PAST MEDICAL HISTORY: Per-op blood glucose is noted to be greater than 200. The patient asked for a medical consult/admission for further evaluation. Currently he denies chest pain and shortness of breath. No dysuria, no increased urine infrequency. Past history is significant for hearing loss in the right ear subsequent to an assault several years ago. Past surgical history includes a lower back surgery and the left ankle surgery.…
He is afebrile, with a heart rate of 130, and respiratory rate of 16. His general physical examination was unremarkable. He has no hepatomegaly, ______(..istic), or dysmorphisms. Peripheral pulses are normal. The comprehensive neurological examination then included testing of skull, spine, and meninges; cranial nerve ______; muscle mass, tone, and strength; sensation; deep tendon reflexes; and plantar responses was normal. The patient's tone was moderately high. Deep tendon reflexes appeared brisk, but with no reduplication. The patient did not visually fix on my…
SUBJECTIVE Mr. Hamilton was readmitted to MCCRC on 03/02 and seen on 03/05/2018. Mr. Hamilton had been here after a motor vehicle accident, leaving here with fractured ribs, pneumonitis, fractured sternal, and a complicated right acetabular hip fracture. He recuperated and was able to return home on analgesics. He was on amiodarone, Lasix, metformin, and glimepiride for his diabetes. He did not check his blood sugar, although I had advised him to do so.…
M.G., a “frequent flier,” is admitted to the emergency department (ED) with a diagnosis of heart failure…
Thursday, September 15th, 2016 at approximately 8:29 a.m., I Detective L. Donegain and Detective D. Johnson conducted a noncustodial interview of Devin McCall (white, male 4/20/1986 of 1201 Southwood Drive, Fayetteville, North Carolina 28304). The interview was audio recorded and is contained in the case file. The following is a summary of Devin McCall’s interview:…
In this case, Joseph Shepter was a patient in a nursing home in Mountain Mesa, California. He had spent his last two years at this nursing home due to being paralyzed from a stroke he had. He also had dementia that had caused to not be able to communicate. In January 2007, he died at the age of 76. Dr. Hoshang Pormir, the nursing home's chief medical officer, put the cause of death was heart failure due to clogged arteries on his death certificate.…
The patient is a 81-year-old female who presented to the ED after a fall several days ago. The patient when she fell was found by the daughter on the floor and was taken to the emergency room at St. Joe's, evaluated and then sent home and since that time the daughter has found that the mother is needing more assistance with dressing and ambulation and other simple chores. There is a definite change in her ability although prior to that she was somewhat limited. Her past medical history calls for a number of allergies, hypertension, dyslipidemia, and some anxiety disorder. The only things on the physical is that she very pleasant but confused. She is in no apparent distress. She is tachycardic, blood pressure is stable. There is no major…
Mrs. Julia Steel is a patient I have had the pleasure of meeting with recently. As discussed during the appointment, Mrs. Steel is a 72 year old retired, married woman. Collectively, Mrs. Steel's family history includes the following information: one son at the age of 40 who is being treated for high blood pressure, father's record showed background of heart disease and deceased at the age of 90 due to a brain aneurysm, mother's record provided extensive history with heart disease and deceased due to congestive heart failure at the age of 92, brother who passed at the age of 81 due to heart disease, sister at the age of 76 who has suffered multiple minor heart attacks. According to the biographical data collected, her family history exhibits a…
All of the interviews mainly favored keeping local authority for St. Luke’s under an affiliation. The interviews have disagreements that Sutter committed to keeping local authority at St. Luke’s. There were responses that Sutter would not leave decision making power to St. Luke’s, and other’s thought Sutter would leave decision making power. Thus, decision made by Sutter Health local boards is approved through its reserve powers. Therefore, capital expenditures by affiliates of over $1 million, budgets, bylaws, strategic plans, and nomination of board members are related to the decisions made. Sutter Health employees are senior hospital managers. However, there were concerns by some interviews that the agreement provides structure for reorganizing…
He was admitted to Flushing Hospital on 12/18/2016 with primary diagnoses of Infected Left Toe, Cellulitis, LT LE and RUE Gangrene, Osteomyelitis, and secondary diagnoses of S/P Partial 4th & 5th Ray Amputation, LLE Angioplasty, S/P RUE Angioplasty, ESRD ON HD ~ RT AVF – M/W/F, PAD/PVD S/P RT BKA W Prosthetic, HTN, DM W Neuropathy, and HLD. Resident is alert and oriented x3 and able to make all needs known. Resident uses a wheelchair to ambulate.…
This case is about Casey Martin, a professional golfer, which had a disability that prevented him from trotting across the golf course in a timely matter. Martin had a degenerative circulatory disorder that constitutes a disability under the Americans with Disabilities Act of 1990 (ADA) (Quimbee.com, 2015). “Passed by Congress in 1990, the American with Disabilities Act (ADA) is the nation’s first comprehensive civil rights law addressing the needs of people with disabilities, prohibiting discrimination in employment, public services, public accommodations, and telecommunications (eeoc.gov, 1990).” Martin requested for the PGA Tour, Inc. and others in association with company to make an exception in their rules to accommodate him using a golf…
daughter insisted on taking him to the ED for evaluation. After orienting him to the room, call light, bed controls, and lights, you perform your physical assessment. The findings are as follows: he is awake, alert, and oriented (AAO) \3, and he moves all extremities well (MAEW). He is restless, is constantly shifting his position, and complains of (C/O) fatigue. Breath sounds are clear to auscultation (CTA). Heart sounds are clear and crisp, with no murmur or rub noted and with a regular rate and rhythm (RRR). Abdomen is flat, slightly rigid, and very tender to palpation throughout, especially in the RUQ; bowel sounds are present. A sharp inspiratory arrest and exclamation of pain occur with deep palpation of the costal margin in the RUQ (positive Murphy’s sign). He reports light-colored stools for 1 week. The patient voids dark amber urine but denies dysuria. Skin and sclera are jaundiced. Admission vital signs (VS) are 164/100, 132, 26, 36° C, SaO2 96% on 2 L of oxygen by nasal cannula (O2/NC).…
Joe Lasicki requested a claims review be conducted of The Republic Underwriters Insurance Group (Republic) Workers’ Compensation program.…
REASON FOR CONSULT: Acute on chronic renal failure. Patient is an 87 year old Caucasian male who has a history of hypertension, severe peripheral vascular disease, chronic renal insufficiency, and atrial fibrillation. He was admitted yesterday for treatment of an infected toe. The plan was to obtain an angiogram to check patients’ blood flow; however he was discovered on admission labs to have acute on chronic renal failure, patient states he is unaware of kidney problems before. He states he is able to pass his urine without difficulty, no obstructive symptoms, no history of kidney stones, no urinary tract infections, no hematosis, no dysuria, and no diabetes mellitus. Patient states he has a history of hypertension, but it has been very mild. He has had trouble with vascular disease to both legs.…
Mrs J was brought to the orthopaedic ward after an elective left hemiarthroplasty. Mrs J was alert on admission to the ward postoperatively. She complained of pain of the operated leg. Baseline observations on admission were recorded as follows: BP: 100/72 mm of Hg, Pulse: 62 beats per minute, Respiration: 16 breaths per minute, Temperature: 36.8°C, SpO2: 97% on room air, thus contributing to National Early Warning Score (NEWS) of…