Also see the farce of Blake Medical Center and medical records.

CONCURRENT RECORDS IS THE ANSWER - GET A COPY OF EVERYTHING IMMEDIATELY!
                                                            FAXED ON MAY 22, 2000  -   UNANSWERED by the Governor          

Dear Governor Bush:

I faxed you about the State of Florida's Agency for Health Care Administration (AHCA) on 16 December 1999.
Why you chose not to answer the letter I cannot understand.  You apparently referred the letter to Ruben J. King-Shaw, Jr.,  who wrote to me on 14 January 2000.
He stated that the complaint was "thoroughly investigated" by AHCA.  This is untrue.
Your agency did not investigate the false laboratory reports nor did they start the review of the heparin therapy on the 11th of January, (when it began) but on the 13th of January- two days later. 

My last letter went into detail, possibly too much to be adequately comprehended.  I will make this simple. It appears that you are in favor of the Wrongful Death Act, in which case your preference towards the savings of insurance costs for doctors over the insurance costs for insured workers would be clear (The insurance costs for potential patients must skyrocket, if health care is provided in the manner documented in my presented case of  Zoe and approved by your health agency).  You appear to offer the doctors and hospitals "carte blanche" in their policies regarding their patients, who are citizens and/or visitors to Florida.

If I hear nothing from you in ten working days, I assume, you agree with the above and following statements.  Any statement left unchallenged will be viewed as your interpretation of  justice in this matter.
According to the plethora of accurate and validated information presented, it appears that :
1. You agree that the AHCA can ignore evidence of falsification and suppression of critical laboratory tests (i.e., 11th and 12th of January).

2. You think it is correct for your agency to start reviewing the medical records for the complaint on heparin therapy two days later than when the therapy actually began (The apparent adverse incident occurred on the first night of admission and was not mentioned in Zoe's medical records.  The patient arrived at the hospital at around noon by ambulance in stable condition on 1//11/99). The heparin therapy began sometime after 1800 (unclear because of faulty if not fraudulent and suppressed records).  Zoe's critical condition due to heparin is not mentioned anywhere by the doctors or nurses in her records. 

3. You think it is proper for the agency to ignore evidence of fraud or total incompetence (laboratory reports missing/ altered, nurses' records false, false admission time to a false location, missing consultation reports and doctors' orders and reports, heparin records missing and not showing hospital heparin protocol being followed).

4. You think it is right for AHCA not to review and ignore a police affidavit, which specifically points out the state statute violations of the HMO hospital in question. (A copy thereof was sent to Ms. Weaver on 30 March.  She has not responded to my questions about what has been done about it since then, despite constant inquiries).
5. You think it is proper for AHCA to ignore their obligations under 42CFR431.115 (e)(3), the Freedom of Information Act. (Your office received an FOIA request from me on 17 March and has not yet given me the requested information). I am willing to pay the $100 charge to receive this information, but feel it is exorbitant and an attempt to make information unavailable to people in a less favorable financial position. {AHCA did give Carol some information, but nothing concerning her mother's records.  This should be available to Carol , but the Agency does not want her to get proof of the agency malfeasance or possible fraud}.

Mr. King-Shaw wrote that Ms. Sarantos wrote "a deficiency against the hospital for failure to provide safekeeping of the medical record,  since an outside force numbered the original pages of the medical record." This outside force was myself.  I numbered the pages, when I saw records disappearing and knew already the Physician's Orders had been altered.  I wanted to make it a little more difficult for the HMO hospital to further falsify the records and wanted to know, which records were being removed.
I believe all pages should be numbered and sealed, so that any change or missing record would be cited as a defect in record keeping.  This would make it difficult to remove or change written records and orders. It appears unconscionably apparent that you and your agency give leeway to allow the hospitals and their staff the possibility to falsify documents.

6. My question on page 6 of my 16 December letter  went unanswered: Is the entire agency corrupt or possibly inept to not follow through on its job description to protect the American citizenry and instead assigned themselves the task of protecting the American medical profession and institutions and health insurance companies against the citizens and patients, whom they are supposed to serve?
Or is the agency just following chief executive orders in suppressing criminal evidence of the "special interests" sector and possible campaign contributors? 
Your lack of  a response in this area appears to warrant a suspicion as to this possibility.

7. You agree that the medical record, which is obtained by an AHCA survey should not be used if it does not match up with the computer records, which were used by your agency for the survey. In other words, your survey team did not work properly in obtaining the medical record and should be cited or you give the hospital another chance to come up with different records to match the "closed records" used by your survey team.

8. You see no evidence of fraud, when original lab reports (seven pages from the hospital computer on 2/3/99 @ 10:16 showing all tests beginning at 13:15 hours on 1/11/99 are replaced with five pages of tests with varying beginning dates :
a) The hematology begins on the 14th, not the 11th. (printout time 0745 date 2/3/99) and chemistry begins on the 14th, not the 11th (printout time 0745 date 2/3/99)
c) coagulation tests begin on the 13th, not the 12th (printout time 0745 date 2/3/99)
(The heparin therapy began on the 11th, the MAR has a computer typed 2000 as start time; the nurse Bette wrote down 2200 without charting the dose in the MAR as required and in the Physician's Orders as required by the hospital heparin protocol).
d) The B12 test, which was originally listed as a normal Blake hospital lab @ 0500 is now listed as having been done by a private lab (SB in Tampa). (Why when in-house test capability exists? Certainly no confirmation of such an important B12 test is needed!) In the certified true copy of 12/11/99 is now found (Replaced computer printout from 12/2/99 @ 1544) a note to the
effect that the newly appeared B12 test was also done in Tampa (This note is found before the lipid serology explanations as if also this missing test would also have been performed there. In the copy provided by the hospital this was barely legible).
e) The Urinalysis tests of the 11th and 12th were missing.
f) The RPR of the 12th was missing.
g) The lipid test of the 12th was also missing.
h) The Microbiology Specimen summaries of the 11th and 12th were missing.
i) The cardiac injury profile is written as a patient summary report on 1/12/99, although the patient is still an inpatient at this time until 2/2/99. (From the last CK-MB value on 1/12/99 @ 0130 hours, if the doctors were at all concerned with the patient's health (heart), more tests should have been made (and apparently were and then suppressed).  The CK value upon arrival to the hospital was only 42 (too late for acute stroke therapy with r-TPA).  I allege the 1730 lab is fraudulent (CK value 521). (I was with my mother at this time.  No test was ordered or performed.  This value reflects the adverse heparin incident (possible CPR), which is not mentioned anywhere in the medical records of Zoe available to me)!
Effectively the tests showing the highly critical condition of the patient due to the heparin therapy were removed/suppressed!! (dates 1/11/99-1/13/99). Labs performed at 0500 on 1/12/99 were hidden.  Apparently, these are not the only tests suppressed or doctors' orders were ignored!

This major blood thinning therapy is performed many times daily at this hospital using the same hospital protocol, which brought my mother  into highly critical condition and possibly stopped her heart. 
{Carol discovered recently that the difference in names at the top of the suppressed laboratory report were of great significance.  One of the doctors in the header had not been with the facility, Blake Medical Center for over one whole year before Zoe's hospitalization.  AHCHA should have noticed this immediately!!  Yet nothing was found wrong during the agency investigation or preparation of the hospital, laboratory and follow-up care surveys.  How is this possible?}

{Carol has proof of contraindicated heparin still being given at Blake Medical Center (and probably elsewhere) and knows of at least one other instance of bad results, which appear to have been covered up.}


9. You agree that if the protocol is not working, as evidenced by delayed reporting of critical values and (non) corrective action, it does not matter. (Nurses and doctors should continue writing false reports (omission of facts must be considered falsification, since complications are required by the CFR to be documented)).
This hospital also tried to force the patient and her surrogate to consent to a stomach tube operation without having properly tested for its necessity.  No proper testing for swallowing capabilities was done before inserting the nasal feeding tube on 1/13/99 (Also no consent form was signed)!  The video swallow test was not performed until over two weeks after admission and showed the patient in no danger of aspiration (The week before shows elaborate "fraudulent" aspiration precautions and a concerted effort at forcing the patient's health surrogate to agree to the operation at a time when the patient was  in critical condition due to the hospital induced conditions (unmonitored drug mannitol in excess along with lasix and zero hydration  after the CHF and pulmonary edema on 1/16 and 1/17/99 resulting in hypokalemia and hypernatremia and near renal failure on 1/18, 1/19 and 1/20/99).

10. You agree that the hospital should continue pressuring stroke victims into unnecessary operations.
(One nurse said "They (the patients) all fail (the swallow test)!"  Filling the state treasury with money from unnecessary operations is more important than the patients' health (In my opinion, all operations may be dangerous).
11. You agree that your Health Quality manager Ms. Adler should ignore all questions about the survey (as she has to date) and not even enclose a copy of the survey results when she notifies the complainant that the complaint has been rejected.{Later, Carol received a peculiar survey report, which is possibly fraudulent using different facility names [expired fictitious names].

I am shocked at what I have experienced to date.  That "profit incentive" hospitals and doctors  would falsify documents to hide their wrong-doings is incomprehensible.
That the state agencies, which are in existence to protect the public ignore such evidence as provided is in my opinion unconscionable if not criminal.

Granted that if by chance I had not been given the computer medical records of 02/03/99 @  10:12-10:17, no proof of the heparin fiasco would be available.  (Probably, this is why Ms. Sarantos cited the hospital for not safekeeping the records. In a corrupt scenario the records,
apparently, should be fabricated to hide all problems, so that AHCA will be unable to find any defects).
However, "chance" did give us proof.  The  manipulated laboratory reports under number 8 above show obvious hospital insider manipulation.  Also on the left side of the Physician's Orders are obvious "medical expert" notations in red ink, crossing out records, with checks for removal of  notations, letters "EO" (edit out?) "UT" and/or "NT" (no test or unfavorable test ?), "MR", "UR" or "NR" (unfavorable or no record?), "MAR", "K" or straight line w/ "<" (This seems  to mean get rid of it or "kill" the notation.) 
I assume, these records are available, because I appeared at the Medical Records Office at about the same time as  the request for the Medical Records by the PRO (28 April 1999) and the hospital working copy  in haste was mistakenly put back in Zoe's records.  These records are the same ones which were picked up by the AHCA 28 June 1999 survey team for further review ("No Match" with the closed records  used by your survey - Ms. Barden's note?)  "Lets Discuss" :-Ms. Adler).

12. You agree that when obvious false records are given to and used by AHCA  and the agency is aware of the fact, no action (except discussion) should be taken!

13. You agree that when the medical records contain entries showing that the hospital and doctors violated the patient's rights ( Florida Statute 381.026 Florida Patient's Bill of Rights and Responsibilities),  that your health agency should ignore such information.

As mentioned above, if I hear nothing from you within ten working days, I assume you are in agreement with what I have written and I may use this information in conjunction with raising awareness  of the unbelievable health conditions  (Wrongful Death Clause and apparent Health Agency corruption and/or Incompetence in covering up the illegal actions of the "top 100" HMO hospital) in the beautiful tourist-loved sunshine state. Your agency is aware of ALL of these facts since I began my quest for justice.

All these facts (and a few new criminal actions) are known to you and your AHCA staff since my December letter to you.  If you are incapable or uninterested  in acting on this information within the year, the potential visitors and residents should be informed of  Florida's dangerous health laws and facility practices and the irresponsible health agency, which you head.
14. I am also requesting under the FOIA the survey report for  CR 2000-00136  of IHS (2-2-99 from Blake - 2/13/99 death at IHS).  I am also requesting  all documentation used in reaching the unknown findings for the unknown complaint of Ms. Adler's Tampa office.  I hope, you as the chief of AHCA will be able to arrange for the receipt of the information within ten working days.  90 days have passed since this survey, so there should be no problems in giving me this information.  I would also like the delinquent previous requested information for the request mentioned under point 5 above.{It is possible that there was no survey at all.  AHCA's head King-Shaw's  made one fake report to
SPCP about the wrong nurse in the wrong town with the wrong record. See
www.spcp4u.homestead.com and check out the link to Ruben King-Shaw Jr. (http://spcp2.homestead.com/kingshaw.html) . [See how he arranged for falsifications of documents to hide zero Agency action].   He was the AHCA head at the time of Carol's complaint under Jeb Bush.
          True to form, his brother, George, took Mr. King-Shaw, jr. along to Washington to manage all of Medicare/Medicaid. It is to be expected that this will be in the interest of corporations and not in the interest of the taxpayers or patients. }!

Thank you in advance for your efforts

Very sincerely,



Carol Stronstorff
Governor Jeb Bush ignores Patient's Rights  -                                  especially the Elderly
The following letter/fax [May 22, 2000] indicates how our Florida Governor has been ignoring the true case of Zoe E. Stronstorff, which indicates extreme Elder Abuse.
(It appears he sacrificed health safety and government funds to protect his corporate cronies (HCA  -IHS) and campaign contributing physicians.   Whether patients are abused does not seem to concern him.
Whether similar incidents could be avoided in the future also seems not to concern him).


This page was last updated on: April 7, 2005

(NOTE:  The red has been added for emphasis, but was part of the original fax.  The italizized blue notes are additions.
          Carol attempted to get an administrative hearing into AHCA's investigation.  She failed, because AHCA had no interest in having their actions investigated.  They denied her standing "with prejudice." {Her appeal to the Second District Court of Appeals [2D00-4076; LT 00-14FO]  failed w/ one word answers (affirmed/denied/stricken)}.
          The Florida Agency  certainly was not fair with Carol nor did it follow the procedures for investigating the Medicare complaint according to the federal State Operations Mannual [SOM}. 
          Carol spoke before Jeb Bush's Commission on Excellence in Health Care in August 2000 in Ft. Lauderdale.  Mr. King-Shaw was personally informed of the charges of fraud/falsification of medical records and the importance of accurate records for any evaluation of health care.  He was the AHCA head at the time of Carol's complaint under Jeb Bush.
          The Agency  under the new head is  still ignoring the case and protecting healthcare providers to the detriment of the public, especially the Elderly!          
Zoe's care  cost  approximately $100,000 ($66,000 hospital (3 weeks) and SNF $12,000 (11-12 days) plus doctors and laboratories.  Zoe had had a common stroke, which will affect many of us baby boomers and elderly in the following years (4 out of 5 families will be affected).  Her daughter was never informed about the availability of home health care. The health care was and the aftermath is a nightmare.


Also see the farce of Blake Medical Center and medical records.

CONCURRENT RECORDS IS THE ANSWER - GET A COPY OF EVERYTHING IMMEDIATELY!