chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: F
Vaccine: RSV
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Patient was 58 years old former cancer patient; This non-serious case was reported by a pharmacist via sales rep and described the occurrence of off label use in unapproved age group in a 58-year-old female patient who received RSVPreF3 adjuvanted (Arexvy) for prophylaxis.   The patient's past medical history included cancer.   On an unknown date, the patient received the 1st dose of Arexvy. On an unknown date, an unknown time after receiving Arexvy, the patient experienced off label use in unapproved age group (Verbatim: Patient was 58 years old former cancer patient). The outcome of the off label use in unapproved age group was unknown.   Additional Information: GSK Receipt Date: 05-MAR-2024 The patient recieved 1 dose of Arexvy.  The patient was a former cancer patient, the provider chose to prescribe due to risk factor which led to off label use in unapproved age group
Age: 2.0
Sex: M
Vaccine: TDAP
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: 2 year old male patient was supposed to receive Infanrix vaccine, but instead was administered Boostrix; supposed to receive Infanrix vaccine, but instead was administered Boostrix; 2 year old male patient administered Boostrix; This non-serious case was reported by a nurse via call center representative and described the occurrence of underdose in a 2-year-old male patient who received DTPa (Reduced antigen) (Boostrix) (batch number DD7F7, expiry date 06-DEC-2025) for prophylaxis.   Previously administered products included DTaP  vaccine (received 1st dose on an unknown date), DTaP vaccine (received 2nd dose on an unknown date) and DTaP vaccine (received 3rd dose on an unknown date).   On 06-MAR-2024, the patient received Boostrix. On 06-MAR-2024, an unknown time after receiving Boostrix, the patient experienced underdose (Verbatim: 2 year old male patient was supposed to receive Infanrix vaccine, but instead was administered Boostrix), wrong vaccine administered (Verbatim: supposed to receive Infanrix vaccine, but instead was administered Boostrix) and inappropriate age at vaccine administration (Verbatim: 2 year old male patient administered Boostrix). The outcome of the underdose, wrong vaccine administered and inappropriate age at vaccine administration were unknown.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK Receipt Date: 06-MAR-2024.  Nurse reported that 2 year old male patient was supposed to receive Infanrix vaccine, but instead was administered Boostrix which led to underdose, wrong vaccine administered and inappropriate age at vaccine administration. The vaccine administration facility was the same as primary reporter.
Age: 9.0
Sex: M
Vaccine: DTAPIPV
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: administration of Kinrix to a 7 y/o and 9 y/o; administration of Kinrix instead of Boostrix; This non-serious case was reported by a other health professional via call center representative and described the occurrence of inappropriate age at vaccine administration in a 9-year-old male patient who received DTPa-IPV (Kinrix) (batch number T343J, expiry date 25-JAN-2025) for prophylaxis.   On 29-FEB-2024, the patient received Kinrix. On 29-FEB-2024, an unknown time after receiving Kinrix, the patient experienced inappropriate age at vaccine administration (Verbatim: administration of Kinrix to a 7 y/o and 9 y/o) and wrong vaccine administered (Verbatim: administration of Kinrix instead of Boostrix). The outcome of the inappropriate age at vaccine administration and wrong vaccine administered were unknown.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK Receipt Date: 06-MAR-2024 The healthcare professional reported that administration of Kinrix to a 9-year-old patient instead of Boostrix which led to inappropriate age at vaccine administration and wrong vaccine administered. The healthcare professional did not need data, had already consulted with the CDC (Centers for Disease Control and Prevention) for guidance. No medical information data needed, just wanted to report adverse event as per healthcare professional adverse event reported to VAERS as well. The reporter consented to follow up. This case had been linked with US2024029875, reported by same reporter.; Sender's Comments:  US-GSK-US2024029875:SAME PRODUCT/ DIFFERENT PATIENT
Sex: M
Vaccine: VARZOS
Symptoms: Inappropriate schedule of product administration
Clinical narrative: but did not receive the second dose after the 2 to 6 months; This non-serious case was reported by a other health professional via call center representative and described the occurrence of incomplete course of vaccination in a 56-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis.   Previously administered products included Shingrix (received 1st dose on 30-JUN-2023).   On an unknown date, the patient did not receive the 2nd dose of Shingrix. On an unknown date, an unknown time after receiving Shingrix, the patient experienced incomplete course of vaccination (Verbatim: but did not receive the second dose after the 2 to 6 months). The outcome of the incomplete course of vaccination was unknown.   Additional Information: GSK Receipt Date: 06-MAR-2024.  A medical assistant called in to report that the patient did not receive the second dose after the 2 to 6 months.  The reporter asked for information but declined follow-up, the patient also only gave partial information about the event. The vaccine administration facility was the same as primary reporter. Till the time of reporting, the patient did not receive second dose of Shingrix, which led to incomplete course of vaccination.
Age: 17.0
Sex: M
Vaccine: MNQ
Symptoms: Expired product administered
Clinical narrative: a patient was inadvertently administered an expired dose; This non-serious case was reported by a other health professional via call center representative and described the occurrence of expired vaccine used in a 17-year-old male patient who received Men ACWY-CRM NVS (Menveo) (batch number AMAA770A, expiry date 31-JAN-2024) and (batch number AMXA770A, expiry date FEB-2025) for prophylaxis.   On 21-FEB-2024, the patient received Menveo. On 21-FEB-2024, an unknown time after receiving Menveo, the patient experienced expired vaccine used (Verbatim: a patient was inadvertently administered an expired dose). The outcome of the expired vaccine used was unknown.   Additional Information: GSK Receipt Date: 07-MAR-2024 Certified medical assistant called to inquire about was the dose valid. The certified medical assistant reported that patient was inadvertently administered an expired dose which led to expired vaccine used of the 2 vial presentation of Menveo powder expiration on 31-jan-2024 and diluent expiration on feb-2025.
Age: 1.25
Sex: M
Vaccine: FLU4
Symptoms: Extra dose administered, No adverse event
Clinical narrative: NO REACTION - EXTRA VACCINE GIVEN
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea
Clinical narrative: Reported Symptoms: 10013963:DYSPNEA; Narrative: Other Relevant HX: Other: DYSPNEA
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, COVID-19, Chronic obstructive pulmonary disease, Condition aggravated, Cough
Clinical narrative: Reported Symptoms:  10054112:HOSPITALISATION; 10084268:COVID-19;  Narrative: 76 yo male patient, with PMH significant for COPD, Home O2 at 2L, HTN, and HLD presented to ED on 07/20/2022 with progressive cough, shortness of breath and N/V. Acute hypoxic respiratory failure, COPD, exacerbation and COVID 19 positive on 07/20/2022. Admitted to hospital for further evaluation and treatment. Pt received remdesivir (07/20-07/23) and dexamethasone (07/21-07/25). Pt symptoms improved and discharged to home on 7/25/2022. Other Relevant HX: 76 yo male pt, wiht PMH significant for COPD, Home O2 at 2L, HTN, and HLD. Other: COVID 19 Infection w/ hospitalization
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Dyspnoea, Nausea, SARS-CoV-2 test positive, Vomiting
Clinical narrative: Reported Symptoms:  10054112:HOSPITALISATION; 10084268:COVID-19;  Narrative: 76 yo male patient, with PMH significant for COPD, Home O2 at 2L, HTN, and HLD presented to ED on 07/20/2022 with progressive cough, shortness of breath and N/V. Acute hypoxic respiratory failure, COPD, exacerbation and COVID 19 positive on 07/20/2022. Admitted to hospital for further evaluation and treatment. Pt received remdesivir (07/20-07/23) and dexamethasone (07/21-07/25). Pt symptoms improved and discharged to home on 7/25/2022. Other Relevant HX: 76 yo male pt, wiht PMH significant for COPD, Home O2 at 2L, HTN, and HLD. Other: COVID 19 Infection w/ hospitalization
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Dehydration, Diarrhoea, Nausea, SARS-CoV-2 test positive
Clinical narrative: Reported Symptoms: 10054112:HOPSITALISATION; 10084268:COVID-19; Narrative: 63 yo male patient w/ PMH for obesity, HTN, gout and chronic sinusitis presented to ED on 08/29/2022 with nausea and diarrhea that began the day before. Patient COVID 19 positive and admitted to hospital for further evaluation and treatment. Patient given fluids for dehydration and treated for diarrhea. Supportive care given for COVID 19. Patient symptoms improved and discharged to home on 09/01/2022. Other Relevant HX: 63 yo male patient w/ PMH for obesity, HTN, gout and chronic sinusitis. Other: COVID infection w/hospitalization
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Atelectasis, COVID-19, Computerised tomogram thorax abnormal, Cough, Diarrhoea
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 77 yo male patient w/ PMH for HTN, HLD, obesity, T2DM, AFIB, LVEF ~45-50% (TTE:07/08/2021), and gout. Pt presented to ED on 08/17/22 with c/o 3 days duration cough, shortness of breath and fever temp of 99.8 and tested COVID positive with home kit on 08/14/2022. Pt reported 1 day of loose stool and vomiting and has subsided prior to ED visit. Pt reported severe body aches and fatigue and pain on his right flank area. Patient noted SOB especially upon exertion. Pt admitted and started on remdesivir (8/17-8/21) and dexamethasone (8/18 for 10 days to be completed at home). Pt continued to improve through the admission though still was intermittently hypoxic. CT chest was not consistent with COVID pneumonitis but did show areas of atelectasis. Patient qualified for home oxygen and this was provided. Pt discharged to home on 08/22/22 on home O2 to complete steroid course. Other Relevant HX: 77 yo male patient w/ PMH for hypertension, hyperlipidemia, chronic obesity, type 2 diabetes mellitus non-insulin requiring, atrial fibrillation/prior history of PE on LTAC with apixaban, LVEF ~45-50% (TTE:07/08/2021), and gout. Other: COVID Infection w/ hospitalization
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Dyspnoea exertional, Echocardiogram, Ejection fraction decreased, Fatigue
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 77 yo male patient w/ PMH for HTN, HLD, obesity, T2DM, AFIB, LVEF ~45-50% (TTE:07/08/2021), and gout. Pt presented to ED on 08/17/22 with c/o 3 days duration cough, shortness of breath and fever temp of 99.8 and tested COVID positive with home kit on 08/14/2022. Pt reported 1 day of loose stool and vomiting and has subsided prior to ED visit. Pt reported severe body aches and fatigue and pain on his right flank area. Patient noted SOB especially upon exertion. Pt admitted and started on remdesivir (8/17-8/21) and dexamethasone (8/18 for 10 days to be completed at home). Pt continued to improve through the admission though still was intermittently hypoxic. CT chest was not consistent with COVID pneumonitis but did show areas of atelectasis. Patient qualified for home oxygen and this was provided. Pt discharged to home on 08/22/22 on home O2 to complete steroid course. Other Relevant HX: 77 yo male patient w/ PMH for hypertension, hyperlipidemia, chronic obesity, type 2 diabetes mellitus non-insulin requiring, atrial fibrillation/prior history of PE on LTAC with apixaban, LVEF ~45-50% (TTE:07/08/2021), and gout. Other: COVID Infection w/ hospitalization
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Flank pain, Gout, Hypoxia, Pain, SARS-CoV-2 test positive
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 77 yo male patient w/ PMH for HTN, HLD, obesity, T2DM, AFIB, LVEF ~45-50% (TTE:07/08/2021), and gout. Pt presented to ED on 08/17/22 with c/o 3 days duration cough, shortness of breath and fever temp of 99.8 and tested COVID positive with home kit on 08/14/2022. Pt reported 1 day of loose stool and vomiting and has subsided prior to ED visit. Pt reported severe body aches and fatigue and pain on his right flank area. Patient noted SOB especially upon exertion. Pt admitted and started on remdesivir (8/17-8/21) and dexamethasone (8/18 for 10 days to be completed at home). Pt continued to improve through the admission though still was intermittently hypoxic. CT chest was not consistent with COVID pneumonitis but did show areas of atelectasis. Patient qualified for home oxygen and this was provided. Pt discharged to home on 08/22/22 on home O2 to complete steroid course. Other Relevant HX: 77 yo male patient w/ PMH for hypertension, hyperlipidemia, chronic obesity, type 2 diabetes mellitus non-insulin requiring, atrial fibrillation/prior history of PE on LTAC with apixaban, LVEF ~45-50% (TTE:07/08/2021), and gout. Other: COVID Infection w/ hospitalization
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 77 yo male patient w/ PMH for HTN, HLD, obesity, T2DM, AFIB, LVEF ~45-50% (TTE:07/08/2021), and gout. Pt presented to ED on 08/17/22 with c/o 3 days duration cough, shortness of breath and fever temp of 99.8 and tested COVID positive with home kit on 08/14/2022. Pt reported 1 day of loose stool and vomiting and has subsided prior to ED visit. Pt reported severe body aches and fatigue and pain on his right flank area. Patient noted SOB especially upon exertion. Pt admitted and started on remdesivir (8/17-8/21) and dexamethasone (8/18 for 10 days to be completed at home). Pt continued to improve through the admission though still was intermittently hypoxic. CT chest was not consistent with COVID pneumonitis but did show areas of atelectasis. Patient qualified for home oxygen and this was provided. Pt discharged to home on 08/22/22 on home O2 to complete steroid course. Other Relevant HX: 77 yo male patient w/ PMH for hypertension, hyperlipidemia, chronic obesity, type 2 diabetes mellitus non-insulin requiring, atrial fibrillation/prior history of PE on LTAC with apixaban, LVEF ~45-50% (TTE:07/08/2021), and gout. Other: COVID Infection w/ hospitalization
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Asthenia, COVID-19, Dyspnoea, Fatigue
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 72 yo male patient w/ PMH for HTN, HLD, giant cell arteritis, VTE/PE on eliquis, HFrEF, CAD s/p stent in 2018, Valley fever (on fluconazole) and hx of prostate ca s/p prostatectomy. Patient presented to ED on 8/31/22 with c/o weakness, fatigue, N/V, and shortness of breath x1 day. Pt was admitted for further evaluation and started on Remdesivir (8/31-9/1)for COVID-19 and was given IVF for AKI. On 9/1, patient symptoms had improved, his kidney function improved with IVF and pts labs and vital were unremarkable. On 9/2, pt kidney function had improved back to baseline and pts vital were stable. Pt discharged to home on 9/2. Other Relevant HX: 72 yo male patient w/ PMH for HTN, HLD, giant cell arteritis, VTE/PE on eliquis, HFrEF, CAD s/p stent in 2018, Valley fever (on fluconazole), and hx of prostate ca s/p prostatectomy. Other: COVID Infection w/ hospitalization
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Nausea, Renal impairment, SARS-CoV-2 test positive, Vomiting
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 72 yo male patient w/ PMH for HTN, HLD, giant cell arteritis, VTE/PE on eliquis, HFrEF, CAD s/p stent in 2018, Valley fever (on fluconazole) and hx of prostate ca s/p prostatectomy. Patient presented to ED on 8/31/22 with c/o weakness, fatigue, N/V, and shortness of breath x1 day. Pt was admitted for further evaluation and started on Remdesivir (8/31-9/1)for COVID-19 and was given IVF for AKI. On 9/1, patient symptoms had improved, his kidney function improved with IVF and pts labs and vital were unremarkable. On 9/2, pt kidney function had improved back to baseline and pts vital were stable. Pt discharged to home on 9/2. Other Relevant HX: 72 yo male patient w/ PMH for HTN, HLD, giant cell arteritis, VTE/PE on eliquis, HFrEF, CAD s/p stent in 2018, Valley fever (on fluconazole), and hx of prostate ca s/p prostatectomy. Other: COVID Infection w/ hospitalization
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arrhythmia, COVID-19, COVID-19 pneumonia, Cough, Dyspnoea
Clinical narrative: Reported Symptoms: 10033556:PALPITATION: 10038678:RESPIRATORY DEPRESSION; 10040047:SEPSIS; 10084380:COVID-19 PNEUMONIA; Narrative: The patient received two doses of Pfizer COVID 19 Vaccine Nov 21 and Feb 22. The patient had severe respiratory failure, sepsis, arrhythmia, and COVID pneumonia on 2 Sep 2022. The patient was hospitalized on 2 September 2022 with COVID 19 and treated. The patient was discharged on 14 September 2022. The patient was still symptomatic on 14 Dec 22. The patient presented to the ED on 14 December 2022 with cough, shortness of breath, sore throat, and sinus pressure. The patient was still positive for COVID 19 and was admitted to the hospital with COVID 19 and treated with supportive care. Reported per EUA. Other Relevant HX: Other: Sepsis, COVID 19 pneumonia
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Oropharyngeal pain, Palpitations, Paranasal sinus discomfort, Respiratory depression, Respiratory failure
Clinical narrative: Reported Symptoms: 10033556:PALPITATION: 10038678:RESPIRATORY DEPRESSION; 10040047:SEPSIS; 10084380:COVID-19 PNEUMONIA; Narrative: The patient received two doses of Pfizer COVID 19 Vaccine Nov 21 and Feb 22. The patient had severe respiratory failure, sepsis, arrhythmia, and COVID pneumonia on 2 Sep 2022. The patient was hospitalized on 2 September 2022 with COVID 19 and treated. The patient was discharged on 14 September 2022. The patient was still symptomatic on 14 Dec 22. The patient presented to the ED on 14 December 2022 with cough, shortness of breath, sore throat, and sinus pressure. The patient was still positive for COVID 19 and was admitted to the hospital with COVID 19 and treated with supportive care. Reported per EUA. Other Relevant HX: Other: Sepsis, COVID 19 pneumonia
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Sepsis
Clinical narrative: Reported Symptoms: 10033556:PALPITATION: 10038678:RESPIRATORY DEPRESSION; 10040047:SEPSIS; 10084380:COVID-19 PNEUMONIA; Narrative: The patient received two doses of Pfizer COVID 19 Vaccine Nov 21 and Feb 22. The patient had severe respiratory failure, sepsis, arrhythmia, and COVID pneumonia on 2 Sep 2022. The patient was hospitalized on 2 September 2022 with COVID 19 and treated. The patient was discharged on 14 September 2022. The patient was still symptomatic on 14 Dec 22. The patient presented to the ED on 14 December 2022 with cough, shortness of breath, sore throat, and sinus pressure. The patient was still positive for COVID 19 and was admitted to the hospital with COVID 19 and treated with supportive care. Reported per EUA. Other Relevant HX: Other: Sepsis, COVID 19 pneumonia
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Aortic arteriosclerosis, Arrhythmia, Asthenia, Atrial flutter
Clinical narrative: Reported Symptoms: 10064112:HOSPITALISATION; 10084268:COVID-19; Narrative: 75 yo male patient with PMH significant for DM, HLD, HTN, CVA, CKD, Vitamin D deficiency and macular degeneration with recent covid infection dating to August 19th treated with OTC meds. Pt presented to ED on 9/7/22 with worsening fatigue, generalized weakness, cough, shortness of breath. Admitted to hospital w/ COVID, hypoxia and symptomatic bradycardia for further evaluation and treatment. COVID positive with suspicious underlying pneumonia given his recent history of Covid pneumonia. Patient was initially on oxygen for his acute hypoxic respiratory failure and successfully transitioned off. Pt treated with dexamethasone (9/7-9/11) for COVID infection. Pt treated with ceftriaxone (9/7-9/8), cefdinir (9/9-9/12) and azithromycin (9/7-9/11) for a suspected community-acquired pneumonia sitting on top of his recent COVID infection. Pt evaluated for new onset atrial flutter which was secondary to underlying disease process but presented as a bradycardia arrhythmia. Cardiology was consulted due to concern for anticoagulation and pacemaker placement, at that time did not recommend pacemaker placement but was subsequently diagnosed with diastolic heart failure and started on low-dose diuretic. Patient discharged to home on 9/11/22. Other Relevant HX: 75 yo male patient with PMH significant for DM, HLD, HTN, CVA, Vitamin D deficiency and macular degeneration Other: COVID Infection w/ hospitalization
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Bradycardia, COVID-19, Cardiomegaly, Chest X-ray abnormal, Cough
Clinical narrative: Reported Symptoms: 10064112:HOSPITALISATION; 10084268:COVID-19; Narrative: 75 yo male patient with PMH significant for DM, HLD, HTN, CVA, CKD, Vitamin D deficiency and macular degeneration with recent covid infection dating to August 19th treated with OTC meds. Pt presented to ED on 9/7/22 with worsening fatigue, generalized weakness, cough, shortness of breath. Admitted to hospital w/ COVID, hypoxia and symptomatic bradycardia for further evaluation and treatment. COVID positive with suspicious underlying pneumonia given his recent history of Covid pneumonia. Patient was initially on oxygen for his acute hypoxic respiratory failure and successfully transitioned off. Pt treated with dexamethasone (9/7-9/11) for COVID infection. Pt treated with ceftriaxone (9/7-9/8), cefdinir (9/9-9/12) and azithromycin (9/7-9/11) for a suspected community-acquired pneumonia sitting on top of his recent COVID infection. Pt evaluated for new onset atrial flutter which was secondary to underlying disease process but presented as a bradycardia arrhythmia. Cardiology was consulted due to concern for anticoagulation and pacemaker placement, at that time did not recommend pacemaker placement but was subsequently diagnosed with diastolic heart failure and started on low-dose diuretic. Patient discharged to home on 9/11/22. Other Relevant HX: 75 yo male patient with PMH significant for DM, HLD, HTN, CVA, Vitamin D deficiency and macular degeneration Other: COVID Infection w/ hospitalization
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Diuretic therapy, Dyspnoea, Fatigue, Hypoxia, Left ventricular failure
Clinical narrative: Reported Symptoms: 10064112:HOSPITALISATION; 10084268:COVID-19; Narrative: 75 yo male patient with PMH significant for DM, HLD, HTN, CVA, CKD, Vitamin D deficiency and macular degeneration with recent covid infection dating to August 19th treated with OTC meds. Pt presented to ED on 9/7/22 with worsening fatigue, generalized weakness, cough, shortness of breath. Admitted to hospital w/ COVID, hypoxia and symptomatic bradycardia for further evaluation and treatment. COVID positive with suspicious underlying pneumonia given his recent history of Covid pneumonia. Patient was initially on oxygen for his acute hypoxic respiratory failure and successfully transitioned off. Pt treated with dexamethasone (9/7-9/11) for COVID infection. Pt treated with ceftriaxone (9/7-9/8), cefdinir (9/9-9/12) and azithromycin (9/7-9/11) for a suspected community-acquired pneumonia sitting on top of his recent COVID infection. Pt evaluated for new onset atrial flutter which was secondary to underlying disease process but presented as a bradycardia arrhythmia. Cardiology was consulted due to concern for anticoagulation and pacemaker placement, at that time did not recommend pacemaker placement but was subsequently diagnosed with diastolic heart failure and started on low-dose diuretic. Patient discharged to home on 9/11/22. Other Relevant HX: 75 yo male patient with PMH significant for DM, HLD, HTN, CVA, Vitamin D deficiency and macular degeneration Other: COVID Infection w/ hospitalization
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Lung infiltration, Pneumonia, SARS-CoV-2 test positive
Clinical narrative: Reported Symptoms: 10064112:HOSPITALISATION; 10084268:COVID-19; Narrative: 75 yo male patient with PMH significant for DM, HLD, HTN, CVA, CKD, Vitamin D deficiency and macular degeneration with recent covid infection dating to August 19th treated with OTC meds. Pt presented to ED on 9/7/22 with worsening fatigue, generalized weakness, cough, shortness of breath. Admitted to hospital w/ COVID, hypoxia and symptomatic bradycardia for further evaluation and treatment. COVID positive with suspicious underlying pneumonia given his recent history of Covid pneumonia. Patient was initially on oxygen for his acute hypoxic respiratory failure and successfully transitioned off. Pt treated with dexamethasone (9/7-9/11) for COVID infection. Pt treated with ceftriaxone (9/7-9/8), cefdinir (9/9-9/12) and azithromycin (9/7-9/11) for a suspected community-acquired pneumonia sitting on top of his recent COVID infection. Pt evaluated for new onset atrial flutter which was secondary to underlying disease process but presented as a bradycardia arrhythmia. Cardiology was consulted due to concern for anticoagulation and pacemaker placement, at that time did not recommend pacemaker placement but was subsequently diagnosed with diastolic heart failure and started on low-dose diuretic. Patient discharged to home on 9/11/22. Other Relevant HX: 75 yo male patient with PMH significant for DM, HLD, HTN, CVA, Vitamin D deficiency and macular degeneration Other: COVID Infection w/ hospitalization
Age: 72.0
Sex: M
Vaccine: COVID19-2, PNC20
Symptoms: Blood creatinine normal, Blood potassium normal, Blood sodium normal, Cerebral small vessel ischaemic disease, Cerebrovascular accident
Clinical narrative: Reported Symptoms: 10010300:CONFUSION; 10041853:SLURRED SPEECH; 10042244:STROKE; Narrative: 72 YO M presented with stroke-like symptoms/slurred speech via Emergency Department notes on 9/15/2022. Denies HA, dizziness, vision changes, N/V/D, or urinary symptoms. Symptom onset at either 0400 or 1900 per pt/wife, presented at 1900. BP 141/62. Hx of processing MS and was noted to have a fever of 102. Code stroke was called on arrival. This was potentially attributed to receiving COVID booster and pneumococcal vaccine on 9/14/2022. CT brain without bleed or acute process, notable for findings of chronic small vessel disease. MRI showed no acute cerebral infarction, no intracranial hemorrhage, and no suspicious focal enhancing mass or mass affect. Denies sx occurring previously. Pt was discharged on 9/15/22 after pt resumed his normal speech/appearance and encouraged to f/u with neurologist and PCP. Per 10/13/22 messaging note, wife reported taking pt to outside ER after being discharged from facility since he continued to have lower extremity weakness and his speech was still unclear, pt was discharged from facility since he continued to have lower extremity weakness and his speech was still unclear, pt was discharged to LTC. As of November 14, 2022, pt was discharged from LTC. Per 1/6/2023 appt, noted no definite dx was made after event and neurologic sx resolved after rx with IV steroids. Other Relevant HX: PMH: neurogenic bladder, multiple sclerosis (secondary progressive, on DMT 06/2022-11/2022; previously followed by outside clinic and now f/u by neurology), OSA on CPAP, falls, overactive bladder, osteoporosis Allergies: None Other: Slurred Speech; Not fully diagnosed but potential stroke
Age: 72.0
Sex: M
Vaccine: COVID19-2, PNC20
Symptoms: Computerised tomogram head abnormal, Confusional state, Dysarthria, Glomerular filtration rate normal, Haemoglobin normal
Clinical narrative: Reported Symptoms: 10010300:CONFUSION; 10041853:SLURRED SPEECH; 10042244:STROKE; Narrative: 72 YO M presented with stroke-like symptoms/slurred speech via Emergency Department notes on 9/15/2022. Denies HA, dizziness, vision changes, N/V/D, or urinary symptoms. Symptom onset at either 0400 or 1900 per pt/wife, presented at 1900. BP 141/62. Hx of processing MS and was noted to have a fever of 102. Code stroke was called on arrival. This was potentially attributed to receiving COVID booster and pneumococcal vaccine on 9/14/2022. CT brain without bleed or acute process, notable for findings of chronic small vessel disease. MRI showed no acute cerebral infarction, no intracranial hemorrhage, and no suspicious focal enhancing mass or mass affect. Denies sx occurring previously. Pt was discharged on 9/15/22 after pt resumed his normal speech/appearance and encouraged to f/u with neurologist and PCP. Per 10/13/22 messaging note, wife reported taking pt to outside ER after being discharged from facility since he continued to have lower extremity weakness and his speech was still unclear, pt was discharged from facility since he continued to have lower extremity weakness and his speech was still unclear, pt was discharged to LTC. As of November 14, 2022, pt was discharged from LTC. Per 1/6/2023 appt, noted no definite dx was made after event and neurologic sx resolved after rx with IV steroids. Other Relevant HX: PMH: neurogenic bladder, multiple sclerosis (secondary progressive, on DMT 06/2022-11/2022; previously followed by outside clinic and now f/u by neurology), OSA on CPAP, falls, overactive bladder, osteoporosis Allergies: None Other: Slurred Speech; Not fully diagnosed but potential stroke
Age: 72.0
Sex: M
Vaccine: COVID19-2, PNC20
Symptoms: International normalised ratio normal, Magnetic resonance imaging head normal, Muscular weakness, Neurological symptom, Pyrexia
Clinical narrative: Reported Symptoms: 10010300:CONFUSION; 10041853:SLURRED SPEECH; 10042244:STROKE; Narrative: 72 YO M presented with stroke-like symptoms/slurred speech via Emergency Department notes on 9/15/2022. Denies HA, dizziness, vision changes, N/V/D, or urinary symptoms. Symptom onset at either 0400 or 1900 per pt/wife, presented at 1900. BP 141/62. Hx of processing MS and was noted to have a fever of 102. Code stroke was called on arrival. This was potentially attributed to receiving COVID booster and pneumococcal vaccine on 9/14/2022. CT brain without bleed or acute process, notable for findings of chronic small vessel disease. MRI showed no acute cerebral infarction, no intracranial hemorrhage, and no suspicious focal enhancing mass or mass affect. Denies sx occurring previously. Pt was discharged on 9/15/22 after pt resumed his normal speech/appearance and encouraged to f/u with neurologist and PCP. Per 10/13/22 messaging note, wife reported taking pt to outside ER after being discharged from facility since he continued to have lower extremity weakness and his speech was still unclear, pt was discharged from facility since he continued to have lower extremity weakness and his speech was still unclear, pt was discharged to LTC. As of November 14, 2022, pt was discharged from LTC. Per 1/6/2023 appt, noted no definite dx was made after event and neurologic sx resolved after rx with IV steroids. Other Relevant HX: PMH: neurogenic bladder, multiple sclerosis (secondary progressive, on DMT 06/2022-11/2022; previously followed by outside clinic and now f/u by neurology), OSA on CPAP, falls, overactive bladder, osteoporosis Allergies: None Other: Slurred Speech; Not fully diagnosed but potential stroke
Age: 72.0
Sex: M
Vaccine: COVID19-2, PNC20
Symptoms: SARS-CoV-2 test negative, White blood cell count normal
Clinical narrative: Reported Symptoms: 10010300:CONFUSION; 10041853:SLURRED SPEECH; 10042244:STROKE; Narrative: 72 YO M presented with stroke-like symptoms/slurred speech via Emergency Department notes on 9/15/2022. Denies HA, dizziness, vision changes, N/V/D, or urinary symptoms. Symptom onset at either 0400 or 1900 per pt/wife, presented at 1900. BP 141/62. Hx of processing MS and was noted to have a fever of 102. Code stroke was called on arrival. This was potentially attributed to receiving COVID booster and pneumococcal vaccine on 9/14/2022. CT brain without bleed or acute process, notable for findings of chronic small vessel disease. MRI showed no acute cerebral infarction, no intracranial hemorrhage, and no suspicious focal enhancing mass or mass affect. Denies sx occurring previously. Pt was discharged on 9/15/22 after pt resumed his normal speech/appearance and encouraged to f/u with neurologist and PCP. Per 10/13/22 messaging note, wife reported taking pt to outside ER after being discharged from facility since he continued to have lower extremity weakness and his speech was still unclear, pt was discharged from facility since he continued to have lower extremity weakness and his speech was still unclear, pt was discharged to LTC. As of November 14, 2022, pt was discharged from LTC. Per 1/6/2023 appt, noted no definite dx was made after event and neurologic sx resolved after rx with IV steroids. Other Relevant HX: PMH: neurogenic bladder, multiple sclerosis (secondary progressive, on DMT 06/2022-11/2022; previously followed by outside clinic and now f/u by neurology), OSA on CPAP, falls, overactive bladder, osteoporosis Allergies: None Other: Slurred Speech; Not fully diagnosed but potential stroke
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Atrial fibrillation, Atrial flutter, COVID-19, Chills, Condition aggravated
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 83 yo male patient with PMH for HTN, HLD, Afib, T2DM, hypothyroid, CHF, Bladder Cancer s/p TURBT 07/19, pulmonary nodules dx on CT thorax on 05/19 presented to ED on 07/26/22 with c/o fatigue, intermittent fevers, chills, urinary incontinence and SOB. Pt COVID 19 positive, hypoxemia and elevated troponin. Admitted to hospital for further evaluation and treatment. Patient received dexamethasone (7/27-8/1) in addition to supportive medications. Elevated troponin I likely secondary to demand ischemia, history of recurring troponin leaks in setting of valvopathy and CAD, afib / flutter. Pt symptoms improved and discharged to SNF on 08/05/22. Other Relevant HX: 83 yo male patient with PMH for HTN, HLD, Afib, T2DM, hypothyroid, CHF, Bladder Cancer s/p TURBT 07/19, pulmonary nodules dx on CT thorax on 05/19. Other: COVID Infection w/ hospitalization
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Coronary artery disease, Dyspnoea, Fatigue, Hypoxia, Myocardial ischaemia
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 83 yo male patient with PMH for HTN, HLD, Afib, T2DM, hypothyroid, CHF, Bladder Cancer s/p TURBT 07/19, pulmonary nodules dx on CT thorax on 05/19 presented to ED on 07/26/22 with c/o fatigue, intermittent fevers, chills, urinary incontinence and SOB. Pt COVID 19 positive, hypoxemia and elevated troponin. Admitted to hospital for further evaluation and treatment. Patient received dexamethasone (7/27-8/1) in addition to supportive medications. Elevated troponin I likely secondary to demand ischemia, history of recurring troponin leaks in setting of valvopathy and CAD, afib / flutter. Pt symptoms improved and discharged to SNF on 08/05/22. Other Relevant HX: 83 yo male patient with PMH for HTN, HLD, Afib, T2DM, hypothyroid, CHF, Bladder Cancer s/p TURBT 07/19, pulmonary nodules dx on CT thorax on 05/19. Other: COVID Infection w/ hospitalization
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Troponin increased, Urinary incontinence
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 83 yo male patient with PMH for HTN, HLD, Afib, T2DM, hypothyroid, CHF, Bladder Cancer s/p TURBT 07/19, pulmonary nodules dx on CT thorax on 05/19 presented to ED on 07/26/22 with c/o fatigue, intermittent fevers, chills, urinary incontinence and SOB. Pt COVID 19 positive, hypoxemia and elevated troponin. Admitted to hospital for further evaluation and treatment. Patient received dexamethasone (7/27-8/1) in addition to supportive medications. Elevated troponin I likely secondary to demand ischemia, history of recurring troponin leaks in setting of valvopathy and CAD, afib / flutter. Pt symptoms improved and discharged to SNF on 08/05/22. Other Relevant HX: 83 yo male patient with PMH for HTN, HLD, Afib, T2DM, hypothyroid, CHF, Bladder Cancer s/p TURBT 07/19, pulmonary nodules dx on CT thorax on 05/19. Other: COVID Infection w/ hospitalization
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Arrhythmia, Atrioventricular block second degree, Bradycardia, COVID-19, Chronic obstructive pulmonary disease
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10034268:COVID-19; Narrative: 81 yo male patient w PMH for COPD, HTN, HLD, GERD, IBS, bladder cancer, Asthma, Osteoporosis w/ history of fracture, and psoriatic arthritis presented to ED on 09/10/22 with altered mental status. Pt COVID 19 positive and admitted due to his COPD exacerbation and metabolic encephalopathy due to acute COVID-19 infection. Prednisone (9/11-9/15) and remdesivir (9/11-9/13) given with good effect for COVID infection. Encephalopathy, cough and SOB resolved within a few days. Mobitz type 1 heart block and bradycardia noted and cardiology involved. Metoprolol was stopped with improvement in heart rate. No other significant arrhythmia's were had during this admission and cardiology is recommending a Holter monitor with cardiac follow up in clinic. Patient's other antihypertensive medications were stopped as his blood pressure was well controlled without these. Prior to this admission pt was living in an RV independently though this was not going well for him. Social work arranged placement. Pt discharged to this facility in stable condition on 10/03/22. Other Relevant HX: 81 yo male patient w/ PMH for COPD, HTN, HLD, GERD, IBS, bladder cancer, Asthma, Osteoporosis w/ history of fracture, and psoriatic arthritis. Other: COVD Infection w/ hospitalization
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Condition aggravated, Cough, Dyspnoea, Mental status changes, Metabolic encephalopathy
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10034268:COVID-19; Narrative: 81 yo male patient w PMH for COPD, HTN, HLD, GERD, IBS, bladder cancer, Asthma, Osteoporosis w/ history of fracture, and psoriatic arthritis presented to ED on 09/10/22 with altered mental status. Pt COVID 19 positive and admitted due to his COPD exacerbation and metabolic encephalopathy due to acute COVID-19 infection. Prednisone (9/11-9/15) and remdesivir (9/11-9/13) given with good effect for COVID infection. Encephalopathy, cough and SOB resolved within a few days. Mobitz type 1 heart block and bradycardia noted and cardiology involved. Metoprolol was stopped with improvement in heart rate. No other significant arrhythmia's were had during this admission and cardiology is recommending a Holter monitor with cardiac follow up in clinic. Patient's other antihypertensive medications were stopped as his blood pressure was well controlled without these. Prior to this admission pt was living in an RV independently though this was not going well for him. Social work arranged placement. Pt discharged to this facility in stable condition on 10/03/22. Other Relevant HX: 81 yo male patient w/ PMH for COPD, HTN, HLD, GERD, IBS, bladder cancer, Asthma, Osteoporosis w/ history of fracture, and psoriatic arthritis. Other: COVD Infection w/ hospitalization
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10034268:COVID-19; Narrative: 81 yo male patient w PMH for COPD, HTN, HLD, GERD, IBS, bladder cancer, Asthma, Osteoporosis w/ history of fracture, and psoriatic arthritis presented to ED on 09/10/22 with altered mental status. Pt COVID 19 positive and admitted due to his COPD exacerbation and metabolic encephalopathy due to acute COVID-19 infection. Prednisone (9/11-9/15) and remdesivir (9/11-9/13) given with good effect for COVID infection. Encephalopathy, cough and SOB resolved within a few days. Mobitz type 1 heart block and bradycardia noted and cardiology involved. Metoprolol was stopped with improvement in heart rate. No other significant arrhythmia's were had during this admission and cardiology is recommending a Holter monitor with cardiac follow up in clinic. Patient's other antihypertensive medications were stopped as his blood pressure was well controlled without these. Prior to this admission pt was living in an RV independently though this was not going well for him. Social work arranged placement. Pt discharged to this facility in stable condition on 10/03/22. Other Relevant HX: 81 yo male patient w/ PMH for COPD, HTN, HLD, GERD, IBS, bladder cancer, Asthma, Osteoporosis w/ history of fracture, and psoriatic arthritis. Other: COVD Infection w/ hospitalization
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Cough, Homicidal ideation, Hypoxia, Intensive care
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 72 yo male patient with PMH for depression, PTSD, alcohol use, chronic pain on suboxone who presented to ED on 09/03/22 for suicidal and homicidal thoughts and was medically cleared for inpatient psychiatric admission. On 09/12/2022 patient had a code stroke and upgraded to MICU where he was worked up and Dx with TIA. Pt transferred back to psych unit on 09/14/2022 and on 9/16/2022 pt COVID positive with symptoms of mild grade fever, nasal congestion and cough and transferred to COVID unit. Pt w/ COVID infection and non-sustained hypoxia. Pt at high risk for disease progression and treated with Remdesivir (9/16-9/20) and dexamethasone (9/17-9/20). Pt received remaining 7 days of 10 day dexamethasone course to be completed at home. Pt improved and discharged to home 09/20/22. Other Relevant HX: 72 yo male patient with PMH for depression, PTSD, alcohol use, chronic pain on suboxone. Other: COVID Infection w/ hospitalization
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Nasal congestion, Pyrexia, SARS-CoV-2 test positive, Suicidal ideation, Transient ischaemic attack
Clinical narrative: Reported Symptoms: 10054112:HOSPITALISATION; 10084268:COVID-19; Narrative: 72 yo male patient with PMH for depression, PTSD, alcohol use, chronic pain on suboxone who presented to ED on 09/03/22 for suicidal and homicidal thoughts and was medically cleared for inpatient psychiatric admission. On 09/12/2022 patient had a code stroke and upgraded to MICU where he was worked up and Dx with TIA. Pt transferred back to psych unit on 09/14/2022 and on 9/16/2022 pt COVID positive with symptoms of mild grade fever, nasal congestion and cough and transferred to COVID unit. Pt w/ COVID infection and non-sustained hypoxia. Pt at high risk for disease progression and treated with Remdesivir (9/16-9/20) and dexamethasone (9/17-9/20). Pt received remaining 7 days of 10 day dexamethasone course to be completed at home. Pt improved and discharged to home 09/20/22. Other Relevant HX: 72 yo male patient with PMH for depression, PTSD, alcohol use, chronic pain on suboxone. Other: COVID Infection w/ hospitalization
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated
Clinical narrative: Reported Symptoms:  10054112:HOSPITALISATION; 10084268;COVID-19;  Narrative: 69 yo male patient w/ PMH for severe COPD and allergic rhinitis presented to ED on 09/12/22 w/ c/o dyspnea and worsening cough. Pt on 2L nasal cannula at baseline now requiring 4L. Pt COVID positive and found to have COVID pneumonia and COPD exacerbation. Pt given remdesivir (9/12-9/15), dexamethasone (9/12-9/17), azithromycin (9/13-9/16) and ceftriaxone (9/14-9/17). Pt improved and discharged home on 09/18 in stable condition. Other Relevant HX: 69 yo male patient w/ PMH for severe COPD and allergic rhinitis. Other: COVID Infection w/ hospitalization
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cough, Dyspnoea, Emphysema, Lung consolidation, Pulmonary mass
Clinical narrative: Reported Symptoms:  10054112:HOSPITALISATION; 10084268;COVID-19;  Narrative: 69 yo male patient w/ PMH for severe COPD and allergic rhinitis presented to ED on 09/12/22 w/ c/o dyspnea and worsening cough. Pt on 2L nasal cannula at baseline now requiring 4L. Pt COVID positive and found to have COVID pneumonia and COPD exacerbation. Pt given remdesivir (9/12-9/15), dexamethasone (9/12-9/17), azithromycin (9/13-9/16) and ceftriaxone (9/14-9/17). Pt improved and discharged home on 09/18 in stable condition. Other Relevant HX: 69 yo male patient w/ PMH for severe COPD and allergic rhinitis. Other: COVID Infection w/ hospitalization
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Reported Symptoms:  10054112:HOSPITALISATION; 10084268;COVID-19;  Narrative: 69 yo male patient w/ PMH for severe COPD and allergic rhinitis presented to ED on 09/12/22 w/ c/o dyspnea and worsening cough. Pt on 2L nasal cannula at baseline now requiring 4L. Pt COVID positive and found to have COVID pneumonia and COPD exacerbation. Pt given remdesivir (9/12-9/15), dexamethasone (9/12-9/17), azithromycin (9/13-9/16) and ceftriaxone (9/14-9/17). Pt improved and discharged home on 09/18 in stable condition. Other Relevant HX: 69 yo male patient w/ PMH for severe COPD and allergic rhinitis. Other: COVID Infection w/ hospitalization
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Computerised tomogram head normal, Dizziness, Gait disturbance, Headache
Clinical narrative: Reported Symptoms: 10013573:DIZZINESS;  10019211:HEADACHE; 10020772:HYPERTENSION;   Narrative: 10/26/22:  This is a 43-year-old male who presents the emergency department via private vehicle ambulatory.  Patient reports that he was at this facility as he is an employee here and began to have some dizziness.  He describes the dizziness as lightheadedness.  States he checked his blood pressure and it was high.  States the patient continued to have symptoms and so came to the emergency department for further evaluation.  Also complains of a headache associated  with this. States the headache is left-sided and frontal.  Patient admitted.  Chest x-ray and CT head  were unremarkable.  Discharged 10/27:discharge diagnosis: headache and abnormal gait  12/20/22: primary care walk-in visit: Patient presents to clinic today for unscheduled visit to discuss his current health status.  Patient is employee here. On 26 Oct 22 while on his shift he began feeling dizzy and co HA. He was seen in ER and had head CT to  rule out CVA. Was scheduled next day for MRI.  The MRI did show some abnormality  of pituitary and fu MRI w/contrast recommended in 4 mths.  However, patient  scheduled MRA on 10 Nov which was noncontributory and brain MRI w/wo on 15 Nov.  Study did show a possible 2-3mm pituitary microadenoma.  As noted patient has aldo seen a neurologist, endocrinologist, and ENT.  Also Internal Med.  Today patient is accompanied by spouse who is also employee here. They are requesting information on the status of a neruorlogy consult here which was  apparently