Patient Name: Putul Barua Hospital No. : 135799 Room No. : CCU-4 Admitted: 01/07/2010 Deceased: 01/15/2010 at 0041 hours Admitting Physician: Joshua Stephen Gatlin, MD This 42-year-old gentleman was admitted on January 7th and died on January 15th. He was admitted with progressive cardiac palpitations, hemoptysis, and dyspnea. Please see his admission history and physical theme for details.
Mr. Barua’s hospital course was characterized by a progressively downhill course. He was initially hospitalized and found to be mildly hypoxemic, which rapidly corrected with supplemental low-flow oxygen therapy; however, he gradually became more oxygen dependet on high- flow oxygen, eventually requiring intubation with mechanical ventilation in order to maintain his oxygenation. He underwent an open-lung biopsy and 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 Mayo Clinic 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 injection fraction of approximately 35%. Dr Cecil Burnett and other members of the cardiology department consulted on the patient. They felt that his hypoxemia and breathlessness were not secondary to his cardiac status. He had supraventricular cardiac arrhythmias, including atrial fibrillation in 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 infections, hospital acquired, including Klebsiella pneumoniae infection and probable fungemia.Multiple evaluations of the sputum and lungs for presence of active pulmonary tuberculosis were negative. (Continue) Student Name: Jagoda MiljkovicCase No. Student Number: 20785247
Patient Name: Patul Barua Hospital No. : 135799 Deceased: 01/15/2010 at 0041 hours Page: 2 The patient developed acute renal failure, managed by Dr. Rex Keating a nephrologists via hemodialysis. A temporary tracheostomy, intravenous dialysis catheter, and gastostomy tube were placed in an attempt to provide further support; however, the patients continue to deteriorate. On January 15th at 0017 hours he became asystolic. Code Blue was called. Patient underwent advenced cardiac life support with multiple medications. He failed to respond to the advanced cardiac life support and was pronounced death 0041 hours on January 15th. Permission for autopsy was denied. FINAL
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