chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 90.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Aspiration, Asymptomatic COVID-19, Atrial fibrillation, Bradycardia, Culture negative
Clinical narrative: 92-year-old female, presented from home (lives with her son) after being found by the son slumped over to the right on the toilet.  She is hypothyroid after treatment for thyroid cancer.  She apparently aspirated after an emesis and she has virtually no cough reflex with suctioning.  Her COVID test was positive, but she was at least 10 days post positive and is asymptomatic.  Her white blood count is elevated.  She has a history of hypertension, hyperlipidemia, CVA.  She is nonresponsive. She started to move whenever involves arms a bit. She has some bradycardia. She had 1 brief episode of atrial fibrillation again and have returned to normal sinus rhythm.  Her final cultures were negative and the patient was discharged on 08/30/2022 to subacute rehab at a Skilled Nursing Facility and Rehab Facility.
Age: 90.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Posture abnormal, SARS-CoV-2 test positive, Unresponsive to stimuli, Vomiting, White blood cell count increased
Clinical narrative: 92-year-old female, presented from home (lives with her son) after being found by the son slumped over to the right on the toilet.  She is hypothyroid after treatment for thyroid cancer.  She apparently aspirated after an emesis and she has virtually no cough reflex with suctioning.  Her COVID test was positive, but she was at least 10 days post positive and is asymptomatic.  Her white blood count is elevated.  She has a history of hypertension, hyperlipidemia, CVA.  She is nonresponsive. She started to move whenever involves arms a bit. She has some bradycardia. She had 1 brief episode of atrial fibrillation again and have returned to normal sinus rhythm.  Her final cultures were negative and the patient was discharged on 08/30/2022 to subacute rehab at a Skilled Nursing Facility and Rehab Facility.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: Blood glucose fluctuation, COVID-19, Nausea, SARS-CoV-2 test positive, Vomiting
Clinical narrative: 67y.o. female presenting with acute nausea and vomiting for about a week. Upon presentation, she was found to be COVID-positive. She did have 3 doses of Pfizer COVID-vaccine and has never had COVID before. She is initially placed on dexamethasone. She was seen by ID as well as endocrinology. She had very labile blood glucose requiring titration of her insulin regimen. Without verified hypoxia, there is no indication for remdesivir or other COVID directed therapies. Steroids were discontinued as she did not require supplemental oxygen. Her symptoms improved and she was able to tolerate oral hydration.Patient was discharged home in stable condition.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Mental status changes, SARS-CoV-2 test positive
Clinical narrative: 67y.o. female presenting with acute nausea and vomiting for about a week. Upon presentation, she was found to be COVID-positive. She did have 3 doses of Pfizer COVID-vaccine and has never had COVID before. She is initially placed on dexamethasone. She was seen by ID as well as endocrinology. She had very labile blood glucose requiring titration of her insulin regimen. Without verified hypoxia, there is no indication for remdesivir or other COVID directed therapies. Steroids were discontinued as she did not require supplemental oxygen. Her symptoms improved and she was able to tolerate oral hydration.Patient was discharged home in stable condition.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Anaemia, Blood creatinine increased, COVID-19, Chest X-ray normal, Computerised tomogram abdomen normal
Clinical narrative: 72y.o. male with hx of prostate CA, DM-II, HTN, CAD (mild), PAD, recurrent syncope, current smoker presented to the ED after a MVC. Patient was driving at around 45 mph when he hit a fire hydrant and his car flipped over in the city. Pt states he lost consciousness prior to the crash. On arrival in ED BP 181/78, O2 100% on RA. Labs revealed Cr 1.49, mild anemia hgb 11.9, trop negative x1.  UA negative. COVID-19 PCR positive in ED. CT hea/C-spine negative for acute process.  CT C/A/P negative for acute process. CXR negative for acute process or infiltrates.  He was cleared by trauma sx team for DC. However, he was admitted for further work up for recurrent syncopal episodes and cardiology is consulted.Patient states he had a similar episodes few months ago but he was not driving at, did not seek medical attention at that time. Patient denies any recent changes to his meds. Pt states he is vaccinated against COVID 19 x2 and boosted x2. He reports mild dry cough, but no shortness of breath, chest pain, or GI symptoms. Patient was not aware that he had COVID-19 infection a prior to the admission. States his mild dry cough started about couple days ago but he thought was related to allergies. All imaging studies including CT head/C-spine, CT C/A/P, CXR, pelvic XR all negative for acute process or fracture. Okay to discharge and schedule loop monitor implant outpatient.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Computerised tomogram head normal, Computerised tomogram spine, Cough, Haemoglobin decreased, Laboratory test abnormal
Clinical narrative: 72y.o. male with hx of prostate CA, DM-II, HTN, CAD (mild), PAD, recurrent syncope, current smoker presented to the ED after a MVC. Patient was driving at around 45 mph when he hit a fire hydrant and his car flipped over in the city. Pt states he lost consciousness prior to the crash. On arrival in ED BP 181/78, O2 100% on RA. Labs revealed Cr 1.49, mild anemia hgb 11.9, trop negative x1.  UA negative. COVID-19 PCR positive in ED. CT hea/C-spine negative for acute process.  CT C/A/P negative for acute process. CXR negative for acute process or infiltrates.  He was cleared by trauma sx team for DC. However, he was admitted for further work up for recurrent syncopal episodes and cardiology is consulted.Patient states he had a similar episodes few months ago but he was not driving at, did not seek medical attention at that time. Patient denies any recent changes to his meds. Pt states he is vaccinated against COVID 19 x2 and boosted x2. He reports mild dry cough, but no shortness of breath, chest pain, or GI symptoms. Patient was not aware that he had COVID-19 infection a prior to the admission. States his mild dry cough started about couple days ago but he thought was related to allergies. All imaging studies including CT head/C-spine, CT C/A/P, CXR, pelvic XR all negative for acute process or fracture. Okay to discharge and schedule loop monitor implant outpatient.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Loss of consciousness, Road traffic accident, SARS-CoV-2 test positive, Troponin normal, Urine analysis normal
Clinical narrative: 72y.o. male with hx of prostate CA, DM-II, HTN, CAD (mild), PAD, recurrent syncope, current smoker presented to the ED after a MVC. Patient was driving at around 45 mph when he hit a fire hydrant and his car flipped over in the city. Pt states he lost consciousness prior to the crash. On arrival in ED BP 181/78, O2 100% on RA. Labs revealed Cr 1.49, mild anemia hgb 11.9, trop negative x1.  UA negative. COVID-19 PCR positive in ED. CT hea/C-spine negative for acute process.  CT C/A/P negative for acute process. CXR negative for acute process or infiltrates.  He was cleared by trauma sx team for DC. However, he was admitted for further work up for recurrent syncopal episodes and cardiology is consulted.Patient states he had a similar episodes few months ago but he was not driving at, did not seek medical attention at that time. Patient denies any recent changes to his meds. Pt states he is vaccinated against COVID 19 x2 and boosted x2. He reports mild dry cough, but no shortness of breath, chest pain, or GI symptoms. Patient was not aware that he had COVID-19 infection a prior to the admission. States his mild dry cough started about couple days ago but he thought was related to allergies. All imaging studies including CT head/C-spine, CT C/A/P, CXR, pelvic XR all negative for acute process or fracture. Okay to discharge and schedule loop monitor implant outpatient.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administered expired vaccine.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Atrial fibrillation, COVID-19, Chest X-ray abnormal, Cough
Clinical narrative: 87y.o. female who presented to the hospital with SOB and cough. She tested + for COVID and found in A Fib with RVR. Please note that the patient lives in a Hotel as had water in her House and is under construction, she is not certain of the PTA medication she is taking. Patient was found in A Fib with RVR and started on IV cardizem, with improving of her rapid rate, she was continued on Xarelto, propafenone and cardizem. She was seen by cardio and Echo was technically difficult, showed EF 50% and no WMA. Patient will contnue with same meds as PTA and F/U with her Cardiologist. She was seen by ID for COVID, completed 5 d of remdesivir. CXR showed hazy opacities but PCT was normal. She required O2 intermittently in the hospital, but she was weaned off and did pass home O2 evaluation test.  She is stable for DC home with family.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Echocardiogram normal, Ejection fraction normal, Lung opacity, SARS-CoV-2 test positive
Clinical narrative: 87y.o. female who presented to the hospital with SOB and cough. She tested + for COVID and found in A Fib with RVR. Please note that the patient lives in a Hotel as had water in her House and is under construction, she is not certain of the PTA medication she is taking. Patient was found in A Fib with RVR and started on IV cardizem, with improving of her rapid rate, she was continued on Xarelto, propafenone and cardizem. She was seen by cardio and Echo was technically difficult, showed EF 50% and no WMA. Patient will contnue with same meds as PTA and F/U with her Cardiologist. She was seen by ID for COVID, completed 5 d of remdesivir. CXR showed hazy opacities but PCT was normal. She required O2 intermittently in the hospital, but she was weaned off and did pass home O2 evaluation test.  She is stable for DC home with family.
Age: 67.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, COVID-19, Laboratory test normal, SARS-CoV-2 test positive, Seizure
Clinical narrative: 69y.o. male who presents after syncopal episode. Patient was recently in another country when he had an episode of syncope. Per family, he was hospitalized overseas and workup was unremarkable. Family brought him to the hospital yesterday for further evaluation. While in the ED waiting area, patient complained of sudden abdominal pain and immediately after had a witnessed seizure. No falls, trauma or injury. He does not have history of seizures. Patient deemed medically stable for discharge by physician. Patient discharged to home with outpatient follow-up
Age: 67.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Syncope
Clinical narrative: 69y.o. male who presents after syncopal episode. Patient was recently in another country when he had an episode of syncope. Per family, he was hospitalized overseas and workup was unremarkable. Family brought him to the hospital yesterday for further evaluation. While in the ED waiting area, patient complained of sudden abdominal pain and immediately after had a witnessed seizure. No falls, trauma or injury. He does not have history of seizures. Patient deemed medically stable for discharge by physician. Patient discharged to home with outpatient follow-up
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Arteriosclerosis coronary artery, Brain natriuretic peptide normal, COVID-19, Cardiac stress test abnormal, Catheterisation cardiac abnormal
Clinical narrative: 75y.o. female with a PMHx significant for asthma, breast ca, hypothyroid, HLD, and as below. Pt presents with c/o worsening chest pressure over the past week. Pt underwent stress test on 8/19 which showed myocardial ischemia to the distal anterior wall and apical wall segment. Pt has cardiac cath planned for 9/19/22. Pt states since chest pressure not improving she decided to present to ED. Pt states upon ED arrival chest pressure improved after receiving SL nitro x3. Upon ED evaluation troponin negative x1, BNP 48. Pt admitted for cardiology evaluation and underwent cardiac cath 8/21 with Dr showed very mild coronary atherosclerosis. Pulmonary consulted per cardio rec, increased symbicort doses and continue albuterol as needed. Referral given for pulmonary rehab. Discussed with nursing staff. Patient is cleared and discharged in a stable condition.
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Chest discomfort, Myocardial ischaemia, SARS-CoV-2 test positive, Troponin normal
Clinical narrative: 75y.o. female with a PMHx significant for asthma, breast ca, hypothyroid, HLD, and as below. Pt presents with c/o worsening chest pressure over the past week. Pt underwent stress test on 8/19 which showed myocardial ischemia to the distal anterior wall and apical wall segment. Pt has cardiac cath planned for 9/19/22. Pt states since chest pressure not improving she decided to present to ED. Pt states upon ED arrival chest pressure improved after receiving SL nitro x3. Upon ED evaluation troponin negative x1, BNP 48. Pt admitted for cardiology evaluation and underwent cardiac cath 8/21 with Dr showed very mild coronary atherosclerosis. Pulmonary consulted per cardio rec, increased symbicort doses and continue albuterol as needed. Referral given for pulmonary rehab. Discussed with nursing staff. Patient is cleared and discharged in a stable condition.
Age: 75.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: SHE WAS ADMITTED FOR ACUTE COVID 19 INFECTION , RECEIVED X3 DAYS OF MONOCLONAL AB IV REMDISIVIR AND IMPROVED , SHE ALSO IS A KIDNEY TX PATIENT, SHE WAS DC HOME
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Angiogram pulmonary abnormal, Aortic valve replacement, Asthenia, Atelectasis, COVID-19
Clinical narrative: Patient admitted for dyspnea on exertion. Recent admission at hospital for open surgery for aortic valve replacement followed by COVID-19 infection which kept him in the hospital for about a month. Seen by pulmonary.  They ordered CTA chest with PE protocol. Results as above no evidence of PE. Noted to have moderate sized right sided pleural effusion with right basilar atelectasis and some loculation. Discussed with pulmonary service.  They do not believe pleural effusion is causing dyspnea.  It could be combination of debility & prolong hospital stay.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Dyspnoea exertional, Pleural effusion, SARS-CoV-2 test positive
Clinical narrative: Patient admitted for dyspnea on exertion. Recent admission at hospital for open surgery for aortic valve replacement followed by COVID-19 infection which kept him in the hospital for about a month. Seen by pulmonary.  They ordered CTA chest with PE protocol. Results as above no evidence of PE. Noted to have moderate sized right sided pleural effusion with right basilar atelectasis and some loculation. Discussed with pulmonary service.  They do not believe pleural effusion is causing dyspnea.  It could be combination of debility & prolong hospital stay.
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood culture negative, CD4 lymphocytes increased, COVID-19, Chest pain, Culture urine negative
Clinical narrative: 38y.o. male presenting with chest pain. He has known history of HIV, previous neurosyphilis. Upon presentation he tested positive for COVID-19. ID was consulted. He had not been on any HIV medications due to disruption of insurance. He did have sepsis on presentation. Both blood and urine cultures were without growth, however he did complete empiric course of ceftriaxone, azithromycin for suspected superimposed bacterial pneumonia. Despite lack of treatment, CD4 count was 504. He will need to follow-up with infectious disease clinic outpatient for resumption of therapy. Care management was consulted for assistance with prescriptions. He improved symptomatically and was able to be discharged home as soon as his antibiotic therapy was completed.
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Insurance issue, Pneumonia bacterial, SARS-CoV-2 test positive, Sepsis, Superinfection
Clinical narrative: 38y.o. male presenting with chest pain. He has known history of HIV, previous neurosyphilis. Upon presentation he tested positive for COVID-19. ID was consulted. He had not been on any HIV medications due to disruption of insurance. He did have sepsis on presentation. Both blood and urine cultures were without growth, however he did complete empiric course of ceftriaxone, azithromycin for suspected superimposed bacterial pneumonia. Despite lack of treatment, CD4 count was 504. He will need to follow-up with infectious disease clinic outpatient for resumption of therapy. Care management was consulted for assistance with prescriptions. He improved symptomatically and was able to be discharged home as soon as his antibiotic therapy was completed.
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Therapy cessation
Clinical narrative: 38y.o. male presenting with chest pain. He has known history of HIV, previous neurosyphilis. Upon presentation he tested positive for COVID-19. ID was consulted. He had not been on any HIV medications due to disruption of insurance. He did have sepsis on presentation. Both blood and urine cultures were without growth, however he did complete empiric course of ceftriaxone, azithromycin for suspected superimposed bacterial pneumonia. Despite lack of treatment, CD4 count was 504. He will need to follow-up with infectious disease clinic outpatient for resumption of therapy. Care management was consulted for assistance with prescriptions. He improved symptomatically and was able to be discharged home as soon as his antibiotic therapy was completed.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asymptomatic COVID-19, Behaviour disorder, Confusional state, Corrective lens user, Fall
Clinical narrative: Very sweet little 90 yo female adm after recent move to independent living with falls/ confsuion- behavioral disturbance. She has covid test positive, and abscess behind right ear.  I&D done in ER.  She is on keflex with 85% resolutionn of bscess  It is right where the arm of her glasses set on her ear posterior pinna- dtr aware if doesn to resolve copmletly- have eye glasses refitted. COVID_ nimal inflammatory markers. asymptomtaic D/w her quarantine- dtr is still testing neg- this could be old infection.  Dtr to mask and hand wash but no wneed for her to quarantine Pt to return to assisted living with help to get to meals, have meds passed and check on her.  Necklace for emergency alert. antibiotic therapy was completed.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Incisional drainage, Inflammatory marker test, SARS-CoV-2 test positive, Subcutaneous abscess
Clinical narrative: Very sweet little 90 yo female adm after recent move to independent living with falls/ confsuion- behavioral disturbance. She has covid test positive, and abscess behind right ear.  I&D done in ER.  She is on keflex with 85% resolutionn of bscess  It is right where the arm of her glasses set on her ear posterior pinna- dtr aware if doesn to resolve copmletly- have eye glasses refitted. COVID_ nimal inflammatory markers. asymptomtaic D/w her quarantine- dtr is still testing neg- this could be old infection.  Dtr to mask and hand wash but no wneed for her to quarantine Pt to return to assisted living with help to get to meals, have meds passed and check on her.  Necklace for emergency alert. antibiotic therapy was completed.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Abdominal pain, Anticoagulant therapy, COVID-19, Chest pain, Computerised tomogram abdomen normal
Clinical narrative: Patient is 91y.o. male who presented to the hospital with chest and abdominal pain. Please note that patient was seen ibn ER the day before for a fall. Patient was diagnosed with COVID, was seen by ID and completed 3 days of Remdesivir. His breathing remained stable, did not require any O2. .  His troponin was elevated, peaked at 1.09, he was seen by Cardio and Eliquis was changed to IV heparin x 48 hrs. Echo did not show any WMA, EF 55%. He will continue with statin and Imdur. His chest pain resolved.His abdominal pain resolved while in the hospital, a CT a/p was done and was unremarkable.  Patient had a couple of BM that were reported as black by our staff, his Hg remained stable, FOB ordered but not done as did not have any other BMs. He was seen by Gi and recommended to continue Eliquis and PPI.  Patient is stable for DC with HC and 24/7 assistance.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Echocardiogram normal, Ejection fraction normal, Fall, Haemoglobin normal, SARS-CoV-2 test positive
Clinical narrative: Patient is 91y.o. male who presented to the hospital with chest and abdominal pain. Please note that patient was seen ibn ER the day before for a fall. Patient was diagnosed with COVID, was seen by ID and completed 3 days of Remdesivir. His breathing remained stable, did not require any O2. .  His troponin was elevated, peaked at 1.09, he was seen by Cardio and Eliquis was changed to IV heparin x 48 hrs. Echo did not show any WMA, EF 55%. He will continue with statin and Imdur. His chest pain resolved.His abdominal pain resolved while in the hospital, a CT a/p was done and was unremarkable.  Patient had a couple of BM that were reported as black by our staff, his Hg remained stable, FOB ordered but not done as did not have any other BMs. He was seen by Gi and recommended to continue Eliquis and PPI.  Patient is stable for DC with HC and 24/7 assistance.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Troponin increased
Clinical narrative: Patient is 91y.o. male who presented to the hospital with chest and abdominal pain. Please note that patient was seen ibn ER the day before for a fall. Patient was diagnosed with COVID, was seen by ID and completed 3 days of Remdesivir. His breathing remained stable, did not require any O2. .  His troponin was elevated, peaked at 1.09, he was seen by Cardio and Eliquis was changed to IV heparin x 48 hrs. Echo did not show any WMA, EF 55%. He will continue with statin and Imdur. His chest pain resolved.His abdominal pain resolved while in the hospital, a CT a/p was done and was unremarkable.  Patient had a couple of BM that were reported as black by our staff, his Hg remained stable, FOB ordered but not done as did not have any other BMs. He was seen by Gi and recommended to continue Eliquis and PPI.  Patient is stable for DC with HC and 24/7 assistance.
Age: 88.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Agitation, Amnesia, Arthralgia, Bladder catheterisation, COVID-19
Clinical narrative: Patient is a 89-year-old male admitted 8/20 for fever and AMS the patient found to have UTI with C/S positive for klepsiella&  And  COVID-positive with isolation removed on 8/24.On 8/23 Ct chest showed loculated left pleural effusion,chest tube was inserted on 8/24 pending results.MRCP abdomen showed Cholelithiasis. No evidence of acute cholecystitis and intraductal papillary mucinous neoplasms& GIT team recommended for F/U after discharge. The patient was admitted on 8/1 2/2 fall and left arm hematoma then he was discharged to SAR on 8/9. Geriatrics followed him during that hospital stay for delirium as well. He was started on Seroquel 12.5 mg qhs after several nights of needed PRN IV haldol. His mentation improved and when he was clinically stable he was d/c'd to hospital for SAR. Per documentation sent from hospital he was weaned off seroquel while he was there and did nto have any further behavior issues.   Per the chart and RN notes the patient had episodes of delirium and non violet agitations over the last few days. Today morning he pulled out the chest tube. He kept trying to pull out foley catheter as well.  He was verbally reoriented and put in 2 points restraints.   Today the patient was seen laying down on his bed calm& Alert, orientedx3. He denied any pain and he stated that he feels comfortable. He stated that he is aware that he pulled the pigtail but he doesn't know why.  His wife and his daughter were bedside. She says patient has been having short term memory loss for about the last 6 months, denies any sundowning or agitated behaviors at home. Says he gave up driving due to feeling unsure of himself and no longer does the finances either. He does manage his own medications at home, he uses a pill box. He is independent for all of his ADLs, she does help him get dressed due to arthritis pain and limited mobility (e.g. can't bend over to put his socks on).
Age: 88.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Chest tube insertion, Cholelithiasis, Computerised tomogram thorax abnormal, Delirium, Fall
Clinical narrative: Patient is a 89-year-old male admitted 8/20 for fever and AMS the patient found to have UTI with C/S positive for klepsiella&  And  COVID-positive with isolation removed on 8/24.On 8/23 Ct chest showed loculated left pleural effusion,chest tube was inserted on 8/24 pending results.MRCP abdomen showed Cholelithiasis. No evidence of acute cholecystitis and intraductal papillary mucinous neoplasms& GIT team recommended for F/U after discharge. The patient was admitted on 8/1 2/2 fall and left arm hematoma then he was discharged to SAR on 8/9. Geriatrics followed him during that hospital stay for delirium as well. He was started on Seroquel 12.5 mg qhs after several nights of needed PRN IV haldol. His mentation improved and when he was clinically stable he was d/c'd to hospital for SAR. Per documentation sent from hospital he was weaned off seroquel while he was there and did nto have any further behavior issues.   Per the chart and RN notes the patient had episodes of delirium and non violet agitations over the last few days. Today morning he pulled out the chest tube. He kept trying to pull out foley catheter as well.  He was verbally reoriented and put in 2 points restraints.   Today the patient was seen laying down on his bed calm& Alert, orientedx3. He denied any pain and he stated that he feels comfortable. He stated that he is aware that he pulled the pigtail but he doesn't know why.  His wife and his daughter were bedside. She says patient has been having short term memory loss for about the last 6 months, denies any sundowning or agitated behaviors at home. Says he gave up driving due to feeling unsure of himself and no longer does the finances either. He does manage his own medications at home, he uses a pill box. He is independent for all of his ADLs, she does help him get dressed due to arthritis pain and limited mobility (e.g. can't bend over to put his socks on).
Age: 88.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Haematoma, Impaired driving ability, Intentional medical device removal by patient, Klebsiella test positive, Magnetic resonance cholangiopancreatography
Clinical narrative: Patient is a 89-year-old male admitted 8/20 for fever and AMS the patient found to have UTI with C/S positive for klepsiella&  And  COVID-positive with isolation removed on 8/24.On 8/23 Ct chest showed loculated left pleural effusion,chest tube was inserted on 8/24 pending results.MRCP abdomen showed Cholelithiasis. No evidence of acute cholecystitis and intraductal papillary mucinous neoplasms& GIT team recommended for F/U after discharge. The patient was admitted on 8/1 2/2 fall and left arm hematoma then he was discharged to SAR on 8/9. Geriatrics followed him during that hospital stay for delirium as well. He was started on Seroquel 12.5 mg qhs after several nights of needed PRN IV haldol. His mentation improved and when he was clinically stable he was d/c'd to hospital for SAR. Per documentation sent from hospital he was weaned off seroquel while he was there and did nto have any further behavior issues.   Per the chart and RN notes the patient had episodes of delirium and non violet agitations over the last few days. Today morning he pulled out the chest tube. He kept trying to pull out foley catheter as well.  He was verbally reoriented and put in 2 points restraints.   Today the patient was seen laying down on his bed calm& Alert, orientedx3. He denied any pain and he stated that he feels comfortable. He stated that he is aware that he pulled the pigtail but he doesn't know why.  His wife and his daughter were bedside. She says patient has been having short term memory loss for about the last 6 months, denies any sundowning or agitated behaviors at home. Says he gave up driving due to feeling unsure of himself and no longer does the finances either. He does manage his own medications at home, he uses a pill box. He is independent for all of his ADLs, she does help him get dressed due to arthritis pain and limited mobility (e.g. can't bend over to put his socks on).
Age: 88.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Magnetic resonance imaging abdominal abnormal, Mental status changes, Mobility decreased, Patient restraint, Pleural effusion
Clinical narrative: Patient is a 89-year-old male admitted 8/20 for fever and AMS the patient found to have UTI with C/S positive for klepsiella&  And  COVID-positive with isolation removed on 8/24.On 8/23 Ct chest showed loculated left pleural effusion,chest tube was inserted on 8/24 pending results.MRCP abdomen showed Cholelithiasis. No evidence of acute cholecystitis and intraductal papillary mucinous neoplasms& GIT team recommended for F/U after discharge. The patient was admitted on 8/1 2/2 fall and left arm hematoma then he was discharged to SAR on 8/9. Geriatrics followed him during that hospital stay for delirium as well. He was started on Seroquel 12.5 mg qhs after several nights of needed PRN IV haldol. His mentation improved and when he was clinically stable he was d/c'd to hospital for SAR. Per documentation sent from hospital he was weaned off seroquel while he was there and did nto have any further behavior issues.   Per the chart and RN notes the patient had episodes of delirium and non violet agitations over the last few days. Today morning he pulled out the chest tube. He kept trying to pull out foley catheter as well.  He was verbally reoriented and put in 2 points restraints.   Today the patient was seen laying down on his bed calm& Alert, orientedx3. He denied any pain and he stated that he feels comfortable. He stated that he is aware that he pulled the pigtail but he doesn't know why.  His wife and his daughter were bedside. She says patient has been having short term memory loss for about the last 6 months, denies any sundowning or agitated behaviors at home. Says he gave up driving due to feeling unsure of himself and no longer does the finances either. He does manage his own medications at home, he uses a pill box. He is independent for all of his ADLs, she does help him get dressed due to arthritis pain and limited mobility (e.g. can't bend over to put his socks on).
Age: 88.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Urinary tract infection
Clinical narrative: Patient is a 89-year-old male admitted 8/20 for fever and AMS the patient found to have UTI with C/S positive for klepsiella&  And  COVID-positive with isolation removed on 8/24.On 8/23 Ct chest showed loculated left pleural effusion,chest tube was inserted on 8/24 pending results.MRCP abdomen showed Cholelithiasis. No evidence of acute cholecystitis and intraductal papillary mucinous neoplasms& GIT team recommended for F/U after discharge. The patient was admitted on 8/1 2/2 fall and left arm hematoma then he was discharged to SAR on 8/9. Geriatrics followed him during that hospital stay for delirium as well. He was started on Seroquel 12.5 mg qhs after several nights of needed PRN IV haldol. His mentation improved and when he was clinically stable he was d/c'd to hospital for SAR. Per documentation sent from hospital he was weaned off seroquel while he was there and did nto have any further behavior issues.   Per the chart and RN notes the patient had episodes of delirium and non violet agitations over the last few days. Today morning he pulled out the chest tube. He kept trying to pull out foley catheter as well.  He was verbally reoriented and put in 2 points restraints.   Today the patient was seen laying down on his bed calm& Alert, orientedx3. He denied any pain and he stated that he feels comfortable. He stated that he is aware that he pulled the pigtail but he doesn't know why.  His wife and his daughter were bedside. She says patient has been having short term memory loss for about the last 6 months, denies any sundowning or agitated behaviors at home. Says he gave up driving due to feeling unsure of himself and no longer does the finances either. He does manage his own medications at home, he uses a pill box. He is independent for all of his ADLs, she does help him get dressed due to arthritis pain and limited mobility (e.g. can't bend over to put his socks on).
Age: 13.0
Sex: M
Vaccine: HPV9
Symptoms: Extra dose administered
Clinical narrative: Patient received 3rd hpv9 when not necessary
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: ADMINISTERED EXPIRED VACCINE
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Blood glucose increased, COVID-19, Cough, Dyspnoea
Clinical narrative: Patient is 88y.o. male who presented to the hospital with DIB/cough. He tested + for COVID. Patient was started on lovenox, decadron, and received 5 days of Remdesivir as directed by ID. Patient was on O2 2L NC, we were able to wean him off O2.  His symptoms improved.  Patient's glucose was elevated, likely 2/2. Steroids, he is not known with DM, HgA1c was done and is elevated. Patient will continue with diet and F/U with PCP. He is stable for DC home with family, F/U PCP next week, will need to repeat monitor CBC, CMP and a CXR in 4 weeks.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Glycosylated haemoglobin increased, SARS-CoV-2 test positive
Clinical narrative: Patient is 88y.o. male who presented to the hospital with DIB/cough. He tested + for COVID. Patient was started on lovenox, decadron, and received 5 days of Remdesivir as directed by ID. Patient was on O2 2L NC, we were able to wean him off O2.  His symptoms improved.  Patient's glucose was elevated, likely 2/2. Steroids, he is not known with DM, HgA1c was done and is elevated. Patient will continue with diet and F/U with PCP. He is stable for DC home with family, F/U PCP next week, will need to repeat monitor CBC, CMP and a CXR in 4 weeks.
Age: 37.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Delivery, Maternal exposure before pregnancy, SARS-CoV-2 test positive
Clinical narrative: NSVB 8/21 baby
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chest X-ray normal, Computerised tomogram head normal, Computerised tomogram spine, Fall
Clinical narrative: Very sweet pleasant lady brought in from her independent living after a fall. She was seen by trauma- no acute injuries. Today, she is ambulating without pain with full room of shoulders elbow/ wrists/ hips/ knees/ ankles. Head ct and c spine ct without acute change She did test incidentally covid positive. Inflammatory markers are minimal> CXR negeative- she has NO cough, sore throat, congestion etc. She may return to her assisted / independent living with ongoing care.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Inflammatory marker test, SARS-CoV-2 test positive
Clinical narrative: Very sweet pleasant lady brought in from her independent living after a fall. She was seen by trauma- no acute injuries. Today, she is ambulating without pain with full room of shoulders elbow/ wrists/ hips/ knees/ ankles. Head ct and c spine ct without acute change She did test incidentally covid positive. Inflammatory markers are minimal> CXR negeative- she has NO cough, sore throat, congestion etc. She may return to her assisted / independent living with ongoing care.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Agitation, Atelectasis, COVID-19, Chest pain, Chest tube insertion
Clinical narrative: 87 yo female with PMH of PNAs, lung abscess, thoracic compression fractures, and recurrent UTIs who presented with lower right-sided chest pain. She had a history of pneumonia in the right lower lobe 7/25, treated with antibiotics. Her daughter reported symptoms seemed to resolve and then she had worsening pain in the same location. On 8/18 she was brought to the hospital for the pain and imaging at the time showed right middle lobe spiculated mass. She made an appt to follow up outpatient with a thoracic surgeon. She continued to have right-sided chest pain and returned to the ED for admission on 8/21. On admission imaging showed a right-sided pleural effusion with bibasilar atelectasis and she was started on Flagyl, Ceftriaxone, and Vancomycin. She also tested positive for Covid with PCR and was started on a 5 day course of Remdesivir. On 8/22 MRSA nares resulted negative and Vancomycin was discontinued. On 8/23 a chest tube was placed which drained about 250 mL of reddish- dark orange fluid. She pulled her tube out that evening and surgery made the decision not to replace the tube but monitor effusion size through daily CXRs. Her right-sided chest pain was significantly improved. Studies of the pleural fluid were consistent with complicated parapneumonia effusion. Most evenings family members stayed with the patient and reported worsening episodes of sundowning. On 8/26 the care team spoke with family regarding whether antibiotics should be continued outpatient at the patient's assisted living community where she may experience less agitation and be able to see family. The concern at the time was whether the pleural effusion would get worse and she would become symptomatic with pain and return to the hospital. The decision was made for her to return home and see if she would need to come back. She was discharged on Augmentin for a total antibiotic course of 21 days and home oxygen with instructions for follow-up imaging through primary care physician.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Delirium, Imaging procedure abnormal, Pain, Pleural effusion, Pleural fluid analysis abnormal
Clinical narrative: 87 yo female with PMH of PNAs, lung abscess, thoracic compression fractures, and recurrent UTIs who presented with lower right-sided chest pain. She had a history of pneumonia in the right lower lobe 7/25, treated with antibiotics. Her daughter reported symptoms seemed to resolve and then she had worsening pain in the same location. On 8/18 she was brought to the hospital for the pain and imaging at the time showed right middle lobe spiculated mass. She made an appt to follow up outpatient with a thoracic surgeon. She continued to have right-sided chest pain and returned to the ED for admission on 8/21. On admission imaging showed a right-sided pleural effusion with bibasilar atelectasis and she was started on Flagyl, Ceftriaxone, and Vancomycin. She also tested positive for Covid with PCR and was started on a 5 day course of Remdesivir. On 8/22 MRSA nares resulted negative and Vancomycin was discontinued. On 8/23 a chest tube was placed which drained about 250 mL of reddish- dark orange fluid. She pulled her tube out that evening and surgery made the decision not to replace the tube but monitor effusion size through daily CXRs. Her right-sided chest pain was significantly improved. Studies of the pleural fluid were consistent with complicated parapneumonia effusion. Most evenings family members stayed with the patient and reported worsening episodes of sundowning. On 8/26 the care team spoke with family regarding whether antibiotics should be continued outpatient at the patient's assisted living community where she may experience less agitation and be able to see family. The concern at the time was whether the pleural effusion would get worse and she would become symptomatic with pain and return to the hospital. The decision was made for her to return home and see if she would need to come back. She was discharged on Augmentin for a total antibiotic course of 21 days and home oxygen with instructions for follow-up imaging through primary care physician.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pulmonary mass, SARS-CoV-2 test positive, Staphylococcus test negative
Clinical narrative: 87 yo female with PMH of PNAs, lung abscess, thoracic compression fractures, and recurrent UTIs who presented with lower right-sided chest pain. She had a history of pneumonia in the right lower lobe 7/25, treated with antibiotics. Her daughter reported symptoms seemed to resolve and then she had worsening pain in the same location. On 8/18 she was brought to the hospital for the pain and imaging at the time showed right middle lobe spiculated mass. She made an appt to follow up outpatient with a thoracic surgeon. She continued to have right-sided chest pain and returned to the ED for admission on 8/21. On admission imaging showed a right-sided pleural effusion with bibasilar atelectasis and she was started on Flagyl, Ceftriaxone, and Vancomycin. She also tested positive for Covid with PCR and was started on a 5 day course of Remdesivir. On 8/22 MRSA nares resulted negative and Vancomycin was discontinued. On 8/23 a chest tube was placed which drained about 250 mL of reddish- dark orange fluid. She pulled her tube out that evening and surgery made the decision not to replace the tube but monitor effusion size through daily CXRs. Her right-sided chest pain was significantly improved. Studies of the pleural fluid were consistent with complicated parapneumonia effusion. Most evenings family members stayed with the patient and reported worsening episodes of sundowning. On 8/26 the care team spoke with family regarding whether antibiotics should be continued outpatient at the patient's assisted living community where she may experience less agitation and be able to see family. The concern at the time was whether the pleural effusion would get worse and she would become symptomatic with pain and return to the hospital. The decision was made for her to return home and see if she would need to come back. She was discharged on Augmentin for a total antibiotic course of 21 days and home oxygen with instructions for follow-up imaging through primary care physician.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Appendicectomy, Appendicitis, COVID-19, Computerised tomogram abdomen abnormal, Laparoscopic surgery
Clinical narrative: Patient was admitted on 8/21 with CT proven appendicitis. She underwent laparoscopic appendectomy. She tolerated this well and was seen postoperatively where her pain was well controlled on oral pain medication, ambulating, tolerating a diet and felt comfortable going home.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, SARS-CoV-2 test positive
Clinical narrative: Patient was admitted on 8/21 with CT proven appendicitis. She underwent laparoscopic appendectomy. She tolerated this well and was seen postoperatively where her pain was well controlled on oral pain medication, ambulating, tolerating a diet and felt comfortable going home.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chills, Cough, Malaise, Oropharyngeal pain
Clinical narrative: 52y.o. female with a history of renal transplant, HTN, dyslipidemia, type IIDM, GERD who presented to EC with a fever and chills. She also reports malaise, sore throat, nonproductive cough. She was instructed to come to EC by her transplant office. Patient was admitted for covid 19 positive test results and evaluated by ID and Nephrology. She was on room air, no respiratory distress, was given 5 days of remdesivir. Adverse effects were discussed. She had a history of CKD s/p renal transplant- she was on  Prednisone myofortic and tacro per transplant. Myfortic was adjusted to 360mg bid and then on 8/29 go  Back to 720mg bid on discharge. Discussed changes with patient bedside. Discharged home on room air.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: 52y.o. female with a history of renal transplant, HTN, dyslipidemia, type IIDM, GERD who presented to EC with a fever and chills. She also reports malaise, sore throat, nonproductive cough. She was instructed to come to EC by her transplant office. Patient was admitted for covid 19 positive test results and evaluated by ID and Nephrology. She was on room air, no respiratory distress, was given 5 days of remdesivir. Adverse effects were discussed. She had a history of CKD s/p renal transplant- she was on  Prednisone myofortic and tacro per transplant. Myfortic was adjusted to 360mg bid and then on 8/29 go  Back to 720mg bid on discharge. Discussed changes with patient bedside. Discharged home on room air.
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Blood creatinine abnormal, COVID-19, Dyspnoea, Oedema, Oedema peripheral
Clinical narrative: 62y.o. male who presented with progressive edema and dyspnea. He does have chronic LE edema and has his legs wrapped on a weekly basis -- he has known venous insufficiency. He was just seen in the office on 8.12 and his creat was worse.  This was thought to be due to his diuresis which was slowed to bumex 2mg BID  metolazone 2.5mg MWF Aldactone 50 He was also advised to hold his ARB. Once he slowed these medications, his swelling and breathing worsened. Patient is stable for discharge with outpatient follow-up.
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Polyuria, SARS-CoV-2 test positive, Swelling
Clinical narrative: 62y.o. male who presented with progressive edema and dyspnea. He does have chronic LE edema and has his legs wrapped on a weekly basis -- he has known venous insufficiency. He was just seen in the office on 8.12 and his creat was worse.  This was thought to be due to his diuresis which was slowed to bumex 2mg BID  metolazone 2.5mg MWF Aldactone 50 He was also advised to hold his ARB. Once he slowed these medications, his swelling and breathing worsened. Patient is stable for discharge with outpatient follow-up.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: ADMINISTERED EXPIRED VACCINE
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Blood creatinine increased, Blood pressure increased, COVID-19, Cerebral infarction, Chronic kidney disease
Clinical narrative: 88y.o. female presenting with altered mental status. Upon presentation she was found to be COVID-positive which was likely source of her altered mental status. MRI brain demonstrated remote left parietal infarct with possible small acute infarcts in left occipital lobe. This was likely secondary to longstanding hypertension. Additionally, was found to have hypertensive urgency. She does have element of CKD with acutely elevated creatinine. Creatinine resolved to previous level with IV fluids. In terms of her blood pressure, metoprolol and clonidine were increased. Once her renal function resolved to baseline, losartan was resumed. Blood pressure was still elevated, and calcium channel blocker was added. This achieved acceptable control of her blood pressure. Following this, she was stable for discharge home. Family is able to provide care for her. She was discharged home accordingly to follow-up expediently with her primary care physician. Patient's daughter had already been in discussion with primary care to set up follow-up appointment.