Dr. Cano: A Case Study

On 5/13/2015 I met with Dr. Navato at Centerpoint Medical Center. Dr. Navato was familiar with the complaint as she had submitted a narrative response to the BHA in February of 2015. The allegation was that Dr. Navato did not honor a (Do Not Resuscitate) order.

CM contacted Ms. Feliciano (parent) to inform her that CM spoke to the IIC and B.A. regarding Devin’s transition. CM and Ms. Feliciano discussed Devin progress since CMO opened and Ms. Feliciano agreed to transition Devin out of CMO and link him to outpatient at Hoboken Medical Center or Jersey City Medical Center. Ms. Feliciano is aware that Devin next meeting on October 7, 2016 will be Devin transition/ IEP meeting. CM informed Ms. Feliciano of IIC and B.A. clinical recommendations.

April 19, 2017. I was sitting at the front check-in desk, Mod J, Hematology/ Oncology. Patient approached the front desk stating he was here for his noon appointment with a Dr. Olinski. I told the patient we did not have a doctor by that name, but before we went any further, I asked what was his last name and last four so that I could look and see what he was referring to. When looking into the system, the only appointment I seen was for 6/5/17 with a Dr. Zhao in our clinic, Mod J. The patient stated he couldn’t remember who called him or where they told him to go, only thing he knew was the name Dr. Olinski. Not saying anything to the patient, I tired looking into the patients chart as he stood there looking at me, I looked in the orders,

This writer was called while in session by Nursing regards to the patient, who had a scar under her eye. Upon meeting with the patient, she appeared to be unease as she explained to this writer in a emotional tone that she does not want to be seen for a session as she is scheduled for a session tomorrow. When asked as to what happen under her eye, she stated that she fell down and tends to be clumsy. According to the nurse from the dosing window, she needs to contact the on call medical doctor to address the matter before dosing; however, the patient was unwilling to wait as she expressed the need to leave the clinic. This writer attempted to calm the patient down and asked her about her day, work, and readdressing the scar. The patient then

This is a complaint about the treatment my wife and I received from your Emergency Room physician, Dr. Skonieczki and two members the nursing staff. Over the past five years my wife and I have used the Wayne Memorial Hospital Emergency Room extensively, and have never experienced the level of discourteousness, and complete disregard for our feelings, in an extremely stressful situation, exhibited by this Doctor.

I received a call from Neely Muratet, RN, BSN; Transition of Care, Nurse at My Care Alabama regarding the patient’s pending discharge from the hospital. The patient has been accepted into Brookshire Healthcare Center, as reported by Neely Muratet, although he will not be discharged until the transportation to and from his dialysis treatment can be arranged. At this time he cannot receive his dialysis at Brookshire because it is a liability issue and they cannot provide transportation to his treatment because his appointment is at 5 AM and they do not provide transportation at that time. Neely reported that the patient will remain at the hospital until this can be worked out, additionally the patient’s status is declining and his kidney’s

Dr. Sandro Frasca has an office in Brooklyn, NY located at 6910 11th Ave. He specializes in Diabetic Foot Care and all Medical and Surgical problems of the foot. Dr. Frasca has over 20 years of experience in surgical and diabetic foot care. Dr. Frasca did his surgical training at New York Methodist.

After we received a report, we had to call doctor to clarify order on one patient, because the insulin was ordered Q4 HRS and finger sticks were ordered 4 times a day. Rasheeda called Dr.Krejci and attempted to explain the situation, but after a few minutes she just gave me the phone and stated “he does not understand, you explain”. When I completed a conversation

The type of anemia this patient has is Iron Deficiency Anemia. Iron Deficiency Anemia (IDA) has been revealed to be the greatest mutual foundation of anemia globally, and it is acknowledged that people with chronic kidney disease (CKD) progress to anemia as their kidney function deteriorates (Wittwer, 2013).

Conferring to the case study 1 of Ms. A, who is suffering from iron deficiency anemia. “People who experience iron deficiency anemia lack adequate iron required to produce hemoglobin. Hemoglobin supports red blood cells in carrying oxygen all through the body” (Mayo Clinic, 2014). In this presentation, the writer will provide rationales where Ms. A is presenting signs and symptoms of Iron Deficiency Anemia.

An increase in the reticulocyte count 7-10 days after beginning iron therapy can confirm our diagnosis of iron deficiency anemia and rule out other causes. The hemoglobin, hematocrit, red blood cell count, MCV, MCH, MCHC, RDW, serum iron, TIBC, transferrin saturation and serum ferritin values all return to normal at different times, therefore a CBC should be rechecked every 2-3 weeks. Mr. Cox’s

Adrian is a 32yo, G3 P2002, who is presently 22 weeks 6 days. She was initially seen for a history of Crohn’s disease with significant diarrhea. She has been unable to get into a GI doctor. We were able to make her a GI appointment and upon doing so, we learned that she had 2 other appointments scheduled by your office that she had reportedly “no showed” to; however, once we obtained the appointment for her we could not contact her to give her the appointment date and time and I feel that perhaps this happened from your office as well. At her visit because of her significant Crohn’s flare I started her on prednisone. She was also having extreme anxiety related to the constant diarrhea. I gave her some hydroxyzine. At today’s office visit

During this reporting period, I met with Mr. Holloway at his monthly physician appointment with Dr. Jenkins, Neurologist. I had an earlier conflict and met with Mr. Holloway and staff towards the end of his appointment. We coordinated his next appointment for October 11, 2017 at 10:30 a.m. Mr. Holloway reported he had difficulty with obtaining his medications again even at his new pharmacy Fraser Pharmacy. Mr. Holloway reported he didn’t obtain a full prescription and had an argument with the pharmacist. He wrote a letter to give to his attorney stating that he had mental distress to the point he was foaming at the mouth, he experienced muscle spasms and tightness to his right shoulder, panic attacks increased to having experienced 7 times.

Conclusions: It is pertinent to detect and treat subclinical iron deficiency in patients with CKD and to not over-investigate the minor haematological variations.

To assess hepatic iron overload, the current gold standard is quantitative iron analysis in liver biopsy specimens through atomic absorption spectroscopy. (12) Unfortunately, liver biopsy is an invasive maneuver and has up to 30% sampling error and so not recommended for follow up studies. (13) Serum markers as TSAT and ferritin is not a proper method of assessment of hepatic iron overload as it overestimates the stores. (14) Mueller et al at Heidelberg University has recently validated a sensitive and non-invasive novel device to assess hepatocellular iron using a room-temperature susceptometer. They compared and validated the results to liver biopsy iron quantitation. (15)