AUDIT KEMATIAN PESAKIT TIBI 2015

Name: Kho Beng SiongIC: 770413-13-5183No daftar TB: 130424/17/1538-year-old Chinese male staying at Lot 490, jln 2 C PujutUnderlying mental retardation & flat foot with calluses

Pre-diagnosisCoughing for 2 weeks; fever x1/52, loose stool x1/12, visit to KK Miri on 6/1/15,Referred to MGH on 6/1/15 and admitted for infective AGE and hyponatremia

HIV NR ? body weightBCG scar unknownMantoux test not doneSAFB +4 (scanty)sputum TB CS NG CXR moderately advancedVDRL negativeDiagnosis: PTB smear positive new case & extra PTB - TB ileocaecal

admitted on 6/1/15, diagnosed on 12/1/15, notified on 12/1/15forecox 4tabs OD on 12/1/15 died on 23/1/15 at 1.28pm at ICU, Miri Hospital (11 days on intensive phase)Cause of death: Extensive pulmonary and extrapulmonary TB

TBISBorang health 1 (notifikasi) adaBorang 10A-1 adaBorang 10A-3 Borang 10C-1 adaBorang 10C-2 Borang 10D-1 Borang 10J ada

CONCLUSIONPesakit TIDAK lewat datang mendapatkan rawatanPesakit bukan kontak tibiPesakit TIDAK LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan suboptimalPesakit PATUH rawatan tibi

Name: Suding HartaniPassport No: AF 626213No daftar TB: 130424/42/1544-year-old Indonesia lady staying at Niah PlantationHIV NR

Pre-diagnosis30.1.15 coughing for one week; SAFB done3.2.15 noted SAFB 3+x1; called up pts relative; promised to come cm4.2.15 noted lethargic and POI, ; pale, BP 90/60 PR 108 weak pulse, T afebrile RR 20 SPO2 99% under RA; wear mask; IVF 1 pint over one hourS/T Physician: for admission through A&EOn admission on 4.2.15, coughing for 1 monthLOA, LOW, night sweatsNo TB ContactLoose stool for one week

HIV rapid test negativeBCG scar unknownStarted on EHRZ (EOD PZA and Ethambuthol) on 4.2.15Body weight 46kgDiagnosis: PTB smear positive new caseCause of Death: unknown

19.2.15 at 8.20am pt requested to be discharged as his manager had bought him flight ticket to IndonesiaAbsconded on 19.2.15 (16 days of intensive phase) at 12.30pm with IJC and branula in situPolice and Health Inspector were informedSuddenly collapsed and Died at home on 20.2.15 at 8pm

TBISBorang health 1 (notifikasi) adaBorang 10A-1 tiadaBorang 10A-3 tiadaBorang 10C-1 adaBorang 10C-2 adaBorang 10D-1 tiadaBorang 10J ada

CONCLUSION

Pesakit TIDAK lewat datang mendapatkan rawatanPesakit bukan kontak tibiPesakit TIDAK LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan suboptimalPesakit PATUH rawatan tibi

Name: Looi Yee YienIC: 810825-13-5730 No daftar TB: 130424/285/1433-year-old Chinese lady staying at 616a, Desa Pujut

Pre-diagnosisPatient was found alive 1day before. Her friend called her and she complained of chest pain.Her brother found out that patient was dead in living roomnoted there was a poison bottle and beer can.

HIV rapid test negativebody weight 46kgBCG scar unknownMantoux test not doneSAFB negativesputum TB CS NG CXR clearVDRL NRDiagnosis: Extra PTB - TB Lymphadenitis

Notified on 22/9/2014, died on 18/5/15Started forecox 3tabs on 22/10/2014, on maintainance phase 7HRcause of death: BID

TBISBorang health 1 (notifikasi) AdaBorang 10A-1 AdaBorang 10A-3 tiadaBorang 10C-1 tiadaBorang 10C-2 Borang 10D-1 Borang 10J ada

CONCLUSIONPesakit TIDAK lewat datang mendapatkan rawatanPesakit bukan kontak tibiPesakit TIDAK LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan suboptimalPesakit PATUH rawatan tibi

Name: Alau PadaIC: 860809-52-6286No daftar TB: MD/15/0329-year-old Penan lady staying at Long Pakan, sungai Patah, MarudiHIV NR

Pre-diagnosisProductive cough x1/12, worsening SOB x3/7, night sweat, nocturnal feverAdmitted to Hospital Marudi on 17/1/15 and then transferred to MGH on 19/1/15 for septic shock secondary to PTBH/o PTB contact (mother)was diagnosed TRO TB lymphadenitis in 2011 but defaulted f/up in SGH

HIV rapid test negativebody weight: 50kgBCG scar NoMantoux test not doneSAFB +3 sputum TB CS NG CXR moderately advancedVDRL NRDiagnosis: PTB smear positive new case

admitted on 17.1.15, diagnosed on 17.1.15, notified on 18.1.15 ; died on 20.1.15 at 5.05amFORECOX 3Tab OD on 17.1.15, Pyridoxine 20mg ODCause of Death: Septic shock with severe metabolic acidosis secondary to PTB

TBISBorang health 1 (notifikasi) AdaBorang 10A-1 tiadaBorang 10A-3 tiadaBorang 10C-1 Borang 10C-2 adaBorang 10D-1 tiadaBorang 10J belum

CONCLUSIONPesakit LEWAT datang mendapatkan rawatanPesakit LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan suboptimalPesakit PATUH rawatan tibi

Name: Sahari Bin AdnanIC: 760420-13-5203No daftar TB: 130424/95/1539-year-old Penan male staying at Kg Ogos Jambatan SuaiRisk factors: Ex IVDUStrong Smoker 1pack/dayAlcoholicHepatitis C +

Pre-diagnosisAbdominal distended x1/12, SOB x1/12, fever on and off x1/12, no coughNo altered bowel habitNo PTB contact

HIV rapid test negativeBCG scar unknownBW 54kgMantoux test not doneSAFB x3 positive; Pleural fluid AFB on 20/3/15 1+sputum TB CS NG; Sputum MTB C&S negative CXR far advancedVDRL negativeHepatitis C reactive Diagnosis: UGIB with severe metabolic acidosisPossible pulmonary hemorrhageU/L PTB with pleural TB

Admitted to MGH on 18.3.15, diagnosed on 20.3.15, notified on 24.3.15; died on 6.6.15 at 8.39pmstarted forecox 3tabs on 20/3/2015Cause of death: Upper GI bleed with metabolic acidosisU/L PTB

TBISBorang health 1 (notifikasi) AdaBorang 10A-1 AdaBorang 10A-3 adaBorang 10C-1 adaBorang 10C-2 tiadaBorang 10D-1 tiadaBorang 10J belum

CONCLUSIONPesakit LEWAT datang mendapatkan rawatanPesakit bukan kontak tibiPesakit TIDAK LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan suboptimalPesakit PATUH rawatan tibi

Name: Besi AK ChamboIC: 610201-13-5349 No daftar TB: 130424/50/1554-year-old Ibanese male staying at Lot 1583-Lorong 4, Permyjayak/c right lung Ca, Hepatitis B +

Pre-diagnosiscough x1/52, no hemoptysis, LOW, LOA History from relative (son)Patient c/o hemoptysis at night before he died. unable to sought any medical treatment

HIV rapid test negative, smoker body weight 37kgBCG scar unknownMantoux test not doneSAFB 3+CXR moderate advancedVDRL NRDiagnosis: Smear positive PTB

Diagnosed on 9.2.15, Notified on 9.2.15died on 17.4.15started forecox 2tabs on 9.2.15cause of death: unknown

TBISBorang health 1 (notifikasi) AdaBorang 10A-1 AdaBorang 10A-3 Borang 10C-1 tiadaBorang 10C-2 Borang 10D-1 Borang 10J ada

CONCLUSIONPesakit TIDAK LEWAT datang mendapatkan rawatanPesakit bukan kontak tibiPesakit TIDAK LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan suboptimalPesakit PATUH rawatan tibi

Name: SahlanPassport No: A 3821626No daftar TB: 130425/14/1546-year-old Indonesian male staying at Samling Plywood Sdn Bhd, Tebanyl Veneer Mill, Ulu Baram

Pre-diagnosisAbdominal pain x1/52, altered bowel habit x1/12.POI x5/7, LOA,LOW x2/52, feverx1/7went to KK Tudan on 11/5/15 and referred to MGH

DM, HIV NREBW: 52kgBCG scar unknownMantoux test not doneSAFB +3 CXR moderate advancedsputum TB CS NGVDRL negativeDiagnosis: Intrabdominal TB with enterocutaneous fistula, PTB smear positive new case

Admitted on 11.5.15, diagnosed on 13.5.15, notified on 13.5.15; died on 12.6.15 at 9.46amstarted forecox 3tabs on 13.5.15Cause of death: Intrabdominal TB with sepsis

TBISBorang health 1 (notifikasi) adaBorang 10A-1 adaBorang 10A-3 tiadaBorang 10C-1 adaBorang 10C-2 adaBorang 10D-1 tiadaBorang 10J belum

CONCLUSIONPesakit LEWAT datang mendapatkan rawatanPesakit bukan kontak tibiPesakit TIDAK LEWAT dilakukan diagnosa Pesakit TIDAK mendapat rawatan subptimalPesakit PATUH rawatan tibi

Name: Usun NgauIC: 590608-13-5804No daftar TB: 130424/148/1556-year-old Kayan lady staying at 4s 3A, Pujut, Padang Kerbau Tanjung

k/c hard palate squamous cell carcinomaunder ENT clinic f/uplatest CECT neck (20/5/15): suggestive of tumour recurrence with agressive local infiltration to left mandibular region & extensive cervical nodal metastasisDiagnosis: TB lymphadenitisstarted forecox on 22/5/15died on 17/6/15 at homecause of death: unknown

Borang health 1 (notifikasi) AdaBorang 10A-1 adaBorang 10A-3 adaBorang 10C-1 ada Borang 10C-2 Borang 10D-1 tiadaBorang 10J belum

CONCLUSIONPesakit TIDAK LEWAT datang mendapatkan rawatanPesakit bukan kontak tibiPesakit TIDAK LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan suboptimalPesakit PATUH rawatan tibi

Name: Adzmer AhalilNo passportNo daftar TB: 130424/178/1524-year-old Filipino male staying at Lot 4938, PermyjayaHIV NR, smoker

Pre- diagnosisBody weakness x2/52, vomiting x2/52, ~5 episodes/day, a/w loose stool x2/52Abd pain, RIF, burning sensation, x1/52cough x3/52, LOW x1/12, no night sweat No PTB contact

HIV rapid test negative, smoker ? body weightBCG scar unknownMantoux test not doneSAFB +3 sputum TB CS NG CXR moderately advancedVDRL negativeDiagnosis: PTB smear positive new case & extra PTB - TB ileocaecal

Started anti TB on 15/6/15 - INH 250mg OD- RIF 600mg OD - ETH 800mg EOD- PZA 1250mg EODAdmitted to MGH 13/6/15, notified 15/6/15, died on 17/6/15 @ 11.12amCause of death: Severe shock 2 PTB complicated with multiorgan failure

TBISBorang health 1 (notifikasi) adaBorang 10A-1 adaBorang 10A-3 tiadaBorang 10C-1 tiadaBorang 10C-2 Borang 10D-1 tiadaBorang 10J belum

CONCLUSIONPesakit LEWAT datang mendapatkan rawatanPesakit bukan kontak tibiPesakit TIDAK LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan suboptimalPesakit PATUH rawatan tibi

Name: Saifuddin Bin SeriIC: 641121-13-5383No daftar TB: 130424/179/1551-year-old Malay male staying at 7235-1-28 Permyjaya

Pre-diagnosisProductive cough x1/12, fever on and off x1/12, worsening SOB x1/7, cough with yellowish sputum and haemoptysis x1/7, pleuritic chest pain, night sweat x1/12

no DM, HIV NR, ? smokerEBW: 40kgBCG scar unknownMantoux test not doneSAFB +3 CXR moderate changessputum TB CS NGDiagnosis: PTB smear positive new case

Admitted on 16.6.15, diagnosed on 16.6.15, notified on 21.6.15; died on 20.6.15 at 4.56pmstarted forecox 3tabs on 16.6.15Cause of death: Severe sepsis secondary to PTB

TBISBorang health 1 (notifikasi) tiadaBorang 10A-1 tiadaBorang 10A-3 tiadaBorang 10C-1 adaBorang 10C-2 adaBorang 10D-1 tiadaBorang 10J belum

CONCLUSIONPesakit LEWAT datang mendapatkan rawatanPesakit bukan kontak tibiPesakit TIDAK LEWAT dilakukan diagnosa Pesakit TIDAK mendapat rawatan subptimalPesakit PATUH rawatan tibi

Name: Mohd ZabaniIC:130424-202-15No daftar TB: KKT/15/5861-year-old,melanau, male staying at RH lot 1646 Tudan Fasa 1HIV NR , non DM,no Smoker

Pre-diagnosisSign and Symptom: -Coughing more than one month -low of appitite -lose of weight - no hemoptysisBody weight: 49kgNo BCG scarMantoux test not doneSAFB positiveTB CS pending

CXR moderate changesDiagnosis: PTB smear positive New Case

Start treatment on 8.7.15 at TBCP Tudan a) intensive phase -started on forecox 3 tablets OD -Pyridoxine 20mg OD -Tab multivitamin 1 tablet OD (9 days on intensive phase)

19.7.15 Pt died at home @ 8am (informed by relative pt)

Borang TBISBorang health 1 (notifikasi) adaBorang 10A-1 adaBorang 10A-3 adaBorang 10C-1 adaBorang 10C-2 adaBorang 10J belum

Pesakit LEWAT datang mendapatkan rawatanAdakah pesakit dikenalpasti sebagai kontak pesakit tibi tetapi tidak disaring?Pesakit LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan subptimalPesakit PATUH rawatan tibi

Name: Serian anak pengabangIC: 350708-13-5235No daftar TB: SA /14/11379-year-old IBAN male staying at RH Langgau ,Jungkong,95000 Sri AmanHIV NR , non DM, EX Smoker

Pre-diagnosisSign and Symptom: -Coughing for two weeks -giddness (on& off) -Generalised bodyweakness26.12.14 :Admit male medical ward hospital sri aman28.12.14 pt discharges from hospital.Relative pt request follow up at tbcp miriFolder pt sent to miri and tbcp miri received on 27 januari 2015

Body weight: 39.5kgBCG scarMantoux test not doneSAFB negativeTB CS NGCXR moderate changesDiagnosis: PTB smear negative New Case

TreatmentA) intensive phase -started on forecox 3 tablets OD -Pyridoxine 20mg OD -Tab multivitamin 1 tablet OD -Complete intensive phase @26.2.15(60 days)B) Maintainance phase27.2.15 @ started on : -Tab INH 200mg OD - Cap. Rifampicin 450mg OD - Tab. Pyridoxin 20mg OD -Tab multivitamin 1 tablet OD - 115 days on maintainance phase

History from relative4.6.15 @ 11 am :patient nearly fainted at home and sent pt to Columbia Hospital Miri then admited till 11.6.15Pt discharge and back homeOn 12.6.15 his son bring pt back home town at Sri Aman20.6.15 pt died at homeFamily pt put OPD card pt inside coffin

Borang TBISBorang health 1 (notifikasi) adaBorang 10A-1 adaBorang 10A-3 adaBorang 10C-1 adaBorang 10C-2 adaBorang 10J belum

Pesakit LEWAT datang mendapatkan rawatanAdakah pesakit dikenalpasti sebagai kontak pesakit tibi tetapi tidak disaring?Pesakit LEWAT dilakukan diagnosaPesakit TIDAK mendapat rawatan subptimalPesakit PATUH rawatan tibi