Case Management

Team struggles to arrange outpatient dialysis treatment for noncompliant patient

Case Management Monthly, January 1, 2011

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Gerald is a 47-year-old male with a history of drug abuse and suicide attempts. He also presents to the ED at least twice per week. 

Gerald presents to the General Hospital (GH) ED complaining of shortness of breath, fluid overload, and urgent hemodialysis. The attending physician admits Gerald for inpatient care and diagnoses him with end-stage renal disease. 

Gerald has a history of congestive heart failure, a 47% ejection fraction, end-stage renal disease, severe hyperparathyroidism, hypertension, dilated cardiomyopathy, lupus, and is anemic. He is also noncompliant with medications and dialysis treatment. 

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