CHIEF COMPLAINT: s/p Motor vehicle crash

PRESENT ILLNESS: 54 yo M with a PMH significant for
tardive dyskinesia (? secondary to prolonged Clozapine
exposure),
bipolar disorder, multiple abdominal surgeries (Roux-en-Y
gastric
bybass, distal pancreatectomy, splenectomy, revision of
gastrectomy/choledochojejunostomy), Vit D/Vit B12/testosterone
deficiency, and anemia of chronic disease who presents as
unrestrained driver in MVC.   Per report he was unrestrained
driver who struck the highway barrier whereafter his car spun
around 180 degrees. The patient was found on the passenger side
of the car. EMS found the patient confused and unable to answer
questions. They could not obtain IV access and found the patient
to be hypotensive with a systolic pressure blood pressure of 80.
For this an interosseous access was established.  Upon arival he
was initially noted to have GCS of 14 with slow speech and was
somnolent.  Patient was initially found to not be responsive to
commands, and he did not remember the event.  He complained of
left forearm pain, nose pain (fracture nose last week with
planned surgical repain in [**State 531**] in [**3-14**] weeks), and headache.

MEDICAL HISTORY: 1. Roux-en-Y gastric bypass surgery with bile duct injury
complicated by stricture
2. S/P revision with total gastrectomy and
choledochojejunostomy.
3. S/P distal pancreatectomy, splenectomy, and ventral hernia
repair
4. Surgery for islet cell hyperplasia of the pancreas
5. MSSA endocarditis
6. recurrent line sepsis
7. circumferential abdominoplasty
8. hypoglycemia thought to be from nesidioblastosis
9. Osteomalacia [**2-11**] vitamin D deficiency
10. Vitamin B12 deficiency
11. Testosterone deficiency
12. Anemia of chronic disease
13. uvulectomy and tonsillectomy
14. lumbar spinal fusion at L4-L5
15. bilateral shoulder surgeries
16. right ankle fusion
17. hx of TB - treated with 4 drug therapy for 9 mo
18. basilar migraines
19. Bipolar disorder

MEDICATION ON ADMISSION: 1. dronabinol 10 mg Capsule Sig: One (1) Capsule PO BID (2 times

ALLERGIES: adhesive bandage / Benzoin / Mastisol Stertip / Compazine /
gabapentin / Neurontin

PHYSICAL EXAM: 

FAMILY HISTORY: Significant for CAD in his father and a sister w/ SLE.

SOCIAL HISTORY: Social History: Denies IVDU, alcohol, or tobacco history. Worked
as a CEO for multiple companies until [**2152**]. Has an 17 yr old
daughter and is divorced.
Open fracture of shaft of radius with ulna,Acute respiratory failure following trauma and surgery,Ventilator associated pneumonia,Foreign body in larynx,Unspecified protein-calorie malnutrition,Friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site,Osteomalacia, unspecified,Lesion of lateral popliteal nerve,Body Mass Index between 19-24, adult,Closed fracture of nasal bones,Closed fracture of middle or proximal phalanx or phalanges of hand,Concussion with no loss of consciousness,Other motor vehicle traffic accident involving collision on the highway injuring driver of motor vehicle other than motorcycle,Foreign body accidentally entering other orifice,Bipolar disorder, unspecified,Other iatrogenic hypotension,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Abrasion or friction burn of other, multiple, and unspecified sites, without mention of infection,Anxiety state, unspecified,Other antipsychotics, neuroleptics, and major tranquilizers causing adverse effects in therapeutic use,Anemia of other chronic disease,Other testicular hypofunction,Migraine with aura, without mention of intractable migraine without mention of status migrainosus,Unspecified hereditary and idiopathic peripheral neuropathy,Subacute dyskinesia due to drugs,Acquired partial absence of pancreas,Bariatric surgery status,Other acquired absence of organ
Fx shaft rad w ulna-open,Ac resp flr fol trma/srg,Ventltr assoc pneumonia,Foreign body in larynx,Protein-cal malnutr NOS,Klebsiella pneumoniae,Osteomalacia NOS,Lat popliteal nerve les,BMI between 19-24,adult,Nasal bone fx-closed,Fx mid/prx phal, hand-cl,Concussion w/o coma,Mv coll w oth obj-driver,FB entering oth orifice,Bipolar disorder NOS,Iatrogenc hypotnsion NEC,Abn react-procedure NEC,Abrasion NEC,Anxiety state NOS,Adv eff antipsychotc NEC,Anemia-other chronic dis,Testicular hypofunc NEC,Mgrn w aura wo ntrc mgrn,Idio periph neurpthy NOS,Subac dyskinesa d/t drug,Acq part absnce pancreas,Bariatric surgery status,Acq absence of organ NEC
Admission Date:  [**2162-4-19**]              Discharge Date:   [**2162-4-29**]

Date of Birth:  [**2108-1-21**]             Sex:   M

Service: SURGERY

Allergies:
adhesive bandage / Benzoin / Mastisol Stertip / Compazine /
gabapentin / Neurontin

Attending:[**First Name3 (LF) 4691**]
Chief Complaint:
s/p Motor vehicle crash

Major Surgical or Invasive Procedure:
1. Irrigation and debridement down to and inclusive of bone
    of open ulna and radius fracture.
2. Open reduction internal fixation both-bones forearm
    fracture including segmental radius and ulnar shaft.
3. Examination under anesthesia distal radioulnar joint for
    joint stability.


History of Present Illness:
54 yo M with a PMH significant for
tardive dyskinesia (? secondary to prolonged Clozapine
exposure),
bipolar disorder, multiple abdominal surgeries (Roux-en-Y
gastric
bybass, distal pancreatectomy, splenectomy, revision of
gastrectomy/choledochojejunostomy), Vit D/Vit B12/testosterone
deficiency, and anemia of chronic disease who presents as
unrestrained driver in MVC.   Per report he was unrestrained
driver who struck the highway barrier whereafter his car spun
around 180 degrees. The patient was found on the passenger side
of the car. EMS found the patient confused and unable to answer
questions. They could not obtain IV access and found the patient
to be hypotensive with a systolic pressure blood pressure of 80.
For this an interosseous access was established.  Upon arival he
was initially noted to have GCS of 14 with slow speech and was
somnolent.  Patient was initially found to not be responsive to
commands, and he did not remember the event.  He complained of
left forearm pain, nose pain (fracture nose last week with
planned surgical repain in [**State 531**] in [**3-14**] weeks), and headache.


Dicussion and history per his brother and sister, he had been
recently "stable" with all his medical problems, and returned
from a trip to [**Location (un) **] this past Saturday.  He had been living
alone and has a tendencey to either over take medication or
undertake medication when not supervised.  He was supposed to go
to physical therapy and had missed his appointment this morning
prior to the accident.  His brother states that he had tried to
call him this morning without success.  For the past several
months he has been eating very little secondary to nausea and
has
had occasional tongue swelling with taste amplification.  He was
recently hospitalized [**Date range (3) 39346**] for altered mental status
and confusion.  At that time, he had been experiencing frequent
falls in which he would hit his head.  Remeron and Trileptal
were
tapered out of concern that these medications could be
contributing to his altered mental status. Since the patient has
no indication for being on Trileptal with the exception of a
possible history of basilar migraines, we conferred with his
psychiatrist who agreed that this medication was unnecessary and
could be contributing to the patient's falls. Also, a neurology
note from [**2162**] stated explicitly that the patient did not have
basilar migraines.  Prior notes have also felt like there was a
large functional component to his neurologic deficits.  Also it
is likely that the patient's numerous  psychotropic medications
in the setting of his leukocytosis have been attributed to his
unsteady gate. A series of labs were sent off for the workup of
a
toxic metabolic syndrome or a nutritional deficiency which could
cause a peripheral neuropathy.  These results came back
negative.
The patients mental status dramatically improved with
antibiotics
and IV hydration during this admission.  The patient has been
seen by Dr. [**Last Name (STitle) **] of Neurology for follow-up of Tardive
Dyskinesia.  He was last seen in the Movement [**Hospital 6920**] Clinic
on
[**2162-1-21**].  At that time, the patient described persistent teeth
grinding, abnormal movmements of the face and tongue, and
slurred, high pitch speech that worsens at the end of the day.
The patient also reported abnormal leg movements with give-way
weakness throughout his legs.  At that time, he had recently
stopped tetrabenazine , which had worked well in the past, due
to
insurance changes.
.


Past Medical History:
1. Roux-en-Y gastric bypass surgery with bile duct injury
complicated by stricture
2. S/P revision with total gastrectomy and
choledochojejunostomy.
3. S/P distal pancreatectomy, splenectomy, and ventral hernia
repair
4. Surgery for islet cell hyperplasia of the pancreas
5. MSSA endocarditis
6. recurrent line sepsis
7. circumferential abdominoplasty
8. hypoglycemia thought to be from nesidioblastosis
9. Osteomalacia [**2-11**] vitamin D deficiency
10. Vitamin B12 deficiency
11. Testosterone deficiency
12. Anemia of chronic disease
13. uvulectomy and tonsillectomy
14. lumbar spinal fusion at L4-L5
15. bilateral shoulder surgeries
16. right ankle fusion
17. hx of TB - treated with 4 drug therapy for 9 mo
18. basilar migraines
19. Bipolar disorder


Social History:
Social History: Denies IVDU, alcohol, or tobacco history. Worked
as a CEO for multiple companies until [**2152**]. Has an 17 yr old
daughter and is divorced.


Family History:
Significant for CAD in his father and a sister w/ SLE.


Pertinent Results:
[**2162-4-19**] 06:55PM   GLUCOSE-105* UREA N-14 CREAT-0.7 SODIUM-138
POTASSIUM-4.7 CHLORIDE-110* TOTAL CO2-25 ANION GAP-8
[**2162-4-19**] 06:55PM   ALT(SGPT)-48* AST(SGOT)-57* ALK PHOS-94 TOT
BILI-0.3
[**2162-4-19**] 06:55PM   CALCIUM-8.0* PHOSPHATE-3.7 MAGNESIUM-1.8
[**2162-4-19**] 06:55PM   LITHIUM-0.7
[**2162-4-19**] 06:55PM   WBC-24.0* RBC-3.18* HGB-9.0* HCT-28.3* MCV-89
MCH-28.2 MCHC-31.8 RDW-16.8*
[**2162-4-19**] 06:55PM   PLT COUNT-372

Imaging:
CXR: Bilateral upper lobe opacities (R>L), similar compared to
[**2162-3-14**] studies, no effusion/pneumothorax
CT head: No acute intracranial process. Buckled right nasal bone
fracture.
CT C-spine: No fracture or malalignment
CT Torso: No intrathoracic or intraabdominal injury
Plain Film Forearm: Dispalced segmental fracture of the radius
and fracture of the mid-to-distal ulna.
Plain Film of Hand: Minimally displaced transverse fracture of
the proximal middle finger phalanx with volar displacement of
the distal fracture fragment. Evidence of old hand surgery with
an anchor in the middle phlanx of right thumb


Brief Hospital Course:
He was admitted to the Acute Care Surgery team. Orthopedics
consulted for the fractures in his left forearm and he was taken
to the operating room for repair of these injures.
Postoperatively he was noted to have significant swelling and
was monitored closely for compartment syndrome. His compartments
on exam did remain soft and the swelling decreased significantly
with elevation using  a stockinette attached to IV pole.

His right middle finger fracture was evaluated by Hand Surgery.
His finger remained splinted while discussions for operative
repair were underway. Occupational therapy was consulted for
splinting of his extremities.

He was taken to the operating room again on [**2162-4-23**] for repair
of his finger fractures and nasal fracture (of note, was an
exacerbation of an old nasal fracture and elective repair had
been scheduled prior to this injury). Following the procedure,
he desaturated in the PACU requiring re-intubation. This is
believed to be from residual anesthetic. He was admitted to the
SICU. Over the next 24 hours, he was weaned from the ventilator
and extubated without incident. He was bronched prior to
extubation and purulent secretions were found.  His chest x-ray
at that time showed bilateral atelectasis with mild hilar
congestion. He was started on Cipro which will continue through
[**4-30**].

He was transferred to the floor the following day
hemodynamically stable. He did require intermittent nasal oxygen
once transferred form the ICU and was continued on nebulizer
treatments.

He was noted with pain control issues postoperatively and was
initially started on MS Contin with oral Dilaudid for
breakthrough pain. Because of some mental status changes felt
likely from the narcotics these were stopped and he was started
on around the clock Tylenol and standing Ultram.

He was also seen by Physical therapy given his history of
frequent falls. It is being recommneded that he go to rehab
after his acute hospital stay.


Medications on Admission:
1. dronabinol 10 mg Capsule Sig: One (1) Capsule PO BID (2 times

a day).
2. ZOFRAN ODT 8 mg Tablet, Rapid Dissolve Sig: One (1) Tablet,
Rapid Dissolve PO three times a day: With meals .
3. clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO three times a

day.
4. hydroxyzine HCl 25 mg Tablet Sig: Two (2) Tablet PO three
times a day as needed for nausea.
5. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO every six (6)

hours as needed for pain.
6. venlafaxine 75 mg Capsule, Ext Release 24 hr Sig: Four (4)
Capsule, Ext Release 24 hr PO DAILY (Daily).
7. zolpidem 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime).

8. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2

times a day).
9. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed for constipation.
10. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO once a day.
11. multivitamin Tablet Sig: One (1) Tablet PO DAILY
(Daily).
12. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).


13. ergocalciferol (vitamin D2) 50,000 unit Capsule Sig: One (1)

Capsule PO EVERY OTHER DAY (Every Other Day).
14. thiamine HCl 100 mg Tablet Sig: 2.5 Tablets PO DAILY
(Daily).
15. tramadol 50 mg Tablet Sig: One (1) Tablet PO every eight (8)

hours as needed for pain.
16. lithium carbonate 450 mg Tablet Extended Release Sig: One
(1) Tablet Extended Release PO HS (at bedtime).
17. Adderall XR 20 mg Capsule, Ext Release 24 hr Sig: One (1)
Capsule, Ext Release 24 hr PO once a day.
18. Calcium Citrate + D 315-200 mg-unit Tablet Sig: Three (3)
Tablet PO twice a day.
19. Pancrelipase 5000 5,000-17,000 -27,000 unit Capsule, Delayed

Release(E.C.) Sig: Twelve (12) Capsule, Delayed Release(E.C.) PO

three times a day: Take with meals .
20. Fish Oil 1,000 mg Capsule Sig: One (1) Capsule PO once a
day.
21. vitamin E 600 unit Capsule Sig: Two (2) Capsule PO once a
day.
22. cyanocobalamin (vitamin B-12) 1,000 mcg/mL Solution Sig: One

(1) ml Injection once a month.
23. Miralax 17 gram/dose Powder Sig: One (1) PO once a day as
needed for constipation.
24. guaifenesin 100 mg/5 mL Syrup Sig: [**5-20**] ml PO every six (6)

hours as needed for cough.
25. DuoNeb 0.5 mg-3 mg(2.5 mg base)/3 mL Solution for
Nebulization Sig: One (1) inhalation Inhalation every six (6)
hours as needed for shortness of breath or wheezing
ALL: &#8206;adhesive bandage / Benzoin / Mastisol Stertip /
Compazine /
gabapentin / Neurontin


Discharge Medications:
1. lipase-protease-amylase 5,000-17,000 -27,000 unit Capsule,
Delayed Release(E.C.) Sig: Three (3) Cap PO TID W/MEALS (3 TIMES
A DAY WITH MEALS).
2. venlafaxine 75 mg Capsule, Ext Release 24 hr Sig: Four (4)
Capsule, Ext Release 24 hr PO DAILY (Daily).
3. hydroxyzine HCl 25 mg Tablet Sig: Two (2) Tablet PO TID (3
times a day).
4. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q6H (every
6 hours).
5. senna 8.6 mg Tablet Sig: 1-2 Tablets PO DAILY (Daily).
6. oxybutynin chloride 5 mg Tablet Sig: Three (3) Tablet PO BID
(2 times a day).
7. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

8. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
9. lithium carbonate 450 mg Tablet Extended Release Sig: One (1)
Tablet Extended Release PO DAILY (Daily).
10. albuterol sulfate 90 mcg/actuation HFA Aerosol Inhaler Sig:
1-2 Puffs Inhalation Q6H (every 6 hours) as needed for shortness
of breath or wheezing.
11. heparin (porcine) 5,000 unit/mL Solution Sig: One (1) ml
Injection TID (3 times a day).
12. amphetamine-dextroamphetamine 20 mg Capsule, Ext Release 24
hr Sig: Two (2) Capsule, Ext Release 24 hr PO daily ().
13. ciprofloxacin 250 mg Tablet Sig: Three (3) Tablet PO Q12H
(every 12 hours) for 2 days.
14. silver sulfadiazine 1 % Cream Sig: One (1) Appl Topical [**Hospital1 **]
(2 times a day): Apply to blisters on left forearm [**Hospital1 **]  .
15. tramadol 50 mg Tablet Sig: One (1) Tablet PO QID (4 times a
day).


Discharge Disposition:
Extended Care

Facility:
[**Hospital6 85**] - [**Location (un) 86**]

Discharge Diagnosis:
s/p Motor vehicle crash
Injuries:
Nasal bone fracture
Left ulnar & radius fractures
Right 3rd phalanx fracture
Pneumonia


Discharge Condition:
Awake and alert, conversant w/ some dysathria
Activity Status: Out of Bed with assistance to chair or
wheelchair.


Discharge Instructions:
You were admitted to the hospital after a motor vehicle crash
where you sustained a broken nasal bone, fractures of your right
middle finger fracture and left arm. Your injuries required
several operations to repair the fractures.  It is important
that you do not put any full weight on your left arm and right
hand and be sure to keep your left arm elevated as high as
possible to minimize the swelling.

You are being recommneded for rehab after discharge from the
hospital to help with rebuilding your strength and endurance
from all of your injuries.

Followup Instructions:
*

Department: SPINE CENTER(PLASTIC DEPT APPT.)
When: FRIDAY [**2162-5-7**] at 2:45 PM
With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 2477**], MD [**Telephone/Fax (1) 39347**]
Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 551**]
Campus: EAST     Best Parking: [**Hospital Ward Name 23**] Garage

Department: ORTHOPEDICS
When: TUESDAY [**2162-5-11**] at 11:20 AM
With: ORTHO XRAY (SCC 2) [**Telephone/Fax (1) 1228**]
Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 551**]
Campus: EAST     Best Parking: [**Hospital Ward Name 23**] Garage

Department: ORTHOPEDICS
When: TUESDAY [**2162-5-11**] at 11:40 AM
With: [**First Name11 (Name Pattern1) 2191**] [**Last Name (NamePattern4) 2192**], NP [**Telephone/Fax (1) 1228**]
Building: [**Hospital6 29**] [**Location (un) 551**]
Campus: EAST     Best Parking: [**Hospital Ward Name 23**] Garage

Department: [**Hospital3 249**]
When: WEDNESDAY [**2162-4-28**] at 8:20 AM
With: [**First Name8 (NamePattern2) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 2010**]
Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **]
Campus: EAST     Best Parking: [**Hospital Ward Name 23**] Garage

Department: SPINE CENTER
When: FRIDAY [**2162-5-7**] at 2:45 PM
With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 2477**], MD [**Telephone/Fax (1) 39347**]
Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 551**]
Campus: EAST     Best Parking: [**Hospital Ward Name 23**] Garage

Department: MEDICAL SPECIALTIES
When: MONDAY [**2162-5-10**] at 8:30 AM
With:  BONE DENSITY TESTING [**Telephone/Fax (1) 4586**]
Building: [**Hospital6 29**] [**Location (un) **]
Campus: EAST     Best Parking: [**Hospital Ward Name 23**] Garage



Completed by:[**2162-5-12**]
{"Open fracture of shaft of radius with ulna,Acute respiratory failure following trauma and surgery,Ventilator associated pneumonia,Foreign body in larynx,Unspecified protein-calorie malnutrition,Friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site,Osteomalacia, unspecified,Lesion of lateral popliteal nerve,Body Mass Index between 19-24, adult,Closed fracture of nasal bones,Closed fracture of middle or proximal phalanx or phalanges of hand,Concussion with no loss of consciousness,Other motor vehicle traffic accident involving collision on the highway injuring driver of motor vehicle other than motorcycle,Foreign body accidentally entering other orifice,Bipolar disorder, unspecified,Other iatrogenic hypotension,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Abrasion or friction burn of other, multiple, and unspecified sites, without mention of infection,Anxiety state, unspecified,Other antipsychotics, neuroleptics, and major tranquilizers causing adverse effects in therapeutic use,Anemia of other chronic disease,Other testicular hypofunction,Migraine with aura, without mention of intractable migraine without mention of status migrainosus,Unspecified hereditary and idiopathic peripheral neuropathy,Subacute dyskinesia due to drugs,Acquired partial absence of pancreas,Bariatric surgery status,Other acquired absence of organ"}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: s/p Motor vehicle crash

PRESENT ILLNESS: 54 yo M with a PMH significant for
tardive dyskinesia (? secondary to prolonged Clozapine
exposure),
bipolar disorder, multiple abdominal surgeries (Roux-en-Y
gastric
bybass, distal pancreatectomy, splenectomy, revision of
gastrectomy/choledochojejunostomy), Vit D/Vit B12/testosterone
deficiency, and anemia of chronic disease who presents as
unrestrained driver in MVC.   Per report he was unrestrained
driver who struck the highway barrier whereafter his car spun
around 180 degrees. The patient was found on the passenger side
of the car. EMS found the patient confused and unable to answer
questions. They could not obtain IV access and found the patient
to be hypotensive with a systolic pressure blood pressure of 80.
For this an interosseous access was established.  Upon arival he
was initially noted to have GCS of 14 with slow speech and was
somnolent.  Patient was initially found to not be responsive to
commands, and he did not remember the event.  He complained of
left forearm pain, nose pain (fracture nose last week with
planned surgical repain in [**State 531**] in [**3-14**] weeks), and headache.

MEDICAL HISTORY: 1. Roux-en-Y gastric bypass surgery with bile duct injury
complicated by stricture
2. S/P revision with total gastrectomy and
choledochojejunostomy.
3. S/P distal pancreatectomy, splenectomy, and ventral hernia
repair
4. Surgery for islet cell hyperplasia of the pancreas
5. MSSA endocarditis
6. recurrent line sepsis
7. circumferential abdominoplasty
8. hypoglycemia thought to be from nesidioblastosis
9. Osteomalacia [**2-11**] vitamin D deficiency
10. Vitamin B12 deficiency
11. Testosterone deficiency
12. Anemia of chronic disease
13. uvulectomy and tonsillectomy
14. lumbar spinal fusion at L4-L5
15. bilateral shoulder surgeries
16. right ankle fusion
17. hx of TB - treated with 4 drug therapy for 9 mo
18. basilar migraines
19. Bipolar disorder

MEDICATION ON ADMISSION: 1. dronabinol 10 mg Capsule Sig: One (1) Capsule PO BID (2 times

ALLERGIES: adhesive bandage / Benzoin / Mastisol Stertip / Compazine /
gabapentin / Neurontin

PHYSICAL EXAM: 

FAMILY HISTORY: Significant for CAD in his father and a sister w/ SLE.

SOCIAL HISTORY: Social History: Denies IVDU, alcohol, or tobacco history. Worked
as a CEO for multiple companies until [**2152**]. Has an 17 yr old
daughter and is divorced. 

### Response:
{"Open fracture of shaft of radius with ulna,Acute respiratory failure following trauma and surgery,Ventilator associated pneumonia,Foreign body in larynx,Unspecified protein-calorie malnutrition,Friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site,Osteomalacia, unspecified,Lesion of lateral popliteal nerve,Body Mass Index between 19-24, adult,Closed fracture of nasal bones,Closed fracture of middle or proximal phalanx or phalanges of hand,Concussion with no loss of consciousness,Other motor vehicle traffic accident involving collision on the highway injuring driver of motor vehicle other than motorcycle,Foreign body accidentally entering other orifice,Bipolar disorder, unspecified,Other iatrogenic hypotension,Other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Abrasion or friction burn of other, multiple, and unspecified sites, without mention of infection,Anxiety state, unspecified,Other antipsychotics, neuroleptics, and major tranquilizers causing adverse effects in therapeutic use,Anemia of other chronic disease,Other testicular hypofunction,Migraine with aura, without mention of intractable migraine without mention of status migrainosus,Unspecified hereditary and idiopathic peripheral neuropathy,Subacute dyskinesia due to drugs,Acquired partial absence of pancreas,Bariatric surgery status,Other acquired absence of organ"}
