Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Renal impairment, Rib fracture, SARS-CoV-2 test positive, Syncope, Tibia fracture
Clinical narrative: Pfizer Dose 1 2/17/21 (en6201) Pfizer Dose 2 3/11/21 (EN6204) Pfizer Dose 3 10/13/21 (FF2587) COVID Positive 1/12/22  1/6/22: A 67-year-old male with a past medical history of hypertension, hyperlipidemia, hypothyroidism, anxiety and depression and acute myelogenous leukemia on Gleevec follows with Dr., is transferred from Medical Center for GI bleed and acute kidney injury.   Patient presented to the Medical Center on 01/02/2022 after he fell and syncopized in service, was evaluated in the ED, noted to have acute fracture medial tibial plateau of right knee and the acute anti 10th rib fracture, nondisplaced.  Patient was evaluated by Dr., orthopedic surgery, and recommended non operative management with the TTWB RLE and pain management.   Patient was also noted to have low hemoglobin, 6.7, was given 2 unit PRBC transfusion.  Patient was noted to have black stools, FOBT is positive.  No hematemesis or abdominal pain or chest pain or dizziness.  Today his BUN and creatinine went up to 47 and 2.7, and patient is transferred for further GI and Nephrology evaluation.   Patient denies any history of prostate enlargement, no urgency or hesitancy.  Patient states that he had recent colonoscopy and small bowel capsule endoscopy with Dr. about a year ago, and no bleeding was noted.  He also follows with Dr. for acute myelogenous leukemia, and has been on Gleevec for the past 15 years.  Patient had COVID-19 infection in October 2020.  He is vaccinated against COVID-19.  2/9/22: A 67-year-old gentleman presented to medical center as a transfer from ED with a history of GI bleed and acute kidney injury.  The patient had a fall 4 days prior to admission.  He is sustained a tibial plateau fracture as well as 10 rib fractures that were nondisplaced.  He was transfused him with 2 units of PRBC for acute blood loss anemia.  The patient eventually underwent EGD that shows that the patient has peptic ulcer strictures and GERD with some esophagitis and duodenitis.  The patient was started on Diflucan as well as proton pump inhibitors.  While in the hospital patient developed acute kidney injuries and was noted to be constipated and not to be able to tolerate any meals.  His abdomen was distended.  He was eventually diagnosed with ileus.  The patient did not have any objective mechanical obstruction.  Surgery was consulted and recommended conservative management with NG tube for decompression, IV fluid and eventually TPN.  Patient's kidney function did not improve and was started on hemodialysis.  The patient had a long, long stay in the hospital with no improvement of his condition.  He could not tolerate any food.  He remained on the hemodialysis with no insight to improvement of his renal function.  After further discussion with the family and the patient being lucid, has opted for comfort measures and will be discharge under hospice care on February 10, 2022.  At this point, all aggressive management has been discontinued and comfort measures have been initiated.  Family member, a daughter, is in arguments with the patient, who has been stating that he is ready to meet the Lord and he wanted to go to the Lord.  The patient will be discharged with hospice care management.  2/11/22: Patient deceased