Update to March 1, 2009 post

Update to April 20, 2011 post

More news from the University of California:


By now, the news of University of California police spraying quietly sitting students with military-grade pepper spray at the UC Davis campus is well known. I have a few things I'd like to say about that.

Firstly, at the ground level, it's pretty clear that this action was unnecessary, brutal, counterproductive, and even unconstitutional.

The students who would eventually be tear gassed were posing no threat, and, at most, were a minor annoyance. The students were, it is true, sitting on a sidewalk, but they certainly weren't blocking movement along that sidewalk. People were simply stepping over the students to get to and fro. There's even a picture of the UC Davis police officer, who would eventually spray the students, doing exactly that. Were the students annoying? Sure. Were they seriously impeding traffic? Apparently not. Sure, if someone in a wheelchair had tried to get by, and if the students had refused to part to allow that person to get by, then perhaps there would have been a stronger case against the students … but, to the best of my knowledge, there was no one in a wheelchair in the area, and my guess is that the students would have made a path for any such disabled person. In the absence of any actual impeding of traffic, I am at a loss to see how the complaint that the students were “impeding traffic” could really be reasonable. Further, if the students really needed to be moved (a point which is far from clear) then there is no reason to believe that the UC Davis police could not have moved those students in the traditional manner, by dragging them off.

So, the UC Davis police eventually used military-grade pepper spray on these sitting, unresisting students. How is that not brutal? The UC Davis police caused pain and suffering for no reason beyond their own enjoyment. The pepper spray did not break up the students, nor cause them to flee, nor had any visible positive impact on public order. “Brutal” and “sadistic” seem like reasonable descriptions of the police action under these circumstances.

So, what were the effects of this UC Davis action? Perhaps most obviously, they've created the precedent that the introduction and use of military-grade weaponry is appropriate at these student protests. As above, that's a precedent that never had to be made. I would classify the creation of such a precedent as “counterproductive” at best. More to the point, it's a precedent that could easily be the foundation of some large scale bloodshed to come.

There's the constitutional issue. The UC Davis police action was cruel. For the use of military-grade weaponry on a bunch of peaceful protesters, the word “cruel” is perhaps not strong enough, but it's certainly accurate. The UC Davis police action was unusual. If it weren't unusual, people around the world wouldn't be talking about it now. And it was punishment. The UC Davis police action caused pain and suffering, which is a pretty good example of punishment. In my copy of the Constitution, the 8th Amendment pretty clearly forbids cruel and unusual punishment. Maybe the Constitution to which the UC Davis police officers swore an oath didn't include that 8th amendment.

And then there's the UC Davis Chancellor handling of this whole issue. The Chancellor of a University of California campus is the highest ranking authority on the campus. It's the Chancellor's job to be responsible for everything that happens on the campus. Either the presence of a large number of student protesters on campus, or the fact that the UC Davis police generated a plan to use military-grade weapons on the peaceful students should have caused the Chancellor to be present. Both events together certainly demanded the presence of the Chancellor, if at all possible. Instead, Chancellor Katehi was absent from this whole event, and only came out of the woodwork later, to try to affix blame to anyone but her. That certainly fits with a pattern I've discussed before on this blog, in which University of California personnel claim and accept payment for performing a service, then don't actually provide the service. Is it too much to ask that someone who is paid to be the Chancellor at UC Davis actually does some Chancelloring (is that a word? Well, it is now) when large scale protests and the use of military-grade weapons occur on campus? Obviously, the answer is yes, it is too much to ask.

If you've read the rest of this blog, you will already have guessed that I was surprised by exactly none of the disgusting behaviors evinced by University of California personnel in this instance. You will also have noticed that, no matter what the University of California does, whether it be stealing children, running fake clinical programs, stealing cadavers, engaging in large scale fraud and embezzlement, or more, nothing serious ever happens to address or correct those actions. Based on previous history, I therefore offer this prediction of what will happen as a result of these events at UC Davis: nothing serious. Probably no one will loose their job, and certainly not their pension, there will be no criminal charges filed, and the next scandal will roll right along without being slowed down by any concern on the part of University personnel about University punishment for their actions.

RIP Steve Jobs. You made a difference both directly and by example. You were more of an inspiration to more people than you probably ever realized. Goodbye and God bless you.

Yet another data point:

Doctors Behaving Badly: FDA says UCLA cardiology chief botched clinical trial

http://www.reportingonhealth.org/blogs/doctors-behaving-badly-fda-says-ucla-cardiology-chief-botched-clinical-trial

In this case, the billing-for-services-not-actually-provided is obvious. The UCLA cardiology chief in question was paid to monitor the health of his patients, ensure their rights were protected, ensure that record keeping sufficient to maintain the usefulness of study results was done, and more. Allegedly, none of those things were done.

The omerta part is pretty obvious too. One patient died, and one underwent multiple hospitalizations while in a clinical study -- and no one told the institutional review board nor the study sponsor for a year. The study continued during that time.

As at the top of this post: just another data point.

Multi million dollar embezzlement, mass death in a fake transplant program, lethal research without the knowledge or consent of the research subjects, consorting with Yakuza, selling people's children, selling cadavers just wasn't enough. Now connections to terrorism.

I bet someone got a good laugh over the fact that university personnel funded a meeting with Hamas (!) partly by diverting money from Jewish donor groups.

Also, there is fairly explicit evidence of how the omerta upon which I've remarked before gets started. University personnel allegedly directed everyone involved in this event, from undergraduate students to University staff, to lie to their families (parents) and to US and foreign government officials (INS / border guards) regarding the trip. That's a pretty good clue as to what motivates omerta at the University of California.

Really. I thought I had lost the ability to be amazed by the news from the University of California. Every time I think that, they just step up their game. How do they keep on thinking up such new and horrible things to do?

Update: if the facts of the lawsuit described here are true, then someone at UC Berkeley may also be getting a good laugh over recent events.

Another update: and then there's this.

Another addition: and then there's the University non-punishment of the "Irvine 11," students from UC Irvine and UC Riverside who disrupted a speech by the Israeli Ambassador Oren in 2010. The University did nothing substantial to stop or punish that behavior. By contrast, the local DA, a grand jury, and eventually a regular jury, all agreed that the "Irvine 11" behavior was so egregious as to warrant 10 criminal convictions, as described here.

Another addition: an interesting article, relevant to the rest of this post, here: California's Most Anti-Semitic College

I've been thinking about this post for a couple of weeks now, dreading the day that this post would come out of me. Today is that day.

A few hours ago, a friend called me to tell me that his sister had died. The sister was 29. In this post, I will refer to her as "C."

For the last few weeks, I've known that call was on it's way. I've been wanting to scream at the world against the insanity of it all, and my loudest voice is this blog .... but I couldn't put my thoughts up on the web, lest C happen to read them. Now, I guess, it's too late to matter.

In comments to an earlier post on this blog, I had written that I was certain that, somewhere out there, there was someone who had seen the pattern I've seen at the University of California, avoided the University as a result, and perhaps avoided an early death. In fact, I had someone particular in mind. That someone was C, a young lady who had liver cancer, diagnosed 6 years ago. For 6 years (SIX YEARS!!!) she was metastasis free, and could have had a transplant. Her Kaiser hepatologist (UCLA trained, BTW) didn't get her on a transplant list. Eventually, after she and her family, encouraged by doctors they knew (apparently including me) pushed for her to get on a transplant list, she wound up on the "transplant list" at UCLA. She told me all about how Dr. Ted Busatil, head of liver transplant surgery at UCLA, assured her that he was going to get her a liver. And yet, for approximately a year and a half on this "transplant list," evaluations were done. Bills were generated, and paid. She had doctor's visits, and tests, and scans, and workups ... and no transplant.

Really, after all that time, something was wrong. UCLA transplanted Yakuza, and alcoholics, and criminals, and not this sweet, innocent girl.

I pointed out to the family that something was not quite right, and I may have had some small part in helping them start looking for a program that would perform an actual transplant. C wound up on what I believe was a real transplant list elsewhere, and was, I believe, on track to have an actual transplant instead of just evaluations for a transplant that would never come. She had advanced imaging which showed she still had no metastasis, and was ready to finally have a real transplant. I understand she was thinking about life after a transplant, and planning a future wedding (that last part is hearsay. C never personally told me herself about planning a wedding. Girl stuff, I suppose).

Then, about two weeks ago, C developed hip pain. She went to the hospital, and an X ray showed a femoral mass. Biopsy results indicated it was a metastasis. Unlike Mickey Mantle, C would never get a transplant with a metastasis ... and that's when I first started thinking about the what-ifs. If she'd only gotten that transplant before that metastasis, if she'd only started to look elsewhere for a liver earlier, events would have been different. Once I knew about the mass, however, I knew that the what-ifs were pointless. I knew what was coming. This blog post started in my head at that time, but I've kept it inside until now.

Tonight, C died. Age 29. She was part of that same pattern I've mentioned elsewhere on this blog. Services were billed, and revenue was generated, and the complete service (a transplant) was never done. Her family and her insurance paid for years for pre-transplant evaluations, with no transplant. And eventually, suddenly, it was too late to do a transplant anywhere at all.

There are no words to express the sorrow I feel for this needless early death. There are likewise no words to express my anger about the way she was convinced for years (YEARS!!) not to look elsewhere for a transplant, and to just continue the same medically pointless (but financially lucrative) medical evaluations that would never lead to a transplant.

By the way, there was one person on the UCLA staff who let C know that a transplant really was not forthcoming at UCLA. If that person is reading this, this paragraph is for you: C got your message, and understood it. She just didn't want to believe the message, however. She desperately wanted to believe that she really was going to get a liver soon, and that the extra time it would take to look another transplant program was not justified. Just so you know why C appeared to ignore your message until, as it turned out, it was too late.

This isn't at all the blog post I was imagining over the last few weeks, since I cannot find the words to write that post that's been growing in my head. I just want to scream at the insanity of this all, and the words for that screaming just do not exist.

Still, though this post is not the scream I wish I could generate, it may at least be a warning to some readers. If you are reading this blog, and you know C ... well, you've probably already absorbed the warning that I think is obvious in this tale. If I see you at the funeral, I plan not to bring up that warning, since I think everyone at the funeral will have already had their eyes opened. For the rest of you, those who still need a warning: consider this your warning. I still believe that this blog may do some good by convincing some sick person out there to do their due diligence when selecting a medical center, and perhaps finding a medical center where the NIH has not made a finding that the personnel have a "culture of noncompliance with the law."

Good luck. And Godspeed, C.

The university's action, the judge said, was "intentional, despicable and unprofessional."

Medical Center Suit Bungled, Regents Admit

http://articles.latimes.com/1997/oct/17/local/me-43662

Standing up for freedom in the face of heartbreaking tragedy:


"This shouldn't happen in this country, or anywhere else, but in a free society, we're going to be subject to people like this. I prefer this to the alternative."
John Green, father of Christina Green, discussing Christina's murder by Jared Lee Loughner just two days previous.

Plenty of other people have said it, and my own poor comment really amounts to nothing compared to Mr. Green's resolute, calm, and eloquent defense of freedom in the face of the worst possible event a parent can face. Still, I add my voice to those recognizing Mr. John Green:

Mr. Green is a better man than I. I've dedicated this blog to trying to make sense of it all ... and Mr. Green, even after his sudden roller coaster ride into hell, makes more sense out of tragedy than I could ever imagine. He's an inspiration to us all. Further, with his few words, he may have just done more to thwart the destruction of the Republic than all but a handful of men in history. God bless you, Mr. Green.

There's been a story in the papers lately about staff at the Olive View - UCLA hospital (jointly run by Los Angeles County and UCLA) who ran what's been described as a "hair and nail salon" in a neonatal ICU. Disappointing story; apparently, the fumes of acetone and other chemicals (in an apparent NEONATAL ICU !!) weren't enough to convince the hospital administration that this salon needed to be shut down. It took pressure from the Joint Committee on the Accreditation of Hospitals (JCAH) to get this salon shut down.

I wasn't sure that this was more than an isolated story ... until further investigation indicated that the story involved elements of standard University of California practices. Perhaps most shocking, the "neonatal ICU" at which this occurred, though being run like a neonatal ICU, and though accepting patients for long term ICU treatment, was not actually a legitimate ICU. The hospital had an intermediate critical care facility, without the staffing or certification of an ICU (even before a hair and nail salon was set up). They used, and presumably billed for, this intermediate critical care facility as an ICU. It's a lot like the UC Irvine / UC San Diego sham liver transplant program, in which a transplant program that didn't actually have the staffing (no full time transplant surgeon, nor transplant-qualified anesthesiologists) was claimed to be a legitimate, and fundable, transplant program. Yet another example of billing for a service, but not actually providing the complete service.

There are two possibilities for the babies who were intubated, and who were put into this sham ICU. One: the babies were actually sick enough to need a real ICU ... which was not actually provided. Two: the babies were not actually sick enough to need an ICU ... but the babies were intubated, subjected to ICU procedures, and the medical staff (and billing office!) just pretended to run an ICU around the not-sick babies. I really haven't yet figured out which possibility is worse.

Not to worry. The most likely event is that both possibilities were actualized. After all, this facility was short of ICU-trained personnel, and was apparently using non-ICU personnel instead. It's likely that, on the margin, the non-ICU personnel would not be able to differentiate between children who needed an ICU (and wouldn't get one anyway), and children who should not have been in an ICU. If the staff could not differentiate between these groups, probably some more-healthy-than-usual kids would likely have wound up in the fake ICU. Some sick kids, who might have benefited from a real ICU, probably wound up not even getting admitted to the fake ICU.

Has anyone out there ever seen a child getting an IV? They are often scared beyond fear. They are scared of the needle, of having their skin broken, of the restraints necessary to hold them as the IV goes in. Still, putting an IV into children is a fairly common occurrence; parents and medical personnel try to ignore the screaming, the crying, the abject terror they are causing, and convince themselves that whatever is being done is being done for the good of the child. And often, whatever is being done is, in fact, being done for the good of the child.

Except in this case. The Olive-View UCLA medical center did everything they could to justify billing for ICU care, including putting in IVs, intubating babies, and all the other billable procedures associated with ICU care ... but didn't actually provide the ICU nor ICU staffing. In this case, the procedures they did weren't part of a legitimate ICU treatment plan, but the procedures that generated billings continued. Providing an actual ICU to medically justify those procedures somehow got left out. I wonder how the staff of this fake ICU explained to parents that they (the staff) were doing all that could be done for the babies, all the while knowing that there was no actual ICU nor ICU staffing.

And, of course, there's the recurrent omertà that seems to enable the "culture of noncompliance with the law." I mean really; intubating a bunch of babies, who were or were not sick enough to be in an actual ICU, and pretending to keep them in an ICU, and apparently billing for ICU services, while not actually providing an ICU ... and no one talks until the JCAH comes investigating parent's complaints that this "ICU" has a hair and nail salon running in the back? Once again: wow. Simply wow.


Also, there are allegations of leaks of confidential patient information. That's apparently pretty routine for UCLA.

The patterns of continued misconduct, consistent with what the NIH apparently called "a culture of noncompliance with the law," continue. I certainly don't expect those patterns to change, though I am disappointed each time those patterns make the news.

Addendum: I've been waiting for some analysis of the death rate differential between the patients of this "ICU" and the patients in a real ICU. As far as I know, no such death rate differential has been published. There's a few possible reasons for that. I think the most likely reason is that this facility, as described above, probably had both the really sick babies who needed an ICU, and some not-so-sick babies who did not need an ICU. The really sick babies would be more likely to die in the fake ICU than in a real ICUs, and the not-so-sick babies would be less likely to die (since they weren't so sick to start with) than the patients in a real ICU. In this situation, the average death rate for the fake ICU could therefore be the same as the average death rate for a real ICU. A simple mortality comparison would thus show that the fake ICU was as safe as a real ICU ... and would be wrong.

If the fake ICU actually had a higher mortality rate than a real ICU (which seems likely, especially since the fake ICU was staffed by people who ran a hair and nail salon in the back), then theres a number of small boxes filled with small decomposing corpses under the ground in the Los Angeles area due to this recurrent U. of California pattern of charging for a service, claiming to provide the service, and not actually providing the service.

So, has anyone done an illness-normalized study of mortality rates for the fake Olive View UCLA ICU? I haven't seen one. Here's a reason, relating to my time working for the U. of California, that I don't think such a study will be done:

During my medical internship, I rotated through the Long Beach VA Medical Center, run by U. California, Irvine. While I was there, one of the cardiology fellows finished work on a paper that was supposed to be about mortality markers for CCU stays. During data analysis, this fellow accidentally documented that the post-angioplasty mortality rate for that facility was approximately three times the mortality rate for the main UC Irvine hospital. Same patient population, same surgeons in many cases, same equipment, same ORs in many cases ... and the patients who got post PTCA care at the VA died at three times the rate of those who did not. My recollection is that it was a 1.8% mortality vs. a .6% mortality. The nationally quoted "standard" mortality was, IIRC, .4%.

You know those boxes I mentioned a few paragraphs up? The boxes filled with decomposing corpses under the ground around a U. of California hospital? Those boxes were known to exist in this case. Not speculation. Actual scientific finding.

Thing is, that finding apparently doomed publication. The paper was never published, and, I was advised by another cardiology fellow, never would be submitted for publication. "You just can't publish things like that, you know," is the phrase I remember being used. From what I understand, the fellow involved allowed the knowledge developed by the creation of this paper to be quashed, in exchange for being allowed to continue in the UC Irvine cardiology fellowship program. It's my guess that documentation of those outrageously high mortality rates at a facility run by the University of California would have led to an investigation as to the cause of those mortality rates, and that the investigation might have led to discovery of outrageously lax credentialing and oversight procedures such as was the case at Olive View UCLA.

Back to the Olive View UCLA "ICU." It's certainly believable to me that a similar set of concerns might have led to either failure to study the mortality rates at that "ICU," or to quash publication of those rates were they ever documented.

Just a thought.

(this posting altered after publication)

Here's a post from a former UCLA anesthesiologist. Somewhat hidden in the post is another example of the same pattern I've noted before at the University of California: billing for things that were not actually done. In particular, there's this passage:

"the O.R. cut–off time for elective dental surgery at UCLA was 4 p.m.

Translated, that meant the patient had to be out of the room and in the recovery room by that time.

That was so everyone could go home by 5 p.m.

...

So part of my job was to inform them at 3 p.m. that they needed to finish up so I could wake the patient up and get her/him to recovery by 4 p.m.

Frequently this would result in abandonment of some crucial part of the procedure or a shortcut to get done in time."

(bolding and ellipse mine).

Just another data point.

Thoughts from Maryland about alleged fraud at the University of California, Davis.

JUST FOR FUN:

Roman Polanski has been in the news a lot lately. People have been wondering -- why now? What was the big change that led to extradition attemps now?

I think the big change that led to Polanki's extradition had nothing to do with Polanski. The Polanski extradition is a message to someone
My guess as to the intended recipient of that message? Marco Morales.

Update: OK, perhaps some of you don't know who Marco Morales is. Marco Morales was a Chicago contractor convicted of bribery in the Chicago Silver Shovel case. After conviction, Mr. Morales was to be transferred from custody in Illinois to federal custody in Michigan. The method of prisoner transfer apparently involved giving Mr. Morales a car in Illinois and telling him to drive himself from custody in Illinois to prison in Michigan.

Mr. Morales never showed up in Michigan. He next surfaced living freely in his home country of Mexico. While Mr. Morales was living in his new home in Mexico, Mr. Morale's young son was awarded 60 million dollars in consulting and contracting fees.

Also, Mr. Morales has been documented to state that he'd been threatened at gunpoint should he talk about the circumstances surrounding his bribery of Chicago officials.

It sounds to me like Mr. Morales knows something that people in Chicago don't want known. Further, it appears he's made a deal to keep his mouth shut, and that he's living up to his end of the deal. Were Mr. Morales to simply die / be killed, it's reasonable to believe that others who might have made similar deals would loose faith in their own deals. Therefore, it is in the best interests of whoever made a deal with Mr. Morales to ensure that Mr. Morales is visibly healthy and happy.

At the same time, whatever Chicago dealmaker apparently made this deal with Mr. Morales certainly has rivals. Every dealmaker in Chicago has rivals. It would be in the best interests of those rivals for Mr. Morales to talk. That way, the original dealmaker might be marginalized, and the rivals could seize the dealmaker's clout. Again, the rivals have no interest in the death of Mr. Morales. If he's dead, he can't talk about whatever it is he's being quiet about.

With Chicago having been considered for the Olympics, and with all the attendant spending, the rivalry among Chicago political factions was likely particularly intense. I think that one of the rivals came up with a plan to encourage Mr. Morales to talk at the direction of that rival. Since Mr. Morales is out of the USA and is apparently under the protection of whoever he made his deal with, the encouragement would have to be somewhat subtle. Such a plan might involve demonstrating to Mr. Morales the rival's ability to reach across international borders and arrange extradition / imprisonment for another fugitive who thought he was safe.

Roman Polanski was that other fugitive. While Chicago was preparing to gather vast sums of money through the Olympics, Mr. Polanski became an example of how US law enforcement can reach out to touch people abroad. As I wrote above, I think Mr. Polanski's fate was meant to encourage Mr. Morales to cooperate with someone.

As for who that "someone" might be -- what (possibly former) Chicago politician might have access to the levers of international power so as to reopen a thirty year old case, and might have an interest in scaring off rivals for the gigantic boodle that was to be part of the Chicago Olympics -- I leave that speculation to you.