chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 65.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Acute respiratory failure, Blood gases abnormal, Blood pH decreased, COVID-19, Chest X-ray normal
Clinical narrative: Discharge Provider:  Primary Care Provider:  MD Admission Date: 3/28/2023 Discharge Date: Apr 5, 2023  PRESENTING PROBLEM: Acute respiratory failure (HCC)  Hypoxia  COVID-19  Acute respiratory failure with hypoxia and hypercapnia (HCC)    HOSPITAL COURSE: DETAILS OF HOSPITAL STAY:   HOSPITAL COURSE: Patient is a 65-year-old male with history of paroxysmal atrial fibrillation, peripheral arterial disease, hyperlipidemia, chronic pain, depression and COPD who presented with 1 week history of increasing shortness of breath, cough, sputum production.  Due to increasing shortness of breath, he called EMS.  EMS found him to have oxygen saturation of 60% on room air, and placed him on a non-rebreather mask.  He was given DuoNebs, albuterol and IV Solu-Medrol en route.  Upon arrival to the emergency department, he was tachycardic in transition to BiPAP therapy with FiO2 of 0.80.  He had an initial venous blood gas with a pCO2 of 72 and a pH of 7.22.  Labs showed a WBC count of 12.1.  Chest x-ray was unremarkable.  He was continued on DuoNeb therapy in the emergency department, as well as BiPAP therapy, and admitted to the hospitalist service to the intensive care unit.   Upon admission, the patient was continued on BiPAP therapy, IV Solu-Medrol and scheduled DuoNebs.  He was started on remdesivir.  Within 24 hours, he was able to be weaned off of BiPAP during the day, and placed on 3 L of oxygen via nasal cannula.  After 48 hours, he was able to be transferred out of the intensive care unit.  He continued to require BiPAP therapy at night, and was noted to have increasing WBC count and purulent sputum production on 3/31.  He was empirically started on IV cefepime and oral doxycycline for suspected superimposed bacterial pneumonia.  Sputum culture was collected, and remained without growth.  He was seen by Physical and Occupational therapy, who recommended inpatient rehabilitation facility, however subsequent evaluations were consistent with home with assist.   Patient had to moved back to intensive care unit least respiratory distress needing BiPAP pulmonary was involved.  Pulmonary rehab was consulted for arrangement of home BiPAP and this was able to be authorized and arranged.  Patient gradually improved on supportive treatment with antibiotics, steroid taper and bronchodilators and was able to be transitioned off the general floor.    When steroid induced hyperglycemia, patient was given 10 days of metformin.  He will finish 7 day course of antibiotics, Ceftin and doxycycline was given
Age: 65.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Cough, Dyspnoea, Hyperglycaemia, Hypoxia, Intensive care
Clinical narrative: Discharge Provider:  Primary Care Provider:  MD Admission Date: 3/28/2023 Discharge Date: Apr 5, 2023  PRESENTING PROBLEM: Acute respiratory failure (HCC)  Hypoxia  COVID-19  Acute respiratory failure with hypoxia and hypercapnia (HCC)    HOSPITAL COURSE: DETAILS OF HOSPITAL STAY:   HOSPITAL COURSE: Patient is a 65-year-old male with history of paroxysmal atrial fibrillation, peripheral arterial disease, hyperlipidemia, chronic pain, depression and COPD who presented with 1 week history of increasing shortness of breath, cough, sputum production.  Due to increasing shortness of breath, he called EMS.  EMS found him to have oxygen saturation of 60% on room air, and placed him on a non-rebreather mask.  He was given DuoNebs, albuterol and IV Solu-Medrol en route.  Upon arrival to the emergency department, he was tachycardic in transition to BiPAP therapy with FiO2 of 0.80.  He had an initial venous blood gas with a pCO2 of 72 and a pH of 7.22.  Labs showed a WBC count of 12.1.  Chest x-ray was unremarkable.  He was continued on DuoNeb therapy in the emergency department, as well as BiPAP therapy, and admitted to the hospitalist service to the intensive care unit.   Upon admission, the patient was continued on BiPAP therapy, IV Solu-Medrol and scheduled DuoNebs.  He was started on remdesivir.  Within 24 hours, he was able to be weaned off of BiPAP during the day, and placed on 3 L of oxygen via nasal cannula.  After 48 hours, he was able to be transferred out of the intensive care unit.  He continued to require BiPAP therapy at night, and was noted to have increasing WBC count and purulent sputum production on 3/31.  He was empirically started on IV cefepime and oral doxycycline for suspected superimposed bacterial pneumonia.  Sputum culture was collected, and remained without growth.  He was seen by Physical and Occupational therapy, who recommended inpatient rehabilitation facility, however subsequent evaluations were consistent with home with assist.   Patient had to moved back to intensive care unit least respiratory distress needing BiPAP pulmonary was involved.  Pulmonary rehab was consulted for arrangement of home BiPAP and this was able to be authorized and arranged.  Patient gradually improved on supportive treatment with antibiotics, steroid taper and bronchodilators and was able to be transitioned off the general floor.    When steroid induced hyperglycemia, patient was given 10 days of metformin.  He will finish 7 day course of antibiotics, Ceftin and doxycycline was given
Age: 65.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: PCO2 increased, Pneumonia bacterial, Positive airway pressure therapy, Productive cough, Respiratory failure
Clinical narrative: Discharge Provider:  Primary Care Provider:  MD Admission Date: 3/28/2023 Discharge Date: Apr 5, 2023  PRESENTING PROBLEM: Acute respiratory failure (HCC)  Hypoxia  COVID-19  Acute respiratory failure with hypoxia and hypercapnia (HCC)    HOSPITAL COURSE: DETAILS OF HOSPITAL STAY:   HOSPITAL COURSE: Patient is a 65-year-old male with history of paroxysmal atrial fibrillation, peripheral arterial disease, hyperlipidemia, chronic pain, depression and COPD who presented with 1 week history of increasing shortness of breath, cough, sputum production.  Due to increasing shortness of breath, he called EMS.  EMS found him to have oxygen saturation of 60% on room air, and placed him on a non-rebreather mask.  He was given DuoNebs, albuterol and IV Solu-Medrol en route.  Upon arrival to the emergency department, he was tachycardic in transition to BiPAP therapy with FiO2 of 0.80.  He had an initial venous blood gas with a pCO2 of 72 and a pH of 7.22.  Labs showed a WBC count of 12.1.  Chest x-ray was unremarkable.  He was continued on DuoNeb therapy in the emergency department, as well as BiPAP therapy, and admitted to the hospitalist service to the intensive care unit.   Upon admission, the patient was continued on BiPAP therapy, IV Solu-Medrol and scheduled DuoNebs.  He was started on remdesivir.  Within 24 hours, he was able to be weaned off of BiPAP during the day, and placed on 3 L of oxygen via nasal cannula.  After 48 hours, he was able to be transferred out of the intensive care unit.  He continued to require BiPAP therapy at night, and was noted to have increasing WBC count and purulent sputum production on 3/31.  He was empirically started on IV cefepime and oral doxycycline for suspected superimposed bacterial pneumonia.  Sputum culture was collected, and remained without growth.  He was seen by Physical and Occupational therapy, who recommended inpatient rehabilitation facility, however subsequent evaluations were consistent with home with assist.   Patient had to moved back to intensive care unit least respiratory distress needing BiPAP pulmonary was involved.  Pulmonary rehab was consulted for arrangement of home BiPAP and this was able to be authorized and arranged.  Patient gradually improved on supportive treatment with antibiotics, steroid taper and bronchodilators and was able to be transitioned off the general floor.    When steroid induced hyperglycemia, patient was given 10 days of metformin.  He will finish 7 day course of antibiotics, Ceftin and doxycycline was given
Age: 65.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Sputum culture, Sputum purulent, Superinfection, Tachycardia, White blood cell count increased
Clinical narrative: Discharge Provider:  Primary Care Provider:  MD Admission Date: 3/28/2023 Discharge Date: Apr 5, 2023  PRESENTING PROBLEM: Acute respiratory failure (HCC)  Hypoxia  COVID-19  Acute respiratory failure with hypoxia and hypercapnia (HCC)    HOSPITAL COURSE: DETAILS OF HOSPITAL STAY:   HOSPITAL COURSE: Patient is a 65-year-old male with history of paroxysmal atrial fibrillation, peripheral arterial disease, hyperlipidemia, chronic pain, depression and COPD who presented with 1 week history of increasing shortness of breath, cough, sputum production.  Due to increasing shortness of breath, he called EMS.  EMS found him to have oxygen saturation of 60% on room air, and placed him on a non-rebreather mask.  He was given DuoNebs, albuterol and IV Solu-Medrol en route.  Upon arrival to the emergency department, he was tachycardic in transition to BiPAP therapy with FiO2 of 0.80.  He had an initial venous blood gas with a pCO2 of 72 and a pH of 7.22.  Labs showed a WBC count of 12.1.  Chest x-ray was unremarkable.  He was continued on DuoNeb therapy in the emergency department, as well as BiPAP therapy, and admitted to the hospitalist service to the intensive care unit.   Upon admission, the patient was continued on BiPAP therapy, IV Solu-Medrol and scheduled DuoNebs.  He was started on remdesivir.  Within 24 hours, he was able to be weaned off of BiPAP during the day, and placed on 3 L of oxygen via nasal cannula.  After 48 hours, he was able to be transferred out of the intensive care unit.  He continued to require BiPAP therapy at night, and was noted to have increasing WBC count and purulent sputum production on 3/31.  He was empirically started on IV cefepime and oral doxycycline for suspected superimposed bacterial pneumonia.  Sputum culture was collected, and remained without growth.  He was seen by Physical and Occupational therapy, who recommended inpatient rehabilitation facility, however subsequent evaluations were consistent with home with assist.   Patient had to moved back to intensive care unit least respiratory distress needing BiPAP pulmonary was involved.  Pulmonary rehab was consulted for arrangement of home BiPAP and this was able to be authorized and arranged.  Patient gradually improved on supportive treatment with antibiotics, steroid taper and bronchodilators and was able to be transitioned off the general floor.    When steroid induced hyperglycemia, patient was given 10 days of metformin.  He will finish 7 day course of antibiotics, Ceftin and doxycycline was given
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Given wrong formulation
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Epilepsy
Clinical narrative: EPILEPSY, UNSPECIFIED
Age: 1.5
Sex: F
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Given wrong formulation (monovalent)
Age: 68.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Aphonia, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Gait inability
Clinical narrative: I had a deep cough that caused me to lose my voice, it would be so bad that I could not even walk across the room. This lasted for three weeks. I was unable to even get out of bed to do my normal activities. Once I got into my doctor into my doctor, she said it was too late to test for COVID-19, RSV, Influenza. I was given a prescription for an inhaler and was told that my COPD had come back.
Age: 68.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Loss of personal independence in daily activities, Mobility decreased
Clinical narrative: I had a deep cough that caused me to lose my voice, it would be so bad that I could not even walk across the room. This lasted for three weeks. I was unable to even get out of bed to do my normal activities. Once I got into my doctor into my doctor, she said it was too late to test for COVID-19, RSV, Influenza. I was given a prescription for an inhaler and was told that my COPD had come back.
Age: 0.67
Sex: F
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Given wrong formulation (monovalent)
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Computerised tomogram abdomen abnormal, Feeling abnormal, Infection, Nausea
Clinical narrative: I had my shot, an one night I wasn't feeling very good and ended up at the hospital and my back was hurting so bad while I was on the stretcher, they put me in wheel chair and something happened and I went home. I saw a DR. later and did a cat scan and saw I had kidney stones. I saw a urologist and I had 3 stones at 3mm in size. I had surgery Oct 2021. I went in for follow up after surgery and they found 3 more of the same size that were blocking my bladder. They wanted to do surgery again 11/26/2021 and I kept getting sick and nauseous and I am still having trouble this year(2023) and its my kidneys again and I went to the DR. and I set up a CAT scan again a month ago and I had one stone in each kidney and one of them was blocking my urethra. I had to do a breathing test to see if I could do surgery and I ended up with an infection and I go again this Friday to see about having surgery to remove the stones.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Nephrolithiasis, Renal surgery, Urethral obstruction, Wheelchair user
Clinical narrative: I had my shot, an one night I wasn't feeling very good and ended up at the hospital and my back was hurting so bad while I was on the stretcher, they put me in wheel chair and something happened and I went home. I saw a DR. later and did a cat scan and saw I had kidney stones. I saw a urologist and I had 3 stones at 3mm in size. I had surgery Oct 2021. I went in for follow up after surgery and they found 3 more of the same size that were blocking my bladder. They wanted to do surgery again 11/26/2021 and I kept getting sick and nauseous and I am still having trouble this year(2023) and its my kidneys again and I went to the DR. and I set up a CAT scan again a month ago and I had one stone in each kidney and one of them was blocking my urethra. I had to do a breathing test to see if I could do surgery and I ended up with an infection and I go again this Friday to see about having surgery to remove the stones.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Obstructive sleep apnoea syndrome, Symptom recurrence
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE  OBSTRUCTIVE SLEEP APNEA  5/30/2022 -- RECURRENCE OF SAME SYMPTOMS
Age: 0.58
Sex: F
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Given wrong formulation (monovalent)
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, COVID-19, Chest X-ray abnormal, Chills, Chronic obstructive pulmonary disease
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 3/29/2023 Discharge Date: 3/31/2023  PRESENTING PROBLEM: Respiratory insufficiency [R06.89] COVID [U07.1] COVID-19 [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE:    The patient is a 60 y.o. female with past medical history of chronic respiratory failure on 3 L oxygen at home, chronic obstructive pulmonary disease exacerbation/emphysema.  Patient recently discharged from other facility after being admitted and intubated due to respiratory failure, right lower lobe pneumonia and chronic obstructive pulmonary disease exacerbation.  Patient was intubated on 2/27, and extubated on 3/7, discharge on 03/11 with home health.   Patient presented to reporting hospital with positive home COVID tests.  Patient woke up in the morning around 3:00 a.m, 3/29. feeling fatigue with significant body aches.  She had significant subjective fevers and chills. Tmax 101 at home. Endorsed mild shortness of breath. Endorsed runny nose.  Endorsed nausea.  Denied vomiting, and abdominal pain, and dysuria.  No diarrhea.  Home oxygen was reported to be 81% on 3 L.    In the emergency department, oxygen is 94% on 2.5 L. Chest x-ray show emphysema no infiltrate.  Complete blood count show WBC of 3, hemoglobin 10. Chemistry panel is unremarkable.  Respiratory viral panel is positive for COVID-19 infection.   Patient was admitted in the hospital for monitoring.  She was placed on breathing treatment, Decadron and azithromycin for possible chronic obstructive pulmonary disease exacerbation.  She was stable on home oxygen therefore there was no indication for remdesivir.  The following day, patient was stable for discharge.  She was discharged on Paxilovid, Decadron, and was recommended for follow-up with primary care doctor.   Placed on gabapentin for chronic back pain.    Patient is discharged in stable condition- all labs and imaging reviewed. No concerns at this time. All questions were answered prior to discharge.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Dyspnoea, Emphysema, Endotracheal intubation, Fatigue
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 3/29/2023 Discharge Date: 3/31/2023  PRESENTING PROBLEM: Respiratory insufficiency [R06.89] COVID [U07.1] COVID-19 [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE:    The patient is a 60 y.o. female with past medical history of chronic respiratory failure on 3 L oxygen at home, chronic obstructive pulmonary disease exacerbation/emphysema.  Patient recently discharged from other facility after being admitted and intubated due to respiratory failure, right lower lobe pneumonia and chronic obstructive pulmonary disease exacerbation.  Patient was intubated on 2/27, and extubated on 3/7, discharge on 03/11 with home health.   Patient presented to reporting hospital with positive home COVID tests.  Patient woke up in the morning around 3:00 a.m, 3/29. feeling fatigue with significant body aches.  She had significant subjective fevers and chills. Tmax 101 at home. Endorsed mild shortness of breath. Endorsed runny nose.  Endorsed nausea.  Denied vomiting, and abdominal pain, and dysuria.  No diarrhea.  Home oxygen was reported to be 81% on 3 L.    In the emergency department, oxygen is 94% on 2.5 L. Chest x-ray show emphysema no infiltrate.  Complete blood count show WBC of 3, hemoglobin 10. Chemistry panel is unremarkable.  Respiratory viral panel is positive for COVID-19 infection.   Patient was admitted in the hospital for monitoring.  She was placed on breathing treatment, Decadron and azithromycin for possible chronic obstructive pulmonary disease exacerbation.  She was stable on home oxygen therefore there was no indication for remdesivir.  The following day, patient was stable for discharge.  She was discharged on Paxilovid, Decadron, and was recommended for follow-up with primary care doctor.   Placed on gabapentin for chronic back pain.    Patient is discharged in stable condition- all labs and imaging reviewed. No concerns at this time. All questions were answered prior to discharge.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Full blood count abnormal, Haemoglobin decreased, Laboratory test normal, Nausea, Pain
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 3/29/2023 Discharge Date: 3/31/2023  PRESENTING PROBLEM: Respiratory insufficiency [R06.89] COVID [U07.1] COVID-19 [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE:    The patient is a 60 y.o. female with past medical history of chronic respiratory failure on 3 L oxygen at home, chronic obstructive pulmonary disease exacerbation/emphysema.  Patient recently discharged from other facility after being admitted and intubated due to respiratory failure, right lower lobe pneumonia and chronic obstructive pulmonary disease exacerbation.  Patient was intubated on 2/27, and extubated on 3/7, discharge on 03/11 with home health.   Patient presented to reporting hospital with positive home COVID tests.  Patient woke up in the morning around 3:00 a.m, 3/29. feeling fatigue with significant body aches.  She had significant subjective fevers and chills. Tmax 101 at home. Endorsed mild shortness of breath. Endorsed runny nose.  Endorsed nausea.  Denied vomiting, and abdominal pain, and dysuria.  No diarrhea.  Home oxygen was reported to be 81% on 3 L.    In the emergency department, oxygen is 94% on 2.5 L. Chest x-ray show emphysema no infiltrate.  Complete blood count show WBC of 3, hemoglobin 10. Chemistry panel is unremarkable.  Respiratory viral panel is positive for COVID-19 infection.   Patient was admitted in the hospital for monitoring.  She was placed on breathing treatment, Decadron and azithromycin for possible chronic obstructive pulmonary disease exacerbation.  She was stable on home oxygen therefore there was no indication for remdesivir.  The following day, patient was stable for discharge.  She was discharged on Paxilovid, Decadron, and was recommended for follow-up with primary care doctor.   Placed on gabapentin for chronic back pain.    Patient is discharged in stable condition- all labs and imaging reviewed. No concerns at this time. All questions were answered prior to discharge.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonia, Pyrexia, Respiratory failure, Respiratory viral panel, Rhinorrhoea
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 3/29/2023 Discharge Date: 3/31/2023  PRESENTING PROBLEM: Respiratory insufficiency [R06.89] COVID [U07.1] COVID-19 [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE:    The patient is a 60 y.o. female with past medical history of chronic respiratory failure on 3 L oxygen at home, chronic obstructive pulmonary disease exacerbation/emphysema.  Patient recently discharged from other facility after being admitted and intubated due to respiratory failure, right lower lobe pneumonia and chronic obstructive pulmonary disease exacerbation.  Patient was intubated on 2/27, and extubated on 3/7, discharge on 03/11 with home health.   Patient presented to reporting hospital with positive home COVID tests.  Patient woke up in the morning around 3:00 a.m, 3/29. feeling fatigue with significant body aches.  She had significant subjective fevers and chills. Tmax 101 at home. Endorsed mild shortness of breath. Endorsed runny nose.  Endorsed nausea.  Denied vomiting, and abdominal pain, and dysuria.  No diarrhea.  Home oxygen was reported to be 81% on 3 L.    In the emergency department, oxygen is 94% on 2.5 L. Chest x-ray show emphysema no infiltrate.  Complete blood count show WBC of 3, hemoglobin 10. Chemistry panel is unremarkable.  Respiratory viral panel is positive for COVID-19 infection.   Patient was admitted in the hospital for monitoring.  She was placed on breathing treatment, Decadron and azithromycin for possible chronic obstructive pulmonary disease exacerbation.  She was stable on home oxygen therefore there was no indication for remdesivir.  The following day, patient was stable for discharge.  She was discharged on Paxilovid, Decadron, and was recommended for follow-up with primary care doctor.   Placed on gabapentin for chronic back pain.    Patient is discharged in stable condition- all labs and imaging reviewed. No concerns at this time. All questions were answered prior to discharge.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, White blood cell count decreased
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 3/29/2023 Discharge Date: 3/31/2023  PRESENTING PROBLEM: Respiratory insufficiency [R06.89] COVID [U07.1] COVID-19 [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE:    The patient is a 60 y.o. female with past medical history of chronic respiratory failure on 3 L oxygen at home, chronic obstructive pulmonary disease exacerbation/emphysema.  Patient recently discharged from other facility after being admitted and intubated due to respiratory failure, right lower lobe pneumonia and chronic obstructive pulmonary disease exacerbation.  Patient was intubated on 2/27, and extubated on 3/7, discharge on 03/11 with home health.   Patient presented to reporting hospital with positive home COVID tests.  Patient woke up in the morning around 3:00 a.m, 3/29. feeling fatigue with significant body aches.  She had significant subjective fevers and chills. Tmax 101 at home. Endorsed mild shortness of breath. Endorsed runny nose.  Endorsed nausea.  Denied vomiting, and abdominal pain, and dysuria.  No diarrhea.  Home oxygen was reported to be 81% on 3 L.    In the emergency department, oxygen is 94% on 2.5 L. Chest x-ray show emphysema no infiltrate.  Complete blood count show WBC of 3, hemoglobin 10. Chemistry panel is unremarkable.  Respiratory viral panel is positive for COVID-19 infection.   Patient was admitted in the hospital for monitoring.  She was placed on breathing treatment, Decadron and azithromycin for possible chronic obstructive pulmonary disease exacerbation.  She was stable on home oxygen therefore there was no indication for remdesivir.  The following day, patient was stable for discharge.  She was discharged on Paxilovid, Decadron, and was recommended for follow-up with primary care doctor.   Placed on gabapentin for chronic back pain.    Patient is discharged in stable condition- all labs and imaging reviewed. No concerns at this time. All questions were answered prior to discharge.
Age: 0.58
Sex: M
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Given wrong formulation (Monovalent)
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Arthritis, Pulmonary embolism
Clinical narrative: I26.99 PULMONARY EMBOLISM, UNSPECIFIED. 7/30/2021 ARTHRITIS OF RIGHT KNEE
Age: 0.58
Sex: M
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Wrong formulation given (monovalent)
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Decreased appetite, Headache, Pyrexia
Clinical narrative: I had a breakthrough case of Covid-19 I started having a really high fever with a raging headache I didn't have any energy or appetite I was prescribed Paxlovid.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: I had a breakthrough case of Covid-19 I started having a really high fever with a raging headache I didn't have any energy or appetite I was prescribed Paxlovid.
Age: 0.5
Sex: M
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Wrong formulation given (monovalent)
Age: 27.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: COVID-19, Fatigue, Headache, Oropharyngeal pain, Photophobia
Clinical narrative: I tested positive for COVID-19 on 2/16/23.  I had a sore throat, extreme fatigue, headache, and light sensitivity. I contacted my doctor but was not prescribed medication. I took Nyquil, Dayquil, and Advil. No other medications were taken. I am feeling better now.
Age: 27.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: SARS-CoV-2 test positive, Streptococcus test negative
Clinical narrative: I tested positive for COVID-19 on 2/16/23.  I had a sore throat, extreme fatigue, headache, and light sensitivity. I contacted my doctor but was not prescribed medication. I took Nyquil, Dayquil, and Advil. No other medications were taken. I am feeling better now.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Condition aggravated, Cor pulmonale acute, Coronary artery disease, Hypotension
Clinical narrative: ACUTE COR PULMONALE 7/3/2022 CAD (CORONARY ARTERY DISEASE) WO ANGINA  HYPOTENSION 4/28/2022 CAD (CORONARY ARTERY DISEASE) WO ANGINA  ACUTE COR PULMONALE 7/3/2022 CAD (CORONARY ARTERY DISEASE) WO ANGINA  HYPOTENSION 4/28/2022 CAD (CORONARY ARTERY DISEASE) WO ANGINA  ACUTE COR PULMONALE 7/3/2022 CHF EXACERBATION, UNSPECIFIED  HYPOTENSION 4/28/2022 CHF EXACERBATION, UNSPECIFIED  ACUTE COR PULMONALE 7/3/2022 MITRAL VALVE REGURGITATION  HYPOTENSION 4/28/2022 MITRAL VALVE REGURGITATION  ACUTE COR PULMONALE 7/3/2022 CHF (CONGESTIVE HEART FAILURE), UNSPECIFIED  HYPOTENSION 4/28/2022 CHF (CONGESTIVE HEART FAILURE), UNSPECIFIED
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Mitral valve incompetence
Clinical narrative: ACUTE COR PULMONALE 7/3/2022 CAD (CORONARY ARTERY DISEASE) WO ANGINA  HYPOTENSION 4/28/2022 CAD (CORONARY ARTERY DISEASE) WO ANGINA  ACUTE COR PULMONALE 7/3/2022 CAD (CORONARY ARTERY DISEASE) WO ANGINA  HYPOTENSION 4/28/2022 CAD (CORONARY ARTERY DISEASE) WO ANGINA  ACUTE COR PULMONALE 7/3/2022 CHF EXACERBATION, UNSPECIFIED  HYPOTENSION 4/28/2022 CHF EXACERBATION, UNSPECIFIED  ACUTE COR PULMONALE 7/3/2022 MITRAL VALVE REGURGITATION  HYPOTENSION 4/28/2022 MITRAL VALVE REGURGITATION  ACUTE COR PULMONALE 7/3/2022 CHF (CONGESTIVE HEART FAILURE), UNSPECIFIED  HYPOTENSION 4/28/2022 CHF (CONGESTIVE HEART FAILURE), UNSPECIFIED
Age: 71.0
Sex: M
Vaccine: VARZOS
Symptoms: Asthenia, Hypoaesthesia, Inflammation, Insomnia, Muscular weakness
Clinical narrative: 1 week post injection still having progressing generalized muscle pain and weakness especially over shoulders and arms. On day 4 developed Achilles tendonitis R foot as off this report date having generalized inflammation  and weakness-this is now 6 days post injection and trouble sleeping. Also experiencing episodes of hand tingling and numbness
Age: 71.0
Sex: M
Vaccine: VARZOS
Symptoms: Myalgia, Paraesthesia, Tendonitis
Clinical narrative: 1 week post injection still having progressing generalized muscle pain and weakness especially over shoulders and arms. On day 4 developed Achilles tendonitis R foot as off this report date having generalized inflammation  and weakness-this is now 6 days post injection and trouble sleeping. Also experiencing episodes of hand tingling and numbness
Age: 56.0
Sex: M
Vaccine: COVID19, FLUC4
Symptoms: Acute kidney injury, Anaemia, Angiopathy, Anticoagulant therapy, Biopsy colon
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD   Admission Date: 3/29/2023 Discharge Date:  4/4/2023  PRESENTING PROBLEM: Syncope and collapse [R55] Syncope, unspecified syncope type [R55] Anemia, unspecified type [D64.9]   HOSPITAL COURSE: ? 58 y.o. male with past medical history significant for cardiomyopathy, chronic combined CHF with recovered EF, AFib/flutter s/p cryoablation on eliquis (2017), sick sinus syndrome s/p dual chamber AICD (2020), coronary artery disease s/p CABG (2020), hypertension, hyperlipidemia, PAD s/p BLE bypass, history of orthostatic hypotension, chronic neck pain on opioids and history of tobacco use disorder (> 100 pack years) who presented to the ED due to dyspnea and syncopal events.   ? In the ED, his hgb was 8.1 which is down from 11 in 11/2022. He  noticed intermittent episodes of formed, black stool as well as intermittent darker red blood in stool that turns toilet bowel rust colored. He was admitted to facility 7/2022 with episode of syncope in setting of BRBPR, dehydration, AKI, hyponatremia and orthostatic hypotension. His hgb remained stable in 10-11 range, so he was discharged with plan for outpatient EGD / Colonoscopy which he never completed. In ED he was mildly hypertensive, temp 37.8°, heart rate 70s-80s, respirations 18 and O2 98% on room air.  Labs notable for sodium 128, hemoglobin 8.1, NT proBNP 7808, troponin 28 with a repeat of 29. Chest x-ray shows mild central vascular congestion without confluent infiltrates or effusions.  Patient admitted to medical floor, tested positive for COVID-19 noted to be on 2 L of oxygen, started on dexamethasone and remdesivir. During the hospital course patient was noted to have nonsustained V-tach for which Cardiology was consulted and recommended conservative management optimization of medications and electrolytes. Patient was started on metoprolol. He finished a five day course of remedesivir and was weaned to RA. EGD done on 4/2 showed no acute findings, colonoscopy done on 4/2 showed multiple large colon polyps. Biospy results pending. GI recommends repeat colonoscopy in 3-6 months. GI will follow bxs. Eliquis was resumed. Patient was found to be iron deficient and given IV iron and started on oral supplements.  He finished a five day course of doxycycline. Dizziness resolved prior to discharge. Patient was medically stable when discharged.
Age: 56.0
Sex: M
Vaccine: COVID19, FLUC4
Symptoms: Blood sodium decreased, COVID-19, Chest X-ray abnormal, Colonoscopy abnormal, Dehydration
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD   Admission Date: 3/29/2023 Discharge Date:  4/4/2023  PRESENTING PROBLEM: Syncope and collapse [R55] Syncope, unspecified syncope type [R55] Anemia, unspecified type [D64.9]   HOSPITAL COURSE: ? 58 y.o. male with past medical history significant for cardiomyopathy, chronic combined CHF with recovered EF, AFib/flutter s/p cryoablation on eliquis (2017), sick sinus syndrome s/p dual chamber AICD (2020), coronary artery disease s/p CABG (2020), hypertension, hyperlipidemia, PAD s/p BLE bypass, history of orthostatic hypotension, chronic neck pain on opioids and history of tobacco use disorder (> 100 pack years) who presented to the ED due to dyspnea and syncopal events.   ? In the ED, his hgb was 8.1 which is down from 11 in 11/2022. He  noticed intermittent episodes of formed, black stool as well as intermittent darker red blood in stool that turns toilet bowel rust colored. He was admitted to facility 7/2022 with episode of syncope in setting of BRBPR, dehydration, AKI, hyponatremia and orthostatic hypotension. His hgb remained stable in 10-11 range, so he was discharged with plan for outpatient EGD / Colonoscopy which he never completed. In ED he was mildly hypertensive, temp 37.8°, heart rate 70s-80s, respirations 18 and O2 98% on room air.  Labs notable for sodium 128, hemoglobin 8.1, NT proBNP 7808, troponin 28 with a repeat of 29. Chest x-ray shows mild central vascular congestion without confluent infiltrates or effusions.  Patient admitted to medical floor, tested positive for COVID-19 noted to be on 2 L of oxygen, started on dexamethasone and remdesivir. During the hospital course patient was noted to have nonsustained V-tach for which Cardiology was consulted and recommended conservative management optimization of medications and electrolytes. Patient was started on metoprolol. He finished a five day course of remedesivir and was weaned to RA. EGD done on 4/2 showed no acute findings, colonoscopy done on 4/2 showed multiple large colon polyps. Biospy results pending. GI recommends repeat colonoscopy in 3-6 months. GI will follow bxs. Eliquis was resumed. Patient was found to be iron deficient and given IV iron and started on oral supplements.  He finished a five day course of doxycycline. Dizziness resolved prior to discharge. Patient was medically stable when discharged.
Age: 56.0
Sex: M
Vaccine: COVID19, FLUC4
Symptoms: Dizziness, Dyspnoea, Endoscopy upper gastrointestinal tract normal, Faeces discoloured, Haematochezia
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD   Admission Date: 3/29/2023 Discharge Date:  4/4/2023  PRESENTING PROBLEM: Syncope and collapse [R55] Syncope, unspecified syncope type [R55] Anemia, unspecified type [D64.9]   HOSPITAL COURSE: ? 58 y.o. male with past medical history significant for cardiomyopathy, chronic combined CHF with recovered EF, AFib/flutter s/p cryoablation on eliquis (2017), sick sinus syndrome s/p dual chamber AICD (2020), coronary artery disease s/p CABG (2020), hypertension, hyperlipidemia, PAD s/p BLE bypass, history of orthostatic hypotension, chronic neck pain on opioids and history of tobacco use disorder (> 100 pack years) who presented to the ED due to dyspnea and syncopal events.   ? In the ED, his hgb was 8.1 which is down from 11 in 11/2022. He  noticed intermittent episodes of formed, black stool as well as intermittent darker red blood in stool that turns toilet bowel rust colored. He was admitted to facility 7/2022 with episode of syncope in setting of BRBPR, dehydration, AKI, hyponatremia and orthostatic hypotension. His hgb remained stable in 10-11 range, so he was discharged with plan for outpatient EGD / Colonoscopy which he never completed. In ED he was mildly hypertensive, temp 37.8°, heart rate 70s-80s, respirations 18 and O2 98% on room air.  Labs notable for sodium 128, hemoglobin 8.1, NT proBNP 7808, troponin 28 with a repeat of 29. Chest x-ray shows mild central vascular congestion without confluent infiltrates or effusions.  Patient admitted to medical floor, tested positive for COVID-19 noted to be on 2 L of oxygen, started on dexamethasone and remdesivir. During the hospital course patient was noted to have nonsustained V-tach for which Cardiology was consulted and recommended conservative management optimization of medications and electrolytes. Patient was started on metoprolol. He finished a five day course of remedesivir and was weaned to RA. EGD done on 4/2 showed no acute findings, colonoscopy done on 4/2 showed multiple large colon polyps. Biospy results pending. GI recommends repeat colonoscopy in 3-6 months. GI will follow bxs. Eliquis was resumed. Patient was found to be iron deficient and given IV iron and started on oral supplements.  He finished a five day course of doxycycline. Dizziness resolved prior to discharge. Patient was medically stable when discharged.
Age: 56.0
Sex: M
Vaccine: COVID19, FLUC4
Symptoms: Haemoglobin decreased, Hypertension, Hyponatraemia, Iron deficiency, Large intestine polyp
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD   Admission Date: 3/29/2023 Discharge Date:  4/4/2023  PRESENTING PROBLEM: Syncope and collapse [R55] Syncope, unspecified syncope type [R55] Anemia, unspecified type [D64.9]   HOSPITAL COURSE: ? 58 y.o. male with past medical history significant for cardiomyopathy, chronic combined CHF with recovered EF, AFib/flutter s/p cryoablation on eliquis (2017), sick sinus syndrome s/p dual chamber AICD (2020), coronary artery disease s/p CABG (2020), hypertension, hyperlipidemia, PAD s/p BLE bypass, history of orthostatic hypotension, chronic neck pain on opioids and history of tobacco use disorder (> 100 pack years) who presented to the ED due to dyspnea and syncopal events.   ? In the ED, his hgb was 8.1 which is down from 11 in 11/2022. He  noticed intermittent episodes of formed, black stool as well as intermittent darker red blood in stool that turns toilet bowel rust colored. He was admitted to facility 7/2022 with episode of syncope in setting of BRBPR, dehydration, AKI, hyponatremia and orthostatic hypotension. His hgb remained stable in 10-11 range, so he was discharged with plan for outpatient EGD / Colonoscopy which he never completed. In ED he was mildly hypertensive, temp 37.8°, heart rate 70s-80s, respirations 18 and O2 98% on room air.  Labs notable for sodium 128, hemoglobin 8.1, NT proBNP 7808, troponin 28 with a repeat of 29. Chest x-ray shows mild central vascular congestion without confluent infiltrates or effusions.  Patient admitted to medical floor, tested positive for COVID-19 noted to be on 2 L of oxygen, started on dexamethasone and remdesivir. During the hospital course patient was noted to have nonsustained V-tach for which Cardiology was consulted and recommended conservative management optimization of medications and electrolytes. Patient was started on metoprolol. He finished a five day course of remedesivir and was weaned to RA. EGD done on 4/2 showed no acute findings, colonoscopy done on 4/2 showed multiple large colon polyps. Biospy results pending. GI recommends repeat colonoscopy in 3-6 months. GI will follow bxs. Eliquis was resumed. Patient was found to be iron deficient and given IV iron and started on oral supplements.  He finished a five day course of doxycycline. Dizziness resolved prior to discharge. Patient was medically stable when discharged.
Age: 56.0
Sex: M
Vaccine: COVID19, FLUC4
Symptoms: N-terminal prohormone brain natriuretic peptide increased, Orthostatic hypotension, SARS-CoV-2 test positive, Syncope, Troponin
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD   Admission Date: 3/29/2023 Discharge Date:  4/4/2023  PRESENTING PROBLEM: Syncope and collapse [R55] Syncope, unspecified syncope type [R55] Anemia, unspecified type [D64.9]   HOSPITAL COURSE: ? 58 y.o. male with past medical history significant for cardiomyopathy, chronic combined CHF with recovered EF, AFib/flutter s/p cryoablation on eliquis (2017), sick sinus syndrome s/p dual chamber AICD (2020), coronary artery disease s/p CABG (2020), hypertension, hyperlipidemia, PAD s/p BLE bypass, history of orthostatic hypotension, chronic neck pain on opioids and history of tobacco use disorder (> 100 pack years) who presented to the ED due to dyspnea and syncopal events.   ? In the ED, his hgb was 8.1 which is down from 11 in 11/2022. He  noticed intermittent episodes of formed, black stool as well as intermittent darker red blood in stool that turns toilet bowel rust colored. He was admitted to facility 7/2022 with episode of syncope in setting of BRBPR, dehydration, AKI, hyponatremia and orthostatic hypotension. His hgb remained stable in 10-11 range, so he was discharged with plan for outpatient EGD / Colonoscopy which he never completed. In ED he was mildly hypertensive, temp 37.8°, heart rate 70s-80s, respirations 18 and O2 98% on room air.  Labs notable for sodium 128, hemoglobin 8.1, NT proBNP 7808, troponin 28 with a repeat of 29. Chest x-ray shows mild central vascular congestion without confluent infiltrates or effusions.  Patient admitted to medical floor, tested positive for COVID-19 noted to be on 2 L of oxygen, started on dexamethasone and remdesivir. During the hospital course patient was noted to have nonsustained V-tach for which Cardiology was consulted and recommended conservative management optimization of medications and electrolytes. Patient was started on metoprolol. He finished a five day course of remedesivir and was weaned to RA. EGD done on 4/2 showed no acute findings, colonoscopy done on 4/2 showed multiple large colon polyps. Biospy results pending. GI recommends repeat colonoscopy in 3-6 months. GI will follow bxs. Eliquis was resumed. Patient was found to be iron deficient and given IV iron and started on oral supplements.  He finished a five day course of doxycycline. Dizziness resolved prior to discharge. Patient was medically stable when discharged.
Age: 56.0
Sex: M
Vaccine: COVID19, FLUC4
Symptoms: Ventricular tachycardia
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD   Admission Date: 3/29/2023 Discharge Date:  4/4/2023  PRESENTING PROBLEM: Syncope and collapse [R55] Syncope, unspecified syncope type [R55] Anemia, unspecified type [D64.9]   HOSPITAL COURSE: ? 58 y.o. male with past medical history significant for cardiomyopathy, chronic combined CHF with recovered EF, AFib/flutter s/p cryoablation on eliquis (2017), sick sinus syndrome s/p dual chamber AICD (2020), coronary artery disease s/p CABG (2020), hypertension, hyperlipidemia, PAD s/p BLE bypass, history of orthostatic hypotension, chronic neck pain on opioids and history of tobacco use disorder (> 100 pack years) who presented to the ED due to dyspnea and syncopal events.   ? In the ED, his hgb was 8.1 which is down from 11 in 11/2022. He  noticed intermittent episodes of formed, black stool as well as intermittent darker red blood in stool that turns toilet bowel rust colored. He was admitted to facility 7/2022 with episode of syncope in setting of BRBPR, dehydration, AKI, hyponatremia and orthostatic hypotension. His hgb remained stable in 10-11 range, so he was discharged with plan for outpatient EGD / Colonoscopy which he never completed. In ED he was mildly hypertensive, temp 37.8°, heart rate 70s-80s, respirations 18 and O2 98% on room air.  Labs notable for sodium 128, hemoglobin 8.1, NT proBNP 7808, troponin 28 with a repeat of 29. Chest x-ray shows mild central vascular congestion without confluent infiltrates or effusions.  Patient admitted to medical floor, tested positive for COVID-19 noted to be on 2 L of oxygen, started on dexamethasone and remdesivir. During the hospital course patient was noted to have nonsustained V-tach for which Cardiology was consulted and recommended conservative management optimization of medications and electrolytes. Patient was started on metoprolol. He finished a five day course of remedesivir and was weaned to RA. EGD done on 4/2 showed no acute findings, colonoscopy done on 4/2 showed multiple large colon polyps. Biospy results pending. GI recommends repeat colonoscopy in 3-6 months. GI will follow bxs. Eliquis was resumed. Patient was found to be iron deficient and given IV iron and started on oral supplements.  He finished a five day course of doxycycline. Dizziness resolved prior to discharge. Patient was medically stable when discharged.
Age: 0.5
Sex: M
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Given wrong formulation (monovalent)
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Hepatic cirrhosis, Hypotension
Clinical narrative: HYPOTENSION 7/27/2021 NONALCOHOLIC CIRRHOSIS
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: No adverse reaction took place , on 04/06/2023 patient received an expired vaccine. We received lot #  FL2757 on 02/02/2023 , keep in fridge under recommended temperature up to 10 weeks , BUD was 04/13/2023. The manufacturer expiration is up to 18 months  which was 03/31/2023 , the vaccine expired before the BUD ( 04/13/2023). The box does not an expiration date on it , we add the BUD on box once received on 02/02/2023. from now on , I place both the Expiration  and BUD  date on box. child is fine.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Confusional state, Death, Decreased appetite, SARS-CoV-2 test positive
Clinical narrative: 3rd dose of COVID Moderna vaccine given 11/9/21, #939905; 4th dose of COVID Moderna vaccine given 8/10/22, #052b22a; pt resides in SNF (Health and Rehab Center and is followed by hospice; 10/3/22 pt had a positive COVID test; no cough or SOB, O2 saturation 95-98% on RA; poor appetite; pt began to have increased confusion and urinary continence; she expired in the SNF
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary incontinence
Clinical narrative: 3rd dose of COVID Moderna vaccine given 11/9/21, #939905; 4th dose of COVID Moderna vaccine given 8/10/22, #052b22a; pt resides in SNF (Health and Rehab Center and is followed by hospice; 10/3/22 pt had a positive COVID test; no cough or SOB, O2 saturation 95-98% on RA; poor appetite; pt began to have increased confusion and urinary continence; she expired in the SNF
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Pain in extremity
Clinical narrative: Arm pain after administration
Age: 1.75
Sex: F
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Given wrong formulation (monovalent)
Age: 2.0
Sex: M
Vaccine: HEP
Symptoms: Extra dose administered, Wrong product administered
Clinical narrative: Pt received 4th Hep B vaccine when should have been Hep A.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Organ failure, Sepsis
Clinical narrative: vaccine was administered outside of clinic- reported by patient- ? NO LOT NUMBER WERE SUPPLIED   ACUTE HYPOXEMIC RESPIRATORY FAILURE 3/22/2022 SEVERE SEPSIS W ACUTE ORGAN DYSFUNCTION
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Discontinued product administered
Clinical narrative: Wrong formulation given (monovalent)
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Neuropathy peripheral, Symptom recurrence
Clinical narrative: CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY, SUBSEQ  11/9/2022 --  RECURRENCE OF SAME SYMPTOMS
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia, Respiratory failure
Clinical narrative: Moderna vaccine was administered outside of Facility- reported by patient ? NO LOT NUMBER WERE SUPPLIED  J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 7/28/2021 PNEUMONIA
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, Dizziness, Headache, Loss of personal independence in daily activities, Mobility decreased
Clinical narrative: splitting headache, nausea, dizziness, & extreme weakness all day on the 18th. I had to get help from my husband to get down the stairs. I was unable to participate in anything on the 18th.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Nausea
Clinical narrative: splitting headache, nausea, dizziness, & extreme weakness all day on the 18th. I had to get help from my husband to get down the stairs. I was unable to participate in anything on the 18th.