Ask Dr. Z

If you were to approach this physician on his documentation of the below generator changeout, what would be your exact verbiage? There is no documentation of work done, nor info on implanted device (only intraprocedural measurements). "PROCEDURE PERFORMED: Generator replacement of a dual chamber biventricular cardiac defibrillators, fluoroscopy of device and lead, and capsulectomy pocket revision. Explanted device is a Guidant CRT-D model D224TRK. Existing leads: Atrial lead is Medtronic model 5076, length 45 cm in the right atrial appendage. The ICD lead is a Medtronic model 6947, length 58 cm in the right ventricular apex, and the CS lead is Medtronic 4196, 78 cm long in the lateral branch. Tachy detection at 300 millisecond. Tachy interval for ventricular fibrillation, first therapy 35 joules then 35 joules x 5. Bed rest for 4 hours. Antibiotics used."