DialysisEthics2 hack

[plugger]

Hi, I should re-introduce myself.  I’m the father of a daughter who was on dialysis back in 2000 (transplant now – I was the donor).  I became active in working for better dialysis when I came up with quite a list of concerns: http://www.dialysisethics2.org/index.php/our-concerns/88-fact-sheet-2007.  The reality of the the dismissal of patients (http://dialysisadvocates.com/patient-stories/) was also an incentive to keep on working for many a year (2000 -2012 were very active).  But lately I’ve been content to be a caretaker of the past history of kidney dialysis with the site http://www.dialysisethics2.org/.  Highlights of all this activism came for me in 2007 and 2012 with passage and renewal of a Colorado state bill for the certification of kidney dialysis technicians.  Audio of 2012 renewal: Colorado-House-of-Representatives-hearing: http://dialysisethics2.org/open_images/audio/coloradoga_02_21-2012_hearing.mp3  Colorado-Senate-hearing: http://dialysisethics2.org/open_images/audio/coloradoga_senate_2012.mp3

That is I was content until the dialysisethics2 site got whacked by a hacker.  My forum is now down and I found davita propaganda in one of my web folders.  Who would do such a dastardly deed?  At first I thought it might be someone from what I’ll call the old davita: http://www.5280.com/magazine/2012/09/strangest-show-earth – not kent thiry of course, but someone like him, an underling, a disciple.  Someone who just LOVES that bottom line - which good patient care often gets in the way of.  I’m thinking of things like proper patient/staff ratios, proper training for staff, longer and gentler treatments, single-use of dialyzers, and a no-dismissal of patients policy.  I like to think though there are people of a New Davita though who love what I just mentioned and aren’t blinded by just the bottom line.  I know I’ve made stabs at getting Warren Buffett (a major shareholder) to clean up the place (hey, I can only try), hope at least he has become aware of what has been going on with the scandals davita has seen.

Ok, my first reaction was it could be someone inside davita who took a whack at my site.  But then I got to thinking what about outside of davita?  Who could hate my site enough that they would knock it down and then try to frame davita?  I came up with a name from my ancient past, someone I knew from the early 2000’s, someone who didn’t like our collection of anti-reuse studies (from the likes of John Hopkins, National Institute of Health, University of Pennsylvania, etc…).  Someone who would throw his mother under the bus for a dollar.  I dare not speak his name, I’ll just call him g.p..  He was quite the reuse advocate (because he was paid to be) and never let things like facts get in the way.

4/12/2017 Reuse article now at:
http://www.dialysisethics2.org/index.php/reuse-is-abuse

[Charlie B53]

Thanks for the link to your site.  You can bet that I will read EVERY word, and every link.  I can tell already you and I are much the same, when we don't like something we want to do something about it. I will not only read everything but I will begin to help spread the word.  Proper Training and Certification is very necessary to ensure all of us received the quality care we need to stay as healthy as possible.

I agree, hacking your site is a dastardly deed.  I hope you can track down the offender and they be dealt with harshly.

[Riki]

I fail to see the point of this post

[Michael Murphy]

The problem is the moronic myth about hackers, the bottom line is they are thieves and crooks.  If I see a house I don't break in to show the owner that they are vulnerable.  I have ran systems in places wit weak security and some where it was done right.  Rvery time one of these yahoo was caught they were surprised that they could end in jail.  Report the hack its amazing what a good forensic systems person Can learn from examine the remains of a system.  That's why the first step is a complete backup of your system the second step is call the police.

[plugger]

I can tell already you and I are much the same, when we don't like something we want to do something about it. I will not only read everything but I will begin to help spread the word.  Proper Training and Certification is very necessary to ensure all of us received the quality care we need to stay as healthy as possible.

I agree, hacking your site is a dastardly deed.  I hope you can track down the offender and they be dealt with harshly.

Back when I felt the urge to do something and I was fortunate enough to fall in with a group of people who felt the same way.  Got handed lemons but decided to make lemonade with this hack, thought I could make a few more people aware of the history of this field of medicine (those who don't know their history are doomed to repeat it) - and maybe get a few more people off reuse.  I should have the forum back up soon with it's anti-reuse studies.  But in the meantime a person from beyond might be saying "Dont' be me".

Betty Allen: http://www.dialysisethics2.org/open_images/flyers/Betty%20Allen.pdf

I do have backups and will get to them shortly, my web skills are a little rusty but I will manage.  I did pull out my access logs and will see what I can do about tracing the jerk who has woken me from my slumber.

[plugger]

And if anybody wanted to read the Betty Allen article:      http://blog.mlive.com/chronicle/2008/10/a_deadly_error_routine_dialysi.html

[Simon Dog]

If you have the funding, consider Armor hosting (armor.com).   I have had great experience with their protection of one of my more critical web sites.

[plugger]

If you have the funding, consider Armor hosting (armor.com).   I have had great experience with their protection of one of my more critical web sites.

I must admit I've been a bit lax with my updates, apparently the school of "if it is working, don't fix it!" doesn't work well for websites.  When I get some time I'll look into that armor.com.

But getting back to matters, I sincerely believe there is a New Davita out there that wants to do the right thing - who is in charge at the denver palace anymore I don't know.  But this incident did make me recall years ago I had questions for the old davita: http://www.dialysisethics2.org/open_images/flyers/12%20questions%20for%20davita.pdf
  I'm just wondering if there is anybody out there who remembers the history of the old davita who could answer them?

[plugger]

I can tell already you and I are much the same, when we don't like something we want to do something about it.

Hi Charlie,

I thought you might be interested in something that is going on now: http://sd33.senate.ca.gov/news/2017-02-14-senator-lara-proposes-dialysis-patient-safety-act-raise-standards-life-saving-care.  If you or anybody is interested in getting involved in this sort of thing, I can start by giving you a short template on how we got our 2007 bill here in Colorado through.

1) Started writing letters-to-the-editor about what I was seeing going on in the dialysis industry

2) Through the above I met a lady on dialysis who was also unhappy with what she was seeing in her clinic, and she knew others who were equally unhappy

3) Started volunteering for a candidate for the statehouse I could believe in and writing other reps about the problems I was seeing.  When the candidate was elected, one of the first things he did was introduce a bill for tech certification and get my State Senator on board.  He also managed to find more people to testify for us (not sure how he did that).

4) We met another group down in Denver who also had been working on tech certification and we joined forces

5) We had people like a retiring dialysis nurse also join us

6) We seemed to breezing through until we hit the state senate health care committee.  DaVita showed up with a clinic manager, a PCT, and a patient (must have been drugged).  They talked about what a whiz-bang company davita was  .  I could see my State Senator up there working on the committee chair - it worked and we got out by one vote!  The Senate floor vote was another cakewalk.

7) 2012 renewal - a cakewalk

Oh, and I'm working on getting the dialysisethics2 site totally functional and updated - things seem to be progressing (knocking the rust off)

[Jean]

Hi Plugger, and welcome back. I have been on IHD since early 2008 and I think I remember you. there was a bunch of us that went on chat and I think you were one of that crowd. We were a great group and had a lot of fun times. If this is you, then double welcome back!!!

Hugs
Jean

[plugger]

Thanks!  I always loved this board.  It reminds me of DialysisEthics at it's beginning, we were a tight group back then too!  This board has done an excellent taking over for those of us that just need that venting thing.

[SKS]

Florida has some very poor requirements for Dialysis Techs - if you can call them that as far as I've been able to determine - we are snow birds from Ohio and my SIL trained there and was a DT until she ended up with health issues.  I know they have a state test and continuing education requirements.  Little did we realize how great our center there was until we got to the center in Florida.   I've been told here that one can walk in off the streets and train on the job.  We are going to try to find a way for my husband to have dialysis appropriate to our situation that doesn't include: poor training; poor attitude; poor cleaning of equipment as we've seen at the center here.  3 swipes of a chair, cleaning the machine (or what passes for it) while patient is still in the chair beside; taking 30-45 minutes getting started after going to chair and  being hooked up for 15- 20 minutes or more after machine goes off. are just a few of the problems at current center.   I only wish I had the time to become an activist in the cause of care in Florida but with all the health issues in our lives currently I'm going to have to rely on a couple of letters and contacts - Glad to have the suggestions listed above.

[Simon Dog]

One question I would like to ask  both DaVita and Fresenius:

"What policies do you have in place that limit equipment/supply prescription/use; treatment schedules; or medication prescription that require the attending MD to obtain permission from a P&T or similar committee, and what prescribing guidelines to these policies establish?".

The two I know about at Fresenius are filters above a 180 and paracalictrol instead of calcitrol.  I also know Fresenius requires you sit in the chair for 4.5 hours before you get a 200 filter that might get you a full treatment in 4 hours.

When you are being prescribed something, it is nice to know if it is because your MD thinks it is the best available, or simply the best (s)he is allowed to get you.

[GA_DAWG]

While new to this site, I have been on dialysis for 5 years. The center I attend has been a really good one judging by the comments concerning others. That being said, it is obvious that cost cutting has become rule number one. All of our techs are good and their main focus is the patients. Of late, the clinic manager, supposedly on direction from corporate, has been making one bad decision after another concerning care. Techs are sent home at every possible time, regardless of the ability of the remaining techs to attend to patients. We have many patients who are unable to hold their own sites, or unwilling as is the case with some. That leaves those who DO hold their own sites sitting for long periods of time waiting to have needles pulled. Further, I do not mind waiting for those who have run their full time, but waiting for those who want off early and demand to be put ahead of those who ran their time, I have a problem with. Due to the lack of techs because of sending some home, this becomes reality though. It is not the techs fault, but rather decisions made over which they have no control.

[Simon Dog]

That leaves those who DO hold their own sites sitting for long periods of time waiting to have needles pulled.

Learn to pull your own needles.   Seriously.     This will probably take an approval from your MD and formal "Training" since medicine is like the military - you don't know how to do anything until you have been officially trained.

I am a home hemo patient, but travel several times a year and use clinics when doing so.   I have never had any objection to my starting or pulling my own needles, though one clinic did ask me to wait until all the techs could form a semicircle in front of my chair to watch me do the insertion.

Once the machine disconnect is done, it's my game.    The techs generally thank me, and get right to stripping the machine while I do the needle pull and bandaging.

[plugger]

Florida has some very poor requirements for Dialysis Techs - if you can call them that as far as I've been able to determine - we are snow birds from Ohio

It is sad to see how quality of care varies from state-to-state and clinic-to-clinic - and add onto that how the for-profits seem to face a greater headwind!  (got to get those numbers)  I understand how it is to be busy, can only do what you can, when you can.

Ohio, eh?  I grew up there, I do miss it in the fall - great colors!

[PrimeTimer]

My husband uses a Fresenius clinic. For the most part, he likes the staff. He says there is one tech that everyone says is mean but he has found her to actually be very good. She just isn't all warm and fuzzy but he feels she is very proficient and takes her job seriously so he gets along great with her. There is one tho that he refers to as "the burnout" who has worked in dialysis several years and who is always asking out loud for everyone to hear "is it time to go home yet?". A patient with 15-gauge needles stuck in their arm never wants to hear that someone is in a hurry....What I don't like, is that they tend to use my husband as the guinea pig for the new ones who are still green. They always choose him because they say he's not a complainer. Well, that's true but it just so happens that no matter what, he's a very quiet guy. You would never know if he was upset with you or in pain. So it's not so much that "he's not a complainer" but rather, it's just not in his nature to speak up or out. 

[Charlie B53]

Sounds a lot like my Fresenius Tech.  I try hard to make her laugh, barely get a smile.  But she knows her business. I don't know how many years she has, but she did tell me she put in 8 years with DaVita before starting at Fresenius.

My cath doesn't like me to move, talk, or breathe even, it alarms so easily.   A number of times she has told me I need to stop breathing.LOL  At least she says it with a smile.

[plugger]

I did get those studies up on the DialysisEthics2 site - and I did have a little more to say: http://www.dialysisethics2.org/index.php/reuse-is-abuse