Description of Event or Problem · 1
PATIENT WITH A HISTORY OF NONISCHEMIC CARDIOMYOPATHY WITH AN EF OF 20%, DYSLIPIDEMIA, HTN, CRI, A HISTORY OF CHRONIC DVT/PE ON COUMADIN AS AN OUTPATIENT WHO INITIALLY PRESENTED TO AN OSH AFTER HIS ICD WAS BEEPING AND WAS FOUND TO HAVE A LOW BATTERY. AT THE OUT SIDE OF HOSPITAL (OSH), THE PATIENT HAD HIS ICD GENERATOR CHANGED SIX DAYS AFTER THE BEEPING. IN THE RECOVERY AREA AFTER THE ICD CHANGE, THE PATIENT DEVELOPED INCREASING SHORTNESS OF BREATH, BECAME HYPERTENSIVE TO THE 170S/140S, AND BECAME TACHYCARDIC. CXR WAS C/W FLASH PULMONARY EDEMA. THE PATIENT WAS INTUBATED AND TAKEN TO THE CCU. DURING HIS STAY IN THE CCU, THE PATIENT CODED AND HE EXPERIENCED EPISODES OF VT REQUIRING BOTH EXTERNAL AND INTERNAL SHOCKING BY HIS DEVICE AS WELL AS CPR. HE ALSO EXPERIENCED AN EPISODE OF PEA. PER THE NOTES, HIS ICD DELIVERED ROUGHLY 24 SHOCKS DURING THIS CODE. AMIODARONE AND LIDOCAINE WERE BOTH STARTED. THE PATIENT DEVELOPED ACUTE RENAL FAILURE AND HE WAS PLACED ON CRRT. PATIENT DIED AFTER WITHDRAWAL OF LIFE SUPPORT.