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Exact Dx synthetic data · demonstration
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.

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ENC-00019: Dario Ingram

59M · MRN17347290 · Hospital Medicine · admitted Tue Nov 03, 2026 10:51 AM · discharged Tue Nov 10, 2026 01:37 PM · attending Dr. Gideon Zeller · resident Dr. Keira Upfield · 179 cm, 106.7 kg

Documented diagnoses (current)

  • Principal: “upper GI bleed” · K92.2 Gastrointestinal hemorrhage, unspecified
  • “morbid obesity” · E66.01 Morbid (severe) obesity due to excess calories
  • “acute hypoxic respiratory failure” · J96.01 Acute respiratory failure with hypoxia
  • “acute blood loss anemia” · D62 Acute posthemorrhagic anemia
  • “type 2 diabetes” · E11.9 Type 2 diabetes mellitus without complications
  • “GERD” · K21.9 Gastro-esophageal reflux disease without esophagitis
  • “hyperlipidemia” · E78.5 Hyperlipidemia, unspecified

Illustrative grouping now: MS-DRG 377 GI hemorrhage with MCC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 378.

Queries and events

No queries yet.

All rules applied

Every rule's outcome for this encounter (clean results included)
RuleCriteriaFindingOutcome
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)
StepExpressionInputs and thresholds readResult
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=1.041, t.ratio_s1=1.5, creat_rise_48h=0.03, 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=1.041, t.ratio_s3=3.0, creat_peak=1.02, 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=1.041, 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=0.03, 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 Clinical judgement required Clinical judgement required Clinical judgement required: Haemoglobin fell 1.4 g/dL without transfusion (between 1 and 2 g/dL).
Trace
Rule trace (rule blood_loss_anemia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: anaemic case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null) sex=M, hgb_nadir=10.45, t.hb_m=13, t.hb_f=12 true
derived: acute_fall hgb_drop >= t.drop_major or prbc_units >= t.prbc_major hgb_drop=1.4, t.drop_major=2.0, prbc_units=0, t.prbc_major=2 false
outcome: met bleeding_documented and anaemic and acute_fall bleeding_documented=True, anaemic=True, acute_fall=False false
outcome: anaemia_only anaemic and hgb_drop < t.drop_min and prbc_units == 0 anaemic=True, hgb_drop=1.4, t.drop_min=1.0, prbc_units=0 false
outcome: not_anaemic present(hgb_nadir) and not anaemic hgb_nadir=10.45, anaemic=True false
outcome: no_source anaemic and acute_fall anaemic=True, acute_fall=False false
outcome: borderline anaemic anaemic=True true
Chronic kidney disease Clinical judgement required No gap Not documented; egfr 60 or above; ckd g1-g2 requires markers of kidney damage, which are not assessed here.
Trace
Rule trace (rule ckd v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: chronic egfr_n >= 2 and egfr_span_days >= t.chronic_days egfr_n=2, egfr_span_days=329, t.chronic_days=90 true
derived: staging_egfr max(egfr_early, egfr_late) egfr_early=87.8, egfr_late=88.8 88.8
derived: both_below_60 egfr_early < t.g2 and egfr_late < t.g2 egfr_early=87.8, t.g2=60, egfr_late=88.8 false
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=88.8, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15 G1-G2
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=False, egfr_early=87.8, egfr_late=88.8, t.g2=60 false
outcome: g1_g2 staging_egfr >= t.g2 staging_egfr=88.8, t.g2=60 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)
StepExpressionInputs and thresholds readResult
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 No gap Not documented and not supported.
Trace
Rule trace (rule hyponatremia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: severity case(na_min < t.profound, 'profound', na_min < t.moderate, 'moderate', na_min < t.low, 'mild', 'none') na_min=136.0, 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=136.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False false
outcome: untreated na_min < t.low na_min=136.0, t.low=135 false
outcome: not_met na_min >= t.low na_min=136.0, t.low=135 true
Malnutrition Insufficient data No gap Insufficient data: the criteria could not be applied.
Trace
Rule trace (rule malnutrition v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: a_sev_intake intake_pct <= t.a_sev_intake_pct and intake_days >= t.a_sev_intake_days intake_pct=unknown, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5 unknown
derived: a_mod_intake intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days intake_pct=unknown, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7 unknown
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=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30 unknown
derived: c_mod_intake intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days intake_pct=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30 unknown
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=unknown, wt_loss_pct=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown 0
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=unknown, a_sev_intake=unknown, a_sev_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_sev_wt=unknown unknown
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=unknown, a_sev_intake=unknown, a_mod_intake=unknown, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_mod_intake=unknown, c_sev_wt=unknown, c_mod_wt=unknown unknown
outcome: severe n_severe >= 2 n_severe=unknown unknown
outcome: moderate n_moderate >= 2 n_moderate=unknown unknown
outcome: one_characteristic n_moderate == 1 n_moderate=unknown unknown
outcome: not_met n_moderate == 0 and n_assessed >= 2 n_moderate=unknown, n_assessed=0 false
Obesity Criteria met Clinical validation gap Documented “morbid obesity” (E66.01) 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)
StepExpressionInputs and thresholds readResult
outcome: not_adult age < t.adult age=59, t.adult=20 false
outcome: class3 bmi >= t.c3 bmi=33.3, t.c3=40 false
outcome: class2 bmi >= t.c2 bmi=33.3, t.c2=35 false
outcome: class1 bmi >= t.c1 bmi=33.3, 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)
StepExpressionInputs and thresholds readResult
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 hypoxic respiratory failure” (J96.01) but the criteria are not met: No hypoxaemia on room air (lowest SpO2 93%), 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)
StepExpressionInputs and thresholds readResult
derived: measured present(spo2_min_ra) or present(pao2_min_ra) or present(pf_min) spo2_min_ra=93.0, 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=93.0, 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=21.0, 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)
StepExpressionInputs and thresholds readResult
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=36.8, t.t_lo=36 false
derived: sirs_hr coalesce(hr_max_48h > t.hr, false) hr_max_48h=90.0, 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=10.32, t.wbc_hi=12, wbc_min_48h=9.29, 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=230.0 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=0.4 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=1.02 0
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=0.98 0
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=0, sofa_renal_baseline=0 0
derived: sepsis3 infection_documented and sofa_delta >= t.sofa_delta infection_documented=False, sofa_delta=0, t.sofa_delta=2 false
derived: sepsis2 infection_documented and sirs_count >= t.sirs_min infection_documented=False, 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=False true

Structured data

Labs (43)
Labs (pre-admission rows are outpatient values)
RowWhenTestValue
LAB-000625Wed Oct 29, 2025 09:15 AMcreatinine0.99 mg/dL
LAB-000626Wed Sep 23, 2026 10:05 AMcreatinine0.98 mg/dL
LAB-000627Tue Nov 03, 2026 11:51 AMcreatinine0.99 mg/dL
LAB-000635Tue Nov 03, 2026 11:51 AMsodium141.0 mmol/L
LAB-000643Tue Nov 03, 2026 11:51 AMhemoglobin11.85 g/dL
LAB-000651Tue Nov 03, 2026 11:51 AMwbc9.29 x10^3/uL
LAB-000652Tue Nov 03, 2026 11:51 AMplatelets285.0 x10^3/uL
LAB-000667Tue Nov 03, 2026 11:51 AMbilirubin0.4 mg/dL
LAB-000628Wed Nov 04, 2026 05:00 AMcreatinine1.02 mg/dL
LAB-000636Wed Nov 04, 2026 05:00 AMsodium140.0 mmol/L
LAB-000644Wed Nov 04, 2026 05:00 AMhemoglobin11.05 g/dL
LAB-000653Wed Nov 04, 2026 05:00 AMwbc10.32 x10^3/uL
LAB-000654Wed Nov 04, 2026 05:00 AMplatelets241.0 x10^3/uL
LAB-000629Thu Nov 05, 2026 05:00 AMcreatinine0.99 mg/dL
LAB-000637Thu Nov 05, 2026 05:00 AMsodium137.0 mmol/L
LAB-000645Thu Nov 05, 2026 05:00 AMhemoglobin10.45 g/dL
LAB-000655Thu Nov 05, 2026 05:00 AMwbc10.31 x10^3/uL
LAB-000656Thu Nov 05, 2026 05:00 AMplatelets230.0 x10^3/uL
LAB-000630Fri Nov 06, 2026 05:00 AMcreatinine0.97 mg/dL
LAB-000638Fri Nov 06, 2026 05:00 AMsodium140.0 mmol/L
LAB-000646Fri Nov 06, 2026 05:00 AMhemoglobin10.55 g/dL
LAB-000657Fri Nov 06, 2026 05:00 AMwbc7.72 x10^3/uL
LAB-000658Fri Nov 06, 2026 05:00 AMplatelets203.0 x10^3/uL
LAB-000631Sat Nov 07, 2026 05:00 AMcreatinine0.98 mg/dL
LAB-000639Sat Nov 07, 2026 05:00 AMsodium139.0 mmol/L
LAB-000647Sat Nov 07, 2026 05:00 AMhemoglobin10.65 g/dL
LAB-000659Sat Nov 07, 2026 05:00 AMwbc10.66 x10^3/uL
LAB-000660Sat Nov 07, 2026 05:00 AMplatelets224.0 x10^3/uL
LAB-000632Sun Nov 08, 2026 05:00 AMcreatinine0.98 mg/dL
LAB-000640Sun Nov 08, 2026 05:00 AMsodium136.0 mmol/L
LAB-000648Sun Nov 08, 2026 05:00 AMhemoglobin10.65 g/dL
LAB-000661Sun Nov 08, 2026 05:00 AMwbc8.51 x10^3/uL
LAB-000662Sun Nov 08, 2026 05:00 AMplatelets270.0 x10^3/uL
LAB-000633Mon Nov 09, 2026 05:00 AMcreatinine1.0 mg/dL
LAB-000641Mon Nov 09, 2026 05:00 AMsodium138.0 mmol/L
LAB-000649Mon Nov 09, 2026 05:00 AMhemoglobin10.65 g/dL
LAB-000663Mon Nov 09, 2026 05:00 AMwbc9.95 x10^3/uL
LAB-000664Mon Nov 09, 2026 05:00 AMplatelets283.0 x10^3/uL
LAB-000634Tue Nov 10, 2026 05:00 AMcreatinine0.97 mg/dL
LAB-000642Tue Nov 10, 2026 05:00 AMsodium138.0 mmol/L
LAB-000650Tue Nov 10, 2026 05:00 AMhemoglobin10.65 g/dL
LAB-000665Tue Nov 10, 2026 05:00 AMwbc5.69 x10^3/uL
LAB-000666Tue Nov 10, 2026 05:00 AMplatelets185.0 x10^3/uL
Vitals (132)
Vitals
RowWhenKindValueDetail
VIT-001776Tue Nov 03, 2026 11:11 AMspo296.0room air
VIT-001777Tue Nov 03, 2026 11:11 AMrr20.0
VIT-001820Tue Nov 03, 2026 11:11 AMtemp_c36.8
VIT-001821Tue Nov 03, 2026 11:11 AMhr90.0
VIT-001822Tue Nov 03, 2026 11:11 AMmap90.0
VIT-001823Tue Nov 03, 2026 11:11 AMgcs15.0
VIT-001778Tue Nov 03, 2026 07:11 PMspo296.0room air
VIT-001779Tue Nov 03, 2026 07:11 PMrr18.0
VIT-001824Tue Nov 03, 2026 07:11 PMtemp_c37.4
VIT-001825Tue Nov 03, 2026 07:11 PMhr78.0
VIT-001826Tue Nov 03, 2026 07:11 PMmap76.0
VIT-001827Tue Nov 03, 2026 07:11 PMgcs15.0
VIT-001780Wed Nov 04, 2026 03:11 AMspo296.0room air
VIT-001781Wed Nov 04, 2026 03:11 AMrr17.0
VIT-001828Wed Nov 04, 2026 03:11 AMtemp_c37.4
VIT-001829Wed Nov 04, 2026 03:11 AMhr85.0
VIT-001830Wed Nov 04, 2026 03:11 AMmap74.0
VIT-001831Wed Nov 04, 2026 03:11 AMgcs15.0
VIT-001782Wed Nov 04, 2026 11:11 AMspo293.0room air
VIT-001783Wed Nov 04, 2026 11:11 AMrr20.0
VIT-001832Wed Nov 04, 2026 11:11 AMtemp_c37.0
VIT-001833Wed Nov 04, 2026 11:11 AMhr85.0
VIT-001834Wed Nov 04, 2026 11:11 AMmap80.0
VIT-001835Wed Nov 04, 2026 11:11 AMgcs15.0
VIT-001784Wed Nov 04, 2026 07:11 PMspo297.0room air
VIT-001785Wed Nov 04, 2026 07:11 PMrr16.0
VIT-001836Wed Nov 04, 2026 07:11 PMtemp_c37.0
VIT-001837Wed Nov 04, 2026 07:11 PMhr84.0
VIT-001838Wed Nov 04, 2026 07:11 PMmap77.0
VIT-001839Wed Nov 04, 2026 07:11 PMgcs15.0
VIT-001786Thu Nov 05, 2026 03:11 AMspo297.0room air
VIT-001787Thu Nov 05, 2026 03:11 AMrr16.0
VIT-001840Thu Nov 05, 2026 03:11 AMtemp_c36.9
VIT-001841Thu Nov 05, 2026 03:11 AMhr69.0
VIT-001842Thu Nov 05, 2026 03:11 AMmap89.0
VIT-001843Thu Nov 05, 2026 03:11 AMgcs15.0
VIT-001788Thu Nov 05, 2026 11:11 AMspo294.0room air
VIT-001789Thu Nov 05, 2026 11:11 AMrr20.0
VIT-001844Thu Nov 05, 2026 11:11 AMtemp_c37.0
VIT-001845Thu Nov 05, 2026 11:11 AMhr81.0
VIT-001846Thu Nov 05, 2026 11:11 AMmap84.0
VIT-001847Thu Nov 05, 2026 11:11 AMgcs15.0
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Medications, orders, echo, history (0)

Notes

History and physical · DOC-000061 · Dr. Keira Upfield (resident) · Tue Nov 03, 2026 01:51 PM

Cited facts from this note (1)
bleeding_source
black tarry stools · cited p. 1, line 5 · confidence 0.85
Show source for bleeding_source
… ervice: Hospital Medicine Attending: Dr. Gideon Zeller History of present illness: 59-year-old man admitted with upper GI bleed. Presented after two days of black tarry stools; GI consulted for endoscopy. Past medical history: type 2 diabetes, GERD, hyperlipidemia. Review of systems otherwise negative. Exam: Lungs: scattered crackles …
Source document DOC-000061: History and physical (synthetic)
HISTORY AND PHYSICAL
Patient: Dario Ingram   MRN: MRN17347290   Admitted: 2026-11-03 10:51
Service: Hospital Medicine   Attending: Dr. Gideon Zeller

History of present illness: 59-year-old man admitted with upper GI bleed. Presented after two days of black tarry stools; GI consulted for endoscopy.
Past medical history: type 2 diabetes, GERD, hyperlipidemia.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. Upper GI bleed: PPI, GI following.

Progress note · DOC-000062 · Dr. Keira Upfield (resident) · Thu Nov 05, 2026 01:51 PM

Source document DOC-000062: Progress note (synthetic)
PROGRESS NOTE (Resident)
Patient: Dario Ingram   MRN: MRN17347290   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Upper GI bleed: continue current management.
2. Morbid obesity: counsel on weight.
3. Acute hypoxic respiratory failure: supplemental oxygen, wean as tolerated.
4. Acute blood loss anemia: trend hemoglobin, transfuse if needed.

Resident: Dr. Keira Upfield   Attending cosign: completed

Discharge summary · DOC-000063 · Dr. Gideon Zeller (attending) · Tue Nov 10, 2026 01:37 PM

Source document DOC-000063: Discharge summary (synthetic)
DISCHARGE SUMMARY
Patient: Dario Ingram   MRN: MRN17347290
Admitted 2026-11-03; discharged 2026-11-10.

Discharge diagnoses:
- upper GI bleed
- morbid obesity
- acute hypoxic respiratory failure
- acute blood loss anemia
- type 2 diabetes
- GERD
- hyperlipidemia

Disposition: home with follow-up.