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I had the opportunity to see a 17-year-old male who had been referred to the pediatric cardiology clinic after his foster care intake exam resulted with an abnormal EKG. He came to the appointment with a group home staff member who knew none of his past medical history, allergies, or current prescribed medications. He was new to our health system and his electronic medical records were outdated and sparse. The answer to every question I asked this young man to ascertain his cardiovascular risk was “I don’t know.” He had no family history to share and none of his birth history or even surgical history was known to him.