The patient is a 59-year-old gentleman who is a resident of Lincoln Park nursing home on hemodialysis end-stage renal disease, has multiplicity of medical problems including diabetes, hypertension, afib, anxiety, either schizophrenia and/or bipolar disease, coronary artery disease, peripheral vascular disease, had a below the knee amputation in 2015. The patient was referred to the ER from the Lincoln Park nursing home because of an ulcerated lesion on his left upper anterior chest over where a porta cath resided. My clinical review of his chart determines that the patient had no fever, no white count, no induration or erythema. He simply had an ulcerated lesion and the porta cath needed to be removed which was done by interventional radiology,
On Tuesday (October 11th), we are requesting Council‘s approval of a resolution authorizing the purchase of 1750 Grant Street (APN: 224-02-022).
Officers responded to North Scott Hall to investigate the report of a 19 year old male UW Oshkosh student checking in with an odor of marijuana on him. The male admitted to smoking marijuana and drinking alcoholic beverages. He was warned for Use of Marijuana and cited for Underage Consumption of Alcoholic Beverages (2nd offense).
Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.
Review of the medical record indicates that he had a MVA in 1977 with C4-5 injury that resulted in him been a Quadriplegic. Due to his bedbound and immobility status he has had multiple pressure ulcers over the years that have resulted in hospital admission and rehab stays. Other medical history include, HTN, hyperlipidemia, Sacral pressure ulcer, Right hip pressure ulcer, Constipation, depression. Bilateral arm contractures, bladder cancer, prostate cancer, urostomy and colostomy, aspiration pneumonia, neuropathy and MRSA.
PAST MEDICAL/SURGICAL HISTORY: As above. SOCIAL HISTORY: Status post heavy smoking, 50+-pack-year history. He quit 10 years ago. Status post alcohol abuse, quit 3 or 4 years ago. He lives by himself and no longer drives but has 2 daughters here in Miami who take him where he needs to go. FAMILY HISTORY: Patient’s wife died 14 years ago of COPD due to lifelong smoking. Brother has diabetes mellitus. Unremarkable family history otherwise. REVIEW OF SYSTEMS: No fever, no nausea, no vomiting. Patient has incontinence of bowel. No shortness of breath, no chest pain, no palpitations. PHYSICAL EXAMINATION: Well-developed, well-nourished white male who is alert and oriented x3. Wears bilateral hearing aids. Afebrile with blood pressure 130/70. NECK: No carotid bruits. LUNGS: Clear to auscultation bilaterally. HEART: S1, S2 normal. No murmur. No S3 or S4. ABDOMEN: Soft, nontender. No arterial bruits. No masses, no organomegaly. EXTREMITIES: No edema. No pulses present in the lower extremities. The right great toe is absent. The left great toe shows a 2 x 1 cm deep ulcer with redness around the toe with pus extruding. PLAN 1. Get consult with Dr. Beth Brian, Infectious Disease. 2. Follow up with Dr. Hirsch, Orthopedics. (Continued)
David Peterson will likely not be held liable for the actions of his son. Courts have determined that a person should not be held liable when an event is not reasonably anticipated. In Smith v. Allen, a child, age eleven, injured the plaintiff, age nine, while swinging a golf club that was left in the backyard by his father. The plaintiff claimed that the father was negligent and liable due to knowing the club was left outside, that his child would play with it, there was no warning against using the club, and improper use could lead to injury. The father demurred claiming the complaint was not sufficient. This demurrer was later sustained as the court held that the action was “not reasonably to be anticipated at all” making the father not
Patient is a 60 year old gentleman with PMH significant for CVA with residual left side weakness and speech difficulties, IDDM2, HFrEF (15% in March 2017 per cardiac Cath, and 32% per TTE 3/23/17 ), and CAD/MI s/p DES X 2 to the LAD (Tampa VA in 2012, 3/2017 at Florida Hospital), presenting initially to OVAMC on 5/19/17 with left hip pain after a mechanical fall at home. He had an MI in late March 2017, at which time he had a DES placed in the proximal-mid LAD (LHC also revealed a LV apical thrombus – 1.6 x 1.4 cm). His EF at that time was reportedly 15% per LHC, and it was suggested he get a Life Vest prior to discharge. Patient subsequently left AMA, without a Life Vest and without prescriptions (including the one
The patient, Ms. Wanda Johnson was treated Humana Hospital now Glen of Virginia for six weeks before
Columbia High School was using the Humanities to 1500 textbook for humanities course in 1975. In 1985, school designed the course textbook as Volume 1 of the Humanities for eleventh and twelfth grade students for optional and required readings. A portion of Lysistrata was read aloud in the class during the fall semester year. After that one of the parents objected to an English translation of the Greek dramatist Aristophanes Lysistrata and to English poet Geoffrey Miller’s. The Miller’s Tale from this textbook and the parent believed that the two works of art were too vulgar. After the parent complaint, the school board review the book and they decided to retain
In the past years Jackson have dealt with major decrease in profit, decrease in patient services and more. However, Jackson Memorial was able to keep a positive net income because of its non-operating revenue. Both income statement and balance sheets are analyzed and compared with Jackson’ competitors to show some of the improvements. In addition, several of the organization’s aspect are finalized, including corporate and business strategies. Although Jackson started to experience major changes such as increase in revenue, increase in patient services, as well as increase in Medicare and Medicaid patient revenue under the leadership of appointed CEO, Carlos A. Miyoga. Jackson entered into new related business lines to build new facilities and
On Tuesday August 30, 2016 a Male 63 years of age came into Christus Spohn South Heath Center with a diagnostic order for chest and rib x-rays. He was being seen because of chest pain on his right side due to a fall. He had an extensive patient history of x-rays that went as far back as 2014. For the year of 2016 he received approximately 12 different x-ray series. For example, on January 12, 2016 he received a chest 1 view image and cardiac catheterization. On May 21, 2016 he received a chest 1 view and a complete 4 view foot. On May 30, 2016 he received a cardiac catheterization. On June 1, 2016 and again on June 2, 2016 he received a chest 1 view. On June 10, 2016 he received a catheterization. On August 25, 2016 he received a chest 2 view. On August 26, 2006 an upper extremity without contrast. The patient also has a history of open heart surgery and receives dialysis treatments and is on oxygen.
Patient is a 45 yo male; 5’7”, 221 lbs who entered the emergency room at 6:30 am on 9/7/14 with severe chest pain (onset at 6:00 am) radiating to his arm, L arm numbness and nausea and vomiting. Past medical history reported by wife includes peptic ulcer, tobacco use (1-2ppd for 27 years), elevated blood pressure (controlled by lopressor). Wife did not know of any family history but reports patient’s father is deceased, died at 42 in his sleep. Mother alive and with high blood pressure.
The accused who is named Paul Kingston was convicted of failing to sustain a logbook which is mandatory from the section 190(3) of the Highway Traffic Act, R.S.O. 1990. This section of the act states that every driver shall maintain a daily log and shall carry it at all times while in charge of a commercial motor vehicle on the highway. R.S.O. 1990, c. H.8, s. 190 (3). On December 9th 2003 the appellant was pulled over in the Town of Sunderland, in the Region of Durham by Officer Constable Hominsky. The accused was driving a three-axle tractor and hauling a four-axle gravel container. After he was pulled over he presented the log book which was not updated then the officer requested him to update the book and after doing so it showed that the
A: Janie is a 60 year old Female with PMH of A-Fib, COPD, Hypothyroidism, HTN, Lung Cancer and recently diagnosed Pulmonary Embolism. Janie presents to ER for evaluation on SOB, cough with greenish sputum, sore thoart, hoarseness and generalized weakness. Janie lives at home with her husband, use to smoke ½ pack per week, but quit many years ago, denies alcohol or drugs. Family history is non-contributory. Allergies: NKDA. Differential diagnosis includes worsening Lung Ca, PE, COPD and CHF. Janie uses home O2 at 4 L/NC. V/S: T=98.7, HR=89, R=16, B/P=132/56, O2 sats=100% on 4L/NC, Pain=6/10. Labs: WBC=7.6, H&H=8.5/27, Na=141, Troponin=0.08/0.06, BNP=495, INR=4.2, UA=3+ protein, 1+ blood and 6-10 RBC. CXR: Impression:1). COPD with nonspecific coarsening of the basilar interstitium. 2). Mild cardiomegaly with borderline cardiac compensation. 3). Right