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Progress Note Printed On Sep 09, 2008 impotence. We recommend that the patient have a s1z1ng of his prostate before proceeding with planning for seed implants. An appointment has been made for prostate sizing and we look forward to seeing the patient at that time. Thank you for referring this nice gentleman with this most unfortunate problem.
Progress Note Printed On Sep 09 2008impotence We recommend that the patient have a s1z1ng of his prostate beforeproceeding with planning for seed implants An appointment has been made forprostate sizing and we look forward to seeing the patient at that timeThank you for referring this nice gentleman with this most unfortunate problemes VASTHI J CHRISTENSENSigned 01 04 2005 14 53es RICHARD WHITTINGTONRadiation OncologistCosigned 01 04 2005 15 1401 04 2005 ADDENDUM STATUS COMPLETEDRev Flippin is a 63yo man recently diagnosed with T2a Gleason 3 3 6 PSA 7 04 CaProstate Metastatic W U not done due to low PSA and Gleason score notrecommended by ACR He has already done extensive reading on prostate cancertreatment options He has nocturia x2 and no other sx of BOO He has no riskfactors for proctitis PMH HTN no other significant PMH physical findingsas described by Dr Christensen We discussed treatment options includingSurgery brachytherapy and small volume ext beam RT We discussed the bladderand rectal irritative sx and the risk of proctitis associated with interstitialand external RT and contraseted that with the risk of incontinence associatedwith surgery We explained the risk of impotence is 45 with brachytherapy 60with surgery and 75 with ext beam RT We answered his questions and he hasdecided he wishes to proceed with brachytherapy We have scheduled in him fortreatment planning ultrasoundes RICHARD WHITTINGTONRadiation OncologistSigned 01 04 2005 15 21LOCAL TITLE NURSE SURGERY CLINICSTANDARD TITLE NURSING OUTPATIENT E M NOTEDATE OF NOTE DEC 29 2004 12 58 ENTRY DATE DEC 29 2004 12 58 13AUTHOR MARTINEZ DAMARIS EXP COSIGNERURGENCY STATUS COMPLETEDName FLIPPIN RICARDO CHALMUSAge 63 Sex MALEPatient has answered NKAPATIENT NAME AND ADDRESS Mechanical Imprinting If available VISTA Electronic Medical DocumentationFLIPPIN RICARDOPrinted at PHILADELPHIA PA VAMCProgress Note Printed On Sep 09 2008Seeds 79 totalScrubbed Drs Kao DorseyUrologYI cystoscopy Schwab MalkowiczNeedles 20Planned dose 160 Gy to prostatePatient was prepped scrubbed and anesthesized without difficultyUltrasound probe was introduced and proper positioning verified Needlespreloaded with iodine seeds were then introduced as per plan derived frommost recent sizing US Cytoscopy by Urology performed after implantationof seeds revealed no seeds in the bladder Followup monitoring by RadiationSafety also found no seeds lying outside of patient The entire procedurewas completed without difficulty orcomplication Anesthesized was reversed and patient taken to the RecoveryRoom in satisfactory conditionGary D Kao MD PhDlesl GARY D KAOSigned os 09 200S 11 13LOCAL TITLE DISCHARGE INSTRUCTIONSSTANDARD TITLE PHYSICIAN EDUCATION DISCHARGE NOTEDATE OF NOTE MAY 09 200S 10 S8 ENTRY DATE MAY 09 200S 10 S8 21AUTHOR SCHWAB C WILLIAM EXP COSIGNERURGENCY STATUS COMPLETEDPHILADELPHIA VETERANS AFFAIRS MEDICAL CENTERPATIENT DISCHARGE INSTRUCTIONSFLIPPIN RICARDO CDate of Admission May 9 200SDate of Discharge may 10 200SType of Discharge Regular Discharge to HomeDischarge Disposition HomeList of all diagnoses treated during this admissionAdmitting Diagnosis prostate caPrincipal Diagnosis sameOther Diagnoses HTNOperative Procedures cystolbrachytherapyPATIENT NAME AND ADDRESS Mechanical Imprinting if available VISTA Electronic Medical DocumentationFLIPPIN RICARDOPrinted at PHILADELPHIA PA VAMCFliPPIN RIr ARno fHllMFFF RA I r ON 11I T NOTF ORl141 OOA n n 1 rofP C RESS tlO II Pllyc l IAN ORDER I li 1 If IIJII jI t r J I f 1 1DIAGNOSIS tABS 0 CBC DlfF i J CEAJCHEM 7 0 HEPATIC FUNCTIONSCAlE 0 10 FILMS 0 CT ABD PELVISo Cf CHESTCHARACTER o PET SCANFREQUENCY o COLONOSCOPVTHE OHIO STATE UNIVER Il Y lftJu11111111111FlIPPIN RICARDO CCOLON RECTAL SURGERYPROGRESS NOTES AND ORDERSP W PTI IIIIIIJIIIIIMC201454 f I04Progress Note Printed On Sep 09 2008es Amit Maity MD PhDSigned 08 13 2008 16 1208 19 2008 ADDENDUM STATUS COMPLETEDInformation pretaining to 1151 claims process and the right to file anadministrative tort claim has been mailed to the veteran POC information forfollow up questions has been providedes SUSANN M KIRLINRISK MANAGERSigned 08 19 2008 11 39LOCAL TITLE RADIATION ONCOLOGY TELEPHONE NOTESTANDARD TITLE RADIATION ONCOLOGY TELEPHONE ENCOUNTER NOTEDATE OF NOTE JUL 15 2008 16 23 ENTRY DATE JUL 15 2008 16 23 36AUTHOR MASLOW JOEL EXP COSIGNERURGENCY STATUS COMPLETEDRADIATION ONCOLOGY TELEPHONE NOTE Has ADDENDAMr Flippin was contacted at work to discuss his treatment and potentialcomplications from this treatmentHe was treated in May 2005 and had a D90 calculated as 66 64 Per Mr Flippin hedeveloped bowel problems and thought that he had radiation proctitis andpresented to the CLarksburg VAMC and was then transferred to Ohio State Univ fortreatment for radation proctitics The long course of treatment resulted in jobloss and he stated he was bed ridden for 6 monthsWe discussed the fact that his case and others were being reviewed and that wewould request that he come out to Philadelphia once independent review oftreatment options were completed likely in 6 8 weeks or hopefully earlier Heasked whether the seeds from his prostate brachytherapy were causative for hisrectal symptoms and this was stated as posisble and that his case including seedplacement would be discussed at his visitesl JOEL MASLOW MDSigned 07 15 2008 16 3107 23 2008 ADDENDUM STATUS COMPLETEDInformation pretaining to 1151 claims process and the right to file anPATIENT NAME AND ADDRESS Mechanical Imprinting If available VISTA Electronic Medical DocumentationFLIPPIN RICARDOPrinted at PHILADELPHIA PA VAMCDEPARTMENT OF VETERANS AFFAIRSVA Medical CenterUniversity and Woodland AvenuesPhiladelphia PA 19104In Reply Refer ToAugust 15 2008Richard C FlippinCharleston WV 25311Dear Mr FlippinRecently a letter was sent to notify you that the care you received for prostate cancer at thePhiladelphia VA Medical Center was being reviewed As part of the follow up to assess yourtreatment a follow up CT scan was perfonned The results of the CT scan indicate that thetreatment you received did not meet VA s high standard of care You recently were notified bytelephone of this result and this letter is being sent to confinn that conversation We have alsoadvised your VA primary care physician of this fact and we will send himlher a copy of thisIf you have any further questions please call Pamela Devine RN in the Radiation OncologyDepartment at 215 to set up a time for your visitIncluded in this packet is infonnation regarding the filing of administrative claims and benefitsfor which you may be eligible If you have questions about the benefits or claims please callSue Kirlin R N Risk Manager at 215 ortoll free at 8 0 0 extensionI apologize for any inconvenience or concerns this may cause regarding the care that youreceived at the Philadelphia VA Medical CenterRICHARD S FACHEMedical Center Director