Provider:

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 22 Sep 2023 @ 0955 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

PROTEIN 7.4 g/dL (6.5-8.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALBUMIN 4.4 g/dL (3.3-4.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

TOTAL BILIRUBIN 0.6 mg/dL (.3-1.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

DIRECT BILIRUBIN <0.1 Low mg/dL (0.1-0.4) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALKALINE

PHOSPHATASE

60 IntUnits/L (37-107) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Interpretation: The normal range is for an adult population less

than 50 years old. Alk Phos increases with age over 50 to about

60% higher values by ages greater than 75 years old.

AST (SGOT) 21 IntUnits/L (8-42) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALT (SGPT) 19 IntUnits/L (5-55) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Metabolic Panel

526652%(57$//(1

'DWHRI%LUWK Page 243 of 337

APPENDIX 702

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 1 of 46 PageID 7381
Lab Type: Chemistry/Hematology Ordering

Provider:

DOMA, ANAMIKA

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 22 Sep 2023 @ 0955 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

GLUCOSE 113 mg/dL (74-118) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

UREA NITROGEN 18 mg/dL (8-26) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CREATININE 1.11 High mg/dL (0.5-1.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

SODIUM 138 mmol/L (136-144) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

POTASSIUM 4.4 mmol/L (3.4-4.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CHLORIDE 104 mmol/L (98-106) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CO2 25 mmol/L (23-33) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CALCIUM 9.5 mg/dL (8.7-10.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

eGFR (CKD-EPI) 75 -- (>60) Final SACRAMENTO VA 

MEDICAL CENTER 

526652%(57$//(1

'DWHRI%LUWK Page 244 of 337

APPENDIX 703

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 2 of 46 PageID 7382
10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Estimated Glomerular Filtration Rate (eGFR) calculated using the 2021

Chronic Kidney Disease-Epidemiology (CKD-EPI) Collaboration creatinine

equation; units of measure are mL/min/1.73 m2.

Results are only valid for adults (=18 years) whose serum creatinine is

in a steady state. eGFR calculations are not valid for patients with

acute kidney injury and for patients on dialysis. Creatinine-based

estimates of kidney function may also be inaccurate in patients with

reduced creatinine generation due to decreased muscle mass (e.g.,

malnutrition, severe hypoalbuminemia, sarcopenia, chronic neuromuscular

disease, amputations, severe heart failure or liver disease) and in

patients with increased creatinine generation due to increased muscle

mass (e.g., muscle builders, anabolic steroids) or increased dietary

intake.

As drug clearance is proportional to total GFR and not GFR indexed to

body surface area (BSA), in individuals with a BSA substantially

different than 1.73 m2, drug dosing should be based the reported eGFR

value de-indexed from BSA by multiplying by the individual's BSA and

dividing by 1.73

CKD is diagnosed based on abnormalities of kidney structure or function,

present for >3 months, with implications for health and disease. CKD is

classified and staged based on cause, eGFR and albuminuria (quantified as

urine albumin to creatinine ratio). An eGFR >60 mL/min/1.73 m2 in the

absence of increased urine albumin excretion or structural abnormalities

does not represent CKD.

eGFR (mL/min/1.73 m2) CKD stage Interpretation

>=90 G1 Normal

60-89 G2 Mild decrease

45-59 G3A Mild to moderate decrease

30-44 G3B Moderate to severe decrease

15-29 G4 Severe decrease

<15 G5 Kidney failure

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: PT w INR~IL ACL

Lab Type: Chemistry/Hematology Ordering

Provider:

DOMA, ANAMIKA

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 22 Sep 2023 @ 0955 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

INR 1.0 Low -- (2.0-3.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

526652%(57$//(1

'DWHRI%LUWK Page 245 of 337

APPENDIX 704

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 3 of 46 PageID 7383
WAY , MATHER, 

CA 95655-4200

Interpretation: Based on the most recent guidelines updated February 2012, for patients

treated with Vitamin K Antagonist (VKA) therapy, the recommendation is a

therapeutic INR range of 2.0 to 3.0 (target INR of 2.5) rather than a

lower (INR< 2) or higher (INR 3.0-5.0) range. Please see guidelines

referenced below for detailed discussion: Antithrombotic Therapy and

Prevention of Thrombosis: American College of Chest Physicians

Evidence-Based Clinical Practice Guidelines (9th Edition) Chest Feb 2012:

141(2) 7S-47S.

For patients with mechanical mitral or mechanical mitral and aortic

valves, a target INR is 3.0 (2.5-3.5). Please see guidelines referenced

below for detailed discussion: Antithrombotic and Thrombolytic Therapy

for Valvular Disease: American College of Chest Physicians Evidence-Based

Clinical Practice Guidelines (9th Edition) Chest Feb 2012.

PROTHROMBIN

TIME

10.7 Seconds (10.4-12.7) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Thromboplastin Time Partial

Lab Type: Chemistry/Hematology Ordering

Provider:

DOMA, ANAMIKA

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 22 Sep 2023 @ 0955 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing Location

PTT 31.3 Seconds (27.1-39.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Lipid Panel

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 19 Jan 2023 @ 1326 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Status Performing 

526652%(57$//(1

'DWHRI%LUWK Page 246 of 337

APPENDIX 705

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 4 of 46 PageID 7384
Range Location

CHOLESTEROL 264 High mg/dL (<200) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

TRIGLYCERIDE 254 High mg/dL (<150) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

HDL CHOLESTEROL 47 mg/dL (>40) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

LDL CHOLESTEROL 166 High mg/dL (<160) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Risk enhancing factors are used in concert with the Pooled Cohort

Equation (10 Year ASCVD Risk - Borderline and Intermediate Risk) to

decide on Management in non-diabetic patients .

Family history of premature ASCVD

Primary hypercholesterolemia -LDL-C, 160-189 mg/dL *.

Metabolic Syndrome

Chronic Kidney Disease

Chronic inflammatory conditions

History of premature menopause (before age 40 yr) and history of

pregnancy-associated conditions that increase later ASCVD risk such as

preeclampsia.

High-risk race/ethnicities

Lipid/biomarkers:

Persistently* elevated, primary hypertriglyceridemia (>=175

mg/dL);

Elevated high hsCRP (>=2.0 mg/L);

Elevated Lp(a): A relative indication for its measurement is family

history of premature ASCVD without know risk factors. An Lp(a) >=50

mg/dL constitutes a risk-enhancing factor especially at higher levels of

Lp(a).

Elevated apoB >=130 mg/dL: A relative indication for its measurement

would be triglyceride >=200 mg/dL. A level >=130 mg/dL corresponds to an

LDL-C >160 mg/dL and constitutes a risk-enhancing factor.

ankle-brachial index ( ABI ) <0.9

Risk-Enhancing Factors for Primary Prevention

* Optimally, 3 determinations.

Rarely if risk status is still uncertain a Coronary Artery Calcium

(CAC) Score can be done to inform decision making and statin therapy.

In Diabetic patients the following Risk Enhancing Factors help decide on

management

526652%(57$//(1

'DWHRI%LUWK Page 247 of 337

APPENDIX 706

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 5 of 46 PageID 7385
Duration of diabetes: >=10 years for T2DM and >=20 years for T1DM

Retinopathy

Albuminuria >30mg/G creatinine

e-GFR < 60 ml/min/m2

Decreased ABI <0.9

Neuropathy

Reference

Grundy SM, Stone NJ, Bailey AL, et al. 2018

AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/ AGS/APhA/ASPC/NLA/PCNA 

guideline on the

management of blood cholesterol: executive summary: a report of the

American College of Cardiology/American Heart Association task force on

clinical practice guidelines. J Am Coll Cardiol 2019; 73: 3168-3209.

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Glycohemoglobin HbA 1c

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Blood (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 19 Jan 2023 @ 1326 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

HGBA1c 5.9 High % (4.1-5.7) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Target A1C values should be individualized. Better understanding of A1C

for Veterans, and discuss treatment options through the process of Shared

Decision Making.

The performance characteristics of this assay have been certified by the

National Glycohemoglobin Standardization Program (NGSP) as having

documented traceability to the Diabetes Control and Complications Trial

reference method. This assay has been in use at our institution since

02/04/05.

eAG 123 High mg/dL (74-118) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: eAG = Calculated Estimated Average Daily Glucose and may

be easier for patients to understand than an A1c result.

Calculation: 28.7 x HGBA1c - 46.7

Comments: Values obtained from A1C measurements can vary. For typical A1C

assays, a reported value of 7.0 could actually be between 6.72

and 7.28 if measured by a reference method. A reported value of 9.0

526652%(57$//(1

'DWHRI%LUWK Page 248 of 337

APPENDIX 707

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 6 of 46 PageID 7386
could actually be between 8.73 and 9.27.

Ref: http://www.ngsp.org/CAPdata.asp

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Thyroid Stimulating Hormone

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 19 Jan 2023 @ 1326 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing Location

TSH 4.03 uIUnits/mL (0.34-5.60) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Prostate Specific Ag

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 19 Jan 2023 @ 1326 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing Location

PSA 0.99 ng/ml (0-4.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Vitamin B12

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 19 Jan 2023 @ 1326 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing Location

526652%(57$//(1

'DWHRI%LUWK Page 249 of 337

APPENDIX 708

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 7 of 46 PageID 7387
B12 146 Low pg/ml (211-911) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Comprehensive Met Panel

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 19 Jan 2023 @ 1326 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

GLUCOSE 116 mg/dL (74-118) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

UREA NITROGEN 19 mg/dL (8-26) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

CREATININE 0.91 mg/dL (0.5-1.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

SODIUM 135 Low mmol/L (136-144) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

POTASSIUM 4.2 mmol/L (3.4-4.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

CHLORIDE 99 mmol/L (98-106) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

CO2 27 mmol/L (23-33) Final SACRAMENTO VA 

MEDICAL CENTER 

526652%(57$//(1

'DWHRI%LUWK Page 250 of 337

APPENDIX 709

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 8 of 46 PageID 7388
10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

PROTEIN 7.6 g/dL (6.5-8.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALBUMIN 4.5 g/dL (3.3-4.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

TOTAL BILIRUBIN 0.9 mg/dL (.3-1.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALKALINE

PHOSPHATASE

57 IntUnits/L (37-107) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Interpretation: The normal range is for an adult population less

than 50 years old. Alk Phos increases with age over 50 to about

60% higher values by ages greater than 75 years old.

AST (SGOT) 17 IntUnits/L (8-42) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALT (SGPT) 18 IntUnits/L (5-55) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

CALCIUM 9.7 mg/dL (8.7-10.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

eGFR (CKD-EPI) >90 -- (>60) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Interpretation: Estimated Glomerular Filtration Rate (eGFR) calculated using the 2021

Chronic Kidney Disease-Epidemiology (CKD-EPI) Collaboration creatinine

equation; units of measure are mL/min/1.73 m2.

Results are only valid for adults (=18 years) whose serum creatinine is

in a steady state. eGFR calculations are not valid for patients with

526652%(57$//(1

'DWHRI%LUWK Page 251 of 337

APPENDIX 710

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 9 of 46 PageID 7389
acute kidney injury and for patients on dialysis. Creatinine-based

estimates of kidney function may also be inaccurate in patients with

reduced creatinine generation due to decreased muscle mass (e.g.,

malnutrition, severe hypoalbuminemia, sarcopenia, chronic neuromuscular

disease, amputations, severe heart failure or liver disease) and in

patients with increased creatinine generation due to increased muscle

mass (e.g., muscle builders, anabolic steroids) or increased dietary

intake.

As drug clearance is proportional to total GFR and not GFR indexed to

body surface area (BSA), in individuals with a BSA substantially

different than 1.73 m2, drug dosing should be based the reported eGFR

value de-indexed from BSA by multiplying by the individual's BSA and

dividing by 1.73

CKD is diagnosed based on abnormalities of kidney structure or function,

present for >3 months, with implications for health and disease. CKD is

classified and staged based on cause, eGFR and albuminuria (quantified as

urine albumin to creatinine ratio). An eGFR >60 mL/min/1.73 m2 in the

absence of increased urine albumin excretion or structural abnormalities

does not represent CKD.

eGFR (mL/min/1.73 m2) CKD stage Interpretation

>=90 G1 Normal

60-89 G2 Mild decrease

45-59 G3A Mild to moderate decrease

30-44 G3B Moderate to severe decrease

15-29 G4 Severe decrease

<15 G5 Kidney failure

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Viral PCR Panel~AUTO MOLECULAR INST 3

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Structure of naris (body structure) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 07 Jul 2022 @ 1158 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing 

Location

COVID-19 (4-

PLEX)

POSITIVE High -- (NEGATIVE) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

FLU A (4-

PLEX)

NEGATIVE -- (NEGATIVE) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

FLU B (4- NEGATIVE -- (NEGATIVE) Final SACRAMENTO VA 

526652%(57$//(1

'DWHRI%LUWK Page 252 of 337

APPENDIX 711

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 10 of 46 PageID 7390
PLEX) MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

RSV (4-PLEX) NEGATIVE -- (NEGATIVE) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: Abbott Alinity M (612A4).

A multiplex real-time reverse transcription (RT) polymerase chain

reaction (PCR) test intended for the simultaneous qualitative

detection and differentiation of RNA from SARS-CoV-2, influenza A

virus, influenza B virus, and/or RSV in anterial nasal or

nasopharyngeal swab specimens.

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Lipid Panel

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 09 Jun 2022 @ 1207 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

CHOLESTEROL 266 High mg/dL (<200) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

TRIGLYCERIDE 231 High mg/dL (<150) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

HDL CHOLESTEROL 42 mg/dL (>40) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

LDL CHOLESTEROL 178 High mg/dL (<160) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Risk enhancing factors are used in concert with the Pooled Cohort

Equation (10 Year ASCVD Risk - Borderline and Intermediate Risk) to

decide on Management in non-diabetic patients .

526652%(57$//(1

'DWHRI%LUWK Page 253 of 337

APPENDIX 712

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 11 of 46 PageID 7391
Family history of premature ASCVD

Primary hypercholesterolemia -LDL-C, 160-189 mg/dL *.

Metabolic Syndrome

Chronic Kidney Disease

Chronic inflammatory conditions

History of premature menopause (before age 40 yr) and history of

pregnancy-associated conditions that increase later ASCVD risk such as

preeclampsia.

High-risk race/ethnicities

Lipid/biomarkers:

Persistently* elevated, primary hypertriglyceridemia (>=175

mg/dL);

Elevated high hsCRP (>=2.0 mg/L);

Elevated Lp(a): A relative indication for its measurement is family

history of premature ASCVD without know risk factors. An Lp(a) >=50

mg/dL constitutes a risk-enhancing factor especially at higher levels of

Lp(a).

Elevated apoB >=130 mg/dL: A relative indication for its measurement

would be triglyceride >=200 mg/dL. A level >=130 mg/dL corresponds to an

LDL-C >160 mg/dL and constitutes a risk-enhancing factor.

ankle-brachial index ( ABI ) <0.9

Risk-Enhancing Factors for Primary Prevention

* Optimally, 3 determinations.

Rarely if risk status is still uncertain a Coronary Artery Calcium

(CAC) Score can be done to inform decision making and statin therapy.

In Diabetic patients the following Risk Enhancing Factors help decide on

management

Duration of diabetes: >=10 years for T2DM and >=20 years for T1DM

Retinopathy

Albuminuria >30mg/G creatinine

e-GFR < 60 ml/min/m2

Decreased ABI <0.9

Neuropathy

Reference

Grundy SM, Stone NJ, Bailey AL, et al. 2018

AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/ AGS/APhA/ASPC/NLA/PCNA 

guideline on the

management of blood cholesterol: executive summary: a report of the

American College of Cardiology/American Heart Association task force on

clinical practice guidelines. J Am Coll Cardiol 2019; 73: 3168-3209.

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Creatinine

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 09 Jun 2022 @ 1207 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

526652%(57$//(1

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APPENDIX 713

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 12 of 46 PageID 7392
Test Name Result Units Reference 

Range

Status Performing 

Location

CREATININE 1.00 mg/dL (0.5-1.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

eGFR (CKD-EPI) 85 -- (>60) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Estimated Glomerular Filtration Rate (eGFR) calculated using the 2021

Chronic Kidney Disease-Epidemiology (CKD-EPI) Collaboration creatinine

equation; units of measure are mL/min/1.73 m2.

Results are only valid for adults (=18 years) whose serum creatinine is

in a steady state. eGFR calculations are not valid for patients with

acute kidney injury and for patients on dialysis. Creatinine-based

estimates of kidney function may also be inaccurate in patients with

reduced creatinine generation due to decreased muscle mass (e.g.,

malnutrition, severe hypoalbuminemia, sarcopenia, chronic neuromuscular

disease, amputations, severe heart failure or liver disease) and in

patients with increased creatinine generation due to increased muscle

mass (e.g., muscle builders, anabolic steroids) or increased dietary

intake.

As drug clearance is proportional to total GFR and not GFR indexed to

body surface area (BSA), in individuals with a BSA substantially

different than 1.73 m2, drug dosing should be based the reported eGFR

value de-indexed from BSA by multiplying by the individual's BSA and

dividing by 1.73

CKD is diagnosed based on abnormalities of kidney structure or function,

present for >3 months, with implications for health and disease. CKD is

classified and staged based on cause, eGFR and albuminuria (quantified as

urine albumin to creatinine ratio). An eGFR >60 mL/min/1.73 m2 in the

absence of increased urine albumin excretion or structural abnormalities

does not represent CKD.

eGFR (mL/min/1.73 m2) CKD stage Interpretation

>=90 G1 Normal

60-89 G2 Mild decrease

45-59 G3A Mild to moderate decrease

30-44 G3B Moderate to severe decrease

15-29 G4 Severe decrease

<15 G5 Kidney failure

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Metabolic Panel

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

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APPENDIX 714

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 13 of 46 PageID 7393
Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 09 Jun 2022 @ 1207 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

GLUCOSE 115 mg/dL (74-118) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

UREA NITROGEN 19 mg/dL (8-26) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

SODIUM 137 mmol/L (136-144) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

POTASSIUM 5.3 High mmol/L (3.4-4.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CHLORIDE 105 mmol/L (98-106) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CO2 28 mmol/L (23-33) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CALCIUM 9.9 mg/dL (8.7-10.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Glycohemoglobin HbA 1c

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Blood (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

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APPENDIX 715

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 14 of 46 PageID 7394
Date/Time Collected: 09 Jun 2022 @ 1205 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

HGBA1c 6.0 High % (4.1-5.7) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Target A1C values should be individualized. Better understanding of A1C

for Veterans, and discuss treatment options through the process of Shared

Decision Making.

The performance characteristics of this assay have been certified by the

National Glycohemoglobin Standardization Program (NGSP) as having

documented traceability to the Diabetes Control and Complications Trial

reference method. This assay has been in use at our institution since

02/04/05.

eAG 126 High mg/dL (74-118) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: eAG = Calculated Estimated Average Daily Glucose and may

be easier for patients to understand than an A1c result.

Calculation: 28.7 x HGBA1c - 46.7

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Thyroid Stimulating Hormone

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 09 Jun 2022 @ 1205 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing Location

TSH 3.06 uIUnits/mL (0.34-5.60) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Vitamin B12

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

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APPENDIX 716

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 15 of 46 PageID 7395
Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 09 Jun 2022 @ 1205 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing Location

B12 110 Low pg/ml (211-911) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Vitamin D 25 Hydroxy~ACCESS DXI

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 09 Jun 2022 @ 1205 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

VITAMIN D, 25-

HYDROXY

22.5 ng/mL (20-100) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Experts don't agree on optimal Vitamin D levels in blood. Blood leves of

Vitamin D are not a direct indication of Vitamin D inadequacy or

adequacy. A generally accepted target value of Vitamin D greater than 20

ng/mL should be sought for high risk individuals which includes women who

are pregnant, lactating, or perimenopausal. Vitamin D values above 20

ng/mL should also be targeted for people diagnosed with osteopenia,

anorexia nervosa, malabsorption syndromes like celiac sprue, or people

who have had gastric bypass surgeries. In addition, individuals who have

dark skin, or wear total skin covering (and thus absorb less sunlight)

should be screened for Vitamin D deficiency.

In the general population, less than 6% of individuals are deficient with

a Vitamin D value >12.5 ng/mL.

Please review references below for additional discussion of optimal serum

Vitamin D values.

-Ross, A.C.,2011;Institute of Medicine (US) Committee to Review Dietary

Reference Intakes for Vitamin D and Calcium,

https://www.ncbi.nlm.nih.gov/books/NBK56070/ doi:10.17226/13050

-Holick,M.F.,2011; An Endocrine Society Clinical Practice Guideline; J

Clin Endocrinol Metab 96(7):1911-1930

-Manson,J.E.,2016; Vitamin D Deficiency-Is There Really a Pandemic?; N

Engl J Med 375:1817-1820

Comments: --

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APPENDIX 717

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 16 of 46 PageID 7396
Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Blood Occult feces~IMM

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Feces (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 07 Feb 2022 @ 1749 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

OCCULT BLOOD 

(FIT) #1 OF 1

Negative -- (Negative) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Interpretation: The FIT test should NOT be used for suspected upper GI bleeds.

Test performed at VAMC Sacramento, 10535 Hospital Way, Mather,Ca..

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Thyroid Stimulating Hormone

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 08 Dec 2021 @ 1253 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing Location

TSH 3.26 uIUnits/mL (0.34-5.60) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Prostate Specific Ag

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 08 Dec 2021 @ 1253 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

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APPENDIX 718

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 17 of 46 PageID 7397
Test Name Result Units Reference Range Status Performing Location

PSA 1.23 ng/ml (0-4.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Vitamin B12

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 08 Dec 2021 @ 1253 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing Location

B12 110 Low pg/ml (211-911) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Vitamin D 25 Hydroxy~ACCESS DXI

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Serum (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 08 Dec 2021 @ 1253 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

VITAMIN D, 25-

HYDROXY

12.2 Low ng/mL (30-100) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Total 25-OH Vitamin D levels of < 20 ng/ml are indicative of Vitamin D

deficiency. Levels between 20 ng/ml and 30 ng/ml suggest insufficiency.

Optimal Vitamin D levels are > 30 ng/ml.

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

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APPENDIX 719

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 18 of 46 PageID 7398
Lab Test: Hemogram V~SYSMEX XE-2100

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Blood (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 08 Dec 2021 @ 1253 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing Location

WBC 6.7 K/cmm (4.8-10.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

RBC 5.31 M/cmm (4.7-6.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

HGB 15.8 g/dL (14-18) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

HCT 48.0 % (42-52) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MCV 90.4 fL (80-99) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MCH 29.8 uug (27-34) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MCHC 32.9 gm/dL (31.8-35.3) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

PLT 360 K/cmm (130-400) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MPV 9.6 fL (9.1-12.5) Final SACRAMENTO VA 

MEDICAL CENTER 

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APPENDIX 720

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 19 of 46 PageID 7399
10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

LYMPH % 28.0 % (20-51) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

LYMPH # 1.9 K/cmm (1.2-3.4) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MONO % 9.3 % (2.0-13.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MONO # 0.6 K/cmm (0.2-1.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

EOS % 1.6 % (0.5-7.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

EOS # 0.1 K/cmm (0.1-0.5) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

BASO % 0.7 % (0-2.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

NEUT # 4.0 K/cmm (1.5-7.9) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

NEUT % 60.0 % (40-80) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

BASO # 0.1 K/cmm (0.0-0.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

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APPENDIX 721

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 20 of 46 PageID 7400
WAY , MATHER, CA 

95655-4200

IG # 0.0 K/cmm (<0.4) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

IG % 0.4 % (<4.9) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

RDW-SD 45.4 High fL (35.1-43.9) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Glycohemoglobin HbA 1c

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Blood (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 08 Dec 2021 @ 1253 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

HGBA1c 6.0 High % (4.1-5.7) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Target A1C values should be individualized. Better understanding of A1C

for Veterans, and discuss treatment options through the process of Shared

Decision Making.

The performance characteristics of this assay have been certified by the

National Glycohemoglobin Standardization Program (NGSP) as having

documented traceability to the Diabetes Control and Complications Trial

reference method. This assay has been in use at our institution since

02/04/05.

eAG 126 High mg/dL (74-118) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation:

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APPENDIX 722

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 21 of 46 PageID 7401
eAG = Calculated Estimated Average Daily Glucose and may

be easier for patients to understand than an A1c result.

Calculation: 28.7 x HGBA1c - 46.7

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Lipid Panel

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 08 Dec 2021 @ 1252 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

CHOLESTEROL 260 High mg/dL (<200) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

TRIGLYCERIDE 171 High mg/dL (<150) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

HDL CHOLESTEROL 50 mg/dL (>40) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

LDL CHOLESTEROL 176 High mg/dL (<160) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: Risk enhancing factors are used in concert with the Pooled Cohort

Equation (10 Year ASCVD Risk - Borderline and Intermediate Risk) to

decide on Management in non-diabetic patients .

Family history of premature ASCVD

Primary hypercholesterolemia -LDL-C, 160-189 mg/dL *.

Metabolic Syndrome

Chronic Kidney Disease

Chronic inflammatory conditions

History of premature menopause (before age 40 yr) and history of

pregnancy-associated conditions that increase later ASCVD risk such as

preeclampsia.

High-risk race/ethnicities

Lipid/biomarkers:

Persistently* elevated, primary hypertriglyceridemia (>=175

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APPENDIX 723

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 22 of 46 PageID 7402
mg/dL);

Elevated high hsCRP (>=2.0 mg/L);

Elevated Lp(a): A relative indication for its measurement is family

history of premature ASCVD without know risk factors. An Lp(a) >=50

mg/dL constitutes a risk-enhancing factor especially at higher levels of

Lp(a).

Elevated apoB >=130 mg/dL: A relative indication for its measurement

would be triglyceride >=200 mg/dL. A level >=130 mg/dL corresponds to an

LDL-C >160 mg/dL and constitutes a risk-enhancing factor.

ankle-brachial index ( ABI ) <0.9

Risk-Enhancing Factors for Primary Prevention

* Optimally, 3 determinations.

Rarely if risk status is still uncertain a Coronary Artery Calcium

(CAC) Score can be done to inform decision making and statin therapy.

In Diabetic patients the following Risk Enhancing Factors help decide on

management

Duration of diabetes: >=10 years for T2DM and >=20 years for T1DM

Retinopathy

Albuminuria >30mg/G creatinine

e-GFR < 60 ml/min/m2

Decreased ABI <0.9

Neuropathy

Reference

Grundy SM, Stone NJ, Bailey AL, et al. 2018

AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/ AGS/APhA/ASPC/NLA/PCNA 

guideline on the

management of blood cholesterol: executive summary: a report of the

American College of Cardiology/American Heart Association task force on

clinical practice guidelines. J Am Coll Cardiol 2019; 73: 3168-3209.

Comments: For eGFR: Race unknown, if African American multiply result by 1.210

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Comprehensive Met Panel

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Plasma (substance) Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 08 Dec 2021 @ 1252 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

GLUCOSE 100 mg/dL (74-118) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

UREA NITROGEN 15 mg/dL (8-26) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

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APPENDIX 724

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 23 of 46 PageID 7403
WAY , MATHER, 

CA 95655-4200

CREATININE 0.90 mg/dL (0.5-1.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

SODIUM 137 mmol/L (136-144) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

POTASSIUM 4.2 mmol/L (3.4-4.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

CHLORIDE 101 mmol/L (98-106) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

CO2 27 mmol/L (23-33) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

PROTEIN 7.7 g/dL (6.5-8.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALBUMIN 4.9 High g/dL (3.3-4.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

TOTAL BILIRUBIN 0.8 mg/dL (.3-1.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALKALINE

PHOSPHATASE

60 IntUnits/L (37-107) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Interpretation: The normal range is for an adult population less

than 50 years old. Alk Phos increases with age over 50 to about

60% higher values by ages greater than 75 years old.

AST (SGOT) 24 IntUnits/L (8-42) Final SACRAMENTO VA 

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APPENDIX 725

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 24 of 46 PageID 7404
MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALT (SGPT) 26 IntUnits/L (5-55) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

CALCIUM 9.5 mg/dL (8.7-10.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

eGFR 85.5 mL/min (>60) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Interpretation: eGFR Units = mL/min/1.73 square meters

Comments: For eGFR: Race unknown, if African American multiply result by 1.210

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: SARS-CoV-2 RNA Ql NAA+probe~AUTO MISC INST 2

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Nasopharyngeal structure (body 

structure)

Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 23 Sep 2021 @ 1007 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference Range Status Performing 

Location

COVID-19

(ALINITY M)

Negative -- (Negative) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: Test performed on Abbott Alinity M

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Viral PCR Panel~AUTO MOLECULAR INST 1

Lab Type: Chemistry/Hematology Ordering

Provider:

DULAI,

KAMALPREET

Specimen: Nasopharyngeal structure (body 

structure)

Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 28 Apr 2021 @ 0950 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

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APPENDIX 726

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 25 of 46 PageID 7405
Test Name Result Units Reference 

Range

Status Performing 

Location

COVID-19 PCR 

(FLUVID)

NEGATIVE -- (NEGATIVE) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Interpretation: Negative results do not preclude SARS-CoV2 infection and should not be

used as the sole basis for treatment or other patient management

decisions. Negative results must be combined with clinical observations,

patient history and epidemiological information.

FLU A PCR 

(FLUVID)

NEGATIVE -- (NEGATIVE) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

FLU B PCR 

(FLUVID)

NEGATIVE -- (NEGATIVE) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

RSV PCR (FLUVID) NEGATIVE -- (NEGATIVE) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Comments: Cepheid GeneXpert Dx (612A4)

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Human Coronavirus RNA Ql PCR~VA SAN FRANCISCO, CA

Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Nasopharyngeal structure (body 

structure)

Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 06 Oct 2020 @ 1100 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

COVID-19 (SFVA) Not Detected -- (Not Detected) Final SAN FRANCISCO 

VAMC 4150 

CLEMENT

STREET , SAN 

FRANCISCO, CA 

94121-1545

Interpretation: Negative results do not preclude SARS-CoV2 infection and should not be

used as the sole basis for treatment or other patient management

decisions. Negative results must be combined with clinical observations,

patient history and epidemiological information.

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APPENDIX 727

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 26 of 46 PageID 7406
Comments: This test was approved for in vitro diagnostic use under FDA

Emergency Use Authorization only. The test was developed and

distributed by Abbott Diagnostics. Additional validation has

been performed by the clinical laboratory at San Francisco

VA Medical Center.

Performing Location Name/Address:

SAN FRANCISCO VAMC 4150 CLEMENT STREET , SAN FRANCISCO, CA 94121-1545

Lab Test: Human Coronavirus RNA Ql PCR~VA SAN FRANCISCO, CA

Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Nasopharyngeal structure (body 

structure)

Ordering

Location:

SACRAMENTO VA 

MEDICAL CENTER

Date/Time Collected: 15 Sep 2020 @ 1417 Collected

Location:

SACRAMENTO VA 

MEDICAL CENTER

Test Name Result Units Reference 

Range

Status Performing 

Location

COVID-19 (SFVA) Not Detected -- (Not Detected) Final SAN FRANCISCO 

VAMC 4150 

CLEMENT

STREET , SAN 

FRANCISCO, CA 

94121-1545

Interpretation: Negative results do not preclude SARS-CoV2 infection and should not be

used as the sole basis for treatment or other patient management

decisions. Negative results must be combined with clinical observations,

patient history and epidemiological information.

Comments: This test was approved for in vitro diagnostic use under FDA

Emergency Use Authorization only. The test was developed and

distributed by Abbott Diagnostics. Additional validation has

been performed by the clinical laboratory at San Francisco

VA Medical Center.

Performing Location Name/Address:

SAN FRANCISCO VAMC 4150 CLEMENT STREET , SAN FRANCISCO, CA 94121-1545

Lab Test: Lipid Panel

Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Plasma (substance) Ordering

Location:

MCCLELLAN VA 

CLINIC

Date/Time Collected: 20 Aug 2020 @ 1036 Collected

Location:

MCCLELLAN VA 

CLINIC

Test Name Result Units Reference 

Range

Status Performing 

Location

CHOLESTEROL 234 High mg/dL (<200) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

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APPENDIX 728

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 27 of 46 PageID 7407
TRIGLYCERIDE 285 High mg/dL (<150) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

HDL CHOLESTEROL 38 Low mg/dL (>40) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

LDL CHOLESTEROL 139 mg/dL (<160) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: RISK CATEGORY LDL GOAL

CHD and CHD risk equivalents <100 mg/dL

Multiple (2+) risk factors <130 mg/dL

0-1 risk factor <160 mg/dL

HDL Chol. greater than/equal to 60 mg/dL counts as "negative" risk

factor; its presence removes 1 risk factor from the total count.

Ref: Adult Treatment Panel III (ATP III) JAMA 5/16/01 Vol. 285 #19.

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Hepatic Function Panel

Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Plasma (substance) Ordering

Location:

MCCLELLAN VA 

CLINIC

Date/Time Collected: 20 Aug 2020 @ 1035 Collected

Location:

MCCLELLAN VA 

CLINIC

Test Name Result Units Reference 

Range

Status Performing 

Location

PROTEIN 7.3 g/dL (6.5-8.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALBUMIN 4.5 g/dL (3.3-4.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

TOTAL BILIRUBIN 0.6 mg/dL (.3-1.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

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APPENDIX 729

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 28 of 46 PageID 7408
DIRECT BILIRUBIN <0.1 Low mg/dL (0.1-0.4) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALKALINE

PHOSPHATASE

62 IntUnits/L (37-107) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Interpretation: The normal range is for an adult population less

than 50 years old. Alk Phos increases with age over 50 to about

60% higher values by ages greater than 75 years old.

AST (SGOT) 22 IntUnits/L (8-42) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

ALT (SGPT) 21 IntUnits/L (5-55) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Comments: For eGFR: Race unknown, if African American multiply result by 1.210

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Metabolic Panel

Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Plasma (substance) Ordering

Location:

MCCLELLAN VA 

CLINIC

Date/Time Collected: 20 Aug 2020 @ 1035 Collected

Location:

MCCLELLAN VA 

CLINIC

Test Name Result Units Reference 

Range

Status Performing 

Location

GLUCOSE 117 mg/dL (74-118) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

UREA NITROGEN 19 mg/dL (8-26) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CREATININE 1.10 mg/dL (0.5-1.1) Final SACRAMENTO VA 

MEDICAL CENTER 

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APPENDIX 730

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 29 of 46 PageID 7409
10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

SODIUM 134 Low mmol/L (136-144) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

POTASSIUM 4.1 mmol/L (3.4-4.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CHLORIDE 99 mmol/L (98-106) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CO2 24 mmol/L (23-33) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

CALCIUM 9.3 mg/dL (8.7-10.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

eGFR 68.3 mL/min (>60) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Interpretation: eGFR Units = mL/min/1.73 square meters

Comments: For eGFR: Race unknown, if African American multiply result by 1.210

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Thyroid Stimulating Hormone

Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Serum (substance) Ordering

Location:

MCCLELLAN VA 

CLINIC

Date/Time Collected: 20 Aug 2020 @ 1035 Collected

Location:

MCCLELLAN VA 

CLINIC

Test Name Result Units Reference Range Status Performing Location

TSH 3.51 uIUnits/mL (0.34-5.60) Final SACRAMENTO VA 

MEDICAL CENTER 

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APPENDIX 731

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 30 of 46 PageID 7410
10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Epithelial Cast~MICROSCOPY LIGHT HPF

Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Urine (substance) Ordering

Location:

MCCLELLAN VA 

CLINIC

Date/Time Collected: 20 Aug 2020 @ 1035 Collected

Location:

MCCLELLAN VA 

CLINIC

Test Name Result Units Reference 

Range

Status Performing 

Location

EPITHELIAL

CASTS

[none] per lpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Transitional Epithelial

Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Urine (substance) Ordering

Location:

MCCLELLAN VA 

CLINIC

Date/Time Collected: 20 Aug 2020 @ 1035 Collected

Location:

MCCLELLAN VA 

CLINIC

Test Name Result Units Reference 

Range

Status Performing 

Location

TRANSITIONAL

EPITHELIAL CELLS

[none] per hpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Gen Chem Specimen

Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Urine (substance) Ordering

Location:

MCCLELLAN VA 

CLINIC

526652%(57$//(1

'DWHRI%LUWK Page 273 of 337

APPENDIX 732

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 31 of 46 PageID 7411
Date/Time Collected: 20 Aug 2020 @ 1035 Collected

Location:

MCCLELLAN VA 

CLINIC

Test Name Result Units Reference Range Status Performing 

Location

APPEARANCE Turbid -- Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE COLOR Amber -- Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

SPECIFIC GRAVITY 1.025 -- (1.003-1.035) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

UR. UROBILINOGEN <0.2 Low mg/dL (0.2-1.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE BLOOD Negative -- (NEG) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE BILIRUBIN Negative -- (NEG) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE KETONES Negative mg/dL (NEG) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE GLUCOSE Negative mg/dL (NEG) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE PROTEIN Negative mg/dL (NEGTRACE) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE PH 5.0 -- (5.0-8.0) Final SACRAMENTO VA 

MEDICAL CENTER 

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APPENDIX 733

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 32 of 46 PageID 7412
10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE WBC/HPF 0-5 per hpf (0-5) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE RBC/HPF 0-2 per hpf (0-2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

EPITHELIAL CELLS 0-5 per hpf (0-5) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE BACTERIA Rare per hpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE MUCOUS Rare -- Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

HYALINE CASTS [none] per lpf (0-2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

GRANULAR CASTS [none] per lpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URINE YEAST [none] per hpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

TRICHOMONAS [none] per hpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

AMORPHOUS

SEDIMENT

[none] -- Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

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APPENDIX 734

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 33 of 46 PageID 7413
WAY , MATHER, 

CA 95655-4200

URINE NITRITE Negative -- (NEG) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

LEUKOCYTE

ESTERASE

Negative Leu/uL (NEG) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Interpretation: Reflex cultures are not performed on Urinalysis orders for future

collection. If a culture is needed on this specimen, the laboratory must

be notified within 48 hours of collection.

Mather lab: 916-366-5373

Martinez lab: 916-372-2961

Redding lab: 530-226-7595

Oakland lab: 510-267-7532

Chico lab: 530-879-5024

CELLULAR CASTS [none] per lpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

RENAL EPITHELIAL 

CELLS

[none] per hpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

CALCIUM OXALATE 

CRYST

[none] per hpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

URIC ACID 

CRYSTALS

[none] per hpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

TRIPLE

PHOSPHATE CRYST

[none] per hpf Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, 

CA 95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

Lab Test: Hemogram V~SYSMEX XE-2100

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APPENDIX 735

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 34 of 46 PageID 7414
Lab Type: Chemistry/Hematology Ordering

Provider:

BUCAYCAY,

ELEANOR

Specimen: Blood (substance) Ordering

Location:

MCCLELLAN VA 

CLINIC

Date/Time Collected: 20 Aug 2020 @ 1035 Collected

Location:

MCCLELLAN VA 

CLINIC

Test Name Result Units Reference Range Status Performing Location

WBC 5.1 K/cmm (4.8-10.8) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

RBC 5.25 M/cmm (4.7-6.1) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

HGB 15.7 g/dL (14-18) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

HCT 46.7 % (42-52) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MCV 89.0 fL (80-99) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MCH 29.9 uug (27-34) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MCHC 33.6 gm/dL (31.8-35.3) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

PLT 307 K/cmm (130-400) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MPV 9.7 fL (9.1-12.5) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

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'DWHRI%LUWK Page 277 of 337

APPENDIX 736

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 35 of 46 PageID 7415
WAY , MATHER, CA 

95655-4200

LYMPH % 28.0 % (20-51) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

LYMPH # 1.4 K/cmm (1.2-3.4) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MONO % 8.8 % (2.0-13.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

MONO # 0.5 K/cmm (0.2-1.2) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

EOS % 1.8 % (0.5-7.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

EOS # 0.1 K/cmm (0.1-0.5) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

BASO % 0.6 % (0-2.0) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

NEUT # 3.1 K/cmm (1.5-7.9) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

NEUT % 60.6 % (40-80) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

BASO # 0.0 K/cmm (0.0-0.2) Final SACRAMENTO VA 

MEDICAL CENTER 

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'DWHRI%LUWK Page 278 of 337

APPENDIX 737

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 36 of 46 PageID 7416
10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

IG # 0.0 K/cmm (<0.4) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

IG % 0.2 % (<4.9) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

RDW-SD 43.4 fL (35.1-43.9) Final SACRAMENTO VA 

MEDICAL CENTER 

10535 HOSPITAL 

WAY , MATHER, CA 

95655-4200

Comments: --

Performing Location Name/Address:

SACRAMENTO VA MEDICAL CENTER 10535 HOSPITAL WAY , MATHER, CA 95655-4200

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APPENDIX 738

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 37 of 46 PageID 7417
VA Pathology Reports

Source: VA

Last Updated: 31 Dec 2023 @ 1453

No information was available that matched your selection. However, if you recently had a VA 

pathology specimen collected, the reports may be available thirty-six (36) hours after they have been 

completed. Some studies done at a non-VA facility may not be available or they may not necessarily 

include an interpretation.

Note: Your provider may not have had a chance to read your VA pathology reports. If you have any 

concerns about your reports, contact your health care team.

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APPENDIX 739

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 38 of 46 PageID 7418
Self Reported Labs and Tests

Source: Self-Entered

No information was available that matched your selection.

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APPENDIX 740

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 39 of 46 PageID 7419
VA Vitals and Readings

Source: VA

Last Updated: 31 Dec 2023 @ 1453

VA Vitals and Readings displays your most recent record for each vital sign and health reading listed in 

your VA health record, grouped by the type of vital sign or health reading. Your Shared Vitals that are 

shared with your VA health care team will not display in this report. If you have any questions about 

your information, contact your VA health care team.

This section shows your most recent record for each vital sign and health reading.

Vital Sign or Health Reading Measurement Date/Time Collected

Blood Pressure 145/89 mm[Hg] 22 Sep 2023 @ 1543

Pulse Rate 82 /min 22 Sep 2023 @ 1543

Respiration 18 /min 22 Sep 2023 @ 1400

Temperature 98.3 F 22 Sep 2023 @ 1543

Pain Level 5 22 Sep 2023 @ 1543

Weight 166.2 lb 22 Sep 2023 @ 1543

This section shows all of the vital signs and health readings listed in your VA health record based on 

the dates you selected when you requested your VA Blue Button. They are grouped by the type of vital 

sign or health reading.

Sorted By: Type of Vital Sign or Health Reading, then Date/Time (Descending)

Vital Sign: Blood Pressure

Measurement: 145/89 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1543

Vital Sign: Blood Pressure

Measurement: 146/81 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1400

Vital Sign: Blood Pressure

Measurement: 148/89 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1300

Vital Sign: Blood Pressure

Measurement: 169/92 mm[Hg]

Comments: --

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APPENDIX 741

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 40 of 46 PageID 7420
Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1216

Vital Sign: Blood Pressure

Measurement: 152/94 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 0924

Vital Sign: Blood Pressure

Measurement: 164/91 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 0919

Vital Sign: Blood Pressure

Measurement: 137/87 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 20 Apr 2023 @ 1022

Vital Sign: Blood Pressure

Measurement: 128/76 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 12 Sep 2022 @ 0953

Vital Sign: Blood Pressure

Measurement: 137/83 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 09 Jun 2022 @ 1006

Vital Sign: Blood Pressure

Measurement: 123/70 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 09 Dec 2021 @ 1115

Vital Sign: Blood Pressure

Measurement: 128/74 mm[Hg]

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 15 Sep 2020 @ 1227

Vital Sign: Temperature

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APPENDIX 742

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 41 of 46 PageID 7421
Measurement: 98.3 F

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1543

Vital Sign: Temperature

Measurement: 98.3 F

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1400

Vital Sign: Temperature

Measurement: 98.9 F

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 0919

Vital Sign: Temperature

Measurement: 97.7 F

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 20 Apr 2023 @ 1022

Vital Sign: Temperature

Measurement: 98.3 F

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 12 Sep 2022 @ 0953

Vital Sign: Temperature

Measurement: 98.8 F

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 09 Jun 2022 @ 1006

Vital Sign: Temperature

Measurement: 97 F

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 09 Dec 2021 @ 1115

Vital Sign: Temperature

Measurement: 96.8 F

Comments: --

Location: No CA Healthcare Sys-Martinez

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APPENDIX 743

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 42 of 46 PageID 7422
Date/Time Collected: 28 Apr 2021 @ 1001

Vital Sign: Temperature

Measurement: 98.1 F

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 15 Sep 2020 @ 1227

Vital Sign: Pain Level

Measurement: 5

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1543

Vital Sign: Pain Level

Measurement: 0

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1400

Vital Sign: Pain Level

Measurement: 0

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1300

Vital Sign: Pain Level

Measurement: 0

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1216

Vital Sign: Pain Level

Measurement: 0

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 0924

Vital Sign: Pain Level

Measurement: 9

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 0919

Vital Sign: Pain Level

Measurement: 0

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APPENDIX 744

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 43 of 46 PageID 7423
Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 20 Apr 2023 @ 1022

Vital Sign: Pain Level

Measurement: 5

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 12 Sep 2022 @ 0955

Vital Sign: Pain Level

Measurement: 5

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 12 Sep 2022 @ 0953

Vital Sign: Pain Level

Measurement: 0

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 09 Jun 2022 @ 1006

Vital Sign: Pain Level

Measurement: 6

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 09 Dec 2021 @ 1115

Vital Sign: Pain Level

Measurement: 0

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 15 Sep 2020 @ 1227

Vital Sign: Pulse Oximetry

Measurement: 97 %

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1543

Vital Sign: Pulse Oximetry

Measurement: 98 %

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1400

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APPENDIX 745

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 44 of 46 PageID 7424
Vital Sign: Pulse Oximetry

Measurement: 99 %

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1300

Vital Sign: Pulse Oximetry

Measurement: 100 %

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1216

Vital Sign: Pulse Oximetry

Measurement: 99 %

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 20 Apr 2023 @ 1022

Vital Sign: Pulse Oximetry

Measurement: 98 %

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 12 Sep 2022 @ 0953

Vital Sign: Pulse Oximetry

Measurement: 97 %

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 09 Jun 2022 @ 1006

Vital Sign: Pulse Oximetry

Measurement: 98 %

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 09 Dec 2021 @ 1115

Vital Sign: Pulse Oximetry

Measurement: 98 %

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 15 Sep 2020 @ 1227

Vital Sign: Pulse Rate

Measurement: 82 /min

Comments: --

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APPENDIX 746

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 45 of 46 PageID 7425
Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1543

Vital Sign: Pulse Rate

Measurement: 72 /min

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1400

Vital Sign: Pulse Rate

Measurement: 72 /min

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1300

Vital Sign: Pulse Rate

Measurement: 65 /min

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 1216

Vital Sign: Pulse Rate

Measurement: 69 /min

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 0924

Vital Sign: Pulse Rate

Measurement: 74 /min

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 22 Sep 2023 @ 0919

Vital Sign: Pulse Rate

Measurement: 67 /min

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 20 Apr 2023 @ 1022

Vital Sign: Pulse Rate

Measurement: 60 /min

Comments: --

Location: No CA Healthcare Sys-Martinez

Date/Time Collected: 12 Sep 2022 @ 0953

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APPENDIX 747

Case 4:22-cv-00343-Y Document 239-17 Filed 04/26/24 Page 46 of 46 PageID 7426