Extended criteria (experimental). This is the broader ten-condition engine, kept as a secondary area. It shows ICD-10-CM codes and illustrative grouping effects for CDI staff. The primary surface is Before you sign (kidney, measurement only). All extended pages.

ENC-00005: Gideon Merriweather

81M · MRN68518928 · Hospital Medicine · admitted Tue Nov 10, 2026 01:06 PM · in hospital · attending Dr. Kenji Stavros · resident Dr. Noor Halvorsen · 175 cm, 103.6 kg

Documented diagnoses (current)

Principal: “community-acquired pneumonia” · J18.9 Pneumonia, unspecified organism
“class 3 obesity” · E66.813 Obesity, class 3
“CKD stage 3b” · N18.32 Chronic kidney disease, stage 3b
“acute respiratory failure with hypoxia” · J96.01 Acute respiratory failure with hypoxia
“hyponatremia” · E87.1 Hypo-osmolality and hyponatremia
“type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications
“hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 193 Simple pneumonia and pleurisy with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 195.

Queries and events

No queries yet.

All rules applied

Rule Criteria Finding Outcome

Acute kidney injury

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule aki v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: meets_definition	`creat_ratio >= t.ratio_s1 or creat_rise_48h >= t.rise_abs or coalesce(uo_hours_lt_0_5 >= t.uo_s1_h, false)`	creat_ratio=1.058, t.ratio_s1=1.5, creat_rise_48h=0.02, t.rise_abs=0.3, uo_hours_lt_0_5=unknown, t.uo_s1_h=6	false
derived: stage3	`meets_definition and (creat_ratio >= t.ratio_s3 or creat_peak >= t.scr_s3 or rrt_started or coalesce(uo_hours_lt_0_3 >= t.uo_s3_h, false) or coalesce(anuria_hours >= t.anuria_h, false))`	meets_definition=False, creat_ratio=1.058, t.ratio_s3=3.0, creat_peak=1.83, t.scr_s3=4.0, rrt_started=False, uo_hours_lt_0_3=unknown, t.uo_s3_h=24, anuria_hours=unknown, t.anuria_h=12	false
derived: stage2	`creat_ratio >= t.ratio_s2 or coalesce(uo_hours_lt_0_5 >= t.uo_s2_h, false)`	creat_ratio=1.058, t.ratio_s2=2.0, uo_hours_lt_0_5=unknown, t.uo_s2_h=12	false
derived: stage	`case(stage3, 3, stage2, 2, meets_definition, 1, 0)`	stage3=False, stage2=False, meets_definition=False	0
derived: baseline_independent	`creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started`	creat_baseline_known=True, creat_rise_48h=0.02, t.rise_abs=0.3, rrt_started=False	true
outcome: aki_staged	`stage >= 1 and baseline_independent`	stage=0, baseline_independent=True	false
outcome: aki_presumed_baseline	`stage >= 1`	stage=0	false
outcome: not_met	`stage == 0`	stage=0	true

Acute blood loss anaemia

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule blood_loss_anemia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: anaemic	`case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null)`	sex=M, hgb_nadir=14.92, t.hb_m=13, t.hb_f=12	false
derived: acute_fall	`hgb_drop >= t.drop_major or prbc_units >= t.prbc_major`	hgb_drop=0.4, t.drop_major=2.0, prbc_units=0, t.prbc_major=2	false
outcome: met	`bleeding_documented and anaemic and acute_fall`	bleeding_documented=False, anaemic=False, acute_fall=False	false
outcome: anaemia_only	`anaemic and hgb_drop < t.drop_min and prbc_units == 0`	anaemic=False, hgb_drop=0.4, t.drop_min=1.0, prbc_units=0	false
outcome: not_anaemic	`present(hgb_nadir) and not anaemic`	hgb_nadir=14.92, anaemic=False	true

Chronic kidney disease

Criteria met

No gap

Supported as documented (N18.32).

Trace

Rule trace (rule ckd v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: chronic	`egfr_n >= 2 and egfr_span_days >= t.chronic_days`	egfr_n=2, egfr_span_days=358, t.chronic_days=90	true
derived: staging_egfr	`max(egfr_early, egfr_late)`	egfr_early=33.5, egfr_late=39.2	39.2
derived: both_below_60	`egfr_early < t.g2 and egfr_late < t.g2`	egfr_early=33.5, t.g2=60, egfr_late=39.2	true
derived: category	`case(staging_egfr >= t.g2, 'G1-G2', staging_egfr >= t.g3a, 'G3a', staging_egfr >= t.g3b, 'G3b', staging_egfr >= t.g4, 'G4', 'G5')`	staging_egfr=39.2, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15	G3b
outcome: duration_not_shown	`not chronic`	chronic=True	false
outcome: straddles_60	`not both_below_60 and min(egfr_early, egfr_late) < t.g2`	both_below_60=True, egfr_early=33.5, egfr_late=39.2, t.g2=60	false
outcome: g1_g2	`staging_egfr >= t.g2`	staging_egfr=39.2, t.g2=60	false
outcome: g3a	`category == 'G3a'`	category=G3b	false
outcome: g3b	`category == 'G3b'`	category=G3b	true

Heart failure

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

Trace

Rule trace (rule heart_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: np_elevated	`coalesce(bnp_max >= t.bnp, false) or coalesce(ntprobnp_max >= t.ntprobnp, false)`	bnp_max=unknown, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300	false
derived: acute_count	`count(iv_loop_diuretic, np_elevated, new_o2)`	iv_loop_diuretic=False, np_elevated=False, new_o2=False	0
derived: hf_type	`case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange')`	lvef=unknown, t.ref=40, t.pres=50	unknown
derived: improved	`coalesce(lvef_prior_min <= t.ref and lvef > t.ref and lvef - lvef_prior_min >= t.improved_rise, false)`	lvef_prior_min=unknown, t.ref=40, lvef=unknown, t.improved_rise=10	false
derived: acuity	`case(acute_count >= 2 and hf_history, 'acute on chronic', acute_count >= 2, 'acute', acute_count == 0 and hf_history, 'chronic', null)`	acute_count=0, hf_history=False	unknown
outcome: improved_ef	`improved`	improved=False	false
outcome: midrange	`hf_type == 'midrange'`	hf_type=unknown	unknown
outcome: sys_aoc	`hf_type == 'systolic' and acuity == 'acute on chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: sys_acute	`hf_type == 'systolic' and acuity == 'acute'`	hf_type=unknown, acuity=unknown	unknown
outcome: sys_chronic	`hf_type == 'systolic' and acuity == 'chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: dia_aoc	`hf_type == 'diastolic' and acuity == 'acute on chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: dia_acute	`hf_type == 'diastolic' and acuity == 'acute'`	hf_type=unknown, acuity=unknown	unknown
outcome: dia_chronic	`hf_type == 'diastolic' and acuity == 'chronic'`	hf_type=unknown, acuity=unknown	unknown
outcome: one_indicator	`acute_count == 1`	acute_count=0	false

Hyponatraemia

Criteria not met

Clinical validation gap

Documented “hyponatremia” (E87.1) but the criteria are not met: All sodium values 135 or above (lowest 138).

Trace

Rule trace (rule hyponatremia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: severity	`case(na_min < t.profound, 'profound', na_min < t.moderate, 'moderate', na_min < t.low, 'mild', 'none')`	na_min=138.0, t.profound=125, t.moderate=130, t.low=135	none
outcome: met	`na_min < t.low and na_low_count >= t.repeat and na_treated`	na_min=138.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False	false
outcome: untreated	`na_min < t.low`	na_min=138.0, t.low=135	false
outcome: not_met	`na_min >= t.low`	na_min=138.0, t.low=135	true

Malnutrition

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule malnutrition v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: a_sev_intake	`intake_pct <= t.a_sev_intake_pct and intake_days >= t.a_sev_intake_days`	intake_pct=100.0, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5	false
derived: a_mod_intake	`intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days`	intake_pct=100.0, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7	false
derived: a_sev_wt	`(wt_loss_days <= 7 and wt_loss_pct > 2) or (wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: a_mod_wt	`(wt_loss_days <= 7 and wt_loss_pct >= 1) or (wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: c_sev_intake	`intake_pct <= t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
derived: c_mod_intake	`intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days`	intake_pct=100.0, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30	false
derived: c_sev_wt	`(wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5) or (wt_loss_days <= 183 and wt_loss_pct > 10) or (wt_loss_days <= 366 and wt_loss_pct > 20)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: c_mod_wt	`(wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5) or (wt_loss_days <= 183 and wt_loss_pct >= 10) or (wt_loss_days <= 366 and wt_loss_pct >= 20)`	wt_loss_days=unknown, wt_loss_pct=unknown	unknown
derived: n_assessed	`known(intake_pct, wt_loss_pct, fat_loss, muscle_loss, fluid, grip_reduced)`	intake_pct=100.0, wt_loss_pct=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown	4
derived: n_severe	`case(nutr_context == 'acute', count(a_sev_intake, a_sev_wt, fat_loss >= 2, muscle_loss >= 2, fluid >= 2, grip_reduced), nutr_context == 'chronic', count(c_sev_intake, c_sev_wt, fat_loss >= 3, muscle_loss >= 3, fluid >= 3, grip_reduced), null)`	nutr_context=acute, a_sev_intake=False, a_sev_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_sev_wt=unknown	0
derived: n_moderate	`case(nutr_context == 'acute', count(a_sev_intake or a_mod_intake, a_sev_wt or a_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), nutr_context == 'chronic', count(c_sev_intake or c_mod_intake, c_sev_wt or c_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), null)`	nutr_context=acute, a_sev_intake=False, a_mod_intake=False, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_mod_intake=False, c_sev_wt=unknown, c_mod_wt=unknown	0
outcome: severe	`n_severe >= 2`	n_severe=0	false
outcome: moderate	`n_moderate >= 2`	n_moderate=0	false
outcome: one_characteristic	`n_moderate == 1`	n_moderate=0	false
outcome: not_met	`n_moderate == 0 and n_assessed >= 2`	n_moderate=0, n_assessed=4	true

Obesity

Criteria met

Clinical validation gap

Documented “class 3 obesity” (E66.813) conflicts with what the criteria support (Obesity, class 1, E66.811).

Trace

Rule trace (rule obesity v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
outcome: not_adult	`age < t.adult`	age=81, t.adult=20	false
outcome: class3	`bmi >= t.c3`	bmi=33.8, t.c3=40	false
outcome: class2	`bmi >= t.c2`	bmi=33.8, t.c2=35	false
outcome: class1	`bmi >= t.c1`	bmi=33.8, t.c1=30	true

Pressure injury

Insufficient data

No gap

Insufficient data: the criteria could not be applied.

Trace

Rule trace (rule pressure_injury v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sacral	`wound_site == 'sacral'`	wound_site=unknown	unknown
outcome: no_wound_note	`not present(wound_stage)`	wound_stage=unknown	true

Acute respiratory failure

Criteria not met

Clinical validation gap

Documented “acute respiratory failure with hypoxia” (J96.01) but the criteria are not met: No hypoxaemia on room air (lowest SpO2 94%), oxygen no more than 0 L/min, no advanced support.

Trace

Rule trace (rule respiratory_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: measured	`present(spo2_min_ra) or present(pao2_min_ra) or present(pf_min)`	spo2_min_ra=94.0, pao2_min_ra=unknown, pf_min=unknown	true
derived: hypoxemia	`coalesce(spo2_min_ra < t.spo2_ra, false) or coalesce(pao2_min_ra < t.pao2, false) or coalesce(pf_min < t.pf, false)`	spo2_min_ra=94.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300	false
derived: distress	`coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support`	rr_max=20.0, t.rr_distress=28, wob_increased=unknown, adv_resp_support=False	false
outcome: chronic_baseline	`home_o2 and hypoxemia`	home_o2=False, hypoxemia=False	false
outcome: met	`hypoxemia and distress`	hypoxemia=False, distress=False	false
outcome: hypoxemia_only	`hypoxemia`	hypoxemia=False	false
outcome: not_met	`measured and not hypoxemia and o2_max_lpm <= t.o2_low and not adv_resp_support`	measured=True, hypoxemia=False, o2_max_lpm=0.0, t.o2_low=2, adv_resp_support=False	true

Sepsis

Criteria not met

No gap

Not documented and not supported.

Trace

Rule trace (rule sepsis v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
Step	Expression	Inputs and thresholds read	Result
derived: sirs_temp	`coalesce(temp_max_48h > t.t_hi, false) or coalesce(temp_min_48h < t.t_lo, false)`	temp_max_48h=37.4, t.t_hi=38, temp_min_48h=36.6, t.t_lo=36	false
derived: sirs_hr	`coalesce(hr_max_48h > t.hr, false)`	hr_max_48h=79.0, t.hr=90	false
derived: sirs_rr	`coalesce(rr_max_48h > t.rr, false) or coalesce(paco2_min_48h < t.paco2, false)`	rr_max_48h=20.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32	false
derived: sirs_wbc	`coalesce(wbc_max_48h > t.wbc_hi, false) or coalesce(wbc_min_48h < t.wbc_lo, false) or coalesce(bands_max_48h > t.bands, false)`	wbc_max_48h=9.82, t.wbc_hi=12, wbc_min_48h=7.56, t.wbc_lo=4, bands_max_48h=unknown, t.bands=10	false
derived: sirs_count	`count(sirs_temp, sirs_hr, sirs_rr, sirs_wbc)`	sirs_temp=False, sirs_hr=False, sirs_rr=False, sirs_wbc=False	0
derived: sofa_resp	`coalesce(case(pf_min_48h < 100 and adv_resp_support, 4, pf_min_48h < 200 and adv_resp_support, 3, pf_min_48h < 300, 2, pf_min_48h < 400, 1, 0), 0)`	pf_min_48h=unknown, adv_resp_support=False	0
derived: sofa_coag	`coalesce(case(platelets_min_48h < 20, 4, platelets_min_48h < 50, 3, platelets_min_48h < 100, 2, platelets_min_48h < 150, 1, 0), 0)`	platelets_min_48h=192.0	0
derived: sofa_liver	`coalesce(case(bili_max_48h >= 12, 4, bili_max_48h >= 6, 3, bili_max_48h >= 2, 2, bili_max_48h >= 1.2, 1, 0), 0)`	bili_max_48h=0.56	0
derived: sofa_cardio	`coalesce(case(norepi_max_48h > 0.1, 4, norepi_max_48h > 0, 3, map_min_48h < 70, 1, 0), 0)`	norepi_max_48h=0.0, map_min_48h=74.0	0
derived: sofa_cns	`coalesce(case(gcs_min_48h < 6, 4, gcs_min_48h < 10, 3, gcs_min_48h < 13, 2, gcs_min_48h < 15, 1, 0), 0)`	gcs_min_48h=15.0	0
derived: sofa_renal	`coalesce(case(creat_max_48h >= 5, 4, creat_max_48h >= 3.5, 3, creat_max_48h >= 2, 2, creat_max_48h >= 1.2, 1, 0), 0)`	creat_max_48h=1.83	1
derived: sofa_renal_baseline	`coalesce(case(creat_baseline >= 5, 4, creat_baseline >= 3.5, 3, creat_baseline >= 2, 2, creat_baseline >= 1.2, 1, 0), 0)`	creat_baseline=1.73	1
derived: sofa_delta	`sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline`	sofa_resp=0, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=1, sofa_renal_baseline=1	0
derived: sepsis3	`infection_documented and sofa_delta >= t.sofa_delta`	infection_documented=True, sofa_delta=0, t.sofa_delta=2	false
derived: sepsis2	`infection_documented and sirs_count >= t.sirs_min`	infection_documented=True, sirs_count=0, t.sirs_min=2	false
derived: shock	`sepsis3 and norepi_max_48h > 0 and coalesce(lactate_max_48h > t.lactate, false)`	sepsis3=False, norepi_max_48h=0.0, lactate_max_48h=unknown, t.lactate=2	false
outcome: no_infection	`not infection_documented`	infection_documented=True	false
outcome: septic_shock	`shock`	shock=False	false
outcome: both	`sepsis3 and sepsis2`	sepsis3=False, sepsis2=False	false
outcome: sepsis3_only	`sepsis3`	sepsis3=False	false
outcome: definitions_disagree	`sepsis2`	sepsis2=False	false
outcome: neither	`true`	—	true

Structured data

Labs (23)

Labs (pre-admission rows are outpatient values)
Row	When	Test	Value
LAB-000152	Tue Sep 30, 2025 09:15 AM	creatinine	1.97 mg/dL
LAB-000153	Wed Sep 23, 2026 10:05 AM	creatinine	1.73 mg/dL
LAB-000154	Tue Nov 10, 2026 02:06 PM	creatinine	1.83 mg/dL
LAB-000158	Tue Nov 10, 2026 02:06 PM	sodium	140.0 mmol/L
LAB-000162	Tue Nov 10, 2026 02:06 PM	hemoglobin	15.11 g/dL
LAB-000166	Tue Nov 10, 2026 02:06 PM	wbc	8.77 x10^3/uL
LAB-000167	Tue Nov 10, 2026 02:06 PM	platelets	303.0 x10^3/uL
LAB-000174	Tue Nov 10, 2026 02:06 PM	bilirubin	0.56 mg/dL
LAB-000155	Wed Nov 11, 2026 05:00 AM	creatinine	1.78 mg/dL
LAB-000159	Wed Nov 11, 2026 05:00 AM	sodium	141.0 mmol/L
LAB-000163	Wed Nov 11, 2026 05:00 AM	hemoglobin	15.29 g/dL
LAB-000168	Wed Nov 11, 2026 05:00 AM	wbc	7.56 x10^3/uL
LAB-000169	Wed Nov 11, 2026 05:00 AM	platelets	192.0 x10^3/uL
LAB-000156	Thu Nov 12, 2026 05:00 AM	creatinine	1.74 mg/dL
LAB-000160	Thu Nov 12, 2026 05:00 AM	sodium	138.0 mmol/L
LAB-000164	Thu Nov 12, 2026 05:00 AM	hemoglobin	15.06 g/dL
LAB-000170	Thu Nov 12, 2026 05:00 AM	wbc	9.82 x10^3/uL
LAB-000171	Thu Nov 12, 2026 05:00 AM	platelets	237.0 x10^3/uL
LAB-000157	Fri Nov 13, 2026 05:00 AM	creatinine	1.76 mg/dL
LAB-000161	Fri Nov 13, 2026 05:00 AM	sodium	140.0 mmol/L
LAB-000165	Fri Nov 13, 2026 05:00 AM	hemoglobin	14.92 g/dL
LAB-000172	Fri Nov 13, 2026 05:00 AM	wbc	5.64 x10^3/uL
LAB-000173	Fri Nov 13, 2026 05:00 AM	platelets	306.0 x10^3/uL

Vitals (60)

Vitals
Row	When	Kind	Value	Detail
VIT-000431	Tue Nov 10, 2026 01:26 PM	spo2	95.0	room air
VIT-000432	Tue Nov 10, 2026 01:26 PM	rr	19.0
VIT-000451	Tue Nov 10, 2026 01:26 PM	temp_c	36.9
VIT-000452	Tue Nov 10, 2026 01:26 PM	hr	78.0
VIT-000453	Tue Nov 10, 2026 01:26 PM	map	74.0
VIT-000454	Tue Nov 10, 2026 01:26 PM	gcs	15.0
VIT-000433	Tue Nov 10, 2026 09:26 PM	spo2	97.0	room air
VIT-000434	Tue Nov 10, 2026 09:26 PM	rr	19.0
VIT-000455	Tue Nov 10, 2026 09:26 PM	temp_c	37.4
VIT-000456	Tue Nov 10, 2026 09:26 PM	hr	77.0
VIT-000457	Tue Nov 10, 2026 09:26 PM	map	88.0
VIT-000458	Tue Nov 10, 2026 09:26 PM	gcs	15.0
VIT-000435	Wed Nov 11, 2026 05:26 AM	spo2	94.0	room air
VIT-000436	Wed Nov 11, 2026 05:26 AM	rr	20.0
VIT-000459	Wed Nov 11, 2026 05:26 AM	temp_c	36.9
VIT-000460	Wed Nov 11, 2026 05:26 AM	hr	79.0
VIT-000461	Wed Nov 11, 2026 05:26 AM	map	90.0
VIT-000462	Wed Nov 11, 2026 05:26 AM	gcs	15.0
VIT-000437	Wed Nov 11, 2026 01:26 PM	spo2	96.0	room air
VIT-000438	Wed Nov 11, 2026 01:26 PM	rr	20.0
VIT-000463	Wed Nov 11, 2026 01:26 PM	temp_c	36.7
VIT-000464	Wed Nov 11, 2026 01:26 PM	hr	73.0
VIT-000465	Wed Nov 11, 2026 01:26 PM	map	80.0
VIT-000466	Wed Nov 11, 2026 01:26 PM	gcs	15.0
VIT-000439	Wed Nov 11, 2026 09:26 PM	spo2	96.0	room air
VIT-000440	Wed Nov 11, 2026 09:26 PM	rr	17.0
VIT-000467	Wed Nov 11, 2026 09:26 PM	temp_c	36.6
VIT-000468	Wed Nov 11, 2026 09:26 PM	hr	72.0
VIT-000469	Wed Nov 11, 2026 09:26 PM	map	82.0
VIT-000470	Wed Nov 11, 2026 09:26 PM	gcs	15.0
VIT-000441	Thu Nov 12, 2026 05:26 AM	spo2	94.0	room air
VIT-000442	Thu Nov 12, 2026 05:26 AM	rr	19.0
VIT-000471	Thu Nov 12, 2026 05:26 AM	temp_c	36.6
VIT-000472	Thu Nov 12, 2026 05:26 AM	hr	78.0
VIT-000473	Thu Nov 12, 2026 05:26 AM	map	89.0
VIT-000474	Thu Nov 12, 2026 05:26 AM	gcs	15.0
VIT-000443	Thu Nov 12, 2026 01:26 PM	spo2	96.0	room air
VIT-000444	Thu Nov 12, 2026 01:26 PM	rr	17.0
VIT-000475	Thu Nov 12, 2026 01:26 PM	temp_c	37.4
VIT-000476	Thu Nov 12, 2026 01:26 PM	hr	86.0
VIT-000477	Thu Nov 12, 2026 01:26 PM	map	77.0
VIT-000478	Thu Nov 12, 2026 01:26 PM	gcs	15.0
VIT-000445	Thu Nov 12, 2026 09:26 PM	spo2	94.0	room air
VIT-000446	Thu Nov 12, 2026 09:26 PM	rr	16.0
VIT-000479	Thu Nov 12, 2026 09:26 PM	temp_c	37.5
VIT-000480	Thu Nov 12, 2026 09:26 PM	hr	78.0
VIT-000481	Thu Nov 12, 2026 09:26 PM	map	76.0
VIT-000482	Thu Nov 12, 2026 09:26 PM	gcs	15.0
VIT-000447	Fri Nov 13, 2026 05:26 AM	spo2	97.0	room air
VIT-000448	Fri Nov 13, 2026 05:26 AM	rr	19.0
VIT-000483	Fri Nov 13, 2026 05:26 AM	temp_c	37.1
VIT-000484	Fri Nov 13, 2026 05:26 AM	hr	78.0
VIT-000485	Fri Nov 13, 2026 05:26 AM	map	90.0
VIT-000486	Fri Nov 13, 2026 05:26 AM	gcs	15.0
VIT-000449	Fri Nov 13, 2026 01:26 PM	spo2	95.0	room air
VIT-000450	Fri Nov 13, 2026 01:26 PM	rr	20.0
VIT-000487	Fri Nov 13, 2026 01:26 PM	temp_c	37.0
VIT-000488	Fri Nov 13, 2026 01:26 PM	hr	88.0
VIT-000489	Fri Nov 13, 2026 01:26 PM	map	84.0
VIT-000490	Fri Nov 13, 2026 01:26 PM	gcs	15.0

Medications, orders, echo, history (4)

MED-000031 11-10 14:06 piperacillin-tazobactam per protocol IV
MED-000032 11-11 05:00 cefepime per protocol IV
MED-000033 11-12 05:00 ceftriaxone per protocol IV
ORD-000004 11-10 13:36 blood_culture: blood cultures x2

Notes

History and physical · DOC-000016 · Dr. Noor Halvorsen (resident) · Tue Nov 10, 2026 04:06 PM

Cited facts from this note (1)

infection_source: multifocal pneumonia · cited p. 1, line 5 · confidence 0.85

Show source for infection_source

… ce: Hospital Medicine Attending: Dr. Kenji Stavros History of present illness: 81-year-old man admitted with community-acquired pneumonia. Chest x-ray shows multifocal pneumonia; blood cultures drawn and ceftriaxone started. Past medical history: type 2 diabetes, hyperlipidemia. Review of systems otherwise negative. Exam: Lungs: scatte …

Source document DOC-000016: History and physical (synthetic)

HISTORY AND PHYSICAL
Patient: Gideon Merriweather   MRN: MRN68518928   Admitted: 2026-11-10 13:06
Service: Hospital Medicine   Attending: Dr. Kenji Stavros

History of present illness: 81-year-old man admitted with community-acquired pneumonia. Chest x-ray shows multifocal pneumonia; blood cultures drawn and ceftriaxone started.
Past medical history: type 2 diabetes, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Community-acquired pneumonia: antibiotics.
2. CKD stage 3b: renally dose medications.

Nutrition assessment · DOC-000015 · Vera Pemberton, RD (dietitian) · Wed Nov 11, 2026 04:06 PM

Cited facts from this note (5)

fat_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for fat_loss

… MRN: MRN68518928 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
fluid_accumulation: none · cited p. 1, line 7 · confidence 0.90

Show source for fluid_accumulation

… e: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
intake_pct: 100 · cited p. 1, line 5 · confidence 0.90

Show source for intake_pct

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Gideon Merriweather MRN: MRN68518928 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. …
muscle_loss: none · cited p. 1, line 7 · confidence 0.90

Show source for muscle_loss

… acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: well nourished; no malnutrition identified.
nutrition_context: acute · cited p. 1, line 4 · confidence 0.95

Show source for nutrition_context

NUTRITION ASSESSMENT (Registered Dietitian) Patient: Gideon Merriweather MRN: MRN68518928 Context: acute illness Intake: eating 100% of meals. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle was …

Source document DOC-000015: Nutrition assessment (synthetic)

NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Gideon Merriweather   MRN: MRN68518928

Context: acute illness
Intake: eating 100% of meals.
Weight history: weight stable over the past 3 months.
Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation.
Assessment: well nourished; no malnutrition identified.

Progress note · DOC-000017 · Dr. Noor Halvorsen (resident) · Fri Nov 13, 2026 02:55 PM · awaiting cosign

Source document DOC-000017: Progress note (synthetic)

PROGRESS NOTE (Resident)
Patient: Gideon Merriweather   MRN: MRN68518928   Hospital day 4

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Community-acquired pneumonia: continue current management.
2. Class 3 obesity: counsel on weight.
3. Acute respiratory failure with hypoxia: supplemental oxygen, wean as tolerated.
4. Hyponatremia: trend sodium.

Resident: Dr. Noor Halvorsen   Attending cosign: pending