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Evelyn presented to ER
Complaints of chestpain
Sometime in evening -
Admitted to ER by Dr. Thomas
Orders: GI consult; ultrasound -
Physical Exam and History Conducted by Dr. Smith
Admission paperwork shows "Surgeries: Gallbladder," past-surgical history = "cholecystectomy," signed by MD, family medical history says, "Surgeries: GB removed." (Admission paperwork #1, #2, #5) -
Period: to
Evelyn Roosevelt's Arrival @ All Saints Until Death
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Tests Conducted
- GI Consult by Dr. Roberts (consultation form's past surgical history says only "reportedly a kidney stone surgery")
- Ultrasound by Dr.Kennedy
- Cardio Consult by Dr. Germillion (bilirubin level 1.3) (see consultation form)
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Pre-operation
Hermatocrit level 36
Decedent seen by Dr. Sotomayor
Soto calls off gastroscopy
Jesse Roosevelt tells Thomas about prior gall bladder surgery -
Cholycestectomy
Dr. Sotomayor performs gall bladder removal surgery -
Post-operation
Kerry Roosevelt tells Soto about prior gall bladder surgery -
Sotomayor's Initial Consultation
Consultation Form: "Previous surgery: Kidney stone removal and left shoulder surgery." Physical exam lacks mention of umbilical scar. General section says patient in no acute distress (argue: non-urgent). Bilirubin level 1.2. -
Recovery from GB removal
Hematocrit drops to 26.9 Monitoring but pulse machine is wrong -
Complications
o Pulse drops to 40so Appears pale and weak, family requests manual checko No FFP (fresh frozen plasma) giveno Sotomayor + Thomas suspect GI bleedo Respitory complications o Renal failureo No treatment given until eveningo Lovenox stopped (Scalia 94:24 – 94:25)o Plavix stopped (Scalia 94)o Hematocrit drops to 19 -
Exploratory Laparotomy
o Soto does exploratory laparotomy o FFP admin’d o Soto called partner Dr. Oscar Meyer -
Supportive measures removed
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Decedent dies