Toxicology Cases From THE PITT

9 cases 4 episodes · S01E01 – S02E13

All emergency department cases involving Toxicology from The Pitt, documented with medically accurate clinical timelines, diagnostic workups, and expert clinical pearls.

Patient with visible scleral icterus and jaundiced skin.

S02E13 Moderate

48 · Female

Mrs. Davis

Nausea and yellowing of the skin (jaundice).

A 48-year-old previously healthy female presents to the ED with nausea and noticeable yellowing of her skin. The patient initially attributed the skin changes to a 100% natural sugar-beet bronzer (DHA). Triage labs revealed significantly elevated liver enzymes indicating acute hepatic inflammation. She is a strict vegan, exercises regularly, and denies all alcohol, acetaminophen, prescription medication, and illicit drug use. She denies eating raw shellfish.

ToxicologyHepatology +1 more

S02E12 Moderate

Adult · Male

Curtis Larson

Extreme agitation, combativeness, and subsequent head trauma (fall)

Curtis Larson, an adult male patient, was brought to the ED following reported alcohol consumption on a golf course. Upon arrival, he became profoundly combative, triggering a 'Code Hula Hoop' (hospital worker assault) after putting a nurse (Emma) in a headlock. During the scuffle, he slipped and sustained blunt head trauma resulting in a bloody nose. He was chemically restrained by another nurse (Dana) using 4mg of Midazolam (Versed) that was on hand.

ToxicologyPsychiatry +2 more

Eddie Cohen sitting awkwardly after his wife's MVA.

S02E12 Complex

84 · Male

Eddie Cohen

Unsteady gait and cognitive/motor slowing (Noted by physician; originally presented as an uninjured driver in a low-speed MVA).

84-year-old male who presents to the ED accompanying his wife, whom he accidentally backed his car into at low speed. The patient initially denies any injuries or complaints. However, the attending physician observes an unsteady gait, slow movements, and balance issues. The patient's daughter reports a recent decline in both parents' mobility and mentions the patient has a complex medical team ('a whole team of -ologists').

GeriatricsNeurology +2 more

Patient arriving via private vehicle in severe respiratory distress.

S02E12 Complex

55 · Male

Oliver Haas

Severe respiratory distress and hypoxia

Oliver Haas is a patient with End-Stage Renal Disease (ESRD) on a Monday/Wednesday/Friday hemodialysis schedule. He missed his Friday session due to attending a wedding. His son attempted to take him to the local clinic on Saturday morning, but it was closed for the 4th of July holiday. With their local rural hospital (Pine Ridge) permanently closed, his 20-year-old son Mason drove him 1.5 hours to The Pitt. Patient arrived in extremis, exhibiting severe respiratory distress and altered mental status upon arrival.

NephrologyDialysis +4 more

S01E02 Moderate

19 · Male

Nick Bradley

Found unresponsive in bed by parents

19-year-old college student found unresponsive in his bed by his mother. No known medical history, no daily medications, no known allergies. Found barely breathing with pinpoint pupils and a heart rate of 38. Prehospital EMS administered Narcan which improved pupillary response, but the patient failed to breathe spontaneously and required endotracheal intubation. No obvious signs of trauma, and no drugs or alcohol were reported on the scene.

ToxicologyOverdose +3 more

Patient presenting with severe intoxication.

S01E01 Brief

56 · Male

Louie Cloverfield

Tolerant Severe Alcohol Intoxication

Louie Cloverfield is a known patient to the ED who presented at 11:00 PM the previous night with a potentially lethal blood alcohol content (BAC) of 0.420. Due to severe chronic alcohol tolerance, he survived the acute intoxication and is currently sobering up. He is now being evaluated for acute alcohol withdrawal.

ToxicologyAddiction Medicine +1 more

S01E01 Complex

31 · Male

Otis Williams

Shortness of breath and severe fatigue after attempting a morning run.

A 31-year-old healthy male presents with shortness of breath and severe fatigue. He reports feeling fine until about two weeks ago, following the Rochester Marathon. He frequently participates in triathlons. Attempted to run this morning but had to quit after one minute due to dyspnea. No recent falls, injuries, or previous medical issues reported.

CardiologyNephrology +3 more

Patient presenting with severe intractable vomiting and dehydration.

S01E01 Moderate

54 · Female

Theresa

Intractable vomiting

54-year-old female brought to the ED by her 18-year-old son, David. Patient was found on the bathroom floor and has had intractable vomiting since last night. Denies prior stomach problems, new medications, or recent travel. Husband passed away a few years ago from COVID-19.

ToxicologyPsychiatry +2 more

Lethargic 4-year-old male upon ED arrival.

S01E01 Moderate

4 · Male

Tyler Jones

Lethargic and Unarousable 4-year-old boy brought to the ED by his parents.

4-year-old male with no past medical history, no antecedent illness, no fever, and no vomiting. Brought to the ED because his parents could not wake him up in the morning. Usually a highly active child. No apparent access to locked medications, no known trauma, and no sick contacts at his preschool.

PediatricsToxicology +1 more