Also known as: Cytokine storm
Multiple participants in a Phase 1 cancer immunotherapy trial develop severe cytokine release syndrome after receiving a CD28 receptor agonist drug. The episode centers on the diagnostic challenge of distinguishing this from sepsis, with John dying from multisystem organ failure and Jessica requiring dialysis for acute kidney injury.
Also known as: Metal poisoning from hip implant
Ernest has a metal-on-metal hip replacement from 2012 that has been slowly leaking cobalt and chromium into his bloodstream, causing multi-organ toxicity including blindness, deafness, cognitive changes, heart failure, and extensive tissue damage. He requires complex revision surgery to remove the toxic implant.
Also known as: Kidney failure
Jessica develops acute kidney failure as a complication of the cytokine storm and requires dialysis. Her kidneys may or may not recover.
Also known as: Heart failure
Ernest has developed cardiomyopathy leading to heart failure as a result of cobalt toxicity from his metal hip implant, requiring cardiothoracic monitoring during his revision surgery.
Also known as: Drug addiction in recovery
Jessica's history of opioid addiction and recovery is relevant context for why she participated in the drug trial (to make money while staying clean) and shapes her relationship with John and her sister Nic.