To Whom It May Concern:

THE ANNALS OF MY WIFE, CONSTANCE "BUC" WEBB, THROUGH THE MEDICAL SYSTEM OF THE GREATEST AND MOST MODERN WORLD CIVILIZATION.

SATURDAY DEC 28, 1996 - Buc suffered an aneurysm leading to a giant intercranial subarachnoid hemorrhage of Hunt & Hess Grade 4-5 while playing tennis.  She collapsed on the court at about 2:30 in the afternoon and is rushed to UCLA, undergoing evacuation surgery by 10 PM and aneurysm repair at 1 AM.  She is wheeled into ICU by 5:30 Sunday morning.  She has cleared 85 percent mortality at this point and has received the best surgical treatment in the world utilizing the latest in Guglielmi detachable platinum coils.  UCLA assumes the most aggressive therapy, called Triple H procedures, sparing Buc from the usual damaging affects of 21 days of vaso-spasms.  This is the period of time that the brain clears itself of free red blood cells outside the vascular system.  Statistically, Buc has as high as a 45 percent good to excellent recovery because of these new procedures (less than three years old) when before, patient mortality was 100 percent and thus three years ago, victims of large intercranial hemorrhages received only "patient comfort measures".
 What shouild have been aggressive and good treatment then turns into the disaster of abandonment by her HMO, Maxicare of California, Inc..  Following is the chronology of Buc's passage through the health care system.

THURSDAY JANUARY 23, 1997 -  UCLA, not being a contracted provider to Maxicare, is costing them too much each day.  Thus, despite UCLA being one of the best facilities for the treatment of care of Buc's class patient, along with the University of Irvine and Massachusetts General Hospital, she is taken to Freeman Marina Hospital, against the objections of UCLA and myself.  She was deemed to be stable for transfer by Dr. Lee, of Maxicare, despite having undergone major brain trauma, having a rash over her entire body, a collapsed lung, pnuemonia, spinal staph infection and a one-hundred and three degree fever.  Though arriving at Freeman at three o'clock in the afternoon, on a cold and rainy day, they were unaware of her presence.  From this time untial nine o'clock, when I finally caught up to her, she had lain in a cold room, unattended, with only light sheet.  Her pulsitile stockings and boots were not on her and all that the nurse could say about her as she took me into her room, was that she had a nice hairdo.  She also told me that they were not aware of her medication nor feeding schedules, since neither her medical records nor intrafacility transfer summary were in their possession.  As some of you might know, Dr. Lee has undergone investigative audits with Maxicare, and has been found operating without certification.

FRIDAY, JANUARY 24, 1997 TO FRIDAY, FEBRUARY 12, 1997- During this period, Buc's stay at Freeman Marina Hospital has been mostly damage control to prevent the spread of infection, including the new and potentially deadly VRE which she acquire while at Freeman.  VRE is spread by contact, by not washing hands.  Also, during this period, she was returned to Intensive Care because of dehydration due to sloppy nursing.  For a patient who is quadraplegic, and thus unable to remove their blankets when overheated, heart failure becomes emminent as the heart tries to beat faster to circulate the blood faster in it attempt to cool the patient.  This happened twice!  More notably during this period, there was very little neurological evaluation by Maxicare's assigned neurologist Dr. Howard Chew, an alumnus of UCLA.

WEDNESDAY, FEBRUARY 12, 1997 - Because of this absence of neurological attention and patient concern, I called Dr. Gramer (1:05 PM) to inform him that I would like Dr. Chew removed and replaced by Alexander or another outside specialist.  I was informed that Dr. Gramer will be gone until Friday.  On Friday I could not call Dr. Gramer because I myself was too busy at my job.  Dr. Gramer was assigned by Maxicare as Buc's Primary Care Physician (PCP).  Dr. Gramer is hired by Prairie Group, Maxicare's assigned Provider.  It is Dr. Gramer who then controls the selection and assignment of specialists, and what hospitals the patient will stay in.

FRIDAY, FEBRUARY 14, 1997 - Maxicare's urologist, Dr. Friedman, in meeting me at Buc's door, told me that I should let her go.  I sobbed in the social worker's office.

SUNDAY, FEBRUARY 16, 1997 -- Dr. Lieber, Dr. Sprau's backup internist, told me that Buc's care should now be changed to sub-acute care available at her present location, Freeman Marina Hospital.  During this conversation, he indicated that the best place to move her, with the type of care she will need, is only down the hall.  He seemed to know in advance that Buc was going to be moved somewhere.

MONDAY, FEBRUARY 17, 1997 - By phone (5:23pm), I informed Dr. Gramer that I would like Dr. Chew removed and replaced by Dr. Alexander or another outside specialist.  He seemed very unprofessional and clumsy in his response to me, though I was following Maxicare's prescribed procedure in the matter;  giving me no answer.

TUESDAY, FEBRUARY 18, 1997 - Called Integrated Physicians (348-7800 x450) to have Dr. Chew removed.  They instructed me to again call Dr. Gramer at 829-3130 about this.

TUESDAY, FEBRUARY 18, 1997 - I call 829-3130, but Dr. Gramer is gone for the day.

TUESDAY, FEBRUARY 18, 1997 - Dr. Chew calls me (5:15pm) for the first time saying that he was not that familiar with Buc's records and hadn't seen her charts his prognosis is that she will be chronic vegetative.  My heart sinks.  This is her first prognosis, and it is done by phone.

TUESDAY, FEBRUARY 18, 1997 - Dr. Sprau dismisses herself from the case without warning, leaving Dr. Lieber as Buc's internist.

SUNDAY, FEBRUARY 23, 1997 - 2/23/97 - Called Dr. Lieber (9:30am  453-1414) to delay any move.  He did not call back until very, leaving the message that she will be moved, despite my wishes to the contrary.

MONDAY, FEBRUARY 24, 1997 - Again I tried to reach Dr. Gramer (829-3130) to have Dr. Chew dismissed and to avoid moving Buc.  Dr. Gramer's receptionist Stephanie took my message.  She told me that he will be gone until noon.  (Of course then he gets his usual two hour lunch.  So technically, if I called at 10:00AM, I won't be able to reach him for at least another five hours!) .  Dr. Greenspan is also not there as backup

MONDAY, FEBRUARY 24, 1997 - I phoned in a grievance to Maxicare's, Frank Kasperzyk, but I only reached his voice mail (213) 365-3494 x3257.

MONDAY, FEBRUARY 24, 1997 - Later this day, Dr. Gramer calls to inform me that Buc is going to be shortly moved.  I voice my selection as being Freeman sub-acute care down the hall from her room, as Dr. Lieber suggested.  He tells me that Freeman cannot accept her, because they have no room.  On July 23rd, I visit Freeman Marina for Buc's MRI.  Both her old wing and sub-acute care are empty!  He also offers me another good choice.  It is Brotman Hospital in Culver City.  Though further than Freeman, I accept it.

TUESDAY, FEBRUARY 25, 1997 - Dr. Gramer then called me by phone to informed me that Brotman decided not to accept Constance because she had a contageous disease, but that there is anothe excellent facility in Lomita.  He does not explain that by accepting this as a choice, we condemn our beloved Buc to a ninty day limit Outpatient Care status vs. unlimited hospital sub-acute care without co-payment.  He explains that it is a very good choice, and that its administrator, Janet Miller is ready to meet with me and my son.

BETWEEN TUESDAY, FEBRUARY 25, 1997 AND MONDAY, MARCH 3, 1997 - My son and I meet with Ms. Miller.  Casa Colina is clean and seems like a very fine place.  We have no idea what we are about to do.  Because of Dr. Chew's negative prognosis, we decide to allow Mom only one hundred days more.  In explanation of our intent to their staff, they continue to echoe back only ninty days.  On the way home, my son and I commented as to why we kept saying one-hundred and Mary Loffer, their social worker, kept responding with ninty, as though she had never heard us.  Now we know as the conspiracy unfolds.

MONDAY, MARCH 3, 1997 - Dr. Gramer informs me that it is no longer required that any neurologist is assigned to Buc.  I am greatly relieved that Dr. Chew is off the case.

MONDAY, MARCH 3, 1997 - Buc is moved to Casa Colina. We find it strange that though Buc was confined to a closed quaranteen room at Freeman, where everyone entering and leaving had to wear gown and mask, and wash their hands, and where Brotman addimatantly refused Buc's acceptance because of her contageous condition, Casa Colina neither restricted admittance to her room nor even closed her door, even though their were many old patients in rooms next to hers.

MONDAY, MARCH 3, 1997 - Justin and I meet with Casa Colina's social worker, speech therapist and physical therapist.  They seem to have no confidence in Buc's outcome; riding on Dr. Chew's misdiagnosis, yet they intended to assert aggressive therapy.  Their motivation seems strange to me, especially in light of the fact that such therapy was abruptly discontinued by Speech Therapists Mary Giffin on June 24, 1997.  The discontinuance of speech theraphy was supported by Casa Colina's head nurse Blanca who told me that "the patient was no longer receiving benefit" from such speech therapy, yet, less than two months later, on April 27, 1997, Buc squeezed my fingers with her right hand, on command.  This squeeze later came to signify yes.  She could also extend her fingers, which came to signified yes as well.  From this I learned that she was able to do this at the time when Mary Giffin discontinued her speech therapy!

In the ensuing weeks, a great number of things went wrong, requiring enforcement by the Department of Corporations, which are not presented here, since they relate more to medical mal-practice than abandonment.

WEDNESDAY, MAY 14, 1997 - I returned Carmel's phone call to me from Casa Colina (11:45am)  She is in their business office handling billing.  She tells me that Buc's Maxicare coverage was retroactively terminated April 1st by Maxicare.   This was confirmed by Buc's previous employer assigning her medical insurance plan to Maxicare and by another company, Tate & Partners.  Maxicare's comptroller has denied this, and as recently as December of last year, Maxicare has engaged in advertising in the State, and sending my wife brochures and a sundary materials concerning her coverage, including breast cancer detection tips.  To this date, you can catch their Internet homepage, which indicates that they are still doing business in the State.

WEDNESDAY, JUNE 11, 1997 - Maxicare agrees to the DOC's moratorium.   They assure me that things will indeed be better

WEDNESDAY, JULY 23, 1997 - Buc gets her first and only MRI paid for by her insurance company, though many patients with lessor injuries, receive MRIs as frequently as every two weeks!.

TUESDAY, SEPTEMBER 2, 1997  -  Michael Petherick from the DOC informed me by phone that their independent examiner ruled in favor of Maxicare on the basis of insufficient evidence despite having receive massive documentation of this case.  It is a clear whitewash to clear their dockets.  He advises me that we might take advantage of State and Federal social services.

SUNDAY FEB 15th 1998 - It is a glowing sunset, and I sit exhausted.  As the sun sinks, I think back on today's activities,  my wife smilling and laughing at Kim (my nephew's wife) while Kim spun their tale of Disneyland.  My wife delighted in it all, trying to speak back in her excitement.   At lunch, she incessantly stared at me while I ate my Double Big Mac, she is only allowed purees. Her nurse, Mary Hoyt, also told me she completely straightened her fingers and riased her arm over her stomach.  And her smile is returning to the left side of her face, the side first paralyzed by her Hunt & Hess Grade Five Subarachnoid Hemorrhage, caused by an aneurysm while plaing tennis over a year ago, December 28th 1997.  But you know all of this.
 Currently, Buc is only recieving disability, her State disability soon to run out.  Though Buc is fully disabled, being unable to speak or move, she will not be eligible for Federal Medicare until June 1999 and she does not qualify for State In-Home Supportive Services.  Casa Colina has charged us with over fifty-thousand dollars in retroactive bills.  We also receive old bills from UCLA neurosurgey.  We have ammassed almost thirty thousand dollars against our credit cards.