Mar 12, 2026 11:58 To: +16042339777 Page: 44/46 From: Foremed Medical Clinic Fax: 16043985614

FRASER HEALTH AUTHORITY Emerg Note
Royal Columbian Hospital HOLAND,MARK THOMAS
RC0473383/25

| Temperature 36.7 C [05/03/2026 11:46 |

| Temperature Source | oral |_ 05/03/2026 11:46 |

_ Pulse Rate 417 | 05/03/2026 11:46 |

| Respiratory Rate 16 | 05/03/2026 11:46 |

| Blood Pressure 153/103 H | 05/03/2026 11:46 |

_ Pulse Oximetry | 98 | 05/03/2026 11:46 |
Documentation
Presentation:

This patient has had multiple presentations to the emergency department for somewhat bizarre
complaints. { have also reviewed the available history as well as a psychiatric consultation. His
primary complaints seem to be related around ear pain. He tells me that he believes that a specific
frequency of sound is causing him to lose his hearing and that this “impacts his vagal nerve and
causes him to have seizures”. I have reviewed the footage of him sleeping that he has shown me
and I do not see any evidence of tonic-clonic movements.

In his previous visits he has demanded to see an otolaryngologist and these referrals have already
been completed. He has already had audiclogy testing completed. He does seem quite fixated on his
health and says that his generai health is dectining.

Relevant Medical History:
Migraines

Medications:
Per med rec

Social History:
Denies recreational drugs or intoxicants today

Exam:
He appears well, nondistressed,

This record contains confidential information which must be protested. Any unauthorized use or disclosure is stri¢tly prohibited.

Meditech Report !D: 0503-00199 2084

PAGE 44/46 * RCVD AT 3/12/2026 11:59:36 AM [Pacific Daylight Time] * SVR:FAXP21/12 * DNIS:9777 * CSID:16043985614 * ANI:6043985614 * DURATION (mi