Pulmonologist/Critical Care Physician Needed for Hospital Record Review

Title: Pulmonologist/Critical Care Physician Needed for Hospital Record Review – Respiratory Failure, PE & Pre-Arrest Deterioration I am seeking a board-certified or board-eligible pulmonologist, preferably with critical-care experience, to independently review a focused portion of a prolonged hospitalization involving progressive altered mental status, respiratory deterioration, cardiac arrest, subsequent prolonged respiratory failure, and later-diagnosed bilateral pulmonary emboli. This is initially a confidential medical-record consulting engagement, not a request for testimony. The principal question is whether the patient’s evolving clinical condition before and after cardiac arrest was appropriately recognized, investigated, monitored, and escalated. Areas for review include: * Pre-arrest respiratory and hemodynamic deterioration. * Significance of profound altered mental status in a medically fragile hospitalized patient. * Appropriate indications for escalation from a medical-surgical floor to higher-acuity monitoring or ICU evaluation. * Clinical significance of lack of telemetry/continuous monitoring where applicable. * Differential diagnosis surrounding PEA cardiac arrest. * Evaluation of persistent post-arrest hypoxic respiratory failure. * Recurrent mucus plugging, bronchoscopies and healthcare-associated/ventilator-associated pneumonia. * Appropriate consideration and diagnostic evaluation of pulmonary embolism. * Significance and limitations of noncontrast chest CT examinations for detecting PE. * Later discovery of bilateral pulmonary emboli and what, if anything, can reasonably be inferred regarding their possible duration. * Whether an earlier CTA or other PE evaluation would ordinarily have been considered given the patient’s risk factors and clinical trajectory. * Relationship, if any can reasonably be established, between respiratory deterioration, infection, thromboembolism and cardiac arrest. Deliverable: A concise written assessment separating documented facts from clinical interpretation, identifying significant concerns, reasonable alternative explanations, missing information, and issues requiring further investigation. Please provide your specialty/board certification, ICU experience, experience managing PE and complex respiratory failure, record-review experience, availability, and proposed rate. I am not seeking an opinion supporting a predetermined conclusion. I am specifically seeking an independent review that identifies both findings consistent with appropriate care and clinically significant concerns or departures, if any.