Preview
THERESA .1. BARTA (State Bar No. 150995)
BARTA LAW
4041 MacArthur Blvd., Suite 280 FILED
Newport Beach, California 92660
Tel. (949) 833-3383 FEB ~ 6 2018
Fax (949) 209-2530
Email: theresafl/barta-lawcom
Attorney for Plaintiff,
Diana P. Blum, M.D.
SUPERIOR COURT OF CALIFORNIA
COUNTY OF SANTA CLARA
DIANA p. BLUM, M.D,, ) Case No. llS-CV-277582
)
)
. . ) PLAINTIFF’S OFFER OF PROOF IN
Plaintiff, ) SUPPORT OF PLAINIFF’S REQUEST TO
) RE-OI’EN HER CASE IN RESPONSE TO
vs. ) DEFENDANTS SUTTER HEALTH AND
) PALO ALTO MEDICAL FOUNDATION’S
MOTION FOR NON-SLIT
SUTTER HEALTH, a California corporation;
3
PALO ALTO FOUNDATION MEDlCAL ) Trial Date: January 3, 2018
GROUP, a California corporation; PALO ) Time: 3:45 a:m.
15 ALTO MEDICAL FOUNDATION, a )
Dept; 16
Califomia corporation: and DOES Ithrough judge: Hon. Drew C. Takaichi
l6 ;‘
20 a
J
Defendants. )
17 )
‘w '
a
, -,
)
18
19
20 Plaintiff, Diana Blum, MID. (“Plaintiff") hereby presents the following offer of proofin
2] support of Plaintiff‘s request to reopen her case in response to defendants Sutter Health and Palo
Alto Medical Foundation’s Motion for Nonsuit.
23
24
l
PLAINTIFF’S OFFER 0F PROOF IN SUPORT 0F REQUEST TO RE-OPEN CASE IN RESPONSE TO
SUTTER HEALTH AND PALO ALTO MEDICAL FOUNDATION‘S MOTION FOR NON-SUIT
Testimony of Brian Roach
- Sutter Medcial Network
- Sutter Medical Network Participation Agreement
Testimonv of Collette Boudreau
—
Financials of Sutter Health and PAMF
- Relationship between Sutter Health and its affiliates and affiliates’ medical groups
Testimony of Jan Voge
- Sutter Health’s contracts with Aetna, Blue Shield, Blue Cross, Cigna and Health Net
Testimony of Raul Gorospc
- Financial relationship between all defendants
- PAMF’s contracts with third party payers and governmental (Medicare and Medi-Cal
Intermediaries)
Testimonyitjileff Gerard
-Relationship between all defendants and Sutter Health’s involvement in contract between
PAMF and PAFMG
Testimony of Diana Hedge
-Defer1dants policies and procedures re: patient reassignment, notification ofprovider
leaving group and continuity of care issues
Testimony of Pat Smcekens
- Not allowing 0r permitting Plaintiff to use questionnaires,
—
Not allowing or permitted Plaintiff to print paper charts from the EMR,
- Not allowed Plaintiff's staff/MA to make reminder calls to patients,
—
Length of patient visits being scheduled in less than the 60 minutes needed for new
patient visits,
- Length oftime between patient visits being extended
Testimony of Al Galvez
- Not allowing or permitting Plaintiff to use questionnaires,
- Not allowing or permitted Plaintiff to print paper charts from the EMR,
- Not allowed Plaintiffs staff/MA to make reminder calls to patients.
- Length of patient visits being scheduled in less than the 60 minutes needed for new
patient visits,
20 - Length oftime between patient visits being extended
21 Testimony of Dr. David Gershfield
- Not allowing or permitting Plaintiff to use questionnaires,
22 - Not allowing or permitted Plaintiff to print paper charts from the EMR,
- Not allowed Plaintiff‘s staff/MA to make reminder calls to patients,
23 - Length ofpatient visits being scheduled in less than the 60 minutes needed for new
patient visits,
24
7
PLAINTIFF’S OFFER 0F PROOF IN SUPORT OF REQUEST TO RE-OPEN CASE IN RESPONSE TO
SUTTER HEALTH AND PALO ALTO MEDICAL FOUNDATION’S MOTION FOR NON-SUIT
- Length of time between patient visits being extended
- Tracking of Referrals Out-Of—Network (“OON”)
- Sample medications
- Plaintiff’s complaints at departmental meetings
Dr. Ealon Joelson
- Plaintiff’s complaints at departmental and shareholder meetings
Testimony of Dr. Hernandez
- Auto Refill of Prescriptions
Testimony of Dr. Bronstein or Managed Care Director
- Tracking of Referrals Out-Of—Network (“OON”)
Estimony of Ellen Evans
- Notification letters sent to patients
Manny of Plaintiff
10 - interference with patients and physicians relationships
- patient abandonment
11 - plaintiff‘s emotional distress and worry about her patients as relates to patient
abandonment
12 - continuity ot‘eare issues (including regulatory and policies ofSulter Health)
- patients’ communications that they were not provided with plaintiff’s contact
information or told where plaintiff was after her last day at PAF MG
« patients’ communications that they wanted to continuing treating with plaintiff but
were not able to find her after her last day at PAFMG
Testimony of Drs. Ando. Hylton & Krocs - interference with Plaintiffs prospective economic
relationship with physicians
16
Testimonyfij Dr. Massie or Dr. Rose -—re violation of 17200 (business practice)
17
Testimony of Ruth Anderson — to show interference with Plaintiff’s prospective economic
18 relationship with patients
19 Testimony of Dr. Smith. Dr. Epstein and/or Dr. Nordgren -authenticating and discussing
Exhibit 42 PowerPoint Presentation,
20
Expert Testimony of Dr. Bryan Bohman ~Bus. & Prof. Code Section 2056 advocacy, medical
21 appropriateness, defendants decisions, policies and practices
22 Expert Testimony of Dr. Lorne Label
-Medical appropriateness of Plaintiff‘s referrals out-of-network
23 - Medical appropriateness of Plaintiff (as a Neurologist) referring Parkinson’s patients for
physical therapy
24
3
PLAINTIFF'S OFFER 0F PROOF 1N SUPORT OF REQUEST TO RE-OPEN CASE IN RESPONSE TO
SUTTER HEALTH AND PALO ALTO MEDICAL FOUNDATION’S MOTION FOR NON-SUIT
- Medical appropriateness of Plaintiff referring patients to a facility for CTA scans that
has clearer scans
- Medical appropriateness of Plaintiff‘s approach to practicing neurology
Exhibits ll. 12, 13, 32, 38, 42, 51, 52, 68, 78, 79, 80, 81, 84, 89, 91, 99E,100,102 and 106 —
each of which are attached hereto, except for Exhibits 13, 51, 52, 78, 79, 99B and 100 (which will
be filed separately).
Dated: January 28, 2018 Respectfully Submitted,
«:1 new»
Theresa .1. Band
Attorney for Plaintiff, Diana Blum, M.D.
10
ll
13
14
16
17
18
19
20
21
22
23
24
4
PLAINTIFF’S OFFER OF PROOF IN SUPORT 0F REQUEST TO RE-OPEN CASE IN RESPONSE To
SUTTER HEALTH AND PALO ALTO MEDICAL FOUNDATION’S MOTION FOR NON-SUIT
Exhibit 11
6/7/2015
08:37
MM: —
AM
_ 00_
For
Pt.
,3:..-..-e._¢--u=.a==-=—==..=.==..--=-
Start
Admit
Date:
Phys:
Complaint:
End Date:
8/5/2013
8/5/2013 Discn
Acctl
Dx:
Sutter
RaLazlona
No.:
Health
CONFIDENTIAL
Facility:
—
Palo
Age:
ENCOUNTER
262157511
Attend Phys:
(Corporate)
Event
PATIENT
Alto
-Doa:
and
DATA
50015160
Interview
INFORMATION
Medical
—Sex:
Data
Foundation
.~
.-._-----—...-...-..-..=------.__nn
PAGE 1
.
3
=a;;‘-t-uuau-_.--~=-,====ns.===.=—==. EVENT DATA =.u=ae.-=.--.—..-....-.-..-.=-.====-
Date Received: 11/6/2013 Information Source: PATIENT
‘
No: 13-7244 Facility: Palo Alto Medical Foundat
Date: 11/6/2013 Time: Sh;ft:
LDC: PMPA NEUROCLIN PALO ALTO Room No:
Entered Dy: Hoovez,sail Kzeamer
Phys Notified: N tslclan: L
Risk qt Notified: N
Event Type
COMPLEMENT 1 1
Outcomes: RESOLVED
Significance: Parameters: OTHER / PHYSICIER
Attr Depts: Attr Empls; Attr Phys: Elum,Dicn5 Pcany
Comma t: ‘
H Follcw-Up '
Reviewer: Hocve:.Gail Kreamer Date:
Statue: CLOSED - RESOLVED Data Closed: 11/7/2015
Comments/Abstract: »—-11/7/2013 1517 by
Dr» Blum wk: Always t are a p me with my Parkinson Dlsease. she 1
took time to explain things to me, and help me.
I met bar at one of tha meetings, at the Senior Center, and asked her
to be my doctor, whlch she immediately agreed to.
She will be missed.
CONFIDENTIAL PAMFOOOO1507
011
6/7/2016 Sutter Health (Corporate) PAGE 2
08:37 AM 00_ Pt. Relations - Event and Interview Data
CONFIDENTIAL PATIENT INFORMATION
For Facility: Palo Alto Medical Foundation
--__..-—--.--.. -------_.-._.._...-.. INTERVIEW DATA unBa---
Date Time Peraan Interviewed Location
11/7/2013 2135? PT emailed PR
Notes: -——11/7/2013 1516 by
Cr. Slum was always there to help me with my Parkinson
Disease. She took time to explain things to me, and help
me.
I met her at one of the maecinga. at the Senior Canter,
and asXed her to be my doctor. which aha immediately
agreed 10‘
She will be misuad.
I
CONFIDENTIAL PAMFODOO1 508
011-002
6/7/2016 Suttet Health (Corporetn) PNSL 1
—
Relations -
_
08:38 AM 00_ PE. Event and Interview Data
CORIIDENTZAL PATIENT INFORMATION
—
For Facility: Palo Alto Medical. [inundation
:—
!
Nm
10:
Age: -
OUT PAT IENT
Occupation:
Sex: Unknown
—
Add“!!! 1'
Addreu 2.
City: MOUNTAIN VIEW State; CA Zip Codei94043
Hana Phone: Work Phone: Cell Phona:
.....------_--_--==...-m-..---u EVENT DATA --...-...=_.-=m.---..-.m...-_any..-"
Date Received: 4/20/2013 Intnmaclon Sourcn: PATIENT
x
No: 13—1413 E’cility: Palo Alto Medical roundat
Date: 4/3/2013 Time: shift:
10:: PHPA NEUROCLIN PAID ALTO Room No:
Batu-red By: Kiel, Barbaxa9
Phys Notified: N Physician: Risk Mgm: Notified: N ,
,
Event Type Quantity
COMPLIHENT 1
.
CCJMPLIHENT 1
Outcomes: STA?! NH) / GR PHYSICXAN RECOGNITION
Significance: Pam-ate”: OTHER / PZ' SICIAH ,
OTHER / STAM‘
l
,
hm: Depts: Act: Bmpla: mu: Phys: Blum,Diana Poxtn‘: l
Treatment:
Ccmant: Closad. Iarwnrdad to Deputmanz.
Reviewer: Fallen—Up Date:
Status: CLOSED - RESOLVED Data Closnd: 0/13/2013
Garments/Abstract: "-11/29/2013 1631 by Barbara Kiel"
Cloned. Forwarded to Department.
--—fl/l3/2013 1432 by Barbara Kiel"-
EPIC Encounter I: 275555205
_
—-—09/13/2013 1421 by PraL,RDE——-
Sent: Saturday, April 20, 2013 6:02 PM
4
To: PM? Patient Relations
Subject: Compliment for axcaconal aaruice -How Are We Doing?
”115”
Compliment for exceptional service
"we
CONFIDENTIAL PAMF00001515
011-003
6/7/2016 Sutter Health (corporate) PAGL 2
08:39 AM 00_ Pt. Relation: —
Event and Interview Date
CONFIDENTIAL PATIENT INFORMATION
For Facility: Palo Alto Modical Foundation
Comments/Abstract:
Phone
Date
Would
—
(Continued)
Email
ConLacL
Nuaber
of Birth
you
by:
like us
Email
to contact you? Ye:
I would like to commend Dr. Diana Elum and her staff (name unknown,
sorry), for all :hair afforta an my behalt regarding Earns. letters
medical rncorda etc. which have been a real nightmare for all of u&
I an a diaabled patiant (recently :etired from PAMF), and I an
inundated wlth requests tram Various agencies to update my condition,
explain why 1 am no longer disabled (NOT true), when all; I be
returning to work, etc. Drt Blum and stat! have been most graclous in
their attempt to placate these requetcza, over and over again. I am
so sorry I have put her in this poalLicn, but I seem to nave no
choice. I am so very grateful to: all tho assistance from he: ofilca,
PAH! i: so fortunate to have her and her MA on stafl. Thank you so
very much for the opportunity to express myself, and I hope this
message is Vlewd b7 bx. Bluukgnar HA. and PAM? administrative stali
who deal with patient comments.
nun-nu-uupnn—I—nnnnI-x—‘u-I-mng: INTERVIEW DATA n-u-n----.-----------‘--=H:-ui----==a
Date Time Person Interviewed Location
4/20/2013 Pt emailed PR directly
Notes: ---B/13/2013 1‘38 by Barbara Kiol--—
EPIC Encounter i: 275555205
Sent: Saturday, April 2D, 2013 6:02 PM
To. 23M? Patient Relations
Subje ': ComFllment for exceptional service -How Fro We
Dc‘ng',’ 1911:“
Compllm.nt tor exceptional carving
Phone Number
Data of Birth
Would you like us to cuntac you? Yes
Contact by: Email
I would like to command Dr. Diana Slum and her staff (name
unknown, sorry}, for all their efforts on ny behair
regarding torus, latturs, medical records etc. which have
been a real nlghtmara [or all of us. I am a disablcd
patient (recently retired from PAME), and I am inundated
with request: from variou: agencies to upd=:e my
condition, explain why I am no longer dlsablac (NOT true),
CONFIDENTIAL PAMF00001516
01 1—004
6/7/2016 Sutzer Health (Corporate) PAGE 3
-
—
08:38 AM 00_ Pt. Relations Event and Interview Data
CONFIDENTIAL PATIENT INFORMATION
— For Facility: Palo Alto Medical Foundation 1
“mm
Date Time Paracn Interviawed Location :Contmuad)
ubnn will I be returning to work, etc. Or. Blun and staff
have been most gracious in their attempt to placate these
raqustors, ova: and over again. I am so sorry I have put
her in this position, but I seen: to have no choice. I Im
so very grateful to: all the assistance from her office.
PAM? is so tortunate to have he: and her MA on start.
Thank you so very much for the opportunity to express
myself, and I hope this message is vzeud by Dr. Slum. he:
MA, and PAM? administrative staff who deal with patient
cormnnta.
-_
Date Time Parson Interviewed tocarion
8/13/2013 PR referred Neurology Dept - Palo Alto
Notes:
i
CONFlDENTIAL PAMF00001517
011-005
Exhibit 12
K%1 Sutter Health
We Plus You
REDACTED - AIC PRIVILEGED
From: PAMF Patient Relations
Sent: Thursday, November 07, 2013 3:21 PM
To: Blum, Diem MD
Cc: Gershfield, David N. MD (PAMF); Fischer, David MD
Subject: FW: 13-7244_Bravol - Dr. Diana Blum
Dr Blum,
Thank you for all you do for our patients, it makes a difference!
Patient Statement;
II! t;1l1lllli(¢'}’/“7!\) ,, m M) [III In.“ I-‘l:.‘(“MIMI/I. H‘IsuI'h 3m: [VOA 1117!; .10
~
w,
:p/CH”
‘ L‘.
[Ill/If”.u.v
III1376’,
, JL.’
t!”[! IIcl/} -
HIL’.
[mot Ul’l'I’lf(”3"“-1.421“,”lbi'r’i‘ligfl I'II'
III:>XI’IzIw' I IIlI’l’l'.
(Illf . I’ 110/ III In,»NH (/m f.:;:
“ 12’“111 III’\ II"III
I'I‘iIIiI'xl/llllflb' (.52"(’I
MIC m1”: In mmxml’.
III l'zII!
MI'uiI'nns i‘i’
Ix’IIpIax.I:1.I1
g1 l’eIlCI Mix,- M; ,‘
.41}:FUN? IILIlIiiIII
Suite: Health
Palo Alto Medical Faundafian Patient Relations
direct 831-458-5579
tollfree 88819504598
fax 831-475-2892
email ggmfizgfienrrelafl'gngflmmfizg
Quality & Patient Safety Department
PAMFGOO5138
lmsJ/resclWWCWWWIWHMONDFMMWHWUNDAwMDAxNTMEmZkZWM4YmZmV2MmZmd<0flJZDlAqYowN mas.1l2
012
202550queIAwnue
Santa Cruz, CA 95062
HOWE 0F CONFID ENTIAUTY
Trus 919: message mcluamg rammed and‘cv ofancmey wuk 9'0d Cod-Gems ariocmaum
antmis. mamas Mormacon w'rcn rm. be con-Mama ws
ncmxng an new
NOEC'Mby stateam ieoaal Ian Vac a) me Hazw
Insme For fiyam Accomm‘ ._ Ac.
w, "emiazrxs ml
This Is JIF'MDDE renewedonly by
me
rm: a
a aganaanon namedmessee Hyou were mum m
nu me 5 «253392 lo! vamnsruela rm 4.
l. "7255399 In sum pason. a dzsdosen
you may not L58. cooy.
Sent:
To:
Palo All!) Medical
Wednesday,
PAMF
Subject:
Foundation
Patient Relations
13-7244_Bravo! -
WW
WWI/EN message a any ‘nfiormt-sn comma: m the message
From:
November 06, 2013 2:35 PM
Dr. Diana Blum
What person(s) would you like to (all us nboul‘.’ Dr. Diana Blum
The person(s) depaflmenl/loution neurology
Please provide us details ol’how this person“) Dr. Blum wag always there to help me with my Parkinson Disasc‘ She took time to
provided exceptional smiee to you. explain thing; to me, and help me‘
I met her alone ofthe meetings. at the Senior center, and asked her to be my docton
which she immediately agreed Io‘
She will be missed.
Name (optlonnl) REDACTED
Email (optional) REDACTED
399M
,_
Copyright © 2011—2016 Cisco Systems, Inc. and/or All rights
its affiliates. reserved.
PAMFG005139
”mamasdsco.comlarwelopeopenerlposoxedonflDFtX2wYTFjYTU2MDAwMDAxNTMEmZkZWM4Ym2mYzMxNmZmdOTIJZDIAUSQYobfiNO/mes., 212
012—002
Exhibit 32
Blum
Dy. Dxana
418 \Wflow Rd, Marlo Pam. CA 94025
59‘ 6504604495; Fax 650-332-8345
Office Visit Note MRI.
Paflent Nam
anhe ume ofvxs'l
Seen by Dana Slum, MD
Date 01 Encounter: 061192016
Exam Reason (CC): Follow-Up - PD
Probkm.
Doped":
Landau; 01Sncmei 1! 153m. Exam V
469m
LnylngBP'HE; ‘53 53
Sufism: EP' {Hm/b, puma 58
vs
GENCRP‘L: umfied Parkmson‘s D‘scase R.Ln_.: Scale Motor Exanur-azwn
Speech '
Peas: Ema-amen 1
Trcmc' a! vast
EU 0
Fit. 0
1x, 1|
L.. 3
Acton OI Pasmmi T:
RU 0
RL 0
LU 0
r'mgencp:
R i
L 2
Hand Movemams
R 1
l 1
83‘v All Ham Movements
K
L ‘
Leg Agiluy
R 1
l ‘.
Arlyn: from Chan 0
Panama I
Gum
. H. - _..,~._. M... "hm/armrmnmmnmm mmvawmm W
CONFIDENTIAL
P1041
032
032
‘
PosturalSiabmzy
Bmay‘unesfia
'
Yolal Score‘ 16(LCV—16)RigN5 L315
Complete MOCA was cone wday aw aauenl sawed 2530, ha mlssed ‘ mm! on wpwrg reczmgles than N be was
In RWC Inmaa o! Menk) Part and mzssea 2 words on mean mougn he 90! mm mm a duo, he genmilcd 2 ‘5'
words :n1 mum:
Anusmem:
Plan:
Tami taoeh hue runs was 75 MW”, weaker than 50% wa| spent m mswsslon OhfiyeS as note: above
Eleclrmcafly signec by Dana b‘lum. MD or. 064712016 7'59 am in rElma-mm.rr
”H h...“ .w .. )r'rwu' am, «um mmm‘moimunz-m’mnm ‘3‘
2/2
CONFIDENTIAL
P1042
032-002
032-002
Exhibit 3 8
Meeting with Dr. Blum
Date: April 9, 2013 @ 12:00pm
Location: Dr. Blum’s Office
Members: Dr. Diana Blum
Pat Smeekens, Clinical Manager
Ai Galvez, Clinical Supervisor
Topics Discussed:
- clinical staff making reminder calls
0 Discussed with Dr. Blum regarding her request for her clinical assistant to make
reminder calls a day prior to patient’s appointment. Explained to Dr. Blum that the
organization’s Televox system sends out a reminder call and email to patients 3 days
prior to their appointment. Reassured Dr. Blum that recent data found that calls have
been going out to her patients. Management's request was for clinical staff to
discontinue matting these calls. Calls will be made only to patients known to no-show
or cancel. Feedback from the neurology staff was that patients were getting upset
with the redundant reminder calls. Dr. Blum disagrees with our decision. States that
Dr Cheyette has her assistant make these calls and that her no show rate has
drastically decreased. Dr. Blum states that Dr. Cheyette was disappointed that
management made such a decision and that she would contact us in regards to this.
Dr. Blum did not receive our message well. Continues to push for assistant to make
calls. Explained to Dr. Blum that assistant has other ciinicai tasks that reflect the right
gob forthe right person. Dr. Blum remains resistant to this change wants to continue
with reminder calls.
. Telephone encounters workflow
o Discussed with Dr. Blum to click into telephone encounter and to document response
in patient‘s chart, then route encounter back to pool; rather than sending a repiy
message that does not go into chart. Dr. Blum acknowledges this and will do this
moving fonuard.
. Paperwork prep
0 Discussed with Dr. Blum regarding the necessity/importance of paperwork prepared
prior to patients appointment. Note that other providers in department to not
require such forms. Dr. Blum states that forms are incomplete and are not being
prepared. Proposed to Dr. Blum the possibility of minimizing or decreasing paperwork
prep. Dr. Blum states the assistant consistently does not prepare requested
PAM FGOOOO1 2
038
paperwork correctly. Notified Dr Blum would update form usage with PSR but we can
not be certain that ALL pts will get forms. Asked her to be flexible.
. Dr. Blum’s Response
0 After discussing items above, the remainder of the meeting was discussing Dr. Blum’s
feedback for her assistant’s review. Dr. Blum expresses that her assistant’s speed was
slow, was not anticipating her needs, and incomplete rooming standards.
Conversation and attitude seemed reactive to discussions above. Management has
received nothing but positive feedback from other MD’s and clinical staff in the
department. Reiterated to Dr Blum that her MA is only working part-time much like
her and she is catching up on things when she is working. Explained to Dr Blum that
request for paperwork prep and her firmness that errors should not be occurring with
paperwork, visit type, etc. is not always realistic. She needed to be more
understanding. She felt the mishap are detrimental to her workflow and impact her
day tremendously.
PAMFG000013
038—002
Exhibit 42
Our World is Changing
And so must we.”
CONFIDENTIAL PAMF6004725
042
Some examples:
PAMF lost 17,000 HMO lives last year
PAMF is still excluded from narrow networks
Blue Cross, Blue Shield and HealthNet refuse
to work with us on shared savings
Walmart announced it will send its employees
to Mayo for cardiac surgery
Safeway
Preview
THERESA .1. BARTA (State Bar No. 150995) BARTA LAW 4041 MacArthur Blvd., Suite 280 FILED Newport Beach, California 92660 Tel. (949) 833-3383 FEB ~ 6 2018 Fax (949) 209-2530 Email: theresafl/barta-lawcom Attorney for Plaintiff, Diana P. Blum, M.D. SUPERIOR COURT OF CALIFORNIA COUNTY OF SANTA CLARA DIANA p. BLUM, M.D,, ) Case No. llS-CV-277582 ) ) . . ) PLAINTIFF’S OFFER OF PROOF IN Plaintiff, ) SUPPORT OF PLAINIFF’S REQUEST TO ) RE-OI’EN HER CASE IN RESPONSE TO vs. ) DEFENDANTS SUTTER HEALTH AND ) PALO ALTO MEDICAL FOUNDATION’S MOTION FOR NON-SLIT SUTTER HEALTH, a California corporation; 3 PALO ALTO FOUNDATION MEDlCAL ) Trial Date: January 3, 2018 GROUP, a California corporation; PALO ) Time: 3:45 a:m. 15 ALTO MEDICAL FOUNDATION, a ) Dept; 16 Califomia corporation: and DOES Ithrough judge: Hon. Drew C. Takaichi l6 ;‘ 20 a J Defendants. ) 17 ) ‘w ' a , -, ) 18 19 20 Plaintiff, Diana Blum, MID. (“Plaintiff") hereby presents the following offer of proofin 2] support of Plaintiff‘s request to reopen her case in response to defendants Sutter Health and Palo Alto Medical Foundation’s Motion for Nonsuit. 23 24 l PLAINTIFF’S OFFER 0F PROOF IN SUPORT 0F REQUEST TO RE-OPEN CASE IN RESPONSE TO SUTTER HEALTH AND PALO ALTO MEDICAL FOUNDATION‘S MOTION FOR NON-SUIT Testimony of Brian Roach - Sutter Medcial Network - Sutter Medical Network Participation Agreement Testimonv of Collette Boudreau — Financials of Sutter Health and PAMF - Relationship between Sutter Health and its affiliates and affiliates’ medical groups Testimony of Jan Voge - Sutter Health’s contracts with Aetna, Blue Shield, Blue Cross, Cigna and Health Net Testimony of Raul Gorospc - Financial relationship between all defendants - PAMF’s contracts with third party payers and governmental (Medicare and Medi-Cal Intermediaries) Testimonyitjileff Gerard -Relationship between all defendants and Sutter Health’s involvement in contract between PAMF and PAFMG Testimony of Diana Hedge -Defer1dants policies and procedures re: patient reassignment, notification ofprovider leaving group and continuity of care issues Testimony of Pat Smcekens - Not allowing 0r permitting Plaintiff to use questionnaires, — Not allowing or permitted Plaintiff to print paper charts from the EMR, - Not allowed Plaintiff's staff/MA to make reminder calls to patients, — Length of patient visits being scheduled in less than the 60 minutes needed for new patient visits, - Length oftime between patient visits being extended Testimony of Al Galvez - Not allowing or permitting Plaintiff to use questionnaires, - Not allowing or permitted Plaintiff to print paper charts from the EMR, - Not allowed Plaintiffs staff/MA to make reminder calls to patients. - Length of patient visits being scheduled in less than the 60 minutes needed for new patient visits, 20 - Length oftime between patient visits being extended 21 Testimony of Dr. David Gershfield - Not allowing or permitting Plaintiff to use questionnaires, 22 - Not allowing or permitted Plaintiff to print paper charts from the EMR, - Not allowed Plaintiff‘s staff/MA to make reminder calls to patients, 23 - Length ofpatient visits being scheduled in less than the 60 minutes needed for new patient visits, 24 7 PLAINTIFF’S OFFER 0F PROOF IN SUPORT OF REQUEST TO RE-OPEN CASE IN RESPONSE TO SUTTER HEALTH AND PALO ALTO MEDICAL FOUNDATION’S MOTION FOR NON-SUIT - Length of time between patient visits being extended - Tracking of Referrals Out-Of—Network (“OON”) - Sample medications - Plaintiff’s complaints at departmental meetings Dr. Ealon Joelson - Plaintiff’s complaints at departmental and shareholder meetings Testimony of Dr. Hernandez - Auto Refill of Prescriptions Testimony of Dr. Bronstein or Managed Care Director - Tracking of Referrals Out-Of—Network (“OON”) Estimony of Ellen Evans - Notification letters sent to patients Manny of Plaintiff 10 - interference with patients and physicians relationships - patient abandonment 11 - plaintiff‘s emotional distress and worry about her patients as relates to patient abandonment 12 - continuity ot‘eare issues (including regulatory and policies ofSulter Health) - patients’ communications that they were not provided with plaintiff’s contact information or told where plaintiff was after her last day at PAF MG « patients’ communications that they wanted to continuing treating with plaintiff but were not able to find her after her last day at PAFMG Testimony of Drs. Ando. Hylton & Krocs - interference with Plaintiffs prospective economic relationship with physicians 16 Testimonyfij Dr. Massie or Dr. Rose -—re violation of 17200 (business practice) 17 Testimony of Ruth Anderson — to show interference with Plaintiff’s prospective economic 18 relationship with patients 19 Testimony of Dr. Smith. Dr. Epstein and/or Dr. Nordgren -authenticating and discussing Exhibit 42 PowerPoint Presentation, 20 Expert Testimony of Dr. Bryan Bohman ~Bus. & Prof. Code Section 2056 advocacy, medical 21 appropriateness, defendants decisions, policies and practices 22 Expert Testimony of Dr. Lorne Label -Medical appropriateness of Plaintiff‘s referrals out-of-network 23 - Medical appropriateness of Plaintiff (as a Neurologist) referring Parkinson’s patients for physical therapy 24 3 PLAINTIFF'S OFFER 0F PROOF 1N SUPORT OF REQUEST TO RE-OPEN CASE IN RESPONSE TO SUTTER HEALTH AND PALO ALTO MEDICAL FOUNDATION’S MOTION FOR NON-SUIT - Medical appropriateness of Plaintiff referring patients to a facility for CTA scans that has clearer scans - Medical appropriateness of Plaintiff‘s approach to practicing neurology Exhibits ll. 12, 13, 32, 38, 42, 51, 52, 68, 78, 79, 80, 81, 84, 89, 91, 99E,100,102 and 106 — each of which are attached hereto, except for Exhibits 13, 51, 52, 78, 79, 99B and 100 (which will be filed separately). Dated: January 28, 2018 Respectfully Submitted, «:1 new» Theresa .1. Band Attorney for Plaintiff, Diana Blum, M.D. 10 ll 13 14 16 17 18 19 20 21 22 23 24 4 PLAINTIFF’S OFFER OF PROOF IN SUPORT 0F REQUEST TO RE-OPEN CASE IN RESPONSE To SUTTER HEALTH AND PALO ALTO MEDICAL FOUNDATION’S MOTION FOR NON-SUIT Exhibit 11 6/7/2015 08:37 MM: — AM _ 00_ For Pt. ,3:..-..-e._¢--u=.a==-=—==..=.==..--=- Start Admit Date: Phys: Complaint: End Date: 8/5/2013 8/5/2013 Discn Acctl Dx: Sutter RaLazlona No.: Health CONFIDENTIAL Facility: — Palo Age: ENCOUNTER 262157511 Attend Phys: (Corporate) Event PATIENT Alto -Doa: and DATA 50015160 Interview INFORMATION Medical —Sex: Data Foundation .~ .-._-----—...-...-..-..=------.__nn PAGE 1 . 3 =a;;‘-t-uuau-_.--~=-,====ns.===.=—==. EVENT DATA =.u=ae.-=.--.—..-....-.-..-.=-.====- Date Received: 11/6/2013 Information Source: PATIENT ‘ No: 13-7244 Facility: Palo Alto Medical Foundat Date: 11/6/2013 Time: Sh;ft: LDC: PMPA NEUROCLIN PALO ALTO Room No: Entered Dy: Hoovez,sail Kzeamer Phys Notified: N tslclan: L Risk qt Notified: N Event Type COMPLEMENT 1 1 Outcomes: RESOLVED Significance: Parameters: OTHER / PHYSICIER Attr Depts: Attr Empls; Attr Phys: Elum,Dicn5 Pcany Comma t: ‘ H Follcw-Up ' Reviewer: Hocve:.Gail Kreamer Date: Statue: CLOSED - RESOLVED Data Closed: 11/7/2015 Comments/Abstract: »—-11/7/2013 1517 by Dr» Blum wk: Always t are a p me with my Parkinson Dlsease. she 1 took time to explain things to me, and help me. I met bar at one of tha meetings, at the Senior Center, and asked her to be my doctor, whlch she immediately agreed to. She will be missed. CONFIDENTIAL PAMFOOOO1507 011 6/7/2016 Sutter Health (Corporate) PAGE 2 08:37 AM 00_ Pt. Relations - Event and Interview Data CONFIDENTIAL PATIENT INFORMATION For Facility: Palo Alto Medical Foundation --__..-—--.--.. -------_.-._.._...-.. INTERVIEW DATA unBa--- Date Time Peraan Interviewed Location 11/7/2013 2135? PT emailed PR Notes: -——11/7/2013 1516 by Cr. Slum was always there to help me with my Parkinson Disease. She took time to explain things to me, and help me. I met her at one of the maecinga. at the Senior Canter, and asXed her to be my doctor. which aha immediately agreed 10‘ She will be misuad. I CONFIDENTIAL PAMFODOO1 508 011-002 6/7/2016 Suttet Health (Corporetn) PNSL 1 — Relations - _ 08:38 AM 00_ PE. Event and Interview Data CORIIDENTZAL PATIENT INFORMATION — For Facility: Palo Alto Medical. [inundation :— ! Nm 10: Age: - OUT PAT IENT Occupation: Sex: Unknown — Add“!!! 1' Addreu 2. City: MOUNTAIN VIEW State; CA Zip Codei94043 Hana Phone: Work Phone: Cell Phona: .....------_--_--==...-m-..---u EVENT DATA --...-...=_.-=m.---..-.m...-_any..-" Date Received: 4/20/2013 Intnmaclon Sourcn: PATIENT x No: 13—1413 E’cility: Palo Alto Medical roundat Date: 4/3/2013 Time: shift: 10:: PHPA NEUROCLIN PAID ALTO Room No: Batu-red By: Kiel, Barbaxa9 Phys Notified: N Physician: Risk Mgm: Notified: N , , Event Type Quantity COMPLIHENT 1 . CCJMPLIHENT 1 Outcomes: STA?! NH) / GR PHYSICXAN RECOGNITION Significance: Pam-ate”: OTHER / PZ' SICIAH , OTHER / STAM‘ l , hm: Depts: Act: Bmpla: mu: Phys: Blum,Diana Poxtn‘: l Treatment: Ccmant: Closad. Iarwnrdad to Deputmanz. Reviewer: Fallen—Up Date: Status: CLOSED - RESOLVED Data Closnd: 0/13/2013 Garments/Abstract: "-11/29/2013 1631 by Barbara Kiel" Cloned. Forwarded to Department. --—fl/l3/2013 1432 by Barbara Kiel"- EPIC Encounter I: 275555205 _ —-—09/13/2013 1421 by PraL,RDE——- Sent: Saturday, April 20, 2013 6:02 PM 4 To: PM? Patient Relations Subject: Compliment for axcaconal aaruice -How Are We Doing? ”115” Compliment for exceptional service "we CONFIDENTIAL PAMF00001515 011-003 6/7/2016 Sutter Health (corporate) PAGL 2 08:39 AM 00_ Pt. Relation: — Event and Interview Date CONFIDENTIAL PATIENT INFORMATION For Facility: Palo Alto Modical Foundation Comments/Abstract: Phone Date Would — (Continued) Email ConLacL Nuaber of Birth you by: like us Email to contact you? Ye: I would like to commend Dr. Diana Elum and her staff (name unknown, sorry), for all :hair afforta an my behalt regarding Earns. letters medical rncorda etc. which have been a real nightmare for all of u& I an a diaabled patiant (recently :etired from PAMF), and I an inundated wlth requests tram Various agencies to update my condition, explain why 1 am no longer disabled (NOT true), when all; I be returning to work, etc. Drt Blum and stat! have been most graclous in their attempt to placate these requetcza, over and over again. I am so sorry I have put her in this poalLicn, but I seem to nave no choice. I am so very grateful to: all tho assistance from he: ofilca, PAH! i: so fortunate to have her and her MA on stafl. Thank you so very much for the opportunity to express myself, and I hope this message is Vlewd b7 bx. Bluukgnar HA. and PAM? administrative stali who deal with patient comments. nun-nu-uupnn—I—nnnnI-x—‘u-I-mng: INTERVIEW DATA n-u-n----.-----------‘--=H:-ui----==a Date Time Person Interviewed Location 4/20/2013 Pt emailed PR directly Notes: ---B/13/2013 1‘38 by Barbara Kiol--— EPIC Encounter i: 275555205 Sent: Saturday, April 2D, 2013 6:02 PM To. 23M? Patient Relations Subje ': ComFllment for exceptional service -How Fro We Dc‘ng',’ 1911:“ Compllm.nt tor exceptional carving Phone Number Data of Birth Would you like us to cuntac you? Yes Contact by: Email I would like to command Dr. Diana Slum and her staff (name unknown, sorry}, for all their efforts on ny behair regarding torus, latturs, medical records etc. which have been a real nlghtmara [or all of us. I am a disablcd patient (recently retired from PAME), and I am inundated with request: from variou: agencies to upd=:e my condition, explain why I am no longer dlsablac (NOT true), CONFIDENTIAL PAMF00001516 01 1—004 6/7/2016 Sutzer Health (Corporate) PAGE 3 - — 08:38 AM 00_ Pt. Relations Event and Interview Data CONFIDENTIAL PATIENT INFORMATION — For Facility: Palo Alto Medical Foundation 1 “mm Date Time Paracn Interviawed Location :Contmuad) ubnn will I be returning to work, etc. Or. Blun and staff have been most gracious in their attempt to placate these raqustors, ova: and over again. I am so sorry I have put her in this position, but I seen: to have no choice. I Im so very grateful to: all the assistance from her office. PAM? is so tortunate to have he: and her MA on start. Thank you so very much for the opportunity to express myself, and I hope this message is vzeud by Dr. Slum. he: MA, and PAM? administrative staff who deal with patient cormnnta. -_ Date Time Parson Interviewed tocarion 8/13/2013 PR referred Neurology Dept - Palo Alto Notes: i CONFlDENTIAL PAMF00001517 011-005 Exhibit 12 K%1 Sutter Health We Plus You REDACTED - AIC PRIVILEGED From: PAMF Patient Relations Sent: Thursday, November 07, 2013 3:21 PM To: Blum, Diem MD Cc: Gershfield, David N. MD (PAMF); Fischer, David MD Subject: FW: 13-7244_Bravol - Dr. Diana Blum Dr Blum, Thank you for all you do for our patients, it makes a difference! Patient Statement; II! t;1l1lllli(¢'}’/“7!\) ,, m M) [III In.“ I-‘l:.‘(“MIMI/I. H‘IsuI'h 3m: [VOA 1117!; .10 ~ w, :p/CH” ‘ L‘. [Ill/If”.u.v III1376’, , JL.’ t!”[! IIcl/} - HIL’. [mot Ul’l'I’lf(”3"“-1.421“,”lbi'r’i‘ligfl I'II' III:>XI’IzIw' I IIlI’l’l'. (Illf . I’ 110/ III In,»NH (/m f.:;: “ 12’“111 III’\ II"III I'I‘iIIiI'xl/llllflb' (.52"(’I MIC m1”: In mmxml’. III l'zII! MI'uiI'nns i‘i’ Ix’IIpIax.I:1.I1 g1 l’eIlCI Mix,- M; ,‘ .41}:FUN? IILIlIiiIII Suite: Health Palo Alto Medical Faundafian Patient Relations direct 831-458-5579 tollfree 88819504598 fax 831-475-2892 email ggmfizgfienrrelafl'gngflmmfizg Quality & Patient Safety Department PAMFGOO5138 lmsJ/resclWWCWWWIWHMONDFMMWHWUNDAwMDAxNTMEmZkZWM4YmZmV2MmZmd<0flJZDlAqYowN mas.1l2 012 202550queIAwnue Santa Cruz, CA 95062 HOWE 0F CONFID ENTIAUTY Trus 919: message mcluamg rammed and‘cv ofancmey wuk 9'0d Cod-Gems ariocmaum antmis. mamas Mormacon w'rcn rm. be con-Mama ws ncmxng an new NOEC'Mby stateam ieoaal Ian Vac a) me Hazw Insme For fiyam Accomm‘ ._ Ac. w, "emiazrxs ml This Is JIF'MDDE renewedonly by me rm: a a aganaanon namedmessee Hyou were mum m nu me 5 «253392 lo! vamnsruela rm 4. l. "7255399 In sum pason. a dzsdosen you may not L58. cooy. Sent: To: Palo All!) Medical Wednesday, PAMF Subject: Foundation Patient Relations 13-7244_Bravo! - WW WWI/EN message a any ‘nfiormt-sn comma: m the message From: November 06, 2013 2:35 PM Dr. Diana Blum What person(s) would you like to (all us nboul‘.’ Dr. Diana Blum The person(s) depaflmenl/loution neurology Please provide us details ol’how this person“) Dr. Blum wag always there to help me with my Parkinson Disasc‘ She took time to provided exceptional smiee to you. explain thing; to me, and help me‘ I met her alone ofthe meetings. at the Senior center, and asked her to be my docton which she immediately agreed Io‘ She will be missed. Name (optlonnl) REDACTED Email (optional) REDACTED 399M ,_ Copyright © 2011—2016 Cisco Systems, Inc. and/or All rights its affiliates. reserved. PAMFG005139 ”mamasdsco.comlarwelopeopenerlposoxedonflDFtX2wYTFjYTU2MDAwMDAxNTMEmZkZWM4Ym2mYzMxNmZmdOTIJZDIAUSQYobfiNO/mes., 212 012—002 Exhibit 32 Blum Dy. Dxana 418 \Wflow Rd, Marlo Pam. CA 94025 59‘ 6504604495; Fax 650-332-8345 Office Visit Note MRI. Paflent Nam anhe ume ofvxs'l Seen by Dana Slum, MD Date 01 Encounter: 061192016 Exam Reason (CC): Follow-Up - PD Probkm. Doped": Landau; 01Sncmei 1! 153m. Exam V 469m LnylngBP'HE; ‘53 53 Sufism: EP' {Hm/b, puma 58 vs GENCRP‘L: umfied Parkmson‘s D‘scase R.Ln_.: Scale Motor Exanur-azwn Speech ' Peas: Ema-amen 1 Trcmc' a! vast EU 0 Fit. 0 1x, 1| L.. 3 Acton OI Pasmmi T: RU 0 RL 0 LU 0 r'mgencp: R i L 2 Hand Movemams R 1 l 1 83‘v All Ham Movements K L ‘ Leg Agiluy R 1 l ‘. Arlyn: from Chan 0 Panama I Gum . H. - _..,~._. M... "hm/armrmnmmnmm mmvawmm W CONFIDENTIAL P1041 032 032 ‘ PosturalSiabmzy Bmay‘unesfia ' Yolal Score‘ 16(LCV—16)RigN5 L315 Complete MOCA was cone wday aw aauenl sawed 2530, ha mlssed ‘ mm! on wpwrg reczmgles than N be was In RWC Inmaa o! Menk) Part and mzssea 2 words on mean mougn he 90! mm mm a duo, he genmilcd 2 ‘5' words :n1 mum: Anusmem: Plan: Tami taoeh hue runs was 75 MW”, weaker than 50% wa| spent m mswsslon OhfiyeS as note: above Eleclrmcafly signec by Dana b‘lum. MD or. 064712016 7'59 am in rElma-mm.rr ”H h...“ .w .. )r'rwu' am, «um mmm‘moimunz-m’mnm ‘3‘ 2/2 CONFIDENTIAL P1042 032-002 032-002 Exhibit 3 8 Meeting with Dr. Blum Date: April 9, 2013 @ 12:00pm Location: Dr. Blum’s Office Members: Dr. Diana Blum Pat Smeekens, Clinical Manager Ai Galvez, Clinical Supervisor Topics Discussed: - clinical staff making reminder calls 0 Discussed with Dr. Blum regarding her request for her clinical assistant to make reminder calls a day prior to patient’s appointment. Explained to Dr. Blum that the organization’s Televox system sends out a reminder call and email to patients 3 days prior to their appointment. Reassured Dr. Blum that recent data found that calls have been going out to her patients. Management's request was for clinical staff to discontinue matting these calls. Calls will be made only to patients known to no-show or cancel. Feedback from the neurology staff was that patients were getting upset with the redundant reminder calls. Dr. Blum disagrees with our decision. States that Dr Cheyette has her assistant make these calls and that her no show rate has drastically decreased. Dr. Blum states that Dr. Cheyette was disappointed that management made such a decision and that she would contact us in regards to this. Dr. Blum did not receive our message well. Continues to push for assistant to make calls. Explained to Dr. Blum that assistant has other ciinicai tasks that reflect the right gob forthe right person. Dr. Blum remains resistant to this change wants to continue with reminder calls. . Telephone encounters workflow o Discussed with Dr. Blum to click into telephone encounter and to document response in patient‘s chart, then route encounter back to pool; rather than sending a repiy message that does not go into chart. Dr. Blum acknowledges this and will do this moving fonuard. . Paperwork prep 0 Discussed with Dr. Blum regarding the necessity/importance of paperwork prepared prior to patients appointment. Note that other providers in department to not require such forms. Dr. Blum states that forms are incomplete and are not being prepared. Proposed to Dr. Blum the possibility of minimizing or decreasing paperwork prep. Dr. Blum states the assistant consistently does not prepare requested PAM FGOOOO1 2 038 paperwork correctly. Notified Dr Blum would update form usage with PSR but we can not be certain that ALL pts will get forms. Asked her to be flexible. . Dr. Blum’s Response 0 After discussing items above, the remainder of the meeting was discussing Dr. Blum’s feedback for her assistant’s review. Dr. Blum expresses that her assistant’s speed was slow, was not anticipating her needs, and incomplete rooming standards. Conversation and attitude seemed reactive to discussions above. Management has received nothing but positive feedback from other MD’s and clinical staff in the department. Reiterated to Dr Blum that her MA is only working part-time much like her and she is catching up on things when she is working. Explained to Dr Blum that request for paperwork prep and her firmness that errors should not be occurring with paperwork, visit type, etc. is not always realistic. She needed to be more understanding. She felt the mishap are detrimental to her workflow and impact her day tremendously. PAMFG000013 038—002 Exhibit 42 Our World is Changing And so must we.” CONFIDENTIAL PAMF6004725 042 Some examples: PAMF lost 17,000 HMO lives last year PAMF is still excluded from narrow networks Blue Cross, Blue Shield and HealthNet refuse to work with us on shared savings Walmart announced it will send its employees to Mayo for cardiac surgery Safeway