Donella Keebler =============== Race: White Ethnicity: Non-Hispanic Gender: F Age: DECEASED Birth Date: 1981-02-03 Marital Status: S -------------------------------------------------------------------------------- ALLERGIES: No Known Allergies -------------------------------------------------------------------------------- MEDICATIONS: 2001-04-19[CURRENT] : Alteplase 100 MG Injection 2001-04-19[CURRENT] : Clopidogrel 75 MG Oral Tablet 1981-07-11[CURRENT] : glycopyrrolate 1.5 MG Oral Tablet [Glycate] for Excessive salivation (disorder) -------------------------------------------------------------------------------- CONDITIONS: 2001-04-19 - 2001-04-19 : Stroke 2000-10-17 - : Normal pregnancy 2000-04-04 - : Full-time employment (finding) 1999-03-30 - : Stress (finding) 1999-03-30 - 2000-04-04 : Not in labor force (finding) 1999-03-30 - : Received certificate of high school equivalency (finding) 1998-03-24 - : Risk activity involvement (finding) 1981-07-11 - : Retention of urine (disorder) 1981-03-05 - : Dribbling from mouth (finding) 1981-03-05 - : Excessive salivation (disorder) 1981-03-05 - : Gastroesophageal reflux disease (disorder) 1981-03-05 - : Intellectual disability (disorder) 1981-03-05 - : Osteoporosis (disorder) 1981-03-05 - : Spasticity (finding) 1981-03-05 - : Dystonia (disorder) 1981-03-05 - : Cerebral palsy (disorder) -------------------------------------------------------------------------------- CARE PLANS: 2000-10-17[CURRENT] : Routine antenatal care Activity: Antenatal education Activity: Antenatal risk assessment Activity: Antenatal blood tests -------------------------------------------------------------------------------- REPORTS: 2001-05-01 : U.S. standard certificate of death - 2003 revision - Cause of Death [US Standard Certificate of Death] Stroke 2000-04-04 : Alcohol Use Disorder Identification Test - Consumption [AUDIT-C] - Total score [AUDIT-C] 1.0 {score} 2000-04-04 : Patient Health Questionnaire 2 item (PHQ-2) [Reported] - Patient Health Questionnaire 2 item (PHQ-2) total score [Reported] 1.0 {score} 2000-04-04 : Humiliation, Afraid, Rape, and Kick questionnaire [HARK] - Total score [HARK] 0.0 {score} 2000-04-04 : Morse Fall Scale panel - Fall risk total [Morse Fall Scale] 37.0 {#} - Fall risk level [Morse Fall Scale] Moderate Risk (MFS Score 25 - 45) -------------------------------------------------------------------------------- OBSERVATIONS: 2001-05-01 : Cause of Death [US Standard Certificate of Death] Stroke 2000-04-04 : Total score [AUDIT-C] 1.0 {score} 2000-04-04 : Patient Health Questionnaire 2 item (PHQ-2) total score [Reported] 1.0 {score} 2000-04-04 : Total score [HARK] 0.0 {score} 2000-04-04 : Fall risk level [Morse Fall Scale] Moderate Risk (MFS Score 25 - 45) 2000-04-04 : Fall risk total [Morse Fall Scale] 37.0 {#} 2000-04-04 : Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE] - In the past year, have you been afraid of your partner or ex-partner? No - Do you feel physically and emotionally safe where you currently live? Yes - Are you a refugee? No - In the past year, have you spent more than 2 nights in a row in a jail, prison, detention center, or juvenile correctional facility? No - Stress is when someone feels tense, nervous, anxious or can't sleep at night because their mind is troubled. How stressed are you? A little bit - How often do you see or talk to people that you care about and feel close to (For example: talking to friends on the phone, visiting friends or family, going to church or club meetings)? 3 to 5 times a week - Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living? No - In the past year, have you or any family members you live with been unable to get any of the following when it was really needed? I choose not to answer this question - During the past year, what was the total combined income for you and the family members you live with? This information will help us determine if you are eligible for any benefits. 21452 /a - What is your main insurance? None/uninsured - What is your current work situation? Full-time work - What is the highest level of school that you have finished? High school diploma or GED - What address do you live at? 917 Kshlerin Fork Suite 70 - Are you worried about losing your housing? No - What is your housing situation today? I have housing - How many family members, including yourself, do you currently live with? 3.0 {#} - What language are you most comfortable speaking? English - Have you been discharged from the armed forces of the United States? No - At any point in the past 2 years, has season or migrant farm work been your or your family's main source of income? No - Which race(s) are you? White - Are you Hispanic or Latino? No 2000-04-04 : Tobacco smoking status Never smoked tobacco (finding) 2000-04-04 : Respiratory rate 14.0 /min 2000-04-04 : Heart rate 90.0 /min 2000-04-04 : Blood Pressure - Diastolic Blood Pressure 66.0 mm[Hg] - Systolic Blood Pressure 128.0 mm[Hg] 2000-04-04 : Body mass index (BMI) [Percentile] Per age and gender 91.4 % 2000-04-04 : Body Mass Index 28.5 kg/m2 2000-04-04 : Body Weight 68.8 kg 2000-04-04 : Pain severity - 0-10 verbal numeric rating [Score] - Reported 4.0 {score} 2000-04-04 : Body Height 155.3 cm -------------------------------------------------------------------------------- PROCEDURES: 2001-04-19 : Percutaneous mechanical thrombectomy of portal vein using fluoroscopic guidance 2001-04-19 : Echocardiography (procedure) 2001-04-03 : Auscultation of the fetal heart for Normal pregnancy 2001-04-03 : Evaluation of uterine fundal height for Normal pregnancy 2001-03-06 : Auscultation of the fetal heart for Normal pregnancy 2001-03-06 : Evaluation of uterine fundal height for Normal pregnancy 2001-03-06 : Urine screening for glucose for Normal pregnancy 2001-03-06 : Vaccination for diphtheria, pertussis, and tetanus for Normal pregnancy 2001-03-06 : Hemoglobin / Hematocrit / Platelet count for Normal pregnancy 2001-02-06 : Auscultation of the fetal heart for Normal pregnancy 2001-02-06 : Evaluation of uterine fundal height for Normal pregnancy 2001-01-24 : Monitoring of patient (regime/therapy) for Excessive salivation (disorder) 2001-01-09 : Auscultation of the fetal heart for Normal pregnancy 2001-01-09 : Evaluation of uterine fundal height for Normal pregnancy 2000-12-12 : Auscultation of the fetal heart for Normal pregnancy 2000-12-12 : Evaluation of uterine fundal height for Normal pregnancy 2000-12-12 : Alpha-fetoprotein test for Normal pregnancy 2000-12-12 : Fetal anatomy study for Normal pregnancy 2000-11-14 : Screening for chromosomal aneuploidy in prenatal amniotic fluid for Normal pregnancy 2000-11-14 : Auscultation of the fetal heart for Normal pregnancy 2000-11-14 : Evaluation of uterine fundal height for Normal pregnancy 2000-10-17 : Physical examination of mother for Normal pregnancy 2000-10-17 : Urine protein test for Normal pregnancy 2000-10-17 : Skin test for tuberculosis for Normal pregnancy 2000-10-17 : Measurement of Varicella-zoster virus antibody for Normal pregnancy 2000-10-17 : Rubella screening for Normal pregnancy 2000-10-17 : Hepatitis C antibody test for Normal pregnancy 2000-10-17 : Urine screening test for diabetes for Normal pregnancy 2000-10-17 : Cytopathology procedure, preparation of smear, genital source for Normal pregnancy 2000-10-17 : Urine culture for Normal pregnancy 2000-10-17 : Syphilis infection test for Normal pregnancy 2000-10-17 : Gonorrhea infection test for Normal pregnancy 2000-10-17 : Chlamydia antigen test for Normal pregnancy 2000-10-17 : Human immunodeficiency virus antigen test for Normal pregnancy 2000-10-17 : Hepatitis B Surface Antigen Measurement for Normal pregnancy 2000-10-17 : Hemoglobin / Hematocrit / Platelet count for Normal pregnancy 2000-10-17 : Blood typing, RH typing for Normal pregnancy 2000-10-17 : Auscultation of the fetal heart for Normal pregnancy 2000-10-17 : Evaluation of uterine fundal height for Normal pregnancy 2000-10-17 : Ultrasound scan for fetal viability for Normal pregnancy 2000-10-17 : Standard pregnancy test for Normal pregnancy 2000-08-22 : Removal of intrauterine device 2000-06-13 : Monitoring of patient (regime/therapy) for Excessive salivation (disorder) 2000-04-04 : Assessment using Alcohol Use Disorders Identification Test - Consumption (procedure) 2000-04-04 : Assessment of substance use (procedure) 2000-04-04 : Depression screening using Patient Health Questionnaire Two-Item score (procedure) 2000-04-04 : Depression screening (procedure) 2000-04-04 : Screening for domestic abuse (procedure) 2000-04-04 : Assessment using Morse Fall Scale (procedure) 2000-04-04 : Assessment of health and social care needs (procedure) 2000-02-15 : Replacement of contraceptive intrauterine device 1999-09-10 : Monitoring of patient (regime/therapy) for Excessive salivation (disorder) -------------------------------------------------------------------------------- IMMUNIZATIONS: 2000-04-04 : Influenza, seasonal, injectable, preservative free -------------------------------------------------------------------------------- ENCOUNTERS: 2001-05-01 (Dr. Ethyl Rau) : Encounter at WALPOLE MEDICAL CENTER, PC : Encounter for Stroke 2001-04-19 (Dr. Gabriel Reilly) : Encounter at Fitchburg Outpatient Clinic 2001-04-03 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC : Encounter for Normal pregnancy 2001-03-06 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC : Encounter for Normal pregnancy 2001-02-06 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC : Encounter for Normal pregnancy 2001-01-24 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC 2001-01-09 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC : Encounter for Normal pregnancy 2000-12-12 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC : Encounter for Normal pregnancy 2000-11-14 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC : Encounter for Normal pregnancy 2000-10-17 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC : Encounter for Normal pregnancy 2000-08-22 (Dr. Trinidad King) : Encounter at STEWARD NORWOOD HOSPITAL INC 2000-06-13 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC 2000-04-04 (Dr. Ethyl Rau) : Encounter at WALPOLE MEDICAL CENTER, PC 2000-02-15 (Dr. Trinidad King) : Encounter at STEWARD NORWOOD HOSPITAL INC 1999-09-10 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC 1999-03-30 (Dr. Ethyl Rau) : Encounter at WALPOLE MEDICAL CENTER, PC 1998-03-24 (Dr. Ethyl Rau) : Encounter at WALPOLE MEDICAL CENTER, PC 1981-07-11 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC 1981-03-05 (Dr. Abdul White) : Encounter at STEWARD NORWOOD HOSPITAL INC : Encounter for Cerebral palsy (disorder) -------------------------------------------------------------------------------- IMAGING STUDIES: --------------------------------------------------------------------------------