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.
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 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