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MRN: 9066488
Visit: 9000406554
! UC Irvine Healthcare DOE, ISOLA TE 16394
Gender: Female 1 Location: Emergency
_ _ . __ __ _ ,_ t?.~P.~r.t!:!)ent __ Ag~: !J~y __ (Q1-!)1 .:-1899) .. _
Emergency Physician Treatment Record [06-23-2013 10:461-for Visit: 9000406554, Final,
Entered, Signed in Full, General
History of Present Illness:
A 114 year old female patient presented with .
Onset
Location
Duration
Character
Severity
Associated Symptoms
Contributing History
Past Medical, Family and Social History:
Past Medical History
Past Surgical History
Family History
Social History
Review of Systems:
System Review
Nursing/Medications Reviewed :
Nursing/Medications Reviewed
Physical Exam:
General
HEENT
Chest
CVS
Abdomen
Back
Extremities
Neurologic
Skin
Procedure Note:
Procedure Note
Medical Decision Making:
Impression/MOM
Assessment and Plan :
Plan
Diagnosis
sudden acute
chest
pta
gsw
severe
apneic, cardiac arrest
20 yo female , BIBA s/p GSW to left upper back and
right upper back. arrives in cardiac arrest. no pulse
for greater than 20 minutes. cpr in progress.
unknown
unknown
unkp9wn
unknown
unknown
nursing notes and vital signs reviewed
unresponsive
pupils are dilated and fixed
breath sounds with BVM
asystole
soft nontender nondistended
BSW to bilateral upper back
no pu lses, cyanotic
GCS 3, unresponsive
cyanotic, mottled
A 7.5 mm tube was inserted to a depth of 23 cm at
the teeth . One attempt. The tube was secured in
the standard fashion using a gl idescope . There were
no complications .
full arrest, trauma/ GSW, time of death called by
trauma fellow .
intubation
chest tube
thoracotomy
traumatic full arr est
. .. --. -. ..
Requested by:_96:2~-201~ t 1 :3? _ Page 1 of 2
-
MRN: 9066488
Visit: 9000406554
~ge...: 11~~ (<!1-~1:18~~L
Billing
Disposition
--,. . . ...
DOE, ISOLA TE 16394
Gender: Female
critical care
intubation
expired
• UC Irvine Healthcare l Location: Emergency
_J !?.~.l?~!.!Jl)e~t_ _
TREATMENT NOTE FINALIZATION:
NOTE IS READY TO BE
COMPLETED
PATH STATEMENT:
Physicians at Teaching Hospitals:
Chart is complete and signed
Attending Physician Statement I personally evaluated patient and discussed the
management plan with the resident. I reviewed the
res ident's note an d agree with the documented
find ings and plan of care . Any additions or revisions
are included in the reco rd.
Electronic Signatures:
(MD (A)) (Signed 06-23-2013 10:57)
Authored: HP/, PFSH, ROS, NURSING/MED PROFILE, Physical Exam, PROCEDURE
NOTE, MEDICAL DECISION MAKING, ASSESSMENT AND PLAN, TREATMENT NOTE
FINALIZATION, PATH STATEMENT
Last Updated: 06-23-2013 10:57 by (MD (A))
· . .-·
Page 2 of ~.
NAME:
COLLECTED AT/FROM:
SHERIFF-CORONER DEPART1\1ENT
1071 West Santa Ana Blvd.
Santa Ana, California 92703
Telephone: 714-647-7400
PROPERTY INVENTORY
Case No.
Date:
Time:
CURRENCY LIST CREDIT CARDS SEPARATELY
I @ ) = 5'"
2.. @ s--= /(J)
0 @ 2.fJ> = I 1-Jl;
@ =
@ =
@ =
COINS =
TOTAL CASH / 3S--·•·· -
OTHER ARTICLES
WITNESSED BY:
signed agency
INVESTIGATOR:
witne~s print na1ne 5ignature
RECEIPT
I certify that, pursuant to Section 8461, Probate Code, State of C alifornia, it is my legal right to take
hours
custody of personal property of the above deceased, and I acknowledge receip t of all property describ ed except:
RECIPIENT:
print name Si!,'Tlature
address relationship
c ity: state,zi p code identification
RELEASED BY: Date: Time
WITNESS:
F06X0-205 . l (c) (R. 3!23 :2004)
Santa Ana PD 2013-17495: Supplemental Report by #3193 Page 1 of 1
Case Type:
Prepared by:
Date prepared :
Santa Ana Police
Department
60 Civic Center Plaza --Santa Ana,
CA 92701
Supplemental Report
ors
Ofc . C. Price #3193
Section: Patrol Watch 1/SE
06/23 /2 013 16 :4 7 hours
Case No.
2013-17495
II I II I Ill I II I II I II I II I II I Ill II I II I II I II I I Ill Ill I IIII I IIII I Ill Ill
Reviewed by: ---=.:$(;=,-..:..· ...:::.;r.:....:•...::£'-=~"-"M_,,.:....::ft.c....+-:=.-=-.-:...-_-_---Date/Time: 7(1s:/1..3. ;;,)67y~ (Rev . 0 .60)
Records Distribution: Review: _____ Total Copies : _l By:?_~-'-~a...f __ Date: 7 -\ L--()
O Animal Control
D District Inv.
D Domestic Violence
D Career Criminal Unit
D Juvenile Hall
#550000000000158746
D Court Liaison
~G)
D Crime Prevention
D Crime Analysis
D Stats
D Orangewood
D Evidence
D Narcotics
D Gangs
□Rap
D Other ________ _
D T raffic
□Vice
D Juvenile Inv.
D Trackers
D Sex Crimes
D Graffiti
D Fax/Name ______ _
D other ________ _
D Other ________ _
-----------------
Incident Activity Summary:
Special Attention:
Incident Date/Time: Occurred : 06/23 /2013 08:07 to 06/23/2013 08 :07
Reported: 06/23/2013 08:07
Location Occurred: 800 S. Townsend Street, Santa Ana, CA 92704-0000
Grid: 106 Dist.: 4
Factual Synopsis:
Person:
Involvement:
Gender/Race:
DOBs:
Identification:
Description:
Scars/Marks/Tattoos:
Narrative:
Supplemental report to an Officer Involved Shooting
Jessica Gonzalez
Suspect
Female/ Hispanic
11/11/1977
Driver License: (CA)
Physical: Female, Hispanic, 5'05" tall, 110 lbs ., thin build, long brown
hair, brown eyes,
1. Tattoo/Word Upper Back -
2. Tattoo/Picture Right Upper Back -
On 6-23-13 at 0810 hours I arrived at 805 S Townsend (east alley) to assist on the scene of an
Officer involved shooting. I assisted in putting up crime scene tape and maintaining the
perimeter. I cleared the scene at 0929 hours.
http://ir2/default.aspx?action=view _report _readonly&userid=3 51 &reportid=55 000000000... 6/23/2013
Santa Ana PD 2013-17495: Supplemental Report by #2979 Page 1 of 2
Santa Ana Police
Department
60 Civic Center Plaza --Santa Ana,
CA 92701
Case No.
2013-17495
II I Ill II I I II I II I IIIII I II I IIIII I Ill II I II II Ill I II I IIIII IIIIIII I Ill
Supplemental Report
Case Type: OIS
Prepared by: Sgt. P. Craft #2979
Section: Patrol Watch I/NE
Date prepared: 06/23/2013 17: 10 hours
Reviewed by: _ ____.,,s...,· ,......,·,-..... _,3.="-. ..,_[;=:s...:...~=¥=1=,t-.__ ___ _ Date/Time: 7--/~-, .s c) tJ 7'fg
-:, ...,,,;'.)e,
Records Distribution: Review: _____ Total Copies:_.:, __ By: __ ,,.--. __ 1> __
O Animal Control
O District Inv.
O Domestic V iolence
O Court Liaison
~ D Crime Prevention
D Orangewood
D Evidence
D Narcotics
D Traffic
□V i ce
D Juven ile Inv.
(Rev. 0.60)
D Trackers
D Sex Crimes
D Graffiti
O Career Criminal Unit
O Juvenile Hall
#550000000000158753
D Crime Ana lys is D Gangs D Fax/Name _______ _
D Stats D Rap D other ________ _
D other ________ _ D Other ________ _
Incident Activity Summary:
Special Attention:
Incident Date/Time: Occurred: 06/23/2013 08 :07 to 06/23/2013 08 :07
Reported : 06/23/2013 08:07
Location Occurred: East Alley
Grid: 106 Dist.: 4 805 S. Townsend Street, Santa Ana, CA 92704-0000
Factual Synopsis: On above date and time an Officer Involved Shooting occurred at the
above location. This report will reflect my actions and observations
during the investigation.
Person: Unknown
Involvement: Suspect
Gender/Ethnicity: Female/ Hispanic
Description: Physical: Female, 5'05 " tall, 110 lbs., long hair,
Narrative:
On June 23, 2013, at approx. 0807 hours, I monitored a radio broadcast of a 998-Officer Involved
Shooting in the area of 800 South Townsend Street. I responded to the area from 400 N. Grand Avenue.
While driving to the location, one of the officers involved stated that two additional related subjects
were ma garage.
I arrived from the southern direction at the shooting scene in the east alley of 805 S. Townsend Street.
http ://ir2/Report. aspx?userid=2979&reportid=55000000000015 87 5 3&recordtype=N arrativ... 6/23/2013