DEATH SUMMARY

Patient Name: Putul Barua

Patient ID: 135799

Room Number: CCU-4

Date of Admission: 01/07/...

Date Of Death: 01/15/... at 0041 hours

Admitting Physician: Simon Williams, MD, Pulmonology

Consultation: J.K. McClain, MD, Cardiology Trevor Jordan, MD, Nephrology

This 42-year-old gentleman was admitted on January 7 and expired on January 15. 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 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 negative.

The patient developed acute renal failure, managed by Dr. Trevor Jordan and his team of nephrologists
via hemodialysis. Mechanical ventilation, hemodialysis, and the nasoduodenal feeding tube were
completed in an attempt to provide further support; however, the patient continued to deteriorate. On
January 15 at 0017 hours, he became asystolic. Code Blue was called. The patient underwent advanced
cardiac life support with multiple medications. He fails to respond to the advanced cardiac life support
and was pronounced dead 0041 hours on January 15. Permission for autopsy was denied.
DEATH SUMMARY

Patient Name: Putul Barua

Patient ID: 135799

FINAL DIAGNOSIS:
1. Idiopathic pulmonary fibrosis with alveolitis.
2. History of tuberculosis.
3. Acute renal failure and before hospital acquired septicemia and fungemia secondary to multiple
organisms.

Simon Williams, MD, Pulmonology

SW: hs
D: 01/15/
T: 01/20/...