The following is from a combination of our extensive written contemporaneous note and my father’s medical records from El Camino Hospital, which I requested and received on June 20.
While still unconscious, my father was taken by ambulance to Santa Clara Valley Medical Center. To let pressure in his skull subside, my father was sedated for eight days.
While my father was in surgery, my mother accedentally walked into an unmarked glass panel at the front entrance to the hospital, breaking her eyeglasses and getting a black eye bad enough to swell shut. I insisted that she go to the emergency room. No one in the emergency department knew how to take a report (or seemed to care) that her injury occurred while on the premises, and VMC billed her Medicare account.
When I met with VMC CEO Paul Lorenz for a second time on Tuesday June 19, 2018, I shared my opinion that this billing appeared to be Medicare fraud. He said he’d look into it, and on Monday August 6 (about a week after this site went live), my mother received a warrant (check) from the County of Santa Clara for the Medicare deductibles she had paid. (The warrant was dated June 25 and the date from the postage meter was July 2.)
I don’t yet see if my mother’s Medicare account has received such a refund.
After eight days, the sedation was lifted, and my father was clearly able to answer yes/no questions while still intubated.
The next day, apparently without knowing or caring that my father had been alert, Dr. Mark Lee gave us an ultimatum: allow his surgeons to place a breathing tube through my father’s thrachea and a feeding (PEG) tube through my father’s abdomen, or take him off the ventilator to see if he lives or dies.
Around 7:30 in the morning, Santa Clara Valley Medical Center (VMC) called and said they were going to discharge my father that day to a nearby nursing home. This was the first we knew of the alleged "discharge plan". We scrambled to get to the nursing home, which we found totally unacceptable.
When we arrived at VMC later that morning, my father had already been moved out of his room.
Among other problems, VMC violated my father’s rights as a Medicare patient (42 CFR 482.43) through a hasty discharge carried out by case managers Aiping Yu, RN (who wore her badge backward, did not even identify herself with her last name or that she was a case manager, and could not speak English well enough to be understood) and Lisa Sater, RN PHN (who was too lazy to meet in person, and actually threatened us over the phone).
My father was admitted via ambulance to El Camino Hospital for an infection and abcess around his abdominal feeding (PEG) tube, which apparently had caused a fever and lethargy for about three days. Dr. Gary Klapman, MD notes “Mental status normal.” and “We had some difficulty finding a surgeon in that we were trying to reach 1 surgeon who apparently was not on call. We eventually did reach surgeon that was on call and Dr. Legha will be taking the patient to the operating room for definitive care.”
Dr. Prithvi Legha, MD surgically cleans my father’s infected abdomen.
Dr. Troy Thoai Lam, MD incorrectly notes that my father has a broken hip.
My father was moved to room 3121, and gets a new case manager. Now that my father no longer has the abdominal feeding tube and is still unable to eat, we request intravenous nutrition.
My father was moved to room 3224 (Unit 3B), and gets a new case manager.
Mary Deirdre Ann Martin, RD notes no recent nutrient intake, “unintentional wt [weight] loss” of about 10 pounds since admission (4 days earlier), that the patient “is at high nutrition risk”, and recommends intravenous nutrition—which I learn only on June 5.
My father was moved to room 2320, and gets a new case manager.
According to the chart, my father starts showing signs of seizures. Nobody tells us. I later learn that this is apparently common before death by starvation.
According to the chart, neurologist Dr. Arti Renata Muralidhara, MD notes “occasional twitching of hands” and “EEG showing right hemisphere runs of discharges and clinically worse today”. Again, nobody tells us.
In the radiology department, a nasogastric (NG) tube was placed for feeding, but could not be made to work.
Dr. Prithvi Legha, MD orders continued feeding via NG tube, apparently after seeing the tube and assuming it worked, without actually checking to see that my father was being fed.
Around 11pm, we get a call that my father has an irregular heartbeat (which I now recognize as another common symptom of starvation) and was moved to room 3214A for monitoring, and gets a new case manager.
Around 9:15pm, intravenous nutrition starts.
I didn’t realize until later that he was still being undernourished because he started receiving a diet that assumed his height was five feet seven inches (5’7”) despite his actual height being six feet two inches (6’2”). That he was taller should have been obvious to even a casual observer, as his bed had been extended to accomodate his height.
Early in the moring, CEO Dan Woods responds to my email from the day before:
John,
I am very sorry to hear about this experience and will ask the Chief Medical Officer and Chief Nursing Officer to look into the care we have provided to your father and ask for the appropriate information to be shared.
We make our best efforts to provide world class care to our patients and appreciate the opportunity to improve and address any concerns a patient or family member has during their stay at El Camino.
Sincerely,
Dan
My father was moved to room 3319 (telemetry), and gets a new case manager.
Later that morning, Interim Chief Medical Officer Mark Adams and Chief Nursing Officer Cheryl Reinking come to my father’s room.
Dr. Prithvi Legha, MD notes that my father “is getting less responsive of unclear etiology.”
After requesting a different doctor, Dr. Troy Thoai Lam, MD again incorrectly notes that my father has a broken hip, this time in his discharge summary to Dr. James J. Chen, MD.
Dr. James J. Chen, MD describes my father as having death of brain cells due to metabolic encephalopathy. When I asked if it were possibly due to starvation, he says yes.
My father was moved to room 4129 (“medical”), and gets a new case manager. Now that my father no longer has the abdominal feeding tube and is still unable to eat, we request intravenous nutrition.
Dr. James J. Chen, MD had requested a family meeting to “clarify” that my father’s brain loss was due to “septic encephalopathy”, not starvation, suggesting that starvation happens only “in Africa”.
I later read in the chart that he wrote shortly before the meeting that he “Will have a meeting with all family members regarding future planning and no brain injury due to ‘lack of TPN’.” (TPN is “total parenteral nutrition”, a form of intravenous nutrition.) This suggests to me that he was instructed to down play the effect of my father’s starvation, presumably by his colleague Dr. Lam and/or the hospital’s executive management.
Through a failed attempt to replace the intravenous nutrition with a nasogastric (NG) tube without a backup plan, my father’s source of nutrition was removed.
I requested and received from El Camino Hospital copies of my father’s medical records to date.
Through a failed attempt to replace the nasogastric (NG) tube with a nasojejunal (NJ) tube without a backup plan, my father’s source of nutrition was removed again.
That evening, I ask to speak to the person in charge of the hospital at that moment, and meet hospital administrator Nikki Miller. Later that evening, she happened to meet the attorney who had come to the hospital to consult.
My father was discharged from El Camino Hospital about 20 pounds lighter (and weaker).