility to provide information on events that deprived Glenda of medical treatment for the medical problem that brought her to the hospital and then Manor Care. and partner for 18 years.Medical Industry’s Death Panels sponsibility. If you disagree with my interpretation of the facts. Dr. of which Bruns House hospice facility was a unit. could arrive at that estimate. The following was my letter to her: To Dr. It was their culture of cover-up that made the corrupt culture possible―and the resulting deaths. fax to Dr.
That applied also to Manor Care SNF where Glenda was sent for treatment to improve her shortness of breath through pulmonary rehabilitation treatment—that she never received! • On February 2. the day after Glenda Guilinger’s highly suspicious and unnatural death in Bruns House hospice. Effective 1/31/12. That Certification of Terminal Illness document was dated February 2. Your extremely brief Certification of Terminal Illness stated: • This is to certify that the above named patient has a prognosis of six (6) months or less. and that her death would be caused by esophageal cancer. Attestation: I confirm that this narrative is based on my review of the patient’s medical record and/or examination of the patient. 78 yo woman with metastatic esophageal cancer and history of DMII and CAD who died on 2/1/12. (*single diagnosis most likely limiting the life expectancy). Hospice of the East Bay. stating that she had less than six months to live. who had treated Glenda for the sole reason she was there—shortness of breath—made any mention of esophageal cancer or provided any treatment for it. The copy provided to me by your employer. Based upon the facts. I recommend this patient be admitted to hospice services. lacked a signature. • • . you apparently signed a certification of terminal illness for Glenda Guilinger. Terminal Diagnosis* metastatic esophageal cancer.175 Last in Series of Fighting Corruption Illness. 2012. None of the physicians at John Muir or Kaiser Permanent hospitals. That diagnosis was without support. 2012. if the illness runs its normal course. I view that certification as a sham—a sham that resulted in two immediate deaths! Your certification of terminal illness (CTI) stated that Glenda had less than six months to live and would die of esophageal cancer.
Your CTI didn’t have any medical reports attached (assuming your Hospice of the East Bay employer provided me all the reports pertaining to Glenda that were in their possession and upon which you made your impending-death certification). • • . regulatory. You implied by your Certification of terminal illness that” • The medical condition for which Glenda was in Manor Care skilled nursing facility (shortness of breath) was untreatable and that she would die of that medical condition within six months. • Legal requirements arising from statutory. and case law requires that a physician preparing a Certification of Terminal Illness (CTI) prepare a detailed narrative supporting that certification. The pulmonary rehabilitation treatment was not effective.” What was it? A review of the records? Or an examination of the patient? Your wording avoids stating what you based your early deathwithin-six-month decision upon! It was similar to using an off-theshelf form for some multiple minor office matters.Medical Industry’s Death Panels Jan Spencer. That the pulmonary rehabilitation treatment ordered by John Muir hospital to improve that pulmonary shortness of breath had been given to Glenda. • Your CTI report stated that it was “based on my review of the patient’s medical record and/or examination of the patient. and that Glenda’s condition had worsened to where her death from the shortness of breath condition would occur any time within six months. Your CTI did not have any narrative. MD Hospice Physician 2/2/12. only unsupported statements.
if the medical conditions were in fact treatable and did not indicate a fatal ending within six months. That the statutory. fraudulently held to have a pulmonary condition that could not be improved upon. and the only decision for her was to accept palliative treatment and die. and case law requirements for hospice had been met for you to legally sign the Certification of Terminal Illness. .177 Last in Series of Fighting Corruption • That there were no irregularities or fraud in the medical care for Glenda while at Manor Care that contributed to the expected death within six months. • • • • All of the above were false. regulatory. The esophageal cancer that your Certification of Terminal Illness stated as Glenda’s expected cause of death appears nowhere on any of the medical records that you could have viewed. and scheduled for additional curative or remission cancer therapy with the cancer-fighting drug. You stated that esophageal cancer was “most likely limiting life expectancy. Taxol. That the drugs given to Glenda at Manor Care did not worsen her breathing problem. That Glenda was made fully aware of the above irregularities. which was in apparent remission.” That statement was false and you surely knew it: • Glenda had lived for four years since her original diagnosis of Stage IV esophagus cancer. knew that she had been fraudulently denied the pulmonary rehabilitation treatment. It would be a criminal offense to sign a certification of terminal illness if any of the above conditions existed. That the intense pain from the ulcer/wound/bed sore was not treatable.
initial visit for shortness of breath made any reference to esophageal cancer as her current medical problem. the most probable physical signs that you would have noticed would be: • • • Shortness of breath. Each of the physicians’ treatment was for pulmonary problems. Your report said nothing about Glenda’s primary problem: the shortness of breath and pain from the bed sore/wound/ulcer on her back. Pulmonary problem was the reason for Glenda’s presence at Manor Care. • • • • • • Assuming your CTI was based on a physical examination. Not one of the medical facilities that had examined or cared for Glenda since her January 5. Pain from the bed sore/wound/ulcer on her back. Your reference to CAD and DMII had no relationship to Glenda’s hospitalization or terminal illness. 2012. The pulmonary rehabilitation ordered for Glenda was never given by Manor Care as they did not have such pulmonary treatment. Pulmonary rehabilitation treatment was ordered to improve upon Glenda’s breathing.Medical Industry’s Death Panels • • Millions of people have cancer and continue living for years. You would not have seen any evidence of coronary artery dis- .
These records would reveal that: • • • Glenda’s initial hospitalization showed a treatable shortness of breath. 2012. • • If your CTI was based on an examination of the records available at Manor Care.” History of Medical Misconduct Revealed By . Asymptomatic on 2 L of oxygen. as shown by one John Muir hospital report that stated: “The patient was admitted to the hospital with shortness of breath. Manor Care had no such facility. and Manor Care skilled nursing facility. the Kaiser Permanente hospital from January 21. 2012 to January 23. There was no reference to any terminal medical condition. She looks comfortable without any shortness of breath or tachypnea. Esophageal cancer would not have been recognized (A condition she had been living with and was under control since Stage IV esophagus cancer was first diagnosed four years earlier). Quite the opposite. … Clinically. they would have been the records from the January 5. Glenda never received that pulmonary rehabilitation therapy. … The patient is to be discharged to a skilled nursing facility. • You would not have seen any evidence of diabetes (which had never been stated to Glenda and for which no medication had ever been prescribed). and the order for pulmonary rehabilitation therapy. hospitalization at John Muir hospital. 2012. she is doing relatively well.179 Last in Series of Fighting Corruption ease (which most adults have). Neither of the CAD or diabetes mellitus II would be terminal and never made known to Glenda or her caregiver.
stated that Manor Care did not have a pulmonary rehabilitation program or pulmonary specialist. 2012. a major source of Manor Care’s business. and would not accept Glenda as a patient. John Muir hospital physicians reported that Glenda had fluid on her lungs and a possible fungus infection—which she previously had a year or two earlier.Medical Industry’s Death Panels The Records You Would Have Examined • On January 5. during two separate discussions with three different people. Prior to that transfer. Kindred’s admission personnel had earlier stated to me and my daughter that Kindred did have a pulmonary rehabilitation unit. notified Manor Care that they were sending Glenda to their facility for pulmonary rehabilitation treatment —Manor Care management remained silent about not being able to provide that treatment for Glenda. Manor Care’s nearby competitor in the skilled nursing facility business did have a pulmonary rehabilitation unit. Laura Stengel. I brought Glenda Guilinger to John Muir hospital in Walnut Creek because of shortness of breath. That sole and important treatment was never provided to Glenda! John Muir hospital personnel selected Manor Care Rossmoor Parkway to provide the pulmonary rehabilitation treatment. Their facilities were about 300 feet from your office building. She was transported there on January 14. They ordered that this treatment be given to Glenda at a skilled nursing facility (SNF). Admissions Director at Manor Care. They showed us the room Glenda would be in and confirmed that • • • • • . 2012. When John Muir hospital personnel. John Muir hospital physicians determined that Glenda’s shortness of breath could be improved with pulmonary rehabilitation treatment.
181 Last in Series of Fighting Corruption they would accept her. of course. 2012. on January 15. That was of course a deliberate lie to get Manor Care out of the predicament that Manor Care got themselves into by fraudulently accepting Glenda when John Muir hospital notified Manor Care that they were having Glenda transported to Manor Care for pulmonary rehabilitation treatment. that Glenda was not capable of having her shortness of breath improved and that she would be shortly removed from Manor Care. That was. when Manor Care had no such program or pulmonary specialist. one of your associates at Hospice of the East Bay. 2012. Within 24 hours of receiving Glenda. Manor Care risked being cited by Medicare and California regulators. this transfer was cancelled after Kindred admission personnel called the case manager at John Muir hospital to arrange for transfer and was told that Glenda was already being transferred to Manor Care. My January 16. the day after arriving at Manor Care. Chandra’s misconduct to an ailing patient that included: • Withholding from a senior patient the fraudulent accepting of a patient transfer from John Muir hospital • • • . possibly for fraud. That risk of being exposed was quickly addressed by Manor Care personnel. • By accepting Glenda for pulmonary rehabilitation treatment. Smita Chandra. was the first to state to Glenda. However. a lie and a hoax perpetrated upon an ailing senior by physicians expected to be honest about such life-affecting matters. Manor Care personnel notified Glenda that she would have to leave and that she was not capable of having her breathing problems improved upon. Dr. letter to Manor Care addressing Indiatrained Dr.
and for argument. 24 hours since arriving at Manor Care could not have enabled anyone from making such judgment.) Haloperidol Lactate (Published side effect includes shortness of breath and swelling of the mouth. created great stress and anxiety upon the woman. who was leading an active life and who wanted to live. Oxycodone HCL round the clock.) Protonix/Pantoprazole (Published side effects included • • . (Published strong warnings state these drugs are contraindicated in patients with breathing difficulty. resulting in difficulty swallowing—which Glenda experienced. with each dose being cumulative. and others worsened her breathing problems and created other medical problems. even if there had been such a program—which there wasn’t. Obviously. That was a lie: Glenda didn’t yet have the ordered pulmonary rehabilitation treatment and there was no way that you could contradict the physicians atg John Muir hospital that stated she could have her breathing improved. all of which depresses lung function. Duramorph. Norco. accumulating in the body. • Attempting to cover up for that first fraudulent act by immediately stating to an ill patient that she would be evicted from Manor Care and that she was not capable of having her breathing problems improved upon. Sampling of these drugs included: • Morphine sulfate. your cruel statement to Glenda.Medical Industry’s Death Panels under an order for pulmonary rehabilitation treatment when Manor Care had no such program. • The harmful round-the-clock dosing of Glenda with drugs. some of which had published warnings not to be used on patients with pulmonary breathing problems.
change and irregular heartbeat—which Glenda experienced.) Digoxin (Published warning side effects include difficulty breathing.) Ativan/Lorazepam.) • Diltiazem (Published side effects include difficulty in breathing. bone pain. allergic reaction causing swelling of the airways—which Glenda experienced.) Prednisone. swelling of the throat. swelling of the mouth. shortness of breath. and musculoskeletal pain—which Glenda experienced. mental depression. and hoarseness— which Glenda experienced. irregular heartbeat.) Metoprolol Succinate (Published warning side effects include breathing problems. swelling of the mouth. especially to seniors. depression. depression. pain in back—which Glenda experienced.) • • • • • . water retention. swelling of the mouth.) Bisacodyl (Published warning side effects include difficulty breathing and swelling of the mouth—which Glenda experienced. delusions—which Glenda experienced. dryness of the mouth. (Published warning side effects include strong warnings not to give to patients with COPD breathing problems. hinders wound healing. depression. hoarseness.183 Last in Series of Fighting Corruption difficulty breathing. increased blood pressure. (Published warning side effects include breathing difficulties. swelling. shortness of breath.
This improvement may have been due to removal from the breathing-impairment drugs given to Glenda at Manor Care. 2012. Instead of obtaining medical care from a wound specialist. While at Manor Care. Highlights of the life-affecting abuse of Glenda That Made Your Certification of Terminal illness A Deadly Sham: • Fraudulent admission of Glenda into Manor Care for an • • • . Similar to John Muir hospital reports. you and other Manor Care physicians ordered round-the-clock morphine and morphinecontaining drugs to be given to Glenda. and compounded by the misuse of round-the-clock drugs that worsened the breathing difficulties. Those drugs were known to worsen a person’s breathing capabilities. • On January 24. no terminal illness was stated. Ramin Khashayar. Glenda’s oxygen level plummeted.Medical Industry’s Death Panels Various events interfered with Manor Care’s efforts to evict Glenda. This could be due to the failure to provide the John Muir hospital ordered pulmonary rehabilitation treatment. Glenda was rushed to the nearest hospital. Kaiser Permanente. she was discharged to Manor Care on January 23. On January 21. Glenda was transported to John Muir hospital for the thoracentesis procedure to remove the fluid on her lungs that was first discovered nearly three weeks earlier when she was admitted to the hospital for shortness of breath. 2012. That delayed thoracentesis procedure was done by Glenda’s pulmonary doctor. Glenda experienced increasing pain from a wound/bed sore/ulcer on her back. after I reported to the medical board of California that he had abandoned his patient at a life-critical period. Iranian Dr. Manor Care records reported that Glenda showed improvement in her breathing after that procedure was done. 2012. especially among seniors. As her oxygen level improved.
Smita Chandra. using the sham argument that Glenda did not display an ability to improve her pulmonary function. Refusal to obtain a wound specialist to treat Glenda’s worsening wound/ulcer/bed sore on her back. • • • • Further cause for Glenda’s anxiety was the misconduct by pulmonary specialist. within 24 hours of her arrival. some that were not to be used on COPD patients. He refused to treat Glenda unless I signed . • • Denial of the very care ordered to improve Glenda’s breathing. Compounding the harm to Glenda’s breathing problem with round-the-clock dosing with drugs. worsening Glenda’s anxiety arising from all the other wrongs inflicted upon her by physicians. and some that caused anxiety. or elderly patients. Dr. That attempt was vocalized by Dr. including Manor Care’s nearby competitor.185 Last in Series of Fighting Corruption ordered medical treatment that Manor Care did not have. Kindred SNF. and during one phone call accused me of blackmailing him for complaining to the Medical Board of California. Refusal to transfer Glenda to a SNF that had the pulmonary rehabilitation treatment. and then dosing her with round-the-clock morphine and morphine related drugs that worsened her breathing problems. He repeatedly refused my requests to examine Glenda. who acted under your supervision. Fraudulent attempts to evict Glenda from Manor Care by Manor Care physicians. Ramin Khashayar.
Shortly before causing Glenda’s removal from Manor Care. and waiting to be evicted. The complicity of two physicians signing Certification of Terminal Illness was needed to remove Glenda from Manor Care. I had power of attorney over her medical care and authorized to be kept informed. and that her death would come from esophageal cancer. despite the fact that I had been arranging and overseeing her medical care for the prior four years. Kindred refused to accept Glenda. 2012. causing her to just give up and want to die. You signed a certification of terminal illness falsely stating that Glenda had less than six months to live. This rejection. in pain. Khashayar compounded that by having a letter delivered to Glenda complaining about my conduct [seeking to have him attend his seriously ill patient]. Based upon this false information. 2012. and forced Glenda to sign that she received the letter complaining of these matters. as I sought to transfer Glenda to nearby Kindred SNF. where the pulmonary rehabilitation facility did exist. • Possibly to insure that these medical frauds by multiple physicians went unaddressed. Manor Care personnel falsely stated that Glenda was not capable of showing pulmonary improvement. added to the medical abuses already inflicted upon Glenda. compounding her anxiety. Manor Care management and physicians refused to respond to my faxes asking for information about Glenda’s treatment. Several falsehoods arose with those two certifications : • There were no reports in any of the medical facilities that cared for Glenda between January 5. and I was her partner for the past 18 years. Dr. and January 31. addressing Glenda’s underlying can- • • .Medical Industry’s Death Panels a statement that the facts in my complaint were false. That misconduct occurred while Glenda was lying at Manor Care.
2012. The facts indicate that you and your rubber-stamp accomplice fabricated the certification of terminal illness. she never re- • • .187 Last in Series of Fighting Corruption cer. You allowed. Glenda was diagnosed four years earlier with Stage IV esophagus cancer. which assisted in covering up for the major medical misconduct occurring while Glenda was at Manor Care. • • • Your certification contradict everything written by physicians at John Muir Hospital and Kaiser Permanente hospital during the prior several weeks of treatment. Treatment had put that cancer in remission. and there was no involvement of her oncologist in Glenda’s medical treatment or any contacts throughout the period from January 5. Glenda to abandon the pulmonary rehabilitation treatment that unknown to her. were cancer specialists. including what has already been stated. John Muir hospital physicians held that Glenda’s breathing problems could be helped by pulmonary rehabilitation treatment (which Manor Care physicians denied to Glenda). The reports throughout that period focused on Glenda’s shortness of breath. with death from esophageal cancer. to January 31. or encouraged. her oncologists had scheduled Taxol cancer treatment for Glenda prior to her shortness of breath problem and had planned to start that as soon as Glenda returned home. Neither you nor your rubber stamp accomplice signing the certification of terminal illness. 2012. • The certification of terminal illness had to cover up for the prior misconduct inflicted upon Glenda.
personal observations. Make Guilinger. Her death was not from the relatively modest shortness of breath. you covered up for the medical crimes and became complicit. You played major roles in denying to Glenda the pulmonary rehabilitation that could have extended her life. and answering phone calls. hours before she became comatose and died. Instead. reading the newspaper. apparently committed suicide immediately upon hearing of his mother’s death—another consequence of the sham Certification of Terminal Illness! The evidence indicates that Glenda didn’t die of any illness. and almost daily photographs of Glenda. Glenda’s son. and the nearby Kindred SNF had that treatment. and dead. Glenda changed from a smiling and active patient to comatose. cover-up. upon hearing of Glenda’s death. that she had never received that treatment. doing crossword puzzles.Medical Industry’s Death Panels ceived. you sentenced Glenda to a premature death by your sham Certification of Terminal Illness. You made no effort to inform Glenda of these matters when in desperation she decided to give up the available medical treatment that was unknown to hers. and instead go to Bruns House hospice. and resulted in her premature death. strongly indi- • • • • • . and omission. • You knew that the John Muir order for Glenda to receive pulmonary rehabilitation still existed. I have a picture of Glenda on January 31. She was smiling. Within hours of arriving at Bruns House. by deception. She was put to death while at the Bruns House unit of Hospice of the East Bay—your employer! The records. 2012. a unit of Hospice of the East Bay. Instead of arranging for Glenda to receive that fraudulently denied treatment.
Spencer stated that Glenda had . The response justified putting to death anyone exceeding the average life expectancy: "Dr. and there are millions. This doctor was revealing the thinking of others complicit in Glenda’s demise. Spencer Certifying to Death Within Seven to Ten Days As a physician consultant on the board of the Hospice of the East Bay. far outlived her life expectancy. Spencer was also certifying that Glenda had only seven to ten days to live. 2012. Glenda was put to death within about two weeks. Rodney Stich Bizarre Reason Justifying Physician euthanasia (homicide) For Anyone Exceeding Average Life Expectancy! Dr. Glenda’s appearance.. of which Bruns House hospice was a unit. starting with Glenda’s arrival at Manor Care on January 14. 2012 fax from Hospice of the East Bay. And that your final certification to rid themselves of the woman they defrauded out of her life! • If a group of physicians had set out to bring about Glenda’s death. Sincerely. medical record. Jay Spencer provided a lone response to my questions through a March 15. can be put to death according to the mentality shown here! Dr. That was an admission requirement for going to Bruns House. the physician misconduct inflicted upon Glenda could be expected to result in success. Anyone who is alive past the average life expectancy. and actions obviously didn’t meet that .189 Last in Series of Fighting Corruption cates Glenda would be alive today but for the joint misconduct of multiple physicians..
Medical Industry’s Death Panels requirement. But something was done to Glenda within hours of arrival at Bruns House to where that sham certification was made to be true! .
hospice groups provide a valuable service. especially seriously ill patients. know very little about hospice programs and their businesses practices. with any terminal illness.” stated one of the two doctors that signed a sham Certification of Terminal Illness (CTI) for Glenda. The following is a picture of Glenda on the day these two doctors signed a certification that halted efforts to correct the breathing problems (that John Muir hospital physicians had ordered but Glenda never received) and care to heal the open wound on her back. Glenda definitely did not look like a patient with only seven to ten days to live. She was reading. or their caregivers. But there are negatives that must be understood to avoid inflicting even worse harm to already suffering people. and at some hospices. and making phone calls. The American public. For some. using a calculator. Or. She had two treatable medical conditions with treatment .CHAPTER EIGHTEEN Physician Fraud and Euthanasia (Homicide!) “Glenda had already exceeded her life expectancy. Certainly not the activities of a person who would shortly be dead. within hours—unless someone makes the death occur? Upon arriving at Bruns House.
.Medical Industry’s Death Panels denied to her by Manor Care physicians and many physician enablers.
193 Physician Fraud and Euthanasia (Homicide!) Hours Later: medically-induced death by medical industry! .
myquitamlawsuit. defendants will argue that allegations that such con- . Her law practice focuses on qui tam (whistleblower) cases and appellate matters. a decision to order services that are allegedly medically unnecessary. a decision to code a procedure a certain way. a partner at Waters & Kraus. September 12. Law Relating to Criminal Fraud in Physician Certification of Terminal Illness Cases An internet article by Loren Jacobson.Medical Industry’s Death Panels These two revealing pictures are duplicated here in case the reader has not recognized the obvious medical-perpetrated homicide. http://www.com/index. 2011 What Distinguishes Medical Judgment from Fraud? Many qui tam cases involve decisions by physicians—a decision to certify a patient as eligible for hospice. In all of these circumstances. in the firm's Dallas office focused on fraud in a physician's certification of terminal illness.aspx?id=jacobson. LLP.
Specifically. if a physician certifies a patient for hospice care without sufficient information to make the certification or with deliberate indifference or reckless disregard for whether the patient actually meets the objective criteria for such certification.. The key is to be able to show that the physician’s conduct is not being challenged as erroneous. so long as there is a good faith allegation that the physician knowingly acted in direct contradiction to objective facts. the certification and claims for payment of that patient’s hospice care are false. Recently.195 Physician Fraud and Euthanasia (Homicide!) duct is fraudulent are not actionable because differences in scientific opinion. an FCA claim should lie. 3-07-cv-0604 (N. In the Statement of Interest. ex rel. As the Government noted: Hospice care provided to a patient who does not meet objective medical criteria for terminal illness can be false or fraudulent under the FCA. A defendant cannot defeat FCA allegations simply due to the existence of a physician certification of terminal illness when there is evidence that the provider knew or should have known such a patient was not terminally ill. Case No.S. Inc. Tex. Attorney’s office debunked such arguments in a Statement of Interest filed in U. Wall v. in the hospice context. or deliberately upcoded procedures. the Government argued that where a physician acts with deliberate indifference or reckless disregard of objective facts. a fraud claim can lie. but as fraudulent. This reasoning has equal force in the other circumstances described above: where there are allegations that a physician ordered unnecessary procedures or services.). Vista Hospice Care.S. the U.D. . methodology. and judgments cannot support claims under the False Claims Act.
there are tremendous opportunities for fraudulent practices and false billing claims by unscrupulous hospice care providers. But for the intervention of whistleblowers.propublica. Article Source: http://EzineArticles. the number of patients receiving hospice care in the United States grew almost 40% to nearly 1.org/article/gone-without-a-casesuspicious-elder-deaths-rarely-investigated. “Hospice fraud in South Carolina and the United States is an increasing problem as the number of hospice patients has exploded over the past few years.5 million people who died in 2008. Fraud against Medicare.” http://www. Certification raised possible multiple criminal acts.Medical Industry’s Death Panels Loren Jacobson is a partner at Waters & Kraus. . concerned relatives and others. the number of health care companies and individuals who are willing to try to defraud the Medicare and Medicaid hospice benefits programs is on the rise. As recent federal hospice fraud enforcement actions have demonstrated.com/4358159. abuse or even murder of seniors eluded authorities. because hospice eligibility under Medicare and Medicaid involves clinical judgments which may result in the payments of large sums of money from the federal government. in the firm's Dallas office. While most hospice health care organizations provide appropriate and ethical treatment for their hospice patients. Murder of Seniors Eluded/Ignored by Regulators A Frontline NPR article stated that: “ProPublica and PBS Frontline have identified more than three-dozen cases in which the alleged neglect. From 2004 to 2008. and criminal homicide.5 million. Her practice focuses on qui tam (whistleblower) cases and appellate matters. LLP. nearly one million were hospice patients. and of the 2. the truth about these deaths might never have come to light.
html.jonchristianryter.html.co.com/News_Blurbs/blurbs.propublica. http://www. a diminutive 83-year-old who passed away in an assisted-living facility in Bucks County.jonchristianryter.html.jonchristianryter. http://www. Pa.” http://www. citing a "failure to thrive" due to "dementia" as the reason for his demise. As a result. Take the case of William Neff. which had tangled the delicate fibers within his brain cells.org/article/gone-without-a-case-suspicious-elder-deaths-rarely-investigated. http://www.com/2012/02/hospice-eugenics-with-smile-and.uk/news/article-1219853/My-husband-beaten-cancer-doctors-wrongly-told-returned-letdie.dailymail. • • • • • • • .html.com/2009/090830. even obvious signs of abuse have gone unnoticed by authorities in some instances. A World War II veteran. Anne Whalen. “Gone Without a Case: Suspicious Elder Deaths Rarely Investigated. The physician.com/2009/091101. She wasn't at the assisted-living home when he died and never saw his corpse.jonchristianryter.html.html.blogspot. limiting his speech.com/Video/2011/110321. http://lonestarwatchdog. laws are so lax that doctors can sign off on death certificates without having seen a patient in months or actually viewing the body.197 Physician Fraud and Euthanasia (Homicide!) Signing Off Without Seeing the Body In many states. Sampling of related sites: http://www. would later testify that she hadn't seen Neff for 13 days before his death. After Neff died on Sept. http://www. a doctor employed by the facility signed his death certificate. Neff suffered from advanced Alzheimer's disease. 11. 2000.
Medical Industry’s Death Panels .
Exerts from one article http://www. many reports from families about patients with COPD who were given morphine in dosages higher than they were accustomed to receiving. supporting the patient and letting them know that they are valued and loved. Addressing one of several serious problems with some hospice groups was the following comments: “By admitting these folks to hospice.org/no-prnmorphine-copd.. It is about providing relief from distressing symptoms. Most of these patients were given these dosages of morphine by nurses in the hospice setting. who died shortly after getting those morphine dosages.hospicepatients.html stated: Hospice Patients Alliance has received many. they are denied access to routine medical and rehabilitative care that they need to extend . In all the cases reported. the Bad.CHAPTER NINETEEN Hospice: the Good. and the Deadly Real hospice care is not about hastening the death of a patient.. . the physician had ordered that the morphine might be given "as needed" or "PRN" within a certain range and at a certain frequency of time intervals between doses given.
executive director of Catholic Hospice of Pittsburgh. This link provides information that must be understood to avoid even worse harm and suffering to vulnerable people.hospicepatients. and in fact. a non-profit.html. We were formed by experienced hospice staff and other health care professionals who saw that hospices were not always complying with the standards of care. or not providing adequate care to control pain or other distressing symptoms during the end of life period.org/questionable-death. Misconduct reported by Hospice Patients Alliance: http://www.html..” But there are far more serious problems. HPA is warning the public that a form of stealth euthanasia is quietly being introduced throughout the health care system in which the misuse of terminal sedation and other methods of imposing death are used without an actual legalization of euthanasia or assisted-suicide. “A vulnerable and voiceless population is preyed upon for money. . violating the rights of patients and families and exploiting them for financial gain.” said Cristen Krebs. • • http://www. • An article about deliberate killing of patients in hospice: http://www. The misuse of terminal sedation is the Third Way to end life within a health care setting and bypasses laws against medical killing.html. were in some cases. .org/hospic1.org/atty-resource.Medical Industry’s Death Panels and improve their lives.. A few excerpts from that site follows: The Hospice Patients Alliance was formed in August of 1998 as a nonprofit charitable organization and is a 501(c)(3) corporation serving the general public throughout the United States.hospicepatients.hospicepatients. Having received numerous complaints for more than a decade.
Willems. USA. Terri Schindler Schiavo.hospicepatients. Boston.hospicepatients.org/terrischindler-schiavo-docs-links-page. 2000.org/hospicenurse-observes-euthanasia. .html. See hospice death in Texas.hospicepatients. Clarridge BR done at the Center for Outcomes and Policy Research. 160 No. Mass 02115.201 Hospice:the Good.org 1998 and search from the JAMA site for the following article: Aug 12.280(6):507-13 entitled "The practice of euthanasia and physician-assisted suicide in the United States: adherence to proposed safeguards and effects on physicians.html.html. "Attitudes and Practices Concerning the End of Life . 1. • Archives of Internal Medicine .org/cgi/content/full/160/1/63?maxtoshow=&hits=10&RESULTFORMAT=1&author1=Willems&title=Attitudes+and+P ractices+Concerning+the+End+of+Life&andorexacttitle=and& andorexacttitleabs=and&andorexactfulltext=and&searchid=1& FIRSTINDEX=0&sortspec=relevance&volume=160&fdate=1/ 1/2000&tdate=4/30/2001&resourcetype=HWCIT Vol. • • • Research indicating euthanasia is more widespread than commonly thought and that some euthanasia are clearly done without patient knowledge or permission: JAMA at http://jama. Division of Cancer Epidemiology and Control. http://www. Report of overdosing: http://www. Fairclough DL. January 10. Daniels ER. the Bad. Dana-Farber Cancer Institute." written by Emanuel EJ.amaassn. and the Deadly • Mother Killed by Hospice with Morphine Overdose: http://www.ama-assn.A Comparison Between Physicians From the United States and From the Netherlands" (by Dick L.org/euth-acct-three.AMA at http://archinte.
passed away. It is easy to falsify records for hospice. Emanuel. Daniels. • Enter here for Information and News On Involuntary Euthanasia. PhD.html. 11. Paul J. Elisabeth R.Improperly Set Pump) http://www. van der Maas. . PhD. the terminal. in 2009. promoting quality end-of-life services and offers free information and assistance to hospice patients. 2010 Hospice And What They Will Not Tell You.hospicepatients. 2002.blogspot. Case Histories. the sick. Inc. Why is the abuse of animals a much more sensitive issue in America. Hospice Medical Killings. “Thursday. her death was hastened while in the care of (Vitas-HOSPICE) (Pembroke Pines Florida). visit Hospice Patients Alliance online or call  8669127.org/negligent-death-d-t-morphinepump-overdosage. and more important than inhuman treatment of real human beings? Specifically. families and caregivers nationwide. What Hospice and sometimes your OWN relatives. http://hospice-uncovered. The Hospice Patients Alliance.com/. Unfortunately. will not tell you. and the elderly. PhD). when signing your love one into Hospice. PhD. And Much more! Two Daughters Report Mother Killed Due To Negligence Of Hospice Nurses (Morphine Overdosage .Medical Industry’s Death Panels MD. Ezekiel J. animals have much louder advocates for inhumane treatment against them (although they’re not human). January 14. For more information. • See Survey of Physician Ethics Medical Economics Archive: Oct. Gerrit van der Wal. is a non-profit 501(c)(3) charity acting to preserve the original hospice mission. My mom.
203 Hospice:the Good, the Bad, and the Deadly These groups of people are targeted and funneled into Hospice (the silent killer) to cut Medicare cost. The public has a right to know the truth about the (silent) practices used by the Hospice Organizations working in and through, our Hospitals, and Nursing Homes working in conjunction with Medicare. Medicare’s sole agenda is to cut cost by any means necessary. Medicare’s idea of cutting cost is referring your love ones (the elderly, the terminal, and sick) to Hospice. Where the patient supply of medication is cut off. All except the morphine/methadone used to administer a quiet, rapid exit into eternity (someone is saving on their water bill as well because they are dehydrating their patients and not turning to the I.V drip). Other related sites: • http://ezinearticles.com/?Hospice-Fraud---A-Review-For-Employees,-Whistleblowers,-Attorneys,-Lawyers-and-LawFirms&id=4358159. “A recent example of hospice fraud involving a South Carolina hospice is Southern Care, Inc., a hospice company that in 2009 paid $24.7 million to settle an FCA case. The defendant operated hospices in 14 other states, too, including Alabama, Georgia, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Ohio, Pennsylvania, Texas, Virginia and Wisconsin. The alleged frauds were that patients were not eligible for hospice, to wit, were not terminally ill, lack of documentation of terminal illnesses, and that the company marketed to potential patients with the promise of free medications, supplies, and the provision of home health aides. Southern Care also entered into a 5-year Corporate Integrity Agreement with the OIG as part of the settlement. The qui tam relators received almost $5 million.”
Medical Industry’s Death Panels
Fraud between nursing facilities and hospice: • http://oig.hhs.gov/fraud/docs/alertsandbulletins/hospice.pdf. Criminal charges arising from fraudulently certifying people as terminally ill. • http://californiawatch.org/dailyreport/federal-justice-officialsaccuse-hospice-provider-medicare-fraud-14342.
A national for-profit hospice care company partially owned by a San Francisco private equity firm has been accused of bilking Medicare of millions of dollars, according to a legal complaint filed this week by the U.S. Department of Justice. In court documents, the government contends that since at least 2007, Texas-based AseraCare Hospice has fraudulently certified patients as terminally ill to illegally collect Medicare payments. “The United States alleges that AseraCare, through its reckless business practices, admitted and retained individuals who were not eligible to receive Medicare hospice benefits, because it was financially lucrative – and did so even after AseraCare’s auditor alerted AseraCare to troubling problems,” court documents state. “AseraCare misspent millions of Medicare dollars intended for Medicare recipients.” In its complaint, the government describes a corporate culture in which AseraCare employees were given heavy incentives to enroll and retain hospice patients – even if they don’t qualify – because hospice providers are paid per patient per day. Top performers were rewarded with prizes like massage chairs, while those who didn’t meet patient admission goals were disciplined. An internal audit stated in a December 2007 report that a reduction in the number of hospice patients led to layoffs.
205 Hospice:the Good, the Bad, and the Deadly A Bloomberg story chronicles the plight of Janet Stubbs, who “didn’t know that her aunt, Doris Midge Appling, was admitted to Hospice Care of Kansas during the company’s “Summer Sizzle” promotion drive, which paid employees as much as $100 a head for referrals.” For many who have experienced hospice as it was intended — palliative and comfort care for near-death patients and their families — it is shocking to learn that hospice care is promoted like the sale of used cars or mattresses. http://fraudblawg.com/2011/12/13/bloomberg-exposes-medicarehospice-fraud-boom/ .
Hospice patients alliance. http://www.hospicepatients.org/euthcenter.html.
The Grief Inflicted Upon Loved Ones Not described here is the grief inflicted by these corrupt actions upon loved ones left behind, the bereavement that often seems endless.
The Guilty, the Complicit, and the Enablers
Looking at the facts, the following share some form of blame for Glenda’s suffering and death: • • • • John Muir hospital physicians: Plus for them for the treatment of Glenda’s breathing problems, the possible fungus infection. Plus for them for recognizing and ordering the pulmonary rehabilitation treatment. Negative for failure to obtain a wound specialist to treat the painful pressure wound on Glenda’s back. Negative for transferring Glenda to skilled nursing facility that had the pulmonary rehabilitation treatment. Hospital personnel transferred Glenda to Manor Care Walnut Creek, which did not have that type of medical unit, when transfer should have been to Kindred skilled nursing facility. Manor Care Management and Physicians Accepted Glenda for the pulmonary rehabilitation treatment when they did not have such a unit. The acceptance probably
the Complicit. Smita Chandra. including Dr. That sham statement was made without the ordered pulmonary rehabilitation care being given (which they did not have). Manor Care management knew prior to that transfer of Glenda’s need for pulmonary treatment and twice admitted they would not accept Glenda. that were specifically not to be given to COPD patients. and other drugs whose side effects were detrimental to Glenda. by non-pulmonary doctors. Withheld the need for a wound specialist.207 The Guilty. fraudulently stated to Glenda within 24 hours of Glenda’s arrival at Manor Care. before any improvement could have been detected (if such treatment had been started). Encouraged Glenda to deny to me any role her uninformed decision to abandon corrective treatment and instead opt for • • • • • . Instead of corrective treatment. that Glenda was not capable of having her breathing improved upon and that she would be discharged. Manor Care physicians gave Glenda round-the-clock dosing with morphine type drugs that worsened Glenda’s breathing. and the Enablers due to desire to maintain uninterrupted flow of patients from their primary source: John Muir hospital. and even violated the most basic pressure wound treatments. such as avoiding lying on the back and worsening the problem. Repeatedly refused to provide information about Glenda’s treatment to the person responsible for providing for her care: me. • Manor Care physicians. contrary to recognized involvement of a patient’s caregiver. That started Glenda thinking of abandoning treatment for the treatable breathing problem and going to hospice.
Martin Jimenez’s position made him fully aware of the many medically harmful actions and omissions perpetrated against Glenda. Dr. John Muir hospital.Medical Industry’s Death Panels harmful hospice. Kindred Skilled Nursing Facility. and designed to bring about Glenda’s premature death. Admissions director at Manor Care. Laura Stengel Prior to accepting Glenda’s transfer from John Muir hospital. • Conduct that was medically corrupt. His refusal to attend to his patient until I signed a statement stating that what I stated against him to the Medical Board of California was false. Pulmonary Doctor Ramin Khashayar Accused me of blackmail when I complained to the Medical Board of California about his apparent abandonments of Glenda due a critical period. the untreated pressure wound. knowing that Glenda would never receive the treatment that was needed for her survival. if not the primary instigator of them. Walnut Creek. she accepted the transfer. But when Manor Care’s cash cow. during two separate meetings Stengel stated Manor Care did not have pulmonary rehabilitation treatment and would not accept Glenda. Manor Care Physician-in-Charge. the denial of pulmonary rehabilitation. Martin Jimenez Dr. The admission personnel • • • • • . the harmful pulmonary effects of the morphine type of drugs used on Glenda. notified Manor Care of Glenda’s transfer for pulmonary rehabilitation treatments. CA Kindred skilled nursing facility admitting personnel had a moral and legal obligation to accept Glenda when she was being discharged from Manor Care. He obviously knew about the sham acceptance of Glenda by Manor Care. criminal.
that Glenda was given round-the-clock dosing with drugs that worsened the pulmonary condition. the Complicit. Glenda was still in remarkably good physical condition. • . telephone call that Jennifer Hanson made to me in response to a fax I had sent earlier that day to Kindred SNF: Jennifer said that Manor Care personnel (did not get the name) called as Manor Care was discharging Glenda and said Glenda was not a candidate for short term rehabilitation. • During a February 22.209 The Guilty. Jay Spencer. and that resulted in Glenda’s death two days later. and the Enablers with whom I communicated were Stephanie Keshi and Jennifer Hanson. They knew that Glenda had authorization signed by John Muir hospital physicians to received pulmonary rehabilitation treatment. Kwan. Kindred admission personnel knew that Glenda would be sent to Bruns House hospice for an accelerated death if they rejected her. • The admission personnel at Kindred cooperated in the wrongdoings that caused Glenda to give up and accept hospice. 2012. that Glenda was fraudulently accepted by Manor Care to provide that treatment. Despite these abuses. Physicians Signing the Sham Certification of Terminal Illness Dr. Hospice of the East Bay Falsely stated that Glenda had less than six months to live and that death would be due to esophageal cancer. Jennifer said that Manor Care had a practice of accepting patients with medical conditions for which they had no rehabilitation facilities. She said in answer to my question that Manor Care’s medical director was Edgar Y.
a unit of the Hospice of the East Bay. Dr. I sent her several faxes reporting these serious life-threatening matters. which was in remission. Spencer was implying that Glenda had less than a week to live. As a physician consultant of that organization. Glenda’s oncologist was not involved during this January 2012 period of hospital and skilled nursing facility involvement. He had Glenda scheduled for cancer remission treatment upon Glenda’s discharge. India-trained Dr. Bruns House hospice. • • • • . had an admitting requirement that the patient have an expected remaining life of seven to ten days.Medical Industry’s Death Panels • None of the medical reports and treatments at the hospital or Manor Care were directed at Glenda’s underlying cancer. Dr. The references in these reports were solely to her treatable shortness of breath. She said this knowing that: o John Muir hospital ordered Glenda to receive pulmonary rehabilitation treatment that was expected to improve the pulmonary function. Vona Lorenzana. Smita Chandra She was the doctor who lied to Glenda within 24 hours of Glenda’s arrival at Manor Care. either by looking at a vibrant Glenda or examining the medical records. No physician could honestly make such a statement. Chandra told Glenda that her shortness of breath problem was not capable of improvements. Lorenzana chose to accommodate her fellow doctors rather than meet her obligation to Glenda. Glenda’s Primary Care Physician She was fully aware of all the omissions and wrongful acts perpetrated against Glenda.
John Muir Physician Network The head of that group. all of whom were members of that group. o Knew that Glenda was being overdosed at Manor Care with drugs never to be used on COPD patients. Michael Kern. • • A recent April 3. That information is at www. • She was the doctor responsible for ordering the morphine drugs upon Glenda’s arrival at Bruns House hospice. the .com/kaiserpermanente.defraudingamerica. Bruce. and obviously known to the employees of that group. but is of long standing. o Knew that Glenda’s intense pain was from the untreated pressure wound on the back. the Complicit. he and his group became complicit in what was done to Glenda. supported the conduct of the involved doctors. her death. article in WebMD Health News stated that “the longer people lived after their initial cancer diagnosis. and the Enablers o That Glenda had not received that treatment. Dr. o That Manor Care fraudulently accepted Glenda. Medical Board of California The people on the Medical Board of California were fully aware of the misconduct prior to Glenda’s death.html. Morphine overdose killed Glenda without hours of her arrival.211 The Guilty. implying that the SNF had the required unit and that Glenda would receive that treatment. 2012. In that way. This type of widespread misconduct didn’t suddenly occur. and the apparent suicide of Glenda’s son. and they did nothing. Prior complaints about a group of death panel doctors at Kaiser Permanente were covered up by the group.
. In the first five years of diagnosis. Glenda had to be put to death with heavy morphine dosage. Both of the physicians knew that Hospice of the East Bay required before admitting Glenda that her life expectancy be seven to ten days. There was no basis for the two cooperating physicians stating that Glenda had less than six months to live. For that to happen.Medical Industry’s Death Panels more likely they were to die from another disease. 33% of survivors died from a condition other than cancer compared with 63% after 20 years’” The reason for making reference to that article is that Glenda had survived four years with her original Stage IV esophagus cancer and tests showed her cancer in remission. and that death would be from esophageal cancer.
CHAPTER TWENTY ONE Sampling of Glenda in Happier Times Glenda at Bodega Bay .
Medical Industry’s Death Panels Bridge Across Colorado River Glenda at Grand Canyon .
215 Sampling of Glenda in Happier Times .
127. 24. 60. 92. 81. 160. 189. 22. 171. 53. 139. 36. 66. 136. 130. 81. 111. 111. 180. 210. 172. 130. 26. 127. 61. 163. 86. 68. 96. 55. 176. 107. 140. 183 74. 179. 166. 189. 140. 27. Dr. 212 Hospice of the East Bay · 105. 61. 200. 19. 117. 162. 115. 93. 28. 26 Dial. 124. 175. 75. 172. 134. 107. 157 Guilinger. 211 C Cancer · c. 81. Martin · i. J . 175. 208. 163 Homicide. 138. 91. 102. 209. 85. 153. 107. 113. 210. 185. 122. 69. 189. 209. 51. 128. 50. 135. 136. 184. 117. 57. 95. 167. 29.INDEX INDEX A American Hospital Association · 89 Ativan · 84. 202 G Google · 37. 73. 79. 174. 120. 127. 28. 208 Guilinger. 10. 52. 196. 119. 11. 134. 37. 130. 191. 181. 94. 159. 188. 25. 199. 177. 34. 160. 182. 156. 93. 72. 136. 169. Randolph Franklin · 4 E Euthanasia · c. 114. 181. 108. 209. 212 D Diablo Valley Oncology · 25. 201 Caregivers · 28. 108. 90. 173. 176. 165. 210 COICA · 36. 117. 130. 95. 117. 109. 158. 77. 174. 191. 137. 115. 130. 175. 41. 87. 211 Guilinger. 120. 109. 110. 214 Guilinger. 82. 177. 93. 181. 136 Guilinger. 168. 97. 28. 115. 103. 65. 119. 15. 152. 213. 98. 3. 109. 4. 63. 210. 121. 104. 139. 209. 40. 156 Central State College · 3 Certification of Terminal Illness (CTI) · c. 212. 186. 170. 96. Mike · 28. 64. 129. 165. 111. 172. 88. 101. 187. 116. 85. 158. 51. 154 Hospice · c. 207. 210. 78. 62. 164. 129. 139. 175. 105. 106. 188. 70. Lisa · 103. 26. 13. 112. 24. 20. 160. 128. 156. 138. 171. 194. 107. 174. 201. 78. 112. b. 94 H Healthnet PPO · f. 189. 27. Glenda · 1. 134. 35. 35. 174. 112. 80. 111. 8. 60. 5. 138. 211. 42 Contra Costa Oncology · 26. 6. 7. 106. 109. 209 Chandra. 126. 136 B Bow Legs High School · 1 Bruns House hospice · 111. 174. 127. 172. 203. 157. 207. 14. 161. 76. 99. 171. 54. 176. 115. 188. 185. 85. 105. 62. 204. 71. 188. 84. 30. 110. medical · c. 101. Smita · 77. 162. 178. 129. 175. 32. 89. 105. 28. 107. 41. 206. 205. 119. 34. 102. 188. 183. 16. 181. Bruce · 8. 118. 90. 30. 202. 172. 195. 186. 168. 163. 191. 161. 28. 166. 67. 100. 169. 173. 128.
180. 61. 208. 138. 139. 137. 81. 75. 179. 104. 156. 130. 71. 109. 105. 72. 99. Martin · 81. 168. 112. 170. 74. 186. 56. 91. 85. 93. 111. 208 John Muir Hospital · 25. 187 Taxotere · 34. 89. 99. 111. 206. 89. 122. 87. 174. 158. 96. Jerry and Stephanie · 65. 84. 109. 35. 114. 179. 84. 88. 114. 209. 119. 138. 91. 97. 106. 171. 185. 167. 211 Khashayar. 31. 210. 77. 210 M Manor Care Walnut Creek · 70. Jay · 105. 173. 185. 164. 184. 139. 58. 56. 112. 105. 180. 180. 211 Spencer. 163. 187. 174. 106. Laura · 74. 201. 184. 92. 111. 61 U University of Oklahoma · 3 . 209 N Norco · 82. 180. e. 71. 182 P Pressure wound · 68. 152. 79. 54. 172. 86. 100. 99. 185. 91. 120. 94. 113. 206. 208 Kindred skilled nursing facility (SNF) · 74. 134. 73. 170. 92. 171. 186. 182. 100. 96. 120. Ramin · 79. 111. 115. 79. 36. 110. 177. 98. 119. 189 L Lorenzana. 208. 91. 73. 66. 91. 185. 207. 170. 210 Stadtler. 160. 175. 186. 58 Stengel. 95 Skilled nursing facility (SNF) · c. Dr. 172. 107. 93. 88. 163. 172. 173. 181. 72. 97. 93. 94. 163. 90. 157. 208 Stich. 27. 153. m. 87. 74 Stanford Medical Center · 26. 209. 85. 110. 86. 94. 164. 178. 175. 101. 110. 64. 28. 209. Rodney · b. 184. 89. 167. 98. 107. 78. 189. 129. 82. 108 S Sherman. Vona · 24. 161. 166. 176. 113. 90. 138. Dr. 90. 188. 89. 187. 169. 169. 75. j. 75. 164. Dr. 71. 172. 78. 97. 85. 32. 83. 95. 95. 70. 138. f. 26. 60. 112. 80. i. 168. 107. 84. 160. 177. 192. 133. 211 T Taxol · 34. 188. 96. 104. 74.217 INDEX Jimenez. 85. 76. 78. 93. 170. 169. 76. 175. 162.. 38 Morphine sulfate · c. 165. 189. 165. 79. 172. 107. 187 Medicine Equity and Drug Safety Act (MEDS) · 37. 87. 168. 82. 202. 172. 81. 59. 98. 95. Dr. 157. 111. 211 K Kaiser Permanente HMO · 30. 63. 110. Michael · 26. 98. 176. 128. 69. 182. 90.
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