1)Does "not telling her" mean "not telling the doctor"?
2) Does "how to work the system" mean "how to exploit the loophole"?
Context:
A review of her medical records showed Greene carefully hid her pregnancy from her primary doctor. After a home pregnancy test showed she was pregnant, she told her primary doctor she needed to go to a gynecologist for a birth control. She then got prenatal care from
that doctor while
not telling her all the painkillers she was taking. She also skipped appointments with her primary physician when it was obvious she was pregnant and sent her husband to pick up her painkiller prescriptions, Barnette said.
"She was a nurse. She knew
how to work the system," Barnette said. "She caused the loss of that child."
MOre:
http://www.usatoday.com/story/news/nation/2014/04/04/breast-milk-baby-death/7303397/