Medical Report: Iraqi Male, Detainee, Abu Ghraib Prison, Baghdad, Iraq re: Fractured Cranium from Explosive Blast

Medical records of an Iraqi male detainee at Abu Ghraib prison, Iraq. The detainee suffered a fractured skull in an Improvised Explosive Devise (IED) blast. The medical records do not give any personal information on the detainee.

Doc_type: 
Physical (non-death)
Doc_date: 
Saturday, November 1, 2003
Doc_rel_date: 
Friday, October 14, 2005
Doc_text: 

NSN 7540-00-634-4124
VITAL SIGNS RECORD
/IVIL..sa 1 wf 1.— . •.............. •.--HOSPITAL DAY •
DAY
POST-
IIIMIMIIIIIIIIIMMIIIIIIIIMMINUINIMIIII

11111111111MMIKICIIIIIIMMI
t1/41.

MONTH-YEAR ---'. DAY
[Tao . piwi • •
1 7.

_

19
HOUR
—1 www(43COCOCO .0. Am
CZLOLO
xi cst a) a) --.1-.I -4 00COOD00E b a) I-':-.1bi..) Co i.,.) io :r=. bb0) :0a
0 0 0 0 0
0 0 0 0 0 0

(Centigrade Equivalents, for Reference only)
PULSE . TEMP. I: Intl . • •• MA :: :1 I • 41
• • FOAM 40.'
(•) 1,1

to

(0)
.
/
: :
MR

105°
.
. .

i .

104° . . . . . . . . . . .
"7„---180
:::1

. .
.

. . . .. -
.

. . . . . . . . . .

.

.
. .
103°

170
. . . .
. . .. .. . . .

........

' • " . . ' . •. .• '
"
" . .....
"
.
.
. ,. .. . . .

.
t

..
1

"
EMS
. .
: • . .

102° • •• •• • •
. . .

160
• -• •
. . .
.

.
. ' •. ,.
... ..

" . . . . .
"
. . .

150 101°
•-- -
. .
.

....
. : :
....
. .
. .
. . . .
.
77:71,

140 100°
. .
.
.. • •
.
1•E

130 9892: WIE111/111ENZIMISIMINIMMI IMII!M:n:=M11•1.
. . .
. •
P1111.11

.
......

111119111111M

...... • •
... in
• : :
r

120 98 °
:. :.

.

97°
.......... ..... IT

• V •

110
.
......

100 96° .
.... : : : : : r

90 95° , , ' .
" "
" " • . .

. . ..... . . . . .
. . ..... . . . • . . .
. . ..... . . . . . . . .
I .... III
. -
¦•¦••••4
.


. . II
. .
70
l

f
...

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.1
"
.
V
I ..•
.
..........

"
. . .

0
50
(---,

• •
. .
.
.
..........

.
: . : : : : : :
• : : : : :X : : : : :

.. . . . . . .
40

.

RESPIRATION RECORD
ri BLOOD PRESSURE IIIMMIIIIIMainilir, . ' 17/1117 4.
B -6 1 11111 rl gr3 1 7 M11111

9
o I falai/WALT/1E3A

0 .1 HEIGHT: WEIGHT .--. IIMIELNINII11111011 1.11

ITYAISIMINNACILVieiT

. .
. Lifi•
1.9
.2
a
0
Ot,
. . . . . . . 1MA pn run

.
(SSN or other); hospital or medical facility)

PATIENT'S IDENTIFICATION (For typed or wri ten entries give: Name— as , first, mi e; _
VITAL SIGNS RECORDS
Medical Record

STANDARD FORM 511 (REV. 7-95)
Prescribed by GSA/1CMR. F1RMR (41 CFR) 201-9.202-1

MEDCOM - 22841

DOD-036417

MEDICAL RECORD VITAL SIGNS RECORD
HOSPITAL DAY
POST-DAY
MONTH-YEAR DAY 2 42.9) 7 0 , ii 1 )-.
0 •Vz•-

19 HOUR 15 ..... . • • • PULSE TEMP. F i: . ...... ri . 4

1 g •.
• - l' ..".
.
is

:

.

. . .

... ... .
(0) (.1

105° .. 1 ............

.

........ . ..... . .. .. .
.. . . . :

180 104°
.......... ....
. .

170
103'

..- -
...... .......

.. . .......... . .

.

.... .
. .

............ . .

..
a •
. .
. .
..

160 102° ....... , .. .

. : .
....... . . .

.............. .... ... •........ .. .. : . .

150 101° .. ..
. ,
w w w w ww w
al oi o) 0) —-.I --.1 b is) i
o 0 , o 0 0 0

(Centigrade Equivalents, for F
.
..
...
. .
. .
....
.
.
.

140 100°
..........

.. .... . .
........

....... • •

.. . . . ..... . .

.. 4--:___.: .. . . . . . .
..

130 99°
. .---,

....
. . . . .. . . . . . . . .

.

98.6° : : : • : :
.

120 98°
..........

tS-••-•
" ' • I
. . .... .
... . . . • -.. .• r

110 97°
....................

..............

100 96° ..................

............

. .
90

95° .......

.
.

. .
. . .
• • "
. . . .

•-.
. . . . .
. . .
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.......

80
. . . . . .

70 • •• . • . • . •
60 ......................

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::1

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:
:
.
.
40
.. . . . . . . . . . . . .

RESPIRATION RECORD
Record speolal data only when so ordered
BLOOD PRESSURE

HEIGHT: I WEIGHT ••••••¦0.
PATIENT'S IDENTIFIOTION (For typed or written entries give -Name—last, first, middle; ID No.%_(SSN or other); hospital or medical facility) REGISTER NO WARD NO. .
1.., ik0 91;
STANDARD FORM 511 (REV. 7-95) BACK

MEDCOM - 22842

DOD-036418
0
m

m
0
O

m
0
r
E
m
-u
rn
rn
Vild O H1•110ddllI w 4

J
N
0 N
-o
O
m
I
0 O
m

n

0
10POJNI CUAG ANALYZER V4,54

APIDP010 COAG ANALYZER V4.54
SERIAL 1i005485 11/02/03 04:34

ERIAL 8005485 11/01/03 12:15
atiet ID:
Test Nam. :

Test Name :'T

Test Result:= 15.6 sec.

Test Result:= 16.4 sec.

Ratio =

Ratio = 1.3 .
Calculated 11111R.= 1.49

Calculated INR = 1.61

Sample Type:citrated wh. blood

Sample Type:citrated wh. blood

Test Date ,.:11/02/03

Test Date :11/01/03

Test Time :04:32

Test Time :12:13

Card Lot.

:080201

:080201

Card Lot.

...----flprefttor

alrfarM,

Operator
.

RAPIDPOTNT COAG ANALYZER V4.54

PIDPOINT COAG ANAL -IR V4.54

RIAL #005485 11/01/03 12:18 SERIAL 005465 11/02/03 04:51
t i ent I 1.111111111 ( 9.( (7) -(1 ------Pa:t4eR-t--iDillIllb
Test Name :APTT

,esName ..

Test Result:= 35.4 sec.

est Result: = 37.5. sec..
***RESULT NOT RANGE. CNECKED**

Sample Type:citrated wh. blood.
Sample Type:citrated plasma

Test Date :11/01/03.
Test Date :11/02/03

Test Time :12:18.
Test Time :04:49

:030201.
Card Lot.

Card Lot.

Operator :030201
Operator

1111•111
12.9 H x10'3idi.
C.:1-11-03 3.74 L KIOVIL
12:11 10.9 L ght
Ratiert 33,4 L I
• ivdts
.1,fK 17.2 H x10!3/i4 4. -X 10 '6.14 17.0 g/d[. 3.6 I 88.5 ft 4.5 10, 4.Cf,) 6.00 11.0 18,0 35,0 R.0 80.0 99.9 Z2 9.4 3.93 11.5 34.3 L K10'3 ,'111 tlai 29.0 as raiz 32.5 L sAL Pit 151. •41.0'I ,* LI. 12,3 lt
::•• ••':: no • :=9.6 g 27.0 31.0 L g/dL 33.0 37.0 2,35. * k10'3/4 150. 450. 4 .'M.5 51,1 1.3* x10'3Iti . 1.2 3. t7:4 n2112 Pit LYI 29.1 32.9 135. L 11,0 rirr3i/c2

&g24
Patient
4.5 10.5
4,00 6.00 11.'i 12,0
75.0 0.0 ;10.0 99,9
77.0 31.0 310 7.0
trrl

,A
.

51.1

1.2 3,4
1 CAA-7
-.
MEDCOM - 22844

DOD-036420

Ward/Section•
LAST, FIRST, Ml
TEST RESULT
Na
Cl

.
PCO2
P02
TCO2
HCO3

sO
BEecf
AnGap
Ca
BUN

GLU
Creat
Hct
Hgb

TEST RESULT
Troponin-1
Drug of
Abuse

REPORTED BY:

REQ CHEMISTRY RESULT FORM I (Subject to the Privacy Act of 1974) DAT SSN/PSEUDO SSN:
6 L
41*.k.
nuc is to c166E1;6
TEST RESULT REF. RANGE
REF. RANGE:
____= PICCOLO === ---73-118 mg/di

138-146 nano1/L GLU
18:46

23/11/03 7-22 mg/dl
3.5-49 mrooIlL'
MALE BUN

REFERENCE RANGE:.

8.0-10.3 rug/dl98-109 mmoVL CA!

PATIENT #:.

0.6-1.2 mg/dl731-7.45 CRE

METLYTE 8

1° 1152AA4

35-45 mmHg (art) DISC LOT #: NA. 128-145 num.)111 41-51 mmHg, (vcii1 DR #: 000
OPER #: 702

33-4.7 numb1
8D-105 mmHg (ar9
0000100494 K

N/A (ven1 SERIAL #:
cL. 98-108 mmo1/1

23-27 routo10. (ut) ........................ .

24-29 =al. (yen)
119* 73-118 MG/DL .

22-26 'mai. (art) GLU 18-33 mmol/1 23-28 nuuot/L (wit) 13 7-22
MG/DL 95-98V. BUN 0.6-1.2 MG/DL } Lit
CRE 1.2.

U/L

(-2) — (+3) 139 39-380 TEST .RESULT r REF. RANGE ***
CK

=nal& 128-145 MMOVL 10-20 mmol/L NA+ 3.3-4.7 MMOVL LLB 3.3-5.5 gm!
K+ 4.1.

26-84 u/1

1.12-1.32 mmol/L 95* 98-108 MMOVL ,LP
CL-18-10.47 th,

8-26 mg/di 19 LT
tCO2 33-

14-97 WI

70-105 mecil CHEM OC: OK my
INST OC: OK.
HEM 0 , LIP 0 , ICT 0

0.7-1.5 mg/dl ST 11-38 un
38-51% PCV BIL mg/dl
12-17 e& GT 5-65 u/1
5 6.44.1 gAll
1`,

REF. RANGE Coin
EST RESULT REF. RANGE
128-145 mmo1/1
3.3-4.7 mmol/1
98-108 mmo1i1
DATE: LAB ID NO.:

MEDCOM - 22845

DOD-036421

W
LAST, FIELST, MI.
TEST RESULT REF. RANGE
Na 138-146 mutoUL
K 3.5-4.9 mmoULr
Cl 98-109 mmoVL
7-31-7.45
PCO2 35-45 mmHg (art):
41-51 nunEln)
P02 80-105 orrnHg (art) NIA (van)
TCO2 23-27 rosnoUL (art) ' 24-29 rnmola. (ven)
HCO3 22-26 mmol/L (art) 23-211 trirncilL (vex)
s02 95-98%
BEecf (-2) —(+3)
mmol/L
AnGaP 10-20 mmol/L
Ca 1.12-1.32 mmol/L
BUN 8-26 meidl
GLU 70-105 medl
Croat 0.7-1.5 med1
Hct 38-51% PCV
Hgb 12-17 01

11.-61a

TEST RESULT REF. RANGE
Troponin-1
Drug of
Abuse

R.EYLOUCS:
REPORTED BY:
CH EMI...Ski( X .K.N.;SU LT FORM. 'a--(Subject to the Privacy Act of 1974)
.
'1)ATEit SSN/PSEUDO SS1s1 -.
kelabilkkaiiii
-
TEST _ RESULT .REF. TEST RESULT REF. RANGE
GLU 73-118 mg/d1
PICCOLO

7-22 mg/dl
14:32

23/11/03 BUN
8.0-10.3 mg/c11
MALE CA"
REFERENCE RANC

CRE 0.6-1.2 mg/c11
PATIENT #:
METLYTE 8 NIA

128-145
3)52AA4

DISC LOT #:`-'

3.3-4.7 turool4
K+
DR #: 000

OPER #: 702

98-108 mtn01/1
0000100494 CU

SERIAL #:

18-33 rnmo1/1 -
tCO2
114 MG/DL

GLU 73-118

Faintly
BUN MG/DL

15 7-22
CRE 0.6-1.2 MG/DL

1.1 TEST RESULT REF. RANGE CK U/L
158 39-380

ALB 3.3-5.5 ea
26-84 u/1
K - 3.3-4.7 MMOI/L ALP

4.0
CL- 96* 98-108 MMOM_ ALT 10-47 ut).

AMY 14-97 tilt
CHEM OC: OK

INST OC: OK

AST 11-38 u/1
1-EMO , LIP 0 , ICT 0

m icIl
5-65u11
Ata )3 3 GOT
TP g'dl
+Coc3. -3
0#1
• TEST RESULT REF. RANGE
NA+ 128-145 mmol/1
3.3-4.7 mroolii
98-108 =moll!
-CU
tCO2 1 8-3313-mmIA
DATE: LAB ID NO.: '
MEDCOM - 22846
Ward.'Stiction:
REQUESTINGG

CHENIISTRY RESULT FORM
LAST, FIRST, MI. (subject to the Privacy Act of 1974)DAIELT-L-VE SSN/P _ __ _ S c Si.
. -
TEST
N.2
K
CI
13'd PCO2_
P0' TCO2 HCO3

1,z;2s
dEecf
• Crap
Ca BuN
OW
Creat Hut Hgb
TEST
Troccriin-
Drug of Abuse
i ,
,..-,......•
RESULT
414t, v
/0-1 1;15—
,,,,-,2
(in
1
' -

REF. RANGE
139.146 rraloliL
3.5-t.9 rra-rolll
98-109 MPJ0111-
7.31-7.45

35-15 mmHg (Let) 41-51. n-Jr..1-fz (yza)
Ns .OI-:°( ,s, eirri;a18“')
2.3-a7 mrno. Cut)
Ll

24-29 mrnobl-(v=2)
2 -2 mmo4/1., (an)
223-286 TrimoVL tvcri.)
95-98%
(-2)-(4-3) ntmul/L 10-20 rarnoliL 1.12-1.32 nu-not:E.
8-26 tagidl
70-105 mgicil
0.7-1.5 rued! 38-51% PCV
12.17 ,affil
';',.cfieliiis4-y.. 2.:
-. -

RESULT REF. R.iNGE
'
I
I- -.:, -'" -: (p_. i
TEST
ALB
ALP
ALT
AMY
AST
TsrL 13 LIN
CA"
CHOL
CRE
GLU I TP I
,;•(i 1 0) -, c e pi i itry •
RESULT 1 REF. I RANG E
3.5-5.5 gidl 26-84 t:; 10-17 wl
I 14-97 to I 1.38 w1l
0.2-1.6 cng,rel 7-12 ro,g/ d1 3.0-10.3mg/d1
I 00.-2C0 ragjel
0.6-1.2 e.I
73-118 mg.1-11 f 6.4-3.1 Ved
Iccidip)I-eMetlY7t. 8 '7,'.-.E'',-•• ••:-.-...,.' 'f:7, •".:...::-. ;:
TEST RESULT l REF E
GLU I
73-118 mg/di BUN I 7-22 mgjkil CRE I .
0-6-1.2 ma/di CK I 39-33012/1 (ND
L30-190 W1 (F.)NA -1:3-145 cu-. 13-3-4.7 coli) .CL . 98-108 mraol./1 tCO2 18-33 uircal:1
ti

ircoloymEtobolie.paxi•r.:.:._-_:-=
TEST !RESULT REF. RANGE
GLU 73-119 mg/di
BUN 7-22 rogidl
CA" 8.0-10.3 rag;',­.11rag;',-.11
CRE I 0.6-1.2 mildi
NA' 128-145 rr.rr.oV!
ic ).3-4.7 rorrklil
CU 98- 108 mrrolil
tC07 18-33 mmoI/1
.. ..

keiijoYT2k,:frinerP114,:.:--zr-')
,
. •......„..,..,,,::,:-,..,.... -,
..

_-_:,... F,,-z.v ...::-..:.:-.,•
TEST

RESUITREF. RANGE
. ALB I
3.3-5.5 01 ALP 26-84 di
• ALT 10-17 idl
-
14-97 to
."\ril.4
AST I 11-38 ut! TTBR. 0_2 7 1.6 ogid GGT f 5-65 till TP 6.4-3:1 gidl
I
noll
.:: ..7.. ;1:.. -

alee06j..Ejectrob7te.,' ...!),..:-:':: •,_
,-., 1.*•.t.
-i".-.*:;-:•-,....: ".;.-F-:.".
.
.•'.....•1-..:--•,:.; '
-•
TEST RESULT RREFR4..NGE
I
N...1,'
128-145 ramolit
lc
3.3-4.7 mmo'll
CI; 98-108 rr-mo'.1
' tC0z
. 13.33 17..7.o :A
RENY...ARKS:
REPORTED BY:
i DATE: LAB ID SO.:
MEDCOM - 22847

DOD-036423

1 Ward/Section: RE.QUESTING PHYSICI•AN:
LAST, FIRST, M.3.
DATE TIME

ELLA tOlooie) CBC • • rie.Alysis
TEST RESULT REF. RANGE TES
. RANGE WBC 4.8-101 x 10'
Color WA
RBC 4.7-63 x 10‘'

WA

Hob 14-18 g/dt (M) Glu Negati ve
12-16 g./d1(T)
Hct 42-52% (M)

Bili Negative

3747% (F)
MC V 80-94 II (M) Kct Negative
81-99 fl

Pte 134.500x10
SG N/A

vert ctcd
Lymph % 20.5-51.1%

Bid Neptive

) - pH wA .
5-

Segs • Mono Prot Ne }Live
IN

Bands Eos
Urob 0.2-1.0 OA r vIA'

Lymph Baso Nit Negative
Atyp Imm Lc-uk Negative
RBC HCG Ncgatree Morph
' , .
..

d9. CIO/ /1/1
•••••••••.-

Hera atocrit 37=47% (F) ..• . • •
Sed Rate
Cell Count

Other Directigert Negative
-

LABORATORY RESULT FORM ub•cc-t to the Privac • Act of 1974 SS N/PSEUDO SSN:
TEST
RPR
Mono

Source
Gram Stain Oco Bid
H. pylori
,NU:sc. Serology

•• , -• • • . -RESULT REF. RA VGE
Negative . l'yficrobiolow
.• . •• .. • .
r
egativ e Negative
Micro
Malaria
0 & P I
Other I

:Nal-ascot:1k thins •


Blooci.B-ank -..-•


. . MUST SUBMIT SF 518 WITH

EVERY UNIT REQUESTED ABO/Rh

ca.aguLitionStudie:st. • • . '
-Blood Bank Unit Crossmatch• - - •
. -•
(MUST.SUBMIT SF,518 VVTIB EVERY UNIT OF BLOOD • -• REQUESTED)

TEST I RESULT I REF. RANGE
UNIT TYPE
I CROSSM4TCH

PT 9.8-13.6 secs
21-34 sz=

D dL-7.e: 10 uelcrri
FDP 10 REMARKS: REPORTED BY:
DATE: I LAB DD NO.: .
") MEDCOM - 22848

DOD-036424
REQ UES

CECENIISTRY RESULT FORM
Subject to thc Privacy A ct of 1974)LAST, FLR.ST, MI. DATETD,Er SS ­
N/PSEUDO SSN:

s'pitIlSe, Lot, Ti ILM) (-? 2
i-STA
0lo). etabo ic?auct

LEST RES REF. TEST RESULT REF. TEST RESULT
REF. RANGE
I RANGE

Na 138-146 cr.moilL 3.5-5.5 g.'d!
GLU 73-Its m&":11

3.54.9 rrdnoLIL
BUN 7-22 mg/di
CI 93-109 mmol/L

N/4/ LI

8.0-10.3 rag/dl
(to CA

7.31-7.45
02/11/03 CRE 0.6-1.2 ragidi
04:41

PCO2 35-45 mmHg (.rt) REFERENCE RANG.
MALE NA' 123-115 rr.rr.o1/1
4i-5( mirl-fx(vr....1)
30-105 mmHg (s.rt) PATIENT #:1111
P02
raftxtla

N/A (veul
METLYTE 8

23-27 m.mal/L (LI)
TCO2 24 -DISC LOT #: CL 96-108 mmoI/1
29 rnrnotiL (sca)
3151M4
HCO3 22-26 mmoVL CM-I) OPER #: 013

DR #: 000 tCO2 I3-33 mmoLl

23-23 trauo4/1..(vcri)
SERIAL #:

s02 95-98% 0000100684
BEect ( -2 ) — (+3 )
GLU 132* 73-118 TEST RESULT REF. RANGE
rztrnoVI., MG/DL
BUN

Ar.Crap 10-20 mmoliL 10 7-22 MG/OL
ALB 3.3-5.5 g/d1

CRC ICT

0.6-1.2

C 1.12-1.32mmoliL MG/DL
ALP 26-84 till
CK 2149*

39-380 U/L

BUN 8-26 mgAll bIA+ 126* 128ALT 1047 e1
-145 MMO&L
K+ 3.6 3.3-4.7 11108/L

GLU 70-105 medl AMY 11-97
CL-10d 98-108 MMO//L

tCO2 18

Creaz 0.7-L5 mg/dI 18-33 MMOfiL AST
Hct 33-51% PCV
TBIL 0.2 7 1.6 czg/c1
INST GC: OK

CHEM QC: OK

H 12-17 g/d1
HEM 0 , LIP 0 , ICT 2+ GGT 5-65 u/1 TP 1 6.4-3.1 gte.

TEST RESULT REF. RANGE
..C.c.6.1.6)-.E.Iect-pilyie,-.. : •
Tic

TEST I RESULT REF R.42;GE
Drug 01.

NA I 128-145 mmol./1 Abuse _
CL-I 98-105 r=c1..1
tCO.. 13-33 m.-:-.c'..:1

MEDCOM - 22849

DOD-036425

• I TD.•±%Ti7.• I 1",2•.:F. -1 SSNI?SEL.:130 SSN: ) (0) ' 1
1......,,S7.-, F - ""
I 3 ftaiiiirS 1 201"1'
..
.019) . .:..•.:•:•(-,E'olo) . ;'.", f,:1:botic:Pal,i,.z t

.-.• -...,:......., c..,.-
-..cber., ...-,-y :.1:2::: .
_ .. . ... .. .. . . ... . . . . .E's 7 Pc.Sr fr 7 .7-E F. RA-NG E. 72..-51-1 RE.S LT 2 i ILE .. TEST Pr_ I -. '..
¦

, ' 1-.1 '5. • 1 Z5 _ ALB i 3.f-5.5 ,;-rz.1 GC,C.5
N 2 . 35-I..:? r7...-r,c,L 1_ ALP I I :::-34 :11 BUN .22 mi.,%-.::
I i•.-:''S - I '7;9 .-----... c 1 .1. ,s F T 1 C---:7 w) CA---10.3 .7.;-.•f:
CI I I CRE
p:-..
1 I 1-33 12./1 NA'

PCC2 1 t 25-.-27:: AST
TTi! i 0 -.1 - 1 . 6 ::13:c5 :::',.." . : . ':.-.':-_•..-,,.; .•' . N:.A.f ,-.1-1`. 7-2_2 :-.1.g.id: Cl -.1 4:?..-!Ci r.7.1... i ¦ 2:-2? ::`-'7,10- (s.t'l;
I

CO3I 1 22.25 rrirr..:4./1. (.,-.:. CA 1 S...1.10.3r.r.;':::: tco:, I 13-33 -.c'
, :3-zs :17_-.K.4./t.. t've,-)

1 I t 1 95-9S% C7.4.-OL I :c•:,--... ,11] rnv".:2 ..:(Pic6i16)7Live . Paa -el Pius -.-..-.
s02.
1 -"•:).-(# -CRE 0.6-1.2 -.3:c..¦ I RES C.;7..7-i
-i) T57-..-L Er-7. P....-'..Vt.:::1-
BF.....: j
j 1.3-:r_trair_cliL GLU 1 j 73-113 rr-t,;•'•f ,k:_r,B I
Ar.C-22 1
i 6.4.3.1 g1 , 7.-_,-34 ..:..•1 i I
1 i i.17-1.32:-.L.T.olil... T? i AL?
:, :::47....it

3-5 :- -.',.:1 •----•-' -,.. : -(PicoldYNtetiN,:c S .....-:-.. .ALT 1 --5
I 1
? :- F. ...

1 .70-;.-; r....;idt 1 . .3:-%cr i . .
7.1-ST , ?ESLrr r I ;

CS.; 1
1 I :7-'4 VG -7
I
i 73-113 =.7./..: AST, i 11-33 'al

Cr: ' 1 C. 7 .1 .1 E...:ii f. t- L ......
..2..L.6 ..7_•.:_.

1 33-3I% ?CV BUN 7,2 mi-;::.; _ TBIT :­
-. 0.-1.2 1-4, .:1 GGT

i
1 39-3SO ,.....'1 CY) T

. -:',7 •.: IL iNc.*•;Cheinistry'::••:' -..... -.:•:. CK
-, .s.7.‘) :..1 .E) • .

' :23-i-t5 :_-...-:-..:-... 1. •••.: Criecolo) Zic:-. -rolvte.-.: -.- --
TEST ; .?..L,7SULT i .D2F. ...-.14VC:2_7. NA-1 •
I

1 .7_7_6.1 TEST i RES C.':', 7 :I. r-•-. .:•1•1,::•::: E,. 1 ; 93-IO3 =_•-•.:••:.1.."., :•A -1 i:?--....:5.
rs,-,•-•-‘; ' .Cf.:
--• -5 - • j i
I -

..1::.1.:Le. j t•
: 13-33. K-

CO
1
i

`.:::•10S r.-_-:: -...

• C7-.
, . I
: . : ..;";• :-..-..... -.....1
.

P '•'-t"...S.
.6...• or teii34.
/4-Pr'dL I 1f2'-
—,
.
LAB ED .:. O.:

R=1.)01-1 -:=D BY: DATE:
J NOJ q _
110 (6)(u¦ --{-
MEDCOM - 22850

DOD-036426
.-

I2--(CPI

1.----0-111111111.
k. 138 mmoliL Pt Name:

.,
3-1 mmo1 , ,

11:02 E5 mmol/L Oa 13 mmol,

L
He ZZ .PCV K 3.5 mmol/L
7 g/dL TCO2 aR mmol/L
,via Hct Hct 21 %PCV
Hb* 7 g!dL
37C

(9 -evia Hct
PH 7.4.L.:0

PC ._12 34.1 mmHg it 37C .102 229 mmHg pH 7.414 a4 mmol/L PCO2 38.5 mmHm --13 mmol/L an mmHg
(Ecf POE
100 % HCO3__"125 mmol/L

8EPcf 0 mmol /L
A2* 100 %

*calculatg;d

OPatient Temp *calculated
7.431
PCD2 37.0 mmilci

f4t Patient Temp

7.403

E3€. mmHg

35.5 mmHg
Patient Temp: 102.0F

POZ 22t; mmHg
Type_.: ART
r-,atient Tpi 00,:?F
03:40V03 20:16

5ample Type_.;

04HOVG_ 03:35

3Per 11111101t9(Crl— .

-nysician:_, (

Oper : 11111

-

'.

3er# 42015

.11.4 .sici 3 n JAMS,04eR
• CLEW R53

Ser# 4E011
-.:tiMf504

)POINT COAG ANALYZER V4.54 HRIA 0005485 11/04/03 03:37
Patient IDA!. Test Name : Test Result:. 13.5 sec. Ratio 1.1 Calculated INR = 1.18 , Sample Type:citrated wh. blood Test Date 11/04/03 Test Time :03:36 Card Lot' 050206 Operator
k,PIDPOINT COAG ANALYZER V4. SiRIAL 0005485 11/04/03 03:4
TO

Paient 1198 Test Name :APTT -4jTest Result:= 38.0 sec, Sample Type:citrated wh. blood e Test Date 'i1/04/03 Test Time :03:38 Card Lot :100208 Operator
-]2ar;iFir„ Lioits
6.00
35.0 a0
:7E'A r:f.,1 Plt 52.5 L 141. L 2,: 9!dL VHJL ';10'31L 27.0 31,0 33.0 37.0 15C, . 20.5 51.1

MEDCOM - 22851

DOD-036427

LAST. FL-ST, .L. ..1.----
1 33 ' i 19i/

Tit -:--) . • ,2 ::::-...CPolo)'.Cb'iruis:7-‘• 1....2 -: -::.,..• ....•':..(k-'1: .,:plo)•?,, f.,..2::abotic:P .-.. t . •
..... _. _ ,...... .,__ ,..... _.
.
7-;:sr i ..:: -., . 7"7 '.2-I R_EcZ,IT i R::-.7 TEST

':*--1 '‘'-C" -7
---AL F,$),::' 1 I ;3-IIS:r•-'-'
l 3 5.1.9 ;:-.,1-..:1. -1. ALP.' 1
K --- ----PICCOLO
i CI 1¦ 9S-.? 7_-_-....cvE... ALT i 04/11/03 03:39 REFERENCE RANGE : MALE PATIENT #: Mill
i7.3-145 ---,::: ¦

I 35--t5 AST
PC.0 2. 1
. 41.!;::-_-.-:-.:z(v=.1. ....Z¦r•-METLYTE 8 r LW-1 I t so-;o5 mr.-.2-is T.-3„, 3151AA4
PO2 DISC LOT #. ‘-3N-Ll_ ; LI; ,3[-,,..,• OPER #: 269 DR #: 000
TOO:
I 1
SERIAL # : 0000100494

I 22-2:: mr..--:4./L C1r) I rr.r.-.-c!..1
c-
1

! :3-23 zrzuctit_ tvc7.1
I 95-934.4 CHOL 73-118 MG/ DL 71...ive P inil Plus ..-.:-....;
507. GLU 109
7 7-22 MG/DL ... -

BE,:cf (---)-(÷=) CR_E BUN (..-i.."1-j A._' ,..77'. _ J:”
21..T.Vill., i CRE 1.5* 0.6-1.2 MG/DL
1...3-.:0 IrA7...c1IL GLU 1 cK 2291* 39-380 U/L

r-, i t.I -1-1.32:-nr.--..-ii.-1, T? 126* 128-145 MMOlL
,.... NA +
K+ 4.0 3.3-4.7 MMOVL . :-47 i
CL-105 98-108 MMOIA_

CU ¦ 70-;!)5 mg/L:1. TEST 1 ..:22 tCO2 19 18-33 MOM_
i
.

1 NST QC: OK CI-EM QC: OK
Pc: 3 ,....:"N HEM 0 , LIP 1+, ICT 1 +

I

! i2-17 -c:1
i-....7..7
..'"Ntis:c:Cher,-..istc21:::-..:.:-...-:----C -.c:

ID) 0:Vte. '..
., RESULT I R_E:"... P._..1.1VG_E NA
TEST_ •, . „...--•• • -" . -
1 1

1....1. 7 i ?_EF: .:_=.2;,_1;i......
7:cc.•:.:-.:_-.-1 i K"

I

1 i2.i..--:z.1;:::=‘..1
C1-....

A.:....:..t i . ,
1
: .

, . . -LOS;•:-....7..:".:.
. •
'

. •. !•3-33 :-..-....;.:
,

. -
.

! I
C13C-,--Tri h7/ ) 0136 () 5114) --C)..14-11 dr(fri'le 4 illje g ) Pit . i °II
LAB ID NO.:

R=PC.)F.-11.-ED RY: DATE:
.
1
MEDCOM - 22852

DOD-036428

iirosirm
(SuSjcct to
of 1974)
S \-

LAST, FIRS7..N'2.
0,17

_N(Nd SS t6 Cc)) -1

•:. ..•
TEST R.LSCJI T I R_E.F.

4.S-10.2 x 10' t17
4.7-6.1 x 10 Alop I N.'.4, Mono Nc-g21.......t:

' NCS2::Y= 12-16 r.k.1(17) •-• 42 -52% (M) . Bi!i 1 :!!:,--i-Sorc
N 1.4-1S &idt 0,.f) Gu -Nficrobio-lc-J-r:
___iLyr..

HZ:
. . . • ..

37 -17*/. (F')
80-94 n (M) Kcz Gra=

tic...7ative . -•

MCV
81-99 fl. (F) • Stain
P1: 130-5co r.. tO 1 SG NIA 0,7..:: B lc! v=-iC:cd
Ncv.rivc .4,..:&-2.,.i.ec —

20.5-51.1% Bid H. pylori
L y7h %
N/A • MIcro

cgc=L2 t61.6-.-v) Nan a al Dreti21 PH
Parasnes

Mono Pr Ncp.Live Mala.ria
Eos Urob 0.2-1.0 0 S.,: P •
Other

Baso Nit

Im Lcuk •Nclor.o-s.copic UriallySiS
RBC HCG Mor?i,
42-52% (M) F. • ..131-ood.B-ank •-•
cu-7- •. • . .
. . .

37.47% (F)
Ccii MUST SUB= SF 518 WITH

Scd
Court EVERY L-TT REQUESTED
Dircigcn Ncgn.tivG .4.130/R1-1
..-:.-.....! . Mood Rank: Unit Cro.ssoa3rcb . ..... • •

u-s. ,-;raLvionStudiez.• .!! . • (NfUST SUBMIT SF,518.W I. i b EVERY UNTF OF BLOOD.
. ..•
-.: :REQUESTED)
UNIT 2-1!?E• i C.R.05.S.',L4TC1-:"

P--LNGE
9• S-1 3 .6 scc-4
2 1 -34

D
R E MARKS :
CP,tr
I
LAB 1D• NO.: .

REP1DRTED BY: I DATE:
MEDCOM - 22853

DOD-036429
I 2,2 -5. 1;1. 1 0'
14-IS sidl
12-16 cle.1(F) 42-52% (M) 3747% (F)
30-94 u (M)
81-99 ft (r)
130-.1C•0 10 1
ya-ified
20.5-51.1%

cra-Ikao"v)!!,./Astuil piffertatill
Segs. M orin
*ands. Ea's
Lv Baso
I

RBC
Mor?.'n
I 42-52% (M)
(F)

cc:J. Sate
er
- o-tg uLatio a "Studien


1-1­7-ST R RANGE
7-77- . i 5.5-13.6 se-= . •
2!-.34

I ¦ -=::01...&';:.--.i
!

RE.ktA_RICS:
RE PORTED BY:
L AIi-(ALU1 i
-c_EULT FOR_NI
(Subicct Privac- Ac of 19741 TLy..i-: -
rolou • •
• TEST RESULT RS. F. RA ,VC:
ftp
ono Nes-at:v.:
Gc rob i4o
G 1.1.1
Soc
Biti .
.K.ct (*)
CCOLO

Ncve SG NA 09/11/03. 0?:36 AM Net REFERENCE R MALE Nct7---' 67=
Bid
PATIENT #:

PH
BASIC METABOLIC Prot Nc. , DISC LOT #: 3325AA4 OPER #: 013 DR #: 000
a,

Urob.
SERIAL #: 0000100684

Nit
(IU 134* 73-118 MG/OL Ni BUN 11 7-22 MG/DL 02
Lc--A
CA++ 9.0 8.0-1 0 .3 MG/DL

HOG Nc CRE 0.7 0.6-1.2 MG/DL
NA4 -figk W128-145 MMOVL
K4 4.3 3.3-4.7 MMOL

103 98-108 MMOVL

CSF • •
tCO2 22 18-33 MMOVL

..• ­
i18 WITH
c.1.1 INST QC: OK CHEM OC: OK
JESTED
C-o ex/
HEM 0 , LIP 0 , ICT 0

Direc1i3cn I
3 LOG D
• (MT.i5T-„SUBNIT
• TCF
07,7T
1
LAB II). NO.:.

I DATE:
MEDCOM - 22854

DOD-036430
RAPIDPOINT COAG ANALYZER V4.54
SERIAL #005485 11/09/03 05:43

Patient ID:11.111

Test Name

Test Result:= 14.:0 sec.

Ratio = 1.1

Calculated INR = 1.25

Sample Type: trated wh. blood

Test Date : 1/09/03

Test Time 45;41

RAPIDPOINT COAG ANALYZER V4.54
SERIAL #005485 11/10/03 04:30

Pat i east I
Test Name :

Test Result:. 15.„6 sec.

Ratio = 1.3

Calculated INL .. 1.49

Sample Type:citrated wh. blood

Test Date :11/10/03

Test Time :04:29

Card Lot 080201

Operator (4.)---1=1:_ :°8°
1111111.

RAPIDPOINT COAG ANALYZER V4.54 SERIAL #005485 11/09/03 05:45
Patient ID:
Test Name :APTT

Test Result:. 17.9 sec.
***RESULT OUT OF RANGE***
Sample Type:citrated wh. blood
Test Date :11/09/03
Test Time :05:43
Card Lot
Operator


09-11-03
05:40

Patient
Limits

,13.0 x10"3/u1 4.5 10.5
Fit 3. L x1046/uL 4.00 6.00

Hsb eir g/dL.

11.0 18.0

Het 41R:11. I
35.0 60.0

MCV 89.8 ft_

80.0 99.9

HCH 28.1

P9 27.0 31.0

HEHC 31.6 L g/dL 33.0 37.0
Pit 709. H x10"3/u1 150. 450.
LYX 17.6 *I % 20.5 51.1
LY# 2.3 * x10"3/uL 1.2 3.4

RAPIDPOINT COAG ANALYZER V4.54
SERIAL #005485 11/10/03 04:32

Patien

Test Name :
Test Result:. 26.8 sec.
***RESULT OUT OF RANGE***
Sample Type:citrated wh. blood

Test Date :11/10/03

Test Time :04:30 Card Lot :10021 Operator
10-11-03

04:24
Patient

Limits
WDC 24.6 H x10"3/uL 4.5 10.5
RDC 3.52 L x10"6/uL 4.00 6.00
H9b 9.8 L g/dL 11.0 18.0
Hct 31.8 L X 35.0 60.0
IV 90.4 fl 80.0 99.9
NCH 28.0 (19 27.0 31.0
HCHC 30.9 L g/dL 33.0 37.0
Pit 964. H x10"3/uL 150. 450.

LYX 9.7 *I. Z 20.5 51.1
LY# 2.4 * x10"3/111 1.2 3.4

MEDCOM - 22855

•I

(Fizcolo). r• -• ' CE'. k

:11 I
'
'2 •
;•":-: ' .3.:.`•I':': I ! ',-:­..?7..:.:: .`
...-..:0: -120; SO: • : ' i ' -, ' • : : ...7.7-_':z •••• .-.._-.! fl•.•::. -_7.:-...:.,E.,,-.... "..:•-::::....7...::. ­_,..-.i ::•:;.7...:-...71"....;,-:u. i --.....-_-.•::...•_ (.....,. -.:.-3 .• ''.. -.:-.7.;;-.... :3; :-.... C:.-1.0 L.: c • r 1 _ -' ' . -„ .S.:•1...?.3 .z...::.'z; SEi:;,'\i. 4 0711/03 REFCREWF RA\ PALEM1 #• BASIC MLT IC DISC LOI #. OPrr #. I o684 Di . 0.; : 000 10:08 AM MAY —
..1-'. C -2 T: r-,.. ._ E• 1.-N C.:-.7.-_ ­. ; , 1 I 5-20 CL'.... i .1 -_ - i .:::_ :-....-7.:Ii.... .:.....--:.:., :•c7...f.: 0 [.. U . . ._ -----.':• C2- L ::.; ....7y3- ¦ 73-1 '....! 7.1 ?.;..f •(?:•colo): Nteil'.-:.r., 3 :_. - : i .-'-1.¦;0.--; :-. i 72-; !3 m;;.:-" GU BUN CA++ CRE NA-0. CL t(;0"0-7: 3 16 j 0. J ;31 o _ -p3 118 8.0 10.3 . ' .2 28-1 3.3-1 9): 1 3 ii 33 Ni,/DL :11 NIG./UL MMOV1 11110_
: :-: '7 . .-',.!.1. .7.'..lisc..C,Thtliisc:.'::.:_: . .2:•: :: CE:::-. CK . '. .' ',..•..7:-.:.: -..-_k:_: 3-1:.z.•••,,.,­....-,., _ . _ . , 1::- -.•:-.) :L1 r F.)_. (.0 C. C: FM OC: OK HEM 0 !_lP 0 , ICI 14
I 1 ..,.. 1
I 1 i 7'-'• - ''' • t-..:,,, ' :, ' : :CO- . : : • : ; %-:,:: 7. :7_ :. ; I..
.• , • •
1

D Y:
10 4/71/4. ;
MEDCOM - 22856

DOD-036432
(L -7-

Ward/Section: REQUESTING LABORATORY RESULT FORM I C 1" Subject to the Privacy Act of 1974 ) LAST, FIRST, Mt DA E TIME SSN/PSEUDO SSN: 1 ( tdo I 63C
• (Hematology) CBC Urinalysla` Misc. Serology: ‘ ,
TEST RESULT REF. RANGE TEST RESTJEr REF. RANGE TEST RESULT REF. RANGE
WBC 4.8-10.8 x 10' Color N/A RPR Negative
1-14,--4,..--
RBC 4.7-6.1 x 109 App iokd N/A Mono Negative

Hgb 14-18 Wdl (M) Glu Negative Microbio , ogy
et t'

12-16 phi' (F)
Hct 42-52% (M) Bili i Negative Source
37-47% (F) 1---alie—
MCV Ket Gram

80-94 11 (M) Negative 81-99 fl (F) r't r .3
Stain
Plt 130500 x 103 SG I. 0 24) N/A Oce Bld Negative
verified
Lymph % 20.5-51.1% Bld L, Negative H. pylori Negative

(IiematOlogy) Manual Differential pH U N/A Micro
0

Parasites
Segs Mono Prot ..2_11 Negative Malaria

Bands Eos Urob 0.2-1.0 0 & P
h0

Lymph Baso Nit Negative Other
hej

Atyp Imm Leuk Negative •.Microscopic Urinalysis'
An 5 . .
• ...

RBC HCG Negative
:re 110 ri t'S i'' — ed S .

Morph
Ott - 3-f-2 0- 2-5ve C
_.
(n/7 (( — ?— /?1_,z.

42-52% (M)
Spun . CSF -, Blood Bank
Hematocrit 3747% (F)
Sed Rate Cell
MUST SUBMIT SF 518 WITH
Count EVERY UNIT REQUESTED
Other Directigen Negative ABO/Rh

-Coagulation Studies :- Blood tank Unit•Croasimatch .
.,..
(MUSTSUBMIT SF 518.WITH EVERY UNIT OF BLOOD
. .

,. REQUESTED) :. • .. -TEST RESULT REF. RANGE UNIT TYPE CROSSAL4TCH
PT 9.8-13.6 secs
APTT 21-34 secs
D dimer 20 ug/ml
F DP 10 ugh's!
[REMARKS:
NYC \-7

REPORTED BY:

MEDCOM -22857
7-‘ ;2. 117

f
I/ I

7. ­- '.:•
12f a :13 "
UN s02. -.-_ • 7.1:77 %M-h e =list ztv : 7.3 : • 7.4 5 , c7 GLU 125* BUN 13 CRE 1.0 CK 644* K+ 4.0 CL-102 tCO2 20 73-118 MG/DL ?-22 MG/DL 0.6-1.2 MG/DL 39-380 U/L 128-145 MMOVL 3.3-4.7 MMOVL 98-108 MMOVL 18-33 MMOVL INST OC: OK CHEM OC: OK HEM 0 , LIP 0 , ICT 1+ 0 10/11/03 REFERENCE RANGE: PATIENT #:IIIIIII METLYTE 8 DISC LOT #: OPER #: 013 SERIAL #: 04:36 MALE 3151AM • DR #: 000 0000100494 f".1 • I ......... I H-33 mr7..cL-1 T:E-57 ALB AL? ALT ±.S7 T2E-GGT -2: L. icc6loYLivE, i: _ el 1."? ¦. I.­.
1-= ,R.E.F.1117
K. -

MEDCOM - 22858

DOD-036434

G

rr iuwoCCULM: . k., ,
Kt:QUEST
I CHEMISTRY RESULT FORM

1 (,U0&
•(Subject to the Privacy Act of 19-74LAST, FIRST, ML

DAT ,..UM

S N:
-— ­
3

..r.... --._-, c.c.::_0-J4...c0.,0W A.:.
.--_.__.1._.:_et64.....-raVOI,

TEST . RANGE TEST RESULT REF. TEST RESULT REF. RANGE

• RANGE

Na 138-1461=0.14-' ALB
3-5-5.5 19'cil GLU , ,. 73-113 mg/c11
K 3.5-4.9 ttunol/L: ALP 2f.34 :

-iiri• • : BuN

7-22 mg/d1
Cl 98-109 mmoVL ALT 10-47 v/1

CA rogidi 7.31-7.45
Pil • AMY 14-97 WI
CRE 0.6-1.2 mg/d1
PCO2 35-45 mmHg (ort)

AST 11-38 &I
NA+ 128-145 mknolil

41-51 nunI-18 (yea)
P02 80-105 mmHg (art) TEL

0.2
-1.6 mg/d1 K+ 33-4.7 mmul4
NM. (veal

TCO2 23-27 rmnota. (i4) BUN
7-22 mg/d1 CL" 98-108 mmo1/1

24-29 mown (yen)
HCO3 22-26 roatail (art)

CA 8.0-10.3medl tCO2

23-28 grunolit (yen) 18-33 mmol/1 •
s02 95-98%

CHOL 100-200 meidl
,.. ' ''. .. , ,i111:aillik;!!?:?.. : '
IN7Pi4": .....i'llz:...•:i74`5/..,f,:sp...)._;t:,51::,?....-4,--ep... „:

BEecf (-2) — (+3)
CRE 0.6-1.2 mg/dl TEST

REMIT REF RANGE -AnGap 10-20 romo1/1..
mmol/L GLU 73-118 znedl ALB

3.3-5.5 g/d1
Ca 1.12-1.32 mmoUL

TP 6.4-8.1 Wdl
ALP 26-84 oil

_...
BUN 8-26 mg/d1

,
!^:"• .1....
C440 '` .g I e: •-. ALT 10-47 iv.t.

..:':::1..:';:ki.,',-. FT::'-'.::
GLU 70-105 mg/c11

TEST ULT— REF AMY 14-97 WI RANGE

Creat 0.7-1.5 med1
GLU 73-118 flied/ AST 11-38 till
Hct 38-51% PCV

BUN '722 mg/d1

TBIL 0.27 1_6 mell
Hgb 12-17 g/dl

CRE 0.6-L2 mg/d1

GGT 5-65 u/1
'• ,. ::iiiii ...` :-.., CK 39-380 u/l(M)

TP 6.4-8.1 g/dI

30-190u/1(F)
TEST RESULT REF RANGE NA 128-145 mmo1/1 -''"

.eo1oiZIetroijf-e. .
...:.;,...r,
".,,

Troponin-1
K+ 3_34.7 mmoUl

TEST RESULT REF. RANGE

Drug of
.CI: 98-108 =WA
NA' 128-145 uuno1/1

Abuse
tC0 18-33 mmoIJI
r 3.3-4.7 mroolA
' CI: 98-108 mmoVI
tCO2 18-33 mmol/1

REMARKS* . 1-CAA16 •
REPORTED BY:
DATE: LAB ID NO.:
MEDCOM -22859

RAPIDPOINT COAG ANALYZER V4.54
i-5TRT EG.S+

485 (g511.4 4:27

Pt: Patient I i-STAT EGe+
Pt. Name:

Test
est Na
Test Result:= 15.8 sec.

Pt

Na 135 mmol/L Ratio = 1.3

Pt Name:

Calculated INR . 1.52

3.7 mmol/L

Sample Type:citrated wh. blood

TCO2 25 mmol/L

Test Date :f1/11/03 Na 140 mmol/L
Hct 24 ':PCV

Test Time 6'A:26

i. 3.7 mmol/L
Hb* 8 g/cIL Card Lot ,0802r
TCO2 24 mmol/L

Operator (1.1)(1.)-?___.

*via Hct.

Hct 30 ':PCV

Hb* 161 9/dL

At 37C

RAPIDPOINT COAG ANALYZER V4.54

a Hct.

PH 7.428

SERIAL #005485 11/11/03 04:30

PCnE 3 mmHg

At 37C

Patient ID

P02 6. mmHg (CP'7

PH 7.507

Test Nam 11:!!!!11

HCO3 24 mmol/L

Test Result:. 28.6 sec. mmHg
DEPcf 0 mmol/L

***RESULT OUT OF RANGE***

PO2 105 mmHg c-,02* 917 Sample Type:citrated wh. blood
mmol/L

Test Date :11/11/03

*calculated

6Eecf 1 mmol/L

Test Time :04:28

Card Lot. :100208 02* =.19 At Patient Temp Operator

gallnal

*calculated

PH 7.356

PCO2 44.9 mmHg

At Patient Temp
PO2 117 mmHg

pH 7.4•.1

, PRINT CANCELLED ** PCO2 3..9 mmHg

Patient Temp: 107.3F
P02 125 mmHg

FIO2 : 40

Sample Type_:

Patient Temp: 103.9F

FIOE : 50
i-STAT EC8+
Sample Type_:

11NnV03 15:54

11NOV03 04:22
Pt Name:

i-STAT CRER
Oper:111111
Pt:

Glu 101 mq/dL
'Physician:

Pt Name:

graN 24 mq/dL

Na 140 mmol/L r# 42011
mg/dL

Crea___

3.7 mmol/L uPt: JAM5046A
CLEW A53

rl 110 mmol/L

Sample YPe_:
TCO2 24 mmol/L
11N0"03

15:58

AnCiap 11 mmol/L

Hct

11-11-03

1111111111 %PCV
15:5:

04:24 Hb* 8 q/ AL
Patient

PAtisne
*via Hct

Limits
4DC 21.6 H x1T3/aL 4.5 10.5 pH 7.408 WE, 16.7 H 7,104:,'uL 4,5 10.5
RIX 3.13 L x106fuL, 4.r10 6.03

a 2.70 71t--& 4gb 8.8 L gilt 11.0 18.0 PCO2 36-6. mmHg kt 7.6 L g'dL 11.0 16,0 Hct 28.2 L 35.0 60.0 23 mmol/L H:t 24.4 L :5. . v0.0
HCO3 ra 90,6 30.1) 9?.Q

ICV 90.0 fL 80.0 99.9

r

-2 mmol/L ICH 28.3 Pg

Ma 213.0 pg 27.0 31.0 BEPrf , -

r-4: :1.2 L g:dL

MX 31.1 L gill 33.0 37.0
Fit 9E. H :10'3AL 150. 450. Sample Type_: Pit 741. H ,110'3/1;L 150. ',0.

LI. 20.9 * 1

4,11,

'Oa 15.8 *1. 20.5 51.1 '4 C cl 1

LV# 3.4 *H xlce3/;IL Lyg 3.5 0, xl0A7:11L 1.2 3.t

1.2 3.4

MEDCOM -22860

DOD-036436

CFSENITSTRY RESULT FORINT
'Subiect to 011: Privacy of 1974)

TLI.CE
SSN/PS
424-6

.iec"Olo):Ch'e'ruis REF. RANGE TEST I RESULT
133-146 cr.molil..
73-113 rr dl
:BUN 7-22 rnEitil
01/11/03 REFERENCE RANGE 12:10 MALE CA-- 8.0-10.3 rue dl
TCO2 PCO2 P02 cro v.1 35-15 mmHg (rt):I 4 ­S I rn.m.Hx (vcal I SO-105 mmHg (art) N/A.(yeu) ry 1 23-27 trumotil (an) PATIENT #: METLYTE 8 DISC LOT 4: OPER #: 777 3151AA4 K DR #: 000 a_ 0.6-1.2 algid: 128-145 rrtrr.ol/1 3.3 -13 rarruilil

I 24-29 zur.olil- (
..ca) 93-10a

HCO3 22.26 mmot/L (art) SERIAL #: 0000100494 23-28 mruotiL (vcn) tCO2
18-33 mrrto1/1s02 95-93%
O GLU 173* 73-118 MG/DL BEecf (-2) — (+3) BUN 12 7-22 MG/DL nt.mulft, TEST
GRE 1.1 0.6-1.2 MG/DL

10-20 namoliL
CK 1131* 39-380 U/L ALB

1.12-L32 matolIL
NA+ 127* 128-145 MMOVL AL?

26-34 &I BUN K+ 4.7 3.3-4.7 MMOVL
ALT 104 JI
CL-105 98-108 MMOVL
tCO2 18 18-33 MMOVL

14-97 trl

0.7-1.5 mg/dl
INST QC: OK CHEM QC: OK AST

11-38 url

31-51% PCV
HEM 0 , LIP 0 ICT 1 f

1 'BIL
0.2 7 L6 met2

12-17 w'cl 3GT 5-65 WI
": FP 6.4-3.1 g/d1
RESULT REF. RANGE
Trcpcnin-1
Drug of Abuse
98-105
3.33

REMARKS:
DATE: LAB ID NO.:
1 t.-.1.:.1,23

6)(6)-1_
MEDCOM - 22861

DOD-036437
,..•¦¦•¦
ALS
?Cr. TC o: s07. ArC-ap _ • •2 3UN AST. T? 77:-,7 -.-7 , I I I I .3 27...4.N. , ­; - PICCOLO -------11/11/03 04:27 REFERENCE RA MALE PATIENT C... I BASIC METm OLIC ' DISC LOT #: 3325AA4 OPER #: 013 DR #: 000 SERIAL #: 124* 0000100494 73-118 MG/DL1-‘ GLU BUN 23* 7-22 MG/DL CA++ 8.3 8.0-10.3 MG/DL 0.9 0.6-1.2 MG/DLCRE 128-145 MOM__ K+ 4.2 3.3-4,7 MMOVL 107 98-108 MMOVLCL-tCO2 21 18-33 MMOVL INST DC: OK CHEM OC: OK HEM 0 ) LIP 0 ) ICT 1+
C..
.Cr"
K
"-- S .:ED SY: Af)&-i 0 2-1-- I DATE: sV6 r A3

MEDCOM - 22862

DOD-036438

Walt/SeCtiOtt:.-•— REQUES LABORATORY RESULT FORM _IL (Subject to the Privacy Act of 1974) LAST, FIRST, TIME z • SSN/PSEUDO SSN: 3 SO -.• (Hems • Urinalysis .11fisc.Serulog y.
..•.-TEST RESULT REF. RANGE TEST RESULT REF. RANGE TEST RESULT REF. RANGE
WBC 4.8-10.8x 101 Color N/A RPR Negative
RBC 4.76.1 x10° App N/A Mono Negative
14-18 Wdl (M) Glu Negative
-Wcrobiology

12-16y/d1(F) Hct 42-52% Op Bili Negative Source 37-47% (F) MCV 80-9411 (M) Ket Negative Gram 81-99 f1 (F)
Stain Pit 130z500x le SG N/A Occ Bld Negativeverified Lymph % 20.5-51.1% Bid Negative H. pylori Negative
taloa) MAnnd Differential pH N/A Micro
•. • -- •

Parasites

Segs Mono Prot Negative Malaria
Bands Eos Urob 0.2-1.0 O &P
Lymph Baso Nit Negative Other
Atyp Imm Leuk Negative
ivricipscoPic trinalysi

RBC HCG __ Negative
Morph
-

Spun 42-52% (M)
• • ' ' • 13104341.Baas!( •,
. . . _ .

Hematocrit 37-47% (F)
Sed Rate
Cell MUST SUBMIT SI? 518 WITH . .. Count t EVERY UNIT REQUESTED
Other Directigen Negative I ABO/Rh
.. . , .• • .

•CciagliPitioll'4tudies ' :' •Blood Bank Unit Gros:smite!" ...--.'. .. ... '" • •-. — . (KOSTS03110 SF 518 WITH EVERY UNIT OF•BLOOD ..
•:: . ' • . . --•- • -. .* , • ' : -. REQUESTED) ' -•
. -.." '" - . 1 '

TEST RES( ..GE UNIT TYPE CROSSMAT CH
.,.=—...,
' ,

PT 9.8-13.6 secs
APTT 21-34 secs —
•. D dimer . 20 ug/m1
FDP 10 ug/m1
/2.-- G. 1
REMARS: • P i9----F1.1. (L)::..-, Li0 sr-":" 1 63. '
DATE: LAB ID NO.:.
MEDCOM - 22863

DOD-036439
Ward/Section:
sO2
13Eecf
Drug of
Abuse
REPORTED BY:
1 REQUESTING PHYSICIAN: TIME
REF. RANGE
n Jxr.nn

138-146 rrunol/L
tornotil.:
PICCOLO

98.109"PPYL 12/11/03 04:05

7.31-7.45 REFERENCE RANGE: MALE PATIENT #:
3545 mmHg on)
41-51 trunliE veal BASIC METAS IC e.;),ICI 325AA4
SC14(15 mmtig(aM DISC LOT #:
23-27 rarttOW-OPER 013 DR 11' 000-

WA veal '

;
24-29 zrunoa (veal_
SERIAL . #: 0000100491

22-28 mmol/1 (art)
2.348 mmottl.. (vcR)
95-98% GLU 129* 73-118 MG/DL BUN 18 7-22 MG/DL
(-2) —(+3)
CA++ 8.8 8.0-10.3 MG/DL

rnmol/L .10-20 mmol/L MG/DL 1.12-1.32 mmol/L NA..4.----014-- 128-145 MMOI'L K+ 4.3 3.3-4.7 MMOLL
8-26 mg/d1

CL- 103 98-108 MMOtL 70-105 mg/c11 tCO2 20 16-33 MMOVL
DATE: LAB ID NO.:
CH ENTRY RESULT FORM (Subject to the Privacy Act of I974) SSN/PSEUDO SSINI:
RESULT
GLU 73-118 mg/c11
BUN 7-22 mg/d1
CA 8.0-10.3 'ng/d1 CRE mg/dl NAT 128-1:45 I ntrio1/1
KT

33.4.7 trunrarl
CL 98-108 mmo1/1 18-33 mmo1/1
REE RANGE
ALB 3.3-5.5 ga ALP 26-84 u/1 ALT 10-47 no.
14-97 uR
11-38 ul
0.2 : 1_6 rnell 5-65 u/1 6.4-8.1
128-145 nuno1/1
18-33 nuno1/1
MEDCOM - 22864

-3TAT EG6+
: 1111111'

a 135 mmol/L
4.2 mmol/L
28 mmol/L

CO2
32 %PCV

!ct 11 g/di_ib*
*via Hct
;t 37C
7.538
PH Tho mmHg
PCn2
207 mmHg
POE
mmol/L
4 mmnl/L

8Eecf
100 %

502*

*calculated

At Patient Temp
7.4,7
PH
35,1 mmHg
PCO2
22J mmHg

PO2
Patient Temp: 103.4F
: 40

F102
Sample Type_:
04:03

.12NOV03

Oper: 0
Physician:
Ser# 42011
Ver: JAM5046A
CLEW A33

Pg;i5t

a 21.1H xl.r3/11L 4.5 10.5 3.41L q0A6.11iL 4.00 6.00
14?1": 921 gidi. 11.0 1%0
31.0L 35.0

90.9 ft MO '3.'7.9 ra 29.0 pg i7.0 31.0 raz 31.Y L ga ILO MO
H x1Y31 ;f! 150. 45%

11.4 kLY. N.1.5 51.1
2.4* xlVaiL 1:2 14

(00)-`1
) V4,54

APIDPOINT COAG
SERIAL UVO5485 110J/03 05 :57

Patient ID
Test Name :PT
Test Result:, 15.4 sec.
Ratio = 1.3

Sample iype:citrated wh. blood
Test Date 013/03
Test Time T5:56

• /
;080201

Card Lot ,
(lALX'7

•Operator

V4.54

RAPIDPOIN1 COAG ANALYZER
SERIAL. #005465 11/13/03 06:00

; Patient 111111D (9(4L1

1
Test Name :APTT
Test Result:. 29.5 sec.
***RESULT OUT OF RANGE***
Sample Type:citrated wh. blood

Test Date :11/13/03
Test Time :05:58

;

100212

Card Lot
Operator

iT_DPOIN1 COAG ANALYZER V4.54
. dtRIAL #005485 11/12/03 04:06

Patient ID,. (*el
Test Nam e :
Test Result:=17.3 sec.
Ratio = 1.4
Calculated INR = 1.76
Sample Type:citrated wh. blood

'Test Date :11/12/03
Test Time :04:04
Card Lot :08"
Operator '

•'

RAPIDPOINT COAG ANALYZER V4.54 0054MeiZN 0 8
Patient ID: Test Hamel*" Test Result:. 24.8 sec. ***RESULT OUT OF RANGE*** Sample Type:citrated wh. blood Test Date :11/12/03 Test Time :04:06 Card Lot :10 Operator
(q(L\-z_
EG7+
Pt: 1111111/

Pt Name:

1:29 mmol/L

Na

3.7 mmol/L
e7 mmol/L

TCO2
iCa

1.10 mmol/L
2s PCV

Hct
Hb*

10 g/dL
*via Hct

At 37C

:460
PCO2

pH

i _'35. 8 mmHg
64 -mmHg

P02
HCO3

2; mmol/L
BEPcf

u mmol/L
%
*calculated

s02*

Sample Type_:

05:55

13NOV03

Oper:1111

Physician:

Ser# 42015
Ver: JAN5046A

CLEW A93

MEDCOM - 22865

DOD-036441
Ward/Section;
REQUESTING PHYSICIAN:
CHEMISTRY RESULT FORM

LAST, FIRST, MI.

TEST CTAT
ar." RANGE
Na 138-146 mmol/L
K 3_5-4.9 mmoUL:
Cl 98-109 mmol/!.
PH 731-7.45
PCO2 35-45 mmHg (rm) 41-51 rmrilig (yen) PO2 80-105 mmHg (art) WA (yea) TCO2 23-27 mmot/L (in) 24-29 mmol/!. (vett) HCO3 22-26 =DWI. (art) 23-28 mmoUL (vest) sO2 95-98%
BEecf (-2) -- (+3)
mmol/L
AnGap 10-20 mmol/L

Ca 1.12-1.32 nernol/L
BUN ,:-8-26 mg/dl
GLU 70-105 tngfdl
Creat 0.7-1.5 mg/d1
Hct 38-51% PCV
Hgb 12-17 g/d1
TEST RESULT REF. RANGE
Troponin-1
Drug of Abuse
REMARKS:
DATE TINES
ii

TEST RESULT REF.
RANGE
big¦11.1.1¦¦•¦--
ALB 3.5-5.5 g/d1
ALP 26-84 u/1
ALT 10-47 u/1
AMY 14-97 IA
AST 11-38 u/1
IBM 0.2-1.6 mg/dl
BUN 7-22 mg/di
8.0-10.3mg/d1
CHOL 100.200 mg/d1
CRE 0.6-1.2 mg/dl
GLU 73-118 mg/di TP 6.44.1 g/d1
' gc0k);'hit.

TEST RESULT REF: RANGE
GLU 73-118 mg/d1 BUN 7;22 mg/dl CRE 0.6-1.2 mg/di
(Subject to the Privacy Act of 1974 .1 SS1JAW9opli
21/
.PICCOLO
13/11/03 05:15 REFERENCE RANGE: MALE PATIENT #:
I

METLYTE 8 (1.0)—k1
DISC LOT #:
3152M1 OPER #: 013 DR #: 000
I SERIAL #: 0000100607
GLU 132* B144___444-
t CRE 0.8 CK 441* Wrs-44.4—
K+ 4.3 CL— . 100 t CO2 20
73-118 MG/DL 7-22 MG/OL 0.6-1.2 MG/DL 39-380 U/1 128-145 MMOi/L 3.3-4.7 WOK. 98-108 MOW 18-33 MMOtt
INST OC: OK Cl-EM OC: OK I—EM 0 , LIP 0 r ICT 1+

CK NAY 39-380 u/1 (M) 1 30-190 u/1 (F) 128-145 mmo111
.CL­ 3_34.7 mmol/1 98-108 mmo1/1
tCO2 18-33 mn3o1/1 IC• mrn0173
CI: 98-108 mmoi71 —
(CO, 18-33 mmo1/1

C6C__prie-rvL es
' REPORTED BY:
DATE: LAB ID NO.:
MEDCOM - 22866

Ward/Section: fc_o• REQUESTING PHYSICIAN:, LABORATORY RESULT FORM•
LAST, I1RST, I4fi.
.
.........W. 0!(4) .) CBC :: , _Urinalysis Ise: SI-Idogy.: . .... . .
. --•-1?-442INWETigi-L-44144b-T--1( ' TEST RESULT REF RANGE TEST RESULT REF. RANGE
WBC 4.8-10.8% 1o' Color N/A RPR Negative
RBC 4.7-6.1 x 10' App N/A Mono Negative
blob 14-18 ear (M) 12­16 Wdl cF) Gin Negative . .. .. . • •. ' _ Nikrobiology.
Hct 42­52h (M) 37-47% (F) Bili . • • Negative Source
MCV Plt • 80-94 fl (M) 81-99 fl (1) 130:500 x it verified Ret SG . Negative N/A . Gram Stain Oec Bld . Negative
Lymph % - 20.5-51.1% Bld Negative H. pylori Negative
. • ).1‘.43inual Differential .-::•••• pH N/A Micro Parasites
Segs • Mono Prot Negative Malaria •
Bands Eos UrOb 0.2-1.0 0 & P
Lymph • Baso Nit Negative Other

•:. Atyp Imm Leuk Negative r--
. -1Wici°3Cai)k Willi '

RBC HCG Negative Morph
, , e....., .inc.1.13/ A, .n. -••••--
• Blood. l34911t

°cli3747% (P)
ff nuti t
.

Sed Rate
Cell
MUST SUBMIT SF 518 WITH
Count

EVERY UNIT REQUESTED Other Directigen Negative
ABO/Rh I
oagu son
Blood Baik Unit
. . . (MVST,.SUBMIT SF 518 WIETREVERy UNIT OF BLOOD .


TEST RESULT REF. RANGE UNIT TYPE
CROSSAL4TCII

PT 9.8-13.6 secs APIT 21 -34 sees D dimer 20 ug/ml
DP 10 ug/ml
90111111:* C4ct'(tsu1i 5.inaccumte.(Jut 4 3110
REPORTS : DATE: LAB ID NO.: .
MEDCOM - 22867

DOD-036443

Ward/Section: LAST, FIRST, MI.
Creat
Het
Drug of
Abuse
REPORTED BY:
REQUESTING PHYSICIAN:
CO
TEST

2226 romc.111.. (art)
23-28 . ( )
95-98%

(-2) — (+3) ramol/L 10-20 mmol/L

1.12-L32 rarnol/L
8-26 mg/d1

70.105 rag/d1
0.7-1.5 mg/d1 38-51% PCV
NA7
CHEMISTRY RESULT FORM
Sub
-ect to the Privac Act of 1974
DATE TIME Jo
SSNIPSE I 4001/
3. 5 sidl
73-113 mg/di
26-84

BUN 7-22 ms/d1
14-97 u/1
1t-38 /l -\RICCOLO -------
L04:44

14/11/03 \.

0.2-16 mg/d
REFERENCE Ali MALE

7-22med1
PATIENT #:
.

BASIC METABOLIC

DISC LOT #:.

3325AA4
OPER #: 013.

DR #: 000
SERIAL #:.

0000100994

GLU 129* 73-118 MG/DL

BUN 6*

7-PP MG/DL
CA++ 8.3 8.0-10.3 MG/DL
CRE 0.5* 0.6-1.2 MG/DL

NA+.

115* 128-145 MMOL

K+.

4.3

3.3-4.7 MOM__

CL-.

98 98-108 MMUL

tCO2 26

18-33 MOIL

0
100.200med

0.6-1.2mg/d 73-118 ing,M
7;22 mg/d1
0.6-1.2 mg/,
39-380 u/1 (
30-190 till (
128-145 mt

3.3-4.7 may 98-108 mm
18.33 mmc
MEDCOM - 22868

DOD-036444
' Ward/Section: . I REQUEST.

C-/C(

LAST, rERST,C1.
CHEMISTRY RESULT FORM (Subject to the Privacy Act of 1974 DATE
TIME SSNIPSE

TEST
Na
K
PH PCO2 PO2 TCO2 HCO3 s02 BEecf
AnGap Ca BUN
GLU
Creat Hct
. zn.r L1:7
RESULT REF. RANGE
138-146 mmoi/L
3-5-49 minol/Lr
98-109 mmoVL
7_31-7.45

35-45 mmHg (aa)
41 -51 mmHg (van) 80-105 mmHg (an) . WA (veal
23-27 romo1/).

24-29 mmaa (veal 22-28 mown. (art) 23-28 rnmel/L (vca)
95-98%
(-2)— (+3) mmol/L 10-20 mmol/L.

1.12-L32 mmol/L
8-26 mg/dl
70-105 Treed
0.7-L5 mg/dl
38-51% PCV
12-17 g/d1

TEST RESULT f REF. RANGE
Troponin-1
Drug of
Abuse
REMARKS:
REPORTED BY:
t 4CC.)
j4:

41)a)

Sr

TEST
(6)( ) L1

(

PICCOLO

LGLU
15/11/03 13:57 REFERENCE RANGE: MALE .BUN
CA++
PATIENT #: LIVER PANEL PLUS CRE DISC LOT #: 3154AA7
NA-
OPER #: 777 DR #: 000
SERIAL #: 0000100494

CI:
ALB 2.1* 3.3-5.5 G/DL tCO2
RESULT REF. RANGE
73-118 mg/c11 7-22 mg/dl 8.0-10.3 mg/d1 0.6-1.2 retedl 128-145 tumult]

334.7 mmulil
98-108 mmol/1 '18-33 m
ALP 150* 26-84.

U/L
ALTLU/L

151* 10-47.
AMYLU/L

79 14-97.
ASTLU/L

96* 11-38LTBIL 2.2* 0.2-1.6 MG/DL ALB GGTLU/L ALP
421* 5-65.
TP 6.5.

6.4-8.1 . G/DL

ALT
INST QC: OKLAMY
CI-EM QC: OK

HEM 14, LIP 0 , ICT 0
AST 11-3813/1
TBIL mg/dl
GGT 5-65 till
TP 6.4-8.1 Will

TEST RESULT REF. RANGE NA" 128-145 mmol/1 3.3-4_7 mmo1/1
CI: 98-108 =nal 02 18-33 numb]/1

DATE: LAB ID NO.:
MEDCOM - 22869

DOD-036445
RAPIDPOINT C AG ANALYZER V4.54 SERIAL #00548 11/15/03 05:00
NNW Patient I Test Nail" Test Result:. 13.9 sec. Ratio = 1,1 Calculated INR Sample Type:citred wh. blood (est Date :11/1E (0 rest lime :04:5 uard LotL
:0
Operator

J 2.1.2

RAPIDPOINT COAG ANALYZER V4.54 SERIAL #005485 11/15/03 05:03
Patient.

1111111PP

Te.

Name :APTT
st Result:. 27.7 sec.

***RESULT OUT OF RANGE***
Sample Type:citrated wh. blood
Test Date :11/15/03
Test Time :05:00
Card Lot.

:10020
Operator

IDPOINT COAG
ANALYZER V4.54

• SER.

#005485 11/14/03 04:47

Patient IARIB
Test Name :
Test Result:. 18.8 sec.
Ratio = 1.5

Sample Type:citrated wh. bl id
Test Date :11/14/03
Test Time :04:45

Card Lot.

:080201

Operator

RAPIDPOrNT

MEDCOM - 22870
i-STAT E0•+

Pt Name: .

¦
125 mmol/L

Ma.

L3.6 nu TCh2L
33 mmol /L
Hrt .

29 '.PCV

10 9/dL
Hb .
*via Hct

At 37C
PH.
PCm2:LmmHg

33;
P02L145 mmHg
FrO3.

32 mmol/L
BEedL10 mmol/L
-=-02*L100
*calculated

sample Type_:
.

15H0V03 05:40

Oper: 13

Physician:.

3¦:,r# 42015
Ver: IRM504i;R
CLEW FrD3

=

DOD-036446

Ward/Section:
REQUESTING PHYSICIAN:
CI­
ILMISTRY RESULT FORM
IjUAP-

LAST, PERST, (Subject to the Privacy Act of 1974)
DATE lIMB
,SSN/PSEUDO SSN:
01\1
iC
T.410

TEST RESULT
Na
K
Cl
pH
PCO2
P02
TCO2
HCO3
s02
BEecf
AnGap
Ca
BUN
GLU
Creat
Hct
Hgb
TEST RESULT
Troponin-1
Drug of
Abuse

REMARKS:
REPORTED BY:
REF. RANGE
138-146 Ennaot/1.
3.5-49 tme101/D,
98,109 mtnoVL
731-7.45

35-45 mmHg (ar,
41-51 mails (yen)
30-105 naafis (art)
WA (veal

23-27 mull& (4r0
24-29 nunnli. (yen
22-26 rataola, (art)
23-28 mmoUL v

(_sLi
95-98%
(-2) --(+3)
mmo1/L
10-20 inmol/L

1.12-1.32 nunol/L
8-26 ing/d1
70-105 medl
0.7-L5 med1
38-51'/ PCV
12-17 g/dI
TEST RESULT ' 7
REF. TEST
RESULT REF. RANGE
• RANGE
ALB 3.5-5.5 ddl GLU 73-118 mg/d1
BUN 7-22 mg/d1
CA" 8.0-103 mg/c11
PICCOLO L 05:0= AM CRE 0.6-1_2 nag/d1
15/11/03LREFERENCE RANGE:L128-145 totoolt1
MALE NA PATIENT #
IC 3.3-4.7 nuoulit
BASIC METOUTW1

3323AA4 CL 98-108 carno1/1
DISC LOT #:LOPER #: 013LtCO2 18-33 mmo1/1
DR #: 000
SERIAL #:.

0000100684

a_u 1 36* 73-118 MG/DL TEST RESUIT REF. RANGE 7-22 MG/DL
ALB 3.3-5.S g/d1
CA++ 8.7 8.0-10.3 MG/DL

ALP 26-84 u/1
CRE 0.6 0.6-1.2 MG/DL NA L128-145 MMOVL ALT 10-47 oil-
116*

4.0 3.3-4.7 MMOVL

K+.

AMY 14-97 u'I
98-108 MMOVL

CL-.

97*

tCO2 26 18-33 MMOVL

AST 11-38 u/1
INST QC: OKL0.2-1.6 mg/d1
CHEM QC: OK mil_
HEM 0 , LIP 0 , ICT 1+L5-65 u/1

:IGT
np 6.4-8.1 gfdl
:77.77-rr:77^

I TEST
RESULT REF. RANGE
rA4 128-145 mmo1/1
3.34.7 auno1/1
98-108 ramoL/1
18-33 mmo1/1
MEDCOM - 22871

DOD-036447
Ward/Sectionj.....----REQUES •'^ LABORATORY RESULT FORM ,-Sub-ect to the Privac Act of 1974
LAST, FIRST.,.... . r luzamm ,„ . SSN/PSEUDO SSN:
L, (a -4.0•1111,1101talitaw41._
emato.. ei .; ..: ..Urinalysis ,. Misc:. Serology:
............
....

TEST RESULT REF RANGE TEST : F. RANGE TEST RESULT .REF. RANGE
WBC 4.8-10.83: 10 j Color 10 r N/A RPR Negative
.,....,sis

4.7-63 x 10° App RN/A Mono Negative
RBC
lie, 14-18 g/dl (M) Glu it\i Negative • . Klen/biOnY
• .. . . .

12-16 Wdl (F) Het 42-52% (M) Bili Negative Source 37-47% (F) • -Ne-N¦ MCV 80-9411(M) K Negative
Gram 81-99 fl (F)
130500 x103 SO 1401,s_ 'WA . Ocz Bid Negative
Plt
verified Lymph % 20.5-51.1% Bid SI. Negative H. pylori Negative
: --.).D,Tozai piffere. • • ,..,.: pH cr,. 0 N/A . Micro Parasites

Negative Malaria

Segs • Mono Prot N)......\
0.2-1.0

Bands Eos Urob A. 'L.. 0 & P
Negative Other

Lymph Baso Nit
N

Atyp lmm Leuk Negative - • -roscO*Urixii ": :
RBC HCG Negative 0-3 ?AC--• O.. i t...) dc-
Morph
Spun 42-5r4 (MY CSF -. BlOOd.Bi4 •.,
37-47% (F)

Hematocrit Sed Rate M(IST SUBMIT SF 518 WITH
COI

... Count EVERY UNIT REQUESTED Directigen Negative ABO/Rh 1
Other
oagulgior(SItdiet:. - -:. .1 , ;:. • ..• • ' •' .- •i-. •Blooil Iliiiik Volt Ovisoilitcli : -,.......,.
7. .• ....7.
.
mpsT§uigkinr..SF 518.WITIli EVERY upitt, cit..iikooiti . • -

1 .,.- .
• • • • ..,

TEST RESULT REF. RANGE UNIT TYPE CROSSMATCH
9:8-13.6 secs

PT
APTT 21-34 secs
-. D dimer . 40 ug/tel
F DP 10 ug/inl
REMARKS:
REPORTED BY DATE: LAB ID NO.: .
•.
MEDCOM - 22872
CB EMILS 1 It icza vs, L km.w.t.

REQUESTENWard/Section:
Sub-ect to the Privae Act of 1974

IC ug--Or.
DATE TIME.SSN!PSE
LPEST RESULT REF. RANGE

RESULT REF. RANG TEST RESULT REF. RANGE GE
138-146 mmoUL 7i. . 1 1 mg/d1
3.5-49 Intnoll' _TN 7-22 mg/di
98-109 mmol/L 7.31-7.45 35-45 mmHg (art) PICC 17/11/03 REFERENCE RA PATIENT #: LO L 04:29 AM MALE RE L 8.0-10.3 rog/d1 0.6-1.2 mg/d1 128-145 ttlino1/1
HCO3 s02 41-51 rrtmHr vcal 80-105 mmHg (art) WA vent 23-27 manot/I. (art) 24-29 inmo111. (yen 22-26 rocooVI. (art) 23-28 mmoUL (vex) 95-98% METLYTE 8 DISC LOT #: 3152AA4 OPER #: 013 DR #: 000 SERIAL #: 0000100684 GLUL140* 73-118 MG/DL :02 3.3-4.7 nurr41t1 98-108 mmol/1 18-33 mmoUl 1'6'6 t`Pont Plus ; 7

(-2) — (+3)

BEeef BUN 9 7-22 MG/DL
mmol/L CREL1.0 L
LB
0.6-1.2 MG/DL 3.3-5.5 011
10-20 mmol/L

AnGap
CK 101 39-380 U/L 26-84 u/1
LP
1.12-1.32 mmol/L

Ca
APPP---444 128-145 MMOUL

)0.47 ,11.
LT

8-26 mg/dl K+ 4.1 3.3-4.7 MMO//1_
BUN
99 98-108 NNW_

CL-L14-97 ull
LMY
70.105 mg/(11

GLU -33 MOW
tCO2 19 18

11-38 utt
ST
0.7-1.5 medl

Creat
CHEM OIC: OK

INST QC: OKLBli. 0.27 1.6 mg/d1
38-51% PCV

Hct HEM 0 , LIP 0 , ICT 0
. 5-65 u/1
GT
12-17 g/d1

Hgb
6.4-8.1 g/dI
P

e
1 : -
-":,..-ental: liJOtiriiiiite .- 8::-
:-1

TEST f RESULT REF. RANGE TEST RESULT REF. .RANGE
Troponin-1 128445 mmol/1
FA*

Drug of Abuse
3.34.7 mmol/1 98-108 mmolfl
1.." 18-33 mmo1/1
CO2 .

. REMARKS:
DATE: LAB ID NO.:

REPORTED BY:
MEDCOM - 22873

DOD-036449
24-41-03

03:33
Patient

Mt 5.1.

1101/111. 4.5 10.5
Mt 2.111 110‘64 4.00 6.00

N* h71.

11.0. ALO

kt 2161. 1.Plt 256.
35.0 bLO

ICU 064 R.LYZ 31.8
00.0 Ph?

211.3 pg •.LY# 2.0
ZhO 31.0

MAC 32.6L sAL.

33.0 37.0

Pit.

4,014 150. 450.

LYZ 21.5 *.

2L5 5L1

(ip •
i -STRT EG7+
Pt Name: -----------
133-mmol/L.
3.3 mmol/L
TCO2 ________ 29 mMol/L
iCa _______ 1.19 mmol/L

H
--------22 %PCV
Hb*_____ ___7 9/dL
*via Hct.'7-

_______ 7.t20
______34 -0 mm
________ 1,55 mmHg

mmol/L

Er
t ----_ 5 mmol/L
* calculatPd
•ample Type

24NOV03L

04:S4

Oper:1110
Alysician: ______________

Sr# 42015
Var: JR:45046R

CLEW R93
ID:111111
MO
WIC 6.2
x10"3/uL
RBC 2.89 L
25-11-03
04:40
Patient Limits
4.5 10.5
x10"6/al 4.00 6.00
HO
8.0 L g/dL
11.0 18.0
Hct 25.4 L X
35.0 60.0
tfLV 87.8
fL
80.0 99.9
tCH 27.7
P9
27.0 31.0
MX 31.6 L. g/dL
33.0 37.0
110'3/al 150. 450.Z
20.5 51.1
x10"3/uL
1.2 3.4

ral,ttnr
ildt.
A

.4 159 ';, 7,f) 31,6313 L q/dL 3d.B 37. .10'31u1. 15l 450, . 11.5 0_ 205 51.1
1.8 * x10'3%i:L

1.2 3.4
i -STAT EG7+
Pt1

Pt Name:
Na

135 mmol/L L2.7 Mmol/L TO02 ________ 31 Mmol/L iCa ____ _ 1.08 Mmol/L
Hct. 22 %PCV
Hb*
7 g•dL
*via Hct

37C

L

7.46.5

41.a mmHg
ac _________ 91 mmHg
nO3 ________ 30 mmol /L
REecf ________ e mmol/L

02*
'=17
*calculated

6A111;

Sample Type_:
Ic'

25NOV03L

04:34
OPer:111111

Ser# 42011
Ver: JAM:5046A

CLEW A93

1.1*Ex1014 1.2 3.4

MEDCOM -22874

DOD-036450

Ward/Section: 1, Nj2
REQUEST
CiikAIISTRYMESITI:UIN3BNI

LAST, FIRST, k.
TEST RESULT REF. RANGE
Na 138-146 matoUL
13ke

K 3.5-4.9 mnoVL
98-109 mmol/L

PH 7.31-7.45
PCO2 35-45 mmHg (.0.) 41-51 mmHg (Y en)PO2 80- /05 mmHg (art) N/A. (you)
TCO2 23 -27 roma& (an)
24-29 .mmoIlL (yea)HCO3 22-24 mmol (art) 23-28 inmol/L (yen)
s02 95-98%
BEetf (-2) — (+3)
rnmal/L
AnGap 10-20 mrool/L

Ca 1.12-1.32 mmoUl.
BUN 8-26 rug/d1
GLU 70-105 medl
Creat 0.7-L5 mgfdl
Hct 38-51% PCV
H 12-17g/dl
TEST RESULT REF. RANGE
Troponin-1
Drug of
Abuse

REMARKS:
REPORTED BY
e60
TEST RESULT.
REF. RANGE
ALB 3.5-5.5 01
ALP 26-84 WI
ALT 10-47 WI
AMY 14-97 u/
AST 11-38 WI
TBIL 0.2-1.6 mg/d1
BUN
7-22 and CA+' 8.0-10.3mg/d1 CHOL 100-200 IW1
0.6-1.2 mg/dI
39-380 WI (M) 30-190 (F)NA+ 128-145 =DUI
33-4.7 uunoUl
CL 98-108 mrno1/1

1CO2 18-33 mind/1
DATE: LAB ID NO.:
Suliect to the Prinz Act of 1974
SSN/PSEUDO SSN:

GLU 7341$ mg/d1
BUN 7-22 zug/d1
CA" 8.0-10.3 rug/c11
CRE 0.6-1.2 Ing/d1
NA. 128-145 unno1/1
33-4.7 mmulil
I CI: 98-108 mmoUl

PICCOLO L
L18/11/03L

Ob:1? AM
REFERENCE RANGE:L

MALE

PATIENT #41,11,0,..p._
BASIC MET Li
DISC LOT #:L

3325AA1
OPER #: 013L

DR #: 000
SERIAL #:L

0000100684

GLU 135* 73-118 MG/DL
BUNL

02 7-22 MG/DL
CA++ 9.0 8.0-10.3 MG/DL
CRE 0.8 0.6-1.2 MG/DL
NA+ -ZioNg 128-145- MMOVL

K+L

4;4 3.3-4.7 MMOVL

CL-L

99 98-108 MMOL'L
L tCO2 23 18-33 MMOft

INST OC: OKL

CHEM OC: OK
1-EMO , LIP 0 ) ICT 0

MEDCOM - 22875

DOD-036451
ard/Secti on: REQUESTING PHYSIC CHEMISTRY RESULT FORM I
(C.0 Dr (Subject to the Privacy Act of 1974)
DA TIME SSN/PSEUDO SSN:

1ST, FEAST, MI.
2a/A,YA--O'leFC)
. .• •.

404110Y 046666r:so
RESULT REF. TEST RESULT REF. RANGE

TEST RESULT RE F-TEST REF, RANGE
/IT CI

138-146 mmoUL ALB 3.5-5.5 ea
3.5-4.9 inmol/L: ALP e3,644 .10
7.:L====
PICCOLO

98-109 rnmol/L ALT (10-47 un -=7==
07:2320/11/

731-7.45 14-97 IA
3 AMY MALL
NGE:RLVERLNCE.

35-45 mmHg (art) 11-38 till
CO2 AST #1111110
PATIEW

41-51 rrtmHz (vea)
80-105 mmHg (art) TBIL 0.2-1.6 mg/d1 LIVER PANEL. PLUS

02
_

N/A (yen) 315IAA7L
#:L

CO2 23-27 mutottL (art) BUN 7-22 maid! DISC Lca
DR #: 000

24-29 mmol/L (ven) OPER #: 678L22-26 mmot/L (art) 8.0-10.3w/di
CA' ....0000100 494 .
:CO3 23-28 mmoUL (wit) SERIAL #:L95-98% CHOL .L
100-200 raga .
3.3-5.5 G/DL
2.4*
ALB

(-2)— (+3) 0.6-12 mg/c11
• eci CRE U/L
26-84
ALP 226*
ram01/L
U/L
10-47

10-20 mmol/L GLU 73-118 mg/d1 ALT 90*
,nGap
U/L
14-97
81

'a 1.12-1.32 rrunol/L TP 6.4-8.1 g/d1 AMY
UIL
11-38

77* IUN 8-26 mg/dl :c 010 0.2-1.6 MG/DL
AST
TBIL 1.4
U/LOGT 490* 5-65

70-105 rnedl TEST RESULT REF.
iLU
TP 6.8 6.4-8.1 G/DL
RANGE

;feat 0.7-1.5 ingidl GLU /3-ns me&
CHEM DC:: OK
INST OC: OK

38-51% PCV BUN 7;22 mg/t0
Ict LIP 0 , ICI 0
HEM 2+,

12-17 g/dl CRE 0.6-1.2 mg/c11
ieb

k-•• • CK 39-380 u/I (M)
30-190 u/l(F)
128-145 mmolfl

TEST RESULT REF. RANGE NA
froponin-1 3.3-4.7 mcoo1/1
KI"
98-108 mmo1/1

)rug of .CL" 4buse 18-33 mmol/1
tCO2

REMARKS:
PORTED BY: DATE: LAB ID NO.:
MEDCOM - 22876

DOD-036452
CHEMISTRY RESULT FORM
• to the Priv= Act of 1974 SN/PSEUDO SSN:

TCO2
(-2) - (+3) mmol/L 10-20 mmol/L

1.12-1_32 mmollL
8-26 rotu'd
137-1.5 mg/d1
38-51% PCV

Drug of Abuse
REF.. RESULT REF. RANGE
RANGE
ALB 3.5-5.5 giell 73-118 mg/d1
7-22 mg/dl
PICC1 24/11/03 REFERENCE RANG PATIENT # 03:34 MALE CRE 8.0-10.3 mg/dl 0.6-1.2 mg/dl 128-145101mA/1
METLYTE 8 33.4.7 minal
DISC LOT 4: OPER #. 013 31U2•PA DR #' 000 98-108 mmolil
SERIAL #: 0000100494 18-33 mmoV1
73-118 MG/OLOLDL134* REF. RANGE

BUNLMG/DL CRELMG/DL 3.3-55 e/cil
9 7-22L

1.2 CKL39-380 U/L 26-84 u/1

126 21L1-44-4-128-145 MMOVL
10-47 u/1.
K+.3.7 3.3-4.7 MOVE 88 98-108 MMOVL AMY
CL-L

14-971111
t002 21 18-33 MMOVL

AST 11-38 tY1
INST OC: OKL

CHEM OC: OK TBIL
mg/c8
HEM 0 , LIP 0 , ICT 0

5-65 u/1
6.4-83 01
TEST
NA' 128-145 mmol/1
3.3-4.7 uunoln
98-108 mmo1/1
18-33 mmo1/1
MEDCOM - 22877

Ward/Section:
LAST, FIRST, Is
TEST. RESULT
PO2
TCO2
HCO3
s02
BEocf
AnGap
Ca
BUN
GLU
Creat
Hct:
H
TEST RESULT
Troponin-1
Drug of
Abuse
RE MARKS:
REPORTED BY
1
REQUESTING PHYSICIAN!
--.7C-­
it.MISTRY RESULT FORM
(1
Suliect to the Privacy Act of 1974 SSN/PSEUDO SSN:
RESULT
REF. RESULT
• RANGE

138-146 Inmoi/L
3.5-5.5 01 GLU 73-118 mg/d1 ALP 215-SA ,.n
BUN
98-109 mrnol/L
CA 8.0-10.3 mg/dl
7.31-7.45
(4/ CRE
0.6-1.2 mg/c11
PICCOLO ---L

35-45 mmHg (art)
M NIA`

41-51 mmHg (yea) 25/11/03L3:3L
80-105 mmHg (art)
REFERENCE RANK-MALE

N/A (veal „
23-27 mmol//. (art) PATIENT 4:
24-29 inmoliL (yen)

GENERAL. 12

22-26 nand& (art)
PICCOLO

23-28 !moot/(ven) DISC LOT #: 3204AA1 55
s
25/11/03

95-9A54 . DR #: 000 04:34
OPER #: 013

j

REFERENCE ANGE:L

SERIAL #: 0000100884 MALE

(-2) — (4-3)
Ti PATIENT #:
mmo)/1,
METLYTE 8

10-20 mmol/L 2.0* 3.3-5.5 G/DL El
ALBL

DISC LOT #:

3152AA4

1.12-1.32 mmol/L 28-84
ALP 61L

OPER #: 013

.DR #: Q00

10-47 U/LL

ALT 44L

B-26 mg/di SERIAL #:
14-97 U/LL0000100494

AMY 34L

61* 11-38

70.105 mg/dl ASTL
MG/DL GLU :132* 73-118 MG/DL

TBIL 0.6 '0.271.6 t 0.7-1.5 med1 BUN 7 7-22 MG/DL 7-22 MG/DL
CRE 0.8 0.6­

38-51% PCV 7.8* 8.Q10.3 MG/DL 1.2 MG/DL
-

CKL

157.

100200

CCII:YOL L39-380 U/L

12-17 g/di NA..i---+++
128-145

CRE 131 * 0.6-1.2 MG/DL MOM_

1122MG/DL K+ 3.5 3.3-4.7

1 MMOVL

GLUL

ttt

5.7* 6.4-8.1 G/DL CL 98-108 MMOP/L

REF. RANGE N TPLtCO2 20
Mat
CHEM, OC: OK

K INST OC: OKL

GC. OK'L

HEM 24, LIP 0 , ICI, 0 CHEM OC: OK

fr;";0L

LIP ,0 7. ICT 0

¦
DA
MEDCOM - 22878

DOD-036454

r-
al".1..Z¦ tCtiOn: REQUESTING PHYSICIAN: LABORATORY RESULT (Subject to the Privacy Act of 1974) . LAST. FIRST. M. 60A) DATE ;IIML. SSN:PSEUDO SS:
l)

(Hematoior* l'CBC Urinalysis Misc. Seralop-
7.7

TEST kESULT REF. RANGE TEST RESULT REF. RA2VGE TEST RESULT RFF. RANCTh
4.;:-0.1 N. Color I NIA RPR Necative
RBC N 10 App Mono ' NcFative
14-13 (Nry Glu Microbio-logyi2-I di IT
Her 42-52%. !NI) Bili Source 1
1
e.: Ner_uti \ ‘:

MCV 30•9i II (N . Kt1 • Gram I
i

! Stain 1
Ph ¦ ; ...q)-5(lo x lc' ..i Z,I..k Oct: Bid

i SG
I
Lymph % 1 2115-5.1.1% I ,, 11. pylori

(Ilernatolo-v) Manual Differential 11 pH I N:.-1 Micro i Parasites . 1, Malaria : 1 • rTifinds Los I Urob 0 ct 1'
f_yrr.ph I Baso Nit ccatI Other
I et:k \:cgalive
Microscopic 1.Trinaiysis
1
Hai
; 37.47`t
SF Sig WIT FI RE.Q1.7ESTED
A 1304:11

Coagulation Studies Blood Bank Unit Crossmatch (MUST SUBMIT SF 518 WITH EVERY UNIT OF BLOOD REQUESTED) ; JE! . R-OiGE t_TV/7-TYPE
D dicr
DP 1 ' • ID
R PO E 1) B : DAY F: I L.kil IF) NC.: eCa D(.44,e_t--ePa
'cito evo+ usit-k-tr if% feStAt atockl Foto* ap‘‘.
ukt‘•••(.. Re.",britt Set-'40".
MEDCOM 22879

DOD-036455

:NSS -10 -#wa!Ted
0

O

3
MEDCOM - 22880

DOD-036456

(AIN—2—
OSPITAL Laboratory
Final
Status .
W121
amen:
Collected:

Name:
Wound/Sterile site
Source:

Patient I Attd. Phys
Ward of Iso

Ward/Rm: U2/ coI
Status. Final
JC) ,

Acinetobacter baumannii/haemolyticus
Ac baumannlhaem interps
MIC
-Drub

Irerps
MIC

prig
1618

Arnox/K Clay (c) Amp/Sulbactam (c)
16/8 R
16

Ampicillin 16
R
Aztreonam 16
Cefazolin 16
R
Cefepime •
R.
Cefotaxime .(c) 32 32 . .
Cefotetan 16
Cefoxitin
16

Ceftazidime (a)
32

R
Ceftriaxone (c)
16

Cefuroxime (b)
• 16

Cephalothin
16 .

R
Chloramphenicol
R

2
4

Ciprofloxacin
ESBL-a Scrn
. 1

ESBL-b Scrn
4

Gatifloxacin
8

R
Gentamicin
74 S

Imipenem (c)
4

R
Levofloxacin
•=4

S

Meropenem (c) ,
4

Moxifloxacin
64

Nitrofurantoin
8

Norfloxacin
R

64
R

Piperacillin (a)
8
64

Tetracycline
R

Ticar/K Clay (a)
=4

S

Tobramycin
2/38 R

Trimeth/Sulfa
Blank = Data -di avaiiaote or Mug not advisable or tested NiFf = Not Reponee
oeo spectrum cera-iaciainase

= SuscePuiple ESBL r E ue,
S
. --= Not Testae
t ., intermediate • Brat =

Seta-iaciamase•pos:t•ve
TFG = Thyrnictine-clependent straii,
R = Resistance

MIC = mcgiml (mg/L1

• .
= Resistant due to extended spectrum beta-lactarneses (ESBL)

.

R•
EBL? = Suspected ESBL Confirmatory tests needed to differentiate ESBL from other beta-lactamases .
place Of Sensitive with species known to possess inducible beta-lactamases.•ciOte.ntially they May becoine resistant to all beta-lactamOrigs = inducible Beta-lactamase Appears In
lEl mined beta-iactam drugs ,.
Monitoring. of patients during/alter therapy is recommended Avoid other/con-
ICY Enterococcus saec.es

For Mood and CSF Isolates a beta-lactamase test is recommenced . .
. . . -:sa :n oate--:5 A' 0 ,
g•arulocrlopen.a or serious .nrections

an anunogiycdsioe to: P aen..g•
• m poses of drug w .
ta.Use maximum 1701110D; ::', acoiies ff. tn.s m.ist
•,I.) ..se •ti=ti -, -' -:•=i • I cir R •

for BreaKpoints based on.parenteiel dose For cefurnume a.••=r• n/surbactarnwiM Jiterococ.c: rem 7a the freniciii.- •I'verpretaiioe
-...1.c. I ¦

For streptococci refer to penicillin inierPretations For amoxi ,-...:-.•-•.A z avoianate -.•., ai­
'CI F...ctnote kaI, also appl ,es to tics drug
icu For non beta•lacialmase producing enterococci. refer to the ce,c, :i:-.nierpeeia• .....'

baseo on NCCLS M100•S12 Jan 2002 Spadloxacin (for Gram Negative isolates) and moxillo.aein are based on FDA approved breakpoints
interpretive breakpoints are

For S oneumoniae. cefOtaxime and celinaxone breakpoints are based on isolates from patients with meningitis For non-meningitis infections, use 2=S 2=1. 2=R
,--?
Status: Final 0,-N(C,(
Specimen: W121 •

Name: -Collected: /
Wound/Sterile site
Patient ID: ) 1 Req. Phys:

Source:
(;(Cor
1011 ­
Ward of Iso:

Ward/Rm: U2/ '
Tech:. ...."'()
Page 1 of 1

Printed 11/13/2003 10:34.05 AM
MEDCOM - 22881

DOD-036457
:shags pat.pene JaqwnN
e!PAwel 143/00
0
CI) cn --1 co c c
6 -0 =.
co
-.z-
0
c
0.,... 0 0a = o 0—
auo bald :ad/SI uawpads
Cl

CD
C 13)

.);
ea
a

co
CD
CD CD
C.11).s
3 — ci 71 a
cr,.E..-
MEDCOM - 22882

DOD-036458
e!PAtueR10/30

:shags papew JaciwnN
L -M01:13-JeM
CO 0309Z:91ea
Microbiology RequestForm

Laboratory Results
GRAM POST IVE COCCI
Reported
:ewa
OC:awL1.
0
rn

C

m

OLI O)1 01c1 :OCIA1 U0WpedS
q pG13a1
100
:NSSao#Tue!Ted
cn
C.T1
0
CSM
' Cr) 10 CD 70
•=1: to cin 0- 0
3. co 3
3)

0
Cr) --t
00 a 0
3 P.
cn
-n

linsaN /Aea awes
auo Mold:wels weio
MEDCOM - 22883

DOD-036459

CD
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is
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Laboratory

Name: pectmen: R049 Status: Final
Patient ID l Source: Sputum Collected:
Ward/Rm: ila Ward of Iso: Attd. Phys:

(-9(61:?-:
Acinetobacter baumannits•haetnolyticus —Status• Final

Ac baumann/haenn

Drug MIC Interps Drug MIC Interps
Amox/K Clay (c) 16/8
Amp/Sulbactam (c) 16/8
Ampicillin 16

Aztreonam 16
Cefazolin 16
Cefepime 16
Celotaxime (c) .: 32 R.
Cefotetan 32
Cefoxitin 16
Ceftaidime (a) 16
CeftriaXone.(c) 32
CefuroXime.(b) 16
Cephalothin 16

Chloramphenicol 16
Ciprofloxacin 2
ESBL-a Scrn 4
ESBL-P•Scrn 1
Gatifloxacin:. 4

Gentamicin 8 R • ImipeneM(c) tevofloxacin 4 Meropenem (c) =4 Moxifloxacin. 4 Nitrofurantoin 64 Norfloxacin 8 'Piperacillin (a) 64 Tetracycline 8
Ticar/K Clay (a) 64 Tobramycin 8 Trimeth/Sulfa 2/38
S = Susceptible N'R = Not Reported Blank . Data ^..ol available of diug not acAosable or :este°.- intermediate ,-• = • Not Tested
ESBL = biter:leo spectrum beta-laclamase
R -= -Resistor,Ce.

TFG = Thymidine-dependent strain

Blac = Bela-•actamase positiveMIC = : .mcg/mI(mg/L) .
.. . ' • R' = Resistant dUe to extended spectrum beta-lactamases (ESBL I
EEL' = Suspected ESBL Coni rMatory tests needed to differentiate ESBL from Other beta Lactamases
,8
, Inducible Bela-lactamase Appears el place of Sensitive web species known lc possess inducible beta-lactamases potentially they may
be:o-e resistant to all bela-laCiam drugsMonitoring Of pallentS Ourmg/alter therapy is recommended A-,oid otherlcombinecl . nia,lactam ,irugs
For o•000 and CSF Isolates a beta•tactarnaselest is recommennec ',.' :.--..-iterck7.oco_rs sc.:E.:as
t,s Use -,a..murn uose5prprug wain an aminoglycoside tot ae....-:50 r trat,:n!s
P -.: .c.:- 3r a,uincytopenia or venous :nlect.ons ibi af ea,poolts based on parenteral close tor peturowne aveirt :F.3 ...se I8 , 5 3.'8.: - "S=Ri
Footnote rc• aopkes to no drug IC) F Or streptococc rater to anrCrilin interpretations. For amoxtc.11,,X : -..tavulanale or air to ,crorsulOaciam with enterococc. refer to :rie pen.cillin ,nre -;:relation
(a) For non beta-lactamase;ProdUcing enrerococci. refer to the penictItin interpretation Footnote la) also applres to this drug
interpre,ve breakocirits
are based on NCCLS MIOD.S12 Jan 2002 Sparnoxectn (tor Gram Negative Isolates; and mo.J/Ictaacin are based on FDA approved breakpoints
-t. For S' oneumoniae celotax,me and celtnakone breakpoints are based on Isolates from patients with meningitis For non-meninglits inlectIons, use 2-S 2.I. 2=R
Name: ¦• Specimen: R049 Status: Final Patient ID: Source: V
Sputum Collected: -Ward/Rin: U2/ Ward of Iso
Req. Phy .
Printed 11./13/2003 10:33:59 AM Page 1 of 1 —'
MEDCOM -22885

DOD-036461

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MEDCOM - 22886

DOD-036462
MEDCOM - 22887

DOD-036463
MEDCOM - 22888

DOD-036464
CLINICAL RECORD • DOCTOR'S ORDERS For use of this form, see AR 40-66, the proponent agency is OTSG
THE DOCTOR SHALL RECORD DATE, TIME AND SIGN EACH SET OF ORDERS. IF PROBLEM ORIENTED MEDICAL RECORD SYSTEM IS USED, WRITE PROBLEM NUMBER IN COLUMN INDICATED BY ARROW BELOW.
PATIENT IDENTIFICATION DATE OF ORDER TIME OF ORDER LIST TIME ORDER NOT ED AND
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FORM USED .
4256

1APR 79
MEDCOM - 22889

DOD-036465
CLINICAL RECORD • DOCTOR'S ORDERS
For use of this form, see AR 40-66, the proponent agency is OTSG
HE DOCTOR SHALL RECORD DATE, TIME AND SIGN EACH SET OF ORDERS. IF PROBLEM ORIENTED MEDICAL RECORD YSTEM IS USED. WRITE PROBLEM NUMBER IN COLUMN INDICATED BY ARROW BELOW.
ATIENT IDENTIFICATION DATE OF ORDER. TIME OF ORDER LIST TIME ORDER
al 2 IV3.4°4;1'. HOURS NOTED AND SIGN
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IURSING UNIT
ATIENT IDENTIFICATION
•JURSING UNIT
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NURSING UNIT
PATIENT IDENTIFICATION DATE OF ORDER. TIME OF ORDER
51;eic Gsd&
NURSING UNIT
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4 IA7,71, 4256 RE ACES EDITIO

MEDCOM - 22890

DOD-036466

CLINICAL RECORD - DOCTOR'S
ORDERSFor use of this form, see AR 40

-
66, the proponent agency is OTSG

THE DOCTOR SHALL RECORD DATE, TIME AND SIGN EACH SET OF ORDERS, IF PROBLEM ORIENTED MEDICAL RECORD SYSTEM IS USED WRITE PROBLEM NUMBER IN COLUMN INDICATED BY ARROW BELOW.
PATIENT IDENTIFICATION
NURSING
UNIT
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PATIENT
PATIENT IDENTIFICiATION
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NURSING UNIT
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BED NO.
PATIENT IDENTIFICATION
DATE OF ORDER
TIME OF ORDER
HOURS

NURSING UNIT
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BED NO,
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PATIENT IDENTIFICATION,.
DATE OF ORDER
TIME OF ORDER
HOURS

NURSING UNIT
ROOM NO.

IA 1 APR 79"Pm 4256 REPLACES EDITION OF 1 JUL 77, WHICH MAY BE USED.
MEDCOM - 22891

DOD-036467

Doc_nid: 
3962
Doc_type_num: 
77