chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonitis, Pulmonary mass, SARS-CoV-2 test positive, Sinus congestion, Superinfection
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD  Admission Date: 6/25/2023 Discharge Date: 6/29/2023  Active Issues Requiring Follow-up * Pneumonia of both lungs due to infectious organism Assessment & Plan Cough, chills, shortness of breath, fatigue and sinus congestion progressing over the last 2 weeks despite antibiotics and steroids.  COVID-19 PCR positive on 06/25/2023.  Although likely onset of COVID 2 weeks ago. Chest x-ray: Moderate coarse strandy and hazy/patchy multifocal/bilateral airspace disease.  Pneumonia felt to be viral in nature secondary to COVID Discontinue antibiotics at this time     COVID-19 Assessment & Plan Symptom onset date approximately 2 weeks ago. COVID-19 PCR positive on 06/25/2023. Presentation outside window for remdesivir.   CXR: Moderate coarse strandy and hazy/patchy multifocal/bilateral airspace disease.   Current oxygen requirement: SpO2: 92 % O2 Flow Rate (l/min): 2 l/min   CRP: 53.4  D-dimer: 960.   Albuterol INH 2 puffs q 4 hours Dexamethasone - 6 mg oral prescribed at discharge to complete 10 days of therapy.        Acute respiratory failure with hypoxia  Assessment & Plan Secondary to COVID-19 and superimposed bacterial pneumonia. Patient was requiring up to 6 L of oxygen at her worst Overall improving respiratory status and oxygen needs.   Home oxygen at discharge. 2 Liters at rest and 6 Liters with activity.        Pulmonary nodules Assessment & Plan CTA from 06/23/2023: Few small (less than 5 mm) noncalcified/indeterminate apical nodules. Question infectious or inflammatory nodules. Given size, no additional follow-up is indicated if the patient is low risk for lung CA.   Likely inflammatory given current COVID-19 viral illness and superimposed bacterial pneumonia. Follow- up with PCP regarding need for follow- up imaging.    Granulomatosis with polyangiitis  Assessment & Plan Rituximab infusion every 6 months.    Moderate persistent asthma without complication Assessment & Plan Continue home inhalers at discharge.  Follow up with pulmonology outpatient     GERD (gastroesophageal reflux disease) Assessment & Plan Continue PPI
Age: 71.0
Sex: M
Vaccine: COVID19, RSV
Symptoms: Heart rate decreased, Injection site pain, Injection site swelling, Oropharyngeal pain, Urticaria
Clinical narrative: patient experienced pain and swelling at injection site for 3 days after vaccine. He developed hives on scalp, face, neck and back that began on 11/6.  He developed a sore throat on 11/6 as well. He developed low heart rate on 11/7.
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Confusional state, Nausea, SARS-CoV-2 test positive, Vomiting
Clinical narrative: THE PATIENT PRESENTED TO THE ED WITH NAUSEA/VOMITING/CONFUSION. SHE TESTED POSITIVE FOR COVID.
Age: 78.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Asthenia, COVID-19, COVID-19 pneumonia, Decreased appetite, Pyrexia
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/23/2023 Discharge Date: Jun 25, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Syncope, unspecified syncope type [R55] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 78-year-old male with a significant history of Parkinson's, hypertension, diabetes type 2, coronary artery disease and P 80 who presented with weakness, syncope and decreased appetite with recent fever.  He tested positive for COVID and was admitted for further treatment and evaluation.  Throughout hospital course, patient remained stable on room air, not requiring supplemental oxygen or steroids.  Due to age and concomitant comorbid issues, he was started on remdesivir.  Patient began to feel better, increasing his orally intake as well as tolerating working with therapy teams.  He was discharged after the 3rd dose of remdesivir and reporting near baseline clinical status.  No changes to his medications were made, and he was advised to closely follow up with his PCP.
Age: 78.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: SARS-CoV-2 test positive, Sinus pain, Syncope
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/23/2023 Discharge Date: Jun 25, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Syncope, unspecified syncope type [R55] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 78-year-old male with a significant history of Parkinson's, hypertension, diabetes type 2, coronary artery disease and P 80 who presented with weakness, syncope and decreased appetite with recent fever.  He tested positive for COVID and was admitted for further treatment and evaluation.  Throughout hospital course, patient remained stable on room air, not requiring supplemental oxygen or steroids.  Due to age and concomitant comorbid issues, he was started on remdesivir.  Patient began to feel better, increasing his orally intake as well as tolerating working with therapy teams.  He was discharged after the 3rd dose of remdesivir and reporting near baseline clinical status.  No changes to his medications were made, and he was advised to closely follow up with his PCP.
Age: 35.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Deafness, Malaise, Syncope
Clinical narrative: Provider gave this patient two vaccines, Fluzone Quad and Spikevax.  After getting the vaccines the patient reported feeling not well. Provider came to get me to tell me he patient wasn't feeling well.  I spoke to the patient and tried to calm her by taking deep breaths while sitting in the vaccine chair.  She said she couldn't hear me, I put both hands on her shoulder to keep her in the chair.  She fainted in the chair and provider and I carefully moved her to the floor.  As we were moving her to the floor she woke and quickly oriented herself.  I had her still lay down ground and raised her legs.
Age: 63.0
Sex: F
Vaccine: FLU4
Symptoms: Fatigue, Neck pain, Pain in extremity
Clinical narrative: Patient received influenza vaccine on 11/1/23. On 11/2/23, patient started having pain on left side of neck and fatigue. Neck pain resolved after 24 hours. On 11/6/23 patient started having left arm pain. Pain has continued until day of report, 11/8/23. Patient was seen 11/08/23 in clinic with no signs of infection or mobility issues. Recommended OTC ibuprofen for symptoms.
Age: 89.0
Sex: M
Vaccine: COVID19-2, FLUA4, HEPA
Symptoms: COVID-19, Chest X-ray abnormal, Confusional state, Cough, Dyspnoea
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 6/21/2023 Discharge Date: 6/26/2023  DETAILS OF HOSPITAL STAY:   Clinical Narrative: 90-year-old gentleman brought into emergency room by family for shortness of breath cough fever and confusion.  He was brought into the emergency department by family, and height hypoxemia at 88% requiring 2 L of oxygen.  His chest x-ray showed improving bilateral airspace disease compared to recent prior chest x-ray COVID test was positive.   He was treated with IV dexamethasone 6 mg daily as well as cefepime and doxycycline.  By discharge he was back to his baseline status breathing comfortably on 2 L of oxygen (which is his home dose)  with his oxygen saturation in the upper 90s.   e was converted to oral prednisone taper to complete a total 10 day course. On day of discharge, , cxr showed slight worsening of left basilar infiltrate His antibiotics will be continued for an additional 4 days to complete a 10 day course.   He will discharge to home with home health care
Age: 89.0
Sex: M
Vaccine: COVID19-2, FLUA4, HEPA
Symptoms: Hypoxia, Lung disorder, Lung infiltration, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 6/21/2023 Discharge Date: 6/26/2023  DETAILS OF HOSPITAL STAY:   Clinical Narrative: 90-year-old gentleman brought into emergency room by family for shortness of breath cough fever and confusion.  He was brought into the emergency department by family, and height hypoxemia at 88% requiring 2 L of oxygen.  His chest x-ray showed improving bilateral airspace disease compared to recent prior chest x-ray COVID test was positive.   He was treated with IV dexamethasone 6 mg daily as well as cefepime and doxycycline.  By discharge he was back to his baseline status breathing comfortably on 2 L of oxygen (which is his home dose)  with his oxygen saturation in the upper 90s.   e was converted to oral prednisone taper to complete a total 10 day course. On day of discharge, , cxr showed slight worsening of left basilar infiltrate His antibiotics will be continued for an additional 4 days to complete a 10 day course.   He will discharge to home with home health care
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling
Clinical narrative: arm swelling
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Balance disorder, Dizziness, Dysstasia, Lymphadenopathy
Clinical narrative: Sleeplessness due to muscle cramping in leg & ankles.  Inabiity to stand steadily upon rising. Lightheadness, dizziness, hip, leg, ankles aching all of next day.  Chills, slight fever, swollen neck glands.  This lasted through most of the next day, Resulted in using a walker to move from room to room. Restless 2nd night and same inability to stand steadily.. Felt well enough to take a shower, but felt faint and had to get out before finishing.   Better sleep and better standing on day 3.   Everything seems back to normal.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle spasms, Pain in extremity, Pyrexia, Restlessness, Sleep disorder
Clinical narrative: Sleeplessness due to muscle cramping in leg & ankles.  Inabiity to stand steadily upon rising. Lightheadness, dizziness, hip, leg, ankles aching all of next day.  Chills, slight fever, swollen neck glands.  This lasted through most of the next day, Resulted in using a walker to move from room to room. Restless 2nd night and same inability to stand steadily.. Felt well enough to take a shower, but felt faint and had to get out before finishing.   Better sleep and better standing on day 3.   Everything seems back to normal.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope, Walking aid user
Clinical narrative: Sleeplessness due to muscle cramping in leg & ankles.  Inabiity to stand steadily upon rising. Lightheadness, dizziness, hip, leg, ankles aching all of next day.  Chills, slight fever, swollen neck glands.  This lasted through most of the next day, Resulted in using a walker to move from room to room. Restless 2nd night and same inability to stand steadily.. Felt well enough to take a shower, but felt faint and had to get out before finishing.   Better sleep and better standing on day 3.   Everything seems back to normal.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Blood test normal, Cardiac imaging procedure normal, Electrocardiogram ambulatory normal, Electrocardiogram normal
Clinical narrative: About 3 weeks to a month at most, I started getting a strong smell.  Similar to smoke or burning.   Still get it on and off.    Several months after that I started to get a bad case of tinnitus.  Pulsating tinnitus as well.  Still have it.  On and off where it is very bad at times and other times milder but does not completely stop.   Along with the tinnitus came a racing heartbeat which started around the same time as the tinnitus.  Never had anything like that. Not from anxiety although it causes a great deal of anxiety.  Fast heartbeat at the slightest movement when it first started.  Mostly in the morning.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Electroencephalogram normal, Headache, Heart rate increased, Magnetic resonance imaging head normal, Magnetic resonance imaging neck
Clinical narrative: About 3 weeks to a month at most, I started getting a strong smell.  Similar to smoke or burning.   Still get it on and off.    Several months after that I started to get a bad case of tinnitus.  Pulsating tinnitus as well.  Still have it.  On and off where it is very bad at times and other times milder but does not completely stop.   Along with the tinnitus came a racing heartbeat which started around the same time as the tinnitus.  Never had anything like that. Not from anxiety although it causes a great deal of anxiety.  Fast heartbeat at the slightest movement when it first started.  Mostly in the morning.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Neurological symptom, Palpitations, Parosmia, Tinnitus, Vertigo
Clinical narrative: About 3 weeks to a month at most, I started getting a strong smell.  Similar to smoke or burning.   Still get it on and off.    Several months after that I started to get a bad case of tinnitus.  Pulsating tinnitus as well.  Still have it.  On and off where it is very bad at times and other times milder but does not completely stop.   Along with the tinnitus came a racing heartbeat which started around the same time as the tinnitus.  Never had anything like that. Not from anxiety although it causes a great deal of anxiety.  Fast heartbeat at the slightest movement when it first started.  Mostly in the morning.
Age: 0.17
Sex: M
Vaccine: RV5
Symptoms: Culture stool positive, Faeces discoloured
Clinical narrative: Change is stool pattern, no stool x 3 days.  When he had first stool after rota vaccine, it was very dark black.  Next stool 2 days later was also dark black.  Patient po intake was decreased during the week after rota vaccine as well
Age: 11.0
Sex: F
Vaccine: MNQ
Symptoms: Product preparation error
Clinical narrative: Pt was given 1 vial (gray top)of a 2 vial vaccine.  The vial of diluent with strains C,W,Y  was administered without constituting with the orange topped vial of A strain of meningococcal vaccine.  This was discovered on Wed. 11/8/23 when an orange topped vial was spotted in the manufacturers box with out the gray vial.  Printed list of all patients that received Menveo vaccines 11/6/23-11/7/23.  After speaking with staff, found the staff memeber who remembers only using 1 vial of Menveo to administer to pt.
Age: 17.0
Sex: M
Vaccine: MNQ
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Administered an extra dose of MCV4 to student as registered for by parent.  Student had already received the 2nd required dose of MCV4, so this was an additional, unnecessary dose.  Notified parent by phone of administration of unnecessary vaccine, and advised her that she should contact me if student experienced any side-effects.  No side effects reported as of today.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Dysgeusia
Clinical narrative: Metallic taste in mouth two days post vaccine and now 1 month following. My NP told me to report on this site.
Age: 60.0
Sex: M
Vaccine: VARZOS
Symptoms: Asthenia, Gait inability, Loss of personal independence in daily activities, Malaise, Muscular weakness
Clinical narrative: On August 18th I became very weak and I started feeling sick. I was so weak I didn't use the bathroom. At 12:00 am I tried to use the bathroom and noticed I couldn't. I proceeded to head to the ER because I knew something was off. A few hours later I lost feeling in everything below my neck. Thats when I realized I couldn't walk anymore, I couldn't hold anything in my hands and I could no longer use the bathroom on my own. I've been like this ever since.
Age: 60.0
Sex: M
Vaccine: VARZOS
Symptoms: Sensory loss
Clinical narrative: On August 18th I became very weak and I started feeling sick. I was so weak I didn't use the bathroom. At 12:00 am I tried to use the bathroom and noticed I couldn't. I proceeded to head to the ER because I knew something was off. A few hours later I lost feeling in everything below my neck. Thats when I realized I couldn't walk anymore, I couldn't hold anything in my hands and I could no longer use the bathroom on my own. I've been like this ever since.
Age: 0.17
Sex: M
Vaccine: DTAP, HIBV, PNC20, RV5
Symptoms: Circumstance or information capable of leading to medication error, Wrong product administered
Clinical narrative: It is highly likely that DTaP was administer instead of Pediarix was ordered due to a discrepancy in the vaccine count. There was an extra dose of Pediarix and a missing dose of DTaP. (there were no other doses of Pediarix administer on that date 10/25/2023)
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Upper-airway cough syndrome
Clinical narrative: I have had severe postnasal drip for weeks to months after every mRNA vaccine that I have received. I did not make a report previously after receiving Bivalent Pfizer or my initial 2 doses of original Pfizer vaccine (12/2020 & 1/2021), but I decided that I should due to the consistency of the symptoms. I am a nurse, so I have not sought additional medical care.
Sex: U
Vaccine: PPV
Symptoms: Expired product administered, No adverse event
Clinical narrative: No additional AE/PQC.; inadvertent administration of expired PNEUMOVAX 23 to a patient.; This spontaneous report was received from a medical assistant referring to a patient of unknown age and gender. The patient's pertinent medical history, drug reactions/allergies, concurrent conditions and concomitant medications were not reported.  On 23-OCT-2023, the patient was inadvertently vaccinated with an expired dose of pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) (lot # W007035 has been verified to be a valid lot number, expiration date: 20-OCT-2023; strength, dose and route of administration were not reported), administered by a health professional for prophylaxis (expired product administered). No additional adverse event (AE)/product quality complaint (PQC) was reported.
Age: 54.0
Sex: F
Vaccine: PNC20
Symptoms: Erythema, Injection site cellulitis, Pain in extremity, Skin warm
Clinical narrative: Cellulitis of upper right arm which developed 4 days after vaccination. Arm was red, hot and sore with a spreading edge. Went to urgent care clinic and received 7 day course of BactrimDS. Now dealing with a drug rash from the antibiotic, but it seems that original infection has resolved.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Bundle branch block right, COVID-19, Chest X-ray normal, Condition aggravated
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 7/9/2023 Discharge Date: 7/11/2023   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Nausea [R11.0] Weakness [R53.1] SIRS (systemic inflammatory response syndrome) [R65.10] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 80 year old female who lives at home with her son presented to emergency room for generalized weakness, fatigue, fever and nausea.  She has a medical history of asthma, hypothyroidism, hyperlipidemia, anemia and congestive heart failure. On 7/4 she took a home COVID testing was positive she was complaining of fatigue and loss of appetite and was seen in the emergency room and discharged home.  She has fell worsening fatigue and weakness since.  Over the past couple days she has developed nausea with dry heaves and a fever.  The day of arrival she felt so weak that she collapsed, denies injury.  On arrival to the emergency department, she was febrile left with her other vital signs stable.  CMP and CBC were unremarkable.  Procalcitonin was negative.  No lactic acidosis.  UA with infection, urine culture was sent.  EKG with right bundle-branch block without ST changes.  CXR negative for acute findings.  Patient started on Rocephin.  She received Protonix, Zofran, and 1 L of IV normal saline.  Patient is under not feel comfortable with her coming home do to her weakness.  Patient was accepted different Hospital service.  Seems improved markedly.  She had no more shortness of breath or cough.  No dysuria or urgency or back pain.  Urine cultures came back negative.  Laboratory studies stabilized.  She was seen the day of discharge doing well and subsequently discharged home.  Since she is 7 days postop diagnosis for COVID and asymptomatic she can go home without need for ongoing strict isolation.  She was counseled on post COVID care as well as good hand washing and hygiene issues.  We will continue her on cefdinir for total of 5 days of therapy.  She will receive 300 mg twice a day for 3 more days.  She could return to the rest her medications as previously ordered.  She could return to diet and activity as tolerated.  She was given a note to return to work on 07/12/2023 per her request.  She understood her instructions and was discharged home in stable condition.   36 minutes was spent in discharging this patient over 50 percent of which entailed direct face-to-face counseling and coordination of care.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Culture urine negative, Cystitis, Decreased appetite, Electrocardiogram abnormal, Fatigue
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 7/9/2023 Discharge Date: 7/11/2023   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Nausea [R11.0] Weakness [R53.1] SIRS (systemic inflammatory response syndrome) [R65.10] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 80 year old female who lives at home with her son presented to emergency room for generalized weakness, fatigue, fever and nausea.  She has a medical history of asthma, hypothyroidism, hyperlipidemia, anemia and congestive heart failure. On 7/4 she took a home COVID testing was positive she was complaining of fatigue and loss of appetite and was seen in the emergency room and discharged home.  She has fell worsening fatigue and weakness since.  Over the past couple days she has developed nausea with dry heaves and a fever.  The day of arrival she felt so weak that she collapsed, denies injury.  On arrival to the emergency department, she was febrile left with her other vital signs stable.  CMP and CBC were unremarkable.  Procalcitonin was negative.  No lactic acidosis.  UA with infection, urine culture was sent.  EKG with right bundle-branch block without ST changes.  CXR negative for acute findings.  Patient started on Rocephin.  She received Protonix, Zofran, and 1 L of IV normal saline.  Patient is under not feel comfortable with her coming home do to her weakness.  Patient was accepted different Hospital service.  Seems improved markedly.  She had no more shortness of breath or cough.  No dysuria or urgency or back pain.  Urine cultures came back negative.  Laboratory studies stabilized.  She was seen the day of discharge doing well and subsequently discharged home.  Since she is 7 days postop diagnosis for COVID and asymptomatic she can go home without need for ongoing strict isolation.  She was counseled on post COVID care as well as good hand washing and hygiene issues.  We will continue her on cefdinir for total of 5 days of therapy.  She will receive 300 mg twice a day for 3 more days.  She could return to the rest her medications as previously ordered.  She could return to diet and activity as tolerated.  She was given a note to return to work on 07/12/2023 per her request.  She understood her instructions and was discharged home in stable condition.   36 minutes was spent in discharging this patient over 50 percent of which entailed direct face-to-face counseling and coordination of care.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Full blood count normal, Impaired work ability, Metabolic function test normal, Nausea, Procalcitonin normal
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 7/9/2023 Discharge Date: 7/11/2023   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Nausea [R11.0] Weakness [R53.1] SIRS (systemic inflammatory response syndrome) [R65.10] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 80 year old female who lives at home with her son presented to emergency room for generalized weakness, fatigue, fever and nausea.  She has a medical history of asthma, hypothyroidism, hyperlipidemia, anemia and congestive heart failure. On 7/4 she took a home COVID testing was positive she was complaining of fatigue and loss of appetite and was seen in the emergency room and discharged home.  She has fell worsening fatigue and weakness since.  Over the past couple days she has developed nausea with dry heaves and a fever.  The day of arrival she felt so weak that she collapsed, denies injury.  On arrival to the emergency department, she was febrile left with her other vital signs stable.  CMP and CBC were unremarkable.  Procalcitonin was negative.  No lactic acidosis.  UA with infection, urine culture was sent.  EKG with right bundle-branch block without ST changes.  CXR negative for acute findings.  Patient started on Rocephin.  She received Protonix, Zofran, and 1 L of IV normal saline.  Patient is under not feel comfortable with her coming home do to her weakness.  Patient was accepted different Hospital service.  Seems improved markedly.  She had no more shortness of breath or cough.  No dysuria or urgency or back pain.  Urine cultures came back negative.  Laboratory studies stabilized.  She was seen the day of discharge doing well and subsequently discharged home.  Since she is 7 days postop diagnosis for COVID and asymptomatic she can go home without need for ongoing strict isolation.  She was counseled on post COVID care as well as good hand washing and hygiene issues.  We will continue her on cefdinir for total of 5 days of therapy.  She will receive 300 mg twice a day for 3 more days.  She could return to the rest her medications as previously ordered.  She could return to diet and activity as tolerated.  She was given a note to return to work on 07/12/2023 per her request.  She understood her instructions and was discharged home in stable condition.   36 minutes was spent in discharging this patient over 50 percent of which entailed direct face-to-face counseling and coordination of care.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Retching, SARS-CoV-2 test positive, Syncope, Systemic inflammatory response syndrome
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 7/9/2023 Discharge Date: 7/11/2023   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Nausea [R11.0] Weakness [R53.1] SIRS (systemic inflammatory response syndrome) [R65.10] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 80 year old female who lives at home with her son presented to emergency room for generalized weakness, fatigue, fever and nausea.  She has a medical history of asthma, hypothyroidism, hyperlipidemia, anemia and congestive heart failure. On 7/4 she took a home COVID testing was positive she was complaining of fatigue and loss of appetite and was seen in the emergency room and discharged home.  She has fell worsening fatigue and weakness since.  Over the past couple days she has developed nausea with dry heaves and a fever.  The day of arrival she felt so weak that she collapsed, denies injury.  On arrival to the emergency department, she was febrile left with her other vital signs stable.  CMP and CBC were unremarkable.  Procalcitonin was negative.  No lactic acidosis.  UA with infection, urine culture was sent.  EKG with right bundle-branch block without ST changes.  CXR negative for acute findings.  Patient started on Rocephin.  She received Protonix, Zofran, and 1 L of IV normal saline.  Patient is under not feel comfortable with her coming home do to her weakness.  Patient was accepted different Hospital service.  Seems improved markedly.  She had no more shortness of breath or cough.  No dysuria or urgency or back pain.  Urine cultures came back negative.  Laboratory studies stabilized.  She was seen the day of discharge doing well and subsequently discharged home.  Since she is 7 days postop diagnosis for COVID and asymptomatic she can go home without need for ongoing strict isolation.  She was counseled on post COVID care as well as good hand washing and hygiene issues.  We will continue her on cefdinir for total of 5 days of therapy.  She will receive 300 mg twice a day for 3 more days.  She could return to the rest her medications as previously ordered.  She could return to diet and activity as tolerated.  She was given a note to return to work on 07/12/2023 per her request.  She understood her instructions and was discharged home in stable condition.   36 minutes was spent in discharging this patient over 50 percent of which entailed direct face-to-face counseling and coordination of care.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection, Urine analysis abnormal
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: PA-C Admission Date: 7/9/2023 Discharge Date: 7/11/2023   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Nausea [R11.0] Weakness [R53.1] SIRS (systemic inflammatory response syndrome) [R65.10] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 80 year old female who lives at home with her son presented to emergency room for generalized weakness, fatigue, fever and nausea.  She has a medical history of asthma, hypothyroidism, hyperlipidemia, anemia and congestive heart failure. On 7/4 she took a home COVID testing was positive she was complaining of fatigue and loss of appetite and was seen in the emergency room and discharged home.  She has fell worsening fatigue and weakness since.  Over the past couple days she has developed nausea with dry heaves and a fever.  The day of arrival she felt so weak that she collapsed, denies injury.  On arrival to the emergency department, she was febrile left with her other vital signs stable.  CMP and CBC were unremarkable.  Procalcitonin was negative.  No lactic acidosis.  UA with infection, urine culture was sent.  EKG with right bundle-branch block without ST changes.  CXR negative for acute findings.  Patient started on Rocephin.  She received Protonix, Zofran, and 1 L of IV normal saline.  Patient is under not feel comfortable with her coming home do to her weakness.  Patient was accepted different Hospital service.  Seems improved markedly.  She had no more shortness of breath or cough.  No dysuria or urgency or back pain.  Urine cultures came back negative.  Laboratory studies stabilized.  She was seen the day of discharge doing well and subsequently discharged home.  Since she is 7 days postop diagnosis for COVID and asymptomatic she can go home without need for ongoing strict isolation.  She was counseled on post COVID care as well as good hand washing and hygiene issues.  We will continue her on cefdinir for total of 5 days of therapy.  She will receive 300 mg twice a day for 3 more days.  She could return to the rest her medications as previously ordered.  She could return to diet and activity as tolerated.  She was given a note to return to work on 07/12/2023 per her request.  She understood her instructions and was discharged home in stable condition.   36 minutes was spent in discharging this patient over 50 percent of which entailed direct face-to-face counseling and coordination of care.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation, Discomfort, Restless legs syndrome
Clinical narrative: Patient called and reported feeling painful burning sensation developing in her calf muscles in her legs that started day after vaccine administration (Monday). She also described it feeling like restless legs. On Tuesday, it went up to her hips. She said she had to constantly walk to help manage the discomfort. When asked, she reported no other ss - no rash, no swelling, no itching. Neither at the injection site, nor at the area of concern. I called her Wednesday to follow up and she reports that everything is gone and back to normal as of this morning.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Cough, Cystitis, Fall
Clinical narrative: BRIEF OVERVIEW: Admission Date: 7/5/2023 Discharge Date: Jul 6, 2023 Discharge Disposition:  Home with services - Occupational therapy and Physical therapy    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Weakness [R53.1] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1]   HOSPITAL COURSE:   Patient is a 61 y.o. male with traumatic brain injury from MVA with subsequent seizure disorder who presented to ED with generalized weakness associated with falls. On admission family reported they had just returned from a family vacation.  Since then he has had progressive weakness x5 days associated with cough and daily falls.     In ED VS/Labs were stable. Due to URI symptoms resp panel ordered and positive for covid. Admitted to medicine for generalized weakness. Pt did not require 02 and satted >92%. He was monitored and worked with pt/ot which recommended home w hh services. Repeat labs wnl and pt stable for discharge on 7/6. VS remained stable. Pulm rehab was ordered for new cpap mask to use at home. Pt safely discharged home.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test normal, Positive airway pressure therapy, SARS-CoV-2 test positive
Clinical narrative: BRIEF OVERVIEW: Admission Date: 7/5/2023 Discharge Date: Jul 6, 2023 Discharge Disposition:  Home with services - Occupational therapy and Physical therapy    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Weakness [R53.1] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1]   HOSPITAL COURSE:   Patient is a 61 y.o. male with traumatic brain injury from MVA with subsequent seizure disorder who presented to ED with generalized weakness associated with falls. On admission family reported they had just returned from a family vacation.  Since then he has had progressive weakness x5 days associated with cough and daily falls.     In ED VS/Labs were stable. Due to URI symptoms resp panel ordered and positive for covid. Admitted to medicine for generalized weakness. Pt did not require 02 and satted >92%. He was monitored and worked with pt/ot which recommended home w hh services. Repeat labs wnl and pt stable for discharge on 7/6. VS remained stable. Pulm rehab was ordered for new cpap mask to use at home. Pt safely discharged home.
Age: 75.0
Sex: M
Vaccine: RSV
Symptoms: Diplopia, Eye disorder, Heterophoria, VIth nerve paralysis
Clinical narrative: Patient reported that after receiving the RSV vaccine (Arexvy) he began experiencing issues with his eye, stating that it is wondering to the side and he is also experiencing double vision. He has been to the doctor and was told that it was a nerve palsy that was causing it. He did not specify which eye.
Age: 6.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Pt was given complete amount of vaccine in the single dose vial instead of only 0.25ml. Pt got about 0.5ml
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Dyspnoea
Clinical narrative: Admission Date: 7/23/2023 Discharge Date: 7/26/2023    DETAILS OF HOSPITAL STAY:   Clinical Narrative:   The patient is a 70-year-old gentleman with a Gold-stage IV disease/mMRC functional status presented for a recurrent hospital admission.  He has been offered hospice and palliative care on multiple previous occasions, given his appropriateness, but had deferred secondary to concerns regarding his disabled son.  On this occasion you does desire to enter hospice in the home in an effort to stay in the home and avoid a return to the hospital.  He hopes to die in his own home.  We discussed his son circumstance in some detail including the 13 months of bereavement services available to his son after his death.  We discussed the Social Work and Case Management availability with a hospice company and that this may facilitate better care coordination and reaching out to community resources to hopefully provide alternatives for his son.  He will be discharged home to home hospice today at his request.
Age: 34.0
Sex: F
Vaccine: COVID19-2
Symptoms: Abdominal pain upper, Diarrhoea, Feeling cold, Hot flush, Vomiting
Clinical narrative: I felt very cold, so I took a hot shower and got into bed and covered myself with blankets, but that made me too hot. I had intense stomach aches and then vomited a few times and had diarrhea. During that time the stomach aches reached a very painful level, the hot flashes were intense and I didn't feel better until a little while after getting everything out.
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Pt was given complete amount of vaccine in the single dose vial instead of only 0.25ml. Pt got about 0.5ml
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, Blood creatinine, Blood sodium decreased, Brain natriuretic peptide increased, COVID-19
Clinical narrative: Date of Admission: 7/11/2023 Discharge Date: 7/12/2023   DETAILS OF HOSPITAL STAY:   PRESENTING PROBLEM: Tachyarrhythmia [R00.0] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 71 year old female with past medical history of PAF on Xarelto, OSA with CPAP, obesity who presented to the Emergency Department with fatigue and shortness of breath.  Patient stated her symptoms began earlier the day of arrival.  In the emergency department she was found to be positive for COVID, additionally 8 sodium 133, creatinine 1.14, BNP was elevated 2418. EKG demonstrated AFib with RVR.  She was noted to have a heart rate into the 170s while in the emergency department.  They did give her 1 L bolus.  They also did speak with Cardiology who recommended initiating Lopressor, they gave her a dose of 25 mg.  Hospitalist team was consulted for admission.  Patient did have an echocardiogram which demonstrated ejection fraction of 60%, no significant valvular heart disease or anatomical concerns.  Heart rate was much improved after initiation of Lopressor, but it was noted that her heart rate was into the 50s.  She was initially asymptomatic from a COVID standpoint, she has developed dry cough during admission.  At this time her heart rate is much controlled, she will be continued on metoprolol tartrate 25 mg 2 times a day, she will continue to be monitored with a ZIO patch to be sent to her cardiologist office.  She has been instructed follow-up with the cardiologist within 2 weeks.  She has also been instructed to continue quarantine for total of 5 days, continue masking for 5 days after that.  She does have a history noncompliance with Xarelto, she has been educated, and also seems motivated to continue Xarelto as prescribed.   Electrolytes were monitored and repleted PRN throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dyspnoea, Echocardiogram normal, Ejection fraction normal, Electrocardiogram abnormal
Clinical narrative: Date of Admission: 7/11/2023 Discharge Date: 7/12/2023   DETAILS OF HOSPITAL STAY:   PRESENTING PROBLEM: Tachyarrhythmia [R00.0] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 71 year old female with past medical history of PAF on Xarelto, OSA with CPAP, obesity who presented to the Emergency Department with fatigue and shortness of breath.  Patient stated her symptoms began earlier the day of arrival.  In the emergency department she was found to be positive for COVID, additionally 8 sodium 133, creatinine 1.14, BNP was elevated 2418. EKG demonstrated AFib with RVR.  She was noted to have a heart rate into the 170s while in the emergency department.  They did give her 1 L bolus.  They also did speak with Cardiology who recommended initiating Lopressor, they gave her a dose of 25 mg.  Hospitalist team was consulted for admission.  Patient did have an echocardiogram which demonstrated ejection fraction of 60%, no significant valvular heart disease or anatomical concerns.  Heart rate was much improved after initiation of Lopressor, but it was noted that her heart rate was into the 50s.  She was initially asymptomatic from a COVID standpoint, she has developed dry cough during admission.  At this time her heart rate is much controlled, she will be continued on metoprolol tartrate 25 mg 2 times a day, she will continue to be monitored with a ZIO patch to be sent to her cardiologist office.  She has been instructed follow-up with the cardiologist within 2 weeks.  She has also been instructed to continue quarantine for total of 5 days, continue masking for 5 days after that.  She does have a history noncompliance with Xarelto, she has been educated, and also seems motivated to continue Xarelto as prescribed.   Electrolytes were monitored and repleted PRN throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Electrolyte depletion, Electrolyte substitution therapy, Fatigue, Heart rate abnormal, SARS-CoV-2 test positive
Clinical narrative: Date of Admission: 7/11/2023 Discharge Date: 7/12/2023   DETAILS OF HOSPITAL STAY:   PRESENTING PROBLEM: Tachyarrhythmia [R00.0] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 71 year old female with past medical history of PAF on Xarelto, OSA with CPAP, obesity who presented to the Emergency Department with fatigue and shortness of breath.  Patient stated her symptoms began earlier the day of arrival.  In the emergency department she was found to be positive for COVID, additionally 8 sodium 133, creatinine 1.14, BNP was elevated 2418. EKG demonstrated AFib with RVR.  She was noted to have a heart rate into the 170s while in the emergency department.  They did give her 1 L bolus.  They also did speak with Cardiology who recommended initiating Lopressor, they gave her a dose of 25 mg.  Hospitalist team was consulted for admission.  Patient did have an echocardiogram which demonstrated ejection fraction of 60%, no significant valvular heart disease or anatomical concerns.  Heart rate was much improved after initiation of Lopressor, but it was noted that her heart rate was into the 50s.  She was initially asymptomatic from a COVID standpoint, she has developed dry cough during admission.  At this time her heart rate is much controlled, she will be continued on metoprolol tartrate 25 mg 2 times a day, she will continue to be monitored with a ZIO patch to be sent to her cardiologist office.  She has been instructed follow-up with the cardiologist within 2 weeks.  She has also been instructed to continue quarantine for total of 5 days, continue masking for 5 days after that.  She does have a history noncompliance with Xarelto, she has been educated, and also seems motivated to continue Xarelto as prescribed.   Electrolytes were monitored and repleted PRN throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Tachyarrhythmia
Clinical narrative: Date of Admission: 7/11/2023 Discharge Date: 7/12/2023   DETAILS OF HOSPITAL STAY:   PRESENTING PROBLEM: Tachyarrhythmia [R00.0] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 71 year old female with past medical history of PAF on Xarelto, OSA with CPAP, obesity who presented to the Emergency Department with fatigue and shortness of breath.  Patient stated her symptoms began earlier the day of arrival.  In the emergency department she was found to be positive for COVID, additionally 8 sodium 133, creatinine 1.14, BNP was elevated 2418. EKG demonstrated AFib with RVR.  She was noted to have a heart rate into the 170s while in the emergency department.  They did give her 1 L bolus.  They also did speak with Cardiology who recommended initiating Lopressor, they gave her a dose of 25 mg.  Hospitalist team was consulted for admission.  Patient did have an echocardiogram which demonstrated ejection fraction of 60%, no significant valvular heart disease or anatomical concerns.  Heart rate was much improved after initiation of Lopressor, but it was noted that her heart rate was into the 50s.  She was initially asymptomatic from a COVID standpoint, she has developed dry cough during admission.  At this time her heart rate is much controlled, she will be continued on metoprolol tartrate 25 mg 2 times a day, she will continue to be monitored with a ZIO patch to be sent to her cardiologist office.  She has been instructed follow-up with the cardiologist within 2 weeks.  She has also been instructed to continue quarantine for total of 5 days, continue masking for 5 days after that.  She does have a history noncompliance with Xarelto, she has been educated, and also seems motivated to continue Xarelto as prescribed.   Electrolytes were monitored and repleted PRN throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge.
Age: 30.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood test, Cardiac monitoring, Computerised tomogram, Electrocardiogram, Palpitations
Clinical narrative: Had to wear a heart monitor due to heart palpitations, now I have Supraventricular tachycardia (SVT), a heart condition
Age: 30.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Supraventricular tachycardia
Clinical narrative: Had to wear a heart monitor due to heart palpitations, now I have Supraventricular tachycardia (SVT), a heart condition
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Bronchoscopy abnormal, COVID-19, Chills
Clinical narrative: Hematologist/Oncologist: MD  Primary Care Physician at Discharge: MD Admission Date: 7/10/2023 Discharge Date: 07/17/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Community acquired pneumonia of both lungs [J18.9] Acute respiratory failure [J96.00] Respiratory failure [J96.90]   HOSPITAL COURSE: This is a 70 y.o. patient with a past medical history significant for non-hodgkin's lymphoma, HTN, CAD, and HLD who presented to Hospital ER on 7/7 with symptoms of chills, fevers, cough and SOB. Pt reports contracting COVID in early June while on vacation. However his most recent COVID antigen test was negative. He felt he never fully recovered. He began having fevers and chills again on June 30 and presented to ER on 7/7 when his symptoms weren't improving. CTA of the thorax showed no PE but did show bilateral opacities. He was admitted to Hospital with bilateral CAP and treated with azithromycin and Rocephin until his transfer to different hospital for ID and pulmonology consults.  He did receive IVIG at Hospital prior to transfer.   Submitted ID and Pulmonary medicine was consulted and a bronchoscopy was performed on 07/11.  All workup was negative except for on the bronchoscopy did show that patient was COVID positive.  Unfortunately after the bronch on 07/11 patient had an episode of acute hypoxic respiratory failure and a RAP was called.  He was transferred to the intensive care unit and BiPAP was started.  Infectious disease recommended 5 days of remdesivir and steroids.  He was able to transfer out of the intensive care unit on 07/14.  He was very quickly weaned off of oxygen.  Initially pulmonary recommended a very long, approximately 8 week prednisone taper.  However the malignant heme attending was concerned about 18 for that long affecting his immune status.  I did reach out to Pulmonary Medicine on 07/17 to discuss shorter taper.  They were okay with an approximately 2 week taper.  Patient received his last dose of remdesivir and he was stable for discharge.  Above follow-up with Dr. was arranged.  He was discharged home in stable condition