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Initial Public Health Case Report

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Apple Ztest
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Patient Identifiers
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VAN4N7Q2ZJL42G8 OID: 1.2.840.114350.1.13.478.3.7.3.688884.100
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002001257 OID: 1.2.840.114350.1.13.478.3.7.5.737384.14
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About

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Date of Birth
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10/5/1965
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Sex
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Female
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Race
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White
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Ethnicity
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Not Hispanic or Latino
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Preferred Language
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eng
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Contact

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Primary Home (11/22/2017 to // )
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999 Single Lane

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BEVERLY HILLS, CA

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90210, USA

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Primary Home (11/17/2017 to 11/21/2017 )
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USA

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tel: (Primary Home) +1-615-999-9999
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tel: (Mobile Contact) +1-615-999-9999
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email: deidre.wright@vumc.org
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email: none@none.com
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Emergency Contact

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- - (Sister) - - 44160 1.2.840.114350.1.13.478.3.7.2.827665 -
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Contact

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Primary Home
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999 Single Court

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BEVERLY HILLS, CA

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90210, USA

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tel: (Primary Home) +1-615-995-9999
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Author

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Time:
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07/28/2022, 09:01
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Lab Interface
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EDILABIH OID: 1.2.840.114350.1.13.478.3.7.2.697780
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Contact

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Author Organization

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Vanderbilt University Medical Center
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1104202761 OID: 1.2.840.114350.1.13.478.2.7.5.737384.61
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Contact

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Work Place
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3401 West End Ave

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NASHVILLE, TN

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37203, USA

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tel: (Work Place) +1-615-322-5000
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Author

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Time:
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07/28/2022, 09:01
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10.2 OID: 1.2.840.114350.1.1
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Contact

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Author Organization

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Vanderbilt University Medical Center
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1104202761 OID: 1.2.840.114350.1.13.478.2.7.5.737384.61
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Contact

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Work Place
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3401 West End Ave

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NASHVILLE, TN

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37203, USA

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tel: (Work Place) +1-615-322-5000
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Encounter

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Identifier
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1800200448269 OID: 1.2.840.114350.1.13.478.3.7.3.698084.8
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Type
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Transcribe Orders
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Date
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- From: 02/18/2022 -
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- To: 02/18/2022 -
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Location
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Vanderbilt University Adult Hospital of Vanderbilt University Medical Center
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Miscellaneous Notes

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- Not on file - documented in this encounter -
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Immunizations

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NameAdministration DatesNext Due
DTaP, 5 pertussis antigens vaccine (DAPTACEL) - 06/15/2021 -
Hep B, adult vaccine (Engerix/Recombivax) - 09/08/2020 -
SARS-COV-2 (COVID-19) Spikevax Vaccine, Moderna - 01/22/2021 -
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- documented as of this encounter -
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Administered Medications

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- Not on file - documented in this encounter -
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Plan of Treatment

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- - Pending Results - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NameTypePriorityAssociated DiagnosesDate/Time
- PCR SARS-CoV-2 and Influenza A/B - LabRoutine07/27/2022 3:49 PM CDT
- PCR SARS-CoV-2 and Influenza A/B - LabRoutine07/27/2022 3:49 PM CDT
- PCR SARS-CoV-2 and Influenza A/B - LabRoutine07/27/2022 3:49 PM CDT
- PCR SARS-CoV-2 and Influenza A/B - LabRoutine07/27/2022 3:49 PM CDT
- PCR SARS-CoV-2 and Influenza A/B - LabRoutine07/27/2022 3:49 PM CDT
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- - Scheduled Orders - - - - - - - - - - - - - - - - -
NameTypePriorityAssociated DiagnosesOrder Schedule
- PCR Hepatitis C Virus Qt - LabRoutineOrdered: 5/12/22
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- documented as of this encounter -
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Problems

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Active ProblemsNoted Date
COVID toes7/13/22
Chest pain on breathing5/26/22
Type 1 diabetes2/28/22
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Overview:

- - Formatting of this note might be different from the original. -
- BMI Readings from Last 1 Encounters: -
- 08/30/21 28.69 kg/m² -
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Plague pneumonia6/16/21
Absence of menstruation6/12/18
Foot callus8/11/17
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Overview:

- - Formatting of this note might be different from the original. -
- Ouch. - -
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- documented as of this encounter (statuses as of 07/28/2022) -
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Reason for Visit

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- Not on file -
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Results

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  • - (ABNORMAL) SARS-CoV-2 PCR (07/27/2022 3:49 PM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    SARS-CoV-2 Nucleic Acid (Result) - Detected - (A) - Not DetectedVUMC CERNER LAB
    - - Comment: -
    - - A detected result is positive and indicates the presence of the virus in the sample. A not detected result indicates that the test did not detect the virus in the sample. -
    -
    - This test was performed using a multiplexed nucleic acid amplification test that is labeled Emergence Use Only by the U.S. FDA. Results of this test should not be used as the sole basis for diagnosis, treatment, or other management decisions. -
    -
    -     -     -
    SARS-CoV-2 Nucleic Acid Method (Comment) - - Other -
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    - This test was performed using the Roche 6800 COVID-19 test. This test is currently approved for clinical diagnostic testing under Emergency Use Authorization of the FDA; the result should not be considered experimental or for research purposes. -
    -     -     		VUMC CERNER LAB
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    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Other07/27/2022 3:49 PM CDT07/27/2022 3:58 PM CDT
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    Resulting Agency Comment
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    - Ordered by Romney H Humphries -

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    Authorizing ProviderResult Type
    No PcpLAB BODY FLUIDS AND STOOLS ORDERABLES
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    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
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    VUMC CERNER LAB

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    4605 TVC VUMC

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    1301 Medical Center Drive

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    NASHVILLE, TN 37232-5310

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    615-875-5227

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    • -
  • - (ABNORMAL) SARS-CoV-2 PCR (07/27/2022 3:49 PM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    SARS-CoV-2 Nucleic Acid (Result) - Detected - (A) - Not DetectedVUMC CERNER LAB
    - - Comment: -
    - - A detected result is positive and indicates the presence of the virus in the sample. A not detected result indicates that the test did not detect the virus in the sample. -
    -
    - This test was performed using a multiplexed nucleic acid amplification test that is labeled Emergence Use Only by the U.S. FDA. Results of this test should not be used as the sole basis for diagnosis, treatment, or other management decisions. -
    -
    -     -     -
    SARS-CoV-2 Nucleic Acid Method (Comment) - - Oropharynx -
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    - This test was performed using the Roche 6800 COVID-19 test. This test is currently approved for clinical diagnostic testing under Emergency Use Authorization of the FDA; the result should not be considered experimental or for research purposes. -
    -     -     		VUMC CERNER LAB
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    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Oropharynx07/27/2022 3:49 PM CDT07/27/2022 3:58 PM CDT
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    Resulting Agency Comment
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    - Ordered by Romney H Humphries -

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    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    No PcpLAB BODY FLUIDS AND STOOLS ORDERABLES
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    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
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    VUMC CERNER LAB

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    4605 TVC VUMC

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    1301 Medical Center Drive

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    NASHVILLE, TN 37232-5310

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    615-875-5227

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    • -
  • - SARS-CoV-2 PCR (07/27/2022 3:49 PM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    SARS-CoV-2 Nucleic Acid (Result) - Not Detected - Not DetectedVUMC CERNER LAB
    - - Comment: -
    - - A detected result is positive and indicates the presence of the virus in the sample. A not detected result indicates that the test did not detect the virus in the sample. -
    -
    - This test was performed using a multiplexed nucleic acid amplification test that is labeled Emergence Use Only by the U.S. FDA. Results of this test should not be used as the sole basis for diagnosis, treatment, or other management decisions. -
    -
    -     -     -
    SARS-CoV-2 Nucleic Acid Method (Comment) - - Nasopharynx -
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    - This test was performed using the Roche 6800 COVID-19 test. This test is currently approved for clinical diagnostic testing under Emergency Use Authorization of the FDA; the result should not be considered experimental or for research purposes. -
    -     -     		VUMC CERNER LAB
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    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Nasopharynx07/27/2022 3:49 PM CDT07/27/2022 3:58 PM CDT
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    Resulting Agency Comment
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    - Ordered by Romney H Humphries -

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    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    No PcpLAB BODY FLUIDS AND STOOLS ORDERABLES
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    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
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    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

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    1301 Medical Center Drive

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    NASHVILLE, TN 37232-5310

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    615-875-5227

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    • -
  • - SARS-CoV-2 PCR (07/27/2022 3:49 PM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    SARS-CoV-2 Nucleic Acid (Result) - Not Detected - Not DetectedVUMC CERNER LAB
    - - Comment: -
    - - A detected result is positive and indicates the presence of the virus in the sample. A not detected result indicates that the test did not detect the virus in the sample. -
    -
    - This test was performed using a multiplexed nucleic acid amplification test that is labeled Emergence Use Only by the U.S. FDA. Results of this test should not be used as the sole basis for diagnosis, treatment, or other management decisions. -
    -
    -     -     -
    SARS-CoV-2 Nucleic Acid Method (Comment) - - Nares -
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    - This test was performed using the Roche 6800 COVID-19 test. This test is currently approved for clinical diagnostic testing under Emergency Use Authorization of the FDA; the result should not be considered experimental or for research purposes. -
    -     -     		VUMC CERNER LAB
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    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Nares07/27/2022 3:49 PM CDT07/27/2022 3:58 PM CDT
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    - - - - - - - - - - - -
    Resulting Agency Comment
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    - Ordered by Romney H Humphries -

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    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    No PcpLAB BODY FLUIDS AND STOOLS ORDERABLES
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    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

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    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

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    -
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    • -
  • - SARS-CoV-2 PCR (07/27/2022 3:49 PM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    SARS-CoV-2 Nucleic Acid (Result) - Not Detected - Not DetectedVUMC CERNER LAB
    - - Comment: -
    - - A detected result is positive and indicates the presence of the virus in the sample. A not detected result indicates that the test did not detect the virus in the sample. -
    -
    - This test was performed using a multiplexed nucleic acid amplification test that is labeled Emergence Use Only by the U.S. FDA. Results of this test should not be used as the sole basis for diagnosis, treatment, or other management decisions. -
    -
    -     -     -
    SARS-CoV-2 Nucleic Acid Method (Comment) - - BAL -
    -
    - This test was performed using the Roche 6800 COVID-19 test. This test is currently approved for clinical diagnostic testing under Emergency Use Authorization of the FDA; the result should not be considered experimental or for research purposes. -
    -     -     		VUMC CERNER LAB
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    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    BAL07/27/2022 3:49 PM CDT07/27/2022 3:58 PM CDT
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    - - - - - - - - - - - -
    Resulting Agency Comment
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    - Ordered by Romney H Humphries -

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    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    No PcpLAB BODY FLUIDS AND STOOLS ORDERABLES
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    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

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    4605 TVC VUMC

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    1301 Medical Center Drive

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    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

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    • -
  • - (ABNORMAL) Hepatitis C IgG w/Rfx PCR (05/12/2022 6:00 AM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    Hepatitis C Antibody - Positive - (A) - NegativeVUMC CERNER LAB
    - - Comment: -
    - - Positive: Presumptive history of HCV infection; nucleic acid testing recommended to document viral replication. -
    -
    - Equivocal: Antibodies to HCV may or may not be present; repeat serologic testing in approximately 8 weeks or nucleic acid testing is recommended to assess possible infection. -
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    - Negative: Antibodies to HCV not detected; does not exclude possibility of infection with HCV. -
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    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Blood05/12/2022 6:00 AM CDT05/12/2022 11:30 AM CDT
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    Authorizing ProviderResult Type
    Charles W Stratton MDLAB BLOOD ORDERABLES
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    Performing OrganizationAddressCity/State/ZIP CodePhone Number
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    VUMC CERNER LAB

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    4605 TVC VUMC

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    1301 Medical Center Drive

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    NASHVILLE, TN 37232-5310

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    615-875-5227

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    • -
  • - Cytogenomic SNP microarray (04/04/2022 11:55 AM CDT): -
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    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Blood04/04/2022 11:55 AM CDT04/18/2022 2:46 PM CDT
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    Narrative
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    VUMC CERNER LAB - 04/18/2022 2:57 PM CDT

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    - MICROARRAY REPORT- Corrected -
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    - Request#: CG-22-0000006 -
    - Service date: 4/4/2022 11:55 -
    - -
    - Microarray Result: -
    - Normal female -
    - -
    - Microarray Interpretation: -
    - SNP chromosomal microarray analysis (CMA) of a blood sample from this patient demonstrated no copy number changes of known clinical significance. No large regions of homozygosity (ROH) were detected. The ISCN nomenclature describing this result is: arr(X,1-22)x2. -
    - Electronically signed out by: -
    - Benfield, Luis A -
    - -
    - on 04/18/2022 -
    - ___________________________________________________________________ -
    - -
    - Clinical indication: -
    - Specimen List: Blood -
    - Date in Lab: 4/18/2022 14:46 -
    - Date Collected: 4/4/2022 11:55 -
    - ___________________________________________________________________ -
    - -
    - Disclaimer: -
    - -
    - Copy number gains less than 400 kb in size and copy number losses less than 200 kb in size will not be reported unless they represent a known or suspected clinically relevant imbalance. The reporting of copy number variants less than 100 kb in size is at the discretion of the laboratory and some clinically relevant copy number changes under 50 kb may not be reported due to limitations in probe coverage in certain genomic regions. Copy number changes of any size with no apparent clinical significance (likely benign or benign) have not been discussed in this report but may be available upon request. Regions of homozygosity (ROH) less than 10 Mb in size will not be reported unless the ROH is clinically relevant for potential uniparental disomy. Genome-wide ROH under 2% will not be reported. Copy number variants less than 200 kb associated with a carrier status for autosomal recessive conditions will not be reported unless specifically indicated in the reason for referral. -
    - -
    - This microarray was designed and manufactured by Affymetrix for the sole purpose of identifying DNA copy number gains and losses associated with chromosomal imbalances and regions of homozygosity (ROH) associated with uniparental isodisomy (isoUPD).This microarray will detect aneuploidy, deletions and duplications of loci represented on the microarray.  It will not detect balanced alterations including: reciprocal translocations, inversions and balanced insertions. It will not detect point mutations and imbalances less than 10 kb.  Failure to detect an alteration at any locus does not exclude the diagnosis of any of the disorders represented on the microarray. This assay is not designed to detect mosaic gains and losses and its performance in detecting mosaicism has not been established. This test was developed and its performance characteristics determined by Affymetrix as required by CLIA Â’88 regulations. This test is used for clinical purposes and the accuracy and precision has -
    - been established and verified by this laboratory. This test has not been cleared or approved by the U.S. Food and Drug Administration. -
    - -
    - Interpretation of copy number variants is performed using VUMC-laboratory maintained databases as well as the following resources: -
    - Database of Genomic Variants (http://dgv.tcag.ca/dgv/app/home) -
    - Online Mendelian Inheritance in Man (http://www.omim.org/) -
    - UCSC Genome Bioinformatics (http://genome.ucsc.edu/cgi-bin/hgGateway) -
    - ClinGen Clinical Genome Resource (http://www.ncbi.nlm.nih.gov/projects/dbvar/clingen) -
    - DECIPHER Database (https://decipher.sanger.ac.uk/browser) -
    - PubMed-NCBI (http://www.ncbi.nlm.nih.gov/pubmed) -
    - Technical standards for the interpretation and reporting of constitutional copy-number variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClinGen). PMID: 31690835 -
    - -
    - Method: -
    - Microarray platform: ThermoFisher Scientific CytoScanTM HD Cytogenetics Solution -
    - Version: 1.1 (Based on UCSC hg19 assembly) -
    - Number of loci analyzed: 2,696,550 -
    - Mean probe spacing: <700 bp -
    - -
    - -
    - -
    - -
    - -
    - -
    - Testing performed at Vanderbilt Cytogenetics One Hundred Oaks Laboratory, Suite 21100, 719 Thompson Ln, -
    - Nashville, TN 37204  phone 615-875-0228, fax 615-875-0234 -

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    Resulting Agency Comment
    -

    - testing comment -

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    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Carda Testprovqa MDLAB GENETIC TESTING
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    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
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    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

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    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

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    • -
  • - Pharmacogenomics (03/31/2022 5:36 PM CDT): -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    DNA03/31/2022 5:36 PM CDT03/31/2022 5:44 PM CDT
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    - - - - - - - - - - - -
    Narrative
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    VUMC CERNER LAB - 03/31/2022 5:51 PM CDT

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    - Pharmacogenomics: Final Report -
    - -
    - Request #: MD-22-0000041 -
    - -
    - Service Date: 3/31/2022 17:36 -
    - -
    - Reason for Request: Genotyping for Determination of Drug Efficacy, Dosage and Safety -
    - -
    - Type of Specimen: DNA -
    - -
    - Date Received: 3/31/2022 17:44 -
    - -
    - Date Reported: 3/31/2022 17:51 -
    - -
    - Interpretation: -
    - Results from this assay may indicate dosage adjustments or medication alternatives that should be considered for this patient. Additional information regarding the implications of these results is available at www.mydruggenome.org. -
    - -
    - For VUMC patients, clinical decision support regarding the management of this patient with respect to specific drugs based upon the patient's genotype as listed below is available in the patient's electronic medical record under Genomic Indicators. Clinical decision support may also be provided for some drugs through order entry and medication prescribing tools utilized within the VUMC system. -
    - -
    - -
    - -
    - Comments: -
    - -
    - Results: -
    - -
    - CYP2C19 -  Cancelled -
    - -
    - CYP2C9 -   Cancelled -
    - -
    - CYP2D6 -   Cancelled   -
    - -
    - CYP3A5 -   Cancelled -
    - -
    - CYP4F2 -   Cancelled -
    - -
    - DPYD -     Cancelled -
    - -
    - NUDT15 -   Cancelled -
    - -
    - SLCO1B1 -  Cancelled       -
    - -
    - TPMT -     Cancelled -
    - -
    - VKORC1 -   Cancelled     -
    -   -
    - These results should be correlated with other laboratory and clinical findings and additional testing should be considered if clinically indicated. -
    -     -
    - -
    - Methodology: -
    - -
    - DNA was extracted from this specimen and screened for 37 variants in 10 genes that are associated with drug absorption, distribution, metabolism, excretion or response. The reported genotypes were determined using PCR amplification and oligonucleotide primers specific for each interrogated region of the genes listed within this panel. Fluorophore labeled probes were used to identify each variant. -
    - -
    - Variants analyzed in this assay include: CYP2C19 *2, *3, *4, *6, *8, *17; CYP2C9 *2, *3, *6, *8; CYP3A5 *3, *6, *7; CYP4F2 *3; DPYD *2A, *13, c.557A>G, c.1236G>A (HapB3), c.2846A>T;  NUDT15 *2 or *3; SLCO1B1 *5; TPMT *2, *3B, *3C, *4; VKORC1 promoter variant c.-1639G>A; and CYP2D6 copy number and variants *2, *2A, *3, *4, *6, *7, *9, *10, *17, *29 and *41. A *1 allele is considered the reference (normal) sequence and is reported if none of the variants analyzed for a particular gene is detected. This assay is specific for the variants listed above and cannot exclude the presence of other variants within these genes that may affect the pharmacologic function of the protein product encoded by these genes. In most cases, variants for a particular gene exist on separate alleles; however, for individuals in which multiple variants in the same gene are detected, this assay cannot determine if the variants are on the same allele or on different alleles. Further, due to the highly polymorphic -
    - nature of these regions, rare variants may exist that could affect the sensitivity or specificity of this assay and lead to a false-negative or a false-positive result. -
    - -
    - -
    - Electronically signed out by: -
    - Barba, Elizabeth -
    - -
    - on 03/31/2022 -
    - -
    - This assay has not been cleared or approved by the US Food and Drug Administration. The performance of this assay was tested and validated prior to use for patient testing. This test is used for clinical purposes and should not be regarded as investigational or research. This laboratory is regulated by the Clinical Laboratory Improvement Act of 1988. -

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    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Carda Testprovqa MDLAB GENETIC TESTING
    -
    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
  • - Drug Toxicology Monitoring Base Pnl w/Conf, Oral Fl-QSTD (03/29/2022 1:53 PM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    Drug Toxicology Monitoring Base Pnl w/Conf, Oral Fl - - VUMC patients:  Results faxed to Vanderbilt Medical Record. -
    - VPLS clients:   See separate report sent to client. -
    -     -     		VUMC CERNER LAB
    - - Comment: - This test was performed at: Quest Laboratory,Location Varies,,,,,, - -
    -
    -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Oral03/29/2022 1:53 PM CDT03/29/2022 2:07 PM CDT
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    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Carda Testprovqa MDLAB BODY FLUIDS AND STOOLS ORDERABLES
    -
    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
  • - Results Called (03/22/2022 1:27 PM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    Test CalledkVUMC CERNER LAB
    Reason CalledQNSVUMC CERNER LAB
    Called TotestVUMC CERNER LAB
    Read BackYesVUMC CERNER LAB
    Collector IDtest123VUMC CERNER LAB
    -
    -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Blood03/22/2022 1:27 PM CDT03/22/2022 1:29 PM CDT
    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    E Mark Watts MDLAB BLOOD ORDERABLES
    -
    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
  • - (ABNORMAL) Culture Bact CSF (03/17/2022 1:34 PM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    Final ReportModerate growth Neisseria meningitidisVUMC CERNER LAB
    Organism ID - Neisseria meningitidis - (POSITIVE) - VUMC CERNER LAB
    Gram Stain Report - - 3+ Gram negative diplococci; restreak for isolation -
    - 1+ White Blood Cells -
    -     -     		VUMC CERNER LAB
    -
    -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    CSF03/17/2022 1:34 PM CDT03/17/2022 1:34 PM CDT
    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Adam Clark Seegmiller MDLAB MICROBIOLOGY - GENERAL ORDERABLES
    -
    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
  • - (ABNORMAL) Culture Bact CSF (03/17/2022 1:11 PM CDT): -
    - - - - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    Final ReportLight growth Acinetobacter baumanniiVUMC CERNER LAB
    Organism ID - Acinetobacter baumannii - (POSITIVE) - VUMC CERNER LAB
    Gram Stain Report1+ Gram negative rodVUMC CERNER LAB
    -
    -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    CSF03/17/2022 1:11 PM CDT03/17/2022 1:11 PM CDT
    -
    -
    - - - - - - - - - - - - - - - - - - - - - -
    OrganismAntibioticMethodSusceptibility
    Acinetobacter baumanniiAmikacinMIC -

    0.25: Susceptible

    -
    Acinetobacter baumanniiAvycaz (Ceftazidime/Avibactam)MIC -

    0.05: Intermediate

    -
    Acinetobacter baumanniiLevofloxacinMIC -

    0.75: Resistant

    -
    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Adam Clark Seegmiller MDLAB MICROBIOLOGY - GENERAL ORDERABLES
    -
    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
  • - SARS-CoV-2 PCR (03/11/2022 1:05 PM CST): -
    - - - - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    SARS-CoV-2 Nucleic Acid (Result) - Not Detected - Not DetectedVUMC CERNER LAB
    - - Comment: -
    - - A detected result is positive and indicates the presence of the virus in the sample. A not detected result indicates that the test did not detect the virus in the sample. -
    -
    - This test was performed using a multiplexed nucleic acid amplification test that is labeled Emergence Use Only by the U.S. FDA. Results of this test should not be used as the sole basis for diagnosis, treatment, or other management decisions. -
    -
    -     -     -
    SARS-CoV-2 Nucleic Acid Method (Comment) - - Nares -
    -
    - This test was performed using the Hologic Panther COVID-19 test. This test is currently approved for clinical diagnostic testing under Emergency Use Authorization of the FDA; the result should not be considered experimental or for research purposes. -
    -     -     		VUMC CERNER LAB
    -
    -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Nares03/11/2022 1:05 PM CST03/11/2022 1:46 PM CST
    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Adam Clark Seegmiller MDLAB BODY FLUIDS AND STOOLS ORDERABLES
    -
    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
  • - FISH ALL Pnl (03/11/2022 1:05 PM CST): -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Blood03/11/2022 1:05 PM CST03/11/2022 1:09 PM CST
    -
    -
    - - - - - - - - - - - -
    Narrative
    -

    VUMC CERNER LAB - 03/11/2022 1:27 PM CST

    -

    - FISH REPORT -
    - -
    - Request#:CG-22-0000003 -
    - Service date:3/11/2022 13:05 -
    - -
    - -
    - FISH IMPRESSION: -
    - -
    - Abnormal for homozygous deletion of CDKN2A locus at 9p21 in __% of cells. -
    - -
    - FISH KARYOTYPE: -
    - -
    - -
    - -
    - nuc ish (DXZ1x1,DYZ3x1,D18Z1x2)[200] -
    - -
    -   -
    -   -
    -   -
    - -
    - -
    - -
    - COMMENTS: -
    - -
    - -
    - -
    - Results of the FISH studies with the 21 DNA probes described above were analyzed in at least 200 cells per probe and no abnormal signal patterns were detected for the target regions of chromosomes 1, 4, 7, 9, 10, 11, 12, 14, 17, 19, 21, and 22. -
    - -
    - Normal cut off values for probes: -
    - -
    - 1.0% for t(1;19) PBX1/TCF3 -
    - 1.0% for t(9;22) BCR/ABL1 -
    - 1.0% for KMT2A (11q23) -
    - 1.0% for t(12;21) ETV6/RUNX1 -
    - 1.0% for IKZF1/CEP7 -
    - 3.0% for CEP 4 -
    - 2.0% for CEP 10 -
    - 2.0% for CEP 17 -
    - 1.0% for CDKN2A/CEP9 (9p21) -
    - 1.0% for IGH breakapart -
    - 1.0% for ABL2 breakapart -
    - 1.0% for ABL1 breakapart -
    - -
    - These probes were developed by Vysis and their performance characteristics determined by VUMC as required by the CLIA '88 regulations.  These probes have not been cleared or approved by the U.S. Food and Drug administration. -
    - -
    - -
    - Ferrin Courtney Wheeler, PhD, FACMG -
    - reviewed and approved -
    - -
    - Electronically signed out by: -
    - Mavrak, Geoffrey A -
    - -
    - on 03/11/2022 -
    - -
    - Clinical History:  ALL -
    - Specimen List: Blood -
    - Date In Lab: 3/11/2022 13:09 -
    - Date Collected: 3/11/2022 13:05 -
    - -
    - Testing performed at Vanderbilt Cytogenetics One Hundred Oaks Laboratory, Suite 21100, 719 Thompson Ln, -
    - Nashville, TN 37204  phone 615-875-0228, fax 615-875-0234 -

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    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Adam Clark Seegmiller MDLAB GENETIC TESTING
    -
    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
  • - (ABNORMAL) Culture Bact Bld Adult (03/11/2022 8:51 AM CST): -
    - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    Final Report - - Staphylococcus aureus -
    - Gram positive cocci; restreak for isolation Isolated from Aerobic bottle -
    -     -     		VUMC CERNER LAB
    Organism ID - Staphylococcus aureus - (POSITIVE) - VUMC CERNER LAB
    -
    -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Blood (Antecub)03/11/2022 8:51 AM CST03/11/2022 8:51 AM CST
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    -
    - - - - - - - - - - - - - - - - - - - - - -
    OrganismAntibioticMethodSusceptibility
    Staphylococcus aureusAmpicillinMIC -

    0.25: Susceptible

    -
    Staphylococcus aureusRifampinMIC -

    0.75: Resistant

    -
    Staphylococcus aureusVancomycinMIC -

    0.05: Susceptible

    -
    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Adam Clark Seegmiller MDLAB MICROBIOLOGY - GENERAL ORDERABLES
    -
    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
  • - (ABNORMAL) Culture Bact Urine (03/10/2022 2:30 PM CST): -
    - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    Final Report>100,000 cfu/ml Proteus mirabilisVUMC CERNER LAB
    Organism ID - Proteus mirabilis - (POSITIVE) - VUMC CERNER LAB
    -
    -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Urine03/10/2022 2:30 PM CST03/10/2022 2:49 PM CST
    -
    -
    - - - - - - - - - - - - - - - - - - - - - -
    OrganismAntibioticMethodSusceptibility
    Proteus mirabilisAztreonamMIC -

    0.75: Resistant

    -
    Proteus mirabilisCefoxitinMIC -

    0.25: Intermediate

    -
    Proteus mirabilisLevofloxacinMIC -

    0.05: Susceptible

    -
    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Adam Clark Seegmiller MDLAB MICROBIOLOGY - GENERAL ORDERABLES
    -
    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
  • - (ABNORMAL) Culture Bact Bld Adult (03/10/2022 10:00 AM CST): -
    - - - - - - - - - - - - - - - - - - - - - - -
    ComponentValueRef RangeTest MethodAnalysis TimePerformed AtPathologist Signature
    Final Report - - Staphylococcus aureus -
    - Gram Positive Cocci Restreak for isolation Isolated from Aerobic bottle -
    -     -     		VUMC CERNER LAB
    Organism ID - Staphylococcus aureus - (POSITIVE) - VUMC CERNER LAB
    -
    -
    - - - - - - - - - - - - - - -
    Specimen (Source)Anatomical Location / LateralityCollection Method / VolumeCollection TimeReceived Time
    Blood (Antecub)03/10/2022 10:00 AM CST03/10/2022 2:08 PM CST
    -
    -
    - - - - - - - - - - - - - - - - - - - - - -
    OrganismAntibioticMethodSusceptibility
    Staphylococcus aureusAmpicillinMIC -

    3: Resistant

    -
    Staphylococcus aureusVancomycinMIC -

    0.03: Susceptible

    -
    Staphylococcus aureusLevofloxacinMIC -

    2: Intermediate

    -
    -
    -
    - - - - - - - - - - - - - - - -
    Authorizing ProviderResult Type
    Katelyn Kennedy Atwater MDLAB MICROBIOLOGY - GENERAL ORDERABLES
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    -
    - - - - - - - - - - - - - - - -
    Performing OrganizationAddressCity/State/ZIP CodePhone Number
    -

    VUMC CERNER LAB

    -     		-

    4605 TVC VUMC

    -

    1301 Medical Center Drive

    -     		-

    NASHVILLE, TN 37232-5310

    -     		-

    615-875-5227

    -
    -
    -
    • -
- documented in this encounter -
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Social History

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Tobacco UseTypesPacks/DayYears UsedDate
Smoking Tobacco: Never Assessed
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Sex Assigned at BirthDate Recorded
Not on file
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- documented as of this encounter -
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Encounter Details

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DateTypeDepartmentCare TeamDescription
2/18/22Transcribe Orders -

Vanderbilt University Adult Hospital

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1211 Medical Center Dr

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Nashville, TN 37232

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615-322-5000

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Tech, Lab, MLT

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Document maintained by

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Vanderbilt University Medical Center
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Contact

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Work Place
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3401 West End Ave

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NASHVILLE, TN

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37203, USA

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tel: (Work Place) +1-615-322-5000
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Document Information

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Document IdentifierDocument Created
OID: 1.2.840.114350.1.13.478.3.7.8.688883.23088607/28/2022, 09:01
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