chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Dementia
Clinical narrative: vaccine was administered outside of clinic- reported by patient ? NO LOT NUMBER WERE SUPPLIED --------------------------------------------------------------------------------------------------------------------------  ACUTE DVT OF LEFT LEG, UNSPECIFIED VEIN 10/30/2021 UNSPECIFIED DEMENTIA, UNSPECIFIED SEVERITY, WO BEHAVIORAL DISTURBANCE  ACUTE DVT OF LEFT LEG, UNSPECIFIED VEIN 10/30/2021 ACUTE DVT OF LEFT LEG, UNSPECIFIED VEIN
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: BUD date excursion, BUD was 4-7-23 and vaccine administered 4-21-23.
Age: 1.25
Sex: M
Vaccine: COVID19-2, DTAPIPVHIB, PNC13
Symptoms: Bronchiolitis, Cough, Dyspnoea, Ear infection, Gastroenteritis viral
Clinical narrative: He started having congestion, fever of 103, and a cough. He was also having a hard time breathing so we went to the doctor. He was diagnosed with Bronchiolitis. We were told to give him TYLENOL, ibuprofen and nebulizer when needed. This lasted about 10 days and then got sick again with a stomach virus. He was vomiting a lot, and then started having congestion. This lasted for about a week and then we noticed he was pulling on his ear, so we took him to the doctor and was diagnosed with an ear infection. He was given ofloxacin for this and we gave TYLENOL and ibuprofen as needed. He got better and then came down with a common cold and was given albuterol. We are still dealing with the common cold at this time.
Age: 1.25
Sex: M
Vaccine: COVID19-2, DTAPIPVHIB, PNC13
Symptoms: Nasopharyngitis, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative, Vomiting
Clinical narrative: He started having congestion, fever of 103, and a cough. He was also having a hard time breathing so we went to the doctor. He was diagnosed with Bronchiolitis. We were told to give him TYLENOL, ibuprofen and nebulizer when needed. This lasted about 10 days and then got sick again with a stomach virus. He was vomiting a lot, and then started having congestion. This lasted for about a week and then we noticed he was pulling on his ear, so we took him to the doctor and was diagnosed with an ear infection. He was given ofloxacin for this and we gave TYLENOL and ibuprofen as needed. He got better and then came down with a common cold and was given albuterol. We are still dealing with the common cold at this time.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Angina unstable, Aortic arteriosclerosis, Chest pain, Hyperglycaemia
Clinical narrative: I20.0 UNSTABLE ANGINA 7/13/2021 CHEST PAIN I21.4 ACUTE NON ST ELEVATION MI 7/13/2021 CHEST PAIN I21.9 ACUTE MI 5/26/2021 CHEST PAIN J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 2/18/2021 CHEST PAIN I20.0 UNSTABLE ANGINA 7/13/2021 DM 2 W HYPERGLYCEMIA I21.4 ACUTE NON ST ELEVATION MI 7/13/2021 DM 2 W HYPERGLYCEMIA I21.9 ACUTE MI 5/26/2021 DM 2 W HYPERGLYCEMIA J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 2/18/2021 DM 2 W HYPERGLYCEMIA I20.0 UNSTABLE ANGINA 7/13/2021 ATHEROSCLEROSIS OF AORTA I21.4 ACUTE NON ST ELEVATION MI 7/13/2021 ATHEROSCLEROSIS OF AORTA I21.9 ACUTE MI 5/26/2021 ATHEROSCLEROSIS OF AORTA J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 2/18/2021 ATHEROSCLEROSIS OF AORTA I20.0 UNSTABLE ANGINA 7/13/2021 ACUTE NON ST ELEVATION MI I21.4 ACUTE NON ST ELEVATION MI 7/13/2021 ACUTE NON ST ELEVATION MI I21.9 ACUTE MI 5/26/2021 ACUTE NON ST ELEVATION MI J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 2/18/2021 ACUTE NON ST ELEVATION MI
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory failure, Type 2 diabetes mellitus
Clinical narrative: I20.0 UNSTABLE ANGINA 7/13/2021 CHEST PAIN I21.4 ACUTE NON ST ELEVATION MI 7/13/2021 CHEST PAIN I21.9 ACUTE MI 5/26/2021 CHEST PAIN J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 2/18/2021 CHEST PAIN I20.0 UNSTABLE ANGINA 7/13/2021 DM 2 W HYPERGLYCEMIA I21.4 ACUTE NON ST ELEVATION MI 7/13/2021 DM 2 W HYPERGLYCEMIA I21.9 ACUTE MI 5/26/2021 DM 2 W HYPERGLYCEMIA J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 2/18/2021 DM 2 W HYPERGLYCEMIA I20.0 UNSTABLE ANGINA 7/13/2021 ATHEROSCLEROSIS OF AORTA I21.4 ACUTE NON ST ELEVATION MI 7/13/2021 ATHEROSCLEROSIS OF AORTA I21.9 ACUTE MI 5/26/2021 ATHEROSCLEROSIS OF AORTA J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 2/18/2021 ATHEROSCLEROSIS OF AORTA I20.0 UNSTABLE ANGINA 7/13/2021 ACUTE NON ST ELEVATION MI I21.4 ACUTE NON ST ELEVATION MI 7/13/2021 ACUTE NON ST ELEVATION MI I21.9 ACUTE MI 5/26/2021 ACUTE NON ST ELEVATION MI J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 2/18/2021 ACUTE NON ST ELEVATION MI
Age: 68.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Asthenia, COVID-19, Cardiac failure, Cellulitis, Chronic obstructive pulmonary disease
Clinical narrative: Discharge Provider: Primary Care Provider at Discharge: Admission Date: 4/12/2023 Discharge Date: 4/19/2023    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Generalized weakness [R53.1] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 69-year-old gentleman who presented the hospital complaints of weakness.  The patient has multiple recent hospitalizations related to heart failure and chronic obstructive pulmonary disease exacerbation.  Patient on presentation was stable from a respiratory standpoint but was noted to be testing positive for COVID-19.  Patient's respiratory status remained stable throughout his hospitalization.  No medication intervention was necessary related to patient's COVID-19.  Patient was noted to have significant weakness during his hospitalization.  Recommendations from physical and occupational therapy were for the patient to be sent for subacute rehab.  Despite our recommendations and our concern for his ability to care for himself at home, the patient's insurance company did not authorize financial coverage for subacute rehab.  Subsequent plan is to discharge patient home with home health services. During the patient's hospitalization he was noted to have some significant hyperkalemia.  Patient's home Cozaar and Aldactone along with supplementary potassium were placed on hold.  Patient's blood pressure remained stable and in an appropriate range without administration of Cozaar and Aldactone.  Cozaar, Aldactone, and supplementary potassium are being held at discharge.  Recommend a repeat BMP in follow-up. Additionally, the patient was noted to have erythema and swelling surrounding his IV site.  Concern was noted for possible cellulitis.  Patient was started on IV doxycycline and had significant improvement of traced area of erythema.  Patient will be discharged home to complete a 1 week antibiotic course for suspected cellulitis of the left antecubital space. Patient is felt to be in stable condition at this time and is being discharged home with home health services
Age: 68.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Condition aggravated, Erythema, Hyperkalaemia, Metabolic function test, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: Primary Care Provider at Discharge: Admission Date: 4/12/2023 Discharge Date: 4/19/2023    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Generalized weakness [R53.1] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 69-year-old gentleman who presented the hospital complaints of weakness.  The patient has multiple recent hospitalizations related to heart failure and chronic obstructive pulmonary disease exacerbation.  Patient on presentation was stable from a respiratory standpoint but was noted to be testing positive for COVID-19.  Patient's respiratory status remained stable throughout his hospitalization.  No medication intervention was necessary related to patient's COVID-19.  Patient was noted to have significant weakness during his hospitalization.  Recommendations from physical and occupational therapy were for the patient to be sent for subacute rehab.  Despite our recommendations and our concern for his ability to care for himself at home, the patient's insurance company did not authorize financial coverage for subacute rehab.  Subsequent plan is to discharge patient home with home health services. During the patient's hospitalization he was noted to have some significant hyperkalemia.  Patient's home Cozaar and Aldactone along with supplementary potassium were placed on hold.  Patient's blood pressure remained stable and in an appropriate range without administration of Cozaar and Aldactone.  Cozaar, Aldactone, and supplementary potassium are being held at discharge.  Recommend a repeat BMP in follow-up. Additionally, the patient was noted to have erythema and swelling surrounding his IV site.  Concern was noted for possible cellulitis.  Patient was started on IV doxycycline and had significant improvement of traced area of erythema.  Patient will be discharged home to complete a 1 week antibiotic course for suspected cellulitis of the left antecubital space. Patient is felt to be in stable condition at this time and is being discharged home with home health services
Age: 68.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Swelling, Vessel puncture site erythema, Vessel puncture site swelling
Clinical narrative: Discharge Provider: Primary Care Provider at Discharge: Admission Date: 4/12/2023 Discharge Date: 4/19/2023    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Generalized weakness [R53.1] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 69-year-old gentleman who presented the hospital complaints of weakness.  The patient has multiple recent hospitalizations related to heart failure and chronic obstructive pulmonary disease exacerbation.  Patient on presentation was stable from a respiratory standpoint but was noted to be testing positive for COVID-19.  Patient's respiratory status remained stable throughout his hospitalization.  No medication intervention was necessary related to patient's COVID-19.  Patient was noted to have significant weakness during his hospitalization.  Recommendations from physical and occupational therapy were for the patient to be sent for subacute rehab.  Despite our recommendations and our concern for his ability to care for himself at home, the patient's insurance company did not authorize financial coverage for subacute rehab.  Subsequent plan is to discharge patient home with home health services. During the patient's hospitalization he was noted to have some significant hyperkalemia.  Patient's home Cozaar and Aldactone along with supplementary potassium were placed on hold.  Patient's blood pressure remained stable and in an appropriate range without administration of Cozaar and Aldactone.  Cozaar, Aldactone, and supplementary potassium are being held at discharge.  Recommend a repeat BMP in follow-up. Additionally, the patient was noted to have erythema and swelling surrounding his IV site.  Concern was noted for possible cellulitis.  Patient was started on IV doxycycline and had significant improvement of traced area of erythema.  Patient will be discharged home to complete a 1 week antibiotic course for suspected cellulitis of the left antecubital space. Patient is felt to be in stable condition at this time and is being discharged home with home health services
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Symptom recurrence
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE  4/29/2022 -- RECURRENCE OF SAME SYMPTOMS
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19-2
Symptoms: Asthenia, COVID-19, Cough, Fatigue, Myalgia
Clinical narrative: Case was admitted to hospital on 04/21/2023 for an unrelated reason. She acquired COVID 19 in hospital and began becoming symptomatic; cough, severe fatigue, weakness and muscle aches. Case tested positive 05/02/2023. Plan is to go to a Rehab facility for 10 days and return to her home.
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Case was admitted to hospital on 04/21/2023 for an unrelated reason. She acquired COVID 19 in hospital and began becoming symptomatic; cough, severe fatigue, weakness and muscle aches. Case tested positive 05/02/2023. Plan is to go to a Rehab facility for 10 days and return to her home.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Anxiety, Blood creatinine increased, COVID-19, Chest X-ray normal
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO Admission Date: 4/12/2023 Discharge Date:  4/16/23   DISCHARGE DIAGNOSES 1. Chronic obstructive pulmonary disease infection 2. Acute chronic obstructive pulmonary disease exacerbation-resolved 3. Stage 3 kidney disease 4. History of CVA 5. Coronary artery disease 10. Hypertension 11. Anxiety 12. OSA 13. Tobacco use disorder   HOSPITAL COURSE:   Patient is a 76-year-old female with a past medical history of COPD with poor compliance to inhalers, stage III A CKD, history of CVD, coronary artery disease, hypertension, anxiety, OSA on 1 L nasal cannula at night.  She presented to the emergency department on 04/12 on day 6 of the LEs.  She had a one-week history productive cough, worsening wheezing, shortness of breath, congestion and rhinorrhea.  She notes that she had not been taking inhalers at this time.  She takes her Symbicort as needed and rarely uses albuterol.    Patient to the emergency department she was satting 95% on room air and was placed on 2 L nasal cannula.  3 m her vital signs are stable.  She does have positive for COVID 19.  Labs demonstrated a slightly elevated creatinine at 1.46.  Her D-dimer was elevated at 430. Chest x-ray did not demonstrate an acute infectious process.  She was given 6 mg of Decadron and albuterol inhaler and admitted to internal medicine service for management of COVID and chronic obstructive pulmonary disease.   In the management of her COVID, she received 4 days of Decadron 6 mg. She was not a remdesivir candidate.  She was weaned from 2 L nasal cannula to room air over the course of 4 days.  Treatment also included symptomatic care with cough suppressants and decongestants.  In the management of her chronic obstructive pulmonary disease, she was started on her home Symbicort and albuterol as needed every 2 hours, remained on steroids, and received azithromycin.  She was unable to receive nebulized medications due to COVID status.  During course of her stay, she was weaned to room air, shortness of breath and wheezing resolved, and her AKI resolved.  She was discharged on 4/16 with a prednisone taper, instructions to take care Symbicort daily to use albuterol Q 2 to every 4 hours as needed, and follow-up with her PCP.  She noted that she has been trying to quit smoking and this was encouraged.  Is a 25 pack-year smoking history.  She denied desiring nicotine patches or further management for smoking cessation.  Was encouraged that she follow up with her primary care physician regarding this
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chronic kidney disease, Chronic obstructive pulmonary disease, Condition aggravated, Coronary artery disease, Dyspnoea
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO Admission Date: 4/12/2023 Discharge Date:  4/16/23   DISCHARGE DIAGNOSES 1. Chronic obstructive pulmonary disease infection 2. Acute chronic obstructive pulmonary disease exacerbation-resolved 3. Stage 3 kidney disease 4. History of CVA 5. Coronary artery disease 10. Hypertension 11. Anxiety 12. OSA 13. Tobacco use disorder   HOSPITAL COURSE:   Patient is a 76-year-old female with a past medical history of COPD with poor compliance to inhalers, stage III A CKD, history of CVD, coronary artery disease, hypertension, anxiety, OSA on 1 L nasal cannula at night.  She presented to the emergency department on 04/12 on day 6 of the LEs.  She had a one-week history productive cough, worsening wheezing, shortness of breath, congestion and rhinorrhea.  She notes that she had not been taking inhalers at this time.  She takes her Symbicort as needed and rarely uses albuterol.    Patient to the emergency department she was satting 95% on room air and was placed on 2 L nasal cannula.  3 m her vital signs are stable.  She does have positive for COVID 19.  Labs demonstrated a slightly elevated creatinine at 1.46.  Her D-dimer was elevated at 430. Chest x-ray did not demonstrate an acute infectious process.  She was given 6 mg of Decadron and albuterol inhaler and admitted to internal medicine service for management of COVID and chronic obstructive pulmonary disease.   In the management of her COVID, she received 4 days of Decadron 6 mg. She was not a remdesivir candidate.  She was weaned from 2 L nasal cannula to room air over the course of 4 days.  Treatment also included symptomatic care with cough suppressants and decongestants.  In the management of her chronic obstructive pulmonary disease, she was started on her home Symbicort and albuterol as needed every 2 hours, remained on steroids, and received azithromycin.  She was unable to receive nebulized medications due to COVID status.  During course of her stay, she was weaned to room air, shortness of breath and wheezing resolved, and her AKI resolved.  She was discharged on 4/16 with a prednisone taper, instructions to take care Symbicort daily to use albuterol Q 2 to every 4 hours as needed, and follow-up with her PCP.  She noted that she has been trying to quit smoking and this was encouraged.  Is a 25 pack-year smoking history.  She denied desiring nicotine patches or further management for smoking cessation.  Was encouraged that she follow up with her primary care physician regarding this
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Fibrin D dimer, Hypertension, Infection, Obstructive sleep apnoea syndrome, Productive cough
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO Admission Date: 4/12/2023 Discharge Date:  4/16/23   DISCHARGE DIAGNOSES 1. Chronic obstructive pulmonary disease infection 2. Acute chronic obstructive pulmonary disease exacerbation-resolved 3. Stage 3 kidney disease 4. History of CVA 5. Coronary artery disease 10. Hypertension 11. Anxiety 12. OSA 13. Tobacco use disorder   HOSPITAL COURSE:   Patient is a 76-year-old female with a past medical history of COPD with poor compliance to inhalers, stage III A CKD, history of CVD, coronary artery disease, hypertension, anxiety, OSA on 1 L nasal cannula at night.  She presented to the emergency department on 04/12 on day 6 of the LEs.  She had a one-week history productive cough, worsening wheezing, shortness of breath, congestion and rhinorrhea.  She notes that she had not been taking inhalers at this time.  She takes her Symbicort as needed and rarely uses albuterol.    Patient to the emergency department she was satting 95% on room air and was placed on 2 L nasal cannula.  3 m her vital signs are stable.  She does have positive for COVID 19.  Labs demonstrated a slightly elevated creatinine at 1.46.  Her D-dimer was elevated at 430. Chest x-ray did not demonstrate an acute infectious process.  She was given 6 mg of Decadron and albuterol inhaler and admitted to internal medicine service for management of COVID and chronic obstructive pulmonary disease.   In the management of her COVID, she received 4 days of Decadron 6 mg. She was not a remdesivir candidate.  She was weaned from 2 L nasal cannula to room air over the course of 4 days.  Treatment also included symptomatic care with cough suppressants and decongestants.  In the management of her chronic obstructive pulmonary disease, she was started on her home Symbicort and albuterol as needed every 2 hours, remained on steroids, and received azithromycin.  She was unable to receive nebulized medications due to COVID status.  During course of her stay, she was weaned to room air, shortness of breath and wheezing resolved, and her AKI resolved.  She was discharged on 4/16 with a prednisone taper, instructions to take care Symbicort daily to use albuterol Q 2 to every 4 hours as needed, and follow-up with her PCP.  She noted that she has been trying to quit smoking and this was encouraged.  Is a 25 pack-year smoking history.  She denied desiring nicotine patches or further management for smoking cessation.  Was encouraged that she follow up with her primary care physician regarding this
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Tobacco abuse, Treatment noncompliance
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO Admission Date: 4/12/2023 Discharge Date:  4/16/23   DISCHARGE DIAGNOSES 1. Chronic obstructive pulmonary disease infection 2. Acute chronic obstructive pulmonary disease exacerbation-resolved 3. Stage 3 kidney disease 4. History of CVA 5. Coronary artery disease 10. Hypertension 11. Anxiety 12. OSA 13. Tobacco use disorder   HOSPITAL COURSE:   Patient is a 76-year-old female with a past medical history of COPD with poor compliance to inhalers, stage III A CKD, history of CVD, coronary artery disease, hypertension, anxiety, OSA on 1 L nasal cannula at night.  She presented to the emergency department on 04/12 on day 6 of the LEs.  She had a one-week history productive cough, worsening wheezing, shortness of breath, congestion and rhinorrhea.  She notes that she had not been taking inhalers at this time.  She takes her Symbicort as needed and rarely uses albuterol.    Patient to the emergency department she was satting 95% on room air and was placed on 2 L nasal cannula.  3 m her vital signs are stable.  She does have positive for COVID 19.  Labs demonstrated a slightly elevated creatinine at 1.46.  Her D-dimer was elevated at 430. Chest x-ray did not demonstrate an acute infectious process.  She was given 6 mg of Decadron and albuterol inhaler and admitted to internal medicine service for management of COVID and chronic obstructive pulmonary disease.   In the management of her COVID, she received 4 days of Decadron 6 mg. She was not a remdesivir candidate.  She was weaned from 2 L nasal cannula to room air over the course of 4 days.  Treatment also included symptomatic care with cough suppressants and decongestants.  In the management of her chronic obstructive pulmonary disease, she was started on her home Symbicort and albuterol as needed every 2 hours, remained on steroids, and received azithromycin.  She was unable to receive nebulized medications due to COVID status.  During course of her stay, she was weaned to room air, shortness of breath and wheezing resolved, and her AKI resolved.  She was discharged on 4/16 with a prednisone taper, instructions to take care Symbicort daily to use albuterol Q 2 to every 4 hours as needed, and follow-up with her PCP.  She noted that she has been trying to quit smoking and this was encouraged.  Is a 25 pack-year smoking history.  She denied desiring nicotine patches or further management for smoking cessation.  Was encouraged that she follow up with her primary care physician regarding this
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Wheezing
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO Admission Date: 4/12/2023 Discharge Date:  4/16/23   DISCHARGE DIAGNOSES 1. Chronic obstructive pulmonary disease infection 2. Acute chronic obstructive pulmonary disease exacerbation-resolved 3. Stage 3 kidney disease 4. History of CVA 5. Coronary artery disease 10. Hypertension 11. Anxiety 12. OSA 13. Tobacco use disorder   HOSPITAL COURSE:   Patient is a 76-year-old female with a past medical history of COPD with poor compliance to inhalers, stage III A CKD, history of CVD, coronary artery disease, hypertension, anxiety, OSA on 1 L nasal cannula at night.  She presented to the emergency department on 04/12 on day 6 of the LEs.  She had a one-week history productive cough, worsening wheezing, shortness of breath, congestion and rhinorrhea.  She notes that she had not been taking inhalers at this time.  She takes her Symbicort as needed and rarely uses albuterol.    Patient to the emergency department she was satting 95% on room air and was placed on 2 L nasal cannula.  3 m her vital signs are stable.  She does have positive for COVID 19.  Labs demonstrated a slightly elevated creatinine at 1.46.  Her D-dimer was elevated at 430. Chest x-ray did not demonstrate an acute infectious process.  She was given 6 mg of Decadron and albuterol inhaler and admitted to internal medicine service for management of COVID and chronic obstructive pulmonary disease.   In the management of her COVID, she received 4 days of Decadron 6 mg. She was not a remdesivir candidate.  She was weaned from 2 L nasal cannula to room air over the course of 4 days.  Treatment also included symptomatic care with cough suppressants and decongestants.  In the management of her chronic obstructive pulmonary disease, she was started on her home Symbicort and albuterol as needed every 2 hours, remained on steroids, and received azithromycin.  She was unable to receive nebulized medications due to COVID status.  During course of her stay, she was weaned to room air, shortness of breath and wheezing resolved, and her AKI resolved.  She was discharged on 4/16 with a prednisone taper, instructions to take care Symbicort daily to use albuterol Q 2 to every 4 hours as needed, and follow-up with her PCP.  She noted that she has been trying to quit smoking and this was encouraged.  Is a 25 pack-year smoking history.  She denied desiring nicotine patches or further management for smoking cessation.  Was encouraged that she follow up with her primary care physician regarding this
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angioedema, Hypersensitivity, Hypoxia, Symptom recurrence
Clinical narrative: ACUTE HYPOXEMIC RESPIRATORY FAILURE HYPOXIA ANGIOEDEMA, INIT ANGIOEDEMA, SEQUELA ALLERGIC REACTION, INIT 11/8/2022 &  11/21/2022  --  RECURRENCE OF SAME SYMPTOMS
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Mental status changes, SARS-CoV-2 test positive
Clinical narrative: 02/22/23 presents to EC ED for "altered mental status". PMHx of "HTN and dementia"
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE HYPOXIA
Age: 1.25
Sex: F
Vaccine: DTAP
Symptoms: Expired product administered
Clinical narrative: Expired vaccine given (EXP 4/29/2023)
Age: 16.0
Sex: F
Vaccine: MENB
Symptoms: Arthralgia, Injection site nodule, Injection site swelling, Injection site warmth, Loss of personal independence in daily activities
Clinical narrative: She had a reaction the first time she had the vaccine but that was also with the boosters.    She got her vaccine, 20 minutes after the vaccine she started complaining that her arm was getting sore.  She said that it felt like she had been bruised and could hardly move her arm.  The next morning her arm was swollen, it went down halfway down her arm from the shoulder was puffy and swollen and has a knot at the injection site.  It was hot to touch, fever.  She was complaining with body aches, especially in her thighs and hips area, and then down her arm.  The aching was in her shoulders, like she had been running high fever and affecting her joints.  She said it felt like when she had COVID.  She missed school the next day and still cannot pick up things with that arm as it is still swollen and puffed up.  Mother called the doctor, they did not tell her to bring her in and that there was really not much to do for her and to give her Ibuprofen and Tylenol and mother believes she has been taking Ibuprofen and ice packs.
Age: 16.0
Sex: F
Vaccine: MENB
Symptoms: Mobility decreased, Pain, Pain in extremity, Peripheral swelling, Pyrexia
Clinical narrative: She had a reaction the first time she had the vaccine but that was also with the boosters.    She got her vaccine, 20 minutes after the vaccine she started complaining that her arm was getting sore.  She said that it felt like she had been bruised and could hardly move her arm.  The next morning her arm was swollen, it went down halfway down her arm from the shoulder was puffy and swollen and has a knot at the injection site.  It was hot to touch, fever.  She was complaining with body aches, especially in her thighs and hips area, and then down her arm.  The aching was in her shoulders, like she had been running high fever and affecting her joints.  She said it felt like when she had COVID.  She missed school the next day and still cannot pick up things with that arm as it is still swollen and puffed up.  Mother called the doctor, they did not tell her to bring her in and that there was really not much to do for her and to give her Ibuprofen and Tylenol and mother believes she has been taking Ibuprofen and ice packs.
Age: 63.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: BUD date excursion. BUD date was 4-7-23 and vaccine was administered 4-21-23.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Decreased appetite, Headache, Malaise
Clinical narrative: On 02/10/2023, from the time I woke up, I did not feel well. I had body aches, fever, loss of appetite, headache, cough. I took Tylenol and went to bed. I took a COVID-19 Test and it was positive, so I called the doctor. I was prescribed Paxlovid, which I took and it helped. I am better.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: On 02/10/2023, from the time I woke up, I did not feel well. I had body aches, fever, loss of appetite, headache, cough. I took Tylenol and went to bed. I took a COVID-19 Test and it was positive, so I called the doctor. I was prescribed Paxlovid, which I took and it helped. I am better.
Age: 78.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: BUD date excursion. BUD date 4-7-23 and vaccine was administered 4-21-23.
Age: 92.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Acute myocardial infarction, Angiogram cerebral abnormal, Arteriogram carotid abnormal, COVID-19, Cardiac failure congestive
Clinical narrative: Discharge Provider:  Primary Care Provider:  DO Admission Date: 4/14/2023 Discharge Date: Apr 20, 2023  PRESENTING PROBLEM: NSTEMI (non-ST elevated myocardial infarction) (HCC)    HOSPITAL COURSE: 93-year-old female with a known history of hyperlipidemia, anxiety disorder, reflux presented to the Emergency Room 04/14/2023 with a week's worth of shortness of breath that had been progressing.  Was found to be hypoxic in the emergency room requiring 3 L nasal cannula oxygen.  Normally on room air at home.  The patient tested positive for COVID and was started on remdesivir and dexamethasone. Troponins were elevated and cardiology consultation recommended transfer for echocardiogram and cardiology management.  Elevated troponins 154 with repeat 139. Patient denied chest pain, but did have intermittent shortness of breath and cough.  Chest x-ray was read as findings of CHF, bibasilar airspace disease and small pleural effusions, and proBNP was greater than 7000. Patient with improvement in her breathing with treatment for COVID. Cardiology consulted for elevated troponins and EKG changes, thought could be myocarditis related to COVID, recommended no further invasive evaluation.   She also underwent a neurological workup for facial paresthesia. CT head without contrast showed no acute, CTA head and neck revealed no acute intracranial large vessel occlusion but severe short-segment atherosclerotic narrowing of the left anterior cerebral artery A2 segment and some minimal carotid artery disease. Parotid mass measuring 1.9 cm on the left. Has had this worked up and seen ENT 11/2022. Neurology consulted and patient underwent a brain MRI which revealed the left superior cerebellar artery appears to contact and bow the left cisternal trigeminal nerve near the root of entry zone, left anterior inferior cerebellar artery appears to exert mild mass effect upon left cranial nerve. Neurology recommended starting carbamazepine and will follow-up outpatient in clinic
Age: 92.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Carotid artery disease, Cerebellar artery occlusion, Cerebral arteriosclerosis, Chest X-ray abnormal, Computerised tomogram head normal
Clinical narrative: Discharge Provider:  Primary Care Provider:  DO Admission Date: 4/14/2023 Discharge Date: Apr 20, 2023  PRESENTING PROBLEM: NSTEMI (non-ST elevated myocardial infarction) (HCC)    HOSPITAL COURSE: 93-year-old female with a known history of hyperlipidemia, anxiety disorder, reflux presented to the Emergency Room 04/14/2023 with a week's worth of shortness of breath that had been progressing.  Was found to be hypoxic in the emergency room requiring 3 L nasal cannula oxygen.  Normally on room air at home.  The patient tested positive for COVID and was started on remdesivir and dexamethasone. Troponins were elevated and cardiology consultation recommended transfer for echocardiogram and cardiology management.  Elevated troponins 154 with repeat 139. Patient denied chest pain, but did have intermittent shortness of breath and cough.  Chest x-ray was read as findings of CHF, bibasilar airspace disease and small pleural effusions, and proBNP was greater than 7000. Patient with improvement in her breathing with treatment for COVID. Cardiology consulted for elevated troponins and EKG changes, thought could be myocarditis related to COVID, recommended no further invasive evaluation.   She also underwent a neurological workup for facial paresthesia. CT head without contrast showed no acute, CTA head and neck revealed no acute intracranial large vessel occlusion but severe short-segment atherosclerotic narrowing of the left anterior cerebral artery A2 segment and some minimal carotid artery disease. Parotid mass measuring 1.9 cm on the left. Has had this worked up and seen ENT 11/2022. Neurology consulted and patient underwent a brain MRI which revealed the left superior cerebellar artery appears to contact and bow the left cisternal trigeminal nerve near the root of entry zone, left anterior inferior cerebellar artery appears to exert mild mass effect upon left cranial nerve. Neurology recommended starting carbamazepine and will follow-up outpatient in clinic
Age: 92.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Cough, Cranial nerve disorder, Dyspnoea, Electrocardiogram change, Hypoxia
Clinical narrative: Discharge Provider:  Primary Care Provider:  DO Admission Date: 4/14/2023 Discharge Date: Apr 20, 2023  PRESENTING PROBLEM: NSTEMI (non-ST elevated myocardial infarction) (HCC)    HOSPITAL COURSE: 93-year-old female with a known history of hyperlipidemia, anxiety disorder, reflux presented to the Emergency Room 04/14/2023 with a week's worth of shortness of breath that had been progressing.  Was found to be hypoxic in the emergency room requiring 3 L nasal cannula oxygen.  Normally on room air at home.  The patient tested positive for COVID and was started on remdesivir and dexamethasone. Troponins were elevated and cardiology consultation recommended transfer for echocardiogram and cardiology management.  Elevated troponins 154 with repeat 139. Patient denied chest pain, but did have intermittent shortness of breath and cough.  Chest x-ray was read as findings of CHF, bibasilar airspace disease and small pleural effusions, and proBNP was greater than 7000. Patient with improvement in her breathing with treatment for COVID. Cardiology consulted for elevated troponins and EKG changes, thought could be myocarditis related to COVID, recommended no further invasive evaluation.   She also underwent a neurological workup for facial paresthesia. CT head without contrast showed no acute, CTA head and neck revealed no acute intracranial large vessel occlusion but severe short-segment atherosclerotic narrowing of the left anterior cerebral artery A2 segment and some minimal carotid artery disease. Parotid mass measuring 1.9 cm on the left. Has had this worked up and seen ENT 11/2022. Neurology consulted and patient underwent a brain MRI which revealed the left superior cerebellar artery appears to contact and bow the left cisternal trigeminal nerve near the root of entry zone, left anterior inferior cerebellar artery appears to exert mild mass effect upon left cranial nerve. Neurology recommended starting carbamazepine and will follow-up outpatient in clinic
Age: 92.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Lung disorder, Magnetic resonance imaging head abnormal, Mass, Neurological examination, Paraesthesia
Clinical narrative: Discharge Provider:  Primary Care Provider:  DO Admission Date: 4/14/2023 Discharge Date: Apr 20, 2023  PRESENTING PROBLEM: NSTEMI (non-ST elevated myocardial infarction) (HCC)    HOSPITAL COURSE: 93-year-old female with a known history of hyperlipidemia, anxiety disorder, reflux presented to the Emergency Room 04/14/2023 with a week's worth of shortness of breath that had been progressing.  Was found to be hypoxic in the emergency room requiring 3 L nasal cannula oxygen.  Normally on room air at home.  The patient tested positive for COVID and was started on remdesivir and dexamethasone. Troponins were elevated and cardiology consultation recommended transfer for echocardiogram and cardiology management.  Elevated troponins 154 with repeat 139. Patient denied chest pain, but did have intermittent shortness of breath and cough.  Chest x-ray was read as findings of CHF, bibasilar airspace disease and small pleural effusions, and proBNP was greater than 7000. Patient with improvement in her breathing with treatment for COVID. Cardiology consulted for elevated troponins and EKG changes, thought could be myocarditis related to COVID, recommended no further invasive evaluation.   She also underwent a neurological workup for facial paresthesia. CT head without contrast showed no acute, CTA head and neck revealed no acute intracranial large vessel occlusion but severe short-segment atherosclerotic narrowing of the left anterior cerebral artery A2 segment and some minimal carotid artery disease. Parotid mass measuring 1.9 cm on the left. Has had this worked up and seen ENT 11/2022. Neurology consulted and patient underwent a brain MRI which revealed the left superior cerebellar artery appears to contact and bow the left cisternal trigeminal nerve near the root of entry zone, left anterior inferior cerebellar artery appears to exert mild mass effect upon left cranial nerve. Neurology recommended starting carbamazepine and will follow-up outpatient in clinic
Age: 92.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Pleural effusion, Prohormone brain natriuretic peptide increased, SARS-CoV-2 test positive, Trigeminal nerve disorder, Troponin increased
Clinical narrative: Discharge Provider:  Primary Care Provider:  DO Admission Date: 4/14/2023 Discharge Date: Apr 20, 2023  PRESENTING PROBLEM: NSTEMI (non-ST elevated myocardial infarction) (HCC)    HOSPITAL COURSE: 93-year-old female with a known history of hyperlipidemia, anxiety disorder, reflux presented to the Emergency Room 04/14/2023 with a week's worth of shortness of breath that had been progressing.  Was found to be hypoxic in the emergency room requiring 3 L nasal cannula oxygen.  Normally on room air at home.  The patient tested positive for COVID and was started on remdesivir and dexamethasone. Troponins were elevated and cardiology consultation recommended transfer for echocardiogram and cardiology management.  Elevated troponins 154 with repeat 139. Patient denied chest pain, but did have intermittent shortness of breath and cough.  Chest x-ray was read as findings of CHF, bibasilar airspace disease and small pleural effusions, and proBNP was greater than 7000. Patient with improvement in her breathing with treatment for COVID. Cardiology consulted for elevated troponins and EKG changes, thought could be myocarditis related to COVID, recommended no further invasive evaluation.   She also underwent a neurological workup for facial paresthesia. CT head without contrast showed no acute, CTA head and neck revealed no acute intracranial large vessel occlusion but severe short-segment atherosclerotic narrowing of the left anterior cerebral artery A2 segment and some minimal carotid artery disease. Parotid mass measuring 1.9 cm on the left. Has had this worked up and seen ENT 11/2022. Neurology consulted and patient underwent a brain MRI which revealed the left superior cerebellar artery appears to contact and bow the left cisternal trigeminal nerve near the root of entry zone, left anterior inferior cerebellar artery appears to exert mild mass effect upon left cranial nerve. Neurology recommended starting carbamazepine and will follow-up outpatient in clinic
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: Patient was vaccinated with a vaccine that had been past the 12 hour open time period.
Age: 1.0
Sex: M
Vaccine: COVID19, FLU4, HEPA, MMRV, VARCEL
Symptoms: Cough, Dyspnoea, Ear infection, Nasopharyngitis, Pyrexia
Clinical narrative: On 1/17/23, he had a common cold with an ear infection. He had congestion, fever, coughing, and difficulty breathing. We contacted his doctor and was prescribed Albuterol and Amoxicillin. We had to take him back to the doctor because he wasn't getting better, and they prescribed Cefdinir. This lasted until 2/6/23.
Age: 1.0
Sex: M
Vaccine: COVID19, FLU4, HEPA, MMRV, VARCEL
Symptoms: Respiratory tract congestion, SARS-CoV-2 test negative
Clinical narrative: On 1/17/23, he had a common cold with an ear infection. He had congestion, fever, coughing, and difficulty breathing. We contacted his doctor and was prescribed Albuterol and Amoxicillin. We had to take him back to the doctor because he wasn't getting better, and they prescribed Cefdinir. This lasted until 2/6/23.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Hypersomnia, Nausea, Pyrexia
Clinical narrative: 06:30 AM 05/06/23   fever 100 Tylenol 250 mg X1 09:00 AM 05/06/23   fatigue slept most of day (7 hours) 02:30 AM 05/07/23    vomited  X1 extreme nausea  10:00 AM 05/07/23   all events resolved
Age: 34.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: 02/24/23 presents to ED for "SOB and covid infection". PMHx of "Severe uncontrolled Asthma, eosinophilia +elevated IgE"
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Blood sodium decreased, COVID-19, Chest X-ray normal, Chronic obstructive pulmonary disease
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  DO Admission Date: 4/14/2023 Discharge Date:  04/16/2023  PRESENTING PROBLEM: Hyponatremia  Chronic obstructive pulmonary disease with (acute) exacerbation (HCC)  Acute on chronic respiratory failure with hypoxia and hypercapnia (HCC)    HOSPITAL COURSE: Patient is a 70-year-old male with past medical history of chronic obstructive pulmonary disease requiring 2-4 L nasal cannula at his baseline, alcohol abuse, hypertension and obstructive sleep apnea who presented to the hospital for shortness of breath.  Symptoms had been progressively worsening over the prior 2-3 days with no improvement with nebulizer treatments and inhalers.  As result patient came to the ER.  In the ER patient was hypoxic and required non-rebreather that was escalated to BiPAP.  Patient had mild leukocytosis and was found to be acidotic with CO2 retention.  Sodium was also decreased at 122. X-ray did not show any signs or concerns for pneumonia.  Additionally patient was COVID positive which was later found on admission.  Patient was started on Solu-Medrol, doxycycline and admitted for chronic obstructive pulmonary disease exacerbation.  Patient was able to quickly wean off of this went back to his baseline 2-4 L. sodium gradually improved.  No signs of alcohol withdrawal during admission.  Patient is stable breathing at baseline on discharge.  Will be discharged home with remaining course of steroids and antibiotics.  Encouraged to follow up with PCP within 2-5 days for repeat blood draw to evaluate status of hyponatremia.  Will also be discharged home with salt tablets.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Condition aggravated, Dyspnoea, Hypercapnia, Hyponatraemia, Hypoxia
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  DO Admission Date: 4/14/2023 Discharge Date:  04/16/2023  PRESENTING PROBLEM: Hyponatremia  Chronic obstructive pulmonary disease with (acute) exacerbation (HCC)  Acute on chronic respiratory failure with hypoxia and hypercapnia (HCC)    HOSPITAL COURSE: Patient is a 70-year-old male with past medical history of chronic obstructive pulmonary disease requiring 2-4 L nasal cannula at his baseline, alcohol abuse, hypertension and obstructive sleep apnea who presented to the hospital for shortness of breath.  Symptoms had been progressively worsening over the prior 2-3 days with no improvement with nebulizer treatments and inhalers.  As result patient came to the ER.  In the ER patient was hypoxic and required non-rebreather that was escalated to BiPAP.  Patient had mild leukocytosis and was found to be acidotic with CO2 retention.  Sodium was also decreased at 122. X-ray did not show any signs or concerns for pneumonia.  Additionally patient was COVID positive which was later found on admission.  Patient was started on Solu-Medrol, doxycycline and admitted for chronic obstructive pulmonary disease exacerbation.  Patient was able to quickly wean off of this went back to his baseline 2-4 L. sodium gradually improved.  No signs of alcohol withdrawal during admission.  Patient is stable breathing at baseline on discharge.  Will be discharged home with remaining course of steroids and antibiotics.  Encouraged to follow up with PCP within 2-5 days for repeat blood draw to evaluate status of hyponatremia.  Will also be discharged home with salt tablets.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Leukocytosis, Positive airway pressure therapy, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  DO Admission Date: 4/14/2023 Discharge Date:  04/16/2023  PRESENTING PROBLEM: Hyponatremia  Chronic obstructive pulmonary disease with (acute) exacerbation (HCC)  Acute on chronic respiratory failure with hypoxia and hypercapnia (HCC)    HOSPITAL COURSE: Patient is a 70-year-old male with past medical history of chronic obstructive pulmonary disease requiring 2-4 L nasal cannula at his baseline, alcohol abuse, hypertension and obstructive sleep apnea who presented to the hospital for shortness of breath.  Symptoms had been progressively worsening over the prior 2-3 days with no improvement with nebulizer treatments and inhalers.  As result patient came to the ER.  In the ER patient was hypoxic and required non-rebreather that was escalated to BiPAP.  Patient had mild leukocytosis and was found to be acidotic with CO2 retention.  Sodium was also decreased at 122. X-ray did not show any signs or concerns for pneumonia.  Additionally patient was COVID positive which was later found on admission.  Patient was started on Solu-Medrol, doxycycline and admitted for chronic obstructive pulmonary disease exacerbation.  Patient was able to quickly wean off of this went back to his baseline 2-4 L. sodium gradually improved.  No signs of alcohol withdrawal during admission.  Patient is stable breathing at baseline on discharge.  Will be discharged home with remaining course of steroids and antibiotics.  Encouraged to follow up with PCP within 2-5 days for repeat blood draw to evaluate status of hyponatremia.  Will also be discharged home with salt tablets.
Age: 60.0
Sex: F
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Vaccine was administered to patient who did not meet current CDC eligibility criteria for a second bivalent dose of the Moderna COVID vaccine. She was not 65 years or older and not immunocompromised.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Blood glucose increased, Dehydration, Diarrhoea, Hypophagia
Clinical narrative: Patient was seen at the MC ER for c/o elevated blood sugar and dehydration, poor oral intake and chronic diarrhea.  Patient was admitted for further evaluation and treatment.