SA services consistent with their contract?

[+] << Previous Topic | Next Topic >> Go back
Are SA's Services Provided Consistent With Their Contracts?
July 7 2007 at 11:56 AM Finance Department (Login Finance_Department)
Veteran Member
Replying here to Melody's "Context" post in the "Following on" thread, so it does not go off the right edge of the screen..

I think the bottom line on all this discussion about SA's recent CI case will focus on the question posed in the Message Title above. That will extend to a lot of areas and can only be discussed much until we see SA's case writeup, which should by now be forthcoming in less than a (small number of) weeks.

However, let us now take a look at the personnel provided for the case. Here is the protocol as outlined in the agreements between SA and CI and the member:

http://www.cryonics.org/SA/SA_Protocol.html

"When SA manages an SA-CI Standby it shall make best efforts to deploy team members as follows:

Team Leader, being an individual who has participated in at least three prior standbys.

Paramedic, Emergency Medical Technician, or similarly qualified individual able to intubate, establish an intravenous line, mix and push medications, and perform similar tasks.

Surgeon, with the capability to raise femoral (or other suitable) vessels, cannulate, and perfuse with blood washout
solution. Either the Team Leader or the Surgeon must be able to push meds, place the Thumper, assess vital signs, and perform other medically-related tasks.

At least two additional team members who have been trained in SA-CI Standby fundamentals.

No fewer than two team members shall be awake and as near the SA-CI Standby Recipient as possible during each 12-hour period of the SA-CI Standby, while the remaining team members rest in accommodations nearby."

Now we know already what calibre of personnel attended the standby and transport. Hardly consistent with the above requirements. The question remains: Did SA "make best efforts to deploy team members as follows"? I suppose they made some phone calls, and as Melody revealed to us, all the paramedics "on call" apparently have the right to decline. In this case all of them declined??

If the above scenario is correct, I say that SA's provision of personnel violates the stated protocol. SA needs to develop a system for the provision of the standby team, that does not give all of its members the right to "just say no". How about only half of them at any given time, having that right, and enough on call to make up a team? Including taking into account, of course, that some of the group might just say no anyway, violating their own contract with SA, so maybe a couple more members to take that into account.

Analysis and positive suggestions above, is what I am doing. Not trying to bash SA. If Mr. Kent reads this, I suggest he take into account that it is the same personnel situation that would service him (although I'm sure he would also get a bevy of the "inner circle" flying to his aid from all over the country, on a moment's notice}


Respond to this message
Author Reply
George
(Login George1st)
I say this very reluctantly, but...
July 7 2007, 4:06 PM

From what FD describes, it seems obvious that SA contract was violated. If it were not for a discussion here, probably no one would know about it. One individual did everything he could do to mask it, claiming even that SA “does now owe anybody on Coldfilter, the time of day”. Poor “customers” in dewars paid good money, but cannot do a thing about it. I hate to say this, but IMHO only government regulations and oversight will get this industry off the rocky bottom.


Respond to this message
cytosine
(Login cytosine)
Registered User
poor customers
July 7 2007, 4:47 PM

"Poor “customers” in dewars paid good money, but cannot do a thing about it."

About what? This patient got prompt cardiopulmonary support, cooling and a number of neuroprotective and anti-clotting medications. These are the core elements of standby, stabilization and transport.

As for the violation of contract, the contract says: "When SA manages an SA-CI Standby it shall make best efforts to deploy team members as follows..." How do you know that SA didn't make best efforts to deploy a team consistent with this contract?

At worst you can say that SA must have been naive to belief that they would be able to mobilize many of the people they contract with. That might be a valid critique.

Why do you think the government knows how to regulate cryonics? Look what happened to CI. The government made CI a cemetery (!) and forced them to cryoprotect their patients at a local funeral home. Now, that's progress!















Respond to this message
Finance Department
(Login Finance_Department)
Veteran Member
SA's Customers Should Not Be Paying for Naivete
July 7 2007, 8:17 PM

At worst, you say, I can say that SA has "naive" as an excuse?

Sorry. I said it before and I'll say it again: "SA's provision of personnel violates the stated protocol. SA needs to develop a system for the provision of the standby team, that does not give all of its members the right to "just say no"." And in case I need to spell it out for you more clearly, SA's failure to properly organize the availability schedule of their paramedics, does not constitute a valid exception to their "best efforts" requirement. "Best efforts" includes the advance preparation, organization and scheduling to be ready for a case. If they had given their best efforts, they would have had competent team members ready to go and say "yes" not "no".

And sure, I guess, although we haven't seen the SA CASE WRITEUP yet, the patient got some services from basically volunteer-level people, who hopefully had some training, though I've not seen any information about that yet. And those services are probably better than many cryonics patients have received, especially the ones delivered to the mortuary with nothing but ice packed around, or maybe not even that. That, however, is not the point. The point here is that SA was to provide a much higher level and quality of service, using medical professionals, and did not, in violation of their contract.

And no, I do not agree with George that "government regulations and oversight" are needed. All we need in cryonics is for people like Saul Kent to act responsibly and ethically.

FD


Respond to this message
Melody Maxim
(Login melmax)
Veteran Member
Re: SA's Customers Should Not Be Paying for Naivete
July 7 2007, 8:36 PM

FD,

I'm going to start calling you "The Voice of Reason" on this forum. Unlike you, I find it rather hard to keep my cool, when addressing the issues at hand.

As for the "volunteer-level people," these people earn much more than double a paramedic's salary, and none of them know what they are doing, in regard to medical procedures. I believe all of them earn more than $60K, and I know for a fact that at least one of them earns right at $80K, not counting taxes and benefits. (Again, they are not to blame for this, it was Charles who hired them and established their salaries.) For that amount of money, SA could hire a real manager and secure quite a few paramedics and perfusionists to take call on their days off from their regular jobs, perhaps even a few retired perfusionists. When is SA going to quit paying people to build Platt's designs and play on the Internet, and deliver what they've promised?

Melody


Respond to this message
Melody Maxim
(Login melmax)
Veteran Member
Re: Are SA's Services Provided Consistent With Their Contracts?
July 7 2007, 8:19 PM

SA PROTOCOL: “Team Leader, being an individual who has participated in at least three prior standbys.”

This was probably somewhat self-serving, on Charles’ part, as I believe he had been on exactly three standbys when he wrote this protocol. Does this requirement include only cases that were actually performed, or could it include cases, such as the Leary case for which Charles stood by, that never went down? I don’t really see the value of having “participated in at least three prior standbys.” A paramedic, or someone with surgical experience, and familiarity with the cryonics protocols would be much more valuable as a Team Leader. As a student, I observed a wide variety of procedures, but I wouldn’t attempt to perform most of them on my own.

SA PROTOCOL: “Either the Team Leader or the Surgeon must be able to push meds, place the Thumper, assess vital signs, and perform other medically-related tasks.”

This is a little vague. I have this image of two SA team members standing there, saying, “What?! I don’t know how to do that, I thought YOU knew how to do it.” One thing is for certain, the person who was reported to be the Team Leader on the recent SA case isn’t capable of performing these tasks, unless you want to count placing the Thumper on a dummy a few times.

SA PROTOCOL: "At least two additional team members who have been trained in SA-CI Standby fundamentals."

Training is difficult in cryonics, due to the lack of cases. How much can these inexperienced people learn at the SA facility? SA training sessions are few, and far between, and the instructor is a science fiction writer, not a medical professional. How many IV’s has he inserted? How many times has he performed CPS? How many times has he operated the perfusion circuit on a person? Gary, Kelly, and Ken have never operated the perfusion circuit on a person, or even an animal. Do people think this is something you can just walk in off the street and do? None of these three people had ever touched a patient, in any capacity, before this case.

FD: "Now we know already what calibre of personnel attended the standby and transport. Hardly consistent with the above requirements. The question remains: Did SA "make best efforts to deploy team members as follows"? I suppose they made some phone calls, and as Melody revealed to us, all the paramedics "on call" apparently have the right to decline. In this case all of them declined??"

There's no excuse for SA lacking a pool of qualified team members, with personnel qualified to perform each task guaranteed to show up for every case. What have they been doing for five years, other than building Platt's designs? Why haven't they established strong standby teams and done some real research in all this time???

FD: “Including taking into account, of course, that some of the group might just say no anyway, violating their own contract with SA, so maybe a couple more members to take that into account.”

The answer to this is to have a pool of paramedics, with someone legally liable if at least one of them doesn’t show up. You could do this with perfusionists, and surgeons, also. I had wanted to establish a group of SA team members who were REALLY trained to use the perfusion circuit to rotate call, with myself as the backup.

CYTOSINE: “This patient got prompt cardiopulmonary support, cooling and a number of neuroprotective and anti-clotting medications. These are the core elements of standby, stabilization and transport.”

How do we know this? We’re still waiting on the report, which is taking long enough to make me believe there might be some creative writing involved. Is the washout procedure not a core element of stabilization? Did this person have adequate perfusion with the washout solution, without massive air emboli, or some other catastropic perfusion-related event, occurring? I doubt it. At any rate, the person writing the report has told me numerous blatant lies. On the other hand, I’d trust the person helping him with my life, so I guess this balances out somewhere in the middle.

CYTOSINE: “As for the violation of contract, the contract says: "When SA manages an SA-CI Standby it shall make best efforts to deploy team members as follows..."

This is inexcusable. It’s like a surgeon saying he will make his “best efforts” to have a real anesthesiologist show up.

CYTOSINE: “At worst you can say that SA must have been naive to belief that they would be able to mobilize many of the people they contract with. That might be a valid critique.”

“Naïve” is too kind a word. “Negligent” is more appropriate. And the worst we can say is what I've already said: The contracts Charles wrote are sloppy and inadequate. Charles has surely been aware of SA's short-comings, all along, but he seems to feel threatened every time someone tries to change things to make the situation better.

CYTOSINE: Why do you think the government knows how to regulate cryonics? Look what happened to CI. The government made CI a cemetery (!) and forced them to cryoprotect their patients at a local funeral home. Now, that's progress!

I don’t think cryonics is ready for the government to step in, or vice versa, but there should be SOME kind of quality control. There’s not likely to be much self-regulation for so long as you have unqualified personnel making two, or three, times as much as they could earn working anywhere else, and most of the affiliated organizations involved are being paid out of the same pocket. (I just can't imagine most people who would typically earn $20,000 a year saying, "Wait, please quit paying me $60,000 a year, (or more), and hire someone who's better suited for the job." Who could blame them? It's the person who hired them who is to blame for this situation.)


Respond to this message
cytosine
(Login cytosine)
Registered User
Go West Maxim(um) Speed!
July 7 2007, 10:12 PM

Melody writes:

"Why haven't they established strong standby teams and done some real research in all this time??"

"Did this person have adequate perfusion with the washout solution, without massive air emboli, or some other catastropic perfusion-related event, occurring? I doubt it."

" At any rate, the person writing the report has told me numerous blatant lies. On the other hand, I’d trust the person helping him with my life, so I guess this balances out somewhere in the middle."

We have got a pretty consistent picture here. Alcor doesn't have a professional perfusionist willing to do remote cases either but....you can fix all that by becoming a member of their standby team! It's not very likely you will run into Charles Platt there. Alcor is also making progress to do real research again. And, last but not least, you will be able to work with your ex-colleague, Aschwin.

What are you waiting for?!





Respond to this message
Finance Department
(Login Finance_Department)
Veteran Member
Time for Saul Kent to Start Reading This Forum
July 8 2007, 1:17 AM

That is, if he's not already, which I doubt. It is time for him to recognize the absence of properly credentialed individuals to both run SA and to provide the services mandated for its customers.

I don't know Melody and she has not confided in me whatever negotiations for employment she might be doing, east or west. But I will say this. Kent should give her serious, objective consideration to fill in the gaping hole at SA. There appear to be a number of jobs vacant, most of which she sounds pretty qualified, if not overqualified to fill. It would be a real loss if she went to Alcor instead, where other problems prevail and would drown anything positive she might care to do.

That's all from here. Over and out.



Respond to this message
George
(Login George1st)
Hard Choices
July 8 2007, 2:08 AM

I do not like government oversight either. So far the industry has been relatively without major problems. I think that is largely due to the generous financial support of Saul Kent and a few others. It is not hard to imagine, for example, situation with SA without that money flow. Would that support end, it would not be a pretty picture and regulators could be compelled to step in.

As for “going West” it is easy said, but harder to do. Most people do not want to move half way across the country and live in the desert with summer temperatures 110 plus and freezing temperatures in the winter.

If Saul Kent does not read this forum, someone who knows where, could send him transcript.


Respond to this message
Finance Department
(Login Finance_Department)
Veteran Member
"Without major problems"???!!!!!
July 8 2007, 11:50 AM

George, you must be pretty new to cryonics and have not read its history.

I still don't think external regulation is needed, as in at least a lot of cases, the organizations and movers have learned from the problems and are not inclined to let them be repeated.

An exception to this is Alcor's cryopreservation of a celebrity, who never signed up or paid any money, on the application of a relative who had no money, so he was extended credit for several months, a perk the ordinary Alcor member does not enjoy. Alcor has yet to repudiate this policy, the Board is silent on it, when instead they should be publicly affirming that it was a mistake that will never be repeated. It would help Alcor's public image a lot if they did so.

Once there was an idea floated around of a policing organization made up of representatives of all the organizations. Unfortunately it seems that the attitude of competitiveness, especially shown by Alcor lately, prevailed and it never saw the light of day. As the organizations grow and mature, so will the individuals in them and this will be more likely to come about.



Respond to this message
George
(Login George1st)
History Repeats Itself Occassionally
July 9 2007, 10:54 AM

FD: “George, you must be pretty new to cryonics and have not read its history.
I still don't think external regulation is needed, as in at least a lot of cases, the organizations and movers have learned from the problems and are not inclined to let them be repeated.”

COMMENT: I am following cryonics a few years and I am aware of the problems it had. But, I am also well familiar with the history of the nursing industry in the sixties and seventies. The conditions in nursing homes were appalling. Fraud and abuse of patients were common everyday’s events. Patients had no medical care, but medicare and medicaid were bilked out of millions. It got to the point when government was compelled to act. Even special prosecutors were appointed a dishonest operators of nursing homes were prosecuted. In the end, situation in nursing homes considerably improved. Today, probably no one would want government oversight of nursing homes to end.

FD: “An exception to this is Alcor's cryopreservation of a celebrity, who never signed up or paid any money, on the application of a relative who had no money, so he was extended credit for several months, a perk the ordinary Alcor member does not enjoy.”

COMMENT: Personally, I think it is unreasonable, that an organization should require that for everything promised should be paid up front. If, for example cryopreservation costs 150,000 Dollars, I thing advance payment of at most 50 percent should be enough, with balance due after, from the estate, or insurance proceeds. Should that not materialize, the cryonics organization has more than enough to cover the expenses. Few ordinary people have spare 150,000 Dollars to pay for something that in the future they may, or may not have the opportunity to use. It looks like the business model of Donald Trump is being applied, rather that of Henry Ford.

Of course, I agree that there should not be preferences, or perks, which the ordinary members do not enjoy and requirements should apply evenly to all.

As for the recent SA case, whether, or not, malpractice occurred will not be probably known until reanimation is attempted. As someone pointed out, malpractice can occur in any field, cryonics are not exempted. However, in the cryonics field it might be more difficult to establish what kind of malpractice occurred.



Respond to this message
Melody Maxim
(Login melmax)
Veteran Member
Re: Go West Maxim(um) Speed!
July 8 2007, 9:17 AM

CYTOSINE: What are you waiting for?!

To be honest, I've actually been waiting for SA to get out from under the influence of Platt and make some much-needed changes. At some point, I realized this wasn't going to happen without other people knowing what is, and isn't, going on there, but I most likely have burned my bridges over the course of my "public awareness" crusade. The SA facility is just six miles from my home, so it was convenient for me to work there.

My husband is well-known within the toy design business, and our best friends, who are the designers of famous toys such as "Tickle Me Elmo," "Furby," and "Skip It," along with dozens of other successful inventions, live within a few miles of us. Because of the proximity of these inventors, the major toy companies, (and a few minor ones), send reps here, for regular "Show 'n Tells." We often collaborate with our inventor friends on projects. It would be hard for my husband and I to give these thing up, as his inventions are the major source of our income.

In addition, I grew up in central Florida, and most of my family is here. If I need to go somewhere, or want to take a vacation, my sister and my mother are always willing to take care of my sons. My sons are 12 and 14, and we have a beautiful home in a really great neighborhood. It would be difficult to give up all this. As much as I would love the opportunity to work in cryonics and with Aschwin, again, I'm afraid I'm anchored to Florida, for the time-being.

CYTOSINE: "We have got a pretty consistent picture here. Alcor doesn't have a professional perfusionist willing to do remote cases either but....you can fix all that by becoming a member of their standby team!"

A few people have suggested I work with Alcor, but thus far, Alcor hasn't asked me to. I do exchange some technical information with them. I'm not being paid to do so; I do it because it's interesting to me, and I am learning, too. I'm willing to discuss being on Alcor's standby team, but I'd want to review, and possibly revise, their washout circuit, first. Maybe if they'd fly me out and put me up at that nice hotel they used for their conference, I'd be willing to go over the circuit and do a little perfusion training.

Finally, me going somewhere else wouldn't stop this war. For as long as SA is advertising medical services they can't properly provide, I will be raising a ruckus about it. I didn't come to this forum in search of employment; I came here to try to make people aware of what is going on, and to try to change things at SA. Platt may be able to pull the wool over one man's eyes, but I don't think he can fool the world, (even the relatively small world of cryonics).



Respond to this message
Finance Department
(Login Finance_Department)
Veteran Member
Malpractice or Not
July 8 2007, 11:51 AM

As most of you know from my past posts, my background is business, and that is the perspective from which I look at cryonics and its assorted organizations. That is why, for example, I have little to say about perfusion circuits, but a lot to say about an organization's finances and contracts.

I will say this much about the "medical" procedures, though -- I think that Melody's characterization of some of them as "malpractice" is harshly exaggerated. As I believe she pointed out herself, it can't really be malpractice if it is performed on someone who is legally dead. Plus, there are no officially established medical procedures for cryonics. Maybe there should be, and one day there probably will be, but we are totally pioneering here at the moment.

In cryonics cases, you do what you have to and can do, with what you have to do with. Bodies arrive in all manner of condition and lapsed time. Not even SA should be accused of malpractice, for trying to preserve a patient as best they can in a situation. That doesn't mean, though, that they are off the hook for failing to provide proper staffing ahead of time for the higher level of service using medical professionals, as is provided in their contract.

I hope they get better marks for other things we don't yet know about because there is yet no SA CASE REPORT. For example: did the team have all the meds and equipment along with them, that is specified in the contract?

We'll see.


Respond to this message
Melody Maxim
(Login melmax)
Veteran Member
"Malpractice"
July 8 2007, 12:24 PM

Admittedly, it's difficult for me to be less than "harsh" in my criticisms of SA. In my own defense, I tried to change things, nicely, for quite some time, before getting to this place of frustration and anger. "Malpractice," is just a term I use when I believe a medical procedure is being performed improperly. I think the patients should receive the best care possible, even if they are "legally dead," and I don't think SA has provided for that.

FD: In cryonics cases, you do what you have to and can do, with what you have to do with. Bodies arrive in all manner of condition and lapsed time. Not even SA should be accused of malpractice, for trying to preserve a patient as best they can in a situation.

These are valid statements, but SA has had five years and somewhere in the neighborhood of six million dollars at their disposal. They've also had some good advice, (not just my own), much of which they have chosen to ignore. In my opinion, they should have a well-established standby team, with a number of qualified team members for each necessary task, by now.



Respond to this message
filterpatrol
(Login filterpatrol)
Re: "Malpractice"
July 8 2007, 3:54 PM

"Malpractice, is just a term I use when I believe a medical procedure is being performed improperly."

I think you use it for rhetorical effect. When someone neglegently violates basic precepts of a field, that is malpractice. Failing to cool quickly when means was readily available to do so would be cryonics malpractice. When someone doesn't get the best care that is theoretically possible, such as perfusion by a mortician rather than a medical perfusionist, that is substandard care, not malpractice.

Even "substandard care" assumes that standard exist, which is something that people and organizations in cryonics often disagree about. You yourself disagree with the importance of rapid cooling, which I always thought was a "standard of care" of cryonics.

"I think the patients should receive the best care possible, even if they are "legally dead," and I don't think SA has provided for that."

Who in cryonics has?

"SA has had five years and somewhere in the neighborhood of six million dollars at their disposal. They've also had some good advice, (not just my own), much of which they have chosen to ignore. In my opinion, they should have a well-established standby team, with a number of qualified team members for each necessary task, by now."

And what of the other organizations that have had more than 30 years, and even more millions of dollars during that time? Could it be that the personnel, equipment, and logistical needs of cryonics are more difficult to meet than you think?


Respond to this message
George
(Login George1st)
Did SA deanimate?
July 12 2007, 2:40 PM

Did SA deanimate?

Melody Maxim: "SA has had five years and somewhere in the neighborhood of six million dollars at their disposal. They've also had some good advice, (not just my own), much of which they have chosen to ignore. In my opinion, they should have a well-established standby team, with a number of qualified team members for each necessary task, by now."

COMMENT: After such prolonged discussion about SA capabilities (or lack of them) and their possible violation of contract with their customers, no one from SA bothered yet to answer any of it. The promised report on their recent case did not materialize as well. It surely cannot satisfy their paid customers. If it continues, it will look as if SA deanimated.

filterpatrol: And what of the other organizations that have had more than 30 years, and even more millions of dollars during that time? Could it be that the personnel, equipment, and logistical needs of cryonics are more difficult to meet than you think?

COMMENT: Well
Veteran Member