[4922852]
(b)(6) is a (b)(6) boy who was diagnosed as having severe combine immune deficiency on newborn screening. He underwent an unrelated bone marrow transplant on (b)(6) 2014. His course has been complicated by toxicity and infection. He was admitted to the picu on three separate occasions; firstly on (b)(6) 2014 for fluid overload and was transferred back to the bmtu on (b)(6) 2014; secondly on (b)(6) 2014 for severe vod and returned to bmtu on (b)(6) 2014; and lastly on (b)(6) 2014 and stayed until the time of his death. His infectious complications were: disseminated cmv pre and post transplant; disseminated ebv post-transplant; pulmonary aspergillosis; pjp pneumonia (based on clinical symptoms); presumed sepsis culture negative (abdominal pain, tachycardia, hypotension). His toxicities were respiratory failure; severe vod; pulmonary hemorrhage; osteopenia with multiple small bone fractures; pancreatitis; renal insufficiency requiring peritoneal dialysis; ards; hypertriglyceridemia. All medically appropriate intensive care was provided in order to sustain him. However, it had become more difficult to maintain his oxygenation despite the use of oscillator ventilator and nitric oxide. On (b)(6) 2014 he was made and (allowed natural death) by his parents and the picu attending at 0200 and he succumbed at 0955.
Patient Sequence No: 1, Text Type: D, B5