The Incident- Medical Records

Home

The Incident

Ambulance Run Report

ER Record

Physician's Notes from Emergency Dept

Dr. Croaker Discharge Summary

Dr. Croaker Physician's Order Sheet

Initial EKG

Dr. Croaker Progress Notes

Chest X-Ray

Dr. Croaker Lab

Nursing Notes

Morning EKG

Readmit

Code Note

Autopsy

The Cast

The Natural History of a Lawsuit

Legalities

Code Note

Time is arbitrary to maintain chronology.

Code Note; Patient is a 46 Y/O white male brought in by EMS. The patient was discharged from the hospital this a.m. and a short time later became short of breath and called for an ambulance. Upon arrival, the patient complained of shortness of breath but was alert and conversant. The patient was placed on the cart to bring to the ambulance and stated that the cool air felt good and he then became unresponsive. In the ambulance, patient was found to be asystolic and was given epi and atropine down the ET tube. Patient on arrival in the ER was asystolic and pupils were fixed and dilated. No pulse could be palpated. External pacer was placed. There was some pulse transmission, however, due to the patient,s large size it was difficult to palpate a pulse. Pressure did initially give a reading of 120/80 and he did appear to be perfusing. His blood pressure again decreased. He was given multiple doses of epinephrine including 5 mg. of epi. He was given atropine and was shocked at 360 joules times three. Despite all attempts, we were unable to maintain a perfusing rhythm. The patient went into a PEA and eventually no longer responded to the external pacer either. Cardiac compressions were begun as soon it was felt that the patient was not perfusing from the external pacer, however, despite all attempts the patient developed a PEA and went into an agonal rhythm. The code was called approximately forty minutes after beginning CPR and patient was declared dead. The case, because of the patients age and circumstances was referred to ME
2/14/1999 St. Jennifers Med Center - Dr. Mergent Outpatient Emergency Department Report Death secondary cardia arrhythmia.