I am a 35 year old mother to fraternal twin girls. I am a law student in pursuit of making significant changes in the representation of children and parents in family law. I am an advocate, having volunteered and assisted in trials in the Superior courts of California, reviewed thousands of pages of medical records, and helped countless families with a CPS case navigate the system.
My true passion is dependency law! Prior to law school, I obtained my (BSHA) Bachelors of Science in Healthcare Administration. This allowed me to work for multiple teaching hospitals in Southern California. My 15 year experience in healthcare ensures that I stay up to date and compliant with physician and nursing documentation. I am a nurse. I got licensed with the state of California in 2010. I have an amazing, supportive husband, this allows me to take on these complex projects, and change the system, one family at a time.
Experience
My 15 year career in healthcare includes working for;
KECK Medical Center of USC
Norris Cancer Hospital
Dignity Health Facilities; CHMC, NHMC, GMH, SMLB
Los Alamitos Medical Center
Long Beach Hospital
Home Health Care
I have experience working with multiple attorneys on record review in the areas of civil rights and juvenile dependency law.
I was afforded the opportunity to work as a trial assistant on a 12 day WIC 366.26 trial in 2024, as well as the subsequent appeal in 2025 in Fresno County, California.
https://www.linkedin.com/in/tatyana-batrak-61308930/
Education
LVN -Licensed Vocational Nurse, (#251492), 2010
BSHA - Bachelors of Science in Healthcare Administration, 2018
JD - Law Student, 2023 - 2027
Certifications; Forensic Nursing, Internal Compliance Auditor, Medical Law
Beyond working in Healthcare
When my husband and I were blessed with fraternal twin girls in 2020, I had spent a decade building my career in healthcare. I was a nurse who just finished her undergraduate in Healthcare administration. I considered myself significantly knowledgeable in this ever evolving field. Little did I know, that decade was just the beginning. Our beautiful twin daughters were born on September 1st, 2020. As with most twin pregnancies, our girls spent a few weeks in the NICU (Neonatal Intensive Care Unit). We were blessed to deliver our twins at Northridge Hospital, which happens to be where my husband works. Our experience with Northridge hospital was amazing, and after gaining enough weight to get discharged, our girls came home! When our daughter was six months old, she developed pleural effusion (fluid around the lungs), which manifested as congestion and fatigue, similar to that of a flu. We took her to the emergency room when her symptoms did not resolve. This was in March of 2021. We were in for the ride of our lives!
Our daughter was transferred to UCLA Mattel Children's Hospital and subsequently, admitted to diagnose and treat the pleural effusion. Our daughter was ultimately diagnosed with Chylothorax, a condition that perplexed us as well as the UCLA specialist team. Chylothorax is often diagnosed in utero, and measures are taken immediately after birth to manage the condition with medication or, in rare scenarios, surgery. However our daughter was six months old and had absolutely no lung issues at birth. UCLA engaged their specialist time to take a multidisciplinary approach to diagnose and treat this issue. Time was of the essence because part of treating Chylothorax is placing the child on NPO status, i.e. withholding all food and water and placing the child on TPN, total parenteral nutrition. To put this simply, she was getting fed through an intravenous line in her hand.
Concurrent to the child being placed on NPO status, chest tubes are surgically inserted bilaterally to promote the drainage of the chyle (milky bodily fluid consisting of lymph and fatty acids). In most cases, if the oral intake is eliminated, the Chylothorax resolves on its own. The second line of treatment is administering Octreotide, a medication that is often used in the management of Chylothorax due to the reduction of lymphatic fluid flow. Unfortunately, for our daughter, neither treatment worked, which left the medical team with more questions than answers. The next step was conducting a lymphangiogram to visualize the location of the leak, and if possible, remove the blockage that's causing this fluid to essentially "back up" around our daughter’s pleural cavity. We consented and the team carried out two lymphangiograms both of which required sedation for our tiny, fragile baby.
The specialist team at UCLA kept us very involved in our daughter’s plan of care. We were at her bedside every single day, working in her hospital room while our family helped watch our other daughter. We asked a lot of questions, measured her chest tube output. Contrary to our experience with the specialist team, our experience with the hospitalists at UCLA was vastly different. The hospital team on the pediatric unit began running multiple tests. Our daughter was seen by infection control, endocrinology and genetics. I remember seeing three to four residents come in and assess her, document a visit in the chart, and walk away without being able to answer any questions we had. I thought to myself, its been two months since her admission. The hospital is doing blood draws and chest X-Rays every single day, which was concerning on its down due to the exposure for a baby that only weighed 8 pounds. Additionally, our daughter developed an oral aversion due to the length of time she was admitted on NPO status.
In the meantime, my husband and I were receiving a staggering amount of medical bills. Being an auditor by trade, I reviewed our itemized bills and learned that we were being billed $500 every time a resident documented that they saw our child. There was no diagnostic work-up done, I don't even remember physical exams. These bills were submitted to our insurance company daily, while our daughter sat there with tubes draining fluid from her body, with no improvement for 2 months. We realized it was time we advocate for our daughter and demand that the hospital operate, as that was the only option left. She had been NPO for months, had a failed regimen of Octreotide and two lymphangiograms that identified the blockage, but were unsuccessful at removing it. We told the hospital that we wanted our daughter to get the surgery. We understood the risks which terrified us, but we did not believe that this delay in intervention was in our daughter’s best interest.
The specialists respected our request and scheduled surgery a week out. After hours of worry and fear of the unknown, the surgeons came out and said it was "50/50". They did a thoracoscopic duct ligation. While they were able to visualize the thoracic duct, they were only partially certain that they were able to ligate it. All we could do was wait and see if the output of the chyle decreased, so we did. Two weeks later, our daughter got discharged! The operation was a success. Her recovery was amazing, with the exception of the new problem - the oral aversion. We were thrilled that the specialist at UCLA helped our daughter and left the hospital in the best of spirits, promising to send photos to the pediatric team, who grew to love our daughter.
The Second Admission at UCLA
When everything changed...
Our daughter came home and less than 72 hours later, she was admitted to UCLA, again, through the emergency department. We were told upon discharge that she is still healing, and some pain and general discomfort can be anticipated. We noticed that her thigh had slight edema but after observing her for a few hours, we realized that there was something going on with her leg. Our daughter had only been home for two days, she was getting fed through a feeding tube so her movement in general was rather limited. I remember sending her surgeon a text message, alerting him of these symptoms. I was advised to bring her back to UCLA, perhaps it was a case of cellulitis, which is not uncommon in children following a lengthy hospitalization. We took our daughter back to UCLA, where she had just been discharged a few days prior.
We went through the emergency department, where the team took an x-ray of her leg and immediately told us that it was osteomyelitis, which is an infection of the bone, which explained her swelling. We informed the physician that she was just discharged from this hospital a few days ago. We were told that this was something that must have started at the hospital, since osteomyelitis takes time to develop and symptoms are seen within 7-10 days following the infection. We were told that due to the severity of the infection, our daughter would have to be re-admitted to UCLA Children's Hospital and treated with intravenous antibiotics. Frustrated and confused, we agreed, but we had an abundance of questions for the treating team.
This hospitalization was more tumultuous than her first, I lost track of the amount of clinicians that frantically checked her while clearly avoiding contact with us, her parents. This was the same team that was treating her at the prior admission. When we began asking questions, such as; "how did our child develop a bone infection during her admission?"
Once I realized that the hospital team was acting rather strange and refused to explain how this could have happened, I immediately requested access to our daughters "mychart". This allowed us to see all documentation, laboratory studies, interventions and on-going consultations, with the exception of some that we later learned were hidden by the hospital, who knew this patient's parents worked in healthcare. While our daughter was admitted, receiving a number of intravenous antibiotics to heal a bone infection, my husband and I, after multiple requests received roughly 6,000 pages of medical records from her original admission. Being a nurse, I immediately looked at the labs. I learned that just days prior to our daughters discharge, her platelets were significantly elevated, as well as her inflammatory markers. I've worked in healthcare long enough to know that labs are always reviewed prior to discharging a patient, as these values indicate whether or not the patient is stable enough to go home. Once I found a few red flags, I decided to conduct a full line by line audit of my daughters stay to find out what really happened during her admission at one of the best children's hospitals in Southern California.
While I audited my daughters medical records, my husband submitted multiple requests to a department called "Patient Experience". This department acts as a liaison between the patients and their families and the hospital team, especially when there is a concern with the care being provided or a barrier in communication with the treating team. Our emails and calls to Patient experience were ignored and we later learned that they had been instructed to forward any communication from "us" to the legal team. We sat in our daughters hospital room from 7 in the morning until 8 pm, at times later. We saw every person that came to assess her, every time she allegedly got physical therapy and feeding therapy.
At this point, the bill for our daughters 3 month stay at UCLA children's hospital was 3.5 million dollars, but one thing was clear - the information documented in the medical record was grossly different from the actual care our daughter was receiving.
What we learned....
- Our daughter's lab results 2 days prior to discharge clearly indicated that her body was actively fighting an infection
- The treating team failed to get consents for multiple invasive procedures and failed to produce any of these consents upon specific request.
- The Orthopedic team documented that the saw my child and evaluated her leg, given that she was there for decreased leg movement. They later admitted that it was the resident who saw our daughter, the physician overseeing that resident signed this note and agreed with his findings without ever physically seeing our daughter.
-There was an attempted PICC line insertion at the exact location of the osteomyelitis, which was terminated due to pain. This information was documented in the record but denied by the hospital.
-Due to her hospital acquired oral aversion, our daughter needed feeding therapy. While observing one of the sessions, we found that the therapist failed to follow the proper procedure for food storage and safety when attempting to feed/encourage feeding of our daughter.
-Multiple physicians collectively adopted another providers "running diagnosis" which led to contradictory findings and treatment plan outcomes.
-Our daughter's medical record was compromised after a nurse failed to lock the computer upon exiting her room.
-A note observed and documented by the parents was deleted when the team was questioned about it, the charge nurse confirmed that the change was made by one of the nurses, while we were still speaking to the attending physician.
-The hospital then refused to follow the proper process by filing an incident report, instead stating, they would re-train the employee.
- The circumferance of our daughters leg, which was monitored for healing, was documented incorrectly. The nurse then re-measured it and changed the measurement.
- Our requests to conduct a biopsy to identify the cause of the infection was denied on the basis that it would put the child at a greater risk of infection. She already had an infection and failed to respond to antibiotics for 3 weeks.
- UCLA Children's Hospital staff failed to review records from the transfering hospital, which led to failure to discover material facts about her treatment.
-It was further confirmed that these records were sent and UCLA was in receipt of records since the day of admission.
The Possibility of Liability
Despite a lengthy battle with the hospital, the system, and the courts, the hospital refused to take any responsibility in initially misdiagnosing our child and discharging her with an active infection of the bone.
So where's the liability?
The irony in our complex case was that an expert witness retained on our behalf, actually worked with UCLA, yet he disagreed with his colleagues "opinions". The truth is; you as a parent are legally entitled to having the ability to ask questions, make suggestions and be fully engaged in your child's care. This is your right. Sometimes, when a parent asks a lot of questions, people panic. They get defensive and it’s a natural part of the instinct of self-preservation. So when an entire pediatric unit of residents, fellows and nurses panic, it takes away from the most fundamental aspect of the organization - patient care.
Our daughter went through so much and it goes without saying that we are beyond blessed. She is a healthy, spunky 4 year old who does not stop talking (like her mom).
As parents we tend to blindly trust that if our child is in a place with some of the best medical professionals, they are safe. The goal is always to discharge the patient in a better state, than they were admitted. I feel that for a children’s hospital, that's the most integral piece that when missing, can cause a world of trouble.
Parents should not have to follow their child's care in their medical record. They shouldn't have to find that the measurements being taken by skilled nurses, are incorrect. They shouldn't have to and often cannot be at the bedside for months on end making sure that the people billing for conducting an assessment of their child, actually did it. They shouldn't have to, because these types of things should not happen. We are taught to trust the doctors, the healthcare system and the process. The truth is, this does happen.
Once our daughter was home and healthy, having seen more specialists than I care to recall, I realized that there is a much bigger problem, and its not confined in the walls of our home or the walls of the treating hospital, its a systemic issue. We tend to forget that doctors are humans, people make mistakes. The true tragedy occurs when parents are railroaded because they asked too many questions. I soon realized just how many parents had the same issue, to some extent, with other facilities. They had no experience in healthcare and medical records looked like a foreign language. It overwhelmed them, which is what the hospitals expect and why liability is rarely established.
After our ordeal, I decided to go back to school to get my law degree. In the meantime, I want to help parents, attorneys and people in general get a fair, objective review of medical records, especially if there is a suspicion of misdiagnosis or acts/omission that fell below the standard of care.
I've been auditing medical records for 15 years, I speak the language, I know the tricks. I've been there, I know what to look for.
Disclaimer: This website is not an attempt to practice medicine or law, or provide specific medical or legal advice and it should not be used to make a diagnosis or to replace or overrule a qualified healthcare provider's judgement or licensed attorney's legal opinion.