Case 2:85-cv-04544-DMG-AGR Document 420-2 Filed 04/23/18 Page 27 of 49 Page ID #:16553 Attachment 4 Exhibit 27 Page 144 Case 2:85-cv-04544-DMG-AGR Document 420-2 Filed 04/23/18 Page 28 of 49 Page ID #:16554 04/04/2016 Patient Profile - Active Medications Client: Teaching RUIZ-NAZARIO, Physician:JAVIER Allergies:No Known Drug Allergy Rx # Home:sB-B MD Instructions Medication *** Psychotropic Start Medications *** 53227 PRAZOSIN HCL CAP 2MG TAKE 1 CAPSULE BY MOUTH DAILY at 53285 QUETIAPINE TAB 200MG TAKE 1 TABLET BY MOUTH DAILY at 53249 SERTRALINE TAB 50MG TAKE 1 *** PRN Psychotropic ~ 1/2 Date 9:00 9:00 TABLETS BY MOUTH DAILY at PM 03/16/2016 PM 7:45 03/29/2016 AM 03/22/2016 Medications*** 53294 OLANZAPINE TAB lOMG TAKE l TABLET BY MOUTH EVERY 6 HOURS AS NEEDED FOR MILD AGITATION 03/30/2016 53300 OLANZAPINE TAB lOMG ODT DISSOLVE 1 TABLET BY MOUTH EVERY 6 HOURS AS NEEDED FOR MODERATE AGITATION 03/31/2016 *** Non-Psychotropic Medications*** 7: 53230 BAC/NEO/POLY QIN APPLY TO AFFECTED AREA ON FEET TWICE A DAY at 45 AM and 9:00 PM 53229 DEEP SEA SPR 0.65% INHALE 2 SPRAYS INTO NOSTRIL TWICE A DAY AS NEEDED at 7:45 AM and 9:00 PM 03/16/2016 53295 OLANZAPINE INJ INJECT iOMG INTRAMUSCULARLY EVERY 6 HOURS AS NEEDED FOR SEVERE AGITATION 03/30/2016 lOMG 03/16/2016 Exhibit 27 Page 145 Case 2:85-cv-04544-DMG-AGR Document 420-2 Filed 04/23/18 Page 37 of 49 Page ID #:16563 Attachment 9 Exhibit 27 Page 154 Case 2:85-cv-04544-DMG-AGR Document 420-2 Filed 04/23/18 Page 38 of 49 Page ID #:16564 12/12/2016 - Active Profile Patient Medications Teaching Client: Physician Home:s s-A :JAVIER RUIZ- NAZARIO, MD Allergies: Rx # Instructi Medication «*• / Psychotropic Start o ns Date Med ica tions TAKE 1 TABLET BY MOUTH DAI LY at 9:0 0 PM 0 7 /0 5/20 16 53713 BENZTROPIN E TAB lMG 54435 CLONAZEPAM TAB 2MG 5 443 4 DIV ALPROEX TAB 50 0MG ER 539 7 4 DULOXETINE CAP 60MG 54427 GUANFACINE TAB 2MG ER 54384 LATUDA TAB 120 MG TAKE l TABLET BY MOUTH DAIL Y FOR 4 DAYS THEN I NC at 9: 0 0 PM 11 / 29 / 2 0 16 5438 5 LATUDA TAB 40MG TAKE l TABLET BY MOUTH DAILY (TAKE ALONG lvIT H 160MG AFTER BEING ON 1 20MG 4 DAYS ) at 9:00 PM 11 / 29 /20 1 6 / / c/ / TAKE 1 TABLET BY MOUTH TWIC E A DAY at 9: 00 PM 7:4 5 AM a nd 12 / 12 /20 16 TAKE 1 TABLET BY MOUTH TWICE A DAY at 9: 00 PM 7: 4 5 AM an d 1 2/ 1 2/20 16 TAKE l CAPSULE BY MOUTH DAI LY a t 7:45 AM 0 9/ 14 /201 6 TAKE l TABLET BY MOUTH DAI LY at *** PRN Psychotropic 7 : 45 )Uol 12 / 06/ 20 16 Medicat i ons*** 0 6/ 02 / 20 16 53580 GEODON I NJ 20MG INJE CT 20MG I NTRAMUSCULARLY EVERY 8 HOURS AS NEEDED .OR AGGRESSI VE BEHAVIOR 5 399 7 OLANZAPINE INJ lOMG INJE CT lOMG INTRAMUSCULARLYEVERY 6 HOURS AS NEEDED SE VERE AGIT ATI ON, PBSICAL AGRES S ION 09 /2 0 /2 0 1 6 539 98 OLANZAPI NE TAB lOMG ODT DIS SOLVE 1 TABLET BY MOUTH EVERY 6 HOURS AS NEEDED FOR AGITATI ON AND AGGRESSIO N 09 /2 0/ 20 16 Non-Psyc hotropi 54399 MEAL REPLACEMENT SHAKE c Medic ati ons ~** GI VE 1 S HAKE 3 TIMES DAI LY (OFFE R TO REPLACE A MEAL ) a t 7:45 AM, 12:00 PM a nd 6 :00 PM 11 / 30/2 016 Exhibit 27 Page 155 Case 2:85-cv-04544-DMG-AGR Document 420-2 Filed 04/23/18 Page 39 of 49 Page ID #:16565 06/13/2016 Patient Client: Physician:JAVIER Allergies: Rx # - Active Profile Medications Teaching RUIZ-NAZARIO, Home:s8-A MD Start Instructions Medication *** Psychotropic Medications *** 9:00 BENZTROPINE TAB 0.SMG TAKE 1 TABLET BY MOUTH DAILY at 53578 HALOPERIDOL TAB lMG TAKE 3 TABLETS BY MOUTH DAILY at 53579 LORAZEPAM TAB lMG DAILY at TAKE 3 TABLETS BY MOUTH 3 TIMES PM and 9:00 PM 3:30 53606 LORAZEPAM TAB 2MG 3 TIMES TAKE 1 & 1/2 TABLETS BY MOUTH PM PM and 9:00 45 AM, 4:00 53580 GEODON INJ 20MG ?~~sychotropic '-ttefl.-P Medications 9:00 06/02/2016 PM 53577 *** Date 06/02/2016 PM 7:45 DAILY at AM, 06/02/2016 7: 06/08/2016 *** 8 HOURS AS INJECT 20MG INTRAMUSCULARLY EVERY NEEDED FOR AGGRESSIVE BEHAVIOR 06/02/2016 NCYL_000980 Exhibit 27 Page 156 Case 2:85-cv-04544-DMG-AGR Document 420-4 Filed 04/23/18 Page 71 of 81 Page ID #:16714 Exhibit 56 REDACTED VERSION OF DOCUMENT FILED UNDER SEAL Exhibit 56 Page 397 Case 2:85-cv-04544-DMG-AGR Document 420-4 Filed 04/23/18 Page 72 of 81 Page ID #:16715 01/09/2018 Patient Profile - Active Medications Client: I 'I'eaohing Home: WOOD HOUSE [ Physician; JAVIER RtJIZ-NAZARIO, MD Allergies: IBUPROFEN;SPICY FOODS FISH I f SOUR CREAM r l Rx # Instructions Medication ~*• Start Date i' ! Psychotropic Medications*** 56169 8UPnOPI0N TAD lOOMG SR TAKE 1 TABLET SY MOU'l'H DAILY at 0:00 PM 12/19/2017 56100 GJ\BAPE:NTrn CAP lOOMG TA.KE 1 CAPSULE B'( MOUTH 3 TIMES DAILY at 8 l 00 AM, 12/05/2017 2;00 PM and 8:00 PM Non-Psychotropic Medications l I I J H<- 56127 CALCIUM. PLUS TAKE 2 TABLE.TS BY MOUTH DA.IL'!:' Qt 8:00 PM 12/06/2011 56126 COREPl:,EX WJTH rnm1 TAl:'iE 2 TABLETS 8'( MOUTH WITH BREAKFAST DAILY at 8: 00 I\M 12/06/2017 II I I 56124 OMF.:GAPLEX TAKE l CAPSULE BY MOUTH WITH BREAKFAST AND DINNER T\UCE A DA\' at 8;00 AM and 4 :00 PM 12/06/2011 56125 PROBIOTIC RESTORE ULTRA TARE 1 CAPSULE BY MOUTH WITH BRFJI.KE'AST DA1L'i at B: 00 AM 12/06/2011 I II • I I f, l I' II I II 'I ! ! Exhibit 56 Page 398 i" I '' Case 2:85-cv-04544-DMG-AGR Document 420-4 Filed 04/23/18 Page 73 of 81 Page ID #:16716 Exhibit 57 REDACTED VERSION OF DOCUMENT FILED UNDER SEAL Exhibit 57 Page 399 Case 2:85-cv-04544-DMG-AGR Document 420-4 Filed 04/23/18 Page 74 of 81 Page ID #:16717 11/27/201'7 Patient Profile - Active Medications I Teaching Home: 58-A Client: Physician: JAVIER RUIZ-NAZARIO, MD Allergies: NKDA Rx # Medication I Start Date lnstructions "'"* Psychotropic Medlcatio11s *** at 56042 CLONIDINE 56007 BSCITALOPRAM TAB 20MG 56009 QU~~T I AP INE 56043 QU8TIA.PINE 55904 CALCIUM PLUS 'fAKE 2 TABLETS BY MOUTH DAILY at 8: 00 Pr-! 10/18/2017 55903 CORl-1FLEX TAKE 2 TABLETS BY MOOTH Dl\Il,Y \HTH BREAKFl\ST at 8: 00 AM 10/18/2017 55901 OMEGA.FLEX TAKE 1 CAP.SULE BY MOUTH 'rl'/ICE A Di\Y WITH BREi\KFAST l\ND UlNNER at 8:00 AM and 4:00 PM 10/18/20.\1 55907. PROIHOT1C RESTORE UI,TRA TAKE 1 Cl\l'SUJ,E BY MOUTH llAIJ,Y ~/ITH BREl\KE'/1.S'l' at. 8: 00 AM 10/18/2017 56011 IHPHF.:NHYDRAM !NJ 50MG/ML INJECT 25MG INTRAMUSCULARLY EVERY 6 HOURS AS NEEDED FOR i\Gtl'ATION/ANXIETY {USE WITH ATIVl\N} 11/14/2017 INJECT 0. 5Ml, INTRAMUSCULARLY ~WERY 6 HOURS i\S NEEDEIJ r'OR 11.GITl\.TION/ ANXIE:TY (USE WITH BENADRYL) 11/14/2017 8: 00 PM. 11/21/2017 TAKE l TABLET BY MOUTH l)AILY at 8:00 PM 11/14/2017 Tl\B lOOMG Ti\KE 1 TABLET HY MOUTH DAILY at 8:00 PM ll/lq/2017 TAB 50MG TAKE 1 TABLE:T BY MOUTH {TAK~: WTTH THE 100MG TT!.BLET 1'0 MAKE 150MG oosr;) f)A[LY at 8:00 !.'M ll./21/2017 TAB 0,lMG TAKE 1 TABLET BY. MOUTH DAILY ~** 56010 INJ 2MG/ML Non-Psychotropic Medications i** Exhibit 57 Page 400 Case 2:85-cv-04544-DMG-AGR Document 420-4 Filed 04/23/18 Page 75 of 81 Page ID #:16718 Exhibit 58 REDACTED VERSION OF DOCUMENT FILED UNDER SEAL Exhibit 58 Page 401 Case 2:85-cv-04544-DMG-AGR Document 420-4 Filed 04/23/18 Page 76 of 81 Page ID #:16719 i ( 07/31/2017 Patient Profile - Active Medications Client: Teaching Home:58-c Physician: ,JAVIER B.OIZ-NAZARJ:O, MD Allergies:No Known # Drug Allergy Medication Instructions 55501 ARIPTPR11.t0LE t1\B 10MG 'l'AKE 1- TABLET B'l MOUT.11 DAILY at 8: 00 PM 0//18/2017 55353 BENZ-TROPINE T1JI 1.MG nKE 1 TABLET BY •MOUTE TWICE A DAY at 8:00 Mt and 8100 P~l 06/01/2017 555?.:2 CH[,ORE'ROMA;.:a: TAB 'l'AKE 1 TABLE'!.' B'i MOU'l'H DAIL'i at S: 00 PM 07/25/2011 55354 OESMOPRf:SSIN 'l'l\B O ,2MG TAKE 2 TABLETS B'i MOUT8 DAJ'!-Y at 8:00 PH 06/01/2017 5550:l ESC1TALOPRAM TAB 20MG Tl\l{E 1 TABLE'.t BY t,!0UT1l Dhll.Y at 8: 00 .Ml 07/18/2011 55524 LAMO'rRIGINE 55525 Li\t,.\OTRIGJ;N:& TAB 25MG '1'1'.KE 3 TABLETS BY HOQ'l'H {'15MG) DAILY FOR 1 DAYS, 'l'l!EN INCREASE, 8EGIN LITltIUM DECR8ASE, at 8: 00 J?M 01/25/2017 55526 LM>IOT}UGINS TKB 25MG TAKE 4 TABLETS B~ MOUTH (100MG) DA1LY at O:OO PM 07/25/2011 55504 J.ITHll.lH CARR cl\P 300MG 'rA'KE 1 Ci\l?SOLE AFTER TWICE A DAY at 8:00 AM and 8: 07/18/2011 Rx TAB 25NG 25MG Sta~t Pate 'l'i\KE 2 TABLETS B't MOU'l.'H DAlft_Y, FOf} 7 Dl\'tf, INCREASE at 8: ()0 PM t)~ '-\-h\ ~ 'l'JIEN o\O'f:>c° 00 PM 5552? LITillUM Cl\RB Ci\P 300MG TAKE 1 C~PSULE BY MOUTH DAILY FOR 1 DAYS THEN D/C (H~GIN OECREl\SE OH .3RD \>1EEI( orr I,1\MO'l'RlG)'.NE:.) at 07/25/2011 8: 00 PM ~•~ PRN Psyohotropic Medications**~ TAKE 1 TABLET BY MOUTH EVERY 8 HOURS AS NEED~D 55428 06/28/i017 HALLUC1NA'f10MS 55505 TRAZQOONE 'l'Ml!t 1 TABUi'l' B'i MOU'l'H Pi\lL'.i AS NEEDED FOR ST.EEP at. 8100 l'vl TAB 50MG ~•k 0'1/18/2017 Non-Psychot~opic Medications*** 55151 DOK CAP 100MG 't1,.1 100° Minor aches and pains Headache Fever> 100° Minor aches and pains A-\l~rC\y ,JI Mild pain Menstrual cramps 0 Hibiclens {Liquid) D Insect Repellant (Aerosol) Prevent insect bites D Triple Antibiotic Ointment Minor cuts scrapes abrasions 0 Milk of Magnesia (Liquid) Constipation D Pepto Bismol Upset stomach 0 Swimmer's Ear (Solution) Prevent infection from swimming Minor.cuts, scrapes and abrasions Off-si.te Day Campuses Only D Benadryl Allergic Reaction EPS Symptoms Parent, Guardian, or Conservator Rev. 09/10 Date S-1 Copy to Medical Chart and Travel Folder Exhibit 59 Page 405 Case 2:85-cv-04544-DMG-AGR Document 420-4 Filed 04/23/18 Page 80 of 81 Page ID #:16723 Exhibit 60 REDACTED VERSION OF DOCUMENT FILED UNDER SEAL Exhibit 60 Page 406 Case 2:85-cv-04544-DMG-AGR Document 420-4 Filed 04/23/18 Page 81 of 81 Page ID #:16724 -' -00 Office of Refugee Resettlement Shiloh Treatment Center, Inc. Admission Packet Medication Information and Reconciliation all medication the client is currently prescribed. C/~7-/ '7 ~c Form Completed By Date of Completion Source of Medicatiori Information: Check All That Apply ~harmacy Label 0Physician Prescription 0Parent or Client IS).Pischarge Summary/Records From Transferring Facility Facility: - - - - - - - - []Other:----------------------------For Use by Clinic Staff Medication at Admission Dose Name of Medication e.,-\--\ r-.:e ('()el~~;~ --\- \ U O)( Frequency ;)Um ;?,(Y\ -;- [i)A,r,,, ),.L Prescriber Route pr, I.If.\ , di\.\."- ff\ Target Symptoms D3te Prescribed - \~" 8/H:i(/ C ' - -.,..,.....-,:,...,_µ I - - I Last Dose Order on Change Dlscontlnuc Quantity Quantity on Admit on Admit Provlded at Received at Admit Admit Admit Date ime o/e, o/c,, H5 3,g ~~ y N H5 116& LP?, ( ~ y f\) /V 11 I \ - q_ 7-(7 Date Parent, Guardian, or Conservator For Use by Clinic Staff Review of Medication Conducted By: Physician Approving Medication: ---"-'d_,_,_b_....OI.....,_/. . . .f'---'-,_,_..-/f'-5=--- Date: __CJ_-_7_-_J7_ Time: 0Rafael Gu~rrero, MD OVictor Oderinde, MD ~vier Ruiz, MD 0Vernon Walling, MD Change in Medication: Rev. 09/10 Copy to Medical Chart and Copy Completed Form to Pharmacy R-1 Exhibit 60 Page 407