chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Electrocardiogram T wave inversion, Electrocardiogram abnormal, Fatigue, Full blood count normal
Clinical narrative: Date of Admission: 9/20/2022 Discharge Date: 9/22/2022  PRESENTING PROBLEM: Hypoxia [R09.02] Elevated troponin [R77.8] AKI (acute kidney injury) COVID [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 73 y.o. female who presents today with fatigue. pmh htn,obesity,gerd, depression and anxiety, dm 2. Notes onset today with " non feeling well. Noted onset feeling shaky and legs feeling weaker than normal.    In ed found to be hypoxic to 88% on room air requiring 2 l nc o2. cxr neg for acute process. Febrile to 38.1 tachycardic , rr elevated . Labs with creat 1.36 last obtained in 2017 0.69. troponin baseline 22 with 2 hr pending . Ecg with diffuse t inversion v1 v6 no st abnormality. Lactic 1.2 cbc normal ranges . Tested positive for covid . Given fluids 2 liters , decadron ,tylenol in ed .  Hospitalist service consulted for admission further evaluation.  She was continued on COVID-19 therapy with dexamethasone and remdesivir.  She was continued on severe respiratory isolation.  Supplemental oxygen was continued and weaned to room air.  She is noted to have continued generalized weakness needing assistance greater than her baseline.  PT/OT evaluated and advised home with assist and no additional services needed upon discharge.  MSW/CM on board for discharge plan referral and arranging outpatient services. Electrolytes were monitored and repleted throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoxia, Malaise, Muscular weakness, Nervousness, Pyrexia
Clinical narrative: Date of Admission: 9/20/2022 Discharge Date: 9/22/2022  PRESENTING PROBLEM: Hypoxia [R09.02] Elevated troponin [R77.8] AKI (acute kidney injury) COVID [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 73 y.o. female who presents today with fatigue. pmh htn,obesity,gerd, depression and anxiety, dm 2. Notes onset today with " non feeling well. Noted onset feeling shaky and legs feeling weaker than normal.    In ed found to be hypoxic to 88% on room air requiring 2 l nc o2. cxr neg for acute process. Febrile to 38.1 tachycardic , rr elevated . Labs with creat 1.36 last obtained in 2017 0.69. troponin baseline 22 with 2 hr pending . Ecg with diffuse t inversion v1 v6 no st abnormality. Lactic 1.2 cbc normal ranges . Tested positive for covid . Given fluids 2 liters , decadron ,tylenol in ed .  Hospitalist service consulted for admission further evaluation.  She was continued on COVID-19 therapy with dexamethasone and remdesivir.  She was continued on severe respiratory isolation.  Supplemental oxygen was continued and weaned to room air.  She is noted to have continued generalized weakness needing assistance greater than her baseline.  PT/OT evaluated and advised home with assist and no additional services needed upon discharge.  MSW/CM on board for discharge plan referral and arranging outpatient services. Electrolytes were monitored and repleted throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory rate increased, SARS-CoV-2 test positive, Tachycardia, Troponin increased
Clinical narrative: Date of Admission: 9/20/2022 Discharge Date: 9/22/2022  PRESENTING PROBLEM: Hypoxia [R09.02] Elevated troponin [R77.8] AKI (acute kidney injury) COVID [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 73 y.o. female who presents today with fatigue. pmh htn,obesity,gerd, depression and anxiety, dm 2. Notes onset today with " non feeling well. Noted onset feeling shaky and legs feeling weaker than normal.    In ed found to be hypoxic to 88% on room air requiring 2 l nc o2. cxr neg for acute process. Febrile to 38.1 tachycardic , rr elevated . Labs with creat 1.36 last obtained in 2017 0.69. troponin baseline 22 with 2 hr pending . Ecg with diffuse t inversion v1 v6 no st abnormality. Lactic 1.2 cbc normal ranges . Tested positive for covid . Given fluids 2 liters , decadron ,tylenol in ed .  Hospitalist service consulted for admission further evaluation.  She was continued on COVID-19 therapy with dexamethasone and remdesivir.  She was continued on severe respiratory isolation.  Supplemental oxygen was continued and weaned to room air.  She is noted to have continued generalized weakness needing assistance greater than her baseline.  PT/OT evaluated and advised home with assist and no additional services needed upon discharge.  MSW/CM on board for discharge plan referral and arranging outpatient services. Electrolytes were monitored and repleted throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Abdominal discomfort, Bell's palsy, Computerised tomogram normal, Condition aggravated, Ear disorder
Clinical narrative: Ear problems and severe headache. Afterwards I started to notice symptoms of Bell's Palsy. I went to the ER on 09/29/2022 in the morning due to symptoms. There was concern of possibly having a stroke. The reason I believed Bell's Palsy is because I felt a droopy eye and swollen tongue on my right side. I brushed my teeth and noticed I couldn't hold water in my mouth and my lymph node on my right side is still swollen. I have a severe headache on the right middle area of my head. They did keep me over night, and they did run a CT scan and MRI scan. There were no findings associated with the MRI or CT scans. I have come to realize in the hospital that I should have prednisone and a prescription for prednisone. A couple of days later I started on VALTREX. I started to feel a bit better however I then began to feel worse. My stomach was upset and my headache was worse. The Bell's Palsy symptoms slightly improved. I have ceased taking the antiviral. I have been feeling better since getting off the antiviral.
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Facial paralysis, Headache, Lymphadenopathy, Magnetic resonance imaging normal, Swollen tongue
Clinical narrative: Ear problems and severe headache. Afterwards I started to notice symptoms of Bell's Palsy. I went to the ER on 09/29/2022 in the morning due to symptoms. There was concern of possibly having a stroke. The reason I believed Bell's Palsy is because I felt a droopy eye and swollen tongue on my right side. I brushed my teeth and noticed I couldn't hold water in my mouth and my lymph node on my right side is still swollen. I have a severe headache on the right middle area of my head. They did keep me over night, and they did run a CT scan and MRI scan. There were no findings associated with the MRI or CT scans. I have come to realize in the hospital that I should have prednisone and a prescription for prednisone. A couple of days later I started on VALTREX. I started to feel a bit better however I then began to feel worse. My stomach was upset and my headache was worse. The Bell's Palsy symptoms slightly improved. I have ceased taking the antiviral. I have been feeling better since getting off the antiviral.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Urticaria
Clinical narrative: Hives on legs.
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, Product administered to patient of inappropriate age
Clinical narrative: CHILD RECEIVED INCORRECT PFIZER FORMULATION FOR AGE GROUP. RECEIVED ADULT PFIZER FORMULATION. SHOUL'DVE RECEIVED THE 5-11YO FORMULATION.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: covid vaccine breakthrough   dose 1 7/8/21 Pfizer EW0191 dose 2 7/29/21 Pfizer EW00191
Age: 70.0
Sex: F
Vaccine: FLU4
Symptoms: Cellulitis, Erythema, Pruritus
Clinical narrative: CELLULITIS TYPE SYMPTOMS; REDNESS, ITCH
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Asthenia, COVID-19, Death, Diarrhoea
Clinical narrative: tested + for covid 6-22-22 , hospitalized 6-22-22 , sx onset 6-19-22, sx at time she was hosp was diarrhea, abd pain ,weakness.  She passed away on 7-13-22;  I have no further information.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: tested + for covid 6-22-22 , hospitalized 6-22-22 , sx onset 6-19-22, sx at time she was hosp was diarrhea, abd pain ,weakness.  She passed away on 7-13-22;  I have no further information.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Covid vaccine breakthrough.
Age: 57.0
Sex: F
Vaccine: VARZOS
Symptoms: Eye swelling, Swelling face
Clinical narrative: Patient is a doctor as is her husband.  Her eyes and face swelled.  Eyes started first late in the evening 9/26.  By the morning of 9/27 her eyes and face were swollen.  She reports taking a Benadryl 25mg and Motrin 600mg every 6 hours.  She said the adverse effects slowly subsided.
Age: 52.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Pain in extremity, Sleep disorder
Clinical narrative: Lower extremity pain, from waist down to toes. Started in the evening and continued for about 36 Hours. Was slightly alleviated by OTC ibuprofen. Interfered with sleep. On a 10 point scale was about a 5. Movement helped.
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness, Feeling abnormal, Headache, Hypertension, Malaise
Clinical narrative: Became dizzy, felt very odd, vision changes, headache on top of head.  I waited for symptoms to pass, and informed hospital staff that I wasn't feeling well.  Sat in a recliner.  Blood pressure check revealed bp of 210/110, which is extremely unusual for me.  I waited and drank juice and water, bp came down some what, but has remained high ever since.  I have never had high blood pressure before.
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: Visual impairment
Clinical narrative: Became dizzy, felt very odd, vision changes, headache on top of head.  I waited for symptoms to pass, and informed hospital staff that I wasn't feeling well.  Sat in a recliner.  Blood pressure check revealed bp of 210/110, which is extremely unusual for me.  I waited and drank juice and water, bp came down some what, but has remained high ever since.  I have never had high blood pressure before.
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dysphagia, Pruritus, Tonsillar inflammation
Clinical narrative: Female patient of 64 years of age, CAOX3 was in the area of observation begins to report feeling strange when swallowing feeling of inflamed tonsils. Patient kept under observation and then refers to itching of left ear. 25mg of Benadryl P.O. is administered by medical order of Dr. Reports improvement of symptoms within 30 minutes of taking the medication.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: covid vaccine breakthrough  dose 1 Pfizer 4/15/21  EW0162 dose 2 Pfizer 5/6/21 EW0164
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Echocardiogram normal, Ejection fraction normal, Electrocardiogram abnormal, Gram stain positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: PA Admission Date: 9/26/2022 Discharge Date: Sep 30, 2022  PRESENTING PROBLEM: Shortness of breath [R06.02] Acute hypoxemic respiratory failure due to COVID-19 [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: 60 year old male with past medical history of AFib on Eliquis, heart failure preserved ejection fraction, history of severe aortic stenosis status post valve replacement, right bundle-branch block, non-insulin-dependent type 2 diabetes with neuropathy, anxiety/depression, physical deconditioning secondary to peri-prostatic hip fracture who presented to the hospital complaining shortness of breath for 1 week.   In the ER, patient was found new have low heart rate 42, need oxygen 4 L O2 initially.  White count 12.7.  Found to be COVID positive.  CT angiogram was performed rule out thrombotic disease.  CT came back negative for pulmonary embolism but showed showed multifocal patchy central lobular nodules with surrounding ill-defined ground-glass throughout the lungs, most suggestive of small airway infection, a few larger solid nodules at the right lung apex, short-term posttreatment noncontrast CT chest is recommended to ensure expected improvement.  EKG with QTC greater than 500 milliseconds and right bundle blanch block.  He was admitted to the hospital for acute hypoxic respiratory failure secondary to COVID pneumonia.   After admission, patient was started on dexamethasone and remdesivir.  He complained about shortness of breath preceding COVID diagnosis.  Did consult pulmonology who recommended continue with current care of steroids and remdesivir.  Pulmonology also recommend checking sputum culture and procalcitonin level.  Procalcitonin level came back elevated 0.3 and sputum culture came back showing Gram-positive cocci in chains/pairs.  Was started on antibiotics for pneumonia.  MRSA screen collected and ID consulted.  Sputum culture finalized as normal flora.  MRSA screen came back negative.  Id recommended stopping antibiotics.    In terms of low heart rate, heart medications Cardizem and beta-blocker were held and Cardiology was consulted.  Initially Hospital consult but patient follows with provider for his history of aortic valve replacement and therefore was admission cardiology was consulted as patient continues to want to follow with provider after discharge.  Heart rate did improve after holding of his heart medications.  Echo was performed showing normal ejection fraction, no wall motion abnormalities. Losartan 100 mg daily was added for BP control.  Also, added amoldipine 5 mg daily and lopressor 12.5 two times daily for ectopy on tele.    Patient weaned to 2L o2 at discharge at night.  Set up with home O2 at night by rehab.  PT saw him and recommend outpatient PT.   Did send with 5 more days of steroids for covid.    2 week Zio placed at discharge per Cardiology recs. Could also consider nuclear stress outpatient once convalesced from COVID. Hospital said would defer to patient's primary cardiologist.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Sputum culture positive, Staphylococcus test negative, White blood cell count increased
Clinical narrative: Discharge Provider: MD Primary Care Provider: PA Admission Date: 9/26/2022 Discharge Date: Sep 30, 2022  PRESENTING PROBLEM: Shortness of breath [R06.02] Acute hypoxemic respiratory failure due to COVID-19 [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: 60 year old male with past medical history of AFib on Eliquis, heart failure preserved ejection fraction, history of severe aortic stenosis status post valve replacement, right bundle-branch block, non-insulin-dependent type 2 diabetes with neuropathy, anxiety/depression, physical deconditioning secondary to peri-prostatic hip fracture who presented to the hospital complaining shortness of breath for 1 week.   In the ER, patient was found new have low heart rate 42, need oxygen 4 L O2 initially.  White count 12.7.  Found to be COVID positive.  CT angiogram was performed rule out thrombotic disease.  CT came back negative for pulmonary embolism but showed showed multifocal patchy central lobular nodules with surrounding ill-defined ground-glass throughout the lungs, most suggestive of small airway infection, a few larger solid nodules at the right lung apex, short-term posttreatment noncontrast CT chest is recommended to ensure expected improvement.  EKG with QTC greater than 500 milliseconds and right bundle blanch block.  He was admitted to the hospital for acute hypoxic respiratory failure secondary to COVID pneumonia.   After admission, patient was started on dexamethasone and remdesivir.  He complained about shortness of breath preceding COVID diagnosis.  Did consult pulmonology who recommended continue with current care of steroids and remdesivir.  Pulmonology also recommend checking sputum culture and procalcitonin level.  Procalcitonin level came back elevated 0.3 and sputum culture came back showing Gram-positive cocci in chains/pairs.  Was started on antibiotics for pneumonia.  MRSA screen collected and ID consulted.  Sputum culture finalized as normal flora.  MRSA screen came back negative.  Id recommended stopping antibiotics.    In terms of low heart rate, heart medications Cardizem and beta-blocker were held and Cardiology was consulted.  Initially Hospital consult but patient follows with provider for his history of aortic valve replacement and therefore was admission cardiology was consulted as patient continues to want to follow with provider after discharge.  Heart rate did improve after holding of his heart medications.  Echo was performed showing normal ejection fraction, no wall motion abnormalities. Losartan 100 mg daily was added for BP control.  Also, added amoldipine 5 mg daily and lopressor 12.5 two times daily for ectopy on tele.    Patient weaned to 2L o2 at discharge at night.  Set up with home O2 at night by rehab.  PT saw him and recommend outpatient PT.   Did send with 5 more days of steroids for covid.    2 week Zio placed at discharge per Cardiology recs. Could also consider nuclear stress outpatient once convalesced from COVID. Hospital said would defer to patient's primary cardiologist.
Age: 92.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Condition aggravated, Confusional state, Pyrexia, Tremor
Clinical narrative: On day 2 post vaccine, patient developed a low grade fever, was more confused than normal and was "shaking more that usual"  This lasted 2 days then patient resumed to her normal
Age: 86.0
Sex: F
Vaccine: FLU4
Symptoms: Contusion, Erythema, Induration, Pyrexia, Skin discolouration
Clinical narrative: patient is experiencing severe bruising &  discoloration with induration, redness low grade fever...area covering from elbow to shoulder
Age: 5.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Inappropriate schedule of product administration, Incorrect dose administered, No adverse event
Clinical narrative: Patient was given the 6m-4y Pfizer dose, instead of 5y-11y.  She was also not due for a booster yet--3rd dose was administered too early.  No adverse effects noted.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Asthma, Bronchial hyperreactivity, COVID-19, Chest X-ray normal, Dyspnoea
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 9/26/2022 Discharge Date: Sep 28, 2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Reactive airway disease without complication, unspecified asthma severity, unspecified whether persistent COVID-19 virus infection   HOSPITAL COURSE: 51-year-old female with PMH significant for history of goiter and Hashimoto's thyroiditis (status post total thyroidectomy), subsequent hypoparathyroidism/hypothyroidism and seasonal allergies (no history of asthma or COPD) (even though uses p.r.n. albuterol an occasional steroid tapers for bronchospasm) presented to the hospital on 9/26 due to 3 day history of worsening dyspnea, myalgias.In ER, patient was noted to be tachycardic 108, hypertensive 183/81, afebrile and with normal oxygenation.  Labs were all unremarkable including D-dimer and proBNP.  Chest x-ray was clear of any infiltrates.  She tested positive for COVID-19.  Patient however appeared to be in respiratory distress, significant inspiratory/expiratory wheezing.  Patient was giving breathing treatment and IV Solu-Medrol and subsequently admitted to hospitalist service for further management.    Patient stayed in hospital for approximately 2 days.   Patient was provided with supportive care, breathing treatment.  She was continued on prednisone 40 mg daily. She was given total of 3 doses of IV remdesivir which she tolerated well with liver function, kidney function monitored.  Patient remained on room air during this hospital stay.  Patient's breathing much improved that she was discharged home stable.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Fibrin D dimer normal, Hypertension, Liver function test, Myalgia, Prohormone brain natriuretic peptide
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 9/26/2022 Discharge Date: Sep 28, 2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Reactive airway disease without complication, unspecified asthma severity, unspecified whether persistent COVID-19 virus infection   HOSPITAL COURSE: 51-year-old female with PMH significant for history of goiter and Hashimoto's thyroiditis (status post total thyroidectomy), subsequent hypoparathyroidism/hypothyroidism and seasonal allergies (no history of asthma or COPD) (even though uses p.r.n. albuterol an occasional steroid tapers for bronchospasm) presented to the hospital on 9/26 due to 3 day history of worsening dyspnea, myalgias.In ER, patient was noted to be tachycardic 108, hypertensive 183/81, afebrile and with normal oxygenation.  Labs were all unremarkable including D-dimer and proBNP.  Chest x-ray was clear of any infiltrates.  She tested positive for COVID-19.  Patient however appeared to be in respiratory distress, significant inspiratory/expiratory wheezing.  Patient was giving breathing treatment and IV Solu-Medrol and subsequently admitted to hospitalist service for further management.    Patient stayed in hospital for approximately 2 days.   Patient was provided with supportive care, breathing treatment.  She was continued on prednisone 40 mg daily. She was given total of 3 doses of IV remdesivir which she tolerated well with liver function, kidney function monitored.  Patient remained on room air during this hospital stay.  Patient's breathing much improved that she was discharged home stable.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Renal function test, Respiratory distress, SARS-CoV-2 test positive, Tachycardia, Wheezing
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 9/26/2022 Discharge Date: Sep 28, 2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Reactive airway disease without complication, unspecified asthma severity, unspecified whether persistent COVID-19 virus infection   HOSPITAL COURSE: 51-year-old female with PMH significant for history of goiter and Hashimoto's thyroiditis (status post total thyroidectomy), subsequent hypoparathyroidism/hypothyroidism and seasonal allergies (no history of asthma or COPD) (even though uses p.r.n. albuterol an occasional steroid tapers for bronchospasm) presented to the hospital on 9/26 due to 3 day history of worsening dyspnea, myalgias.In ER, patient was noted to be tachycardic 108, hypertensive 183/81, afebrile and with normal oxygenation.  Labs were all unremarkable including D-dimer and proBNP.  Chest x-ray was clear of any infiltrates.  She tested positive for COVID-19.  Patient however appeared to be in respiratory distress, significant inspiratory/expiratory wheezing.  Patient was giving breathing treatment and IV Solu-Medrol and subsequently admitted to hospitalist service for further management.    Patient stayed in hospital for approximately 2 days.   Patient was provided with supportive care, breathing treatment.  She was continued on prednisone 40 mg daily. She was given total of 3 doses of IV remdesivir which she tolerated well with liver function, kidney function monitored.  Patient remained on room air during this hospital stay.  Patient's breathing much improved that she was discharged home stable.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Patient received monovalent when they were supposed to get bivalent, no adverse reaction noted.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received monovalent instead of bivalent.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Aspiration pleural cavity, COVID-19, Cardiac failure acute, Chronic obstructive pulmonary disease
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 9/23/2022 Discharge Date: 10/3/2022   PRESENTING PROBLEM: Pleural effusion  Hypoxia  Acute respiratory failure with hypoxia (HCC)  Hypotension, unspecified hypotension type  Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type COVID-19    HOSPITAL COURSE:   Patient is a 76 y.o. male with PMH of coronary artery disease, chronic AFib, COPD, chronic systolic heart failure, ischemic cardiomyopathy, CABG. recurrent right pleural effusions who presented on 9/23 with shortness of breath. A few days before admission he noticed that with exertion he was more winded than usual. He thought he had allergies because he had rhinorrhea, coughing, increased sputum, congestion with no fevers. He usually wears 2L at night, but started needing oxygen during the day as well. COVID test was positive. During admission, he was treated for acute hypoxic respiratory failure secondary to COVID, COPD exacerbation, right pleural effusion, and acute on chronic heart failure. His symptoms dramatically improved with IV diuresis, decadron, remdesivir. Thoracentesis with performed, showing exudative fluid.  Additionally, the patient was seen by the wound care team regarding lower extremity wounds. ABI was abnormal. Vascular saw the patient and recommended compression stockings with outpatient follow up.    Pt diuresed well throughout his hospital stay, with his oxygen needs returning to baseline. The pt has a new estimated dry weight of 97.5 kg. The pt was previously on Warfarin for a-fib. Consideration was given to transitioning to Eliquis, for which the patient was agreeable. After discussion with pulmonology, who is planning to perform a thoracoscopy on 10/5, the pt was instructed to start this after the procedure. Will hold all anticoagulation per pulmonary recommendations (no warfarin, Eliquis, or ASA) until post procedure. The pt's torsemide was decreased from 20mg BID to 20mg once daily as he continued to have diuresis on day of discharge. His potassium was decreased to once daily. His home losartan was also decreased to 12.5 mg daily, and was continued for the cardioprotective remodeling benefits.    Pt discharged to SAR on 10/3 in stable condition.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Dyspnoea, Dyspnoea exertional, Gastrointestinal haemorrhage
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 9/23/2022 Discharge Date: 10/3/2022   PRESENTING PROBLEM: Pleural effusion  Hypoxia  Acute respiratory failure with hypoxia (HCC)  Hypotension, unspecified hypotension type  Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type COVID-19    HOSPITAL COURSE:   Patient is a 76 y.o. male with PMH of coronary artery disease, chronic AFib, COPD, chronic systolic heart failure, ischemic cardiomyopathy, CABG. recurrent right pleural effusions who presented on 9/23 with shortness of breath. A few days before admission he noticed that with exertion he was more winded than usual. He thought he had allergies because he had rhinorrhea, coughing, increased sputum, congestion with no fevers. He usually wears 2L at night, but started needing oxygen during the day as well. COVID test was positive. During admission, he was treated for acute hypoxic respiratory failure secondary to COVID, COPD exacerbation, right pleural effusion, and acute on chronic heart failure. His symptoms dramatically improved with IV diuresis, decadron, remdesivir. Thoracentesis with performed, showing exudative fluid.  Additionally, the patient was seen by the wound care team regarding lower extremity wounds. ABI was abnormal. Vascular saw the patient and recommended compression stockings with outpatient follow up.    Pt diuresed well throughout his hospital stay, with his oxygen needs returning to baseline. The pt has a new estimated dry weight of 97.5 kg. The pt was previously on Warfarin for a-fib. Consideration was given to transitioning to Eliquis, for which the patient was agreeable. After discussion with pulmonology, who is planning to perform a thoracoscopy on 10/5, the pt was instructed to start this after the procedure. Will hold all anticoagulation per pulmonary recommendations (no warfarin, Eliquis, or ASA) until post procedure. The pt's torsemide was decreased from 20mg BID to 20mg once daily as he continued to have diuresis on day of discharge. His potassium was decreased to once daily. His home losartan was also decreased to 12.5 mg daily, and was continued for the cardioprotective remodeling benefits.    Pt discharged to SAR on 10/3 in stable condition.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Hypotension, Laboratory test abnormal, Pleural effusion, Polyuria, Respiratory tract congestion
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 9/23/2022 Discharge Date: 10/3/2022   PRESENTING PROBLEM: Pleural effusion  Hypoxia  Acute respiratory failure with hypoxia (HCC)  Hypotension, unspecified hypotension type  Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type COVID-19    HOSPITAL COURSE:   Patient is a 76 y.o. male with PMH of coronary artery disease, chronic AFib, COPD, chronic systolic heart failure, ischemic cardiomyopathy, CABG. recurrent right pleural effusions who presented on 9/23 with shortness of breath. A few days before admission he noticed that with exertion he was more winded than usual. He thought he had allergies because he had rhinorrhea, coughing, increased sputum, congestion with no fevers. He usually wears 2L at night, but started needing oxygen during the day as well. COVID test was positive. During admission, he was treated for acute hypoxic respiratory failure secondary to COVID, COPD exacerbation, right pleural effusion, and acute on chronic heart failure. His symptoms dramatically improved with IV diuresis, decadron, remdesivir. Thoracentesis with performed, showing exudative fluid.  Additionally, the patient was seen by the wound care team regarding lower extremity wounds. ABI was abnormal. Vascular saw the patient and recommended compression stockings with outpatient follow up.    Pt diuresed well throughout his hospital stay, with his oxygen needs returning to baseline. The pt has a new estimated dry weight of 97.5 kg. The pt was previously on Warfarin for a-fib. Consideration was given to transitioning to Eliquis, for which the patient was agreeable. After discussion with pulmonology, who is planning to perform a thoracoscopy on 10/5, the pt was instructed to start this after the procedure. Will hold all anticoagulation per pulmonary recommendations (no warfarin, Eliquis, or ASA) until post procedure. The pt's torsemide was decreased from 20mg BID to 20mg once daily as he continued to have diuresis on day of discharge. His potassium was decreased to once daily. His home losartan was also decreased to 12.5 mg daily, and was continued for the cardioprotective remodeling benefits.    Pt discharged to SAR on 10/3 in stable condition.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive, Sputum increased
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 9/23/2022 Discharge Date: 10/3/2022   PRESENTING PROBLEM: Pleural effusion  Hypoxia  Acute respiratory failure with hypoxia (HCC)  Hypotension, unspecified hypotension type  Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type COVID-19    HOSPITAL COURSE:   Patient is a 76 y.o. male with PMH of coronary artery disease, chronic AFib, COPD, chronic systolic heart failure, ischemic cardiomyopathy, CABG. recurrent right pleural effusions who presented on 9/23 with shortness of breath. A few days before admission he noticed that with exertion he was more winded than usual. He thought he had allergies because he had rhinorrhea, coughing, increased sputum, congestion with no fevers. He usually wears 2L at night, but started needing oxygen during the day as well. COVID test was positive. During admission, he was treated for acute hypoxic respiratory failure secondary to COVID, COPD exacerbation, right pleural effusion, and acute on chronic heart failure. His symptoms dramatically improved with IV diuresis, decadron, remdesivir. Thoracentesis with performed, showing exudative fluid.  Additionally, the patient was seen by the wound care team regarding lower extremity wounds. ABI was abnormal. Vascular saw the patient and recommended compression stockings with outpatient follow up.    Pt diuresed well throughout his hospital stay, with his oxygen needs returning to baseline. The pt has a new estimated dry weight of 97.5 kg. The pt was previously on Warfarin for a-fib. Consideration was given to transitioning to Eliquis, for which the patient was agreeable. After discussion with pulmonology, who is planning to perform a thoracoscopy on 10/5, the pt was instructed to start this after the procedure. Will hold all anticoagulation per pulmonary recommendations (no warfarin, Eliquis, or ASA) until post procedure. The pt's torsemide was decreased from 20mg BID to 20mg once daily as he continued to have diuresis on day of discharge. His potassium was decreased to once daily. His home losartan was also decreased to 12.5 mg daily, and was continued for the cardioprotective remodeling benefits.    Pt discharged to SAR on 10/3 in stable condition.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Death, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: patient tested +  7/5/22 for covid and expired on 7/15-22 .  was admitted 7-12 with dyspnea and weakness.
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine had expired on 09/30/2022, child experienced no adverse effects from vaccine
Age: 65.0
Sex: F
Vaccine: TDAP
Symptoms: Arthralgia, Joint injury, Joint range of motion decreased, Pain
Clinical narrative: within one hour of administration, severe burning pain developed from shoulder to elbow, then progressed down to wrist. Pain persisted and shoulder movement became restricted.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Aspiration pleural cavity, Blood culture negative, COVID-19, Chest pain
Clinical narrative: Discharge Provider: DO Primary Care Provider : DO  Admission Date: 9/23/2022 Discharge Date: 09/30/2022  PRESENTING PROBLEM: Bilateral pneumonia   HOSPITAL COURSE: The patient is a 70-year-old female with a history of diabetes mellitus type 2, essential hypertension, dyslipidemia, GERD with moderate hiatal hernia, who presented with chest pain on 09/23.  Patient reports that she did have COVID pneumonia in August of 2022. Patient did have a cough and shortness of breath at that time which resolved.  Patient subsequently had developed urinary retention, and had been diagnosed with a urinary tract infection and began Macrobid as an outpatient on 09/20.  The patient noted improvement in her ability to void, but noted left-sided chest pain, under her left breast, worse with deep inspiration, and also radiating to her left shoulder.  Because of her symptoms she came to the emergency room.  CT scan of the chest showed no evidence of PE but did show evidence of left lower lobe pneumonia and moderate loculated effusion on the left side.  The patient was also noted again to be positive for COVID.  It was felt the patient likely had secondary bacterial community-acquired pneumonia, possibly leading to parapneumonic effusion versus empyema.  The patient was started on Rocephin and azithromycin.  With antibiotics the patient's leukocytosis improved.  Blood cultures obtained at the time of admission showed no growth. IR was consulted for thoracentesis which was performed on 9/26/22, showing transudative pleural effusion. Pulm consulted recommended IR consult for possible pleural drain. IR repeated CT chest that showed very small pleural effusion and IR did not recommend pleural drain. Pulm recommended completion of 3 weeks of antibiotics total with Augmentin, also recommended repeat CXR in two weeks with PCP.     As mentioned previously, the patient had noted dysuria and had been diagnosed with a urinary tract infections an outpatient.  Urine culture grew pansensitive E coli.  Macrobid was discontinued at the time of admission.  The patient was treated with Rocephin for pneumonia, also covering any urinary pathogens, with patient being asymptomatic during her hospital stay.   Patient was also noted to have a 1.3 cm right kidney lesion on CT scan of the abdomen pelvis.  This was solid, being suspicious for renal cell carcinoma.  Urology consulted, Given its small size recommended that she follow up with Urology as outpatient, with patient previously seeing Dr.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Condition aggravated, Cough, Dyspnoea, Empyema
Clinical narrative: Discharge Provider: DO Primary Care Provider : DO  Admission Date: 9/23/2022 Discharge Date: 09/30/2022  PRESENTING PROBLEM: Bilateral pneumonia   HOSPITAL COURSE: The patient is a 70-year-old female with a history of diabetes mellitus type 2, essential hypertension, dyslipidemia, GERD with moderate hiatal hernia, who presented with chest pain on 09/23.  Patient reports that she did have COVID pneumonia in August of 2022. Patient did have a cough and shortness of breath at that time which resolved.  Patient subsequently had developed urinary retention, and had been diagnosed with a urinary tract infection and began Macrobid as an outpatient on 09/20.  The patient noted improvement in her ability to void, but noted left-sided chest pain, under her left breast, worse with deep inspiration, and also radiating to her left shoulder.  Because of her symptoms she came to the emergency room.  CT scan of the chest showed no evidence of PE but did show evidence of left lower lobe pneumonia and moderate loculated effusion on the left side.  The patient was also noted again to be positive for COVID.  It was felt the patient likely had secondary bacterial community-acquired pneumonia, possibly leading to parapneumonic effusion versus empyema.  The patient was started on Rocephin and azithromycin.  With antibiotics the patient's leukocytosis improved.  Blood cultures obtained at the time of admission showed no growth. IR was consulted for thoracentesis which was performed on 9/26/22, showing transudative pleural effusion. Pulm consulted recommended IR consult for possible pleural drain. IR repeated CT chest that showed very small pleural effusion and IR did not recommend pleural drain. Pulm recommended completion of 3 weeks of antibiotics total with Augmentin, also recommended repeat CXR in two weeks with PCP.     As mentioned previously, the patient had noted dysuria and had been diagnosed with a urinary tract infections an outpatient.  Urine culture grew pansensitive E coli.  Macrobid was discontinued at the time of admission.  The patient was treated with Rocephin for pneumonia, also covering any urinary pathogens, with patient being asymptomatic during her hospital stay.   Patient was also noted to have a 1.3 cm right kidney lesion on CT scan of the abdomen pelvis.  This was solid, being suspicious for renal cell carcinoma.  Urology consulted, Given its small size recommended that she follow up with Urology as outpatient, with patient previously seeing Dr.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Infectious pleural effusion, Leukocytosis, Pain, Pleural effusion, Pneumonia
Clinical narrative: Discharge Provider: DO Primary Care Provider : DO  Admission Date: 9/23/2022 Discharge Date: 09/30/2022  PRESENTING PROBLEM: Bilateral pneumonia   HOSPITAL COURSE: The patient is a 70-year-old female with a history of diabetes mellitus type 2, essential hypertension, dyslipidemia, GERD with moderate hiatal hernia, who presented with chest pain on 09/23.  Patient reports that she did have COVID pneumonia in August of 2022. Patient did have a cough and shortness of breath at that time which resolved.  Patient subsequently had developed urinary retention, and had been diagnosed with a urinary tract infection and began Macrobid as an outpatient on 09/20.  The patient noted improvement in her ability to void, but noted left-sided chest pain, under her left breast, worse with deep inspiration, and also radiating to her left shoulder.  Because of her symptoms she came to the emergency room.  CT scan of the chest showed no evidence of PE but did show evidence of left lower lobe pneumonia and moderate loculated effusion on the left side.  The patient was also noted again to be positive for COVID.  It was felt the patient likely had secondary bacterial community-acquired pneumonia, possibly leading to parapneumonic effusion versus empyema.  The patient was started on Rocephin and azithromycin.  With antibiotics the patient's leukocytosis improved.  Blood cultures obtained at the time of admission showed no growth. IR was consulted for thoracentesis which was performed on 9/26/22, showing transudative pleural effusion. Pulm consulted recommended IR consult for possible pleural drain. IR repeated CT chest that showed very small pleural effusion and IR did not recommend pleural drain. Pulm recommended completion of 3 weeks of antibiotics total with Augmentin, also recommended repeat CXR in two weeks with PCP.     As mentioned previously, the patient had noted dysuria and had been diagnosed with a urinary tract infections an outpatient.  Urine culture grew pansensitive E coli.  Macrobid was discontinued at the time of admission.  The patient was treated with Rocephin for pneumonia, also covering any urinary pathogens, with patient being asymptomatic during her hospital stay.   Patient was also noted to have a 1.3 cm right kidney lesion on CT scan of the abdomen pelvis.  This was solid, being suspicious for renal cell carcinoma.  Urology consulted, Given its small size recommended that she follow up with Urology as outpatient, with patient previously seeing Dr.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonia bacterial, SARS-CoV-2 test positive, Urinary retention, Urinary tract infection
Clinical narrative: Discharge Provider: DO Primary Care Provider : DO  Admission Date: 9/23/2022 Discharge Date: 09/30/2022  PRESENTING PROBLEM: Bilateral pneumonia   HOSPITAL COURSE: The patient is a 70-year-old female with a history of diabetes mellitus type 2, essential hypertension, dyslipidemia, GERD with moderate hiatal hernia, who presented with chest pain on 09/23.  Patient reports that she did have COVID pneumonia in August of 2022. Patient did have a cough and shortness of breath at that time which resolved.  Patient subsequently had developed urinary retention, and had been diagnosed with a urinary tract infection and began Macrobid as an outpatient on 09/20.  The patient noted improvement in her ability to void, but noted left-sided chest pain, under her left breast, worse with deep inspiration, and also radiating to her left shoulder.  Because of her symptoms she came to the emergency room.  CT scan of the chest showed no evidence of PE but did show evidence of left lower lobe pneumonia and moderate loculated effusion on the left side.  The patient was also noted again to be positive for COVID.  It was felt the patient likely had secondary bacterial community-acquired pneumonia, possibly leading to parapneumonic effusion versus empyema.  The patient was started on Rocephin and azithromycin.  With antibiotics the patient's leukocytosis improved.  Blood cultures obtained at the time of admission showed no growth. IR was consulted for thoracentesis which was performed on 9/26/22, showing transudative pleural effusion. Pulm consulted recommended IR consult for possible pleural drain. IR repeated CT chest that showed very small pleural effusion and IR did not recommend pleural drain. Pulm recommended completion of 3 weeks of antibiotics total with Augmentin, also recommended repeat CXR in two weeks with PCP.     As mentioned previously, the patient had noted dysuria and had been diagnosed with a urinary tract infections an outpatient.  Urine culture grew pansensitive E coli.  Macrobid was discontinued at the time of admission.  The patient was treated with Rocephin for pneumonia, also covering any urinary pathogens, with patient being asymptomatic during her hospital stay.   Patient was also noted to have a 1.3 cm right kidney lesion on CT scan of the abdomen pelvis.  This was solid, being suspicious for renal cell carcinoma.  Urology consulted, Given its small size recommended that she follow up with Urology as outpatient, with patient previously seeing Dr.
Age: 17.0
Sex: M
Vaccine: HPV9
Symptoms: Extra dose administered, No adverse event, Vaccination error
Clinical narrative: Patient was administered a fourth dose of HPV9 by mistake. No adverse reaction was reported.
Age: 7.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine had expired on 09/30/2022, vaccine was given to child today, no adverse events experienced by child
Age: 46.0
Sex: M
Vaccine: COVID19-2
Symptoms: Computerised tomogram head normal, Electrocardiogram normal, Laboratory test normal, Magnetic resonance imaging head, Seizure
Clinical narrative: had new onset seizure 24 hours after administration of Moderna Bivalent booster at pharmacy.  Seen at ER and had negative work up including CT head, EKG, labs.   Seen at PCP office in follow up and being sent for evaluation with neurologist, further labs, and MRI brain.
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Confusional state, Hypotension, Lethargy
Clinical narrative: On 10/1 at 12:17pm, Dr. was made aware that the resident appeared with and with confusion. Resident alert and able to respond. BS 100. Orders were received to Hold Humalog Insulin at 12pm, B/P 90/50,5 0,97.2, 18,Spo2 96%. Orders also received to give Midodrine 5mg for hypotension . At 1:53 PM Dr. ordered to transfer resident to local hospital ER  for Hypotension, lethargy via 911 for further evaluation. Resident was  lethargic, but responsive to verbal and tactile stimuli. BP=90/50, pulse=50, SPO2=94 on 2 liters.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood sodium decreased, COVID-19, Dyspnoea, Hyperkalaemia
Clinical narrative: Discharge Provider:  DO Primary Care Provider: MD Admission Date: 9/23/2022 Discharge Date: 9/28/2022 PRESENTING PROBLEM: Hyperkalemia [E87.5] Hyponatremia [E87.1] Difficulty breathing [R06.89] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 73 years old male with history of squamous cell cancer of epiglottis status post total laryngectomy and partial pharyngectomy and bilateral neck dissection with cricophyargeal myotomy, hypothyroidism, chronic bronchitis on 2L oxygen at home, On salt tabs who presented to the hospital with weakness and shortness of breath with URI symptoms. He was found to have covid infection and severe hyponatremia, Na 120. He was treated with antibiotics, steroid and breathing treatment. He was back to baseline on home oxygen at discharge. He was evaluated by PT, and OT, recommended for home with home health services. This was changed to subacute as PT and OT agreed with patient that he was too weak to be discharge home. He was discharged on salt tabs three times per day.