Malpractice in California:the killing of Veronica

Malpractice in California:the killing of Veronica: Greggory R.DeVore,Md.Geronimo Rodriguez,Md,Joseph Y Li,Md and nurses, headed Veronica Glaubach to a bloody death,due to their medical ignorance

2012-01-20T08:55:00.000-08:00

Malpractice in California:the killing of Veronica: Greggory R.DeVore,Md.Geronimo Rodriguez,Md,Joseph Y Li,Md and nurses, headed Veronica Glaubach to a bloody death,due to their medical ignorance

Greggory R.DeVore,Md.Geronimo Rodriguez,Md,Joseph Y Li,Md and nurses, headed Veronica Glaubach to a bloody death,due to their medical ignorance

2011-01-10T15:46:00.000-08:00

Malpractice in California:the killing of Veronica
The objective of this blog is to give wide publicity to the outrageous case of medical malpractice which conducted my beloved daughter Veronica Solange Glaubach to a bloody death at the age of 28 years,on June 30th,2002 at the Huntington Memorial Hospital of Pasadena,California.

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lunes 10 de enero de 2011
Greggory Russell DeVore Md.OBGYN-Geronimo Rodriguez Md and Joseph Y Li Md committed gross failures conducting my daughter VERONICA to a bloody death ,
Greggory Russell DeVore failed to detect a mild preclampsia when he attended our daughter Veronica Glaubach.She died.
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Submitted by roberto glaubach on Fri, 01/07/2011 - 19:41
Medical & Doctor Related Forum
Greggory DeVore,obgyn from Pasadena, performed an ecosound test to our daughter Veronica Solange Glaubach,during her pregnancy and abvout two months previous to the time of childbirth.He was in possesion of her prenatal records on which several big warnings about preclampsia,IUGR and preterm labour can be readed !,including ,on said prenatal records ,Lab tests pointing high blood presure,swalling a,back pain and +2 proteinuria. Mr DeVore,notwithstanding said evidence,signed an ecosound report dismissing any possibility of toxemmia(preclampsia), IUGR (intrauterin grow retardement of the fetus),or pre term labour. My daughter went to deliver the baby on june 30,2002 to the HUNTINGTON MEMORIAL HOSPITAL.She was atended during the labour by Geronimo Rodriguez obgyn and Joseph Y Li (I´ve already posted forum topics concerning the aforesaid two "docs...?". They avoided any concern about preclampsia(maybe following DeVore statement) so she delivered the baby amid high blood pressure,started four hours after with hughe upper abdominal pain ,nausea,seeing spot lights,vomits,swalling body etc progressing to a fatal HELLP.Nobody attended accurately the outcoming preclampsia progresing to a terminal hellp,so she died some hours after with any kind of accurate treatement to manage the preclampsia(just Tylñenol,Mylanta and a liquid diet prescripted by Joseph Y Li (a real stupid prescription). She died bleeding even by eyes with no one plattelet.Say no more.Thos doc´s are not only irresponsibles but dangerous,They are simpli IGNORANTS.Our experts pointed all of them as big wrongdoers.Say no more.
Roberto Glaubach
The father of VERO (still mourning my poor child )

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Dear Roberto, I am so sorry
Submitted by heartthrob on Sun, 01/09/2011 - 23:24.
Dear Roberto, I am so sorry to hear that you are still suffering such pain. I suppose that is ceaseless with the loss of a child. I cannot imagine that. I have read Veronica's story many times, but until now had not studied it in depth. Things seemed to have happened so fast that I have to wonder if earlier aggressive treatment could have saved her.

In the investigation notes, there is no indication of what orders were given to treat her post partum hypertension (if any). While investigation notes state repeatedly that there is no nurses note to indicate that the doctor was notified, they also state that there were orders written between 7 pm (June 30) and 5:15 am (July 1).... at 7:45 pm, 8:15 pm, 10:45 pm, 3 am, 3:55 am, and 4:15 am. I would love to know who wrote those orders since investigators state that nurses notes failed to indicate that doctor was notified. Nurses aren't allowed to write orders, with the exception of phone orders. I would also be interested in what actions those orders entailed.

Sometimes when there is a crisis, writing notes is the last thing you want your nurse to be doing. Unfortunately the law says "if you didn't write it, you didn't do it." It sounds like the doctors WERE being called.

Assuming that they were trying to treat her hypertension (which I cannot tell), the first critical sign was the drop (by 1/2) in her platelet count, and elevation of WBC, which was reported at 4:05 pm. I don't believe there was indication in the CBC of hemolysis. She then had a siezure at 4:30 pm., when a code blue was called? There is nothing in the record as to exactly what time she was transferred to critical care. I know that sometimes when a CC bed is called for there is no bed available, in which case patients have to be shuffled to accomodate a transfer. Also there is no indication that she was administered platelets, but that doesn't mean she wasn't. Not seeing the records, you can't tell.

I also wondered whether her liver enzymes were elevated, which would have been another big warning signal. (I think)

So, were the nurses negligent in their actions, or dismissive in their charting? Who can say. They clearly took the blame according to the investigation.

I wonder if documentation of immediate action could have altered the horrible outcome.

The informaton that I looked at came from Roberto's blog:

http://veronicaglaubachmalpracticeinusa.blogspot.com/

I had a patient once who developed DIC after her delivery. It was reportedly caused by an amniotic emboli, which causes the body to release heparin, which then can result in DIC. She bled from every port, and was in that condition when she arrived in ICU. She was my patient for weeks. We wound up giving her >300 units of blood and/or blood products. In all that time, she was at deaths door. We just kept transfusing to try to stay ahead of the blood loss and to correct the DIC. Although she lived, she had chronic health problems thereafter and did develop hepatitis. Point is that when things like this happen, they happen so fast that it is very hard, if not impossible to reverse.

I am very, very sorry Roberto. I hope that at some time you can be at peace. My heart goes out to you.

Pam

»
reply quote
Dear Pam: It seems,and I feel
Submitted by roberto glaubach on Mon, 01/10/2011 - 19:23.
Dear Pam:
It seems,and I feel so,that you have medical knowledge,maybe you are a Md,RN or medical expert.Allow me to provide some information that I hope can be useful to you to have a much more clear "panorama" on my daughter case.After all theese years,I have no aoubt about the existent brotherhood between the Medical Board and doc´s(no matter how many peolpe-patients-they´ve killed due to their unskillness) and between the Reg.Nursing Board and nurses(no matter how many patients harmed or killed due to the same circumstance of unskillness,negligence,etc).The whole system is infected with this kind of cooptation and corruption.Helth providers(hospitals),prepaid medicine,Insurance Cartels and legislators have their own responsibility on the issue.

Here goes one of dozens of letters I´ve submitted to the MBofCa authorities and Reg N Board although the case,from the point of view of material indemnification for my granddaughter was completed after a mediation on which the counselors of involved doc´s,hospital,nurses and LACounty,recognized(off the record...shh..of course) this brutish case of ignorance,incompetence and lack of expertis and knowledge .I was there personnaly and my lawyer recommended to accept having into account that it was much better than going to a "local jury judgement" because being I a foreign (the 50% of my relatives are 5th generation in USA,and in a big part of my soul I feel myself american ) although the plaintiff was an american citizen(my grandchild)it was going to be really dangerous to challenge a "local hospital and the involved doc´s,nurses,etc",even accepting that we were going to succeed,maybe-having into account frozen MICRA amounts-we´ll obtain less than in a mediation setlement due to the wages and costs coming from the legal battle.
Hope this letter,will clarify your information.Do not hesitate to ask me for more documentation.
Thank you so much.
Roberto

Tue, September 15, 2009 11:29:38 PMI demand truthfulness and justice
From: Roberto Glaubach View Contact
To: Susan Cady ;

byaroslavsky@mbc.ca.gov
;

bjohnston@mbc.ca.gov
;

rthreadhill@mbc.ca.gov
7 Files Download All
1.doc (219KB); 2.doc (282KB); 3.doc (714KB); 4.doc (185KB); 5.doc (423KB); 6.doc (258KB); 7.doc (311KB)

--------------------------------------------------------------------------------

Buenos Aires,September 17,2009

To :

The Medical Board of California
Mrs Barbara Jaroslavsky
Barb Johnston
Renee Threadhill

Att: Mrs Susan Cady

" You can have good health insurance,live in a community with state of the art facilities and yet none of that matters if you can´t find a doctor,or the doctor treating you is incompetent,negligent or dishonest.That´s why medical boards matter.".. Barb Johnston .May 7,2009

This letter is to reply Mrs Susan Cady,staff services manager, attached letter dated July 15,2009 and at the same time to insist once more with my request of a complete and fairer revision over Case 11-2003-144255 and Case 11-2003-144256.Geronimo Rodríguez MD and Joseph Li MD, both OBGYN who I blame as main responsibles of the death of my 28 years old daughter Veronica Solange Glaubach at the Huntington Memorial Hospital,Pasadera,on June 30th 2002,at the age of 28 .

I will expose and point out in a clear cut the reasons which will sustain and explain my insistence in pursue a disciplinarian action to be taken against those irresponsible and unskilled physicians .

Mrs Cady: as you explain in your letter,the Board must be able to obtain the whole necessary information …etc…etc ..within seven years of the date of the incident,according BPCODE Section 2230.5, it´s true,but,it doesn´t fit to this case. Why ? , because in my complaint,timely submitted, I am reporting not only a medical malpractice case, because at the same time I´m accusing Rodríguez and Li for unfair procedures as a furtherance of their failures.

That means: unprofessional conduct based on incompetente,gross negligence and worse of all willful and intentional actions in order to conceal from discovery his failures as even the most distracted analyst can easily realize just taking a simple but thorough look over his hypocritical ,coward and prevaricant discharge summary, our experts discovered indeed.

Just contrasting said “discharge summary” with the death certificate,signed by Rodríguez,and with the contradictoty and misleading hospital´s attestation report,even the most dull witted analyst will clairly see the flagrant existent contradictions which I have to attribute to the urgency with which they runnned (hospital authorities+nurses+doctors) to conceal, to mislead and to hide the true events after the death of Veronica.

I was pressing requesting in a firmly manner at the medical records office to full copy of medical records,which they gave to me,at last,but in the most incredible disorder which leaded me to go inside the office and to work there for at least six hours to organize those papers ant to assemble big flowsheets. Late,very late,those “papers” whose the hospital is “custodian” were been already “touched” Well Mrs Cady,it seems that they committed errors again.That simple indeed

The Board spent almost three years (just a little delay ¿??) to investigate this clear case of medical malpractice. Just to compare: The Public Health Service spent no more than six months to conduct a thorough depth investigation and to submit it conclusions. The same documentation and witness reports has been given to the PHS and to the MBC.

Mr Alan Irish can state how many times I´d been going to Diamond Bar to provide elements germane to this case.Same as Dave Thornton and former President Ron Wender, and DAG Robert Mc Kim Bell ,so I am absolutely “on time” having into account the unacceptable delay of the Board to insist in my request of true and decency and disciplinarian actions against the aforementioned wrongdoers.

The California Department of Health Services,declares in a ten pages summary signed by Marlene Taylor Chief of HFD and Eric Stone,Supervisor AAU:…” A review of the closed medical record revealed that the diagnosis of hipertensión in pregnancy,preeclampsia/eclampsia and HELLP síndrome were absent from MD 1´s discharge summary despite documentation of these syndromes by MD 1 in the medical record and that they were the critical events and conditions that led to the patient´s death”.

MD1 is ,of course, Mr Gerónimo Rodríguez, Why ?..because he signed the aforesaid discharge summary.

Which has been the diagnosis signed by Rodríguez ?

“Disease due to failure to cardiorespiratory system due to brain hemorrhage”

So it seems that my poor daughter died due to a brain hemorraghe ,yes,it´s true,if you want,..,but that was the last outcome of the store: an inexistent diagnosis and as a logical consequence of said inexistent diagnosis, the absence of any timely accurate treatment to manage the sickness. That´s why my daughter went to the sky.

About the “failure of cardiorespiratory system”… it doesn´t deserves any further comment.Everybody knows that people dies due to the aforesaid failure.A real stupidity.

Why did Rodríguez remain silent and avoided to state and sign the correct diagnosis of preclampsia/eclampsia/Hellp ? It´s quite simple. Because by signing the aforesaid diagnosis (lately realized by Gurevitch not for him) he was admitting his wide incompetence and gross negligence since he never ordered any accurated treatment to manage preeclampsia,eclampsia or Hellp indeed..

So Rodríguez (maybe in combination with Li and some authorities of the Huntington ¿?) decided to mislead and conceal his lack of ability ,to mislead further investigations,shading the true facts, in short :he lied. What for ¿ To avoid disciplinarian consequences.
That´s why this case is not subject to the limitation provided for by subdivision a) pursuant to Section 11503 of the Government Code as it apppears on paragraph (c) on BPCode Section 2230.5

It´s quite clear that the Medical Board didn´t take into account the dishonest action performed by Rodríguez on his signed prevaricant summary and related documents, which in my humble opinión means that this case is uncomplete whatsoever .

The Medical Board of California is owing us explanations about this incongruent and false discharge summary,and about the other existing incongruences and contradictions emerging from the documentation.

But,we still have many other details concerning this complaint:

Let´s see:
Rodríguez signed his false discharge summary on July 2nd,2002 on which he mentioned “cord entangle” without giving relevance to said situation ,he stated: “..cord around the neck was seen..” Its clear that “cord around the neck is germane to the baby situation. Nothing to do with my daughter´s preeclampsia in progress , eclampsia or further HELLP and death as well.

On July 7th,2002, Rodríguez signed a death certificate stating as immediate causes of death:

1.- Cardiorrespiratory Arrest

2.- Intracerebrum Hemorrhage

3.- Hellp

The Hospital´s final diagnosis written in the “attestation report” of July 8,2002 has been the following:

Principle Diagnosis: Cord entangle neck (¿?)

If cord entangle neck (a stupidity) was the principle diagnosis recognized by the Hospital authorities as main circumstance which developed to Hellp,you need no further analysis to conclude that nor Rodríguez nor Li,neither nurses or whoever,did any accurate diagnosis. We face contradictions and incongruences one after another.Pure Lies.

Secondary Diagnosis:Cerebrovasculart disease (consequence of HELLP))

Coagulation deficiency (consequence of HELLP)

Severe preeclampsia .

Allow me to ask: Severe preeclampsia stated by the hospital,?? But where is the Hellp stated by Rodríguez on his summary ¿? And why he signed hellp on the death certificate ¿? Who told rodríguez that it was a Hellp ¿?

Why the hospital statement postulates a “ severe preeclampsia “as secondary diagnosis ? ..,because only Gurevitch started a slight procedure to try to stop the outcoming drama when my poor daughter,medically abandonned ,was irremediably out of any hope. Previously to that point, for instance Li was prescripting a liquid diet . Do you need more proofs ¿???

It is more than clear the existing incongruences between Rodríguez discharge summary,the death certificate signed by him and the hospital´s attestation report .Same pattern of default of honesty and decency to avoid responsibilities.

It seems that Rodríguez discovered the real diagnosis five days after the death of my daughter, It seems… or …are we facing another incongruent lie (having into account what he signed on the aforesaid summary ¿?One lie after another lie.

Let´s analyze the rest of the aforesaid “untruthful “discharge summary:

Rodríguez stated that at the time of admisión (01.20 am) blood pressure was: 133/86 (which is high) and… nothing else was remarkable. Did Rodríguez take even a quick look over the prenatal records ¿? The prenatal records are full of clear warnings and concerns about preclampsia,preterm labor, IUGR, proteinuria+2 and HBP all symptoms of a mild preclampsia ,a big signal notifying to everybody that Veronica was a “high risk patient” indeed.
Moreover ,when admitted Veronica mentioned to have seen spots the previous day. What else ¿?

Blood pressure at 03.00 am 142/91

Blood pressure at 03.32 am 151/91

Moreover: at 04.10 am it´s written: she had alive reflexes,which are clear symptoms of neurological disturbance

At 06.48 Veronica gave birth to my granddaughter who weighted 2029 grams ,thats a clear sign of IUGR and even all the aforesaid symptoms Rodríguez did not considered the possibility of preclampsia.

At 6.50 she vomited 100cm3 of clear liquid.

Where are the instructions given by Rodríguez to make specific and more rigorous chekups on my daughter ¿? They do not exist.

Blood pressure at 07.00 am 148/92

Blood pressure at 07.15 am 148/97

Blood pressure at 07.45 am 138/75

Blood pressure at 08.00 am 153/83

All the blood pressure levels were abnormals,all the time:

Notwithstanding the aforementioned high blood pressure levels we can read

The entry signed by Rodríguez on the Hospital Course: Laboratory initially was done,as I mentioned,because the blood pressure was “ somewhat elevated,although the patient was completely asymptomatic and denied any headache,blurry vision or epigastric pain”….

What means “somewhat elevated”? A little elevated,less elevated ¿??

High blood pressure is anything else than that: high blood pressure. Our experts felt astonished reading that outrageous explanation indeed. All the blood pressure levels has been abnormals,all the time.-

What is the worse:….the patient was completely asymptomatic and denied any headache,blurry vision or epigastric pain”….this assertion is another big lie,but at the same time it unveils a real true.Let´s see:

Rodríguez assertion that Veronica was asymptomatic is anything else than a complete recognition of his wide ignorance about symptoms germane to the existing eclampsia in progress to hellp since he was watching -but not recognizing- clear symptoms saiod pathology.

At the same time he is lying since Veronica mentioned having seen spot lights and complained about headaches,terrible upper abdominal pain,suffered nausea,vomits and her hands and legs showed edema.

The California Dep..of Health Services statement indicates:…”A review of the closed medical record revealed an incomplete and unsigned physician´s Progress Note on June 30th,2002 at 6.03 am “….Further review of the closed medical record revealed that the physician´s Progress Note on June 30,2002,entered after the Progress note of 7PM couyld not be read and the signatura cannot be identified. The same handwriting was found in a Progress Note on July 1,2002 for which no time of entry was documented”…

…” a review of the closed medical record revealed that MD 2 (Li) did not indicate the time of his note on June 30,2002”

…” a review of the closed medical record revealed that a Physician´s order on July 1,2002 at 06.16 am was not signed”…

…” Although an autopsy was not performed,( it´s been declined by an e-mail signed by Dr Lois Pena who never saw the body ) the record review revealed that the patient was hypertensive throughout her hospital course untill hours before her death.The clinical diagnosis were Eclampsia and Hellp Syndrome”…(diagnosis ignored by Rodríguez on his discharge summary)

Rodríguez states on the summary:…”Then the patient went to the floor.In that area at approximately 12 in the afternoon the nurse called saying the patient was having vomiting.She vomited the Tylenol #3 and seemed like she had some gastritis and that time Mylanta was ordered (by whom ¿?)and DC´d Tylenol and give her vicodin and they believed (who believed ¿? Nurses ¿?)) that perhaps the codeine produced her gastritis”…

This statement is an absolute lie. One of the nurses suspected that the symptoms were germane to preclampsia and she did informed Rodríguez about said concerns.

Veronica was accompanied by her mother and her boyfriend.They witnessed everything.Nurses also. At 12.15 am Veronica had a growing and unbeareable epigastric pain.,nausea,saw spot lights,showed edematic hands and legs,She was given Tylenol which she vomited right Hawai.It seems that Rodríguez ordered Tylenol and Mylanta telling the nurses (by telephone because he was absent) that it was a post partum pain (what is expected in puerperium is perineal pain not epigastric pain).

Rodriguez ordered additionnaly Vicodin which she vomited as well.Vicodin is a narcotic analgesic (hydroxycodone). Medically,narcotics analgesics are not indicated for a patient suffering from usual labor pain but for a thorougly different symptoms,unrelated to organs envolved in labor process.

Another proof of medical ignorance ant the total disorientation of Rodríguez.He was attacking the pain not the causes. Why ¿? Because he never identified the sickness which was producing said symptoms indeed.

On the contrary,what world have been advisable was to be on guard considering that those symptoms were the most frequent of HELLP syndrome (65% of cases).In addition: in the Clinical resume there is no record of investigations carried out due to epigastric pains.

Thereafter,Rodríguez abandoned the patient for a long long almost three “golden” hours.Several attempts to contact Rodríguez were absolutelly unsuccesful.In spite of having being paged once and again Rodríguez has been all the time unavailable and out of reach or else he has been always late.

Not only has he always been late or absent but also he has note even dared to enter any entry in the medical records and clearly enough he had left the case in the hands of the registered nurses without even giving a diagnosis .

After 14.30 pm till 18.00 pm there is a total absence of entries in the medical history.

As Rodríguez was out of reach,Li had to be called in emergency (he atended Veronica during pregnancy so he must know her prenatal records indeed).He ordered some lab tests and a stupidity: a liquid diet(¿? What for) and a vial of Demerol to calm pain.He never inquirid or investigated the real cause of that upperabdominal pain,whose cause remained without any explanation.

There you have another demonstration of medical incompetence

Rodríguez and Li knew the results of blood tests ordered at 16.05.Platelets showed a dangerous low lever of 119.000 mm3. All studies are coincidental :platelets below 150.000 mm3 shall cause great concern about Hellp.They saw that result but haven´t done any accurate managment :v.g .a platelets transfusión for example.

So: of what single departures are you talking about ¿?

The Board´s final conclusión about Rodríguez and Li is outreageously and daringly unacceptable and it offends and underestimates the inteligence of any skilled and trained doctor or/and any forensic witness expert.

It is by far clear that Rodríguez failed by far in much more than to order a simple urine protein determination.,as the board´s status.He failed to diagnose,(he didn´t diagnose),thereafter he failed to recognize any single symptom of the progressing eclampsia,he abandoned the patient,he lied and falsified his report to conceal his own ignorance from discovery and experts are strongly concerned about the missing sheets of the medical records and many obvious incongruences on statements and entries.

About the other wrongdoer Li,the board´s final report:…” …he failed to properly evaluate Veronica´s complaint by reviewing the medical records.The persistent complaint of epigastric pain (without an alternative diagnosis..??)should have prompted therapy with magnesium sulfate..” shows the same pattern of irresponsible indulgence and a wide distortion of the true .

The real true is that nor Rodríguez neither Li took a minnimum single look over the records (pre natal and hospital recordsas well) and both of them ignored the upper abdominal unbearable pain germane to eclampsia,so they never started any therapy with Mg sulfate.Mg sulfate has been administered just when it was very late.

As(renowned) forensic expert Dr Ricardo Bocacci reported, (I attach with this letter the full report) Dr Gurevich was the first one to wonder about the possibility of preeclampsia during pregnancy but it was very late (19.00 pm) but Veronica was already out of any hope.Late very late.
The Board´s conclusion seems to be aimed to protect those two dangerous negligent and incompetent wrongdoers.Experts are absolutely coincidental about the lack of ability and their further intentional misleading and concealing behaviour.

The Board spent almost three years to investigate this clear case of medical malpractice. The Public Health Service spent no more than six months to conduct a thorough depth investigation and to submit it conclusions.Same documentation and witness reports has been given to the PHS and to the MBC,moreover,Mr Alan Irish knows how many times I´d been going to Diamond Bar to provide elements germane to this case.Saqme as Dave Thornton and former President Ron Wender,so I am absolutely “on time” to insist in my request of true and decency and disciplinarian actions against the aforementioned wrongdoers.

By the way: Your qualification of “single departure from standards” is unsustainable from every point of serious view.,no matter what kind of interpretation you give to that “bargain clause” a big “black hole” of the
MPAct of BPCode. Anything can be framed with the aforesaid definition.

Not in this case.
When I say “bargain” I know(as you know) of what I´m talking about. Said definition (bargain) was given to me at the office of Senator Sheila Kuhel

I mean:she knows of what she talks about.

Copy of this letter will be sent to Governor Arnold Schwartzenegger´s office and to LATimes investigative reporter Charles Ornstein autor of “When caregivers harm” …"Veronica Glaubach Joy of birth,then drama" ,and to David Gumpert,maybe the next investigative report should be:”When Medical Board harm ¿?”

I demand true and justice,now !.,a matter of human rights and decency

Architect Roberto A Glaubach,Veronica´s father,and family

Posadas 1265(1011) Buenos Aires

Argentine Republic

telefax: 0054114-815-0537/17

The following report ,which is by far very clarifying, is the transcription of the original signed by Ricardo Boccacci ,MD,forensic,expert before The Supreme Court of Justice,a wellknown pathologist, and clinical expert with almost 40 years of expertise and international experience.

A) BACKGROUND: PREECLAMPSY

The patient Veronica Solange Glaubach was having a high-risk pregnancy due to several indicators of preeclampsy, namely:

1. She had positive albuminuria type 1 on June 8th and 25th and type 2 on June 11th. In general, proteinuria is the last sign to appear in preeclampsy and therefore, such sign is of highly clinical importance.(pages 1-2)

2. According to checkups made on her during pregnancy, levels of blood pressure were of 90/60 and 100/70 as from January 9th till May 1st and 112/70, 112/68, 110/70, 100/60, 116/70 as from March 21st till June 25th what clearly shows that the patient had a caracteristical basal hypotension . When she went into the Hospital, the levels of blood pressure increased significantly : on June 30th . 01.20 blood pressure was of 133/86; 04.10 am : 140-150/80- 90 mm Hg. Although there exist several definitions of preeclampsy, many describe it as clinical symptoms with tensional levels above 140/90 mm Hg , an increase of systolic blood pressure of 30 mm Hg or an increase of the diastolic blood pressure by 15 mm Hg after week 20 together with proteinurea in excess of 300 mg during the 24 hours. It is obvious that Verónica had all to fit that diagnostics.(page 3)

3. Moreover, it is important to point out that in the pre-natal control flow sheets you can read several times that precautions must be taken. Shall I ask you why?(pages 1-2-3)

4. When she got into the Hospital, it has been written in the Maternal Clinical Resume that the reports of pre-natal controls had been noticed. In such reports you can read in several places the existence of proteinurea and the need of taking precautions . Notwithstanding, in the Clinical Resume there is no reference that such warnings had been communicated to the doctors in charge. (page 4)

5. From the moment Verónica got into the hospital , she had shown high tensional values and mentioned to have seen spots on the previous day. Moreover, at 04.10 it`s written,she had alive reflexes.,symptoms of neurological disturbance. At 06.50 she vomited 100 cm3 of clear liquid . However, these symptoms didn’t arise any concern to the medical staff in charge so that nobody gave instructions to make specific or more rigorous checkups on the patient, being no record that this abnormal symptoms have been informed to any of the doctors in charge. (page 5)

6. At 6.,48 Verónica gave birth to her daughter who weighted 2029 grams . There exist several definitions for I.U.G.R. (retarded intrauterine growth ). However, most of the doctors agree to define I.U.G.R. as less than 10 percent of predicted fetal weight for gestational age. In general , any birth in term with the newborn weighting less than 2.500 grams implies an I.U.G.R. Now my question is, considering the weight of the newborn baby , nobody of the medical staff considered the possibility of preeclampsy? (page 6)

B) LACK OF ADEQUATE POSTPARTUM CONTROL–ONSET OF

ECLAMPSY – H.E.L.L.P. SYNDROME:

1. The labor which in the medical staff view required precautions, took place on June 30th. at 06.48 . However, the next record was only made at 09.00 indicating breastfeeding without any mention of the health of the parturient.(page 7)

2. In all Obstetrics services, it is wide known that immediate puerperium must be strictly surveyed, mostly during the first two hours , putting emphasis on heavy bleeding, frequency of the pulse, blood pressure, and uterine involution. Such controls must be made each 15 minutes. Pursuant the post anesthesia recovery data sheet , blood pressure has been controlled each 15 minutes and levels were all abnormal , worrying and unrelated to the levels the patient had shown during pregnancy and that were registered in prenatal control data sheets: at 7.00 blood pressure of 148/92; 7.15 – 148/97; 7.30 – 138/5 ; 7.45 – 148/76 and at 8.00 –153/83. Notwithstanding this abnormal tensional increase, there is no mention of it in the Patient Progress Record so as there is any mention of actions taken by doctors or registered nurses to clarify this anomaly. In fact, the Patient Progress Record goes from the record taken at 6.31 when Dr. Rodriguez arrived to the corresponding verification of birth taken at 6.48 , and from there to the record of no breastfeeding taken at 9.00 and to “growing epigastric pain” at 12.15. In short , for more than six hours , there have been no statements regarding the medical condition of the patient, her blood pressure, diuresis, uterus involution, etc.

In the Progress Record the situation is worse though, there is no record till the intervention of an obstetrician in emergency[2].. This means that from the medical staff point of view the patient almost did not exist : she was a problem ascribed to the registered nurses.

However, it is clear enough that five from eight records of systolic blood pressure taken between 7.00 and 8.00 were within hypertensive range, same as two of those of diastolic blood pressure. (page 7-8-9)

3. The lack of controls and negligence are obvious also in the Maternal Flow Sheets because there are sporadic records of the levels of blood pressure taken at 03.00, 04.00, 05.00 and 06.00 being all of them abnormals 142/91, 139/50, etc. However, next register is only at 09:00 – 140/56 and the next one at 12:00 – 170/55 , that is to say three hours later. Pain level is also therein registered but only at 11:00, 12:00 and 14.:00. At 12:00 she was administered Vicodin and at 14:00, Demerol.

4. At 12:15 Veronica had a growing epigastric pain . She was given Paracetamol, an unespecified anesthetic (Tylenol) which the pacient vomited right away. What is expected in puerperium is perineal not epigastric pain. Nobody cared for this symptom which is in fact one of the first symptoms to appear when HELLP onsets. (page 7)

5. Faced with a growing epigastric pain and vomits , Dr. Rodriguez administered Mylanta (antiacid) and narcotic analgesics (hydroxycodone) whose commercial name is Vicodin , what she immediately vomited as well. Medically, narcotic analgesics are not indicated for a patient suffering from usual labor pain but for a thoroughly different symptoms, unrelated to organs or structures involved in labor process. On the contrary, what would have been advisable was to be on guard considering that those symptoms were, as aforementioned , the most frequent of HELLP syndrome(present in 65% of the cases). In the Clinical Resume there is no record of investigations carried out due to epigastric pains.

6. With growing pain, sickness and vomits , it has been attempted to contact Dr. Rodriguez , unsuccessfully though. In spite of having being paged once and again, as from Veronica’s admission to the Hospital till her demise, Dr.Rodriguez has been all the time unavailable and out of reach or else he has always been late. Not only has he always been late or absent but also he has not even dared to enter any entry in the medical records and clearly enough , he had left the case in the hands of the registered nurses without even giving a diagnosis .

7. As Dr. Rodriguez was out of reach, an obstetrician Dr.Li had to be called in emergency and ordered to have medical tests done , a liquid diet (???) and a vial of Demerol (derived from morphine) which was absolutely useless for this is used to calm but not to find out the real cause of such pain. It is important to point out , that the idea was not to calm genital pains caused by labor but the epigastrics, whose cause remained without any explanation. (page 9)

8. Also, in the medical record you can read an entry saying “Respiratory stand by’s intro ven x 45’ ” which is very confusing . There is no reference made to the real status of the patient , her medical condition or time of the entry. Worse though is that there is an electrocardiogram covering the page hindering whatever important or not had been written below.(page 10)

9. The only real fact is that controls had been few and isolated and in spite of the alarming signals, the medical staff remained unconcerned. Besides, after 14:30 till 18:00 there is a total absence of entries in the medical history. Although is truth that in the separate pages you can find entries of the Code Blue but there is no chronological sequence in it. So, in a page you find entries about what happened at 18:00 and in the next page, strangely enough, you find entries with the diagnosis and treatment given at 17.45: Eclampsy. Haematuria. Hyperreflexia. Maintain magnesium sulfate. Sodium bicarbonate . (page 11)

10. Patient Progress Records states at 18:00 - Admitted into maternity , accompanied by the doctor. +RN – slight hypertension - lungs condition was stable - Respiratory Assistance (RA) – Haematuria . (page 10)

11. When was Respiratory Assistance administered? In the succinct CODE BLUE pages the equipment was required at 16:30 and it came at 16:33. It is also stated that the patient went into convulsions and was completely unconscious. Various tensional levels are registered (the first being particularly abnormal: 146/ 99,22 mm Hg) Determination of arterial blood gas is requested by the doctors .The report says AERIAL TRACT IS ORAL…. What does this phrase mean? Aerial tract is always oral and incidentally nasal or by tracheotomy. Why then it has not been acknowledged that beyond doubts she needed to be intubated or managed with an ambu, to get RA? (page 12-13)

12. What for and where was she administered local anesthesia? (Dermoplast-Benzocaine)The patient didn’t have pelvic pain and even if this had been the case , local anesthesia would have not eased the pain. Usually, these type of anesthetics are used to anesthetize the oral part of pharynx so as to insert a nasogastric tube or a tube for endotracheal intubation . So why she was administered local anesthesia on June 30th. at 11:40 hs?(page 14)

13. Regarding respiration, in the CODE BLUE sheet , as aforementioned, the only reference made is that the aerial tract WAS ORAL. In addition you can read that the oxygen saturation ,when the team arrived ,was of 92% and that there was a wheezing in the superior aerial tract. Under the item intubation, you have no entries. However, the pressure of arterial blood gas was of 150 mm Hg at 16:49. How did she reach that value when arterial blood gas on room air is 100 mm Hg? How is it that she has to go intubated to IUC when in the CODE BLUE sheets there is no reference to such a situation? The only description therein made was AERIAL TRACT IS ORAL…(page 12)

14. Poor and almost sporadic information is shown in the prenatal flow sheets on June 30th. Before labor blood pressure entries are at 03:00; 04:00 , 05:00 and 06:00. The values shown there were all abnormal and even quite unbelievable, eg. Value change from 151/91 mmHg goes to 142/55 without any medical intake in the middle. Also, after labor checkups were made during 2 hours each 15 minutes, but as above mentioned after 08:00 the next entry was only made at 09:00 with a value of 140/56 and the next one at 12:00 yielding an alarming value ( 170/55 mm Hg) that should have caused alarm and consequently, the immediate staff intervention.

15. Unfortunately , if we consider the Progress Record , such medical staff didn’t exist since there is no record on the medical history till the doctor for emergencies , Dr. Lee , intervened and without registering the timetable of his intervention , he prescribed analysis and anodyne measures , such as a liquid diet.!

16. Apparently the registered nurses are the ones to be blamed for they were not conscious of their role which was, supposedly, to replace the doctors and therefore the checkups had been scarce and they failed to give the symptoms the importance they have . On June 30th. at 11:00, 12:00 and 14:00 they registered in the maternal flow sheets ABDOMINAL PAIN - ACHING GRADES 6, 5 and 8. No reference has been made that this symptom had been informed to the doctors in charge, which as aforementioned , has nothing to do with the normal consequences of labor. On the contrary , this symptom is a clear alert of eclampsy and most of all of H.E.L.L.P.syndrome.

17. Moreover, in the same maternal flow sheets , same time as before mentioned you can read “Behavior : Agitated” . Once again the nurses were not alarmed by this. Six hours have passed by after labor , the parturient was still being agitated but there was nothing to be worried about.

18. Poor information, lack of clarity in the registers most of them illegible which is a serious fault since if a doctor was called in emergency , how could he get an idea of what the patient previous medical scenario was?; All these have been a constant in the medical history. In fact, the medical history is full of abbreviations or acronyms almost unknown for the common of the doctors. To picture this, in the progress record on June 30th. at 17:15 you can barely read : “Code Blue Note: Code Blue Note called 2º to pt. Because unresponsive eyes rolli … foamy secretions … “ (the rest of it is illegible)(page 15)

19. The issue of the platelets remains particularly unclear to any fairly educated doctor . We all know that the normal number of this cells in peripheral blood is of 150.000 to 400.000 mm3 . In Veronica’s case, the register at 04:35 showed 222.000mm3 and strangely , another blood test was ordered at 16:05, showing 119.000mm3 . This last test should have raised alarm since in all studies, treatises or papers made on the subject, it is very clear that platelets below 150.000 m3 shall cause great concern . Why? Because proteinuria and the increase of the levels of uric acid are useful to diagnose preeclampsy but not to detect H.E.L.L.P. syndrome. The best indicator to detect H.E.L.L.P. syndrome is the number of platelets. Doctors and nurses of Huntington Memorial Hospital had seen that result but haven’t done anything . It was exactly at that moment that H.E.L.L.P. syndrome should have been diagnosed. Accordingly a vigorous line of action should have been carried out so as to control blood pressure and to substitute by means of blood transfusions the platelets that were in decrease. It is obvious that an early diagnosis was critical for effective treatment of such syndrome.(page 16)

20. However, long before there had been a tests whose abnormal results should have been reason enough to be taken as a warning. At 04:35 fibrin degradation products (pdf) which should be lower than 5, showed a level higher than five but lower than twenty. This result that forced to discard the onset of a consumption coagulopathy has not been object of concern to the health professionals involved. In fact, they should have ordered a D-Dimer test, which is a sensitive indicator of a sub-clinical coagulopathy and it can be positive before that coagulation tests show abnormalities. However, this hasn’t been done. The subsequent progress of the patient reports coagulopathy : at 18:15 pdf was higher than twenty , fibrin diminished to 113 mg % ( reference level: 200 to 400); as for the platelets they diminished much more. (page 17)

C) FINAL DIAGNOSIS :

1. None of the involved obstetricians , Dr. Lee or Dr. Rodriguez, have registered a specific diagnosis in the clinical history till it was too late. Moreover, their almost inexistent and poor remarks are superficial and incidental. They’ve not made any reference to hypertension, proteinurea, thrombocytopenia, etc. They treated abdominal pain as a regular puerperal pain by administering Vicodin and Demerol or as it would have been a gastritis they administered Mylanta. They have never been conscious of the existence of a preeclampsy , eclampsy or H.E.L.L.P. syndrome. Only at 17:15 (page 15)they wrote :” Pt is in eclampsia (pt has elevated BP during peripartum period” . Then , at 05,15 on July 1st. when the patient did not respond to verbal orders or pain stimulus, that is to say , when she was beyond hope , gone for ever, Rodriguez wrote: “ Lab: as noted: Hellp syndrome”.

2. Dr. Gurevich (page 18)has been the first one to wonder about the possibility of “preeclamsy during pregnancy “, at 19:00 , once the symptoms were completely displayed and as an unidentified subject established that Veronica was already in an eclampsic condition (page 11).However, although he had suspected a preeclampsy and he was witnessing the first eclampsy consequences such as convultions, even though the patient had upper abdominal pain, and in spite of her having a low quantity of platelets , he has not concluded a H.E.L.L.P. syndrome diagnosis , neither did he indicated platelets transfusions to the patient nor any other effective action in order to stop the coagulopathy.

3. The Hospital ‘s final diagnosis written in the Attestation Report has been the followingLpage 19)

Principle Diagnosis: Cord entangle neck

Secondary diagnosis :

674.02 – Cerebrovascular disease

666.32 – Coagulation deficiency

642.52 – Severe preeclampsia

The above categorization of the diagnosis is incoherent : If Cord entangle neck is considered as the principle diagnosis just because it has been the first one , that could work but if we consider this as the main diagnosis it is absurd.

The cordon around the neck might harm the newborn baby but not the mother.

She died because she suffered bassicaly a preclampsia undetected by RN and doctors of Huntington Memorial.Hospital.With any kind of managing or accurate treatement,preeclampsia progressed to severe eclampsia which developed in a HELLP syndrome with a drastic drop of platelets and intravascular consumption of fibrinogen which led to an intracerebral hemorrhage ,killing Veronica.

4. In the Discharge Summary ,(page 20) Dr. Rodriguez describes the evolution of the medical symptoms of the patient without mentioning eclampsy diagnosis or H.E.L.L.P. syndrome in it. As discharge diagnosis he establishes the following: “Disease due to cardiorrespiratory failure due to brain hemorrhage. However, cardiorrespiratory failure is the final form of death of all individuals and brain hemorrhage might respond to many causes: brain injury, artery aneurysm rupture, arteriovenous malformation, hypertensive crise, encephalic tumor, coagulopathies, etc. In short, the Discharge Summary failed to provide a specific diagnosis ( It`s obvious that Rodriguez made a false statement to hide the true fact of his enormous lack of knowledge and gross negligence)

5. Finally, there is another surprisingly fact. No one from Los Angeles County Department of Coroner has reviewed the medical history. However, in the entry To Report a Death you can read that this death was not a coroner case per LA Coroner Office. Apparently , the communication was made through Internet because at the superior angle of the page you can read : “ Dr. Lois Pena @ L.A. coroner Office declines as coroner case”.(page 21)

CONCLUSIONS:

Veronica was a healthy young woman
She was intelligent and blessed with great artistic sensibility
However, she -as any other human being- could have passed away for many reasons: a road accident, an infection or as a result of unpredictable complications during pregnancy such as an hemorrhage due to placenta previa , an endovascular coagulopathy due a detached placenta, etc.
But, she was treated by doctors and registered nurses whose gross negligence and clear lack of skill led my daughter to her death:

They didn’t notice that the patient was having clear signs of preeclampsy during the pregnancy

The abnormally high tensional registers taken from the very beginning when she had been admitted into hospital have not caused any concern to the doctors neither have they given rise to communications of any kind among them.
After labor the levels of blood pressure during the first two hours have been abnormal. However, there is no proof that this situation has been informed to the doctors and therefore, controls more often . After the first two hours controls and entries are scarce and more isolated.

Epigastric pain, nausea and vomits are symptoms that should have given raise to great concern. Mostly since the frequency of such symptoms are clear indicators of H.E.L.L.P. syndrome . However, they have been minimized, attributed to gastritis and ridiculously treated with a diet, Mylanta, etc.

The indication to administer Vicodin or Demerol (narcotics agents) to trat an epigastric pain is also an obvious and blatant example of the lack of medical skill.

The fact that the medical staff has not taken immediate action when an sudden drop of platelets has taken place, which in fact could not have been attributed to nothing but intravascular coagulation which is the most important sign of H.E.L.L.P. syndrome , is another proof of their lack of skill.

RICARDO BOCACCI MD,forensic expert before the Supreme Court.

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Two month after Vero´s death
Submitted by roberto glaubach on Fri, 01/07/2011 - 20:18.
Two month after Vero´s death
I visited Mr DeVore at his office in Fair Oaks Pasadena.The man,attended me for a long while(about two hours) during which he tried to convince me that he wasn´t responsible of the disaster that headed my daughter to the "other world",he displayed charts showing that my granddaughter was very little according with this,bla,bla,or that,bla bla.Notwithstanding that I told him that our experts in san Diego(out of the LA area,of course) and other renowned forensic docs and experts in Argentina were coincidental about the failures of his ecosound report(over which ,I suspect,he never took even a short look and maybe was completed by his asistant to be simply signed by him),he spent hours trying to mislead any decent explanation.He never gave any explanation about his statement of "non existing danger of toxemia or IUGR or pre-term labour.
A real liar.Veronica gave birth 20 days before the scheduled day.That is just pre-term labour precisely !.Thereafter she died due to a mild-non attended-toxemia which progresed to a fatal HELLP:
Perhaps,God can forgive you Mr DeVore,not my family not me.You are responsible although the corupted Board protected you,as well as Geronimo Rodriguez and Joseph Y Li.I wonder,why then ,the Hospital and doctors lawyer Mr Robert Reback admitted the malpractice to my lawyer Richard Cohn(Sta Ana) and accepted to pay more than two MICRA (550000) to my grandchild??? .Was it only a money issue to you and the other wrongdoers?? ...for sure for you ,but not for the witness experts,because this is a clear case of pure MEDICAL IGNORANCE and a human being has been killed as a consequence of said criminal MEDICAL IGNORANCE.Have you any remorse on your soul???...well only if you have a soul of which I feel unlikely !!.
Roberto Glaubach,arq
The father of Veronica Solange Glaubach( will never forget you !)

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I don't understand it all -
Submitted by wishandaprayer on Fri, 01/07/2011 - 20:32.
I don't understand it all - but it seeems to me that a mistake was made and that a sincere apology and promise to do better in the future might have prevented further emotional harm.

I hope that you find some peace.

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dear WISHANDAPRAYER: What
Submitted by roberto glaubach on Sat, 01/08/2011 - 22:58.
dear WISHANDAPRAYER:
What part of my story you do not understand?
Listen,this "doc..." failed in an incredibly way (from the point of view of ecosound experts and witness experts we´ve consulted) to detect clear symptoms of an existing mild preclampsia.We are sure this liar did not even spent one second to review his own ecosound. Should him do that ,should him sign a correct diagnosis.No one doubt about that.The prenatal records given by Veronica to him,were showing several RED SPOT LIGHTS WITH recommendations and warnings about a possible preclampsia (or toxemia as you prefer),and preterm labour.Moreover Labt tests included on the records were showing +2 proteinuria,a BLATTANT SPOT SIGNAL of toxemia in progress.DeVore DVD of his ecosound showed echoes in the placenta,a clear signal of abnormality coincident with a toxemia diagnosis.
Of what kind of MISTAKE ARE YOU TALKING ABOUT?...That "mistake" has been crucial in this case because,since the report signed by this ignorant and irresponsible physician,dismissing the possibility of toxemia ,intrauterin grow retardement and preterm labour(every one of which finnaly occured heading Vero to a bloody death)went with the rest of the PRENATAL RECORDS to the HUNTINGTON MEMORIAL HOSPITAL where Geronimo Rodriguez md,obgyn,Joseph Y Li,and registered nurses Criki Morrisey,Robin O Brien and Hillary Warren didn´t take into account the possibility of the aforesaid disease.There you have the second main "mistake" as you call it. A mistake that headed Veronica to a bloody death with no one minnimum accurate managing of her symptoms.Should she been attended by skilled docs and nurses,shoul she be alive.I spent the last 8 years and more investigating every and each path on this case,that´s why I can give this testimony,because all this unskilled pro´s can not respond anything accurate,any thruthful explanation ,so gross,so huge are their "mistakes". Of what apology are you talking about ?. Try,for an instant,to sit down on my chair !!!! They killed my child ! Can you imagine what is that?? A health profesional supossed to take care of you,committed a "mistake" and killed you,a "single departure"(stupid bargain definition of the Medical Practice Act negociated by the doc´s mafia with insurance cartels and corrupted medical board& legislators,to avoid consequences of their malpractice-wrongdoings).Whatr I cannot understand is your last opinion concerning "...a sincere apology and promise to do better in the future...????? of what future?? whom future??? yuours??? because they cutted my poor child´s future(28 years old).If you want to know more try veronicaglaubachmalpracticeinusa.blogspot.com by google or yahoo or try simply her name in Internet.By trhe way....DeVore never gave any kind of apology because he never recognized his "mistake",he spent two hours at his office trying to convince me about stupid explanations(he was ignorant about my 6 american and argentine witnes experts who at that time reported this malpractice case).Say no more.His failure was just due to a gross incapacity,wide unskill and knowledgeless
Allow me to say: I found peace in my other 6 daughters and granddaughter but I´ll never forgive.never forget especially because the corupted Medical Board of Caslifornia,although the Public Health Service of cal pointed a collection of failures done by dopcs and nurses,did not acted against the involved wrongdoers,Maybe sent em to take a short course of eclampsia or hellp.Many people,inocent patients die daily due to the corrupted medical system which allows the malfeasance of ignorant health caregivers who can thereafter go to another state to get a new license.Just trash medical enforcement. nothing else.
Roberto the father of Veronica killed by doc´s "mistake"...(as you call a gross criminal malpractice case)

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reply quote
roberto glaubach wrote: dear
Submitted by wishandaprayer on Sat, 01/08/2011 - 23:48.

roberto glaubach wrote:
dear WISHANDAPRAYER:
What part of my story you do not understand?
Listen,this "doc..." failed in an incredibly way (from the point of view of ecosound experts and witness experts we´ve consulted) to detect clear symptoms of an existing mild preclampsia.We are sure this liar did not even spent one second to review his own ecosound.

I can understand that - a doctor doing a test and not reviewing his own results. To me - it's gross negligence.

I think that protein in the urine indicates a problem.

It must seem as though it was delberate.

When doctors and nurses don't take accountability and apologize - it can make you feel that it was deliberate.

Your chair would be much too uncomfortable to even think of sitting in. I can not say that I fully understand the pain of losing a child as I have never lost a child. I did nearly lose my baby daughter at birth. I was very lucky that she was saved. I was heartbroken that she was very sick. I didn't even think that it was the doctor's fault; I thought that it was all my fault. With hindsight, I know that the doctors could have done better, but I am just very grateful that the anesthesiologist was able to save my baby.

Health professionals should take accountability for the mistakes that they make.

I would expect an apology from the doctors but it may not be enough for you. What do you want? Do you want the doctor to go to jail for manslaughter? If doctors neglect to do their job well, and it causes death - should the doctor go to jail? If that were the case, I think that many good people would not want to become doctors.

I am very glad that you got the expert witnesses that you needed. I am glad that you got some validation from that and that you got some money - although the loss of Veronica's life cannot ever be compensated for.

It is good to know that you can have some comfort and peace with your family and I hope that you can be a comfort to them as well.

I can understand your immense anger, heartache and grief and I I certainly didn't mean to upset you and I'm very sorry for that. It shouldn't have happened, but negligence and mistakes do happen, and when doctors don't take accountability - I feel that it only causes more anger and pain.

And when you think that people are minimizing what happens, it can increase your anger and frustration, and I did that, and I'm sorry. That wasn't my intention and I am sorry.

I wish you and your family peace today and in the future.

»
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VERONICA SOLANGE GLAUBACH
En la foto con su hijita Indiana Agote Glaubach
Ver todo mi perfil

Greggory Russell DeVore Md.OBGYN-Geronimo Rodriguez Md and Joseph Y Li Md committed gross failures conducting my daughter VERONICA to a bloody death ,

2011-01-10T15:35:00.000-08:00

Greggory Russell DeVore failed to detect a mild preclampsia when he attended our daughter Veronica Glaubach.She died.
View Edit
Submitted by roberto glaubach on Fri, 01/07/2011 - 19:41
Medical & Doctor Related Forum
Greggory DeVore,obgyn from Pasadena, performed an ecosound test to our daughter Veronica Solange Glaubach,during her pregnancy and abvout two months previous to the time of childbirth.He was in possesion of her prenatal records on which several big warnings about preclampsia,IUGR and preterm labour can be readed !,including ,on said prenatal records ,Lab tests pointing high blood presure,swalling a,back pain and +2 proteinuria. Mr DeVore,notwithstanding said evidence,signed an ecosound report dismissing any possibility of toxemmia(preclampsia), IUGR (intrauterin grow retardement of the fetus),or pre term labour. My daughter went to deliver the baby on june 30,2002 to the HUNTINGTON MEMORIAL HOSPITAL.She was atended during the labour by Geronimo Rodriguez obgyn and Joseph Y Li (I´ve already posted forum topics concerning the aforesaid two "docs...?". They avoided any concern about preclampsia(maybe following DeVore statement) so she delivered the baby amid high blood pressure,started four hours after with hughe upper abdominal pain ,nausea,seeing spot lights,vomits,swalling body etc progressing to a fatal HELLP.Nobody attended accurately the outcoming preclampsia progresing to a terminal hellp,so she died some hours after with any kind of accurate treatement to manage the preclampsia(just Tylñenol,Mylanta and a liquid diet prescripted by Joseph Y Li (a real stupid prescription). She died bleeding even by eyes with no one plattelet.Say no more.Thos doc´s are not only irresponsibles but dangerous,They are simpli IGNORANTS.Our experts pointed all of them as big wrongdoers.Say no more.
Roberto Glaubach
The father of VERO (still mourning my poor child )

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Dear Roberto, I am so sorry
Submitted by heartthrob on Sun, 01/09/2011 - 23:24.
Dear Roberto, I am so sorry to hear that you are still suffering such pain. I suppose that is ceaseless with the loss of a child. I cannot imagine that. I have read Veronica's story many times, but until now had not studied it in depth. Things seemed to have happened so fast that I have to wonder if earlier aggressive treatment could have saved her.

In the investigation notes, there is no indication of what orders were given to treat her post partum hypertension (if any). While investigation notes state repeatedly that there is no nurses note to indicate that the doctor was notified, they also state that there were orders written between 7 pm (June 30) and 5:15 am (July 1).... at 7:45 pm, 8:15 pm, 10:45 pm, 3 am, 3:55 am, and 4:15 am. I would love to know who wrote those orders since investigators state that nurses notes failed to indicate that doctor was notified. Nurses aren't allowed to write orders, with the exception of phone orders. I would also be interested in what actions those orders entailed.

Sometimes when there is a crisis, writing notes is the last thing you want your nurse to be doing. Unfortunately the law says "if you didn't write it, you didn't do it." It sounds like the doctors WERE being called.

Assuming that they were trying to treat her hypertension (which I cannot tell), the first critical sign was the drop (by 1/2) in her platelet count, and elevation of WBC, which was reported at 4:05 pm. I don't believe there was indication in the CBC of hemolysis. She then had a siezure at 4:30 pm., when a code blue was called? There is nothing in the record as to exactly what time she was transferred to critical care. I know that sometimes when a CC bed is called for there is no bed available, in which case patients have to be shuffled to accomodate a transfer. Also there is no indication that she was administered platelets, but that doesn't mean she wasn't. Not seeing the records, you can't tell.

I also wondered whether her liver enzymes were elevated, which would have been another big warning signal. (I think)

So, were the nurses negligent in their actions, or dismissive in their charting? Who can say. They clearly took the blame according to the investigation.

I wonder if documentation of immediate action could have altered the horrible outcome.

The informaton that I looked at came from Roberto's blog:

http://veronicaglaubachmalpracticeinusa.blogspot.com/

I had a patient once who developed DIC after her delivery. It was reportedly caused by an amniotic emboli, which causes the body to release heparin, which then can result in DIC. She bled from every port, and was in that condition when she arrived in ICU. She was my patient for weeks. We wound up giving her >300 units of blood and/or blood products. In all that time, she was at deaths door. We just kept transfusing to try to stay ahead of the blood loss and to correct the DIC. Although she lived, she had chronic health problems thereafter and did develop hepatitis. Point is that when things like this happen, they happen so fast that it is very hard, if not impossible to reverse.

I am very, very sorry Roberto. I hope that at some time you can be at peace. My heart goes out to you.

Pam

»
reply quote
Dear Pam: It seems,and I feel
Submitted by roberto glaubach on Mon, 01/10/2011 - 19:23.
Dear Pam:
It seems,and I feel so,that you have medical knowledge,maybe you are a Md,RN or medical expert.Allow me to provide some information that I hope can be useful to you to have a much more clear "panorama" on my daughter case.After all theese years,I have no aoubt about the existent brotherhood between the Medical Board and doc´s(no matter how many peolpe-patients-they´ve killed due to their unskillness) and between the Reg.Nursing Board and nurses(no matter how many patients harmed or killed due to the same circumstance of unskillness,negligence,etc).The whole system is infected with this kind of cooptation and corruption.Helth providers(hospitals),prepaid medicine,Insurance Cartels and legislators have their own responsibility on the issue.

Here goes one of dozens of letters I´ve submitted to the MBofCa authorities and Reg N Board although the case,from the point of view of material indemnification for my granddaughter was completed after a mediation on which the counselors of involved doc´s,hospital,nurses and LACounty,recognized(off the record...shh..of course) this brutish case of ignorance,incompetence and lack of expertis and knowledge .I was there personnaly and my lawyer recommended to accept having into account that it was much better than going to a "local jury judgement" because being I a foreign (the 50% of my relatives are 5th generation in USA,and in a big part of my soul I feel myself american ) although the plaintiff was an american citizen(my grandchild)it was going to be really dangerous to challenge a "local hospital and the involved doc´s,nurses,etc",even accepting that we were going to succeed,maybe-having into account frozen MICRA amounts-we´ll obtain less than in a mediation setlement due to the wages and costs coming from the legal battle.
Hope this letter,will clarify your information.Do not hesitate to ask me for more documentation.
Thank you so much.
Roberto

Tue, September 15, 2009 11:29:38 PMI demand truthfulness and justice
From: Roberto Glaubach View Contact
To: Susan Cady ;

byaroslavsky@mbc.ca.gov
;

bjohnston@mbc.ca.gov
;

rthreadhill@mbc.ca.gov
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1.doc (219KB); 2.doc (282KB); 3.doc (714KB); 4.doc (185KB); 5.doc (423KB); 6.doc (258KB); 7.doc (311KB)

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Buenos Aires,September 17,2009

To :

The Medical Board of California
Mrs Barbara Jaroslavsky
Barb Johnston
Renee Threadhill

Att: Mrs Susan Cady

" You can have good health insurance,live in a community with state of the art facilities and yet none of that matters if you can´t find a doctor,or the doctor treating you is incompetent,negligent or dishonest.That´s why medical boards matter.".. Barb Johnston .May 7,2009

This letter is to reply Mrs Susan Cady,staff services manager, attached letter dated July 15,2009 and at the same time to insist once more with my request of a complete and fairer revision over Case 11-2003-144255 and Case 11-2003-144256.Geronimo Rodríguez MD and Joseph Li MD, both OBGYN who I blame as main responsibles of the death of my 28 years old daughter Veronica Solange Glaubach at the Huntington Memorial Hospital,Pasadera,on June 30th 2002,at the age of 28 .

I will expose and point out in a clear cut the reasons which will sustain and explain my insistence in pursue a disciplinarian action to be taken against those irresponsible and unskilled physicians .

Mrs Cady: as you explain in your letter,the Board must be able to obtain the whole necessary information …etc…etc ..within seven years of the date of the incident,according BPCODE Section 2230.5, it´s true,but,it doesn´t fit to this case. Why ? , because in my complaint,timely submitted, I am reporting not only a medical malpractice case, because at the same time I´m accusing Rodríguez and Li for unfair procedures as a furtherance of their failures.

That means: unprofessional conduct based on incompetente,gross negligence and worse of all willful and intentional actions in order to conceal from discovery his failures as even the most distracted analyst can easily realize just taking a simple but thorough look over his hypocritical ,coward and prevaricant discharge summary, our experts discovered indeed.

Just contrasting said “discharge summary” with the death certificate,signed by Rodríguez,and with the contradictoty and misleading hospital´s attestation report,even the most dull witted analyst will clairly see the flagrant existent contradictions which I have to attribute to the urgency with which they runnned (hospital authorities+nurses+doctors) to conceal, to mislead and to hide the true events after the death of Veronica.

I was pressing requesting in a firmly manner at the medical records office to full copy of medical records,which they gave to me,at last,but in the most incredible disorder which leaded me to go inside the office and to work there for at least six hours to organize those papers ant to assemble big flowsheets. Late,very late,those “papers” whose the hospital is “custodian” were been already “touched” Well Mrs Cady,it seems that they committed errors again.That simple indeed

The Board spent almost three years (just a little delay ¿??) to investigate this clear case of medical malpractice. Just to compare: The Public Health Service spent no more than six months to conduct a thorough depth investigation and to submit it conclusions. The same documentation and witness reports has been given to the PHS and to the MBC.

Mr Alan Irish can state how many times I´d been going to Diamond Bar to provide elements germane to this case.Same as Dave Thornton and former President Ron Wender, and DAG Robert Mc Kim Bell ,so I am absolutely “on time” having into account the unacceptable delay of the Board to insist in my request of true and decency and disciplinarian actions against the aforementioned wrongdoers.

The California Department of Health Services,declares in a ten pages summary signed by Marlene Taylor Chief of HFD and Eric Stone,Supervisor AAU:…” A review of the closed medical record revealed that the diagnosis of hipertensión in pregnancy,preeclampsia/eclampsia and HELLP síndrome were absent from MD 1´s discharge summary despite documentation of these syndromes by MD 1 in the medical record and that they were the critical events and conditions that led to the patient´s death”.

MD1 is ,of course, Mr Gerónimo Rodríguez, Why ?..because he signed the aforesaid discharge summary.

Which has been the diagnosis signed by Rodríguez ?

“Disease due to failure to cardiorespiratory system due to brain hemorrhage”

So it seems that my poor daughter died due to a brain hemorraghe ,yes,it´s true,if you want,..,but that was the last outcome of the store: an inexistent diagnosis and as a logical consequence of said inexistent diagnosis, the absence of any timely accurate treatment to manage the sickness. That´s why my daughter went to the sky.

About the “failure of cardiorespiratory system”… it doesn´t deserves any further comment.Everybody knows that people dies due to the aforesaid failure.A real stupidity.

Why did Rodríguez remain silent and avoided to state and sign the correct diagnosis of preclampsia/eclampsia/Hellp ? It´s quite simple. Because by signing the aforesaid diagnosis (lately realized by Gurevitch not for him) he was admitting his wide incompetence and gross negligence since he never ordered any accurated treatment to manage preeclampsia,eclampsia or Hellp indeed..

So Rodríguez (maybe in combination with Li and some authorities of the Huntington ¿?) decided to mislead and conceal his lack of ability ,to mislead further investigations,shading the true facts, in short :he lied. What for ¿ To avoid disciplinarian consequences.
That´s why this case is not subject to the limitation provided for by subdivision a) pursuant to Section 11503 of the Government Code as it apppears on paragraph (c) on BPCode Section 2230.5

It´s quite clear that the Medical Board didn´t take into account the dishonest action performed by Rodríguez on his signed prevaricant summary and related documents, which in my humble opinión means that this case is uncomplete whatsoever .

The Medical Board of California is owing us explanations about this incongruent and false discharge summary,and about the other existing incongruences and contradictions emerging from the documentation.

But,we still have many other details concerning this complaint:

Let´s see:
Rodríguez signed his false discharge summary on July 2nd,2002 on which he mentioned “cord entangle” without giving relevance to said situation ,he stated: “..cord around the neck was seen..” Its clear that “cord around the neck is germane to the baby situation. Nothing to do with my daughter´s preeclampsia in progress , eclampsia or further HELLP and death as well.

On July 7th,2002, Rodríguez signed a death certificate stating as immediate causes of death:

1.- Cardiorrespiratory Arrest

2.- Intracerebrum Hemorrhage

3.- Hellp

The Hospital´s final diagnosis written in the “attestation report” of July 8,2002 has been the following:

Principle Diagnosis: Cord entangle neck (¿?)

If cord entangle neck (a stupidity) was the principle diagnosis recognized by the Hospital authorities as main circumstance which developed to Hellp,you need no further analysis to conclude that nor Rodríguez nor Li,neither nurses or whoever,did any accurate diagnosis. We face contradictions and incongruences one after another.Pure Lies.

Secondary Diagnosis:Cerebrovasculart disease (consequence of HELLP))

Coagulation deficiency (consequence of HELLP)

Severe preeclampsia .

Allow me to ask: Severe preeclampsia stated by the hospital,?? But where is the Hellp stated by Rodríguez on his summary ¿? And why he signed hellp on the death certificate ¿? Who told rodríguez that it was a Hellp ¿?

Why the hospital statement postulates a “ severe preeclampsia “as secondary diagnosis ? ..,because only Gurevitch started a slight procedure to try to stop the outcoming drama when my poor daughter,medically abandonned ,was irremediably out of any hope. Previously to that point, for instance Li was prescripting a liquid diet . Do you need more proofs ¿???

It is more than clear the existing incongruences between Rodríguez discharge summary,the death certificate signed by him and the hospital´s attestation report .Same pattern of default of honesty and decency to avoid responsibilities.

It seems that Rodríguez discovered the real diagnosis five days after the death of my daughter, It seems… or …are we facing another incongruent lie (having into account what he signed on the aforesaid summary ¿?One lie after another lie.

Let´s analyze the rest of the aforesaid “untruthful “discharge summary:

Rodríguez stated that at the time of admisión (01.20 am) blood pressure was: 133/86 (which is high) and… nothing else was remarkable. Did Rodríguez take even a quick look over the prenatal records ¿? The prenatal records are full of clear warnings and concerns about preclampsia,preterm labor, IUGR, proteinuria+2 and HBP all symptoms of a mild preclampsia ,a big signal notifying to everybody that Veronica was a “high risk patient” indeed.
Moreover ,when admitted Veronica mentioned to have seen spots the previous day. What else ¿?

Blood pressure at 03.00 am 142/91

Blood pressure at 03.32 am 151/91

Moreover: at 04.10 am it´s written: she had alive reflexes,which are clear symptoms of neurological disturbance

At 06.48 Veronica gave birth to my granddaughter who weighted 2029 grams ,thats a clear sign of IUGR and even all the aforesaid symptoms Rodríguez did not considered the possibility of preclampsia.

At 6.50 she vomited 100cm3 of clear liquid.

Where are the instructions given by Rodríguez to make specific and more rigorous chekups on my daughter ¿? They do not exist.

Blood pressure at 07.00 am 148/92

Blood pressure at 07.15 am 148/97

Blood pressure at 07.45 am 138/75

Blood pressure at 08.00 am 153/83

All the blood pressure levels were abnormals,all the time:

Notwithstanding the aforementioned high blood pressure levels we can read

The entry signed by Rodríguez on the Hospital Course: Laboratory initially was done,as I mentioned,because the blood pressure was “ somewhat elevated,although the patient was completely asymptomatic and denied any headache,blurry vision or epigastric pain”….

What means “somewhat elevated”? A little elevated,less elevated ¿??

High blood pressure is anything else than that: high blood pressure. Our experts felt astonished reading that outrageous explanation indeed. All the blood pressure levels has been abnormals,all the time.-

What is the worse:….the patient was completely asymptomatic and denied any headache,blurry vision or epigastric pain”….this assertion is another big lie,but at the same time it unveils a real true.Let´s see:

Rodríguez assertion that Veronica was asymptomatic is anything else than a complete recognition of his wide ignorance about symptoms germane to the existing eclampsia in progress to hellp since he was watching -but not recognizing- clear symptoms saiod pathology.

At the same time he is lying since Veronica mentioned having seen spot lights and complained about headaches,terrible upper abdominal pain,suffered nausea,vomits and her hands and legs showed edema.

The California Dep..of Health Services statement indicates:…”A review of the closed medical record revealed an incomplete and unsigned physician´s Progress Note on June 30th,2002 at 6.03 am “….Further review of the closed medical record revealed that the physician´s Progress Note on June 30,2002,entered after the Progress note of 7PM couyld not be read and the signatura cannot be identified. The same handwriting was found in a Progress Note on July 1,2002 for which no time of entry was documented”…

…” a review of the closed medical record revealed that MD 2 (Li) did not indicate the time of his note on June 30,2002”

…” a review of the closed medical record revealed that a Physician´s order on July 1,2002 at 06.16 am was not signed”…

…” Although an autopsy was not performed,( it´s been declined by an e-mail signed by Dr Lois Pena who never saw the body ) the record review revealed that the patient was hypertensive throughout her hospital course untill hours before her death.The clinical diagnosis were Eclampsia and Hellp Syndrome”…(diagnosis ignored by Rodríguez on his discharge summary)

Rodríguez states on the summary:…”Then the patient went to the floor.In that area at approximately 12 in the afternoon the nurse called saying the patient was having vomiting.She vomited the Tylenol #3 and seemed like she had some gastritis and that time Mylanta was ordered (by whom ¿?)and DC´d Tylenol and give her vicodin and they believed (who believed ¿? Nurses ¿?)) that perhaps the codeine produced her gastritis”…

This statement is an absolute lie. One of the nurses suspected that the symptoms were germane to preclampsia and she did informed Rodríguez about said concerns.

Veronica was accompanied by her mother and her boyfriend.They witnessed everything.Nurses also. At 12.15 am Veronica had a growing and unbeareable epigastric pain.,nausea,saw spot lights,showed edematic hands and legs,She was given Tylenol which she vomited right Hawai.It seems that Rodríguez ordered Tylenol and Mylanta telling the nurses (by telephone because he was absent) that it was a post partum pain (what is expected in puerperium is perineal pain not epigastric pain).

Rodriguez ordered additionnaly Vicodin which she vomited as well.Vicodin is a narcotic analgesic (hydroxycodone). Medically,narcotics analgesics are not indicated for a patient suffering from usual labor pain but for a thorougly different symptoms,unrelated to organs envolved in labor process.

Another proof of medical ignorance ant the total disorientation of Rodríguez.He was attacking the pain not the causes. Why ¿? Because he never identified the sickness which was producing said symptoms indeed.

On the contrary,what world have been advisable was to be on guard considering that those symptoms were the most frequent of HELLP syndrome (65% of cases).In addition: in the Clinical resume there is no record of investigations carried out due to epigastric pains.

Thereafter,Rodríguez abandoned the patient for a long long almost three “golden” hours.Several attempts to contact Rodríguez were absolutelly unsuccesful.In spite of having being paged once and again Rodríguez has been all the time unavailable and out of reach or else he has been always late.

Not only has he always been late or absent but also he has note even dared to enter any entry in the medical records and clearly enough he had left the case in the hands of the registered nurses without even giving a diagnosis .

After 14.30 pm till 18.00 pm there is a total absence of entries in the medical history.

As Rodríguez was out of reach,Li had to be called in emergency (he atended Veronica during pregnancy so he must know her prenatal records indeed).He ordered some lab tests and a stupidity: a liquid diet(¿? What for) and a vial of Demerol to calm pain.He never inquirid or investigated the real cause of that upperabdominal pain,whose cause remained without any explanation.

There you have another demonstration of medical incompetence

Rodríguez and Li knew the results of blood tests ordered at 16.05.Platelets showed a dangerous low lever of 119.000 mm3. All studies are coincidental :platelets below 150.000 mm3 shall cause great concern about Hellp.They saw that result but haven´t done any accurate managment :v.g .a platelets transfusión for example.

So: of what single departures are you talking about ¿?

The Board´s final conclusión about Rodríguez and Li is outreageously and daringly unacceptable and it offends and underestimates the inteligence of any skilled and trained doctor or/and any forensic witness expert.

It is by far clear that Rodríguez failed by far in much more than to order a simple urine protein determination.,as the board´s status.He failed to diagnose,(he didn´t diagnose),thereafter he failed to recognize any single symptom of the progressing eclampsia,he abandoned the patient,he lied and falsified his report to conceal his own ignorance from discovery and experts are strongly concerned about the missing sheets of the medical records and many obvious incongruences on statements and entries.

About the other wrongdoer Li,the board´s final report:…” …he failed to properly evaluate Veronica´s complaint by reviewing the medical records.The persistent complaint of epigastric pain (without an alternative diagnosis..??)should have prompted therapy with magnesium sulfate..” shows the same pattern of irresponsible indulgence and a wide distortion of the true .

The real true is that nor Rodríguez neither Li took a minnimum single look over the records (pre natal and hospital recordsas well) and both of them ignored the upper abdominal unbearable pain germane to eclampsia,so they never started any therapy with Mg sulfate.Mg sulfate has been administered just when it was very late.

As(renowned) forensic expert Dr Ricardo Bocacci reported, (I attach with this letter the full report) Dr Gurevich was the first one to wonder about the possibility of preeclampsia during pregnancy but it was very late (19.00 pm) but Veronica was already out of any hope.Late very late.
The Board´s conclusion seems to be aimed to protect those two dangerous negligent and incompetent wrongdoers.Experts are absolutely coincidental about the lack of ability and their further intentional misleading and concealing behaviour.

The Board spent almost three years to investigate this clear case of medical malpractice. The Public Health Service spent no more than six months to conduct a thorough depth investigation and to submit it conclusions.Same documentation and witness reports has been given to the PHS and to the MBC,moreover,Mr Alan Irish knows how many times I´d been going to Diamond Bar to provide elements germane to this case.Saqme as Dave Thornton and former President Ron Wender,so I am absolutely “on time” to insist in my request of true and decency and disciplinarian actions against the aforementioned wrongdoers.

By the way: Your qualification of “single departure from standards” is unsustainable from every point of serious view.,no matter what kind of interpretation you give to that “bargain clause” a big “black hole” of the
MPAct of BPCode. Anything can be framed with the aforesaid definition.

Not in this case.
When I say “bargain” I know(as you know) of what I´m talking about. Said definition (bargain) was given to me at the office of Senator Sheila Kuhel

I mean:she knows of what she talks about.

Copy of this letter will be sent to Governor Arnold Schwartzenegger´s office and to LATimes investigative reporter Charles Ornstein autor of “When caregivers harm” …"Veronica Glaubach Joy of birth,then drama" ,and to David Gumpert,maybe the next investigative report should be:”When Medical Board harm ¿?”

I demand true and justice,now !.,a matter of human rights and decency

Architect Roberto A Glaubach,Veronica´s father,and family

Posadas 1265(1011) Buenos Aires

Argentine Republic

telefax: 0054114-815-0537/17

The following report ,which is by far very clarifying, is the transcription of the original signed by Ricardo Boccacci ,MD,forensic,expert before The Supreme Court of Justice,a wellknown pathologist, and clinical expert with almost 40 years of expertise and international experience.

A) BACKGROUND: PREECLAMPSY

The patient Veronica Solange Glaubach was having a high-risk pregnancy due to several indicators of preeclampsy, namely:

1. She had positive albuminuria type 1 on June 8th and 25th and type 2 on June 11th. In general, proteinuria is the last sign to appear in preeclampsy and therefore, such sign is of highly clinical importance.(pages 1-2)

2. According to checkups made on her during pregnancy, levels of blood pressure were of 90/60 and 100/70 as from January 9th till May 1st and 112/70, 112/68, 110/70, 100/60, 116/70 as from March 21st till June 25th what clearly shows that the patient had a caracteristical basal hypotension . When she went into the Hospital, the levels of blood pressure increased significantly : on June 30th . 01.20 blood pressure was of 133/86; 04.10 am : 140-150/80- 90 mm Hg. Although there exist several definitions of preeclampsy, many describe it as clinical symptoms with tensional levels above 140/90 mm Hg , an increase of systolic blood pressure of 30 mm Hg or an increase of the diastolic blood pressure by 15 mm Hg after week 20 together with proteinurea in excess of 300 mg during the 24 hours. It is obvious that Verónica had all to fit that diagnostics.(page 3)

3. Moreover, it is important to point out that in the pre-natal control flow sheets you can read several times that precautions must be taken. Shall I ask you why?(pages 1-2-3)

4. When she got into the Hospital, it has been written in the Maternal Clinical Resume that the reports of pre-natal controls had been noticed. In such reports you can read in several places the existence of proteinurea and the need of taking precautions . Notwithstanding, in the Clinical Resume there is no reference that such warnings had been communicated to the doctors in charge. (page 4)

5. From the moment Verónica got into the hospital , she had shown high tensional values and mentioned to have seen spots on the previous day. Moreover, at 04.10 it`s written,she had alive reflexes.,symptoms of neurological disturbance. At 06.50 she vomited 100 cm3 of clear liquid . However, these symptoms didn’t arise any concern to the medical staff in charge so that nobody gave instructions to make specific or more rigorous checkups on the patient, being no record that this abnormal symptoms have been informed to any of the doctors in charge. (page 5)

6. At 6.,48 Verónica gave birth to her daughter who weighted 2029 grams . There exist several definitions for I.U.G.R. (retarded intrauterine growth ). However, most of the doctors agree to define I.U.G.R. as less than 10 percent of predicted fetal weight for gestational age. In general , any birth in term with the newborn weighting less than 2.500 grams implies an I.U.G.R. Now my question is, considering the weight of the newborn baby , nobody of the medical staff considered the possibility of preeclampsy? (page 6)

B) LACK OF ADEQUATE POSTPARTUM CONTROL–ONSET OF

ECLAMPSY – H.E.L.L.P. SYNDROME:

1. The labor which in the medical staff view required precautions, took place on June 30th. at 06.48 . However, the next record was only made at 09.00 indicating breastfeeding without any mention of the health of the parturient.(page 7)

2. In all Obstetrics services, it is wide known that immediate puerperium must be strictly surveyed, mostly during the first two hours , putting emphasis on heavy bleeding, frequency of the pulse, blood pressure, and uterine involution. Such controls must be made each 15 minutes. Pursuant the post anesthesia recovery data sheet , blood pressure has been controlled each 15 minutes and levels were all abnormal , worrying and unrelated to the levels the patient had shown during pregnancy and that were registered in prenatal control data sheets: at 7.00 blood pressure of 148/92; 7.15 – 148/97; 7.30 – 138/5 ; 7.45 – 148/76 and at 8.00 –153/83. Notwithstanding this abnormal tensional increase, there is no mention of it in the Patient Progress Record so as there is any mention of actions taken by doctors or registered nurses to clarify this anomaly. In fact, the Patient Progress Record goes from the record taken at 6.31 when Dr. Rodriguez arrived to the corresponding verification of birth taken at 6.48 , and from there to the record of no breastfeeding taken at 9.00 and to “growing epigastric pain” at 12.15. In short , for more than six hours , there have been no statements regarding the medical condition of the patient, her blood pressure, diuresis, uterus involution, etc.

In the Progress Record the situation is worse though, there is no record till the intervention of an obstetrician in emergency[2].. This means that from the medical staff point of view the patient almost did not exist : she was a problem ascribed to the registered nurses.

However, it is clear enough that five from eight records of systolic blood pressure taken between 7.00 and 8.00 were within hypertensive range, same as two of those of diastolic blood pressure. (page 7-8-9)

3. The lack of controls and negligence are obvious also in the Maternal Flow Sheets because there are sporadic records of the levels of blood pressure taken at 03.00, 04.00, 05.00 and 06.00 being all of them abnormals 142/91, 139/50, etc. However, next register is only at 09:00 – 140/56 and the next one at 12:00 – 170/55 , that is to say three hours later. Pain level is also therein registered but only at 11:00, 12:00 and 14.:00. At 12:00 she was administered Vicodin and at 14:00, Demerol.

4. At 12:15 Veronica had a growing epigastric pain . She was given Paracetamol, an unespecified anesthetic (Tylenol) which the pacient vomited right away. What is expected in puerperium is perineal not epigastric pain. Nobody cared for this symptom which is in fact one of the first symptoms to appear when HELLP onsets. (page 7)

5. Faced with a growing epigastric pain and vomits , Dr. Rodriguez administered Mylanta (antiacid) and narcotic analgesics (hydroxycodone) whose commercial name is Vicodin , what she immediately vomited as well. Medically, narcotic analgesics are not indicated for a patient suffering from usual labor pain but for a thoroughly different symptoms, unrelated to organs or structures involved in labor process. On the contrary, what would have been advisable was to be on guard considering that those symptoms were, as aforementioned , the most frequent of HELLP syndrome(present in 65% of the cases). In the Clinical Resume there is no record of investigations carried out due to epigastric pains.

6. With growing pain, sickness and vomits , it has been attempted to contact Dr. Rodriguez , unsuccessfully though. In spite of having being paged once and again, as from Veronica’s admission to the Hospital till her demise, Dr.Rodriguez has been all the time unavailable and out of reach or else he has always been late. Not only has he always been late or absent but also he has not even dared to enter any entry in the medical records and clearly enough , he had left the case in the hands of the registered nurses without even giving a diagnosis .

7. As Dr. Rodriguez was out of reach, an obstetrician Dr.Li had to be called in emergency and ordered to have medical tests done , a liquid diet (???) and a vial of Demerol (derived from morphine) which was absolutely useless for this is used to calm but not to find out the real cause of such pain. It is important to point out , that the idea was not to calm genital pains caused by labor but the epigastrics, whose cause remained without any explanation. (page 9)

8. Also, in the medical record you can read an entry saying “Respiratory stand by’s intro ven x 45’ ” which is very confusing . There is no reference made to the real status of the patient , her medical condition or time of the entry. Worse though is that there is an electrocardiogram covering the page hindering whatever important or not had been written below.(page 10)

9. The only real fact is that controls had been few and isolated and in spite of the alarming signals, the medical staff remained unconcerned. Besides, after 14:30 till 18:00 there is a total absence of entries in the medical history. Although is truth that in the separate pages you can find entries of the Code Blue but there is no chronological sequence in it. So, in a page you find entries about what happened at 18:00 and in the next page, strangely enough, you find entries with the diagnosis and treatment given at 17.45: Eclampsy. Haematuria. Hyperreflexia. Maintain magnesium sulfate. Sodium bicarbonate . (page 11)

10. Patient Progress Records states at 18:00 - Admitted into maternity , accompanied by the doctor. +RN – slight hypertension - lungs condition was stable - Respiratory Assistance (RA) – Haematuria . (page 10)

11. When was Respiratory Assistance administered? In the succinct CODE BLUE pages the equipment was required at 16:30 and it came at 16:33. It is also stated that the patient went into convulsions and was completely unconscious. Various tensional levels are registered (the first being particularly abnormal: 146/ 99,22 mm Hg) Determination of arterial blood gas is requested by the doctors .The report says AERIAL TRACT IS ORAL…. What does this phrase mean? Aerial tract is always oral and incidentally nasal or by tracheotomy. Why then it has not been acknowledged that beyond doubts she needed to be intubated or managed with an ambu, to get RA? (page 12-13)

12. What for and where was she administered local anesthesia? (Dermoplast-Benzocaine)The patient didn’t have pelvic pain and even if this had been the case , local anesthesia would have not eased the pain. Usually, these type of anesthetics are used to anesthetize the oral part of pharynx so as to insert a nasogastric tube or a tube for endotracheal intubation . So why she was administered local anesthesia on June 30th. at 11:40 hs?(page 14)

13. Regarding respiration, in the CODE BLUE sheet , as aforementioned, the only reference made is that the aerial tract WAS ORAL. In addition you can read that the oxygen saturation ,when the team arrived ,was of 92% and that there was a wheezing in the superior aerial tract. Under the item intubation, you have no entries. However, the pressure of arterial blood gas was of 150 mm Hg at 16:49. How did she reach that value when arterial blood gas on room air is 100 mm Hg? How is it that she has to go intubated to IUC when in the CODE BLUE sheets there is no reference to such a situation? The only description therein made was AERIAL TRACT IS ORAL…(page 12)

14. Poor and almost sporadic information is shown in the prenatal flow sheets on June 30th. Before labor blood pressure entries are at 03:00; 04:00 , 05:00 and 06:00. The values shown there were all abnormal and even quite unbelievable, eg. Value change from 151/91 mmHg goes to 142/55 without any medical intake in the middle. Also, after labor checkups were made during 2 hours each 15 minutes, but as above mentioned after 08:00 the next entry was only made at 09:00 with a value of 140/56 and the next one at 12:00 yielding an alarming value ( 170/55 mm Hg) that should have caused alarm and consequently, the immediate staff intervention.

15. Unfortunately , if we consider the Progress Record , such medical staff didn’t exist since there is no record on the medical history till the doctor for emergencies , Dr. Lee , intervened and without registering the timetable of his intervention , he prescribed analysis and anodyne measures , such as a liquid diet.!

16. Apparently the registered nurses are the ones to be blamed for they were not conscious of their role which was, supposedly, to replace the doctors and therefore the checkups had been scarce and they failed to give the symptoms the importance they have . On June 30th. at 11:00, 12:00 and 14:00 they registered in the maternal flow sheets ABDOMINAL PAIN - ACHING GRADES 6, 5 and 8. No reference has been made that this symptom had been informed to the doctors in charge, which as aforementioned , has nothing to do with the normal consequences of labor. On the contrary , this symptom is a clear alert of eclampsy and most of all of H.E.L.L.P.syndrome.

17. Moreover, in the same maternal flow sheets , same time as before mentioned you can read “Behavior : Agitated” . Once again the nurses were not alarmed by this. Six hours have passed by after labor , the parturient was still being agitated but there was nothing to be worried about.

18. Poor information, lack of clarity in the registers most of them illegible which is a serious fault since if a doctor was called in emergency , how could he get an idea of what the patient previous medical scenario was?; All these have been a constant in the medical history. In fact, the medical history is full of abbreviations or acronyms almost unknown for the common of the doctors. To picture this, in the progress record on June 30th. at 17:15 you can barely read : “Code Blue Note: Code Blue Note called 2º to pt. Because unresponsive eyes rolli … foamy secretions … “ (the rest of it is illegible)(page 15)

19. The issue of the platelets remains particularly unclear to any fairly educated doctor . We all know that the normal number of this cells in peripheral blood is of 150.000 to 400.000 mm3 . In Veronica’s case, the register at 04:35 showed 222.000mm3 and strangely , another blood test was ordered at 16:05, showing 119.000mm3 . This last test should have raised alarm since in all studies, treatises or papers made on the subject, it is very clear that platelets below 150.000 m3 shall cause great concern . Why? Because proteinuria and the increase of the levels of uric acid are useful to diagnose preeclampsy but not to detect H.E.L.L.P. syndrome. The best indicator to detect H.E.L.L.P. syndrome is the number of platelets. Doctors and nurses of Huntington Memorial Hospital had seen that result but haven’t done anything . It was exactly at that moment that H.E.L.L.P. syndrome should have been diagnosed. Accordingly a vigorous line of action should have been carried out so as to control blood pressure and to substitute by means of blood transfusions the platelets that were in decrease. It is obvious that an early diagnosis was critical for effective treatment of such syndrome.(page 16)

20. However, long before there had been a tests whose abnormal results should have been reason enough to be taken as a warning. At 04:35 fibrin degradation products (pdf) which should be lower than 5, showed a level higher than five but lower than twenty. This result that forced to discard the onset of a consumption coagulopathy has not been object of concern to the health professionals involved. In fact, they should have ordered a D-Dimer test, which is a sensitive indicator of a sub-clinical coagulopathy and it can be positive before that coagulation tests show abnormalities. However, this hasn’t been done. The subsequent progress of the patient reports coagulopathy : at 18:15 pdf was higher than twenty , fibrin diminished to 113 mg % ( reference level: 200 to 400); as for the platelets they diminished much more. (page 17)

C) FINAL DIAGNOSIS :

1. None of the involved obstetricians , Dr. Lee or Dr. Rodriguez, have registered a specific diagnosis in the clinical history till it was too late. Moreover, their almost inexistent and poor remarks are superficial and incidental. They’ve not made any reference to hypertension, proteinurea, thrombocytopenia, etc. They treated abdominal pain as a regular puerperal pain by administering Vicodin and Demerol or as it would have been a gastritis they administered Mylanta. They have never been conscious of the existence of a preeclampsy , eclampsy or H.E.L.L.P. syndrome. Only at 17:15 (page 15)they wrote :” Pt is in eclampsia (pt has elevated BP during peripartum period” . Then , at 05,15 on July 1st. when the patient did not respond to verbal orders or pain stimulus, that is to say , when she was beyond hope , gone for ever, Rodriguez wrote: “ Lab: as noted: Hellp syndrome”.

2. Dr. Gurevich (page 18)has been the first one to wonder about the possibility of “preeclamsy during pregnancy “, at 19:00 , once the symptoms were completely displayed and as an unidentified subject established that Veronica was already in an eclampsic condition (page 11).However, although he had suspected a preeclampsy and he was witnessing the first eclampsy consequences such as convultions, even though the patient had upper abdominal pain, and in spite of her having a low quantity of platelets , he has not concluded a H.E.L.L.P. syndrome diagnosis , neither did he indicated platelets transfusions to the patient nor any other effective action in order to stop the coagulopathy.

3. The Hospital ‘s final diagnosis written in the Attestation Report has been the followingLpage 19)

Principle Diagnosis: Cord entangle neck

Secondary diagnosis :

674.02 – Cerebrovascular disease

666.32 – Coagulation deficiency

642.52 – Severe preeclampsia

The above categorization of the diagnosis is incoherent : If Cord entangle neck is considered as the principle diagnosis just because it has been the first one , that could work but if we consider this as the main diagnosis it is absurd.

The cordon around the neck might harm the newborn baby but not the mother.

She died because she suffered bassicaly a preclampsia undetected by RN and doctors of Huntington Memorial.Hospital.With any kind of managing or accurate treatement,preeclampsia progressed to severe eclampsia which developed in a HELLP syndrome with a drastic drop of platelets and intravascular consumption of fibrinogen which led to an intracerebral hemorrhage ,killing Veronica.

4. In the Discharge Summary ,(page 20) Dr. Rodriguez describes the evolution of the medical symptoms of the patient without mentioning eclampsy diagnosis or H.E.L.L.P. syndrome in it. As discharge diagnosis he establishes the following: “Disease due to cardiorrespiratory failure due to brain hemorrhage. However, cardiorrespiratory failure is the final form of death of all individuals and brain hemorrhage might respond to many causes: brain injury, artery aneurysm rupture, arteriovenous malformation, hypertensive crise, encephalic tumor, coagulopathies, etc. In short, the Discharge Summary failed to provide a specific diagnosis ( It`s obvious that Rodriguez made a false statement to hide the true fact of his enormous lack of knowledge and gross negligence)

5. Finally, there is another surprisingly fact. No one from Los Angeles County Department of Coroner has reviewed the medical history. However, in the entry To Report a Death you can read that this death was not a coroner case per LA Coroner Office. Apparently , the communication was made through Internet because at the superior angle of the page you can read : “ Dr. Lois Pena @ L.A. coroner Office declines as coroner case”.(page 21)

CONCLUSIONS:

Veronica was a healthy young woman
She was intelligent and blessed with great artistic sensibility
However, she -as any other human being- could have passed away for many reasons: a road accident, an infection or as a result of unpredictable complications during pregnancy such as an hemorrhage due to placenta previa , an endovascular coagulopathy due a detached placenta, etc.
But, she was treated by doctors and registered nurses whose gross negligence and clear lack of skill led my daughter to her death:

They didn’t notice that the patient was having clear signs of preeclampsy during the pregnancy

The abnormally high tensional registers taken from the very beginning when she had been admitted into hospital have not caused any concern to the doctors neither have they given rise to communications of any kind among them.
After labor the levels of blood pressure during the first two hours have been abnormal. However, there is no proof that this situation has been informed to the doctors and therefore, controls more often . After the first two hours controls and entries are scarce and more isolated.

Epigastric pain, nausea and vomits are symptoms that should have given raise to great concern. Mostly since the frequency of such symptoms are clear indicators of H.E.L.L.P. syndrome . However, they have been minimized, attributed to gastritis and ridiculously treated with a diet, Mylanta, etc.

The indication to administer Vicodin or Demerol (narcotics agents) to trat an epigastric pain is also an obvious and blatant example of the lack of medical skill.

The fact that the medical staff has not taken immediate action when an sudden drop of platelets has taken place, which in fact could not have been attributed to nothing but intravascular coagulation which is the most important sign of H.E.L.L.P. syndrome , is another proof of their lack of skill.

RICARDO BOCACCI MD,forensic expert before the Supreme Court.

»
edit reply quote
Two month after Vero´s death
Submitted by roberto glaubach on Fri, 01/07/2011 - 20:18.
Two month after Vero´s death
I visited Mr DeVore at his office in Fair Oaks Pasadena.The man,attended me for a long while(about two hours) during which he tried to convince me that he wasn´t responsible of the disaster that headed my daughter to the "other world",he displayed charts showing that my granddaughter was very little according with this,bla,bla,or that,bla bla.Notwithstanding that I told him that our experts in san Diego(out of the LA area,of course) and other renowned forensic docs and experts in Argentina were coincidental about the failures of his ecosound report(over which ,I suspect,he never took even a short look and maybe was completed by his asistant to be simply signed by him),he spent hours trying to mislead any decent explanation.He never gave any explanation about his statement of "non existing danger of toxemia or IUGR or pre-term labour.
A real liar.Veronica gave birth 20 days before the scheduled day.That is just pre-term labour precisely !.Thereafter she died due to a mild-non attended-toxemia which progresed to a fatal HELLP:
Perhaps,God can forgive you Mr DeVore,not my family not me.You are responsible although the corupted Board protected you,as well as Geronimo Rodriguez and Joseph Y Li.I wonder,why then ,the Hospital and doctors lawyer Mr Robert Reback admitted the malpractice to my lawyer Richard Cohn(Sta Ana) and accepted to pay more than two MICRA (550000) to my grandchild??? .Was it only a money issue to you and the other wrongdoers?? ...for sure for you ,but not for the witness experts,because this is a clear case of pure MEDICAL IGNORANCE and a human being has been killed as a consequence of said criminal MEDICAL IGNORANCE.Have you any remorse on your soul???...well only if you have a soul of which I feel unlikely !!.
Roberto Glaubach,arq
The father of Veronica Solange Glaubach( will never forget you !)

»
reply quote
I don't understand it all -
Submitted by wishandaprayer on Fri, 01/07/2011 - 20:32.
I don't understand it all - but it seeems to me that a mistake was made and that a sincere apology and promise to do better in the future might have prevented further emotional harm.

I hope that you find some peace.

»
reply quote
dear WISHANDAPRAYER: What
Submitted by roberto glaubach on Sat, 01/08/2011 - 22:58.
dear WISHANDAPRAYER:
What part of my story you do not understand?
Listen,this "doc..." failed in an incredibly way (from the point of view of ecosound experts and witness experts we´ve consulted) to detect clear symptoms of an existing mild preclampsia.We are sure this liar did not even spent one second to review his own ecosound. Should him do that ,should him sign a correct diagnosis.No one doubt about that.The prenatal records given by Veronica to him,were showing several RED SPOT LIGHTS WITH recommendations and warnings about a possible preclampsia (or toxemia as you prefer),and preterm labour.Moreover Labt tests included on the records were showing +2 proteinuria,a BLATTANT SPOT SIGNAL of toxemia in progress.DeVore DVD of his ecosound showed echoes in the placenta,a clear signal of abnormality coincident with a toxemia diagnosis.
Of what kind of MISTAKE ARE YOU TALKING ABOUT?...That "mistake" has been crucial in this case because,since the report signed by this ignorant and irresponsible physician,dismissing the possibility of toxemia ,intrauterin grow retardement and preterm labour(every one of which finnaly occured heading Vero to a bloody death)went with the rest of the PRENATAL RECORDS to the HUNTINGTON MEMORIAL HOSPITAL where Geronimo Rodriguez md,obgyn,Joseph Y Li,and registered nurses Criki Morrisey,Robin O Brien and Hillary Warren didn´t take into account the possibility of the aforesaid disease.There you have the second main "mistake" as you call it. A mistake that headed Veronica to a bloody death with no one minnimum accurate managing of her symptoms.Should she been attended by skilled docs and nurses,shoul she be alive.I spent the last 8 years and more investigating every and each path on this case,that´s why I can give this testimony,because all this unskilled pro´s can not respond anything accurate,any thruthful explanation ,so gross,so huge are their "mistakes". Of what apology are you talking about ?. Try,for an instant,to sit down on my chair !!!! They killed my child ! Can you imagine what is that?? A health profesional supossed to take care of you,committed a "mistake" and killed you,a "single departure"(stupid bargain definition of the Medical Practice Act negociated by the doc´s mafia with insurance cartels and corrupted medical board& legislators,to avoid consequences of their malpractice-wrongdoings).Whatr I cannot understand is your last opinion concerning "...a sincere apology and promise to do better in the future...????? of what future?? whom future??? yuours??? because they cutted my poor child´s future(28 years old).If you want to know more try veronicaglaubachmalpracticeinusa.blogspot.com by google or yahoo or try simply her name in Internet.By trhe way....DeVore never gave any kind of apology because he never recognized his "mistake",he spent two hours at his office trying to convince me about stupid explanations(he was ignorant about my 6 american and argentine witnes experts who at that time reported this malpractice case).Say no more.His failure was just due to a gross incapacity,wide unskill and knowledgeless
Allow me to say: I found peace in my other 6 daughters and granddaughter but I´ll never forgive.never forget especially because the corupted Medical Board of Caslifornia,although the Public Health Service of cal pointed a collection of failures done by dopcs and nurses,did not acted against the involved wrongdoers,Maybe sent em to take a short course of eclampsia or hellp.Many people,inocent patients die daily due to the corrupted medical system which allows the malfeasance of ignorant health caregivers who can thereafter go to another state to get a new license.Just trash medical enforcement. nothing else.
Roberto the father of Veronica killed by doc´s "mistake"...(as you call a gross criminal malpractice case)

»
reply quote
roberto glaubach wrote: dear
Submitted by wishandaprayer on Sat, 01/08/2011 - 23:48.

roberto glaubach wrote:
dear WISHANDAPRAYER:
What part of my story you do not understand?
Listen,this "doc..." failed in an incredibly way (from the point of view of ecosound experts and witness experts we´ve consulted) to detect clear symptoms of an existing mild preclampsia.We are sure this liar did not even spent one second to review his own ecosound.

I can understand that - a doctor doing a test and not reviewing his own results. To me - it's gross negligence.

I think that protein in the urine indicates a problem.

It must seem as though it was delberate.

When doctors and nurses don't take accountability and apologize - it can make you feel that it was deliberate.

Your chair would be much too uncomfortable to even think of sitting in. I can not say that I fully understand the pain of losing a child as I have never lost a child. I did nearly lose my baby daughter at birth. I was very lucky that she was saved. I was heartbroken that she was very sick. I didn't even think that it was the doctor's fault; I thought that it was all my fault. With hindsight, I know that the doctors could have done better, but I am just very grateful that the anesthesiologist was able to save my baby.

Health professionals should take accountability for the mistakes that they make.

I would expect an apology from the doctors but it may not be enough for you. What do you want? Do you want the doctor to go to jail for manslaughter? If doctors neglect to do their job well, and it causes death - should the doctor go to jail? If that were the case, I think that many good people would not want to become doctors.

I am very glad that you got the expert witnesses that you needed. I am glad that you got some validation from that and that you got some money - although the loss of Veronica's life cannot ever be compensated for.

It is good to know that you can have some comfort and peace with your family and I hope that you can be a comfort to them as well.

I can understand your immense anger, heartache and grief and I I certainly didn't mean to upset you and I'm very sorry for that. It shouldn't have happened, but negligence and mistakes do happen, and when doctors don't take accountability - I feel that it only causes more anger and pain.

And when you think that people are minimizing what happens, it can increase your anger and frustration, and I did that, and I'm sorry. That wasn't my intention and I am sorry.

I wish you and your family peace today and in the future.

»
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GROSS INCONGRUENCES BETWEEN THE HOSPITAL LAST REPORT ,THE DISCHARGE SUMMARY OF GERONIMO RODRIGUEZ MD. AND THE DEATH CERTIFICATE. BAD FAITH & LIES

2009-12-14T15:38:00.000-08:00

IF YOU PAY ATTENTION AND READ THIS DOCUMENTS YOU´LL FIND THE FOLLOWING:

1. GERONIMO RODRIGUEZ AVOIDED TO DISCHARGE THE TRUE ABOUT THE EXISTENT PRECLAMPSIA,PROGRESSING TO ECLAMPSIA AND HELLP WHICH FINNALLY CONDUCTED VERONICA TO DEATH.
WHY???

BECAUSE HE CANNOT ADMIT THE TRUE HAVING INTO CCOUNT THAT HE NEVER PERFORMED ANY KIND OF ACCURATE MANAGEMENT OR TREATMENT TO STOP THE DISEASE WHICH CLEAR SYMPTOMS HE NEVER
RECOGNIZED AT ALL.THAT´S WHY I BLAME HIM AS RESPONSIBLE OF ABANDONMENT OF A PATIENT AND GROSS INCOMPETENCE DUE THEIR TOTAL IGNORANCE ON THE MATTER.HE IS THE MAIN RESPONSIBLE,(AND NURSES INDEED),OF THE DEATH OF MY POOR CHILD.

SO.ALLOW ME TO ASK TO THE INVESTIGATORS OF THE MEDICAL BOARD OF CALIFORNIA: WHERE IS THE "STANDARD OF CARE WITHIN"WHICH ARE YOU TALKING ABOUT???? JUST BLUFF AND CONCEAL OF THE TRUE.NOTHING ELSE THAN THAT.

2.-THE HOSPITAL ATTESTATION CLAIMS AS PRINCIPLE DIAGNOSIS. CORD ENTANGLE NEC-DELIV AND AS A FURTHER POINT:SEVERE PREECLAMPSIA.SO.ALLOW ME TO ASK "MR HOSPITAL",WHER IS THE AFORESAID DIAGNOSIS ON RODRIGUEZ STATEMENT AND MOREOVER,IF CORD ENTANGLE WAS THE PRINCIPLE DIAGNOSIS,SAID "CORD ENTANGLE" IS ONLY GERMANE TO THE HEALTH OF THE BABY,NOT THE MOTHER INDEED. BULLSHIT ! NOTHING ELSE THAN BULLSHIT..MR HUNTINGTON MEMORIAL HI TEC FACILITY !!!! WHERE MIRACLES OCCUR....NEVER THE MIRACLE OF THE TRUE INDEED.......

3.-LAST BUT NOT LEAST,SEE THE DEATH CERTIFICATE SIGNED BY THE IRRESPONSIBLE LIAR DR.GERONIMO RODRIGUEZ....WHEN DID HE KNEW THAT THE HELLP SYNDROME WAS THE CAUSE OF DEATH???? (HE SIGNED ON JULY 8TH,2002) ALMOST A WEEK AFTER THEIR DISCHARGE SUMMARY..........WHO TOLD HIM ABOUT A SYNDROME NEVER TREATED????

COMPARE THIS WITH THE HOSPITAL REPORT

CARE DEFICIENCIES: THE CONCLUSIONS OF THE DEPARTMENT OF HEALTH SERVICES.COUNTY OF LOS ANGELES.HEALTH FACILITIES DIVISION.

2009-12-14T15:18:00.000-08:00

FINAL REPORT OF THE INVESTIGATION DONE BY THE DHS
SUBJET OF INVESTIGATION: THE HUNTINGTON MEMORIAL HOSPITAL OF PASADENA,CA

THIS IS ONLY ONE OF THE DOCUMENTS ACCESSED BY US.OUR EXPERTS REPORTED GROSS FAILURES AND FURTHER OMISSIONS AND AMENDMENTS AND ALTERATIONS ON THE MEDICAL RECORDS,SAME MEDICAL RECORDS THAT NOTWITHSTANDING SAID OMISSIONS AND AMMENDMENTS,GAVE TO THE HEALTH FACILITIES DIVISION OF THE DEPT OF PUBLIC HEALTH SERVICES INVESTIGATORS ENOUGH MATERIAL TO ISSUE THE FOLLOWING REPORT

PREGNANCY PROBLEMS EXTRACTED FROM "WOMAN`S PASSIONS"

2009-12-09T12:00:00.000-08:00

PUBLISHED BY:
WOMAN`S PASSIONS
*
Pregnancy problems. Complications
12Nov2009 Filed under: Pregnancy Author: admin

Most common complications during pregnancy: early and late gestosis, threatening interruption of pregnancy, pregnancy with extragenital pathology.

Gestosis
Gestosis of pregnant women include a number of pathological conditions that occur during pregnancy, complicating its course. There are early gestosis, usually occurring in the first trimester of pregnancy, and late gestosis, developing in the second half of pregnancy.

Early gestosis includes: vomiting in pregnancy (mild form), excessive vomiting and ptializm (salivation). Etiological factor of gestosis, according to many authors, is the failure of mechanisms to adapt to emerged pregnancy. Congenital and acquired deficiency of neuroendocrine regulation of adaptive responses (hypoxia, infection, intoxication, malnutrition in the antenatal period, hereditary factors) contribute to gestosis development, as well as presence of extragenital pathology in a woman (on the part of cardiovascular system - hypertension, hypotension, cardiac defects, endocrine disease - diabetes mellitus, hyper-and hypothyroidism, urinary tract disease - pyelonephritis, glomerulonephritis).

Early gestosis (vomiting during pregnancy) include vomiting, which is repeated several times during the day, accompanied by nausea, a decrease in appetite, change in taste and olfactory sensations. In accordance with the severity of the disease they distinguish:

• light form;

• moderate (moderate);

• excessive vomiting (severe).

Mild form corresponds to a phase of functional changes in nervous system (phase neuroses), the form of medium gravity - intoxication phase (phase toxicity), a severe form corresponds to a phase of dystrophy.

Late gestational toxicosis often occurs in the third trimester of pregnancy and is characterized by multiple organ failure. Late gestosis is manifested by three main symptoms - edema, proteinuria, arterial hypertension, at least - more severe symptoms (convulsions, coma, etc.). In modern obstetrics late gestosis is denoted as OPG-gestosis (under the name of three major symptoms). There are many classifications of late gestosis, but in practical obstetrics they distinguish 4 main clinical forms:

• hydrocephalus of pregnant;

• nephropathy (mild, moderate, severe);

• pre-eclampsia;

• eclampsia.

We should also note pre-clinical stage of gestosis - pregestoz. All clinical forms of late gestosis are specific stages of a single pathological process.

Excess weight gain during pregnancy is one of early signs of pregnancy complications called gestosis, an evidence of initially hidden, and then, perhaps, obvious edema.

Hidden edema are detected with regular measurement of body weight (weighing a patient) and definition of diuresis. If weight gain exceeds 300-400 g per week and negative diuresis will be identified, these symptoms indicate underlying edema.

Explicit, visible swelling differ in the degree of distribution:

• I degree - swelling of feet and legs;

• II degree - edema of the lower extremities and the anterior abdominal wall;

• III degree - generalized edema up to anasarca.

Nephropathy of pregnancy is divided into three levels:

• mild (hypertension is not higher than 150/100 mm Hg. Art., swelling of feet not higher than shins, proteinuria less than 1 g / l, the fundus has uneven caliber of retinal vessels);

• moderate (blood pressure not higher than 175/115 mm Hg. Art., swelling extended to the lower extremities and abdominal wall, proteinuria of 1 g / l to 3 g / l, there is swelling of the retina);

• severe degree (blood pressure above 175/115 mm Hg. Art., Anasarca, proteinuria more than 3 g / l, the fundus has hemorrhage, marked degenerative changes).

Pre-eclampsia - a critical, but a reversible condition, which developed against the background of severe gestosis. In addition to the triad of symptoms of gestosis (OPG), a patient has a headache, nasal congestion, visual disturbances. These signs are regarded as cerebral circulation disorder.

Eclampsia - the most severe form of pregnancy problem called gestosis, which is characterized by seizures with loss of consciousness. The duration and number of seizures of eclampsia may be different. During a seizure there develop abnormalities of cerebral blood flow, bleeding in the brain and its membranes. Hemorrhages in internal organs are frequent. Hypoxia and metabolic disease are sharply increasing, there occurs acidosis. Renal function is rapidly deteriorating, oligouriya increases. Internal organs often have degenerative changes. Eclampsia is life-threatening for both mother and fetus.

The threat of termination and miscarriage

The most frequent complication of pregnancy is a threat of interruption and premature birth - one of the main perenataln cause of morbidity and mortality. The main reasons for threat of abortion and miscarriage are:

• infectious diseases of mother;

• complications related to pregnancy;

• traumatic injuries;

• iso serological incompatibility of blood between mother and fetus;

• developmental anomalies of female genitalia;

• neuroendocrine pathology;

• various non-communicable diseases of mother;

• chromosomal abnormalities.

There are genetic reasons for miscarriage. In presence of chromosomal aberrations of an embryo there develops the threat of interruption on early stages of pregnancy. Spontaneous miscarriage in this case can be regarded as a device, worked out in the process of evolution, resulting in the birth of children with deformities is quite rare.

Endocrine causes of miscarriage include hypovaria, hyperandrogenism of different genesis (adrenal, ovarian), thyroid dysfunction. The first place is occupied by mother’s infectious diseases. These are primarily latent infectious diseases such as chronic tonsillitis, urinary organs infections, listeriosis, toxoplasmosis, mycoplasma infection, chronic inflammatory diseases of genital organs and viral infections.

Under certain circumstances, there occurs an immunologic conflict in the mother-placenta-fetus, leading to the risk of abortion and spontaneous abortion.

Among malformations of the uterus as a cause of miscarriages most common are: bicornuate, saddle, unicorns uterus, intrauterine septum, doubling of the uterus, rudimentary uterus.

The reasons contributing to emergence of miscarriages also include genital infantilism, isthmic-cervical insufficiency, uterine myoma and extragenital diseases of mother.

Extragenital pathology

Course of pregnancy is also complicated by presence of mother’s extragenital pathology.

A group of increased risk of miscarriage primarily includes women with cardiovascular system diseases, hypertension, chronic kidney disease, diabetes, anemia.

Premature termination of pregnancy in these women is also contributed by significant changes in the body: hypoxia, metabolic disturbances and complications of pregnancy, which is accompanied by extragenital pathology (toxaemia in the second half of pregnancy, fetoplacental insufficiency).

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Malpractice in California:the killing of Veronica: Some pictures of Veronica,Indiana,Jose and Veronica´s works

2009-12-08T10:45:00.000-08:00

Malpractice in California:the killing of Veronica: Some pictures of Veronica,Indiana,Jose and Veronica´s works

A CRAZY WAY FOR AN INDUSTRY TO OPERATE by CHARLES ORNSTEIN AND TRACY WEBER

2009-12-07T12:10:00.000-08:00

ProPublica : Journalism in the Public Interest

ProPublica
Health & Science
A ‘Crazy’ Way for an Industry to Operate
by Charles Ornstein and Tracy Weber, ProPublica - December 5, 2009 9:06 am EST

When a hospital or temporary agency wants to hire a nurse, there's no easy way to check whether the person has run afoul of regulators elsewhere in the country.

A solution has sat in the hands of federal bureaucrats more than two decades -- but it's off limits to most employers. In 1987, Congress ordered federal health officials to create a database of state disciplinary actions against nurses and other health professionals.

The information was to be added to a database of similar information about doctors, which was opened up to hospitals and other eligible health employers in 1990.

But the move to add the nurses and others got caught in years of technological difficulties, uncertainty over what should be released and questions about who'd foot the bill.

Currently, only federal and state agencies and health plans, such as HMOs, are allowed access to the information about nurses. If hospitals could gain access, "then it would be very hard to hide any action taken against you anywhere in the country," said Katherine Eaves, chief nursing officer for Riverside County Regional Medical Center.

An official at the U.S. Health Resources and Services Administration said the information on nurses and other health professionals should be available next year.

There is one obstacle remaining, however: Under the law, temp agencies would be allowed to search a nurse's background only if they were designated as agents of particular hospitals or other authorized users. Hospitals might not be willing to designate multiple staffing firms as their agents.

"The way our industry works is really crazy," said Mark Stagen, chief executive officer of Emerald Health Services, a temp firm in Marina del Rey. "You've got people with lives in their hands, and there's no effective way to check if they've had serious problems."

See main story: Temp Firms a Magnet for Unfit Nurses [1]

Write to Charles Ornstein at Charles.Ornstein@propublica.org [2].

Want to know more? Follow ProPublica on Facebook [3] and Twitter [4], and get ProPublica headlines delivered by e-mail every day [5].
Tags: California, California Board of Registered Nursing, Nurses, Temp Agencies, Temporary Nurses

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Links

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Our Complete Coverage

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* The Los Angeles Times and ProPublica have conducted a joint investigation into the failed oversight of California's health professionals. In July 2009, we reported that the Board of Registered Nursing took more than three years, on average, to investigate and discipline errant nurses. It failed to act against nurses whose misconduct already had been thoroughly documented and sanctioned by others. And the board gave probation to hundreds of nurses – ordering monitoring and work restrictions – then failed to crack down as many landed in trouble again and again. Read our complete coverage here.

Ask the reporters about the series: Email QandA@propublica.org
Database

*
* California Sanctioned Nurse Database - The Los Angeles Times and ProPublica compiled a database of nearly 2,400 California nurses who have been sanctioned since 2002. Search the records of nurses who have faced disciplinary proceedings and the circumstances of allegations against them.

Multimedia

* Vignette
* Interactive Graphic: From 1995 to 2002, at least five employers complained to the California Board of Registered Nursing about Carolyn Fay Thomas. The board did not revoke her license until August 2005. Follow Thomas' case (Los Angeles Times)
* Chart: Complaint to Discipline
* Chart: California takes far longer to discipline registered nurses than many other large states, according to a review by the Los Angeles Times and ProPublica. Click graphic to see the full details.
* Interactive Chart: About the Board - The California Board of Registered Nursing oversees the education, licensure, practice standards and discipline of the state's 350,000 nurses.

Profiles

* Spencer Sullivan
* Spencer Sullivan - In the prime of his life, Spencer Sullivan was rendered a quadriplegic. It took the nursing board more than six years later to revoke the license of a nurse involved in his care. Read more | LA Times Audio Slideshow
* Caitlin Greenwell
* Caitlin Greenwell - Caitlin Greenwell's family alleges that she suffers from cerberal palsy because nurses neglected to monitor her during her birth. LA Times Audio Slideshow
* Dr. Iraj Zandi
* Dr. Iraj Zandi – During a surgery, Dr. Iraj Zandi discovered that a nurse had stolen painkiller drugs intended for his patient. He found out later that the nurse had been accused of pilfering drugs from a previous employer. Read more...
* Veronica Glaubach
* Veronica Glaubach – Veronica Glaubach’s nurses missed crucial signs of a life-threatening complication during and after childbirth, her family alleged. She died. The nursing board absolved the nurses. Read more...

ProPublica Reporting Network

© Copyright 2009 Pro Publica Inc.

FREE REPRINTS

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WHO KILLED OUR DAUGHTER VERONICA?? DO YOU KNOW MR GOVERNOR ARNOLD ??. ANSWER PLEASE !! About the Nursing Board of California-BY CHARLES ORNSTEIN

2009-12-05T16:42:00.000-08:00

e-mail sent to my e-mail box by Charles Ornstein. December 5th,2009

I wanted to let you know that the third major installment of our nurses project will run this Sunday in the Los Angeles Times. It is now accessible online at http://www.propublica.org/feature/temporary-nurses-danger-inadequate-oversight-1206 or www.latimes.com/nurses. The package includes several components: a main story, sidebar, interactive graphics, and an update to our extensive online database. Additional stories will run later this month.

I sincerely want to thank you for your help in recent months as we put together this project. We are eager for your comments and feedback.

Top picture:Indiana Agote Glaubach,our granddaughter
Bottom pictures Veronica while she was pregnant few months before being killed by brutish ignorant Doc´s and Nurses at the Huntington Memorial Hospital,Pasadena,a supposed hi-tec facility...?¿?¿?

Temp Firms a Magnet for Unfit Nurses
by Tracy Weber and Charles Ornstein, ProPublica - December 5, 2009 7:52 am EST

A chronic shortage of nurses has created a free-wheeling environment for temp agencies, allowing some to skimp on background checks and hiring standards.
A chronic shortage of nurses has created a free-wheeling environment for temp agencies, allowing some to skimp on background checks and hiring standards.

This story was co-published with the Los Angeles Times [1] on Dec. 6, 2009.

Firms that supply temporary nurses to the nation's hospitals are taking perilous shortcuts in their screening and supervision, sometimes putting seriously ill patients in the hands of incompetent or impaired caregivers.

Emboldened by a chronic nursing shortage and scant regulation, the firms vie for their share of a free-wheeling, $4-billion industry. Some have become havens for nurses who hopscotch from place to place to avoid the consequences of their misconduct. (see related story: A ‘Crazy’ Way for an Industry to Operate [2])

A joint investigation with the Los Angeles Times found dozens of instances in which staffing agencies skimped on background checks or ignored warnings from hospitals about sub-par nurses on their payrolls. Some hired nurses sight unseen, without even conducting an interview.

As a result, fill-in nurses with documented histories of poor care have fallen asleep on the job, failed to perform critical tests or stolen drugs intended to ease patients' pain or anxiety.

"A lot of them are really bad nurses," said Sandra Thompson, a nursing supervisor at Northridge Hospital Medical Center and Sherman Oaks Hospital, both in the San Fernando Valley. "Sometimes I see them here [at Northridge] and think, 'I wonder how long before I see them over' " at Sherman Oaks?

Interactive Graphic: Registered nurse Andrew Fernando Reed was accused of stealing drugs while working for a series of staffing agencies in California and Minnesota. But that didn't stop him from getting new jobs. Click to see interactive graphic.
Interactive Graphic: Registered nurse Andrew Fernando Reed was accused of stealing drugs while working for a series of staffing agencies in California and Minnesota. But that didn't stop him from getting new jobs. Click to see interactive graphic.
[3]Some agencies are diligent about checking nurses' records, said Joey Ridenour, executive director of the Arizona State Board of Nursing.

Others are not. As a result, if wayward nurses want to work, "I think it's easier to hide in the registries," Ridenour said. "Some just sign them up."

Among reporters' findings, based on disciplinary records, personnel files, court documents and interviews:

• Firms hired nurses who had criminal records or left states where their licenses had been restricted or revoked. At least three firms employed a nurse in California [4] whose license had been suspended in Minnesota for stealing drugs at a string of temp jobs. One used him after he'd been convicted of doing the same thing at a Santa Rosa nursing home.

• Temp agencies shuffled errant nurses from one hospital to another, even as complaints mounted. A Culver City agency continued sending one nurse to hospitals [5] despite more than a dozen warnings that she was ignoring her patients and sleeping on the job. Before she was hired, the nurse had been convicted of 12 crimes, including prostitution, carrying a concealed weapon and possessing cocaine.

• Nurses who got in trouble at one agency had no problem landing a job at another. An Oklahoma nurse cycled through [6] at least four Southern California agencies in a year, accused of pilfering drugs while at each. Before her final stop, she was arrested in her home state for calling in prescriptions while posing as a doctor's office employee.

Failings in the temp industry are magnified in states like California, where nurses are in particularly short supply. Almost every facility, from rural medical outposts to prestigious hospitals, must rely on temporary help.

Nearly 6% of registered nurses licensed in California – or about 19,300 people – are temps, based on a 2008 survey commissioned by the state. About half of these nurses live in other states.

Here, oversight of nurses in general has been weak. A Times/ProPublica investigation in July [7] found years-long delays in disciplining nurses accused of serious misconduct. Regulators say they are working to fix the problems. Still, California's registered nursing board is among a minority that does not require hospitals, agencies or anyone else to report even serious lapses by nurses, including temps.

When staff nurses err, hospitals typically retrain or monitor them afterward. Temp nurses often are just exchanged for replacements, never receiving further guidance.

Industry executives and healthcare administrators say the firms are invaluable to hospitals and nursing homes, filling in for nurses who are sick or on strike and helping in swamped emergency rooms.

Nurses find the jobs attractive because they can see the country and control their schedules – all while collecting premium wages, bonuses and sometimes travel and living expenses. Some work locally while others are employed by "travel" firms that send them all over the country. (They must have licenses in states where they work.)

"There are very good people who work registries who do not want to be tied to anything regular," said Katherine Eaves, chief nursing officer at Riverside County Regional Medical Center. "There's another group of people who are working registries because, guess what? They can't work anywhere else."

Many agencies leave it to applicants to reveal previous problems. Using multi-page checklists, they are asked to rate themselves on how well they manage critical care patients, use complex equipment and administer drugs.

Some nurses admit lying on applications or withholding information from their employers.

Raphael Obiora [8] was hired by an agency despite allegations of drug thefts that were fully detailed on the California nursing board's website. Once on staff, he admits, he did not tell the agency when the board placed him on probation.

He said it was up to his agency to verify his credentials.

"I don't have to tell you nothing," he said. "You have to check."

A trail of complaints

In trouble in her home state of North Carolina, nurse Beverley Cathey saw an opportunity out West.

The day after Cathey applied at EZ Staffing in Glendale, she was on the job.

She said on her application in July 2007 that she was qualified to work in critical care units, tending to a hospital's sickest patients.

It didn't take long before hospitals disagreed.

Cathey "sat at the nurse's station most of the time not doing anything," a supervisor at Northridge Hospital Medical Center complained in August 2007, according to EZ Staffing records reviewed by reporters. "Not up to our standards for ER," wrote a nurse from Huntington Memorial Hospital in Pasadena the following week.

The then-57-year-old nurse gave inaccurate patient information to colleagues and failed to perform an electrocardiogram as ordered for a patient with an abnormally fast heart rate, the records show.

In August and September 2007 alone, four hospitals filed six complaints against her, according to the firm's records, including three by Huntington.

The next month EZ Staffing contacted North Carolina's Board of Nursing to check on her license: Cathey, it turned out, was on probation [9]. One condition was that she not work at a staffing agency.

While a temp nurse at a North Carolina hospital, she'd failed to account for drugs she'd signed out, falsified records and provided negligent care, according to the North Carolina board's allegations. These records had been posted on the board's public website since December 2006.

Asked for comment, Cathey said in an e-mail that the accusations against her were "not valid or creditable."

Abraham Abirafeh, who started EZ Staffing in 1991, did not respond to questions about the case and accused a reporter in e-mails of trying to harm EZ's reputation.

In November 2007, the North Carolina board indefinitely suspended Cathey's license [10]. Twenty-one months later, California regulators initiated formal proceedings [11] against her license.

While her case winds its way through the disciplinary process, Cathey remains free to accept temp jobs in California.

Easy profits touted

Dee Patrick, a veteran nurse, built a temp business in the mid-1980s. (Liz O. Baylen / Los Angeles Times)
Dee Patrick, a veteran nurse, built a temp business in the mid-1980s. (Liz O. Baylen / Los Angeles Times)
Dee Patrick recalls sitting in a box at the Kentucky Derby some years ago exchanging pleasantries with a couple next to her. She told them about her Phoenix temp business – how, as a veteran nurse, she'd built it from scratch in the mid-1980s when virtually no one was doing it.

Six months later, Patrick said, she was shocked when the woman called to say, "Hey, we opened up one of those businesses."

"They have no background in nursing," said Patrick. "They don't have to know anything."

Although the healthcare system as a whole is increasingly regulated, the nurse staffing industry remains a Wild West. No one knows how many agencies exist nationwide; estimates range from 3,000 to 6,000.

Dozens of Internet sites tout the easy profits and hawk how-to guides for as low as $69.95.

"Be One among the Millionaires, Start Your Own Nursing Agency," trumpets one site. "You will be up and running in a week," promises another. "You don't have to be a nurse to start your own Nurse Agency," assures a third.

Agencies range from those run on dining room tables to publicly traded companies. They open and close, merge, swap staffs and change locations. Standards for screening vary widely.

Recruiters sometimes poach on one another's rosters. One Los Angeles agency alleged in court papers last year that a rival firm's employee had joined its staff, stolen its list of employees and salaries, and then returned to her old firm.

Many agencies allow applicants to take competency tests online. Testifying in a malpractice lawsuit earlier this year, an official at Fastaff, a large traveling-nurse firm based in Colorado, said applicants have been hired without even a phone interview. References weren't contacted "unless it was out of the ordinary," she said.

Some healthcare institutions say they interview and check the credentials of every temp nurse. Others say they don't, particularly in a crunch. "Clearly we have no time – we have to count on them," said Fred Benson, administrator of Santa Rosa Convalescent Hospital in Northern California.

It hasn't always worked out. He recalled that two temp nurses at his facility took the keys to a drug cabinet.

Mark Stagen, president of the National Assn. of Travel Healthcare Organizations, acknowledges the need for improvement in his industry. (Liz O. Baylen / Los Angeles Times)
Mark Stagen, president of the National Assn. of Travel Healthcare Organizations, acknowledges the need for improvement in his industry. (Liz O. Baylen / Los Angeles Times)
Unlike hospitals and nursing homes, which are inspected regularly, temp firms aren't accountable to anyone but their clients. Mark Stagen, president of the National Assn. of Travel Healthcare Organizations, acknowledged the need for improvement.

Companies' standards can be "loose or nonexistent," allowing poor-performing nurses to easily "game the system," said Stagen, head of a Marina del Rey travel firm.

Reporters asked 12 public entities that run hospitals in California whether they had audited firms that supplied them with nurses. Only five had done so in the last three years.

Last year Los Angeles County health staffers went through the files of 29 agencies seeking to provide nurses to its public hospitals. Most of the firms lacked key documents, including evidence of tuberculosis screenings or proof that nurses had current licenses. One agency had 90 missing or invalid records, another 63.

The lapses were "surprising," said Vivian C. Branchick, director of nursing affairs for the county Department of Health Services. "They know – and they've known it all along" – what the standard is.

All of these firms were allowed to correct their shortcomings and won county business.

In late 2006, the county audited Reliable Health Care Services [12] in Culver City, which had received $8.9 million for temp services during the previous fiscal year.

The audit found that Reliable had "forged" results of tuberculosis skin tests, physical exams and CPR training cards, which "jeopardized the safety of county patients." Reliable also made "false and misleading statements," the audit said, citing a general "lack of trustworthiness and integrity."

After the county terminated the Reliable contract, the firm filed a claim alleging libel [13], breach of contract and fraud. As part of a settlement [14], the county agreed not to formally bar the agency from county work, and Reliable agreed not to seek any for 10 years.

A lawyer for the firm called the county's allegations baseless.

Seal of approval

Some in the industry say staffing firms already have an able watchdog.

Since 2004, the Joint Commission, better known for accrediting hospitals, has been reviewing healthcare staffing firms. The national organization bestows its seal of approval on those that meet standards for screening applicants, following up on complaints and ensuring competency.

This seal is displayed prominently on firms' websites. Some hospitals will use only agencies that have it.

But the program is voluntary and used by a minority of temp agencies – 337 firms – in part because they must pay the commission thousands of dollars to be reviewed. Most of the largest firms are certified.

The commission doesn't release detailed findings on the firms, even to hospitals. It has withdrawn its seal of approval from temporary staffing agencies seven times this year – all but once for nonpayment of fees.

At the same time, firms that display the seal have been cited in audits, nursing board records and court files for bad judgment or behavior.

Joseph Baiden, owner of JFB Staffing, Inc., was arrested on suspicion of fraud. But his firm is still listed with a gold seal of approval on the Joint Commission's website.
Joseph Baiden, owner of JFB Staffing, Inc., was arrested on suspicion of fraud. But his firm is still listed with a gold seal of approval on the Joint Commission's website.
Joseph Baiden, owner of JFB Staffing in Diamond Bar, was arrested in August [15] on charges of defrauding the state workers' compensation fund of $1.4 million by misrepresenting the number of nurses on his payroll.

Some hospitals cut ties with JFB, and authorities froze Baiden's bank accounts and seized his property.

Although Baiden has pleaded not guilty, his attorney Tracy Green said that she is working toward a resolution with the district attorney's office and that Baiden plans to repay whatever he owes.

In the meantime, on the Joint Commission's website, there is a gold seal of approval [16] by the JFB name.

Problems no barrier

Paystaff Pacific not only hired nurse Raphael Obiora in 2007 despite his troubled past, it also kept sending him out when it learned he wasn't a skilled nurse, documents show.

In a little more than a year, seven hospitals rejected Obiora, telling Paystaff he'd made a medication error, failed to follow a doctor's order [17] and been "inappropriate" with a patient's relative.

Hospital managers use such rejection notices, known as "Do Not Sends," to alert agencies to the shortcomings of temp nurses. But the agencies are under no obligation to act on the information.

In April 2008, the Monterey Park firm dispatched Obiora to Garfield Medical Center. There, he failed to adequately monitor [18] the vital signs of two critically ill patients. His conduct was "unsafe," wrote Simon Marcus, the hospital's critical care director, on a form he sent to Paystaff.

Unknown to the hospital, Paystaff had already evaluated Obiora and found his competence to be below average. Shortly before he was sent to Garfield, the firm had determined that he should be fired immediately, according to agency records that became part of a regulatory proceeding.

Only after Marcus raised an alarm did Paystaff fire Obiora.

Hugh Wu, a Paystaff official, said in an e-mail that the company acted responsibly. Other complaints about Obiora were not as serious as Garfield's, he said, and Obiora had hidden state nursing board discipline against his license.

Obiora, an evangelist who preaches at a Celestial Church of Christ in Gardena, ultimately lost his California license.

Marcus said his experience with Obiora "makes you wonder" about temp nurses. "Have they made errors elsewhere? Who is monitoring them?"

Some temp firms indicated that they don't use a nurse again if they feel at all uneasy. "We just don't want to take the risk," said Jim Essey, who runs a New York-based temp agency and is a former chairman of the American Staffing Assn., an industry trade group.

Other agencies say most rejections stem from picayune problems, such as tardiness and personality clashes.

But data provided by public hospitals show this isn't necessarily so.

According to Riverside County Regional Medical Center, for example, more than 60% of the 339 temp nurses rejected since 2003 failed to demonstrate basic nursing skills on the job. Arrowhead Regional Medical Center, San Bernardino County's public hospital, reported that it had rejected 61 temp nurses since 2005 – more than half for performance problems.

Hospitals sometimes lose track of which nurses they have already booted. A nurse can be red-flagged by one unit and later sent to another.

At Lakewood Regional Medical Center in March 2008, temp nurse Kelvin Brown [19] was found in a deep sleep at the nurses' station on a ward of patients hooked up to monitors.

An excerpt from a complaint by the California Board of Registered Nursing against nurse Kelvin Brown, who is accused of falling asleep repeatedly on the job.
An excerpt from a complaint by the California Board of Registered Nursing against nurse Kelvin Brown, who is accused of falling asleep repeatedly on the job.

He was roused but later fell asleep in a patient's room. Awakened again, he dozed off in the break room. Asked to leave the hospital, he made it as far as the intensive care waiting room before slipping into sleep once more. He left after security called police, according to the nursing board's December 2008 accusation against him [20].

A supervisor later discovered that Brown had had problems at the hospital before. He had fallen "heavily asleep on every shift and exhibited behavior – such as talking to and answering himself aloud – that made staff uncomfortable," the accusation said.

In fact, Brown had been placed on the hospital's "Do Not Return" list while working for another agency for such reasons, the document states.

A spokesman for Tenet Healthcare Corp., Lakewood's parent, confirmed that Brown had worked at the hospital before but disputed the state's account that he'd been previously barred from working there.

Brown could not be located for comment.

In another case, St. Jude Medical Center in Fullerton informed MedStaff Healthcare Solutions in March 2007 that it suspected nurse Donald Paradise [21] of stealing drugs and asked that he never return, a hospital spokesman said. Six months later, Paradise was accused of stealing drugs at a sister hospital, where he also had been sent by MedStaff.

Click to see our complete coverage of California's failed oversight of its health professionals.
Click to see our complete coverage of California's failed oversight of its health professionals.
[22]"It's absolutely not acceptable," said Kevin Andrus, a spokesman for St. Joseph Health System, which includes St. Jude.

MedStaff's contract, he said, prohibited it from sending a rejected nurse back to any hospital in the chain, but Andrus conceded that the chain doesn't keep a master list, as some entities do.

A spokesman for MedStaff said that Paradise had passed a drug screening after the St. Jude incident and that the hospital had indicated it was satisfied with that. Andrus says that was not so.

Paradise, who faces a nursing board accusation, could not be reached for comment.

In interviews, several temp nurses who had been in trouble said their employers focused more on keeping slots filled than on who filled them.

That was a lifeline for Obiora.

The agencies "just send and send and send and send," he said.

See related story: A ‘Crazy’ Way for an Industry to Operate [2]

Lisa Schwartz, director of research at ProPublica, and researcher Kitty Bennett contributed to this report.

Write to Charles Ornstein at Charles.Ornstein@propublica.org [23]

Write to Tracy Weber at Tracy.Weber@propublica.org [24].

Want to know more? Follow ProPublica on Facebook [25] and Twitter [26], and get ProPublica headlines delivered by e-mail every day [27].
Tags: California, California Board of Registered Nursing, Health Care, Nurses, Temp Agencies, Temporary Nurses

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This story can be found on the web at the following address:
http://www.propublica.org/feature/temporary-nurses-danger-inadequate-oversight-1206/
Links

* 1. http://www.latimes.com/news/local/la-me-nurses6-2009dec06,0,2880251,full.story
* 2. http://www.propublica.org/feature/a-crazy-way-for-an-industry-to-operate-temp-nurses
* 3. http://www.latimes.com/news/specials/la-me-nurses-6dec62009-f,0,2783623.flash
* 4. http://rn.ca.gov/public/rn609399.pdf
* 5. http://rn.ca.gov/public/rn374283.pdf
* 6. http://rn.ca.gov/public/rn646200.pdf
* 7. http://www.propublica.org/feature/when-caregivers-harm-california-problem-nurses-stay-on-job-710
* 8. http://rn.ca.gov/public/rn509286.pdf
* 9. https://www.ncbon.com/LicenseVerification/Common/Ajax/DocumentViewer.aspx?PTH=http%3A//dmrsys.corp.ncbon.com/DataTier/Documents/Repository/0/0/3/0/0e325297-d147-4c5c-bb4a-861b42c02686.pdf&CB=145
* 10. https://www.ncbon.com/LicenseVerification/Common/Ajax/DocumentViewer.aspx?PTH=http%3A//dmrsys.corp.ncbon.com/DataTier/Documents/Repository/0/0/5/5/194c9671-a7d1-4477-b06a-1289417e215f.pdf&CB=53
* 11. http://rn.ca.gov/public/rn677505.pdf
* 12. http://s3.amazonaws.com/propublica/assets/nurses/reliableaudit.pdf
* 13. http://s3.amazonaws.com/propublica/assets/nurses/reliableclaim.pdf
* 14. http://s3.amazonaws.com/propublica/assets/nurses/reliablesettle.pdf
* 15. http://www.insurance.ca.gov/0400-news/0100-press-releases/0080-2009/release126-09.cfm
* 16. http://www.qualitycheck.org/consumer/searchresults.aspx?nm=jfb+staffing&ddstatelist=&st_nm=-1&st=
* 17. http://s3.amazonaws.com/propublica/assets/nurses/obioradonotsend.pdf
* 18. http://s3.amazonaws.com/propublica/assets/nurses/obioragarfield.pdf
* 19. http://www2.dca.ca.gov/pls/wllpub/WLLQRYNA$LCEV2.QueryView?P_LICENSE_NUMBER=590541&P_LTE_ID=828
* 20. http://rn.ca.gov/public/rn590541.pdf
* 21. http://rn.ca.gov/public/rn697019.pdf
* 22. http://www.propublica.org/series/nurses
* 23. mailto:Charles.Ornstein@propublica.org
* 24. mailto:Tracy.Weber@propublica.org
* 25. http://www.facebook.com/propublica
* 26. http://www.twitter.com/propublica
* 27. http://www.propublica.org/special/propublica-daily-email

Our Complete Coverage

*
* The Los Angeles Times and ProPublica have conducted a joint investigation into the failed oversight of California's health professionals. In July 2009, we reported that the Board of Registered Nursing took more than three years, on average, to investigate and discipline errant nurses. It failed to act against nurses whose misconduct already had been thoroughly documented and sanctioned by others. And the board gave probation to hundreds of nurses – ordering monitoring and work restrictions – then failed to crack down as many landed in trouble again and again. Read our complete coverage here.

Ask the reporters about the series: Email QandA@propublica.org
Database

*
* California Sanctioned Nurse Database - The Los Angeles Times and ProPublica compiled a database of nearly 2,400 California nurses who have been sanctioned since 2002. Search the records of nurses who have faced disciplinary proceedings and the circumstances of allegations against them.

Multimedia

* Vignette
* Interactive Graphic: From 1995 to 2002, at least five employers complained to the California Board of Registered Nursing about Carolyn Fay Thomas. The board did not revoke her license until August 2005. Follow Thomas' case (Los Angeles Times)
* Chart: Complaint to Discipline
* Chart: California takes far longer to discipline registered nurses than many other large states, according to a review by the Los Angeles Times and ProPublica. Click graphic to see the full details.
* Interactive Chart: About the Board - The California Board of Registered Nursing oversees the education, licensure, practice standards and discipline of the state's 350,000 nurses.

Profiles

* Spencer Sullivan
* Spencer Sullivan - In the prime of his life, Spencer Sullivan was rendered a quadriplegic. It took the nursing board more than six years later to revoke the license of a nurse involved in his care. Read more | LA Times Audio Slideshow
* Caitlin Greenwell
* Caitlin Greenwell - Caitlin Greenwell's family alleges that she suffers from cerberal palsy because nurses neglected to monitor her during her birth. LA Times Audio Slideshow
* Dr. Iraj Zandi
* Dr. Iraj Zandi – During a surgery, Dr. Iraj Zandi discovered that a nurse had stolen painkiller drugs intended for his patient. He found out later that the nurse had been accused of pilfering drugs from a previous employer. Read more...
* Veronica Glaubach
* Veronica Glaubach – Veronica Glaubach’s nurses missed crucial signs of a life-threatening complication during and after childbirth, her family alleged. She died. The nursing board absolved the nurses. Read more...

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© Copyright 2009 Pro Publica Inc.

FREE REPRINTS

Unless otherwise noted, you can republish our articles and graphics (but not our photographs) for free. You just have to credit us and link to us, and you can’t edit our material or sell it separately. (We're licensed under Creative Commons, which provides the legal details.)

TEMP FIRMS A MAGNET FOR UNFIT NURSES. A LOS ANGELES TIMES PROPUBLICA INVESTIGATION BY CHARLES ORNSTEIN AND TRACY WEBER

2009-12-05T16:31:00.000-08:00

EMAIL SENT TO ME BY THE PULITZER´S PRIZE WINNER INVESTIGATIVE REPORTER MR CHARLES ORNSTEIN.LOS ANGELES TIMES & PROPUBLICA

Temp Firms a Magnet for Unfit Nurses: A Los Angeles Times-ProPublica investigation
...
Sat, December 5, 2009 12:09:14 PM
From:
Charles Ornstein
...
View Contact
To: Charles Ornstein
I wanted to let you know that the third major installment of our nurses project will run this Sunday in the Los Angeles Times. It is now accessible online at http://www.propublica.org/feature/temporary-nurses-danger-inadequate-oversight-1206 or www.latimes.com/nurses. The package includes several components: a main story, sidebar, interactive graphics, and an update to our extensive online database. Additional stories will run later this month.

I sincerely want to thank you for your help in recent months as we put together this project. We are eager for your comments and feedback.

Charlie Ornstein

---
Charles Ornstein
Senior Reporter, ProPublica
One Exchange Plaza, 55 Broadway, 23rd Floor New York, NY 10006
E-mail: charles.ornstein@propublica.org
Office: (917) 512-0222
Fax: (212) 785-2634
Cell: (818) 679-9363

This is Vero´s hand mask,taken at the Huntington Memorial .End of physical life.. for her

2009-12-02T16:29:00.000-08:00

VERONICA´S HAND SEEMS TO SAY: STOP KILLING INNOCENT PEOPLE !!!

VERONICA´S HAND SEEMS TO CLAIM: CORRUPTED BOARDS-HOODS,..STOP TO HIDE WRONGDOERS YOU HAVE TO PROTECT PATIENTS AND INJURED PEOPLE.WITHDRAW UNSKILLED PROFESSIONALS !!!!YOU HAVE TO ACCOMPLISH WITH YOUR OBLIGATIONS INDEED !

We are still awaiting an apologie from Hospital authorities,and a further truthful explanation about why involved wrongdoers are still working at the hospital.

Some pictures of Veronica,Indiana,Jose and Veronica´s works

2009-12-01T16:52:00.000-08:00

medical malpractice crisis in USA

2009-12-01T16:32:00.000-08:00

medical malpractice crisis in USA
veronicaglaubachmalpracticeinusa.blogspot.com

BAD FAITH AND LIES .DR GERONIMO RODRIGUEZ LAST MISLEADING SUMMARY.SERIOUS INCOINGRUENCES WITH DEATH CERTIFICATE AND HOSPITAL´S ATTESTATION

2009-11-27T11:00:00.000-08:00

PAYING ATTENTION OVER RODRIGUEZ DISCHARGE SUMMARY YOU CAN REALIZE THAT HE NEVER SAY EVEN A WORD ABOUT THE DIAGNOSIS.OF COURSE THAT TELLING THE TRUE DIAGNOSIS WHICH HAS BEEN INFORMED TO HIM AFTER VERO´S STROKE,HE WOULD HAVE THE OBLIGATION TO EXPLAIN WHAT KIND OF TREATMENET ADMINISTERED HIM TO TAKE CARE AND TO MANAGE ACCURATELY VERO´S PRECLAMPSIA.REMEMBER:HE ORDERED TYLENOL AND MYLANTA.REMEMBER.HE STATED ND CONSIDERED THE UPPER ABDOMINAL PAIN AS POST PARTUM PAIN.UNBELIEVABLE MEDICAL BLOOPER INDEED!!

JOSEPH Y LI,TWO HOURS AFTER RODRIGFUEZ PRESCRIPTION OF TYLENOL AND MYLANTA ORDERED:A LIQUID DIET AND SOME LAB TESTS (HE ALSO IGNORED BLATTANT SYMPTOMS OF THE PRECLAMPSIA PROGRESSING TO ECLAMPSIA AND HELLP.

TAKE A LOOK OVER THE HOSPITAL ATTESTATION AND SPECIALLY THE PRINCIPLE DIAGNOSIS DATED 7/8/2002

PRINCIPLE DIAGNOSIS: CORD ENTANGLE (IF TRUE IT HAD TO HURT THE BABY NOT THE MOTHER)

THE REST OF POINTS DESERVE AN EXPLANATION COMING FROM THE HOSPITAL AUTHORITIES TELLING US WHAT KIND OF ACCURATE TREATMENT HAS BEEN ADMINISTERED TO MANAGE
PREECLAMPSIA,ECLAMPSIA:SILENCE, OF COURSE ,BECAUSE NO ONE ACCURATE TREATMENT
ALL THE ATTESTED OUTCOMES ARE "DEADLY FINAL OUTCOMES" AND IN THE MEANWHILE, BETWEEN DELIVERY AND STROKE,THERE ARE NON LESS THAN 12 "WASTED"HOURS WITHOUT ANY KIND OF DIAGNOSIS OR TREATMENT.THAT´S WHY VERONICA IS DEAD.

SEE: ON THE CERTIFICATE OF DEATH ,GERONIMO RODRIGUEZ SIGNED: AS IMMEDIATE CAUSE OF DEATH:

SHAMELESS ANSWER OF THE REGISTERED NURSING BOARD interin EXECUTIVE OFFICER Louise Bailey,M.Ed,RN to my last request of true.She replaces Mrs Terry

2009-11-26T12:37:00.000-08:00

VERO´S GRAVE IN BUENOS AIRES,JARDIN DE PAZ CEMETERY

2009-11-26T11:49:00.000-08:00

Facebook | Tus fotos - Fotos de muro

2009-11-23T12:11:00.000-08:00

Facebook | Tus fotos - Fotos de muro

Facebook | Mis fotos - Fotos de muro

2009-11-23T12:09:00.000-08:00

Facebook | Mis fotos - Fotos de muro

What Is Considered High Blood Pressure? | urine blood causes

2009-11-19T15:41:00.000-08:00

What Is Considered High Blood Pressure? | urine blood causes

HUNTINGTON MEMORIAL "PROPAGANDA" ...LETTER OF OUR FAMILY. TO THE WRONGDOERS

2009-11-18T14:04:00.000-08:00

VERONICA SOLANGE GLAUBACH

BORN IN BUENOS AIRES ON SEPTEMBER 12TH/1973
KILLED ON JUNE 30TH/2002
AT THE HUNTINGTON MEMORIAL
HOSPITAL OF PASADENA,CALIFORNIA
MAY SHE REST IN PEACE

WE´LL ALLWAYS REFRESH THE MEMORY OF
THE FOLLOWING IRRESPONSIBLES INDIVIDUALS :

GERONIMO RODRIGUEZ MD.OBGYN
JOSEPH Y LI,MD.OBGYN
MICHAEL GUREVITCH,MD,CCD
CRICKI MORRISEY,RN
ROBIN O BRIEN RN
HILLARY WARREN,RN

ALL OF THEM STILL ON DUTY AT HUNTINGTON MEMORIAL HOSPITAL,PASADENA

IF ALIVE,OUR BELOVED DAUGHTER SHOULD HAVE 36 YEARS OLD AND SHOULD BE ABLE TO TAKE CARE OF INDIANA AGOTE GLAUBACH
HER DAUGHTER ,AND OUR BEAUTY GRANDDAUGHTER
JUST A HAPPY FAMILY AND A NORMAL LIFE..
BROKEN,RUINED LIVES INDEED !

BUT

YOUR CRIMINAL IRRESPONSIBLE AND UNFORGIVABLE MEDICAL IGNORANCE,YOUR GROSS INCOMPETENCE,YOUR SHAMELESS TO CONFESS WHAT YOU DID AND THE INCREDIBLE FAILURES COMMITTED WHILE SHE WAS UNDER YOUR CARE.... SENT OUR DAUGHTER VERO TO THE SKY

THE HUNTINGTON MEMORIAL HOSPITAL PROPAGANDA PROCLAME
“OUR LIMIT IS THE SKY”
WHAT A TERRIFIC TRUE INDEED ¡!
THEY SENT VERONICA STRAIGHT THERE !!!

THE HUNTINGTON MEMORIAL HOSPITAL PROPAGANDA PROCLAME
"MEDICAL MIRACLES HAPPEN AT HUNTINGTON HOSPITAL"
WHAT IRONICAL AND ARROGANT ASSERTION INDEED!.

FURTHER WILLFUL OMISSIONS AND INCONGRUENT MANIPULATION OF THE STRONG AND CLEAR EVIDENCE OF YOUR FAULTS ON THE MEDICAL RECORDS,TO AVOID CONSEQUENCES,WITH THE OBVIOUS COMPLICITY OF THE HOSPITAL SHOWS WITHOUT ANY DOUBT YOUR DEEP AND CRAVEN UNMORALITY INDEED.

THE MEDICAL BOARD-HOOD OF PEERS OF CALIFORNIA AND THE REGISTERED NURSING BOARD-HOOD OF PEERS PROTECTED YOU FROM YOUR MORE THAN DESERVED PUNITION,BUT WILL BE UNABLE TO PROTECT ALL OF YOU FROM YOUR OWN POOR MIND.ALTHOUGH IT´S QUITE PROBABLE THAT YOU DON´T HAVE NOR MIND,NEITHER SOUL

WE WILL NEVER EVER FORGET ALL OF YOU
WE WILL NEVER EVER FORGIVE ALL OF YOU

BY THE WAY:

THE HUNTINGTON MEMORIAL
AUTHORITIES AND THE AFORESAID
INDIVIDUALS NEVER APOLOGIZED
FOR THE KILLING OF VERONICA
EVEN AFTER SETTLING THE CASE

WHAT A NAKED ARROGANCE INDEED !!

ROBERTO THE FATHER,MARTA THE MOTHER, ANDREA,VANESA,NADIA,NICOLE,FIONA,AND ZOE DAUGHTERS OF VERONICA SOLANGE GLAUBACH AND OF COURSE INDIANA AGOTE GLAUBACH,HER DAUGHTER

SHE WILL BE ALIVE FOR EVER !
SHE IS ALIVE TO MAKE WRONGDOERS REMEMBER
ITS CRIMINAL IGNORANT IRRESPONSIBLE BEHAVIOUR INDEED !!!
SHE IS ALIVE AND SHE CLAIMS FOR TRUE AND JUSTICE
REMEMBER,ALLWAYS REMEMBER....REMEMBER FOR THE REST OF YOUR NASTY LIFE !

QUIZ:The Medical Board-erhood of California and Registered Nursing Board-erhood...JUST corruption and anything else..

2009-11-18T11:03:00.000-08:00

Veronica and Indiana. Just few hours of Joy. Vero feeding Indiana. Vero,Jose and Indi

This pictures taken around 9,00 am. At 12.00 am started the upper abdominal pain,headaches,blurred vision,swelling legs and hands and nobody at the Huntington Memorial Hospital of Pasadena (suposedly a hi-tec facility),nor nurses Cricki Morrisey,Robin O Brien,Hillary Warren neither Geronimo Rodriguez MD OBGYN or Joseph Y Li MD OBGYN,or Michael Gurevitch MD CCD ,on charge did even recognized those clear symptoms.
Geronimo Rodrigruez prescription: Tylenol and Mylanta !!
Geronimo (Hannibal...)Rodriguez stated that the Upper Abdominal pain was a post-partum pain,while he was in front of a blattant symptom of preclampsia.!!!

Joseph (Animal...) Y Li prescription ordered four hours later,has been just a criminal stupidity and a clear evidence of his wide medical ignoramnce and irresponsibility indeed !!: He signed a prescription of a...Liquid Diet!!!. What else ??? ...In the meanwhile Vero was very close to a fatal stroke
Michael Gurevitch,critical care doctor ,when asked about why a fresh plattelets trasfussion wasn´t administered to our daughter (as wellknown medical standards indicate),stated (Vero was brain dead)in front of many witnesses that the blood of Vero was "rare"...(she was ABRh+).Can anybody believe that assertion ??? I will ignore said imbecility but,however, allow us to ask: is there a blood bank at the famous HI-TEC (they proudly say that" many miracles happen at the Hospital"¿¿ ??? on its advertisings and propaganda on the street in front of the Hospital at Fair Oaks Ave,Pasadena,Ca)???????????. That shameless assertion done by Gurevitch points him as a complete criminal liar and shows in a clear cut a willful shameless intention of mislead .
What for ??
TO HIDE THE TRUE,BECAUSE HE WAS UNABLE TO EXPLAIN THE BRUTALITY OF THE CRIME COMMITTED WITH MY DAUGHTER WHATSOEVER.HE WAS PROTECTING HIMSELF AND THE OTHER INVOLVED WRONGDOERS...AND(OF COURSE) THE HOSPITAL RESPONSIBILITY AS IF HE WERE TALKING TO IGNORANT PEOPLE...BUT WE ARE NOT AT ALL.

THE PUBLIC HEALTH SERVICE REPORT IS TAXATIVE ABOUT THE FAILURES OF THE HOSPITAL,DOCTORS AND NURSESIN THIS CASE.

Allow us to ask to the Medical Board and Registered Nursing Board of California,liers genius "experts"

IS THIS A SINGLE DEPARTURE OF STANDARDS ??? OR IT IS JUST CLEAR MEDICAL IGNORANCE ???
THE CORRUPTED CRITERIA OF THE AFORESAID BOARDS IS NOTHING ELSE THAN PURE CRAP !!!!!

INDIANA ´s birth weight:under normal and IUGR,denied by Greggory Devore MD,ignored by Dr. Rodriguez ,a clear sign of the mild preclampsia of Vero

2009-11-17T17:42:00.000-08:00

To : MEDICAL BOARD OF CALIFORNIA AND REGISTERED NURSING BOARD AUTHORITIES:

HOW CAN YOU SUSTAIN THAT WE ARE FACING DOC´S AND NURSES MANAGING "WITHIN NORMAL STANDARDS" ??? YOU OWE AN APOLOGIZE FOR YOUR INCREDIBLE SHAMELESS INDEED !!!!!
YOU SEEMS TO BE A COLLECTION OF UNSCRUPULOUS BUREAUCREATS: "DOC´S SERVANTS"

Report of the Working Group on Research on Hypertension During Pregnancy

2009-11-17T17:36:00.000-08:00

Link: Report of the Working Group on Research on Hypertension During Pregnancy

Pregnancy-related hypertension as related to Hypertension

2009-11-17T17:28:00.000-08:00

Link:Pregnancy-related hypertension as related to Hypertension

PRENATAL RECORDS OF VERONICA GLAUBACH SHOWED + 2 PROTEINURIA,AMID OTHER CLEAR SYMPTOMS.THE MEDICAL BOARD OF CALIFORNIA NOTWITHSTANDING EXPERTS REPORTS POINTING A GROSS CASE OF MALPRACTICE,CONSIDERED THAT GERONIMO RODRIGUEZ MD,OBGYN,PASADENA,JOSEPH Y LI,MD,OBGYN,PASADENA AND MICHAEL GUREVITCH,MD,CCD,(HUNTINGTON MEMORIAL HOSPITAL) DID NOT COMMITTED ANYTHING ELSE THAN A "SINGLE DEPARTURE FROM STANDARDS" A BARGAIN CLAUSE INSERTED ON THE MEDICAL PRACTICE ACT OF THE BPCODE TO PROTECT DOCTORS.THAT SINGLE DEPARTURE WAS "NOT HAVING ORDERED A URINE TEST" NOTWITHSTANDING HUGHE EXISTING WARNINGS ON THE PRENATAL RECORDS,+2 PROTEINURIA,HBP,PAIN,SWELL,LIGHT SPOTS SEEING,ETC ETC,AND EVEN AFTER READING TERRIBLE LAB TESTS SHOWING AN UPCOMING COAGULOPATY DUE TO THE INCREDIBLE LOW NUMBER OF BLOOD PLATELETS.BLOOD TRANSFUSSION ?; NEVER PERFORMED.....DIAGNOSIS?:INEXISTENT ON TIME ONLY AFTER DEATH.
WHAT IS THE MEDICAL BOARD OF CALIFORNIA VALUE TO PROTECT HEALTH CARE QUALITY ???? : +0(CERO)

Coding for Pregnancy-Related Hypertension

2009-11-17T17:13:00.000-08:00

Link: Coding for Pregnancy-Related Hypertension

Preeclampsia Causes, Symptoms, Diagnosis, and Treatment on MedicineNet.com

2009-11-17T17:02:00.000-08:00

Link: Preeclampsia Causes, Symptoms, Diagnosis, and Treatment on MedicineNet.com

VERONICA´S CASE. A GROSS FAILURE TO DIAGNOSE DONE BY TWO IRRESPONSIBLES AND IGNORANT DOC´S GERONIMO RODRIGUEZ MD,OBGYN AND JOSEPH Y LI,MD,OBGYN AND THE COMPLICITY OF A THIRD ONE MICHAEL GUREVITCH,MD AT THE HUNTINGTON MEMORIAL HOSPITAL,PASADENA,CA
THIS WRONGFUL DEATH DUE TO MEDICAL"IGNORANCE"MALPRACTICE REMAINS WITHOUT SANCTION AGAINST THE AFORESAID WRONGDOERS DUE TO THE COMPLICITY OF THE WIDE CRITICIZED AND USELESS MEDICAL BOARD OF CALIFORNIA.IN ADDITION THREE NURSES INVOLVED ARE STILL WORKING BECAUSE THE REGISTERED NURSING BOARD OF CALIFORNIA,ANOTHER USELESS AND CORRUPTED BOARD RECENTLY DENOUNCED IN A SERIES OF ARTICLES BY CHARLES ORNSTEIN AND TRACY WEBER,LATIMES,JULY 11TH 2009,PROTECT WRONGDOERS AS WELL.

The following article points out which are the symptoms of PREECLAMPSIA.
All of them were present in Veronica.All of them ignored by Doctors and Nurses.
That´s why she died without any kind of accurate treatment.
That´s why we face a blattant case of MEDICAL FAILURE DUE TO MEDICAL IGNORANCE.

THAT´S WHY I BLAME THE MEDICAL BOARD OF CALIFORNIA AS USELESS AND CORRUPTED
THAT´S WHY THE MEDICAL BOARD IS GUILTY OF WILLFUL OMISSION IN COMPLICITY WITH CRIMINALLY IGNORANT PHYSICIANS JUST TO PROTECT THEM FROM THE DUE DISCIPLINARIAN ACTION.MEANWHILE,THE PEOPLE DIES EVERY DAY AND THOSE INDIVIDUALS(TOTALLY UNSKILLED) ARE STILL ATTENDING INOCENT PATIENTS,ALL OF THEM POTENTIAL VICTIMS OF THEIR CRIMINAL FAILURES.

lET´S see:

Mayo Clinic Health Manager

Symptoms
By Mayo Clinic staff

Preeclampsia can develop gradually but often attacks suddenly, after 20 weeks of pregnancy. Preeclampsia may range from mild to severe. If your blood pressure was normal before your pregnancy, signs and symptoms of preeclampsia may include:

* High blood pressure (hypertension) — 140/90 millimeters of mercury (mm Hg) or greater — documented on two occasions, at least six hours but no more than seven days apart
VERONICA HAD NOT ONLY 140/90 BUT MUCH HIGHER THAN THAT.

* Excess protein in your urine (proteinuria)

VERONICA SHOWED +2

* Severe headaches

VERONICA HAD UNBEAREABLE HEADACHE ,Geronimo Rodriguez,MD ,OBGYN
prescription has been :Tylenol and Mylanta

* Changes in vision, including temporary loss of vision, blurred vision or light
sensitivity.

VERONICA SAW SPOT LIGHTS AND BLURRED VISION

* Upper abdominal pain, usually under your ribs on the right side

VERONICA WAS UNABLE TO SUPPORT AN UNBEAREABLE UPPER ABDOMINAL PAIN
GERONIMO RODRIGUEZ PRESCRIPTED: TYLENOL,MYLANTA AND FINNALY VICODIN
HE CONSIDERED THAT PAIN ASX A POST PARTUM PAIN
ANOTHER DOCTOR.JOSEPH Y LI MD OBGYN WHO SAW VERONICA LATER
PRESDCRIPTED A LIQUID DIET !!!(sHE WAS GOING STRAIGHT TO DEATH AT THAT
POINT !!!)

* Nausea or vomiting

VERONICA VOMITED EVERYTHING: THE TYLENOL,MYLANTA ETC-TERRIBLE NAUSEA
* Dizziness
* Decreased urine output
* Sudden weight gain, typically more than 2 pounds (.9 kilograms) a week

Swelling (edema), particularly in your face and hands, often accompanies preeclampsia. Swelling isn't considered a reliable sign of preeclampsia, however, because it also occurs in many normal pregnancies.

VERONICA SUFFERED EDEMA (FACE AND HANDS AND LEGS)

AND THE WORSE:ALL OF THESE SYMPTOMS WERE POST PARTUM.VERONICA WAS CRYING.VERONICA
WAS DYING.NOBODY AT THE HUNTINGTON MEMORIAL HOSPITAL(NEVER GAVE AN APOLOGY TO US)
DID ANYTHING ACCURATE WHEN IT WAS TIMELY TO SAVE HER LIFE.THEY IGNORED EVERYTHING.
HOW CAN THE MEDICAL BOARD OF CALIFORNIA AND THE REGISTERED NURSING BOARD OF CALI-
FORNIA,SUSTAIN THAT IT WAS JUST A MISTAKE OF RODRIGUEZ AND LI,JUST A SINGLE
DEPARTURE OF STANDARDS????? WHEN ITS A CLEAR CASE OF MEDICAL IGNORANCE,INCOMPETEN
CE AND NEGLIGENCE'''''???? THE CYNICISM OF THE BOARDS REVIEWERS AND AUTHORITIES IS
NOT ONLY A PERVERTED BEHAVIOUR,IT IS VERY DANGEROUS FOR THE HEALTH CARE QUALITY
INDEED!

When to see a doctor
Contact your doctor immediately or go to an emergency room if you have severe headaches, blurred vision or severe pain in your abdomen.

Because headaches, nausea, and aches and pains are common pregnancy complaints, it's difficult to know when new symptoms are simply part of being pregnant and when they may indicate a serious problem — especially if it's your first pregnancy. If you're concerned about your symptoms, contact your doctor.
Causes Definition
References

1. Pregnancy. National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/hbp/issues/preg/preg.htm. Accessed March 3, 2009.
2. Conde-Agudelo A, et al. Maternal infection and risk of preeclampsia: Systematic review and metaanalysis. American Journal of Obstetrics and Gynecology. 2008;198:7.
3. Bodnar LM, et al. Maternal vitamin D deficiency increases the risk of preeclampsia. The Journal of Clinical Endocrinology & Metabolism. 2007;92:3517.
4. High blood pressure during pregnancy. March of Dimes. http://www.marchofdimes.com/printableArticles/188_1054.asp. Accessed Feb. 11, 2009.
5. Norwitz ER, et al. Management of preeclampsia. http://www.uptodate.com/home/index.html. Accessed March 2, 2009.
6. Leanos-Miranda A, et al. Urinary prolactin as a reliable marker for preeclampsia, its severity, and the occurrence of adverse pregnancy outcomes. Journal of Clinical Endocrinology Metabolism. 2008;93:2492.
7. Fact sheets: High blood pressure during pregnancy. March of Dimes. http://www.marchofdimes.com/printableArticles/14332_1222.asp. Accessed Feb. 11, 2009.
8. August P, et al. Clinical features, diagnosis and prognosis of preeclampsia. http://www.uptodate.com/home/index.html. Accessed March 2, 2009.
9. Barton JR, et al. Prediction and prevention of recurrent preeclampsia. Obstetrics & Gynecology. 2008;112:359.
10. Bellamy L, et al. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: Systematic review and meta-analysis. British Medical Journal. 2007;335:974.
11. Facchinetti F, et al. Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalgia: An International Journal of Headache. 2009;29:286.

DS00583

April 21, 2009

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Pregnancy problems. Complications | Woman's Passions

2009-11-17T16:39:00.000-08:00

Link: Pregnancy problems. Complications | Woman's Passions

How Common Is High Blood Pressure In Pregnancy? | urine blood causes

2009-11-17T16:37:00.000-08:00

Link: How Common Is High Blood Pressure In Pregnancy? | urine blood causes

Pregnancy-related hypertension - Blogs

2009-11-17T16:36:00.000-08:00

Link: Pregnancy-related hypertension - Blogs

Blood biomaker to predict preclampsia

2009-11-17T16:12:00.000-08:00

New Study Heralds Use of Blood Biomarkers to Predict Preeclampsia

November 17, 2009 by admin

A new study that examines the value of maternal blood biomarkers will help identify and monitor patients at risk of developing preeclampsia and is set to change the way expectant mothers are cared for in prenatal clinics around the world.

The study, conducted by scientists at the highly-respected National Institute of Child and Human Development of the National Institute of Health (NICHD/NIH), set out to determine the diagnostic indices and predictive values of biomarkers measured in maternal blood in the first and second trimester of pregnancy. The goal of the study was to determine if the biomarkers could predict the subsequent development of preeclampsia.

“This study represents a very important step forward; for the first time ever, we are presented with the possibility, for clinical use, of a combination of factors to predict early onset preeclampsia with a reasonable degree of accuracy,” says Professor Marshall Lindheimer, Professor Emeritus of Medicine and Obstetrics & Gynaecology at the University of Chicago.

Preeclampsia is the leading cause of infant death and the second leading cause of maternal death Around the world. Conservative estimates indicate that preeclampsia is responsible for some 76,000 maternal deaths and more than 500,000 infant deaths every year, according to the Preeclampsia Foundation. Early onset preeclampsia is the most dangerous form of this disease.

Known worldwide as ‘the silent killer’, preeclampsia is a disorder that occurs during pregnancy and after delivery. It is characterized by high blood pressure and the presence of protein in maternal urine. However, preeclampsia can affect other organs such as the liver, the kidney, the brain. Sometimes mothers develop seizures (eclampsia) and have intracranial haemorrhage which is the main cause of death. In some instances, women develop blindness when preeclampsia is severe. They may also suffer catastrophic complications such as liver rupture.

The findings of this new study are published in the November issue of the Journal of Maternal-Fetal & Neonatal Medicine.

“Left untreated, preeclampsia leads to serious - or fatal - complications for both the mother and baby,” says Dr Kusanovic of the Perinatology Research Branch of the NIH and Wayne State University/Hutzel Women’s Hospital in Detroit, Michigan and lead author of the study.

“Our study found that maternal plasma concentrations (of angiogenic and antiangiogenic factors) together with a combination of other demographic, biochemical and biophysical factors are useful in assigning risk for the subsequent development of early-onset preeclampsia,” explains Dr Roberto Romero, Chief of the Perinatology Research Branch of the NIH, who is one of the world’s leading experts on this condition and in the study of complications of pregnancy.

“The establishment of an accurate means to assess the risk for preeclampsia will enable health care practitioners to identify women who require more intensive monitoring to safeguard both mother and baby from this devastating condition,” says Dr Romero.

Dr Mario Merialdi, Coordinator for Improving Maternal and Perinatal Health at the World Health Organisation (WHO) said: “The results of the study conducted by the international team led by Dr Romero have important implications for clinical practice and public health policies. Hypertensive disorders of pregnancy are one of the major causes of maternal and fetal mortality worldwide.”

“Reliable screening tests that could identify women at risk for developing preeclampsia are not yet available and the findings of Kusanovic et al. provide the scientific basis for the development of such tests,” explained Dr Merialdi.

“The World Health Organization, in collaboration with the Perinatal Research Branch of the NICHD, is presently analyzing samples collected in more than 10,000 pregnancies in eight countries around the world to further validate the results obtained by Dr Romero’s scientific team.”

Informa - publishers of the Journal of Maternal-Fetal & Neonatal Medicine - has made the full article available for open access on its website and invites visitors to log onto: http://informahealthcare.com/doi/abs/10.3109/14767050902994754

SOURCE Journal of Maternal-Fetal & Neonatal Medicine
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see. malpracticeincalifornia.the killing of veronica

2009-11-16T19:56:00.000-08:00

see my other blog:: veronicaglaubachmalpracticeinusa.blogspot.com

2009-11-16T19:53:00.000-08:00

THE MEDICAL BOARD OF CALIFORNIA AUTHORITIES ARE SIMPLY PUBLIC SERVANTS.THEY HAVE TO ACCOMPLISH ITS DUTIES

2009-11-16T18:55:00.000-08:00

I am still awaiting that Mrs Jaroslavsky and Mrs Johnston honor her quality of PUBLIC SERVANTS.THEY HAVE TO GIVE AN ANSWER TO MY LAST REQUE4ST OF FULL REDOING OF ALL,having into account the evidence and the incongruent last report signed by the Medical Board.
I will sustain this complaint FOR THE REST OF MY LIFE,and each day will grow and grow untill they will not be able to avoid a public explanation .No matter how long will be my insistence or how long will they turn her faces to the other side to avoid her unavoidables duties as what they really are:simply PUBLIC EMPLOYEES but with heavy responsibilities. The main responsibilitie: TELL THE TRUE INDEED!!!!!!!

LAST CLAIM TO THE MEDICAL BOARD-STILL WITHOUT RESPOND FROM MRS BARB JAROSLAVSKY BARB JOHNSTON BOARD DIRECTORS..SEEMS THEY ARE COLD PEOPLE INDEED !!

2009-11-16T18:48:00.000-08:00

Buenos Aires,September 17,2009

REF.11-2003-144255
11-2003-144256
11-2005-166043
PHYSICIANS. GERONIMO RODRIGUEZ,JOSEPH Y LI AND MICHAEL GUREVITCH

FACILITY:HUNTINGTON MEMORIAL HOSPITAL,PASADENA COMPLAINT CA 00034156 COUNTY OF LOS ANGELES DEPT OF HEALTH SERVICES,HEALTH FACILITIES DIVISION.
Buenos Aires,September 17,2009

To :
The Medical Board of California
Mrs Barbara Jaroslavsky
Barb Johnston
Renee Threadhill
Att: Mrs Susan Cady
cc. Gov.Arnold Schwartzenegger´s office
cc. Charles Ornstein Pro Publica org.
cc. David Gumpert

“ You can have good health insurance,live in a community with state of the arts facilities and yet none of that matters if you can´t find a doctor,or the doctor treating you is incompetent,negligent or dishonest. That´s why medical boards matter”…Barb Johnston,may 7,2009

“The most crucial step toward healing is having the right diagnosis. If the disease is precisely identified, a good resolution is far more likely. Conversely a bad diagnosis or the absence of diagnosis generally jeans a bad outcome , no matter how skilled the physician is. Healing begins with the correct diagnosis”..

THE KILLING OF VERONICA, is a clear case of wrong diagnosis (lack of it ) originated in a mix of incompetence and negligence of doctors and nurses worsened by the hospital´s further complicity to veil the true facts.Moreover,after realizing the mess,the involved physicians concealed the evidence of their failures.The prenatal records and all the symptoms were blatantly clear to any skilled professional. Not in this case.

This letter is to reply your attached letter dated July 15,2009 and at the same time to insist once more with my request of a complete and fairer revision over Case 11-2003-144255 and Case 11-2003-144256.Geronimo Rodríguez MD and Joseph Li MD, both OBGYN who I blame as main responsibles of the death of my 28 years old daughter Veronica Solange Glaubach at the Huntington Memorial Hospital,Pasadera,on June 30th 2002,at the age of 28 .

I will expose and point out in a clear cut the reasons which will sustain and explain my insistence in pursue a disciplinarian action to be taken against those irresponsible and unskilled physicians .

Mrs Cady: as you explain in your letter,the Board must be able to obtain the whole necessary information …etc…etc ..within seven years of the date of the incident,according BPCODE Section 2230.5, it´s true,but,it doesn´t fit to this case. Why ? , because in my complaint,timely submitted, I am reporting not only a medical malpractice case, because at the same time I´m accusing Rodríguez and Li for unfair procedures as a furtherance of their failures.

That´s mean: unprofessional conduct based on incompetente,gross negligence and worse of all willful and intentional actions in order to conceal from discovery his failures as even the most distracted analyst can easily realize just taking a simple but thorough look over his hypocritical ,coward and prevaricant discharge summary, our experts discovered indeed.

Just contrasting said “discharge summary” with the death certificate,signed by Rodríguez,and with the contradictoty and misleading hospital´s attestation report,even the most dull witted analyst will clairly see the flagrant existent contradictions which I have to attribute to the urgency with which they runnned (hospital authorities+nurses+doctors) to conceal, to mislead and to hide the true events after the death of Veronica.

I was pressing requesting in a firmly manner at the medical records office to full copy of medical records,which they gave to me,at last,but in the most incredible disorder which leaded me to go inside the office and to work there for at least six hours to organize those papers ant to assemble big flowsheets. Late,very late,those “papers” whose the hospital is “custodian” were been already “touched” Well Mrs Cady,it seems that they committed errors again.That simple indeed

The Board spent almost three years (just a little delay ¿??) to investigate (or whatever) this clear case of medical malpractice. Just to compare: The Public Health Service spent no more than six months to conduct a thorough depth investigation and to submit it conclusions. The same documentation and witness reports has been given to the PHS and to the MBC.

Mr Alan Irish can state how many times I´d been going to Diamond Bar to provide elements germane to this case.Same as Dave Thornton and former President Ron Wender, and DAG Robert Mc Kim Bell ,so I am absolutely “on time” having into account the unacceptable delay of the Board to insist in my request of true and decency and disciplinarian actions against the aforementioned wrongdoers.

The California Department of Health Services,declares in a ten pages summary signed by Marlene Taylor Chief of HFD and Eric Stone,Supervisor AAU:…” A review of the closed medical record revealed that the diagnosis of hipertensión in pregnancy,preeclampsia/eclampsia and HELLP síndrome were absent from MD 1´s discharge summary despite documentation of these syndromes by MD 1 in the medical record and that they were the critical events and conditions that led to the patient´s death”.

MD1 is ,of course, Mr Gerónimo Rodríguez, Why ?..because he signed the aforesaid discharge summary.

Which has been the diagnosis signed by Rodríguez ?

“Disease due to failure to cardiorespiratory system due to brain hemorrhage”

So it seems that my poor daughter died due to a brain hemorraghe ,yes,it´s true,if you want,..,but that was the last outcome of the store: an inexistent diagnosis and as a logical consequence of said inexistent diagnosis, the absence of any timely accurate treatment to manage the sickness. That´s why my daughter went to the sky.

About the “failure of cardiorespiratory system”… it doesn´t deserves any further comment.Everybody knows that people dies due to the aforesaid failure.A real stupidity.

Why did Rodríguez remain silent and avoided to state and sign the correct diagnosis of preclampsia/eclampsia/Hellp ? It´s quite simple. Because by signing the aforesaid diagnosis (lately realized by Gurevitch not for him) he was admitting his wide incompetence and gross negligence since he never ordered any accurated treatment to manage preeclampsia,eclampsia or Hellp indeed..

So Rodríguez (maybe in combination with Li and some authorities of the Huntington ¿?) decided to mislead and conceal his lack of ability ,to mislead further investigations,shading the true facts, in short :he lied. What for ¿ To avoid disciplinarian consequences.
That´s why this case is not subject to the limitation provided for by subdivision a) pursuant to Section 11503 of the Government Code as it apppears on paragraph (c) on BPCode Section 2230.5

It´s quite clear that the Medical Board didn´t take into account the dishonest action performed by Rodríguez on his signed prevaricant summary and related documents, which in my humble opinión means that this case is uncomplete whatsoever .

The Medical Board of California is owing us explanations about this incongruent and false discharge summary,and about the other existing incongruences and contradictions emerging from the documentation.

But,we still have many other details concerning this complaint:

Let´s see:
Rodríguez signed his false discharge summary on July 2nd,2002 on which he mentioned “cord entangle” without giving relevance to said situation ,he stated: “..cord around the neck was seen..” Its clear that “cord around the neck is germane to the baby situation. Nothing to do with my daughter´s preeclampsia in progress , eclampsia or further HELLP and death as well.

On July 7th,2002, Rodríguez signed a death certificate stating as immediate causes of death:

1.- Cardiorrespiratory Arrest
2.- Intracerebrum Hemorrhage
3.- Hellp

The Hospital´s final diagnosis written in the “attestation report” of July 8,2002 has been the following:

Principle Diagnosis: Cord entangle neck (¿?)
If cord entangle neck (a stupidity) was the principle diagnosis recognized by the Hospital authorities as main circumstance which developed to Hellp,you need no further analysis to conclude that nor Rodríguez nor Li,neither nurses or whoever,did any accurate diagnosis. We face contradictions and incongruences one after another.Pure Lies.

Secondary Diagnosis:Cerebrovasculart disease (consequence of HELLP))
Coagulation deficiency (consequence of HELLP)
Severe preeclampsia .

Allow me to ask: Severe preeclampsia stated by the hospital,?? But where is the Hellp stated by Rodríguez on his summary ¿? And why he signed hellp on the death certificate ¿? Who told rodríguez that it was a Hellp ¿?

Why the hospital statement postulates a “ severe preeclampsia “as secondary diagnosis ? ..,because only Gurevitch started a slight procedure to try to stop the outcoming drama when my poor daughter,medically abandonned ,was irremediably out of any hope. Previously to that point, for instance Li was prescripting a liquid diet . Do you need more proofs ¿???

It is more than clear the existing incongruences between Rodríguez discharge summary,the death certificate signed by him and the hospital´s attestation report .Same pattern of default of honesty and decency to avoid responsibilities.

It seems that Rodríguez discovered the real diagnosis five days after the death of my daughter, It seems… or …are we facing another incongruent lie (having into account what he signed on the aforesaid summary ¿?One lie after another lie.

Let´s analyze the rest of the aforesaid “untruthful “discharge summary:

Rodríguez stated that at the time of admisión (01.20 am) blood pressure was: 133/86 (which is high) and… nothing else was remarkable. Did Rodríguez take even a quick look over the prenatal records ¿? The prenatal records are full of clear warnings and concerns about preclampsia,preterm labor, IUGR, proteinuria+2 and HBP all symptoms of a mild preclampsia ,a big signal notifying to everybody that Veronica was a “high risk patient” indeed.
Moreover ,when admitted Veronica mentioned to have seen spots the previous day. What else ¿?

Blood pressure at 03.00 am 142/91
Blood pressure at 03.32 am 151/91
Moreover: at 04.10 am it´s written: she had alive reflexes,which are clear symptoms of neurological disturbance

At 06.48 Veronica gave birth to my granddaughter who weighted 2029 grams,thats a clear sign of IUGR and even all the aforesaid symptoms Rodríguez did not considered the possibility of preclampsia.

At 6.50 she vomited 100cm3 of clear liquid.
Where are the instructions given by Rodríguez to make specific and more rigorous chekups on my daughter ¿? They do not exist.

Blood pressure at 07.00 am 148/92
Blood pressure at 07.15 am 148/97
Blood pressure at 07.45 am 138/75
Blood pressure at 08.00 am 153/83
All the blood pressure levels were abnormals,all the time:

Notwithstanding the aforementioned high blood pressure levels we can read
The entry signed by Rodríguez on the Hospital Course: Laboratory initially was done,as I mentioned,because the blood pressure was “ somewhat elevated,although the patient was completely asymptomatic and denied any headache,blurry vision or epigastric pain”….

What means “somewhat elevated”? A little elevated,less elevated ¿??
High blood pressure is anything else than that: high blood pressure. Our experts felt astonished reading that outrageous explanation indeed. All the blood pressure levels has been abnormals,all the time.-

What is the worse:….the patient was completely asymptomatic and denied any headache,blurry vision or epigastric pain”….this assertion is another big lie,but at the same time it unveils a real true.Let´s see:

Rodríguez assertion that Veronica was asymptomatic is anything else than a complete recognition of his wide ignorance about symptoms germane to the existing eclampsia in progress to hellp since he was watching -but not recognizing- clear symptoms saiod pathology.

At the same time he is lying since Veronica mentioned having seen spot lights and complained about headaches,terrible unbearable upper abdominal pain,suffered nausea,vomits and her hands and legs showed edema.

The California Dep..of Health Services statement indicates:…”A review of the closed medical record revealed an incomplete and unsigned physician´s Progress Note on June 30th,2002 at 6.03 am “….Further review of the closed medical record revealed that the physician´s Progress Note on June 30,2002,entered after the Progress note of 7PM couyld not be read and the signatura cannot be identified. The same handwriting was found in a Progress Note on July 1,2002 for which no time of entry was documented”…

…” a review of the closed medical record revealed that MD 2 (Li) did not indicate the time of his note on June 30,2002”
…” a review of the closed medical record revealed that a Physician´s order on July 1,2002 at 06.16 am was not signed”…

…” Although an autopsy was not performed,( it´s been declined by an e-mail signed by Dr Lois Pena who never saw the body ) the record review revealed that the patient was hypertensive throughout her hospital course untill hours before her death.The clinical diagnosis were Eclampsia and Hellp Syndrome”…(diagnosis ignored by Rodríguez on his discharge summary)

Rodríguez states on the summary:…”Then the patient went to the floor.In that area at approximately 12 in the afternoon the nurse called saying the patient was having vomiting.She vomited the Tylenol #3 and seemed like she had some gastritis and that time Mylanta was ordered (by whom ¿?)and DC´d Tylenol and give her vicodin and they believed (who believed ¿? Nurses ¿?)) that perhaps the codeine produced her gastritis”…

This statement is an absolute lie. One of the nurses suspected that the symptoms were germane to preclampsia and she did informed Rodríguez about said concerns.

Veronica was accompanied by her mother and her boyfriend.They witnessed everything.Nurses also. At 12.15 am Veronica had a growing and unbeareable epigastric pain.,nausea,saw spot lights,showed edematic hands and legs,She was given Tylenol which she vomited right away.It seems that Rodríguez ordered Tylenol and Mylanta telling the nurses (by telephone because he was absent) that it was a post partum pain (what is expected in puerperium is perineal pain not epigastric pain).

Rodriguez ordered additionnaly Vicodin which she vomited as well.Vicodin is a narcotic analgesic (hydroxycodone). Medically,narcotics analgesics are not indicated for a patient suffering from usual labor pain but for a thorougly different symptoms,unrelated to organs envolved in labor process.

Another proof of medical ignorance ant the total disorientation of Rodríguez.He was attacking the pain not the causes. Why ¿? Because he never identified the sickness which was producing said symptoms indeed.

On the contrary,what world have been advisable was to be on guard considering that those symptoms were the most frequent of HELLP syndrome (65% of cases).In addition: in the Clinical resume there is no record of investigations carried out due to epigastric pains.

Thereafter,Rodríguez abandoned the patient for a long long while almost three “golden” hours.Several attempts to contact Rodríguez were absolutelly unsuccesful.In spite of having being paged once and again Rodríguez has been all the time unavailable and out of reach or else he has been always late.

Not only has he always been late or absent but also he has not even dared to enter any entry in the medical records and clearly enough he had left the case in the hands of the registered nurses without even giving a diagnosis .
After 14.30 pm till 18.00 pm there is a total absence of entries in the medical history.

As Rodríguez was out of reach,Li had to be called in emergency (he atended Veronica during pregnancy so he must know her prenatal records indeed).He ordered some lab tests and a stupidity: a liquid diet(¿? What for) and a vial of Demerol to calm pain.He never inquirid or investigated the real cause of that upperabdominal pain,whose cause remained without any explanation.
There you have another demonstration of medical incompetence

Rodríguez and Li knew the results of blood tests ordered at 16.05.Platelets showed a dangerous low lever of 119.000 mm3. All studies are coincidental :platelets below 150.000 mm3 shall cause great concern about Hellp.They saw that result but haven´t done any accurate managment :v.g .a platelets transfusión for example.

So: of what single departures are you talking about ¿?

The Board´s final conclusión about Rodríguez and Li is outreageously and daringly unacceptable and it offends and underestimates the inteligence of any skilled and trained doctor or/and any forensic witness expert.

It is by far clear that Rodríguez failed by far in much more than to order a simple urine protein determination.,as the board´s states.He failed to diagnose,(he didn´t diagnose),thereafter he failed to recognize any single symptom of the progressing eclampsia,he abandoned the patient,he lied and falsified his report to conceal his own ignorance from discovery and experts are strongly concerned about the missing sheets of the medical records and many obvious incongruences on statements and entries.

About the other wrongdoer Li,the board´s final report:…” …he failed to properly evaluate Veronica´s complaint by reviewing the medical records.The persistent complaint of epigastric pain (without an alternative diagnosis..??)should have prompted therapy with magnesium sulfate..” shows the same pattern of irresponsible indulgence and a wide distortion of the true .

The real true is that nor Rodríguez neither Li took a minnimum single look over the records (pre natal and hospital recordsas well) and both of them ignored the upper abdominal unbearable pain germane to eclampsia,so they never started any therapy with Mg sulfate.Mg sulfate has been administered just when it was very late.

As(renowned) forensic expert Dr Ricardo Bocacci reported, (I attach with this letter the full report) Dr Gurevich was the first one to wonder about the possibility of preeclampsia during pregnancy but it was very late (19.00 pm) but Veronica was already out of any hope.Late very late.

The Board´s conclusion seems to be aimed to protect those two dangerous negligent and incompetent wrongdoers.Experts are absolutely coincidental about the lack of ability and their further intentional misleading and concealing behaviour.

The Board spent almost three years to investigate this clear case of medical malpractice. The Public Health Service spent no more than six months to conduct a thorough depth investigation and to submit it conclusions.Same documentation and witness reports has been given to the PHS and to the MBC,moreover,Mr Alan Irish knows how many times I´d been going to Diamond Bar to provide elements germane to this case.Saqme as Dave Thornton and former President Ron Wender,so I am absolutely “on time” to insist in my request of true and decency and disciplinarian actions against the aforementioned wrongdoers.

By the way: Your qualification of “single departure from standards” is unsustainable from every point of serious view.,no matter what kind of interpretation you give to that “bargain clause” a big “black hole” of the
MPAct of BPCode. Anything ,I repeat anything can be framed with the aforesaid definition.Not in this case.

When I say “bargain” I know (as you know) of what I´m talking about. Said definition (bargain) was given to me at the office of former Senator Sheila Kuhel
I mean:she knows of what is talking about.

A copy of this letter will be sent to Governor Arnold Schwartzenegger´s office and to LATimes investigative reporter Charles Ornstein autor of “When caregivers harm” …Veronica Glaubach Joy of birth,then drama ,and to David Gumpert,maybe the next investigative report should be:”When Medical Board harm ¿?”

I demand true and justice. Just human rights Nothing else.

Roberto A Glaubach,
The father of Veronica
Architect

The following report ,which is by far very clarifying, is the transcription of the original signed by Ricardo Boccacci,MD,forensic,expert before The Supreme Court of Justice,a wellknown pathologist, and clinical expert with almost 40 years of expertise and international experience.

A) BACKGROUND: PREECLAMPSY

The patient Veronica Solange Glaubach was having a high-risk pregnancy due to several indicators of preeclampsy, namely:

1. She had positive albuminuria type 1 on June 8th and 25th and type 2 on June 11th. In general, proteinuria is the last sign to appear in preeclampsy and therefore, such sign is of highly clinical importance.(pages 1-2)

2. According to checkups made on her during pregnancy, levels of blood pressure were of 90/60 and 100/70 as from January 9th till May 1st and 112/70, 112/68, 110/70, 100/60, 116/70 as from March 21st till June 25th what clearly shows that the patient had a caracteristical basal hypotension . When she went into the Hospital, the levels of blood pressure increased significantly : on June 30th . 01.20 blood pressure was of 133/86; 04.10 am : 140-150/80- 90 mm Hg. Although there exist several definitions of preeclampsy, many describe it as clinical symptoms with tensional levels above 140/90 mm Hg , an increase of systolic blood pressure of 30 mm Hg or an increase of the diastolic blood pressure by 15 mm Hg after week 20 together with proteinurea in excess of 300 mg during the 24 hours. It is obvious that Verónica had all to fit that diagnostics.(page 3)

3. Moreover, it is important to point out that in the pre-natal control flow sheets you can read several times that precautions must be taken. Shall I ask you why?(pages 1-2-3)

4. When she got into the Hospital, it has been written in the Maternal Clinical Resume that the reports of pre-natal controls had been noticed. In such reports you can read in several places the existence of proteinurea and the need of taking precautions . Notwithstanding, in the Clinical Resume there is no reference that such warnings had been communicated to the doctors in charge. (page 4)

5. From the moment Verónica got into the hospital , she had shown high tensional values and mentioned to have seen spots on the previous day. Moreover, at 04.10 it`s written,she had alive reflexes.,symptoms of neurological disturbance. At 06.50 she vomited 100 cm3 of clear liquid . However, these symptoms didn’t arise any concern to the medical staff in charge so that nobody gave instructions to make specific or more rigorous checkups on the patient, being no record that this abnormal symptoms have been informed to any of the doctors in charge. (page 5)

6. At 6.,48 Verónica gave birth to her daughter who weighted 2029 grams . There exist several definitions for I.U.G.R. (retarded intrauterine growth ). However, most of the doctors agree to define I.U.G.R. as less than 10 percent of predicted fetal weight for gestational age. In general , any birth in term with the newborn weighting less than 2.500 grams implies an I.U.G.R. Now my question is, considering the weight of the newborn baby , nobody of the medical staff considered the possibility of preeclampsy? (page 6)

B) LACK OF ADEQUATE POSTPARTUM CONTROL–ONSET OF

ECLAMPSY – H.E.L.L.P. SYNDROME:

1. The labor which in the medical staff view required precautions, took place on June 30th. at 06.48 . However, the next record was only made at 09.00 indicating breastfeeding without any mention of the health of the parturient.(page 7)

2. In all Obstetrics services, it is wide known that immediate puerperium must be strictly surveyed, mostly during the first two hours , putting emphasis on heavy bleeding, frequency of the pulse, blood pressure, and uterine involution. Such controls must be made each 15 minutes. Pursuant the post anesthesia recovery data sheet , blood pressure has been controlled each 15 minutes and levels were all abnormal , worrying and unrelated to the levels the patient had shown during pregnancy and that were registered in prenatal control data sheets: at 7.00 blood pressure of 148/92; 7.15 – 148/97; 7.30 – 138/5 ; 7.45 – 148/76 and at 8.00 –153/83. Notwithstanding this abnormal tensional increase, there is no mention of it in the Patient Progress Record so as there is any mention of actions taken by doctors or registered nurses to clarify this anomaly. In fact, the Patient Progress Record goes from the record taken at 6.31 when Dr. Rodriguez arrived to the corresponding verification of birth taken at 6.48 , and from there to the record of no breastfeeding taken at 9.00 and to “growing epigastric pain” at 12.15. In short , for more than six hours , there have been no statements regarding the medical condition of the patient, her blood pressure, diuresis, uterus involution, etc.
In the Progress Record the situation is worse though, there is no record till the intervention of an obstetrician in emergency[2].. This means that from the medical staff point of view the patient almost did not exist : she was a problem ascribed to the registered nurses.
However, it is clear enough that five from eight records of systolic blood pressure taken between 7.00 and 8.00 were within hypertensive range, same as two of those of diastolic blood pressure. (page 7-8-9)

3. The lack of controls and negligence are obvious also in the Maternal Flow Sheets because there are sporadic records of the levels of blood pressure taken at 03.00, 04.00, 05.00 and 06.00 being all of them abnormals 142/91, 139/50, etc. However, next register is only at 09:00 – 140/56 and the next one at 12:00 – 170/55 , that is to say three hours later. Pain level is also therein registered but only at 11:00, 12:00 and 14.:00. At 12:00 she was administered Vicodin and at 14:00, Demerol.

4. At 12:15 Veronica had a growing epigastric pain . She was given Paracetamol, an unespecified anesthetic (Tylenol) which the pacient vomited right away. What is expected in puerperium is perineal not epigastric pain. Nobody cared for this symptom which is in fact one of the first symptoms to appear when HELLP onsets. (page 7)

5. Faced with a growing epigastric pain and vomits , Dr. Rodriguez administered Mylanta (antiacid) and narcotic analgesics (hydroxycodone) whose commercial name is Vicodin , what she immediately vomited as well. Medically, narcotic analgesics are not indicated for a patient suffering from usual labor pain but for a thoroughly different symptoms, unrelated to organs or structures involved in labor process. On the contrary, what would have been advisable was to be on guard considering that those symptoms were, as aforementioned , the most frequent of HELLP syndrome(present in 65% of the cases). In the Clinical Resume there is no record of investigations carried out due to epigastric pains.

6. With growing pain, sickness and vomits , it has been attempted to contact Dr. Rodriguez , unsuccessfully though. In spite of having being paged once and again, as from Veronica’s admission to the Hospital till her demise, Dr.Rodriguez has been all the time unavailable and out of reach or else he has always been late. Not only has he always been late or absent but also he has not even dared to enter any entry in the medical records and clearly enough , he had left the case in the hands of the registered nurses without even giving a diagnosis .

7. As Dr. Rodriguez was out of reach, an obstetrician Dr.Li had to be called in emergency and ordered to have medical tests done , a liquid diet (???) and a vial of Demerol (derived from morphine) which was absolutely useless for this is used to calm but not to find out the real cause of such pain. It is important to point out , that the idea was not to calm genital pains caused by labor but the epigastrics, whose cause remained without any explanation. (page 9)

8. Also, in the medical record you can read an entry saying “Respiratory stand by’s intro ven x 45’ ” which is very confusing . There is no reference made to the real status of the patient , her medical condition or time of the entry. Worse though is that there is an electrocardiogram covering the page hindering whatever important or not had been written below.(page 10)

9. The only real fact is that controls had been few and isolated and in spite of the alarming signals, the medical staff remained unconcerned. Besides, after 14:30 till 18:00 there is a total absence of entries in the medical history. Although is truth that in the separate pages you can find entries of the Code Blue but there is no chronological sequence in it. So, in a page you find entries about what happened at 18:00 and in the next page, strangely enough, you find entries with the diagnosis and treatment given at 17.45: Eclampsy. Haematuria. Hyperreflexia. Maintain magnesium sulfate. Sodium bicarbonate . (page 11)

10. Patient Progress Records states at 18:00 - Admitted into maternity , accompanied by the doctor. +RN – slight hypertension - lungs condition was stable - Respiratory Assistance (RA) – Haematuria . (page 10)

11. When was Respiratory Assistance administered? In the succinct CODE BLUE pages the equipment was required at 16:30 and it came at 16:33. It is also stated that the patient went into convulsions and was completely unconscious. Various tensional levels are registered (the first being particularly abnormal: 146/ 99,22 mm Hg) Determination of arterial blood gas is requested by the doctors .The report says AERIAL TRACT IS ORAL…. What does this phrase mean? Aerial tract is always oral and incidentally nasal or by tracheotomy. Why then it has not been acknowledged that beyond doubts she needed to be intubated or managed with an ambu, to get RA? (page 12-13)

12. What for and where was she administered local anesthesia? (Dermoplast-Benzocaine)The patient didn’t have pelvic pain and even if this had been the case , local anesthesia would have not eased the pain. Usually, these type of anesthetics are used to anesthetize the oral part of pharynx so as to insert a nasogastric tube or a tube for endotracheal intubation . So why she was administered local anesthesia on June 30th. at 11:40 hs?(page 14)

13. Regarding respiration, in the CODE BLUE sheet , as aforementioned, the only reference made is that the aerial tract WAS ORAL. In addition you can read that the oxygen saturation ,when the team arrived ,was of 92% and that there was a wheezing in the superior aerial tract. Under the item intubation, you have no entries. However, the pressure of arterial blood gas was of 150 mm Hg at 16:49. How did she reach that value when arterial blood gas on room air is 100 mm Hg? How is it that she has to go intubated to IUC when in the CODE BLUE sheets there is no reference to such a situation? The only description therein made was AERIAL TRACT IS ORAL…(page 12)

14. Poor and almost sporadic information is shown in the prenatal flow sheets on June 30th. Before labor blood pressure entries are at 03:00; 04:00 , 05:00 and 06:00. The values shown there were all abnormal and even quite unbelievable, eg. Value change from 151/91 mmHg goes to 142/55 without any medical intake in the middle. Also, after labor checkups were made during 2 hours each 15 minutes, but as above mentioned after 08:00 the next entry was only made at 09:00 with a value of 140/56 and the next one at 12:00 yielding an alarming value ( 170/55 mm Hg) that should have caused alarm and consequently, the immediate staff intervention.

15. Unfortunately , if we consider the Progress Record , such medical staff didn’t exist since there is no record on the medical history till the doctor for emergencies , Dr. Lee , intervened and without registering the timetable of his intervention , he prescribed analysis and anodyne measures , such as a liquid diet.!

16. Apparently the registered nurses are the ones to be blamed for they were not conscious of their role which was, supposedly, to replace the doctors and therefore the checkups had been scarce and they failed to give the symptoms the importance they have . On June 30th. at 11:00, 12:00 and 14:00 they registered in the maternal flow sheets ABDOMINAL PAIN - ACHING GRADES 6, 5 and 8. No reference has been made that this symptom had been informed to the doctors in charge, which as aforementioned , has nothing to do with the normal consequences of labor. On the contrary , this symptom is a clear alert of eclampsy and most of all of H.E.L.L.P.syndrome.

17. Moreover, in the same maternal flow sheets , same time as before mentioned you can read “Behavior : Agitated” . Once again the nurses were not alarmed by this. Six hours have passed by after labor , the parturient was still being agitated but there was nothing to be worried about.

18. Poor information, lack of clarity in the registers most of them illegible which is a serious fault since if a doctor was called in emergency , how could he get an idea of what the patient previous medical scenario was?; All these have been a constant in the medical history. In fact, the medical history is full of abbreviations or acronyms almost unknown for the common of the doctors. To picture this, in the progress record on June 30th. at 17:15 you can barely read : “Code Blue Note: Code Blue Note called 2º to pt. Because unresponsive eyes rolli … foamy secretions … “ (the rest of it is illegible)(page 15)

19. The issue of the platelets remains particularly unclear to any fairly educated doctor . We all know that the normal number of this cells in peripheral blood is of 150.000 to 400.000 mm3 . In Veronica’s case, the register at 04:35 showed 222.000mm3 and strangely , another blood test was ordered at 16:05, showing 119.000mm3 . This last test should have raised alarm since in all studies, treatises or papers made on the subject, it is very clear that platelets below 150.000 m3 shall cause great concern . Why? Because proteinuria and the increase of the levels of uric acid are useful to diagnose preeclampsy but not to detect H.E.L.L.P. syndrome. The best indicator to detect H.E.L.L.P. syndrome is the number of platelets. Doctors and nurses of Huntington Memorial Hospital had seen that result but haven’t done anything . It was exactly at that moment that H.E.L.L.P. syndrome should have been diagnosed. Accordingly a vigorous line of action should have been carried out so as to control blood pressure and to substitute by means of blood transfusions the platelets that were in decrease. It is obvious that an early diagnosis was critical for effective treatment of such syndrome.(page 16)

20. However, long before there had been a tests whose abnormal results should have been reason enough to be taken as a warning. At 04:35 fibrin degradation products (pdf) which should be lower than 5, showed a level higher than five but lower than twenty. This result that forced to discard the onset of a consumption coagulopathy has not been object of concern to the health professionals involved. In fact, they should have ordered a D-Dimer test, which is a sensitive indicator of a sub-clinical coagulopathy and it can be positive before that coagulation tests show abnormalities. However, this hasn’t been done. The subsequent progress of the patient reports coagulopathy : at 18:15 pdf was higher than twenty , fibrin diminished to 113 mg % ( reference level: 200 to 400); as for the platelets they diminished much more. (page 17)

C) FINAL DIAGNOSIS :

1. None of the involved obstetricians , Dr. Lee or Dr. Rodriguez, have registered a specific diagnosis in the clinical history till it was too late. Moreover, their almost inexistent and poor remarks are superficial and incidental. They’ve not made any reference to hypertension, proteinurea, thrombocytopenia, etc. They treated abdominal pain as a regular puerperal pain by administering Vicodin and Demerol or as it would have been a gastritis they administered Mylanta. They have never been conscious of the existence of a preeclampsy , eclampsy or H.E.L.L.P. syndrome. Only at 17:15 (page 15)they wrote :” Pt is in eclampsia (pt has elevated BP during peripartum period” . Then , at 05,15 on July 1st. when the patient did not respond to verbal orders or pain stimulus, that is to say , when she was beyond hope , gone for ever, Rodriguez wrote: “ Lab: as noted: Hellp syndrome”.

2. Dr. Gurevich (page 18)has been the first one to wonder about the possibility of “preeclamsy during pregnancy “, at 19:00 , once the symptoms were completely displayed and as an unidentified subject established that Veronica was already in an eclampsic condition (page 11).However, although he had suspected a preeclampsy and he was witnessing the first eclampsy consequences such as convultions, even though the patient had upper abdominal pain, and in spite of her having a low quantity of platelets , he has not concluded a H.E.L.L.P. syndrome diagnosis , neither did he indicated platelets transfusions to the patient nor any other effective action in order to stop the coagulopathy.

3. The Hospital ‘s final diagnosis written in the Attestation Report has been the followingpage 19)

Principle Diagnosis: Cord entangle neck

Secondary diagnosis :
674.02 – Cerebrovascular disease
666.32 – Coagulation deficiency
642.52 – Severe preeclampsia

The above categorization of the diagnosis is incoherent : If Cord entangle neck is considered as the principle diagnosis just because it has been the first one , that could work but if we consider this as the main diagnosis it is absurd.
The cordon around the neck might harm the newborn baby but not the mother.

She died because she suffered bassicaly a preclampsia undetected by RN and doctors of Huntington Memorial.Hospital.With any kind of managing or accurate treatement,preeclampsia progressed to severe eclampsia which developed in a HELLP syndrome with a drastic drop of platelets and intravascular consumption of fibrinogen which led to an intracerebral hemorrhage ,killing Veronica.

4. In the Discharge Summary ,(page 20) Dr. Rodriguez describes the evolution of the medical symptoms of the patient without mentioning eclampsy diagnosis or H.E.L.L.P. syndrome in it. As discharge diagnosis he establishes the following: “Disease due to cardiorrespiratory failure due to brain hemorrhage. However, cardiorrespiratory failure is the final form of death of all individuals and brain hemorrhage might respond to many causes: brain injury, artery aneurysm rupture, arteriovenous malformation, hypertensive crise, encephalic tumor, coagulopathies, etc. In short, the Discharge Summary failed to provide a specific diagnosis ( It`s obvious that Rodriguez made a false statement to hide the true fact of his enormous lack of knowledge and gross negligence)

5. Finally, there is another surprisingly fact. No one from Los Angeles County Department of Coroner has reviewed the medical history. However, in the entry To Report a Death you can read that this death was not a coroner case per LA Coroner Office. Apparently , the communication was made through Internet because at the superior angle of the page you can read : “ Dr. Lois Pena @ L.A. coroner Office declines as coroner case”.(page 21)

CONCLUSIONS:

1. Veronica was a healthy young woman
2. She was intelligent and blessed with great artistic sensibility
3. However, she -as any other human being- could have passed away for many reasons: a road accident, an infection or as a result of unpredictable complications during pregnancy such as an hemorrhage due to placenta previa , an endovascular coagulopathy due a detached placenta, etc.
4. But, she was treated by doctors and registered nurses whose gross negligence and clear lack of skill led my daughter to her death:

a. They didn’t notice that the patient was having clear signs of preeclampsy during the pregnancy

b. The abnormally high tensional registers taken from the very beginning when she had been admitted into hospital have not caused any concern to the doctors neither have they given rise to communications of any kind among them.
c. After labor the levels of blood pressure during the first two hours have been abnormal. However, there is no proof that this situation has been informed to the doctors and therefore, controls more often . After the first two hours controls and entries are scarce and more isolated.

d. Epigastric pain, nausea and vomits are symptoms that should have given raise to great concern. Mostly since the frequency of such symptoms are clear indicators of H.E.L.L.P. syndrome . However, they have been minimized, attributed to gastritis and ridiculously treated with a diet, Mylanta, etc.

e. The indication to administer Vicodin or Demerol (narcotics agents) to trat an epigastric pain is also an obvious and blatant example of the lack of medical skill.

f. The fact that the medical staff has not taken immediate action when an sudden drop of platelets has taken place, which in fact could not have been attributed to nothing but intravascular coagulation which is the most important sign of H.E.L.L.P. syndrome , is another proof of their lack of skill.

GREGGORY R .DEVORE MD,FAILED TO DIAGNOSE-AN ARTICLE ABOUT WRONG DIAGNOSIS

2009-11-16T18:24:00.000-08:00

Greggory r Devore,MD ,is a renowned ultrasound specialized doctor with offices in Pasadena California.He signed the attached report .He states there that there´s no concerns about IUGR or toxemia which was clearly visible on the ecosound as experts pointed out.
I visited him at his office and during two long hours tried to explain that...well the baby was little,bla bla bla..............Indiana agote Glaubach,my granddaughter weighed 2,090 at the time when he was born.That weight is a clear signal of IUGR(Intra Uterin Grow Retardement),abnormal weight and it is showed in the ecosound..with brights in placenta.I´m sure that he never saw the ecosound which maybe has been signed by his assistant or mayby by his secretary. Liar and wrongdoer indeed !!The Wrong Diagnosis
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Read More: Andrew Weil, Dr. Andrew Weil, Health, Health Bill, Health Care, Health Care Bill, Health Reform, Obama Health Care, Living News

So let´s see some concepts about WRONG DIAGNOSIS
(no treatment as a logical consequence)

The Wrong Diagnosis
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Read More: Andrew Weil, Dr. Andrew Weil, Health, Health Bill, Health Care, Health Care Bill, Health Reform, Obama Health Care, Living News

I'm worried -- and if I'm worried, you should be, too.

The reason I'm worried is that the wrong diagnosis is being made.

As any doctor can tell you, the most crucial step toward healing is having the right diagnosis. If the disease is precisely identified, a good resolution is far more likely. Conversely, a bad diagnosis usually means a bad outcome, no matter how skilled the physician.

And, what's true in personal health care is just as true in national health care reform: Healing begins with the correct diagnosis of the problem.

Washington is working on reform initiatives that focus on one problem: the fact that the system is too expensive (and consequently too exclusive.) Reform proposals, such as the "public option" for government insurance or calls for drug makers to drop prices, are aimed mostly at boosting affordability and access. Make it cheap enough, the thinking goes, and the 46 million Americans who can't afford coverage will finally get their fair share.

But what's missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what's even worse than its stratospheric cost is the fact that American health care doesn't fulfill its prime directive -- it does not help people become or stay healthy. It's not a health care system at all; it's a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly.
It's impossible to make our drug-intensive, technology-centric, and corrupt system affordable. Consider that Americans spent $8.4 billion on medicine in 1950, vs. an astonishing 2.3 trillion in 2007. That's $30,000 annually for a family of four. The bloated structure of endless, marginal-return tests; patent-protected drugs and "heroic" surgical interventions for virtually every health problem simply can't be made much cheaper due to its very nature. Costs can only be shifted in various unpalatable ways.

So, a far more salient question that must be addressed is: Are we getting good health for our trillions? Unfortunately, the answer is a resounding, "No." The U.S. ranked near the very bottom of the top 40 nations -- below Columbia, Chile, Costa Rica and Dominica -- in a rating of health systems by the World Health Organization in 2000. In short, we pay about twice as much per capita for our health care as does the rest of the developed world, and we have almost nothing to show for it.

I'm not against high-tech medicine. It has a secure place in the diagnosis and treatment of serious disease. But our health care professionals are currently using it for everything, and the cost is going to break us.

In the future, this kind of medicine must be limited to those cases in which it is clearly indicated: trauma, acute and critical conditions, disease involving vital organs, etc. It should be viewed as a specialized form of medicine, perhaps offered only in major centers serving large populations.

Most cases of disease should be managed in other, more affordable ways. Functional, cost-effective health care must be based on a new kind of medicine that relies on the human organism's innate capacity for self-regulation and healing. It would use inexpensive, low-tech interventions for the management of the commonest forms of disease. It would be a system that puts the health back into health care. And it would also happen to be far less expensive than what we have now.

If we can make the correct diagnosis, the healing can begin. If we can't, both our personal health and our economy are doomed.

Politicians aren't going to resolve this issue overnight. Any health care reform bill that gets jammed through Congress in the next month or two will be dangerously flawed. Washington needs to take a step back and re-examine the entire task with an eye toward achieving the most effective solution, not the cheapest and most expeditious.

Ecosound done by Dr Gregory Devore,Pasadena showing in a clear cut "brights in the placenta" a blatant sign of preclampsia..NOBODY TOOK A LOOK ON THIS

2009-11-16T15:48:00.000-08:00

Greggory Devore,MD ,is a renowned ultrasound specialized doctor with offices in Pasadena California.He signed the attached report .He states there that there´s no concerns about IUGR or toxemia which was clearly visible on the ecosound as experts pointed out.
I visited him at his office and during two long hours tried to explain that...well the baby was little,bla bla bla..............Indiana agote Glaubach,my granddaughter weighed 2,090 at the time when he was born.That weight is a clear signal of IUGR(Intra Uterin Grow Retardement),abnormal weight and it is showed in the ecosound..with brights in placenta.I´m sure that he never saw the ecosound which maybe has been signed by his assistant or mayby by his secretary. Liar and wrongdoer indeed !!The Wrong Diagnosis
digg stumble reddit del.ico.us ShareThis
Read More: Andrew Weil, Dr. Andrew Weil, Health, Health Bill, Health Care, Health Care Bill, Health Reform, Obama Health Care, Living News

So let´s see some concepts about WRONG DIAGNOSIS
(no treatment as a logical consequence)

The Wrong Diagnosis
digg stumble reddit del.ico.us ShareThis
Read More: Andrew Weil, Dr. Andrew Weil, Health, Health Bill, Health Care, Health Care Bill, Health Reform, Obama Health Care, Living News

I'm worried -- and if I'm worried, you should be, too.

The reason I'm worried is that the wrong diagnosis is being made.

As any doctor can tell you, the most crucial step toward healing is having the right diagnosis. If the disease is precisely identified, a good resolution is far more likely. Conversely, a bad diagnosis usually means a bad outcome, no matter how skilled the physician.

And, what's true in personal health care is just as true in national health care reform: Healing begins with the correct diagnosis of the problem.

Washington is working on reform initiatives that focus on one problem: the fact that the system is too expensive (and consequently too exclusive.) Reform proposals, such as the "public option" for government insurance or calls for drug makers to drop prices, are aimed mostly at boosting affordability and access. Make it cheap enough, the thinking goes, and the 46 million Americans who can't afford coverage will finally get their fair share.

But what's missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what's even worse than its stratospheric cost is the fact that American health care doesn't fulfill its prime directive -- it does not help people become or stay healthy. It's not a health care system at all; it's a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly.
It's impossible to make our drug-intensive, technology-centric, and corrupt system affordable. Consider that Americans spent $8.4 billion on medicine in 1950, vs. an astonishing 2.3 trillion in 2007. That's $30,000 annually for a family of four. The bloated structure of endless, marginal-return tests; patent-protected drugs and "heroic" surgical interventions for virtually every health problem simply can't be made much cheaper due to its very nature. Costs can only be shifted in various unpalatable ways.

So, a far more salient question that must be addressed is: Are we getting good health for our trillions? Unfortunately, the answer is a resounding, "No." The U.S. ranked near the very bottom of the top 40 nations -- below Columbia, Chile, Costa Rica and Dominica -- in a rating of health systems by the World Health Organization in 2000. In short, we pay about twice as much per capita for our health care as does the rest of the developed world, and we have almost nothing to show for it.

I'm not against high-tech medicine. It has a secure place in the diagnosis and treatment of serious disease. But our health care professionals are currently using it for everything, and the cost is going to break us.

In the future, this kind of medicine must be limited to those cases in which it is clearly indicated: trauma, acute and critical conditions, disease involving vital organs, etc. It should be viewed as a specialized form of medicine, perhaps offered only in major centers serving large populations.

Most cases of disease should be managed in other, more affordable ways. Functional, cost-effective health care must be based on a new kind of medicine that relies on the human organism's innate capacity for self-regulation and healing. It would use inexpensive, low-tech interventions for the management of the commonest forms of disease. It would be a system that puts the health back into health care. And it would also happen to be far less expensive than what we have now.

If we can make the correct diagnosis, the healing can begin. If we can't, both our personal health and our economy are doomed.

Politicians aren't going to resolve this issue overnight. Any health care reform bill that gets jammed through Congress in the next month or two will be dangerously flawed. Washington needs to take a step back and re-examine the entire task with an eye toward achieving the most effective solution, not the cheapest and most expeditious.