VAERS: 13 Year Old Girl Dies of Just About Everything

Admitted to local HCF 10/30/21. See the following from her death note summary related to hospital course: Pt is a 13 y.o. female admitted for Left atrial mass and has been hospitalized for 30 days. she had her left atrial mass resection on 11/11/21, pericardial window creation, and mediastinal exploration with debridement. Her mass continued to grow and increase in size and Rhee invading the left atrium and possibly the right atrium along with creation of tamponade physiology on the ventricles. She was started on chemotherapy by hematology team, Nephrology team started her her on CRRT since she developed acute kidney injury along was multi organ failure and severe lactic acidosis. Patient was on multiple inotropics support with progressively increasing inotropics support epinephrine up to 0.3 micrograms/kilogram per minute, norepinephrine up to 0.3 micrograms/kilogram per minute along with 2 milliunits per kg per minute vasopressin. Over the past 48 hours prior to patient staff she was getting multiple fluid boluses and she was few L positive every day with severe 3rd spacing and progressively worsening cardiac output. She has had evidence of progressive tamponade physiology despite aggressive chemotherapy. she remained intubated and sedated with extremely high lung peak pressures and very poor compliance with severe pulmonary edema. On 12/1/2021 family expressed the wishes of stop giving fluids to her since she looks very edematous, parents understand that this will lead to cardiac arrest and ending her life within the next few hours, father expressed he is willing to do everything for her but he wants to end her suffering, mom and dad were at the bedside, IV fluid replacement was stopped. Patient vasopressin was weaned along with other inotropic support, family agreed on extubating the patient so that they can spend some time with her prior to the off. Patient continue to progressively having low cardiac output, hypotension and bradycardia, time of death was 7:00 a.m..