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 DEPARTMENT OF VETERANS AFFAIRS
Greater Los Angeles Healthcare System
Imaging Service
11301 Wilshire Blvd
Los Angeles, California 90073

FR6M: IL\I/EP il trctl1t/ PHONE: (310) 268'4s0s

FAX: (310) 268-3258

TO, DEPrtLfugbr OF I/ETflnIIT FAX: ( )

/ 02 5b5 - 7%b
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pAGtrS: (TNCLUDTNG covER sHEEr, (l I ELEVT|)

DArE sENr: 5-/*0?
TII\IE SENT: I 0, D
IF YOU DO NOT RECEI\,'E ALL THE PAGES IN THIS FAX, PLEASE CALL
SENDER AS SOON AS POSSIBLE.

NOTE: This message is intended for the use of the individual or entity for which it
is addressed and may contain information that is privileged, confidential or exempt
from disclosure under applicable Federal or State Law. If the reader of this
message is not the intended recipient, you are hereby advised that any
dissemination, distribution or duplication of this communication is strictly
prohitrited. If you have received this communication in error, please notify us
immediately.

THANK T'OU.
 Oliver Bruce Mitchell III
P. O. Box 1912
Long Beach, California
90801-1912

l2May 2009
OIG
OBM

From: Oliver B. Mitchell III

To: Department of Veterans Affairs, Office of Inspector General
Attn: Representative86

Subj: RESPONSE TO LETTER DATED APRIL 74,2009

In response to letter from OIG dated April 74,2009, postmarked Apr1l28,2009 and received on
May 2,2009 the following information is provided:

The co-worker and employee who attended school during working hours is Bertha Villanueva.
To my knowledge she attended Santa Monica College located at 1900 Pico Blvd. Santa Monica,
California 90405 (310) 434-4000 with a major in Japanese language. Additionally, on the days
she wasn't attending school she was away from the work section daily between the hours of
10am to 2pm. In her absence I was required to cover her assigned duties and work area. To my
knowledge she was given an opportunity to make up her hours missed and compensated with
overtime for such hours.

The following photos have been provided to show the location of the storage of patient medical
information to include (x-rays, charts, graphs and logbooks). This information is located within
Bldg. 507 (MRI Clinic) in a storage closet. This is not a central location for the storage of such
information.

From February 2008 to June 2008 the current interim chief stated "all MRI orders on the backlog
list were to be scheduled as normal". From June 2008 to September 2008 the current interim
chief stated "our clinic had the worst performance numbers compared to other VA's nationwide"
she also stated "management stated no MRI orders could be cancelled andlor deleted". In
September 2008 the current interim chief stated "only MRI orders 6 months or less should be
scheduled". Additionally, in September 2008 the current interim chief informed my co-worker
and myself that she had recently applied for the position of Department Chairman and that our
performance would decide her fate.

Shortly thereafter I noticed that request for MR['s were being cancelled dating from the year
2000 to November 2008. I approached the current interim chief about this matter in which she
responded "management was all over her and she had to do something".
To my knowledge the ordering clinician and patient were not notified the order was being
cancelled. In order to protect patient privacy the name, ssn, dob, and medical history have been
blackened to comply with HIPPA and VA local policy. The original documents remain within
the clinic in its original order.

If you shouldneed additional information or have any comments or questions you may contact
me at (562) 230-7742 or via mail at PO Box 7912 [,ong Beach, Ca 90801.

Oliver
k
flitchell
ltl
 )>Disr:onti:ued Rad/NM Consultation f or WLA-MRI <<Printed: l.{AR 5 ,2OOg 1 1 : 5 Spage
==== == = = = = = = = == = == ===== = ==== ======= = = = = = = === = = = = = == = = =:: =:= == = == = = = === = == == = = =
Name Urgency ROUTINE
ID Num Transport AMBULATORY
r:ate of Birth Patient Loc WLA-NEURO GENERAL N/
Age at req 28, Phone Ext 83116
Sex PEMALE

***CANCELLErp*** ***cANCELLED***
Pregnancy Status: Unknown
Requested: MRI BRAIN (SPECIFY) (MRI Parent )
*rk The requested procedure has contrast media assigned **
Procedure Message:
-Please cal-l (310) 268-4505 or ext. 49507 if you have any questions.
Request Status: DISCONTINUED (dc)
Reason Cancelled: ORDER TOO OLD
*********************
*CANCELLED*
*********************
Requester: JAIN, FELIPE
TeI/Page /Oig page: Unknown
Attend Phy Current: UNKNOWN
Prim Phy Current: HALL,PATRICIA K
TeI/Page /a:-g page z 661-632-tB2B / /
Prim Phy At Order: UNKNOWN
'te/rime Ordered: Aug 04, 20OB 2236 pm by JAIN,FELIPE
--te Desired:
cancelled:
Aug Il, 2008
Mar 05, 2009 11:58 am by vALDovrNos,HERLrNDA M
Reason for Study: See Cl1nica1 History:
C1inical History:
FrRST PROVIDE CLINICAL HX and REASON FOR EXAM (LIMIT 240 Chars )rtrlI

*ALL INFO rS MANDATORY For clarifications call 84505(WLA), B1B-895-9345

(SEP) **You will- be contacted if request is incomplete.
1.Any TMPLANTS? (ie: Pacemakers, reads, defibrirlators, pumps, penire
implants r or other metallic/electric implants.) Call- for-clirification.
NO

2.Has patient EVER had an eye injury with metal?

If there is any doubt (especially with dementia patients)
get ORBITAI X-RAYS prior to requesting MRI. NO
3.BRAIN SURGERY? (ANY METAL PLATES, RODS, CLIPS?) NO

4.ANY OTHER SURGERY/PROSTHESIS? NO

If So, WHAT/WHEN?
 >>Di-scontinued Rad/NM consultation for wLA-MRI <<Pri-nted:MAR 6,2009 09t28Page
==== ==== = == == ====== ============================================ ==== == =========
lriame Urgency : ROUTINE
ID Num Transport : AMBULATORY
Date of Birth Pati-ent Loc: WLA#-SILVER OPEN ACC
Age at req 87 Phone Ext :
Sex MALE

Requested: MRI KNEE: RIGHT W/O CONTRAST (MRI Detailed 13727)

Procedure Modifiers: RIGHT
Request Status: DISCONTINUED (dc)
Reason Cancelled: ORDER TOO OLD
*********************
*CANCELLED*
*********************
Requester: SHAW,GRETA M
rel/Page/o:-g Page: 43287 / / 3316
Attend Phy Current: UNKNOWN
Prim Phy Current: SUGAWARA,MASAHIRO
TeI/Page/oig Pagez 83644 / / 5415
Prim Phy At Order: UNKNOWN
Date/time Ordered: Aug L6, 2008 8:54 pm by SHAW,GRETA M
Date Desired: Aug 76, 2008
Cancelled: Mar 06, 2009 9:28 am by VALDOVINOS,HERLINDA M
ason for Study: See Clinical History:
Clinica1 History:
FIRST PROVIDE CLINICAL Hx and REASON FOR EXAM (LIMIT 240 Chars)>>>

*ALL INFO IS MANDATORY For clarifi-cations call 84505(WLA), 818-895-9345

(SEP) **You wiII be contacted if request is incomplete.
1.Any IMPLANTS? (ie: Pacemakers, 1eads, defibrillators, pumps, penile
implants, ot other metallic/el-ectric implants.) CatI for clarj-fication.
NO

2.Has patient EVER had an eye injury with metal?

If there is any doubt (especially with dementia patients)
get ORBITAL X-RAYS prior to requesting MRI. NO

3.BRAIN SURGERY? (Any METAL PLATES, RODS, CLrPS?) NO

4.ANY OTHER SURGERY/PROSTHES]S? NO

If So, WHAT/WHEN?

5.PREGNANT? NO
 >>Discontirrued Rad/NM Consultation for WLA-MRr <<Printed:MAR 6,2009 09z27Page
Name : Urgency : ROUTINE
ID Num : Transport : AMBULATORY
r-,ate of Birth: Patient Loc: WLA-PM&RS POLYTRAUMA
Age at req z 25 Phone Ext : 310-268 3170
Sex : MALE
***cANCELLED*** ***CANCELLED**,k
Requested: MRI ANKLE: LEFT W/O CONTRAST (MRI Detailed 13727)
Procedure Modifiers: LEFT
Procedure Message:
-Use of intravenous contrast should be limited to evaluation of neoplastrc
or inflammaLorv /infectious processes.
Request Status: DISCONTINUED (dc )
Reason Cancelled: ORDER TOO OLD
*********************
*CANCELLED*
Jr** * * * * * * * * * * * * ** * ***

Requester: PEPPERS, DOMINIQUE

Tel/Page/o:-g Page: 48348 / / 5199
Attend Phy Current: UNKNOWN
Prj-m Phy Current: JOHNSON,BARBARA A M
TeI/Page/org Page: 805 683-7491 463 /
Prim Phy At Order: UNKNOWN
^.teltime Ordered: Aug 15, 2008 3227 pm by PEPPERS,DOMINIQUE C
te Desired: Aug 15, 2008
Cancelled: Mar 06, 2009 9-,27 am by VALDOVINOS,HERLINDA M
Reason for Study: See Clinical History:
Clinical Hi-story:
FIRST PROVIDE (ILINICAL HX and REASON FOR EXAM (LIMIT 240 Chars)>>>

*ALL INFO IS Iv.j\NDATORY For clarif ications call 84505 (WLA) , 818-895-9345
(SEP) **You wirl be contacted if request is incomplete.
1.Any IMPLANTS? (ie: Pacemakers, Ieads, defibrillators, pumps, penile
implants, or other metal-Iic/electric implants.) Call for clarification.
NO

2.Has patient EVER had an eye injury with metal?

If there is any doubt (especially with dementia patients)
get ORBITAL X-RAYS prior to requesting MRI. NO

3.BRAIN SURGERY? (Any METAL PLATES, RODS, CLIPS?) NO

4.ANY OTHER SURGERY/PROSTHES]S? NO

If so, WHAT/WHEN?
 >>Discontinued Rad/NM Consultation for WLA-MRI <<Printed;MAR 5,2009 11:56Page
=== == == ==== = = == ==== == ====== ======== ====== ===== = =:== == == ===== = = = === = = = ===== ====
Name : Urgency : URGENT
ID Num : Transport : AMBULATORY
-.rte of Bi-rth: Patient Loc: SEP ( 5 ) -GREEN MICHELI
Age at req z 4 Phone Ext : 9585
Sex : MALE

***c A N C E L L E.D*** ***cANCELLED***

Requested: MRI L-SPINE W/O CONT (MRI Detailed '72748)
Request Status: DISCONTINUED (dc)
Reason Cancelled: ORDER TOO OLD
*********************
*CANCELLED*
*********************
Requester: cHou,JrM You-JEN
Te1/Page /oig Page Unknown
Attend Phy Current UNKNOWN
Prim Phy Current: GOMEZ , ARTHUR
Tel/Page /oig Page 891-77 77 ,5129 / / 370-825-6301, #10381
Prim Phy At Order: UNKNOWN
Date/fime Ordered: Nov 18, 2008 11 222 am by CHOU,JIM YOU-JEN
Date Desired: Nov 18, 2008
Cancelled: Mar 05, 2009 11 :56 am by VALDOVINOS,HERLINDA M
Reason for Study: chronic lower back pain
inical History:
FIRST PROVIDE CLINICAL HX (LIMIT 240 Chars)>>>

*ALL INFO IS MANDATORY For clarifications call 84505 (WLA) , 818-895-9345

(SEP) **You wiII be contacted if request is incomplete.
- 1.Any IMPLANTS? (ie: pacemakers, Ieads, defibrillators, pumps, penile
implants, or other metallic/electric implants.) CaII for clarification.
NO

2.Has patient EVER had an eye injury with metal?

If there is any doubt (especially with dementia patients)
get ORBITAL X-RAYS prior to requesting MRI. NO
3.BRAIN SURGERY? (ANY METAL PLATES, RODS, cLrPS? ) NO

4.ANY OTHER SURGERY/PROSTHES]S? NO

rf sor WHAT/WHEN?

5.PREGNANT? NO

6.HISTORY OF CLAUSTROPHOBIA? YES

If yes, MRI wiII administer conscious sedation usj-ng IV ATIVAN.
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