Veronica Woods



DEATH SUMMARYPatient Name: Putul BaruaPatient ID: 135799Room #: CCU-4Date of Admission: 01/07/2015Date of Death: 01/15/2015 at 0041 hoursAdmitting Physician: Simon Williams, MD, PulmonologyConsultants: J. K. McClain, MD, Cardiology; Trevor Jordan, MD, NephrologyThis 42-year-old gentleman was admitted on January 7, 2015 and expired on January 15, 2015. He was admitted with progressive tachycardia, hemoptysis, and dyspnea. Please see his admission history and physical exam for details.HOSPITAL COURSE: The patient’s hospital course was characterized by a progressively downhill course. He was initially hospitalized and found to be mildly hypoxic, which rapidly corrected with supplemental low-flow oxygen therapy; however, he gradually became more oxygen dependent on high-flow oxygen, eventually requiring intubation with mechanical ventilation in order to maintain his oxygenation. He underwent an open-lung biopsy in an attempt to delineate the etiology of his pulmonary situation, and this was reported as idiopathic pulmonary fibrosis and alveolitis. The specimen was sent to the Forrest General Pathology Department for further evaluation, and they were able to give no further help concerning the etiology of his pulmonary status. An echocardiogram showed left ventricular wall motion hypokinesia and an ejection fraction of approximately 35%.Dr. J. K. McClain and other members of the cardiology department consulted on the patient. They felt that his hypoxia and breathlessness were not secondary to his cardiac status. He had supraventricular cardiac arrhythmias, including atrial fibrillation and atrial flutter. The cardiology staff utilized intravenous medications that controlled the cardiac rate, adequately resolving these cardiac issues. I managed the patient’s ventilator and intensive care status along with my respiratory therapy team. Unfortunately the patient developed multiple (Continued)DEATH SUMMARYPatient Name: Putul BaruaPatient ID: 135799Room #: CCU-4Date of Death: 01/15/2015Page 2infections, hospital acquired, including Klebsiella pneumoniae infection and probable fungemia. Multiple evaluations of the sputum and lungs for the presence of active pulmonary tuberculosis were negative.The patient developed acute renal failure, managed by Dr. Trevor Jordan and his team of nephrologists via hemodialysis. Mechanical ventilation, hemodialysis, and a nasoduodenal feeding tube were completed in an attempt to provide further support; however, the patient continued to deteriorate. On January 15, 2015 at 0017 hours he became asystolic. Code blue was called. The patient underwent advanced cardiac life support with multiple medications. He failed to respond to the advanced cardiac life support and was pronounced dead at 0041 hours on January 15, 2015. Permission for autopsy was denied.FINAL DIAGNOSES:1. Idiopathic pulmonary fibrosis with alveolitis.2. History of tuberculosis.3. Acute renal failure.4. Hospital-acquired septicemia and fungemia secondary to multiple organisms._________________________Simon Williams, MD, PulmonologySW:vwD: 01/15/2015T: 01/15/2015 ................
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