BRIGHT,MASON DEAN TEXAS CHILDREN'S HOSPITAL 6621 Fannin St MRN: 3002233446 Houston TX 77030 DOB: 2/4/2018, Sex: M TCPA LAB REPORT Texas Children's Pediatrics DtC Panel [2034679921 (Abnormal)(continued) Resulted: 07/19/18 1524. Result status: Final result signed by: Lisa Hensch, M.D. Testing Performed By Valid Date Range Address 6621 Fannin St Lab - Abbreviation 204 ■ TCH LAB Name TCH LAB 260•Unknown TCH THE WOODLANDS McKay. Eileen M, MD Director Unknown 06/15/17 1306-Present Houston TX 77030 (1003238) 17600 Interstate 45 S The Woodlands TX 77384 05/22/17 0803 - Present ABNORMAL FIbrlnogen (Order 203583285) Results Fibrinogen [2035832851 (Abnormal) Ordering provider: Resulted: 07/21/18 1655, Result status: Final result Weiner. Howard L. MD 07/21/18 1619 Resulting lab: TCH LAB Specimen Information ID 203583285S10928 Type Source VENIPUNCTURE Collected On 07/21/18 1602 Components Fibrinogen Value Reference Range Flag 201 220-440 MG/DL L Lab TCH LAB Comment: Neonatal Reference Range from Cord Blood Fibrinogen (135 - 283 mg/dl). Reference ranges are established by previous studies at TCH and relevant literature publications. Testing Performed By Lab - Abbreviation 204-TCH LAB Name TCH LAB Director Unknown Address Valid Date Range 6621 Fannin St Houston TX 77030 06/15/17 1306-Present ABNORMAL Von Wlllebrand Panel(Order 203583288) Results Vbn WIHebrand Panel (2035832881 (Abnormal) Ofderitig provider: Weiner. Howard L. MD 07/21/18 1619 Resulted: 07/24/18 1550. Result status: Final result Resulting lab: TCH LAB Specimen Information ID Type Source VENIPUNCTURE 203583288S10928 Collected On 07/21/18 1602 Components Factor 8 Value Reference Range 77 47-169% Flag Lab TCH LAB VWF Antigen 38 56 r 176% L . JCH LAB VWF Activity lb] 32 50-150% L TCH LAB VWL ActA/WF AG 0.8 0.7-1.2 VWL Pnl Path Cmt Comment: SEE NOTES TCH LAB TCH LAB 5 m.o. male who presents with subdural fluid collections, skull fractures, C2 subdural hematoma and bilateral retinal hemorrhages, concemlng for non-accidental trauma. SUMMARY OF DATA: 1. Normal factor 8 level. 2. Decreased vWF antigen level. 3. Decreased functional activity. 4. Normal activity:antigen ratio. 5. Multlmer analysis will be performed and reported separately. ASSESSMENT: -These data suggest von Willebrand disease type I^The patient carries Bright, Mason Dean Page 5 of 60 TEXAS CHILDREN'S HOSPITAL BRIGHT,MASON DEAN 6621 Fannin St MRN: 3002233446 Houston TX 77030 DOB: 2/4/2018, Sex: M TCPA LAB REPORT Texas Children's Pediatrics Von Willebrand Panel [2035832881 (Abnormal)(continued) a risk for bleeding. Since the low detectable ranges of vWF:Ag and Resulted: 07/24/18 1550. Result status: Final result activity are not the same,the low ratio may not suggest type 2 vWD. Interpretation of the results above should be considered In the context of the patient's personal and family bleeding histories. SUGGESTION; Follow up with pending multimer assay. CRT:85390 Questions; Please call 4-5850 and ask for blood bank physician on call. Electronically VWL Pnl Review By TCH LAB signed by; Michael Loses, M.D. Testing Performed By Lab - Abbreviation 204-TCH LAB Name TCH LAB Director Unknown Address Valid Date Range 6621 Fannin St Houston TX 77030 06/15/17 1306-Present VWF Multimer(Order 203583291) Results VWF Multimer 12035832911 Ordering provider: Weiner, Howard L, MD 07/21/18 1602 Resulted: 08/08/18 1136, Result status: Final result Resulting lab: BLOOD CENTER OF WISCONSIN Specimen Information ID Type Collected On 07/21/18 1602 Source S10928 Components Value Von Willebrand Multimer Reference Range Flag Lab BCW See Results Link Testing Performed By Lab • Abbreviation 121 - BCW Name BLOOD CENTER OF WISCONSIN Director Unknown Address 638 North 18th Stree Milwaukee Wl 53233-2121 BLOOD CENTER OF WISCONSIN Unknown 638 N 18TH ST Milwaukee Wl 53233-2121 Valid Dale Range 06/26/07 1615 - 07/27/18 1008 07/27/18 1008-Present Factor 13 Activity (Order 203583284) Results Factor 13 Activity [2035832841 Ordering provider: Weiner, Howard L, MD 07/21/18 1619 Resulted: 07/27/18 0321, Result status: Final result Resulting lab: QUEST DIAGNOSTICS NICHOLS INSTITUTE Specimen Information ID 203583284S10927 Type Collected On 07/21/181839 Source Components Value Factor 13 Activity 85 Reference Range 57- 192 % activity Flag Lab NIGH Comment: This test was performed using a kit that has not been cleared or approved by the FDA. The analytical perfomiance characteristics of this test have been determined by Quest Diagnostics Nichols Institute San Juan Capistrano. This test should not be used for diagnosis without confirmation by other medically established means. Test Performed at: Quest Diagnostics Nichols Institute Bright, Mason Dean Page 6 of 60