DEATH SUMMARY

Patient Name: Putul Barua

Patient ID: 135799

Room No.: CCU-4

Date of Admission: 01/07/

Date of Death: 01/15/ at 0041 hours

Admitting Physician: Simon Williams, MD, Pulmonology

Consultants: J. K. McClain, MD, Cardiology; Trevor Jordan, MD, Nephrology

This 42-year-old gentleman was admitted on January 7 and expired on January 15. He
was admitted with progressive tachycardia, hemoptysis, and dyspnea. Please see his
admission history and physical exam for details.

HOSPITAL COURSE: The patient’s hospital course was characterized by a

progressively downhill course. He was initially hospitalized and found to be mildly
hypoxic, which rapidly corrected with supplemental low-flow oxygen therapy; however,
he gradually became more oxygen dependent on high-flow oxygen, eventually requiring
intubation with mechanical ventilation in order to maintain his oxygenation. He
underwent an open-lung biopsy in an attempt to delineate the etiology of his pulmonary
situation, and this was reported as idiopathic pulmonary fibrosis and alveolitis. The
specimen was sent to the Forrest General Pathology Department for further evaluation,
and they were able to give no further help concerning the etiology of his pulmonary
status. An echocardiogram showed left ventricular wall motion hypokinesia and an
ejection fraction of approximately 35%.

Dr. J. K. McClain and other members of the cardiology department consulted on the
patient. They felt that his hypoxia and breathlessness were not secondary to his cardiac
status. He had supraventricular cardiac arrhythmias, including atrial fibrillation and atrial
flutter. The cardiology staff utilized intravenous medications that controlled the cardiac
rate, adequately resolving these cardiac issues. I managed the patient’s ventilator and
intensive care status along with my respiratory therapy team. Unfortunately, the patient
developed multiple infections, hospital acquired, including Klebsiella pneumoniae
infection and probable fungemia. Multiple evaluations of the sputum and lungs for the
presence of active pulmonary tuberculosis were negative.

(Continued)
 DEATH SUMMARY

Patient Name: Putul Barua

Patient ID: 135799
Date Deceased: 01/15/
Page 2

The patient developed acute renal failure, managed by Dr. Trevor Jordan and his team of
nephrologists via hemodialysis. Mechanical ventilation, hemodialysis, and a
nasoduodenal feeding tube were completed in an attempt to provide further support;
however, the patient continued to deteriorate. On January 15 at 0017 hours he became
asystolic. Code blue was called. The patient underwent advanced cardiac life support
with multiple medications. He failed to respond to the advanced cardiac life support and
was pronounced dead at 0041 hours on January 15. Permission for autopsy was denied.

FINAL DIAGNOSES: 1. Idiopathic pulmonary fibrosis with alveolitis.

2. History of tuberculosis.
3. Acute renal failure.
4. Hospital acquired septicemia and fungemia secondary to
multiple organisms.

_________________________
Simon Williams, MD, Pulmonology