chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Palpitations, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Throat irritation, Vaccine breakthrough infection
Clinical narrative: I had a breakthrough Covid infection after having 4 doses of the Pfizer vaccine. Symptoms of a Covid infection started on July 30, 2022 (Day 0) while outdoors at a picnic. I thought the symptoms were due to outdoor allergies as I started feeling a scratchy throat while outside. I took an antigen test that afternoon that came back negative. I started feeling slightly chilled that same evening. On July 31 (Day 1) I took two more antigen tests one in the morning and one in the evening that both came back negative, and I was feeling a scratchy throat. On August 1 (Day 2), I tested negative on an antigen test in the morning. After an afternoon nap on August 1, I woke up with a very hoarse sore throat, the back of my neck was sore and stiff.  I also had muscle soreness.  On August 2 (Day 3), I had a virtual visit with my primary care practice.  They did prescribe me Paxlovid, but my normal primary care physician advised me not to take it due to my slightly elevated liver counts. I also went for a PCR test on August 2 which came back positive on August 3. Other symptoms started to increase as well - an extreme sore throat like fire, fatigue, headache, coughing. On August 4 (Day 4) my nose started burning as well, then on August 5 (Day 6) I lost my sense of smell which did not come back for about one week. I continued to test positive on antigen tests until August 12 (Day 13) when I finally tested negative. At that point I still had a cough, nasal congestion, and fatigue. I had an in person visit with my regular primary care doctor as a follow up the the covid infection on August 16. At that point my lungs sounded clear and my heart sounded normal. The following week on August 22, 2022 I was allowed to resume my physical therapy for hip surgery that I had on May 2, 2022 with slow graded exercise due to the Covid infection. At that point I started feeling heart palpitations, a much higher heart rate than normal, more shortness of breath and continuing fatigue. These symptoms I am still continuously feeling. So I had a cardiologist appointment virtually on August 29 to discuss these symptoms as post covid issues which he believes could be POTS and tachycardia related to Covid. He had me do an echocardiogram on September 6 to rule out any structural abnormality and pericardial effusion. The echo came back with all normal results on September 6. He will be following up in an appointment on September 19 to discuss further treatment.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered to patient beyond use date of the product. No adverse reactions reported.
Age: 26.0
Sex: F
Vaccine: COVID19-2
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
Clinical narrative: Recurring fever of 100-101ºF lasting at least two days. Injection site swollen and red.
Age: 4.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event, Product preparation issue
Clinical narrative: Patient was administered incorrect dose of Pfizer Infant/Toddler COVID-19 vaccine. The Pfizer Infant/Toddler COVID-19 vaccine was incorrectly diluted. The vial received 0.22 mL of diluent. The patient received 0.2 mL  of an intramuscular injection from this vial. Patient was observed for 15 mins after vaccine. Patient did not exhibit any sign/symptoms of reactions after getting the vaccine. MD was notified of incident and informed RN to educate mother on signs and symptoms of adverse reactions and when to seek emergency care. Patient's mother also educated to continue monitoring daughter for adverse reactions.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered to patient beyond use date of the product. No adverse reactions reported.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Constant tinnitus.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered to patient beyond date of product use. No adverse reactions reported.
Age: 1.92
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: 23-month-old female inadvertently received expired Moderna (infant) at around 9:30 am 9/6/2022 for her 2nd dose. The vaccine vial expired 34 hours from the manufacturer recommendation date (expired 9/4/2022).
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered to patient beyond use date of the product. No adverse reactions reported.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered to patient beyond use date of the product. No adverse reactions reported.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered to patient beyond use date of the product. No adverse reactions reported.
Age: 2.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: 32 months old female inadvertently received the second dose of expired Moderna infant at around 9:30 AM on 9/6/22. The Moderna vaccine vial expired 34 hours from the manufacturer date (expire on 9/4/22).
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered to patient beyond use date of the product. No adverse reactions reported.
Age: 64.0
Sex: F
Vaccine: FLUA4
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Patient was administered Fluad 65+ when the patient was not 65+. Patient was contacted regarding the error. Patient reported no complications at the time of contact. Patient was advised to contact the pharmacy office if any issues arise.
Age: 0.5
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: 6-month-old male inadvertently received expired Moderna (infant) for his 1st dose at around 9:30 am on 9/6/2022. The Moderna vial expired 34 hours from the manufacturer's recommendation date (expired on 9/4/2022).
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine administered to patient beyond use date of the product. No adverse reactions reported.
Age: 20.0
Sex: M
Vaccine: FLUC4
Symptoms: Cough, Fatigue, Headache, Lethargy, Nasal congestion
Clinical narrative: Symptoms began to appear the following morning starting with a sore throat. General tiredness and lethargy progressed throughout the day. Symptoms peaked that night (9/04) with a fever of 101.5 degrees Fahrenheit at approximately 11 PM, extreme tiredness, headache, and mild nausea. Over-the-counter medications such as NightQuil were taken to alleviate symptoms. The next two days had symptoms lessened to coughs and stuffed/runny nose.
Age: 20.0
Sex: M
Vaccine: FLUC4
Symptoms: Nausea, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative
Clinical narrative: Symptoms began to appear the following morning starting with a sore throat. General tiredness and lethargy progressed throughout the day. Symptoms peaked that night (9/04) with a fever of 101.5 degrees Fahrenheit at approximately 11 PM, extreme tiredness, headache, and mild nausea. Over-the-counter medications such as NightQuil were taken to alleviate symptoms. The next two days had symptoms lessened to coughs and stuffed/runny nose.
Age: 1.25
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: 15-month-old male inadvertently received expired Moderna (infant) for his 2nd dose at around 9:30 am on 9/6/2022. The Moderna vial expired 34 hours from the manufacturer's recommendation date (expired 9/4/2022).
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: 34 months old male inadvertently received the second dose of expired Moderna infant at around 9:30 AM on 9/6/22. The vaccine expired 34 hours from the manufacturer's recommendation date on 9/4/22.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebral disorder, Cerebrovascular accident, Death, Infection, Seizure
Clinical narrative: Seizures, stoke, brain infection and death
Age: 66.0
Sex: M
Vaccine: FLU4
Symptoms: Headache
Clinical narrative: Patient received flu vaccine around 5pm and called the pharmacy at 8pm to report a severe headache localized to the top of the head. Patient took 400mg of ibuprofen and then called the pharmacy.
Age: 24.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Intensive care, Maternal exposure before pregnancy, Pre-eclampsia, Premature delivery
Clinical narrative: Severe Preeclampsia. Born 35weeks 5days due 3/28/22. 5lbs 9oz. 18 days in NICU due to prematurity. Magnesium needed for 36 hours.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pruritus, Injection site rash, Rash macular, Rash papular, Rash pruritic
Clinical narrative: Awful, itchy, blotchy rash on right shoulder onto back currently. Itchy bumps that are raised and pop up out of nowhere.
Age: 18.0
Sex: F
Vaccine: MENB, MNQ
Symptoms: Cold sweat, Pain of skin, Syncope
Clinical narrative: Fainted about 5 minutes after vaccine (patient already left vaccine room), temp taken and temp was 93.9F, patient skin was clammy to the touch. Patient declined pharmacy staff to call EMS or go to emergency room.  Patient waited extra 15-20 minutes in pharmacy waiting room. Patient's doctor was called by patient while waiting in pharmacy waiting room. Patient looked much better when she left pharmacy (skin had more color, temperature was rising when temperature checked later, skin did not feel clammy)
Age: 68.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Underdose
Clinical narrative: Bivalent vaccine was administered with dose of 0.25ml instead of 0.5ml.
Age: 68.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Incorrect dose administered
Clinical narrative: Bivalent vaccine was administered with dose of 0.25ml instead of 0.5ml.
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect dose administered
Clinical narrative: Bivalent booster dose of 0.25ml was administered instead of 0.5ml.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Atrial fibrillation
Clinical narrative: A-Fib/RVR
Age: 37.0
Sex: M
Vaccine: FLU4
Symptoms: Activated partial thromboplastin time normal, C-reactive protein increased, Chest pain, Magnetic resonance imaging abnormal, Myocarditis
Clinical narrative: On 16 Nov 2019, I woke up at 3am with chest pain and right arm pain. I got up, and after about 1 hour it went away. Then at 6pm, while watching TV on my couch, the chest and right arm pain started up again. So I drove myself to the ER. The ER admitted me into the hospital, because my Troponin levels were 3.21 HH. I stayed in the hospital on 19 Nov after many tests.
Age: 37.0
Sex: M
Vaccine: FLU4
Symptoms: Myopericarditis, Pain in extremity, Red blood cell sedimentation rate increased, Sleep disorder, Troponin I increased
Clinical narrative: On 16 Nov 2019, I woke up at 3am with chest pain and right arm pain. I got up, and after about 1 hour it went away. Then at 6pm, while watching TV on my couch, the chest and right arm pain started up again. So I drove myself to the ER. The ER admitted me into the hospital, because my Troponin levels were 3.21 HH. I stayed in the hospital on 19 Nov after many tests.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Bronchitis, COVID-19, Cough, Exposure to SARS-CoV-2, Heart rate increased
Clinical narrative: 4th shot received on 2/18/22.  Symptom onset on 6/14/22 after exposure on 6/11/22. Received paxlovid on 6/15/22. Tested negative on 6/18/22 -6/20/22. Rebounded on 6/22/22 -- testing positive on at home test and symptoms onset. Elevated heart rate 3-4 weeks after infection.  Cough began 7/30/22. Diagnosed with bronchitis and sinus infection. Three doctor visits -- 8/6/22, 8/11/22, and 8/19/22. Given prednisone and benzonatate at first visit, Augmentin at second visit, and Doxycycline at third visit. Steroid inhaler provided inbetween  2nd and 3rd visit -- existing Rx for hx of asthma. Cough still remains as of 9/6/22.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, SARS-CoV-2 test positive, Sinusitis
Clinical narrative: 4th shot received on 2/18/22.  Symptom onset on 6/14/22 after exposure on 6/11/22. Received paxlovid on 6/15/22. Tested negative on 6/18/22 -6/20/22. Rebounded on 6/22/22 -- testing positive on at home test and symptoms onset. Elevated heart rate 3-4 weeks after infection.  Cough began 7/30/22. Diagnosed with bronchitis and sinus infection. Three doctor visits -- 8/6/22, 8/11/22, and 8/19/22. Given prednisone and benzonatate at first visit, Augmentin at second visit, and Doxycycline at third visit. Steroid inhaler provided inbetween  2nd and 3rd visit -- existing Rx for hx of asthma. Cough still remains as of 9/6/22.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Colitis microscopic, Colonoscopy abnormal, Cough, Diarrhoea, Endoscopy
Clinical narrative: The diarrhea began by 7 pm & felt like I had a 105 degree temp! I didn't thankfully, but I ached & my heart raced, etc.! I almost called 911. It is horrible & I have bad allergies & started coughing & wondered if I was going to die! It took a few days but I lived!
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling abnormal, Feeling hot, Gastritis, Pain, Palpitations
Clinical narrative: The diarrhea began by 7 pm & felt like I had a 105 degree temp! I didn't thankfully, but I ached & my heart raced, etc.! I almost called 911. It is horrible & I have bad allergies & started coughing & wondered if I was going to die! It took a few days but I lived!
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Stress
Clinical narrative: The diarrhea began by 7 pm & felt like I had a 105 degree temp! I didn't thankfully, but I ached & my heart raced, etc.! I almost called 911. It is horrible & I have bad allergies & started coughing & wondered if I was going to die! It took a few days but I lived!
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Wrong product administered
Clinical narrative: Monovalent Moderna was administered instead of bivalent Moderna. Wrong bottle of vaccine was pulled from the refrigerator by student intern .
Age: 44.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, Wrong product administered
Clinical narrative: Monovalent Moderna was administered instead of bivalent Moderna. Wrong bottle of vaccine was pulled from the refrigerator by student intern .
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Wrong product administered
Clinical narrative: Monovalent Moderna was administered instead of bivalent Moderna. Wrong bottle of vaccine was pulled from the refrigerator by student intern .
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Monovalent Moderna administered instead of bivalent Moderna. Wrong bottle of vaccine pulled from the refrigerator.
Age: 65.0
Sex: M
Vaccine: COVID19-2
Symptoms: Unevaluable event
Clinical narrative: None stated.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Monovalent Moderna administered instead of bivalent Moderna. Wrong bottle of vaccine pulled from the refrigerator.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Monovalent Moderna administered instead of bivalent Moderna. Wrong bottle of vaccine pulled from the refrigerator.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Hives all over immediately that lasted 96 hours. Used Benadryl every 4-6 hours. Stayed at pharmacy at least 30-60  minutes after injection. Had epipen ready if needed.
Age: 30.0
Sex: M
Vaccine: SMALLMNK, SMALLMNK
Symptoms: Urticaria
Clinical narrative: Both arms and legs breaking out in hives-like spots. Might be psoriasis flare from monkeypox vaccine injections, but I have never flared up like this before. I noticed it in August 2022 after my first dose, and it worsened after my second dose which was almost two weeks ago.
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Pityriasis rosea, Rash, Rash pruritic
Clinical narrative: He has a bumpy rash (tiny bumps) covering his entire chest and upper back. I first noticed the rash on Aug 31, but according to him, it had been there a couple days. It was a little itchy on Aug 31. He had a couple scratch marks on his upper back. My wife and I decided to wait and see if it would clear up on its own. We checked a few times and there was no change. It has not been very itchy since Aug 31. He does not currently have any scratch marks. We took him to his pediatrician Sept 6. After the examination and describing the symptoms, the doctor believes the rash is likely pityriasis rosea. After the appointment, we searched online to learn more about pityriasis rosea. We saw articles listing it as a rare side effect of the COVID-19 vaccine.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Narrative: Patient tested positive for Covid-19 and was hospitalized despite full vaccination (received Pfizer dose 1 and 2, no booster). Pfizer #2 dose received on 02/24/2021
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Narrative: Patient tested positive for Covid-19 and was hospitalized despite full vaccination of Pfizer dose 1,2, and 3 (booster).
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Extra dose administered, SARS-CoV-2 test positive
Clinical narrative: Narrative: Patient tested positive for COVID-19 and was hospitalized despite full vaccination of Pfizer dose 1, 2, 3 (booster), and 4 (2nd booster on 03/02/2022).
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, Extra dose administered, SARS-CoV-2 test positive
Clinical narrative: Narrative: Employee tested positive for Covid-19 and was hospitalized despite full vaccination and boosters (Pfizer 1,2 and Boosters x2). Pt's last booster was on 03/31/2022. Patient died on 06/04/2022
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient tested positive for Covid-19 and was hospitalized despite of full vaccination ( Pfizer 1 and 2) and one booster with Pfizer on 1/28/2022.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient tested positive for COVID-19 and was hospitalized despite full vaccination of Pfizer 1,2, and boosters x2. Last booster was 05/24/2022.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient tested positive for COVID-19 and was hospitalized despite full vaccination of Pfizer 1&2 and booster that was done on 10/26/21
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient tested positive for COVID-19 and was hospitalized despite full vaccination of Moderna 1&2 but did not receive any booster
Age: 95.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient tested positive for COVID-19 and was hospitalized despite full vaccination of Pfizer 1&2 but has not received a booster.
Age: 11.0
Sex: F
Vaccine: HPV9, MNQ, TDAP
Symptoms: Vaccination site erythema, Vaccination site induration, Vaccination site pain
Clinical narrative: large red firm tender area where vaccine was given to L arm - approx 9cm round
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest discomfort, Fatigue, SARS-CoV-2 test positive
Clinical narrative: 58y.o. male with multiple medical problems including ESRD s/p renal transplant, CAD, DM2, HTN, obesity, gout, L3 fracture, anemia of chronic disease admitted on 07/12/2022  for cough, pleuritic chest pain and hypoxia. Initial SATS were 88% and he was subsequently placed on 2L O2. Patient was tested for COVID19 and results were positive. Additional labs revealed elevated Pro-calcitonin and troponins x3. Labs also revealed hyponatremia, hyperkalemia. Patient was also found to have a LLE DVT and was started on IV heparin, has since transitioned to Xarelto for 6 months. Repeat Doppler 7/26 showed no DVT. Patients labs have improved. Creatinine at 2.81. Per nephrology CellCept on hold until D/C and will continue Prograf, hold Lasix and monitor fluid status. During the patients hospital stay he did develop some epistaxis and right nasal cavity was treated with silver nitrate and cautery. He has completed courses of dexamethasone, remdesivir, and tocilizumab for COVID-19 and has been off isolations since 7/22. Consults for this patient include: Internal medicine, Nephrology, ENT, wound care, pain management, pulmonology, and cardiology. The patient was stabilized and medically cleared for transfer to the rehab unit on 08/05/22 for intense inpatient rehabilitation. Patient SOB with conversation, c/o nasal congestion and intermittent epistaxis. Will get humidified oxygen and Afrin.
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Blood creatinine increased, COVID-19, Cautery to nose, Chest pain
Clinical narrative: 58y.o. male with multiple medical problems including ESRD s/p renal transplant, CAD, DM2, HTN, obesity, gout, L3 fracture, anemia of chronic disease admitted on 07/12/2022  for cough, pleuritic chest pain and hypoxia. Initial SATS were 88% and he was subsequently placed on 2L O2. Patient was tested for COVID19 and results were positive. Additional labs revealed elevated Pro-calcitonin and troponins x3. Labs also revealed hyponatremia, hyperkalemia. Patient was also found to have a LLE DVT and was started on IV heparin, has since transitioned to Xarelto for 6 months. Repeat Doppler 7/26 showed no DVT. Patients labs have improved. Creatinine at 2.81. Per nephrology CellCept on hold until D/C and will continue Prograf, hold Lasix and monitor fluid status. During the patients hospital stay he did develop some epistaxis and right nasal cavity was treated with silver nitrate and cautery. He has completed courses of dexamethasone, remdesivir, and tocilizumab for COVID-19 and has been off isolations since 7/22. Consults for this patient include: Internal medicine, Nephrology, ENT, wound care, pain management, pulmonology, and cardiology. The patient was stabilized and medically cleared for transfer to the rehab unit on 08/05/22 for intense inpatient rehabilitation. Patient SOB with conversation, c/o nasal congestion and intermittent epistaxis. Will get humidified oxygen and Afrin.
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cough, Deep vein thrombosis, Dyspnoea, Epistaxis, Hyperkalaemia
Clinical narrative: 58y.o. male with multiple medical problems including ESRD s/p renal transplant, CAD, DM2, HTN, obesity, gout, L3 fracture, anemia of chronic disease admitted on 07/12/2022  for cough, pleuritic chest pain and hypoxia. Initial SATS were 88% and he was subsequently placed on 2L O2. Patient was tested for COVID19 and results were positive. Additional labs revealed elevated Pro-calcitonin and troponins x3. Labs also revealed hyponatremia, hyperkalemia. Patient was also found to have a LLE DVT and was started on IV heparin, has since transitioned to Xarelto for 6 months. Repeat Doppler 7/26 showed no DVT. Patients labs have improved. Creatinine at 2.81. Per nephrology CellCept on hold until D/C and will continue Prograf, hold Lasix and monitor fluid status. During the patients hospital stay he did develop some epistaxis and right nasal cavity was treated with silver nitrate and cautery. He has completed courses of dexamethasone, remdesivir, and tocilizumab for COVID-19 and has been off isolations since 7/22. Consults for this patient include: Internal medicine, Nephrology, ENT, wound care, pain management, pulmonology, and cardiology. The patient was stabilized and medically cleared for transfer to the rehab unit on 08/05/22 for intense inpatient rehabilitation. Patient SOB with conversation, c/o nasal congestion and intermittent epistaxis. Will get humidified oxygen and Afrin.
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hyponatraemia, Hypoxia, Laboratory test abnormal, Nasal congestion, Pleuritic pain
Clinical narrative: 58y.o. male with multiple medical problems including ESRD s/p renal transplant, CAD, DM2, HTN, obesity, gout, L3 fracture, anemia of chronic disease admitted on 07/12/2022  for cough, pleuritic chest pain and hypoxia. Initial SATS were 88% and he was subsequently placed on 2L O2. Patient was tested for COVID19 and results were positive. Additional labs revealed elevated Pro-calcitonin and troponins x3. Labs also revealed hyponatremia, hyperkalemia. Patient was also found to have a LLE DVT and was started on IV heparin, has since transitioned to Xarelto for 6 months. Repeat Doppler 7/26 showed no DVT. Patients labs have improved. Creatinine at 2.81. Per nephrology CellCept on hold until D/C and will continue Prograf, hold Lasix and monitor fluid status. During the patients hospital stay he did develop some epistaxis and right nasal cavity was treated with silver nitrate and cautery. He has completed courses of dexamethasone, remdesivir, and tocilizumab for COVID-19 and has been off isolations since 7/22. Consults for this patient include: Internal medicine, Nephrology, ENT, wound care, pain management, pulmonology, and cardiology. The patient was stabilized and medically cleared for transfer to the rehab unit on 08/05/22 for intense inpatient rehabilitation. Patient SOB with conversation, c/o nasal congestion and intermittent epistaxis. Will get humidified oxygen and Afrin.
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Procalcitonin increased, SARS-CoV-2 test positive, Troponin increased, Ultrasound Doppler normal
Clinical narrative: 58y.o. male with multiple medical problems including ESRD s/p renal transplant, CAD, DM2, HTN, obesity, gout, L3 fracture, anemia of chronic disease admitted on 07/12/2022  for cough, pleuritic chest pain and hypoxia. Initial SATS were 88% and he was subsequently placed on 2L O2. Patient was tested for COVID19 and results were positive. Additional labs revealed elevated Pro-calcitonin and troponins x3. Labs also revealed hyponatremia, hyperkalemia. Patient was also found to have a LLE DVT and was started on IV heparin, has since transitioned to Xarelto for 6 months. Repeat Doppler 7/26 showed no DVT. Patients labs have improved. Creatinine at 2.81. Per nephrology CellCept on hold until D/C and will continue Prograf, hold Lasix and monitor fluid status. During the patients hospital stay he did develop some epistaxis and right nasal cavity was treated with silver nitrate and cautery. He has completed courses of dexamethasone, remdesivir, and tocilizumab for COVID-19 and has been off isolations since 7/22. Consults for this patient include: Internal medicine, Nephrology, ENT, wound care, pain management, pulmonology, and cardiology. The patient was stabilized and medically cleared for transfer to the rehab unit on 08/05/22 for intense inpatient rehabilitation. Patient SOB with conversation, c/o nasal congestion and intermittent epistaxis. Will get humidified oxygen and Afrin.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Abdominal pain, COVID-19, Influenza virus test, Respiratory syncytial virus test, SARS-CoV-2 test positive
Clinical narrative: This is a 66y.o. male with PMHx CAD s/p stent x6, s/p CABG (LIMA-LAD, left radial-OM, SVG-RCA), HTN, T2DM, initially presented to a HCF with abdominal pain, nausea, vomiting, and jaundice on 7/12. Found to have elevated LFTs and was positive for acute hepatitis B, transferred to another facility. Patient does have a distant history of drug abuse. He was started on tenofovir.  Of note, his pre-transplant cardiac cath 7/20/22 showed varying stenosis of LMA, LAD, LCX, and RCA as well as 100% occlusion of the RCA in the mid segment. ECHO 7/20/22 with EF 55%, intermediate LV function. He does have an ICD. Last device check 8/1/22. He underwent liver transplant on 8.3.22, and was transferred to ICU post op.  There was concern  for anaphylaxis to blood vs zosyn vs HBIG during OR as he experienced hypotension and became difficult to ventilate.  This again occurred while he was in ICU.  At that time is was speculated that he was having a reaction to Zosyn therefore Zosyn was placed as an allergy in his medical record.  The patient returned to OR the following day for exploration and washout(1L fresh blood in abdomen and ~2L clot evacuated from abdomen upon entry)   He received daily infusions of hydrocortison/benedryl/HBIG post op.  He developed an ileus on approximately day 7 requiring an NGT. This resolved several days later.  Induration and erythremia were noted to the left side of the abdominal incision, an abdominal CT was completed as well as blood cultures,  several staples were removed and the wound cultured (+ VRE bacteremia/ Klebsiella in wound).  Vancomycin/Azatreonam  were continued thru 8.24.22.  While on 5 center his appetite was poor.  He agreed to a corpak which was discontinued at discharge.  At the time of discharge he had 3 areas of his incision that needed to be packed with continuous piece of dampened Saline.  He wife was taught wound care, and received teaching from the clinic staff and pharmacist.  HOme care/PT/OT were requested thru care mangement.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Vomiting
Clinical narrative: This is a 66y.o. male with PMHx CAD s/p stent x6, s/p CABG (LIMA-LAD, left radial-OM, SVG-RCA), HTN, T2DM, initially presented to a HCF with abdominal pain, nausea, vomiting, and jaundice on 7/12. Found to have elevated LFTs and was positive for acute hepatitis B, transferred to another facility. Patient does have a distant history of drug abuse. He was started on tenofovir.  Of note, his pre-transplant cardiac cath 7/20/22 showed varying stenosis of LMA, LAD, LCX, and RCA as well as 100% occlusion of the RCA in the mid segment. ECHO 7/20/22 with EF 55%, intermediate LV function. He does have an ICD. Last device check 8/1/22. He underwent liver transplant on 8.3.22, and was transferred to ICU post op.  There was concern  for anaphylaxis to blood vs zosyn vs HBIG during OR as he experienced hypotension and became difficult to ventilate.  This again occurred while he was in ICU.  At that time is was speculated that he was having a reaction to Zosyn therefore Zosyn was placed as an allergy in his medical record.  The patient returned to OR the following day for exploration and washout(1L fresh blood in abdomen and ~2L clot evacuated from abdomen upon entry)   He received daily infusions of hydrocortison/benedryl/HBIG post op.  He developed an ileus on approximately day 7 requiring an NGT. This resolved several days later.  Induration and erythremia were noted to the left side of the abdominal incision, an abdominal CT was completed as well as blood cultures,  several staples were removed and the wound cultured (+ VRE bacteremia/ Klebsiella in wound).  Vancomycin/Azatreonam  were continued thru 8.24.22.  While on 5 center his appetite was poor.  He agreed to a corpak which was discontinued at discharge.  At the time of discharge he had 3 areas of his incision that needed to be packed with continuous piece of dampened Saline.  He wife was taught wound care, and received teaching from the clinic staff and pharmacist.  HOme care/PT/OT were requested thru care mangement.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Abdominal pain, Blood culture, COVID-19, Catheterisation cardiac abnormal, Computerised tomogram abdomen
Clinical narrative: This is a 66y.o. male with PMHx CAD s/p stent x6, s/p CABG (LIMA-LAD, left radial-OM, SVG-RCA), HTN, T2DM, initially presented to a HCF with abdominal pain, nausea, vomiting, and jaundice on 7/12. Found to have elevated LFTs and was positive for acute hepatitis B, transferred to another facility. Patient does have a distant history of drug abuse. He was started on tenofovir.  Of note, his pre-transplant cardiac cath 7/20/22 showed varying stenosis of LMA, LAD, LCX, and RCA as well as 100% occlusion of the RCA in the mid segment. ECHO 7/20/22 with EF 55%, intermediate LV function. He does have an ICD. Last device check 8/1/22. He underwent liver transplant on 8.3.22, and was transferred to ICU post op.  There was concern  for anaphylaxis to blood vs zosyn vs HBIG during OR as he experienced hypotension and became difficult to ventilate.  This again occurred while he was in ICU.  At that time is was speculated that he was having a reaction to Zosyn therefore Zosyn was placed as an allergy in his medical record.  The patient returned to OR the following day for exploration and washout(1L fresh blood in abdomen and ~2L clot evacuated from abdomen upon entry)   He received daily infusions of hydrocortison/benedryl/HBIG post op.  He developed an ileus on approximately day 7 requiring an NGT. This resolved several days later.  Induration and erythremia were noted to the left side of the abdominal incision, an abdominal CT was completed as well as blood cultures,  several staples were removed and the wound cultured (+ VRE bacteremia/ Klebsiella in wound).  Vancomycin/Azatreonam  were continued thru 8.24.22.  While on 5 center his appetite was poor.  He agreed to a corpak which was discontinued at discharge.  At the time of discharge he had 3 areas of his incision that needed to be packed with continuous piece of dampened Saline.  He wife was taught wound care, and received teaching from the clinic staff and pharmacist.  HOme care/PT/OT were requested thru care mangement.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Coronary artery occlusion, Coronary artery stenosis, Culture wound positive, Decreased appetite, Echocardiogram normal
Clinical narrative: This is a 66y.o. male with PMHx CAD s/p stent x6, s/p CABG (LIMA-LAD, left radial-OM, SVG-RCA), HTN, T2DM, initially presented to a HCF with abdominal pain, nausea, vomiting, and jaundice on 7/12. Found to have elevated LFTs and was positive for acute hepatitis B, transferred to another facility. Patient does have a distant history of drug abuse. He was started on tenofovir.  Of note, his pre-transplant cardiac cath 7/20/22 showed varying stenosis of LMA, LAD, LCX, and RCA as well as 100% occlusion of the RCA in the mid segment. ECHO 7/20/22 with EF 55%, intermediate LV function. He does have an ICD. Last device check 8/1/22. He underwent liver transplant on 8.3.22, and was transferred to ICU post op.  There was concern  for anaphylaxis to blood vs zosyn vs HBIG during OR as he experienced hypotension and became difficult to ventilate.  This again occurred while he was in ICU.  At that time is was speculated that he was having a reaction to Zosyn therefore Zosyn was placed as an allergy in his medical record.  The patient returned to OR the following day for exploration and washout(1L fresh blood in abdomen and ~2L clot evacuated from abdomen upon entry)   He received daily infusions of hydrocortison/benedryl/HBIG post op.  He developed an ileus on approximately day 7 requiring an NGT. This resolved several days later.  Induration and erythremia were noted to the left side of the abdominal incision, an abdominal CT was completed as well as blood cultures,  several staples were removed and the wound cultured (+ VRE bacteremia/ Klebsiella in wound).  Vancomycin/Azatreonam  were continued thru 8.24.22.  While on 5 center his appetite was poor.  He agreed to a corpak which was discontinued at discharge.  At the time of discharge he had 3 areas of his incision that needed to be packed with continuous piece of dampened Saline.  He wife was taught wound care, and received teaching from the clinic staff and pharmacist.  HOme care/PT/OT were requested thru care mangement.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Ejection fraction, Enterococcus test positive, Erythema, Gastrointestinal tube insertion, Hepatitis B virus test positive
Clinical narrative: This is a 66y.o. male with PMHx CAD s/p stent x6, s/p CABG (LIMA-LAD, left radial-OM, SVG-RCA), HTN, T2DM, initially presented to a HCF with abdominal pain, nausea, vomiting, and jaundice on 7/12. Found to have elevated LFTs and was positive for acute hepatitis B, transferred to another facility. Patient does have a distant history of drug abuse. He was started on tenofovir.  Of note, his pre-transplant cardiac cath 7/20/22 showed varying stenosis of LMA, LAD, LCX, and RCA as well as 100% occlusion of the RCA in the mid segment. ECHO 7/20/22 with EF 55%, intermediate LV function. He does have an ICD. Last device check 8/1/22. He underwent liver transplant on 8.3.22, and was transferred to ICU post op.  There was concern  for anaphylaxis to blood vs zosyn vs HBIG during OR as he experienced hypotension and became difficult to ventilate.  This again occurred while he was in ICU.  At that time is was speculated that he was having a reaction to Zosyn therefore Zosyn was placed as an allergy in his medical record.  The patient returned to OR the following day for exploration and washout(1L fresh blood in abdomen and ~2L clot evacuated from abdomen upon entry)   He received daily infusions of hydrocortison/benedryl/HBIG post op.  He developed an ileus on approximately day 7 requiring an NGT. This resolved several days later.  Induration and erythremia were noted to the left side of the abdominal incision, an abdominal CT was completed as well as blood cultures,  several staples were removed and the wound cultured (+ VRE bacteremia/ Klebsiella in wound).  Vancomycin/Azatreonam  were continued thru 8.24.22.  While on 5 center his appetite was poor.  He agreed to a corpak which was discontinued at discharge.  At the time of discharge he had 3 areas of his incision that needed to be packed with continuous piece of dampened Saline.  He wife was taught wound care, and received teaching from the clinic staff and pharmacist.  HOme care/PT/OT were requested thru care mangement.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Hypotension, Hypoventilation, Ileus, Induration, Infusion
Clinical narrative: This is a 66y.o. male with PMHx CAD s/p stent x6, s/p CABG (LIMA-LAD, left radial-OM, SVG-RCA), HTN, T2DM, initially presented to a HCF with abdominal pain, nausea, vomiting, and jaundice on 7/12. Found to have elevated LFTs and was positive for acute hepatitis B, transferred to another facility. Patient does have a distant history of drug abuse. He was started on tenofovir.  Of note, his pre-transplant cardiac cath 7/20/22 showed varying stenosis of LMA, LAD, LCX, and RCA as well as 100% occlusion of the RCA in the mid segment. ECHO 7/20/22 with EF 55%, intermediate LV function. He does have an ICD. Last device check 8/1/22. He underwent liver transplant on 8.3.22, and was transferred to ICU post op.  There was concern  for anaphylaxis to blood vs zosyn vs HBIG during OR as he experienced hypotension and became difficult to ventilate.  This again occurred while he was in ICU.  At that time is was speculated that he was having a reaction to Zosyn therefore Zosyn was placed as an allergy in his medical record.  The patient returned to OR the following day for exploration and washout(1L fresh blood in abdomen and ~2L clot evacuated from abdomen upon entry)   He received daily infusions of hydrocortison/benedryl/HBIG post op.  He developed an ileus on approximately day 7 requiring an NGT. This resolved several days later.  Induration and erythremia were noted to the left side of the abdominal incision, an abdominal CT was completed as well as blood cultures,  several staples were removed and the wound cultured (+ VRE bacteremia/ Klebsiella in wound).  Vancomycin/Azatreonam  were continued thru 8.24.22.  While on 5 center his appetite was poor.  He agreed to a corpak which was discontinued at discharge.  At the time of discharge he had 3 areas of his incision that needed to be packed with continuous piece of dampened Saline.  He wife was taught wound care, and received teaching from the clinic staff and pharmacist.  HOme care/PT/OT were requested thru care mangement.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Intensive care, Jaundice, Klebsiella test positive, Laryngeal stenosis, Liver function test increased
Clinical narrative: This is a 66y.o. male with PMHx CAD s/p stent x6, s/p CABG (LIMA-LAD, left radial-OM, SVG-RCA), HTN, T2DM, initially presented to a HCF with abdominal pain, nausea, vomiting, and jaundice on 7/12. Found to have elevated LFTs and was positive for acute hepatitis B, transferred to another facility. Patient does have a distant history of drug abuse. He was started on tenofovir.  Of note, his pre-transplant cardiac cath 7/20/22 showed varying stenosis of LMA, LAD, LCX, and RCA as well as 100% occlusion of the RCA in the mid segment. ECHO 7/20/22 with EF 55%, intermediate LV function. He does have an ICD. Last device check 8/1/22. He underwent liver transplant on 8.3.22, and was transferred to ICU post op.  There was concern  for anaphylaxis to blood vs zosyn vs HBIG during OR as he experienced hypotension and became difficult to ventilate.  This again occurred while he was in ICU.  At that time is was speculated that he was having a reaction to Zosyn therefore Zosyn was placed as an allergy in his medical record.  The patient returned to OR the following day for exploration and washout(1L fresh blood in abdomen and ~2L clot evacuated from abdomen upon entry)   He received daily infusions of hydrocortison/benedryl/HBIG post op.  He developed an ileus on approximately day 7 requiring an NGT. This resolved several days later.  Induration and erythremia were noted to the left side of the abdominal incision, an abdominal CT was completed as well as blood cultures,  several staples were removed and the wound cultured (+ VRE bacteremia/ Klebsiella in wound).  Vancomycin/Azatreonam  were continued thru 8.24.22.  While on 5 center his appetite was poor.  He agreed to a corpak which was discontinued at discharge.  At the time of discharge he had 3 areas of his incision that needed to be packed with continuous piece of dampened Saline.  He wife was taught wound care, and received teaching from the clinic staff and pharmacist.  HOme care/PT/OT were requested thru care mangement.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Liver transplant, Nausea, SARS-CoV-2 test positive, Suture removal, Vomiting
Clinical narrative: This is a 66y.o. male with PMHx CAD s/p stent x6, s/p CABG (LIMA-LAD, left radial-OM, SVG-RCA), HTN, T2DM, initially presented to a HCF with abdominal pain, nausea, vomiting, and jaundice on 7/12. Found to have elevated LFTs and was positive for acute hepatitis B, transferred to another facility. Patient does have a distant history of drug abuse. He was started on tenofovir.  Of note, his pre-transplant cardiac cath 7/20/22 showed varying stenosis of LMA, LAD, LCX, and RCA as well as 100% occlusion of the RCA in the mid segment. ECHO 7/20/22 with EF 55%, intermediate LV function. He does have an ICD. Last device check 8/1/22. He underwent liver transplant on 8.3.22, and was transferred to ICU post op.  There was concern  for anaphylaxis to blood vs zosyn vs HBIG during OR as he experienced hypotension and became difficult to ventilate.  This again occurred while he was in ICU.  At that time is was speculated that he was having a reaction to Zosyn therefore Zosyn was placed as an allergy in his medical record.  The patient returned to OR the following day for exploration and washout(1L fresh blood in abdomen and ~2L clot evacuated from abdomen upon entry)   He received daily infusions of hydrocortison/benedryl/HBIG post op.  He developed an ileus on approximately day 7 requiring an NGT. This resolved several days later.  Induration and erythremia were noted to the left side of the abdominal incision, an abdominal CT was completed as well as blood cultures,  several staples were removed and the wound cultured (+ VRE bacteremia/ Klebsiella in wound).  Vancomycin/Azatreonam  were continued thru 8.24.22.  While on 5 center his appetite was poor.  He agreed to a corpak which was discontinued at discharge.  At the time of discharge he had 3 areas of his incision that needed to be packed with continuous piece of dampened Saline.  He wife was taught wound care, and received teaching from the clinic staff and pharmacist.  HOme care/PT/OT were requested thru care mangement.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Wound treatment
Clinical narrative: This is a 66y.o. male with PMHx CAD s/p stent x6, s/p CABG (LIMA-LAD, left radial-OM, SVG-RCA), HTN, T2DM, initially presented to a HCF with abdominal pain, nausea, vomiting, and jaundice on 7/12. Found to have elevated LFTs and was positive for acute hepatitis B, transferred to another facility. Patient does have a distant history of drug abuse. He was started on tenofovir.  Of note, his pre-transplant cardiac cath 7/20/22 showed varying stenosis of LMA, LAD, LCX, and RCA as well as 100% occlusion of the RCA in the mid segment. ECHO 7/20/22 with EF 55%, intermediate LV function. He does have an ICD. Last device check 8/1/22. He underwent liver transplant on 8.3.22, and was transferred to ICU post op.  There was concern  for anaphylaxis to blood vs zosyn vs HBIG during OR as he experienced hypotension and became difficult to ventilate.  This again occurred while he was in ICU.  At that time is was speculated that he was having a reaction to Zosyn therefore Zosyn was placed as an allergy in his medical record.  The patient returned to OR the following day for exploration and washout(1L fresh blood in abdomen and ~2L clot evacuated from abdomen upon entry)   He received daily infusions of hydrocortison/benedryl/HBIG post op.  He developed an ileus on approximately day 7 requiring an NGT. This resolved several days later.  Induration and erythremia were noted to the left side of the abdominal incision, an abdominal CT was completed as well as blood cultures,  several staples were removed and the wound cultured (+ VRE bacteremia/ Klebsiella in wound).  Vancomycin/Azatreonam  were continued thru 8.24.22.  While on 5 center his appetite was poor.  He agreed to a corpak which was discontinued at discharge.  At the time of discharge he had 3 areas of his incision that needed to be packed with continuous piece of dampened Saline.  He wife was taught wound care, and received teaching from the clinic staff and pharmacist.  HOme care/PT/OT were requested thru care mangement.
Age: 62.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19
Clinical narrative: 63 year old female with history of Hereditary Hemorrhagic Telangiectasia with multiple gastrointestinal AVM's with recurrent blood loss anemia who presented to the hospital with GI bleed. She was unsure of the color of stool at the time of admission. She also was noted to have history of chronic hepatitis C with cirrhosis, seizure disorder on gabapentin and phenobarbital. GI was consulted and recommended outpatient follow-up for EGD as bleed had stabilized. Hematology recommended outpatient evaluation for starting Sandostatin. She was continued on her home medication and PPI. She was positive for COVID but on room air and relatively asymptomatic with only cough and mild wheezing and she was treated with azithromycin for 3 days. She was treated with Bactrim for UTI as well. Pain medicine was consulted however later fired by patient and then re-consulted. Disposition was difficult in terms of finding placement as over 200 home healthcare agencies were contacted by social work and all declined. She refused SAR. She was discharged hemodynamically stable with no further bleeding and medically cleared with plan to setup home health care as an outpatient.