Case Discussions

MDT meetings, grand rounds, tumour boards, and mortality reviews

Kavitha Nair — Palliative Oncology + Suicidal Ideation — CD-2026-041

22 Jun 2026 14:00 · Attendees: Dr. R. Iyer (Oncology), Dr. P. Sharma (Palliative), Psycho-oncologist, Liaison Psychiatry, Clinical Nurse Specialist

MDT Meeting

Summary: 52F — laryngeal carcinoma, palliative intent. Distress thermometer 8/10, PHQ-9 15, suicidal ideation. Active psychiatric input initiated. Goals of care redefined — comfort care priority. DNAR discussion completed with family.

Decision: Continue palliative radiotherapy for symptom control only. Mirtazapine started. Escitalopram review 4 weeks. Social work referral for family support. Hospice admission evaluation.

Outcome: Documented in EPR. Copy to GP. Family meeting arranged 24 Jun.

Rajan Mehta — Complex LVAD + VAP Management — CD-2026-040

20 Jun 2026 09:00 · Attendees: Cardiology, Cardiothoracic Surgery, Intensivists, Infectious Disease, Physiotherapy

MDT Meeting

Summary: 75M — end-stage HF on LVAD. Superimposed ESBL Klebsiella VAP. Prognosis poor. Family understand gravity. Antibiotic stewardship balancing infection vs side effects.

Decision: Meropenem 10-day course (Colistin held — nephrotoxicity risk with renal impairment). Daily wake-up trial — ventilator weaning. Goal-directed physiotherapy.

Outcome: Family meeting today. Advance care planning discussion to be initiated.

Baby Arjun — Trisomy 21 + Neonatal Jaundice — CD-2026-039

19 Jun 2026 11:00 · Attendees: Neonatology, Genetics, Cardiology, Ophthalmology, Physiotherapy, Social Work

MDT Meeting

Summary: Down syndrome confirmed (47,XY,+21). VSD small (Cardiology — no surgery for now). Bilirubin peaking — phototherapy Day 2. Thyroid normal. BERA/visual evoked potentials booked.

Decision: Phototherapy continue until TSB < 12. Feeding support from lactation team. Genetics counselling for parents. Early intervention physiotherapy.

Outcome: Parents counselled with family support worker present. Written resources provided.