Patient Name: Putul Barua
Hospital No.: 135799
Room No.: CCU4
Deceased: 01/15/2009 0041 hrs
BRIEF HISTORY: This 42-year-old gentleman was admitted on January 7th and died on January 15th. He was admitted with progressive cardiac palpitation, hemoptysis, and dyspnea. Please see his admission history and physical exam for details.
HOSPITAL COURSE: Mr. Barua’s hospital course was characterized by a progressively downhill course. He was initially hospitalized and found to be mildly hypoxemic which was 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 in 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 ideology of his pulmonary status. An echocardiogram showed left ventricular wall motion apocanesia and an injection traction 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 and atrial flutter. The cardiology staff utilized intravenous medications that control 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 pneumonia infection and probable fungemia. Multiple evaluations of the sputum and lungs for the presence of active pulmonary tuberculosis were...