After being released from the ED, the patient went back home. Later that night, he suddenly began to feel unwell, collapsed, and vomited blood.

911 was called and he was picked up by an ambulance. The ambulance record was hand-written and barely legible, it has been transcribed here for readability.

The patient was brought to the ED and seen initially by an EM resident. Her note is shown below. It is one of the few handwritten ER notes that is actually legible. The court records cut off a slim margin on the right edge.

Due to his borderline low blood pressure and clinical concern for hemorrhagic shock, a Cordis was placed at his right groin. He was given fluids and had a normal blood pressure (115/92) and a heart rate of 100. He was admitted to the ICU, and was sent for a CT scan of his abdomen and pelvis. The results showed an aortoenteric fistula. The entire CT report is shown below for subscribers.

Continue to the next page to see the patient’s outcome.