The Incident- Medical Records
Physician's Notes from Emergency Dept
The Natural History of a Lawsuit
2/13/1999 St. Jennifers Med Center - Dr. Croaker Discharge Summary
Principal Final Diagnosis: Chest tightness, ventricular ectopy secondary
to electrolyte imbalance secondary to dehydration.
Discharge Summary: The patient was admitted with five minute episode
of chest tightness. This resolved very quickly once he got O2 when the
ambulance came. He did get sublingual nitroglycerin also. He had no further
chest discomfort. He had been having some ventricular ectopy and this
may actually have started off with chest discomfort. He had had vomiting
and diarrhea all week long with gastroenteritis and although this is improving
and has now resolved, he probably got somewhat dehydrated and his potassium
was up to 5.2 on laboratory study. I suspect that this then had an effect
on his overall cardiac status and caused ventricular irregularities. I
encouraged him to stop caffeine. I did give him nitroglycerin and discussed
how to use this. He will continue his Zestril 10 mg. daily and Glucotrol.
Follow up in the clinic in two days, for stress test sooner if any worsening.
He is encouraged to call 911 if he has chest discomfort again.
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