Risk Managers: Deny, Defend, Investigate Pt 2


Thank you. Is the statement I made going to be placed in my record? I would like to amend it to any one directed by your group to take my photograph or record my actions on public property.

Thank you,

Thank you. However, I politely answered the nurse when she went at least a great distance the staff door to initiate questions about what I was doing/intent/etc. on public property (not considering that I stated I was not a patient any longer, so why I was being asked such questions on public property raises motive questions) & was followed onto public property multiple times by the bariatric surgeon in another instance. I received a letter that contains incorrect facts, from my records, among other things. Most sad, considering I was extremely impressed by another group physician I met.

I do not have the information requested below regarding another source for privacy person , as They has not responded to my photography related request. Prior history shows a difference between published the medical group practices & practices per se. What practices can we expect from the Privacy office is what I am looking for from another source. The same can be said for you, especially as to why the medical group needs lawyers when I bring legitimate concerns, with no lawyer in tow, that have never been completely addressed, & you have been given multiple opportunities to do so.

Please see second paragraph below, they stated nothing could be done for me. If regular doctors can’t deal with/recognize it, an ER doctor would not either. None of the Nutrition Journals use bloodwork as main indicators since 2011 for malnutrition, nor did you when you made your medical assessment that I did not have malnutrition in 2013, compared to a physician I had a history with and medical research to support the assessment. Do you have further information on who has experience dealing with a complication of bariatric surgery since bariatric surgeon appears to not have, & non compete and “buddy” agreements don’t allow for care in the area from bariatric healthcare personnel? Or who doesn’t drop care when payments can’t be made, which is why a patient couldn’t make an office appointment, contrary to stated the medical group policy?

Because our bodies are very good at compensating during tough times, doctors have observed that blood tests and external measures of illness are inadequate: there are very few indications a body is about to go into crisis until the damage has already been done. Too many families find out only after a life-threatening or fatal episode how close a loved one was to death. In PCM, however, the lymphatic system can’t keep up with the leakage, and the stomach area begins to bloat with its own waste fluids.

Starvation can cause (amongst other things) low blood pressure and poor circulation; osteoporosis leading to possible fractures, deformities, and pain; anaemia; stomach shrinkage, leading to uncomfortable stretching and feelings of fullness when more than a small amount is eaten; increased blood cholesterol levels due to lack of oestrogen; nerve and muscle damage; low glucose levels, which may lead to coma; kidney failure; and death through heart failure.

Thank you,

Victoria Nicholls

Date: 5/5/2014 11:10 PM


I’ve started getting a higher temperature, burning up at times, legs cramping & chest pains, a lot of problems eating and tonight, couldn’t eat without pain. My skin is breaking apart, my MPV and platelets are high for me, indicating thrombosis. I’ve not been able to take medications since November because when the albumin is low, drugs have nothing to bind to and are free in the plasma, amplifying the effects. Some of my bloodwork is high/low for me, meaning the effects of malnutrition are starting to show in the bloodwork because I can no longer compensate for illnesses that weren’t diagnosed & my care disrupted.

Find me someone else who can answer the questions since I’ve been told there is nothing they can do for me. I’ll won’t make it through this because of the bariatric surgeon without any care in the area. They said that ‘if you don’t do as I say, I’ll put it in your record, and other doctors will see it, and wonder why’. They wanted to damage my relationships with other doctors. They succeeded. As an office person said ‘YOU’VE lost a huge chunk of your care.” She was right. I will pay the price for that, although I even asked that you do nothing negative to him, and I’ve seen that the suggestions I made regarding the practice were implemented.

All communications with non disclosure disclaimers won’t be honored, from now on.

On 5/5/2014 3:59 PM, Patient wrote to the group:
> that’s who I’ve been speaking with, (the Risk Manager), as I indicated in the email.
> I was looking for another contact. Do you have one?
> Thank you,

On 4/30/14

Risk Manager, you told me to contact Privacy Officer in reference to some privacy questions. I’ve never seen them answered. Who is the person above him that I can contact on the issue?

I can talk with another two groups on policy questions, & we not need lawyers, risk managers, or anything/any one else, & get them resolved in 2-3 days. One of those items was a mistake, the group admitted & we resolved it, without money being involved either.

Why wasn’t the the policy on photographs given to me as I requested? Or is there one? When will it be given?

My statement, to be put in my medical records, is that I did not give any approval (written or otherwise) for your personnel to photograph me. That includes when I am on public property and/or not for a medical purpose, & whether or not I am a patient of that person/group or not. I would also need to be informed by COB today if any photograph has been taken by your personnel under the circumstances just named. This is not only from the link I alluded to but I do believe I saw a nurse do it, while I was on public property. There can be no justification for this, and I’ll need to alert the community about it. There was one done once with my permission but that was more than 1.5 years ago. That is the only one.

Can you please give me the policy on wearing logo clothing on public property while not on official business? I have several of your other doctors I highly recommend to everyone. I know some personnel either as friends or good acquaintences who I respect. All trying to do their job ethically & responsibly. On their behalf, I would greatly appreciate it being brought up to someone in an admin position, that some actions, done wearing clothing indicating your employment, probably do not best reflect you as a healthcare business. I know the actions I saw & repeat to others do not reflect the dignity, personality, and maturity of people I deal with now.

Since I’ve not gotten answers from the Privacy group, or other topics I’ve asked about, I will be publishing my information/records/etc. on the issues. All I’ve seen or heard so far comes to the same conclusions that we do regarding the Bariatric group. You’ve had time to fix this. Now I’m having, among other things:

1) edema
2) skin issues
3) neuropathies that grew worse after a Nov 2012 doctors exam notes stating that, from medical research they were related to malnutrition
4) doctors asking me about why I’m not following up with the bariatric surgeon
5) reflux that is a problem and can’t be fixed, a known issue after sleeve surgery
6) blood work that is starting to change for the worse, skew more often, and I’m generally sicker
7) peripheral circulation issues

all with a tie in to malnutrition. I asked for the bariatric surgeon to deal with the issue, and it was not. Suggestions & questions, participating in my care with medical research/papers as the source, such as albumin infusions, etc. were met with a negative tone from the bariatric surgeon. I don’t have doctors familiar with albumin infusions, PICC lines or how to manage them after for malnutrition. Bariatric surgeon needed to take responsibility for the situation, as it got here because it was not dealt with while I was with him, nor when 2 doctors I was with sent me back to him, nor did the internist They refers people to. Including his choice to drop my care 2 days after filing alleged HIPAA violations & how the group benefitted positively regarding my suggestion of hiring another doctor, freeing the bariatric surgeon to work to TOL, a positive for your organization. Your responses have not been for me.

Maybe you could use all the medical research I’ve presented on recognizing bariatric surgery complications, if you haven’t been. Then it wouldn’t be just me educating people publically.

Certainly as bad as I’ve been getting, thanks to no care in the area and a doctor who didn’t diagnose issues in their own specialty that an FP & plastic surgeon figured out first, some cooperation would be appreciated. As I pointed out earlier, other groups & I seem to be more nimble in solving problems, but we don’t run to lawyers at the drop of a hat either.


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