On March 12, 2015, Isabel Lainez went to the county’s Los Angeles County’s Edward R. Roybal clinic in East L.A. for help with frequent urinary tract infections that were making her incontinent and were not responding to antibiotics.
March 23, 2015: A nurse practitioner asks a urologist to evaluate and treat Lainez.
16 days from initial referral
April 8, 2015: A urologist asks the nurse practitioner for diagnostic tests.
Nov. 12, 2015: After seven months, the nurse practitioner responds. She indicates that the test results are attached to her message, but the urologist says he can’t see them. That’s where the exchange ends, according to Lainez’s medical records.
Nov. 19, 2015: A different nurse practitioner reaches out to a kidney specialist and informs her of Lainez’s urinary incontinence and lab results that show she has chronic kidney disease.
Nov. 25, 2015: The kidney specialist responds and says she will arrange for a clinic appointment. The specialist sets the appointment time frame for three to six months from then.
Feb. 4, 2016: Two months later, Lainez’s son finds her dead on the floor of his apartment. Her immediate cause of death is listed as chronic kidney disease. She was 61.
Sept. 13, 2016: About seven months after Lainez’s death, someone from the county’s appointment scheduling center tries to reach Lainez to offer her an appointment. The referral is put on hold because of a “bad phone number.”
In 2014, Priscilla Duong, then 32, was in the car with her husband when they were rear-ended on the freeway. Duong immediately felt pain in her back and neck, followed by numbness in her hands that worsened with time.
Nov. 2, 2015: A county nurse practitioner refers Duong to a neurosurgeon.
Three days from initial referral
Nov. 5, 2015: The specialist responds and approves Duong for a face-to-face visit.
Feb. 9, 2016: After waiting more than three months, Duong gets her neurosurgery appointment. At that visit, the doctor notes episodes of unsteadiness, falling and worsening numbness in her hands. To prevent her condition from deteriorating further, they decide Duong needs spinal surgery.
Sept. 9, 2016: After what Duong described as seven months of calls to the hospital begging for an appointment to have the surgery, she finally gets one, almost a year after her initial referral.
Majid Vatandoust, 49, went to the county’s Mid-Valley clinic in Van Nuys for a checkup in early 2014. He had unintentionally lost about 20 pounds, and tests found he was anemic and had blood in his stool, both early indicators of potentially deadly colon cancer.
April 11, 2014: A nurse practitioner puts in a request for a colonoscopy via an internal, email-like computer system called eConsult.
Three days from initial referral
April 14, 2014: A gastroenterologist turns down the request without seeing Vatandoust. She says the test used to detect blood in Vatandoust’s stool was “not valid for patients under 50 years old.”
June 3, 2014: The eConsult is closed, with a note that reads “patients needs addressed.”
June 29, 2015: Vatandoust returns with a persistent cough that isn’t responding to medication. A primary care doctor puts in another request for a colonoscopy, noting that Vatandoust still has blood in his stool and that his anemia has worsened. A specialist responds the same day and approves him for the colonoscopy.
Instead of continuing treatment in the county system, Vatandoust’s friend arranges to take him to Cedars-Sinai Medical Center, where doctors find a large tumor blocking his colon and tell him that the cancer has spread to other organs. He is told the cancer will kill him.
Aug. 23, 2017: Vatandoust dies of colon cancer. He was 52.