Document 104

Case 1:11-cv-20120-AMS Document 104 Entered on FLSD Docket 05/01/2012 Page 1 of 9

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Norhshor M edi Cent -FM C Cam pus
t e cal er
5000 W .Oakl Par Boul d
and k evar Prnt a 02/ 12 0949
i ed t: 28/
Ft Lauder e,FL 33313
. dal
Di
schar
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ven o i
Rx s rt
ta Medication History Next Meda Ta en current
k Continue :top Rx
Date (The Medications Taken at Home infov-xtion Dole zrior to Hospital lrovided
is based on patient-provided infovmxtion. ) Dve Admiysion Medirations

02/28/1 ' B
2 NOXAPARIN S M ( VE
ODIU LO NOX E V) 30 MG I CTI
QUI NJE ON CURRENT
#012 BID SUBCUTANEOUS
MED
IF 1NR ORDERED CALL MD PRIOR TO ADM FOR
1R=2ULS OHRIEODRD
N > NES TEWS REE 7M
INJECT SUBCUTANEOUSLY IN ABDOMINAL WALL

02/28/12 P RK OL ( NDERK L EQ V) 6 MG CAP E C 24
ROP NOL I L A UI 0 SUL R HR HOME CURRENT
#005 ONCB A DAY ORAL j
D NTCUH
O O RS
M TOR PUL
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MD MD
E E t
j

02/28/1 SPI
2 RONOLACTONE (
ALDACTONE EQUI 50 MG TABL
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#0
08 EEY4H
VR 8R OA
PL MM MRET
EE CD N
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E k !
)
!

02/ /12 SPIRO
27 NOLACTO ( ACTO EQUI I0 MG T
NE ALD NE V) 0 ABLET HO
ME CURRENT -
#0G9 EVERY 48HR 0Rh5
MED MED

02/ 12 MFPERI NE HCL ( EROL E V) 5 MG I
27/ DI DEM QUI 0 NJEC N
TIO C
URRENT Q
#017 Q3- HR PR
4 N PRN I MUSCU R
NTRA LA MED
. V
PRN MODEM TE PAIN

02/ 7
2 /12 MEPERT NE HCL ( MFROL E
DI DE QUIV) 7 MG I
5 NJEW ION CURFPNT
#016 Q3-4HR PRN pRx INTRAMuscuLhR .
MED M
PRN SEVERE PAIN

02/27/1 P
2 OTASSI CHLORI ( OR-C 8) 8 MEQ TABL C
UM DE KL ON ET R HOMS CURRENT . ''
#018 ONCE A DAY OPAL
MED MED

02/27/12 DEXTROSE S%-NACL 0. 5% 10 ML
4 00
#013 CURRENT
4
POTASSI CHLO DE 20 ME IO ML
UM RI Q/ INTRA NOUS
VE MED
Rate: 70 ML/HR )

02/27/12 FUROSEMIDE ( SI EQUI 80 MG T T
LA X V) ABLE HOME CURRENT
#011 E RY 48HR
VE OPAL
MED MED x
MONITOR ELECTROLYTES, URIC ACID

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Date:
t,
- Ti
me: Physi an Si nat :
ci ur
/
.
Di
Al gis:
l e
er ctaton #:
i
NKA Height W ei
ght
5. 1. / 18o.
1 ou 3cm 190 l / .180 kg
bs 86

DOB: 12/ 1/
1 54 57Y
M edi on Reconcii on
cali lali PT:lP
I
Page:1 ( i
Contnued) Acct 011497559
# M R# F000493462
BUJDUVEANU,
TRAI
AN
AT:BAYRON,
FERNANDO E AD:BAYRON eFERNANDO E


Norhshor M edi Cent - FM C Cam pus
t e cal er
5000 W .Oakl Par Boul d
and k evar Prnt at 02/ 12 0949
i ed : 28/
Ft.Lauder e,FL 33313
dal
Di
scharge Copy Gi t Patent
ven o i

Rx start Medication History Next Me T en Cu nt
ds ak rre Co n st p
nti ue o Rx
Date (The Medications Taken at Home infoo--tion Doae Prlor to Hoapital Provided
is bas o pa
ed n tient- vide inf mxtion.)
pro d or pue A ml ion Medica'ions
a sa '.

02/28/12 FUROSE DE ( X EQ V) 40 MG TABL
MI LASI UI ET HOME CUARENT
#010 EVERY 48HR ODAL MED MED '
MONITOR ELECTROLYTES , URIC ACID V

02/27/12 ONDANSETR HCL ( OFRAN EQUI 4 MG I CTI
ON Z V) NJE ON .

#1
05 EEY8R I NEE PN
VR H F EDD R ITAEOS
NRVNU MD
E /1
02/27/12 PANTOP (ROTONI I * M
P X V) 40 G/l INJECTI ONCE A DAY
ON C NT
URRF
#014 SODTUM CHLORIDE 0.9% 100 ML INTRAVENOUS MED
I LOC FLUS
V K HED W/S PL
A USH B4/ TZR
AF
Inf Over: 30 Mins
HOSPITAL APPROVED SUBSTITUTIONS:
IV or Oral Pantoprazole substitute for
Prilosec, Nexium, Prevacid Aciphex .
Esomeprazole oral suspension for a11 NG .
PEG, J-Tube, etc

02/27/12 GLYBURIDE ( AS 1. MG TABLE UL MCR
GLYN S) S T TR HOME Cu NT
RRE
#007 ONCE A DAY 0EA5 MED MED '
,
MONITOR FOR SIGNS OF HYPOGLYCEMIA

02/27/1 ' PI
2 OGLI AZO HcL (
T NE AcTos) 30 MG TABLET HOME Cr
mpqNT J
:c
06 OC ADY
NE A oh
RL MD
E MD
E ' l
MNTO FR S G SO HP GY E A
O T R O I N F Y O LCMI .
I

Additio Medications
nal I

1

*
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Dae
t: -
'
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Ti e:
m %& Physi an Si nature:
. x ci Di aton #:
ct i
Al gi
l es:
er H
NKA ei ht
g w ei t
gh
5, 1. ,/ 18o.
1 0' 3cm 190 I / . :80 k
bs 86 g

DO B: 12/ 1/
1 54 57Y
M edi i Reconcii i
cal on lalon PT:IP
I
Acct 011497559
# M R# F000493462
Page:2 ( 1 Page)
Las BUJD UV EA N U .
TRA I N
A
AT:BAYRON,
FERNANDO E AD:BAYRON,FERNANDO E


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T o as s us i our ef ort t di ay accurat i orm at on,patent
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