chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive, Urinary tract infection, Urine analysis abnormal
Clinical narrative: The first time I was seen was on 11/23/2022. My symptoms were headaches, runny nose, chills, and that was it. I tested because I thought I just had a cold. When I tested, I tested positive for COVID-19 and I was shocked. I went to urgent care and they gave me PAXLOVID 300mg. By the next day, I didn't have the headache anymore but I was exhausted. I still had congestion. I stayed home for 5 days and after the 5th day, I could go out and wear a mask. After that, I started feeling like I had a cold again on 12/03/2022 and I tested again and tested positive. I went back to the urgent care, and the doctor said that it's uncommon but it can happen for a rebound case. He prescribed a Z-PAK and said it use it if I really needed to, but I ended up not using it. 8-9 days later, my eyes were blood shot and red, and I went back to urgent care again and they said it seemed as though the COVID-19 infection went to my eyes. They gave me eye drops and told me to quarantine for another 5 days and that seemed to be the last of the COVID-19 infection. On 12/06/2022 was when I went back to urgent care for my eyes. On 12/09/2022, I went to another care facility and they noted I also had a UTI and prescribed some medication. The medication they gave me was resistant to the UTI. So I went back on 12/13/2022 and they did some tests and gave me medication that actually worked. They noted that my immune system must have been ran down because they said I could have fought it off without medication, but my body couldn't do it at that time. I always wore a mask and I was fully vaccinated, so I was a bit shocked when I did get COVID-19.
Age: 21.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: vaccine was past the beyond use date of 2/18/2023
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood sodium decreased, COVID-19, Dyspnoea, Electrolyte imbalance
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD   Admission Date: 2/14/2023 Discharge Date: 2/16/2023  PRESENTING PROBLEM: Hyponatremia [E87.1] SOB (shortness of breath) [R06.02] Hypothyroidism, unspecified type [E03.9] COVID-19 [U07.1]   HOSPITAL COURSE:    Patient is a 85 y.o. male with history of mild left ventricle outlet obstruction, hypertension, well-controlled asthma, chronic dyspnea, hypothyroidism, history of prostate cancer status post chemoradiation, who presented to hospital with one week of weakness, malaise and flu-like symptoms. He felt so "crummy" that he presented to the ED. In the emergency department, he was positive for COVID 19 infection. No oxygen requirement.  His sodium is 122, baseline is normal, 140 in March 2022. He was treated with 1 L of normal saline in the ED.  The patient will be admitted to the Hospitalist Service for further management. His electrolytes and weakness improved with management. His vitals were normal. He was breathing, eating, drinking, eating, and moving bowels with no problems.  He was discharged him in stable condition on decadron, sodium chloride and high dose acetaminophen. He will follow up with his PCP. Return precautions were discussed
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Hyponatraemia, Hypothyroidism, Influenza like illness, Malaise, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: MD   Admission Date: 2/14/2023 Discharge Date: 2/16/2023  PRESENTING PROBLEM: Hyponatremia [E87.1] SOB (shortness of breath) [R06.02] Hypothyroidism, unspecified type [E03.9] COVID-19 [U07.1]   HOSPITAL COURSE:    Patient is a 85 y.o. male with history of mild left ventricle outlet obstruction, hypertension, well-controlled asthma, chronic dyspnea, hypothyroidism, history of prostate cancer status post chemoradiation, who presented to hospital with one week of weakness, malaise and flu-like symptoms. He felt so "crummy" that he presented to the ED. In the emergency department, he was positive for COVID 19 infection. No oxygen requirement.  His sodium is 122, baseline is normal, 140 in March 2022. He was treated with 1 L of normal saline in the ED.  The patient will be admitted to the Hospitalist Service for further management. His electrolytes and weakness improved with management. His vitals were normal. He was breathing, eating, drinking, eating, and moving bowels with no problems.  He was discharged him in stable condition on decadron, sodium chloride and high dose acetaminophen. He will follow up with his PCP. Return precautions were discussed
Age: 52.0
Sex: F
Vaccine: FLU4
Symptoms: Extra dose administered
Clinical narrative: PATIENT RECEIVED INFLUENZA VACCINE 11/10/2022.  ANOTHER DOSE WAS DOCUMENTED AS RECEIVED ON 09/15/2022 BY ANOTHER FACILITY.
Age: 1.33
Sex: F
Vaccine: HIBV
Symptoms: No adverse event, Product storage error
Clinical narrative: no additional AE; temperature excursion of 47.9 F for 47 min; This spontaneous report was received from an other health professional and referred to a 16-month-old female patient. The patient's medical history, concurrent conditions and concomitant therapies were not reported.  On 01-DEC-2022, the patient was vaccinated with the second dose of haemophilus B conjugate vaccine (meningococcal protein conjugate) (LIQUID PEDVAXHIB), intramuscularly at left thigh for prophylaxis (lot #W006596 has been verified to be a valid lot number, expiration date was 11-OCT-2024; dose and strength were not provided). It was reported that the vaccine the patient administered was stored in clinical practice and had a temperature excursion at 47.9 Fahrenheit for 47 minutes which was read from a digital data logger (product storage error). No additional adverse event was reported.  This is one of several reports received from the same reporter.; Sender's Comments:  US-009507513-2301USA009088:
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, COVID-19, Fatigue, Feeling abnormal, Head discomfort
Clinical narrative: I had extreme fatigue and general malaise, joint pain, I just felt terrible, my head felt as if it was too heavy for my neck to hold it up. I was supposed to be travelling so I chose to take a home COVID-19 test to make sure that I was not sick before I left home. The first test I used was expired but did come back positive. I did go out and get a second test that also came back positive. I called my doctor, we discussed the pro's and con's of taking PAXLOVID, I choose not to take it and in five days I was feeling better. For three full weeks I did experience not having headaches which I have not had since getting the idiopathic intercranial hypertension.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, SARS-CoV-2 test positive, Therapeutic response unexpected
Clinical narrative: I had extreme fatigue and general malaise, joint pain, I just felt terrible, my head felt as if it was too heavy for my neck to hold it up. I was supposed to be travelling so I chose to take a home COVID-19 test to make sure that I was not sick before I left home. The first test I used was expired but did come back positive. I did go out and get a second test that also came back positive. I called my doctor, we discussed the pro's and con's of taking PAXLOVID, I choose not to take it and in five days I was feeling better. For three full weeks I did experience not having headaches which I have not had since getting the idiopathic intercranial hypertension.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram, Disturbance in attention, Dizziness, Electrocardiogram, Fall
Clinical narrative: Employee received her vaccine on 2/22/23 and she stated she did fine with the vaccine except having a headache. Employee stated she got up on 2/23/23 with a headache, dizziness, and left sided weakness. Employee stated she was having to really concentrate and think to get her extremities to move. Employee did suffer a fall due to the weakness.. Employee did not receive any injuries from her fall. Employee notified Employee health and was instructed to go to the ER. Employee then called back and stated she was diagnosed with a Complicated Migraine with Hemiplegia or a Hemiplegic Migraine that could be related to the COVID Vaccine. Employee was instructed to follow up with her Primary care provider within a few days and to return to the ER if symptoms worsen.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Full blood count, Headache, Hemiparesis, Hemiplegic migraine, Migraine
Clinical narrative: Employee received her vaccine on 2/22/23 and she stated she did fine with the vaccine except having a headache. Employee stated she got up on 2/23/23 with a headache, dizziness, and left sided weakness. Employee stated she was having to really concentrate and think to get her extremities to move. Employee did suffer a fall due to the weakness.. Employee did not receive any injuries from her fall. Employee notified Employee health and was instructed to go to the ER. Employee then called back and stated she was diagnosed with a Complicated Migraine with Hemiplegia or a Hemiplegic Migraine that could be related to the COVID Vaccine. Employee was instructed to follow up with her Primary care provider within a few days and to return to the ER if symptoms worsen.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Urine analysis
Clinical narrative: Employee received her vaccine on 2/22/23 and she stated she did fine with the vaccine except having a headache. Employee stated she got up on 2/23/23 with a headache, dizziness, and left sided weakness. Employee stated she was having to really concentrate and think to get her extremities to move. Employee did suffer a fall due to the weakness.. Employee did not receive any injuries from her fall. Employee notified Employee health and was instructed to go to the ER. Employee then called back and stated she was diagnosed with a Complicated Migraine with Hemiplegia or a Hemiplegic Migraine that could be related to the COVID Vaccine. Employee was instructed to follow up with her Primary care provider within a few days and to return to the ER if symptoms worsen.
Age: 58.0
Sex: F
Vaccine: COVID19, HEPA
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Bronchiolitis, COVID-19, COVID-19 pneumonia
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  MD Admission Date: 2/13/2023 Discharge Date: Feb 16, 2023  PRESENTING PROBLEM: Acute respiratory failure with hypoxia  [J96.01] Community acquired pneumonia of right lung, unspecified part of lung [J18.9] COVID-19 [U07.1]   HOSPITAL COURSE:   58 y.o. female with a pertinent past medical history of asthma, hx asplenia and nephrectomy 2/2 trauma, chronic pain, HTN, who presented with cough, SOB. Admitted for AHRF.   CTA chest was negative for PE.  Did show multifocal right pneumonia with small areas of cavitation.  Pulmonology evaluated.  Cavitations thought to be infiltrates superimposed on emphysema.  Clinical presentation was consistent with COVID-19 pneumonia with respiratory bronchiolitis.  Was recommended for outpatient follow-up and signed off.    Patient's history was also not suggestive of cavitary pneumonia such as TB.  She denied any history of incarceration or recent travel outside the country, or any hemoptysis.   Patient was initially started on Unasyn and azithromycin for antibiotics.  Also started on Decadron and remdesivir.  DVT prophylaxis had been held in the setting of a possible bronchoscopy with pulmonology which patient eventually did not have.    Infectious Disease followed.  Strep and Legionella were negative.  Sputum culture with no result.  Blood cultures were not collected.   Patient initially required 4 L nasal cannula, remained hemodynamically stable throughout her admission.  She progressively improved and was weaned to room air.  She was discharged on a course of Augmentin to complete 5 day course for CAP, as well as continued Decadron to continue total 10 day course. Case was discussed with ID who was in agreement.
Age: 58.0
Sex: F
Vaccine: COVID19, HEPA
Symptoms: Cough, Dyspnoea, Emphysema, Legionella test, Lung infiltration
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  MD Admission Date: 2/13/2023 Discharge Date: Feb 16, 2023  PRESENTING PROBLEM: Acute respiratory failure with hypoxia  [J96.01] Community acquired pneumonia of right lung, unspecified part of lung [J18.9] COVID-19 [U07.1]   HOSPITAL COURSE:   58 y.o. female with a pertinent past medical history of asthma, hx asplenia and nephrectomy 2/2 trauma, chronic pain, HTN, who presented with cough, SOB. Admitted for AHRF.   CTA chest was negative for PE.  Did show multifocal right pneumonia with small areas of cavitation.  Pulmonology evaluated.  Cavitations thought to be infiltrates superimposed on emphysema.  Clinical presentation was consistent with COVID-19 pneumonia with respiratory bronchiolitis.  Was recommended for outpatient follow-up and signed off.    Patient's history was also not suggestive of cavitary pneumonia such as TB.  She denied any history of incarceration or recent travel outside the country, or any hemoptysis.   Patient was initially started on Unasyn and azithromycin for antibiotics.  Also started on Decadron and remdesivir.  DVT prophylaxis had been held in the setting of a possible bronchoscopy with pulmonology which patient eventually did not have.    Infectious Disease followed.  Strep and Legionella were negative.  Sputum culture with no result.  Blood cultures were not collected.   Patient initially required 4 L nasal cannula, remained hemodynamically stable throughout her admission.  She progressively improved and was weaned to room air.  She was discharged on a course of Augmentin to complete 5 day course for CAP, as well as continued Decadron to continue total 10 day course. Case was discussed with ID who was in agreement.
Age: 58.0
Sex: F
Vaccine: COVID19, HEPA
Symptoms: Pneumonia, Pulmonary cavitation, Sputum culture, Streptococcus test negative
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  MD Admission Date: 2/13/2023 Discharge Date: Feb 16, 2023  PRESENTING PROBLEM: Acute respiratory failure with hypoxia  [J96.01] Community acquired pneumonia of right lung, unspecified part of lung [J18.9] COVID-19 [U07.1]   HOSPITAL COURSE:   58 y.o. female with a pertinent past medical history of asthma, hx asplenia and nephrectomy 2/2 trauma, chronic pain, HTN, who presented with cough, SOB. Admitted for AHRF.   CTA chest was negative for PE.  Did show multifocal right pneumonia with small areas of cavitation.  Pulmonology evaluated.  Cavitations thought to be infiltrates superimposed on emphysema.  Clinical presentation was consistent with COVID-19 pneumonia with respiratory bronchiolitis.  Was recommended for outpatient follow-up and signed off.    Patient's history was also not suggestive of cavitary pneumonia such as TB.  She denied any history of incarceration or recent travel outside the country, or any hemoptysis.   Patient was initially started on Unasyn and azithromycin for antibiotics.  Also started on Decadron and remdesivir.  DVT prophylaxis had been held in the setting of a possible bronchoscopy with pulmonology which patient eventually did not have.    Infectious Disease followed.  Strep and Legionella were negative.  Sputum culture with no result.  Blood cultures were not collected.   Patient initially required 4 L nasal cannula, remained hemodynamically stable throughout her admission.  She progressively improved and was weaned to room air.  She was discharged on a course of Augmentin to complete 5 day course for CAP, as well as continued Decadron to continue total 10 day course. Case was discussed with ID who was in agreement.
Age: 31.0
Sex: U
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 75.0
Sex: M
Vaccine: UNK
Symptoms: No adverse event, Underdose
Clinical narrative: patient given 0.2ml of pfizer covid-19 bivalent booster instead of 0.3 ml -   patient had  no reaction or adverse event. No other immunization were given at time of this injection
Age: 69.0
Sex: U
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Chest X-ray abnormal, Failure to thrive
Clinical narrative: Discharge Provider: MD Primary Care Provider:  DO Admission Date: 2/7/2023 Discharge Date: 2/20/2023  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] Fall, initial encounter [W19.XXXA] Respiratory tract infection due to COVID-19 virus [U07.1, J98.8] Acute respiratory failure with hypoxia (HCC) [J96.01]   HOSPITAL COURSE: Patient is a 77-year-old man with past medical history significant for obesity, non-insulin-dependent diabetes mellitus who presented to ED for generalized weakness and failure to thrive 2/2 to COVID 19. In the emergency department patient's vitals and labs hemodynamically stable.  He was not hypoxic and had normal chest x-ray.  He was severely weak so was admitted to internal medicine service for PT/OT and likely placement.    During hospitalization he did develop hypoxia at one point briefly requiring high-flow nasal cannula.  He was placed on remdesivir and Decadron.  He was quickly weaned back to room air. However again had worsening respiratory status on 2/15. CXR at that time showed worsening RLL infiltrate.  He was seen by SLP w/ concern for aspiration. He had VFSS which did showed low risk for aspiration.    Pt was noted to have waxing and waning mental status. Per wife he has had worsening memory otpt, no longer handles medication or finances. Pt was advised to follow up with neuropsych as an outpatient.   Of note while on steroids he did have uncontrolled hyperglycemia and was placed on basal bolus insulin. Was consulted and they managed insulin therapy while inpatient. Advised that patient patient should increase metformin to 1000mg twice daily at discharge as well as corrective Humalog insulin.   COVID-19 symptoms did improve however remains severely weak.  PT/OT did recommend SAR.    Patient discharged to SAR in stable condition on 2/20/2023
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Fall, Hypoxia, Insulin therapy, Laboratory test, Loss of personal independence in daily activities
Clinical narrative: Discharge Provider: MD Primary Care Provider:  DO Admission Date: 2/7/2023 Discharge Date: 2/20/2023  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] Fall, initial encounter [W19.XXXA] Respiratory tract infection due to COVID-19 virus [U07.1, J98.8] Acute respiratory failure with hypoxia (HCC) [J96.01]   HOSPITAL COURSE: Patient is a 77-year-old man with past medical history significant for obesity, non-insulin-dependent diabetes mellitus who presented to ED for generalized weakness and failure to thrive 2/2 to COVID 19. In the emergency department patient's vitals and labs hemodynamically stable.  He was not hypoxic and had normal chest x-ray.  He was severely weak so was admitted to internal medicine service for PT/OT and likely placement.    During hospitalization he did develop hypoxia at one point briefly requiring high-flow nasal cannula.  He was placed on remdesivir and Decadron.  He was quickly weaned back to room air. However again had worsening respiratory status on 2/15. CXR at that time showed worsening RLL infiltrate.  He was seen by SLP w/ concern for aspiration. He had VFSS which did showed low risk for aspiration.    Pt was noted to have waxing and waning mental status. Per wife he has had worsening memory otpt, no longer handles medication or finances. Pt was advised to follow up with neuropsych as an outpatient.   Of note while on steroids he did have uncontrolled hyperglycemia and was placed on basal bolus insulin. Was consulted and they managed insulin therapy while inpatient. Advised that patient patient should increase metformin to 1000mg twice daily at discharge as well as corrective Humalog insulin.   COVID-19 symptoms did improve however remains severely weak.  PT/OT did recommend SAR.    Patient discharged to SAR in stable condition on 2/20/2023
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Lung infiltration, Malaise, Memory impairment, Mental status changes, Respiratory disorder
Clinical narrative: Discharge Provider: MD Primary Care Provider:  DO Admission Date: 2/7/2023 Discharge Date: 2/20/2023  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] Fall, initial encounter [W19.XXXA] Respiratory tract infection due to COVID-19 virus [U07.1, J98.8] Acute respiratory failure with hypoxia (HCC) [J96.01]   HOSPITAL COURSE: Patient is a 77-year-old man with past medical history significant for obesity, non-insulin-dependent diabetes mellitus who presented to ED for generalized weakness and failure to thrive 2/2 to COVID 19. In the emergency department patient's vitals and labs hemodynamically stable.  He was not hypoxic and had normal chest x-ray.  He was severely weak so was admitted to internal medicine service for PT/OT and likely placement.    During hospitalization he did develop hypoxia at one point briefly requiring high-flow nasal cannula.  He was placed on remdesivir and Decadron.  He was quickly weaned back to room air. However again had worsening respiratory status on 2/15. CXR at that time showed worsening RLL infiltrate.  He was seen by SLP w/ concern for aspiration. He had VFSS which did showed low risk for aspiration.    Pt was noted to have waxing and waning mental status. Per wife he has had worsening memory otpt, no longer handles medication or finances. Pt was advised to follow up with neuropsych as an outpatient.   Of note while on steroids he did have uncontrolled hyperglycemia and was placed on basal bolus insulin. Was consulted and they managed insulin therapy while inpatient. Advised that patient patient should increase metformin to 1000mg twice daily at discharge as well as corrective Humalog insulin.   COVID-19 symptoms did improve however remains severely weak.  PT/OT did recommend SAR.    Patient discharged to SAR in stable condition on 2/20/2023
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract infection, Swallow study abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider:  DO Admission Date: 2/7/2023 Discharge Date: 2/20/2023  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] Fall, initial encounter [W19.XXXA] Respiratory tract infection due to COVID-19 virus [U07.1, J98.8] Acute respiratory failure with hypoxia (HCC) [J96.01]   HOSPITAL COURSE: Patient is a 77-year-old man with past medical history significant for obesity, non-insulin-dependent diabetes mellitus who presented to ED for generalized weakness and failure to thrive 2/2 to COVID 19. In the emergency department patient's vitals and labs hemodynamically stable.  He was not hypoxic and had normal chest x-ray.  He was severely weak so was admitted to internal medicine service for PT/OT and likely placement.    During hospitalization he did develop hypoxia at one point briefly requiring high-flow nasal cannula.  He was placed on remdesivir and Decadron.  He was quickly weaned back to room air. However again had worsening respiratory status on 2/15. CXR at that time showed worsening RLL infiltrate.  He was seen by SLP w/ concern for aspiration. He had VFSS which did showed low risk for aspiration.    Pt was noted to have waxing and waning mental status. Per wife he has had worsening memory otpt, no longer handles medication or finances. Pt was advised to follow up with neuropsych as an outpatient.   Of note while on steroids he did have uncontrolled hyperglycemia and was placed on basal bolus insulin. Was consulted and they managed insulin therapy while inpatient. Advised that patient patient should increase metformin to 1000mg twice daily at discharge as well as corrective Humalog insulin.   COVID-19 symptoms did improve however remains severely weak.  PT/OT did recommend SAR.    Patient discharged to SAR in stable condition on 2/20/2023
Age: 25.0
Sex: F
Vaccine: MMR, VARCEL
Symptoms: Expired product administered, No adverse event
Clinical narrative: diluent used past expiration date, T014588 11/25/2022. No known ADR
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 9.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: I gave Pfizer 5 to 11 year monovalent vaccine not the Pfizer 5 to 11 year old Bivalent vaccine.
Age: 19.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: The pt was injected with Moderna Bivalent without receiving a primary series of the monovalent vaccine first.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, COVID-19, Cerebrovascular accident, Chest X-ray abnormal, Chronic obstructive pulmonary disease
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 2/5/2023 Discharge Date: Feb 22, 2023  PRESENTING PROBLEM: Pneumonia due to organism [J18.9]   HOSPITAL COURSE: Patient is a 76 y.o. male with past medical history significant for CAD w/ bi-V ICD, AS, permanent AFib, hypertension, HLD, T2DM, CKD3A, history of remote right AKA, recent acute ischemic Left MCA CVA with right hemiparesis who is being admitted from IRC with new pneumonia and hypoxia.    Of note, patient with recent hospital admission 1/21-2/2 for this acute CVA. MRI could not be obtained 2/2 pacemaker.  Due to ongoing dysphagia a corpak was placed which he tolerated well. He was treated for COPD exacerbation during that admission as he was having some wheezing. He was ultimately d/c to IRC for continued rehab needs.    On 2/4 patient started developing increased O2 needs and a productive cough. Patient was requiring 3L when he had previously been on RA. IM was consulted and obtained CXR for evaluation. CXR showing possible L basilar pneumonia. IRC provider evaluated patient this AM and thought patient needed admission to acute care/medicine.   Pt was continued on IV antibiotics/CAP coverage. Film array positive for covid. Diuretics were held due to pt developing an AKI w electrolyte imbalance. IR was consulted due to corpak needing advancement. Nephro was consulted. Pts electrolyte imbalance resolved and aKI resolved. Corpak was advanced and tolerating feeds well. On dysphagia diet w no liquid intake. He finished his antibiotics on 2/9. All home meds restarted and pt stable fot discharge to rehab facility on 02/22/2023.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Diuretic therapy, Dysphagia, Electrolyte imbalance, Hypoxia
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 2/5/2023 Discharge Date: Feb 22, 2023  PRESENTING PROBLEM: Pneumonia due to organism [J18.9]   HOSPITAL COURSE: Patient is a 76 y.o. male with past medical history significant for CAD w/ bi-V ICD, AS, permanent AFib, hypertension, HLD, T2DM, CKD3A, history of remote right AKA, recent acute ischemic Left MCA CVA with right hemiparesis who is being admitted from IRC with new pneumonia and hypoxia.    Of note, patient with recent hospital admission 1/21-2/2 for this acute CVA. MRI could not be obtained 2/2 pacemaker.  Due to ongoing dysphagia a corpak was placed which he tolerated well. He was treated for COPD exacerbation during that admission as he was having some wheezing. He was ultimately d/c to IRC for continued rehab needs.    On 2/4 patient started developing increased O2 needs and a productive cough. Patient was requiring 3L when he had previously been on RA. IM was consulted and obtained CXR for evaluation. CXR showing possible L basilar pneumonia. IRC provider evaluated patient this AM and thought patient needed admission to acute care/medicine.   Pt was continued on IV antibiotics/CAP coverage. Film array positive for covid. Diuretics were held due to pt developing an AKI w electrolyte imbalance. IR was consulted due to corpak needing advancement. Nephro was consulted. Pts electrolyte imbalance resolved and aKI resolved. Corpak was advanced and tolerating feeds well. On dysphagia diet w no liquid intake. He finished his antibiotics on 2/9. All home meds restarted and pt stable fot discharge to rehab facility on 02/22/2023.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Medical diet, Pneumonia, Productive cough, SARS-CoV-2 test positive, Wheezing
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 2/5/2023 Discharge Date: Feb 22, 2023  PRESENTING PROBLEM: Pneumonia due to organism [J18.9]   HOSPITAL COURSE: Patient is a 76 y.o. male with past medical history significant for CAD w/ bi-V ICD, AS, permanent AFib, hypertension, HLD, T2DM, CKD3A, history of remote right AKA, recent acute ischemic Left MCA CVA with right hemiparesis who is being admitted from IRC with new pneumonia and hypoxia.    Of note, patient with recent hospital admission 1/21-2/2 for this acute CVA. MRI could not be obtained 2/2 pacemaker.  Due to ongoing dysphagia a corpak was placed which he tolerated well. He was treated for COPD exacerbation during that admission as he was having some wheezing. He was ultimately d/c to IRC for continued rehab needs.    On 2/4 patient started developing increased O2 needs and a productive cough. Patient was requiring 3L when he had previously been on RA. IM was consulted and obtained CXR for evaluation. CXR showing possible L basilar pneumonia. IRC provider evaluated patient this AM and thought patient needed admission to acute care/medicine.   Pt was continued on IV antibiotics/CAP coverage. Film array positive for covid. Diuretics were held due to pt developing an AKI w electrolyte imbalance. IR was consulted due to corpak needing advancement. Nephro was consulted. Pts electrolyte imbalance resolved and aKI resolved. Corpak was advanced and tolerating feeds well. On dysphagia diet w no liquid intake. He finished his antibiotics on 2/9. All home meds restarted and pt stable fot discharge to rehab facility on 02/22/2023.
Age: 49.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: Arthritis, Gait disturbance, Injection site erythema, Injection site swelling, Joint stiffness
Clinical narrative: After the vaccination, I had swelling and redness at the injection site. I also had on top of my right hand, lumps. They did go away the next day. After few days I started to have inflammation of my joints, muscle aches, pain, and stiffness on all of my joints, and nausea. Now I'm to the point that I have to have assistance walking. The doctor prescribed for me some prednisone pack and muscle relaxers.
Age: 49.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: Limb mass, Myalgia, Nausea, Pain
Clinical narrative: After the vaccination, I had swelling and redness at the injection site. I also had on top of my right hand, lumps. They did go away the next day. After few days I started to have inflammation of my joints, muscle aches, pain, and stiffness on all of my joints, and nausea. Now I'm to the point that I have to have assistance walking. The doctor prescribed for me some prednisone pack and muscle relaxers.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoaesthesia, Pallor, Tremor
Clinical narrative: Patient reported loss of feeling in her legs and felt numb. She went pale and could not stop shaking 15 minutes after the vaccination. We called for EMS and they evaluated her further.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Blepharospasm, Blood glucose, Chills, Dizziness
Clinical narrative: Patient reported loss of feeling in her legs and felt numb. She went pale and could not stop shaking 15 minutes after the vaccination. We called for EMS and they evaluated her further.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Electrocardiogram, Hypoaesthesia, Muscle rigidity, Nausea, Paraesthesia
Clinical narrative: Patient reported loss of feeling in her legs and felt numb. She went pale and could not stop shaking 15 minutes after the vaccination. We called for EMS and they evaluated her further.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Seizure like phenomena, Tic, Tremor
Clinical narrative: Patient reported loss of feeling in her legs and felt numb. She went pale and could not stop shaking 15 minutes after the vaccination. We called for EMS and they evaluated her further.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoaesthesia, Pallor, Tremor
Clinical narrative: Walked to the bathroom after receiving shot, Began feelin lightheaded, dizzy and nauseous. Sat  on bench outside near bathroom and has a small amount of cola and a bite of a candy bar.  Right arm began shaking violently and progressed to total body tremors , tick and eye fluttering followed by muscle rigidity. Resembled a seizure with out loss of consciousness. Tremors would subside briefly and then begin again. Numbness and tingling in the extremity could be felt.  Tremors would result in teeth chattering without being cold. Any overall weakness was present. Emergency was call by Pharmacist and I was taken to hospital ER for evaluation.  MD mentioned Rigors but I was not cold nor did I have a temp. I was given PO ativan for symptoms which resolved the shakings, hopefully with no rebound reaction later today
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Blepharospasm, Blood glucose, Chills, Dizziness
Clinical narrative: Walked to the bathroom after receiving shot, Began feelin lightheaded, dizzy and nauseous. Sat  on bench outside near bathroom and has a small amount of cola and a bite of a candy bar.  Right arm began shaking violently and progressed to total body tremors , tick and eye fluttering followed by muscle rigidity. Resembled a seizure with out loss of consciousness. Tremors would subside briefly and then begin again. Numbness and tingling in the extremity could be felt.  Tremors would result in teeth chattering without being cold. Any overall weakness was present. Emergency was call by Pharmacist and I was taken to hospital ER for evaluation.  MD mentioned Rigors but I was not cold nor did I have a temp. I was given PO ativan for symptoms which resolved the shakings, hopefully with no rebound reaction later today
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Electrocardiogram, Hypoaesthesia, Muscle rigidity, Nausea, Paraesthesia
Clinical narrative: Walked to the bathroom after receiving shot, Began feelin lightheaded, dizzy and nauseous. Sat  on bench outside near bathroom and has a small amount of cola and a bite of a candy bar.  Right arm began shaking violently and progressed to total body tremors , tick and eye fluttering followed by muscle rigidity. Resembled a seizure with out loss of consciousness. Tremors would subside briefly and then begin again. Numbness and tingling in the extremity could be felt.  Tremors would result in teeth chattering without being cold. Any overall weakness was present. Emergency was call by Pharmacist and I was taken to hospital ER for evaluation.  MD mentioned Rigors but I was not cold nor did I have a temp. I was given PO ativan for symptoms which resolved the shakings, hopefully with no rebound reaction later today
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Seizure like phenomena, Tic, Tremor
Clinical narrative: Walked to the bathroom after receiving shot, Began feelin lightheaded, dizzy and nauseous. Sat  on bench outside near bathroom and has a small amount of cola and a bite of a candy bar.  Right arm began shaking violently and progressed to total body tremors , tick and eye fluttering followed by muscle rigidity. Resembled a seizure with out loss of consciousness. Tremors would subside briefly and then begin again. Numbness and tingling in the extremity could be felt.  Tremors would result in teeth chattering without being cold. Any overall weakness was present. Emergency was call by Pharmacist and I was taken to hospital ER for evaluation.  MD mentioned Rigors but I was not cold nor did I have a temp. I was given PO ativan for symptoms which resolved the shakings, hopefully with no rebound reaction later today
Age: 65.0
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered, No adverse event
Clinical narrative: Employee given expired flu shot. No adverse symptoms reported.
Age: 1.5
Sex: F
Vaccine: HEPA
Symptoms: Expired product administered
Clinical narrative: Expired vaccination
Age: 46.0
Sex: M
Vaccine: FLU4
Symptoms: Expired product administered, No adverse event
Clinical narrative: Expired vaccine given. No adverse symptoms reported.
Sex: F
Vaccine: RV5
Symptoms: No adverse event, Product storage error
Clinical narrative: No additional AE reported; Temp excursion of 47.9 degree Fahrenheit for 47 min on 01-DEC-2022; This spontaneous report was received from a healthcare professional and refers to a 6-month-old female patient. No information regarding the patient's medical history, concurrent conditions or concomitant therapies was provided.  On 29-DEC-2022, the patient was vaccinated with rotavirus vaccine, live, oral, pentavalent (ROTATEQ) first dose administered orally (strength, dose, lot #, and expiration date were not provided) for prophylaxis. On an unknown date, the patient was vaccinated with rotavirus vaccine, live, oral, pentavalent (ROTATEQ) second dose administered orally (strength, dose, lot #, and expiration date were not provided) for prophylaxis. On 21-DEC-2022, the patient was vaccinated with an improperly stored dose of rotavirus vaccine, live, oral, pentavalent (ROTATEQ) lot #1892784, expiration date: 03-DEC-2023, administered orally (strength was not provided) for prophylaxis (Product storage error).  On 01-DEC-2022, the vaccine underwent a temperature excursion at 47.9 Fahrenheit degrees (F) for 47 minutes. The temperature excursion occurred as a result of reading from a Digital Data Logger. No previous temperature excursions were reported. No adverse events (No adverse event).
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute respiratory failure, Anaemia, Anticoagulant therapy, Aspiration
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 1/26/2023  PRESENTING PROBLEM: Shock (HCC) [R57.9] Encephalopathy [G93.40] Acute on chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (HCC) [J96.20] Acute on chronic anemia [D64.9] Pressure injury of sacral region, stage 4 (HCC) [L89.154] Septic shock (HCC) [A41.9, R65.21] Enterococcus faecalis infection [B95.2]   HOSPITAL COURSE: 73yo M with hx multiple CVAs, chronic trach/PEG (not vent dependant), DMII, non-verbal, diastolic heart failure, Afib (Xarelto), resident who was admitted 1/26 with acute hypoxic respiratory failure and shock.  COVID +, suspected bacterial sepsis, RIGHT sided PNA (recently PSA PNA).  Placed on ventilator, given 3 L IVF with ongoing hypotension needing norepinephrine.  Empiric Vanco and Cefepime were started.  NE off 1/27. Enterobacter 1/2 BC, unclear if true bacteremia.  Palliative care c/s 1/27.  Hemoptysis 1/27, bronch without source, TXA Nebs x24hrs, resolved.  Heparin gtt started 1/29 for afib while holding Xarelto. Limited ECHO NEG vegetation but tricuspid and pulmonic valves not seen, considering TEE.  Worsening AKI, Renal US NEG, renal consulted.  T-piece since 1/28.  Stento growing in sputum felt to be colonizer. Renal function continued to worsening with decreasing urine output.   Case conference with family (son, daughter), guardian, hospitalist, Palliative Care Dr. on 1/30. Hospice informational meeting was arranged and family and guardian decided to make patient comfort measures.  Guarding decided initially to continue tube feeds as family was requesting.  Patient with large episode emesis with aspiration 2/10.  Tube feeds discontinued. Patient with seizure life activity switched to versed and fentanyl. However, did not require boluses and placement being sough however suctioning needs to high. He was transitioned to humidified air by flow meter. Patient noted to be hypothermic and bradycardic on 2/20 while seeking placement at facility switched to prn pushes.     Death Pronouncement: Called to patient's bedside to pronounce that patient has died. Patient was DNR/DNI/Comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 2/22/2023 at 05:09
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Atrial fibrillation, Bacterial sepsis, Blood culture positive, Bradycardia, Breath sounds absent
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 1/26/2023  PRESENTING PROBLEM: Shock (HCC) [R57.9] Encephalopathy [G93.40] Acute on chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (HCC) [J96.20] Acute on chronic anemia [D64.9] Pressure injury of sacral region, stage 4 (HCC) [L89.154] Septic shock (HCC) [A41.9, R65.21] Enterococcus faecalis infection [B95.2]   HOSPITAL COURSE: 73yo M with hx multiple CVAs, chronic trach/PEG (not vent dependant), DMII, non-verbal, diastolic heart failure, Afib (Xarelto), resident who was admitted 1/26 with acute hypoxic respiratory failure and shock.  COVID +, suspected bacterial sepsis, RIGHT sided PNA (recently PSA PNA).  Placed on ventilator, given 3 L IVF with ongoing hypotension needing norepinephrine.  Empiric Vanco and Cefepime were started.  NE off 1/27. Enterobacter 1/2 BC, unclear if true bacteremia.  Palliative care c/s 1/27.  Hemoptysis 1/27, bronch without source, TXA Nebs x24hrs, resolved.  Heparin gtt started 1/29 for afib while holding Xarelto. Limited ECHO NEG vegetation but tricuspid and pulmonic valves not seen, considering TEE.  Worsening AKI, Renal US NEG, renal consulted.  T-piece since 1/28.  Stento growing in sputum felt to be colonizer. Renal function continued to worsening with decreasing urine output.   Case conference with family (son, daughter), guardian, hospitalist, Palliative Care Dr. on 1/30. Hospice informational meeting was arranged and family and guardian decided to make patient comfort measures.  Guarding decided initially to continue tube feeds as family was requesting.  Patient with large episode emesis with aspiration 2/10.  Tube feeds discontinued. Patient with seizure life activity switched to versed and fentanyl. However, did not require boluses and placement being sough however suctioning needs to high. He was transitioned to humidified air by flow meter. Patient noted to be hypothermic and bradycardic on 2/20 while seeking placement at facility switched to prn pushes.     Death Pronouncement: Called to patient's bedside to pronounce that patient has died. Patient was DNR/DNI/Comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 2/22/2023 at 05:09
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Condition aggravated, Death, Decubitus ulcer, Echocardiogram normal
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 1/26/2023  PRESENTING PROBLEM: Shock (HCC) [R57.9] Encephalopathy [G93.40] Acute on chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (HCC) [J96.20] Acute on chronic anemia [D64.9] Pressure injury of sacral region, stage 4 (HCC) [L89.154] Septic shock (HCC) [A41.9, R65.21] Enterococcus faecalis infection [B95.2]   HOSPITAL COURSE: 73yo M with hx multiple CVAs, chronic trach/PEG (not vent dependant), DMII, non-verbal, diastolic heart failure, Afib (Xarelto), resident who was admitted 1/26 with acute hypoxic respiratory failure and shock.  COVID +, suspected bacterial sepsis, RIGHT sided PNA (recently PSA PNA).  Placed on ventilator, given 3 L IVF with ongoing hypotension needing norepinephrine.  Empiric Vanco and Cefepime were started.  NE off 1/27. Enterobacter 1/2 BC, unclear if true bacteremia.  Palliative care c/s 1/27.  Hemoptysis 1/27, bronch without source, TXA Nebs x24hrs, resolved.  Heparin gtt started 1/29 for afib while holding Xarelto. Limited ECHO NEG vegetation but tricuspid and pulmonic valves not seen, considering TEE.  Worsening AKI, Renal US NEG, renal consulted.  T-piece since 1/28.  Stento growing in sputum felt to be colonizer. Renal function continued to worsening with decreasing urine output.   Case conference with family (son, daughter), guardian, hospitalist, Palliative Care Dr. on 1/30. Hospice informational meeting was arranged and family and guardian decided to make patient comfort measures.  Guarding decided initially to continue tube feeds as family was requesting.  Patient with large episode emesis with aspiration 2/10.  Tube feeds discontinued. Patient with seizure life activity switched to versed and fentanyl. However, did not require boluses and placement being sough however suctioning needs to high. He was transitioned to humidified air by flow meter. Patient noted to be hypothermic and bradycardic on 2/20 while seeking placement at facility switched to prn pushes.     Death Pronouncement: Called to patient's bedside to pronounce that patient has died. Patient was DNR/DNI/Comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 2/22/2023 at 05:09
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Encephalopathy, Enterobacter test positive, Enterococcal infection, Feeding tube user, Haemoptysis
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 1/26/2023  PRESENTING PROBLEM: Shock (HCC) [R57.9] Encephalopathy [G93.40] Acute on chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (HCC) [J96.20] Acute on chronic anemia [D64.9] Pressure injury of sacral region, stage 4 (HCC) [L89.154] Septic shock (HCC) [A41.9, R65.21] Enterococcus faecalis infection [B95.2]   HOSPITAL COURSE: 73yo M with hx multiple CVAs, chronic trach/PEG (not vent dependant), DMII, non-verbal, diastolic heart failure, Afib (Xarelto), resident who was admitted 1/26 with acute hypoxic respiratory failure and shock.  COVID +, suspected bacterial sepsis, RIGHT sided PNA (recently PSA PNA).  Placed on ventilator, given 3 L IVF with ongoing hypotension needing norepinephrine.  Empiric Vanco and Cefepime were started.  NE off 1/27. Enterobacter 1/2 BC, unclear if true bacteremia.  Palliative care c/s 1/27.  Hemoptysis 1/27, bronch without source, TXA Nebs x24hrs, resolved.  Heparin gtt started 1/29 for afib while holding Xarelto. Limited ECHO NEG vegetation but tricuspid and pulmonic valves not seen, considering TEE.  Worsening AKI, Renal US NEG, renal consulted.  T-piece since 1/28.  Stento growing in sputum felt to be colonizer. Renal function continued to worsening with decreasing urine output.   Case conference with family (son, daughter), guardian, hospitalist, Palliative Care Dr. on 1/30. Hospice informational meeting was arranged and family and guardian decided to make patient comfort measures.  Guarding decided initially to continue tube feeds as family was requesting.  Patient with large episode emesis with aspiration 2/10.  Tube feeds discontinued. Patient with seizure life activity switched to versed and fentanyl. However, did not require boluses and placement being sough however suctioning needs to high. He was transitioned to humidified air by flow meter. Patient noted to be hypothermic and bradycardic on 2/20 while seeking placement at facility switched to prn pushes.     Death Pronouncement: Called to patient's bedside to pronounce that patient has died. Patient was DNR/DNI/Comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 2/22/2023 at 05:09