chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram head normal, Coronary artery disease, Cough, Dementia, Fall
Clinical narrative: FINAL DIAGNOSIS: 1. COVID-19 PNA 2. Acute Hypoxemic Respiratory Failure 3. Fall 4. Acute Sacral Fracture 5. Chronic Lumbar Compression Fx 6. Dementia 7. Hypertensive Disease with CAD 8. Headache     REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Fall and Back Pain Fall [W19.XXXA] Hypoxia [R09.02] Closed fracture of sacrum, unspecified portion of sacrum, initial encounter [S32.10XA] COVID [U07.1]   HOSPITAL COURSE:  Patient is a 101 y.o. female who presented to Hospital 1/15/2023 with fall   1. COVID-19 pneumonia with superimposed bacterial pneumonia 1. Onset of symptoms this 1 week prior to presentation symptoms included hypoxemia and cough.  COVID test was positive on January 15, 2023.  Patient has received 3 vaccinations for COVID.  Chest x-ray demonstrated superimposed likely bacterial pneumonia.  Patient discharged on completing course of Augmentin.  Oxygen requirements 3 L nasal cannula will be discharged with arrangements for home oxygen.  ID was consulted did not recommend remdesivir or Paxlovid at this time.  2. Acute hypoxemic respiratory failure 1. Arrangements being made for discharge with oxygen at home 3. Fall, unwitnessed 1. Mechanical fall PT OT followed during hospitalization 4. Acute sacral fracture 1. Ortho reports sacral fractures nonsurgical recommended continuation of PT OT and weightbearing as tolerated 5. Chronic lumbar compression fractures 1. Symptomatic management 6. Dementia 1. Returning to memory care unit 7. Hypertensive heart disease with CAD 1. Management per PCP on discharge 8. Headache 1. CT head ruled out any acute intracranial process
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Fracture, Fractured sacrum, Headache, Hypertensive heart disease, Hypoxia
Clinical narrative: FINAL DIAGNOSIS: 1. COVID-19 PNA 2. Acute Hypoxemic Respiratory Failure 3. Fall 4. Acute Sacral Fracture 5. Chronic Lumbar Compression Fx 6. Dementia 7. Hypertensive Disease with CAD 8. Headache     REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Fall and Back Pain Fall [W19.XXXA] Hypoxia [R09.02] Closed fracture of sacrum, unspecified portion of sacrum, initial encounter [S32.10XA] COVID [U07.1]   HOSPITAL COURSE:  Patient is a 101 y.o. female who presented to Hospital 1/15/2023 with fall   1. COVID-19 pneumonia with superimposed bacterial pneumonia 1. Onset of symptoms this 1 week prior to presentation symptoms included hypoxemia and cough.  COVID test was positive on January 15, 2023.  Patient has received 3 vaccinations for COVID.  Chest x-ray demonstrated superimposed likely bacterial pneumonia.  Patient discharged on completing course of Augmentin.  Oxygen requirements 3 L nasal cannula will be discharged with arrangements for home oxygen.  ID was consulted did not recommend remdesivir or Paxlovid at this time.  2. Acute hypoxemic respiratory failure 1. Arrangements being made for discharge with oxygen at home 3. Fall, unwitnessed 1. Mechanical fall PT OT followed during hospitalization 4. Acute sacral fracture 1. Ortho reports sacral fractures nonsurgical recommended continuation of PT OT and weightbearing as tolerated 5. Chronic lumbar compression fractures 1. Symptomatic management 6. Dementia 1. Returning to memory care unit 7. Hypertensive heart disease with CAD 1. Management per PCP on discharge 8. Headache 1. CT head ruled out any acute intracranial process
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Pneumonia bacterial, SARS-CoV-2 test positive, Spinal compression fracture, Superinfection
Clinical narrative: FINAL DIAGNOSIS: 1. COVID-19 PNA 2. Acute Hypoxemic Respiratory Failure 3. Fall 4. Acute Sacral Fracture 5. Chronic Lumbar Compression Fx 6. Dementia 7. Hypertensive Disease with CAD 8. Headache     REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Fall and Back Pain Fall [W19.XXXA] Hypoxia [R09.02] Closed fracture of sacrum, unspecified portion of sacrum, initial encounter [S32.10XA] COVID [U07.1]   HOSPITAL COURSE:  Patient is a 101 y.o. female who presented to Hospital 1/15/2023 with fall   1. COVID-19 pneumonia with superimposed bacterial pneumonia 1. Onset of symptoms this 1 week prior to presentation symptoms included hypoxemia and cough.  COVID test was positive on January 15, 2023.  Patient has received 3 vaccinations for COVID.  Chest x-ray demonstrated superimposed likely bacterial pneumonia.  Patient discharged on completing course of Augmentin.  Oxygen requirements 3 L nasal cannula will be discharged with arrangements for home oxygen.  ID was consulted did not recommend remdesivir or Paxlovid at this time.  2. Acute hypoxemic respiratory failure 1. Arrangements being made for discharge with oxygen at home 3. Fall, unwitnessed 1. Mechanical fall PT OT followed during hospitalization 4. Acute sacral fracture 1. Ortho reports sacral fractures nonsurgical recommended continuation of PT OT and weightbearing as tolerated 5. Chronic lumbar compression fractures 1. Symptomatic management 6. Dementia 1. Returning to memory care unit 7. Hypertensive heart disease with CAD 1. Management per PCP on discharge 8. Headache 1. CT head ruled out any acute intracranial process
Age: 85.0
Sex: M
Vaccine: COVID19, UNK
Symptoms: Blood test, Cerebral haemorrhage, Cerebrovascular accident, Facial paralysis, X-ray
Clinical narrative: Stoke  Blood in brain  Left face sag
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Tinnitus
Clinical narrative: Tinnitus
Age: 67.0
Sex: M
Vaccine: UNK
Symptoms: Herpes zoster, Rash
Clinical narrative: PATIENT REPORTED GETTING "SHINGLES RASH" ON HIS TRUNK ABOUT 2-3 DAYS AFTER RECEIVING THE VACCINE- PATIENT RECEIVED THE SHINGRIX.  I INFORMED HIM TO CONTACT HIS PCP FOR EVALUATION OF THE RASH AND TREATMENT.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Alice in wonderland syndrome, Computerised tomogram head, Coxsackie virus test positive, Epstein-Barr virus antibody positive, Illusion
Clinical narrative: Alice In Wonderland Syndrome - visual and perceptual/proprioceptive distortions. Non-vestibular.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging head abnormal, Metamorphopsia, Migraine, Nerve conduction studies abnormal, Scan with contrast normal
Clinical narrative: Alice In Wonderland Syndrome - visual and perceptual/proprioceptive distortions. Non-vestibular.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Superior semicircular canal dehiscence, Vestibular function test normal
Clinical narrative: Alice In Wonderland Syndrome - visual and perceptual/proprioceptive distortions. Non-vestibular.
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Affective disorder, Angiogram pulmonary normal, Anxiety, Blood creatinine increased
Clinical narrative: Hospital Course:  Patent is a 91 y.o. female with history of dementia, DM and HTN who presented to Hospital.  Patient presented with nausea vomiting and GI losses.  Patient nausea and vomiting has improved.  She was eating and tolerated diet.     During patient's stay the following problem addressed     COVID-19 infection Persistent nausea and vomiting Vaccination status unknown and date of onset unclear with confirmed positive on 1/10/23  GI symptoms present but no hypoxia or clear evidence of PNA on radiographic studies No indication for remdesivir and steroids.   Patient continued to have nausea vomiting despite treatment so far. She has been on PPI IV, Zofran PRN and Reglan scheduled per GI She is being discharged on a PPI and reglan LFT, Lipase normal  CT AP on 1/10 non acute.  Continue gentle hydration, advance diet as tolerated. Has been Monitor Qtc , GI following,  continue to slightly improve. Patient nausea has improved since yesterday.   Hypertension, benign. BP not controlled On metoprolol,   amlodipine was added BP still high but better than was yesterday. Needs to be further adjusted in ECF.     Dementia without behavioral disturbance, psychotic disturbance, mood disturbance, or anxiety Alzheimer's dementia Chronic presentation w/o evidence of acute delerium present  Continue established Namenda/Aricept and avoid Narc/Benzo therapy Maintain sleep/wake cycle and encouraged daytime cognitive therapy   Prolonged Qtc keep Mg > 2,  keep K > 4 S/p Mg IV 1 gm and IV KCL 40 Meq  Monitor on tele Repeat EKG, Qtc 493   Type 2 diabetes mellitus without complication, without long-term current use of insulin (HCC) A1c - 6.2  hold Lantus d/t hypoglycemia and poor eating for now, re started on dextrose 0.45 @ 75 ml/hr on 1/22  AKI on stage 3b chronic kidney disease (HCC) Creatinine on admission 1.47, it is 0.8 Resume home diuretics as able Follow-up labs
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure inadequately controlled, COVID-19, Chronic kidney disease, Condition aggravated, Decreased appetite
Clinical narrative: Hospital Course:  Patent is a 91 y.o. female with history of dementia, DM and HTN who presented to Hospital.  Patient presented with nausea vomiting and GI losses.  Patient nausea and vomiting has improved.  She was eating and tolerated diet.     During patient's stay the following problem addressed     COVID-19 infection Persistent nausea and vomiting Vaccination status unknown and date of onset unclear with confirmed positive on 1/10/23  GI symptoms present but no hypoxia or clear evidence of PNA on radiographic studies No indication for remdesivir and steroids.   Patient continued to have nausea vomiting despite treatment so far. She has been on PPI IV, Zofran PRN and Reglan scheduled per GI She is being discharged on a PPI and reglan LFT, Lipase normal  CT AP on 1/10 non acute.  Continue gentle hydration, advance diet as tolerated. Has been Monitor Qtc , GI following,  continue to slightly improve. Patient nausea has improved since yesterday.   Hypertension, benign. BP not controlled On metoprolol,   amlodipine was added BP still high but better than was yesterday. Needs to be further adjusted in ECF.     Dementia without behavioral disturbance, psychotic disturbance, mood disturbance, or anxiety Alzheimer's dementia Chronic presentation w/o evidence of acute delerium present  Continue established Namenda/Aricept and avoid Narc/Benzo therapy Maintain sleep/wake cycle and encouraged daytime cognitive therapy   Prolonged Qtc keep Mg > 2,  keep K > 4 S/p Mg IV 1 gm and IV KCL 40 Meq  Monitor on tele Repeat EKG, Qtc 493   Type 2 diabetes mellitus without complication, without long-term current use of insulin (HCC) A1c - 6.2  hold Lantus d/t hypoglycemia and poor eating for now, re started on dextrose 0.45 @ 75 ml/hr on 1/22  AKI on stage 3b chronic kidney disease (HCC) Creatinine on admission 1.47, it is 0.8 Resume home diuretics as able Follow-up labs
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Dementia, Dementia Alzheimer's type, Electrocardiogram QT prolonged, Gastrointestinal disorder, Glycosylated haemoglobin normal
Clinical narrative: Hospital Course:  Patent is a 91 y.o. female with history of dementia, DM and HTN who presented to Hospital.  Patient presented with nausea vomiting and GI losses.  Patient nausea and vomiting has improved.  She was eating and tolerated diet.     During patient's stay the following problem addressed     COVID-19 infection Persistent nausea and vomiting Vaccination status unknown and date of onset unclear with confirmed positive on 1/10/23  GI symptoms present but no hypoxia or clear evidence of PNA on radiographic studies No indication for remdesivir and steroids.   Patient continued to have nausea vomiting despite treatment so far. She has been on PPI IV, Zofran PRN and Reglan scheduled per GI She is being discharged on a PPI and reglan LFT, Lipase normal  CT AP on 1/10 non acute.  Continue gentle hydration, advance diet as tolerated. Has been Monitor Qtc , GI following,  continue to slightly improve. Patient nausea has improved since yesterday.   Hypertension, benign. BP not controlled On metoprolol,   amlodipine was added BP still high but better than was yesterday. Needs to be further adjusted in ECF.     Dementia without behavioral disturbance, psychotic disturbance, mood disturbance, or anxiety Alzheimer's dementia Chronic presentation w/o evidence of acute delerium present  Continue established Namenda/Aricept and avoid Narc/Benzo therapy Maintain sleep/wake cycle and encouraged daytime cognitive therapy   Prolonged Qtc keep Mg > 2,  keep K > 4 S/p Mg IV 1 gm and IV KCL 40 Meq  Monitor on tele Repeat EKG, Qtc 493   Type 2 diabetes mellitus without complication, without long-term current use of insulin (HCC) A1c - 6.2  hold Lantus d/t hypoglycemia and poor eating for now, re started on dextrose 0.45 @ 75 ml/hr on 1/22  AKI on stage 3b chronic kidney disease (HCC) Creatinine on admission 1.47, it is 0.8 Resume home diuretics as able Follow-up labs
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Hypertension, Hypoglycaemia, Imaging procedure, Lipase normal, Nausea
Clinical narrative: Hospital Course:  Patent is a 91 y.o. female with history of dementia, DM and HTN who presented to Hospital.  Patient presented with nausea vomiting and GI losses.  Patient nausea and vomiting has improved.  She was eating and tolerated diet.     During patient's stay the following problem addressed     COVID-19 infection Persistent nausea and vomiting Vaccination status unknown and date of onset unclear with confirmed positive on 1/10/23  GI symptoms present but no hypoxia or clear evidence of PNA on radiographic studies No indication for remdesivir and steroids.   Patient continued to have nausea vomiting despite treatment so far. She has been on PPI IV, Zofran PRN and Reglan scheduled per GI She is being discharged on a PPI and reglan LFT, Lipase normal  CT AP on 1/10 non acute.  Continue gentle hydration, advance diet as tolerated. Has been Monitor Qtc , GI following,  continue to slightly improve. Patient nausea has improved since yesterday.   Hypertension, benign. BP not controlled On metoprolol,   amlodipine was added BP still high but better than was yesterday. Needs to be further adjusted in ECF.     Dementia without behavioral disturbance, psychotic disturbance, mood disturbance, or anxiety Alzheimer's dementia Chronic presentation w/o evidence of acute delerium present  Continue established Namenda/Aricept and avoid Narc/Benzo therapy Maintain sleep/wake cycle and encouraged daytime cognitive therapy   Prolonged Qtc keep Mg > 2,  keep K > 4 S/p Mg IV 1 gm and IV KCL 40 Meq  Monitor on tele Repeat EKG, Qtc 493   Type 2 diabetes mellitus without complication, without long-term current use of insulin (HCC) A1c - 6.2  hold Lantus d/t hypoglycemia and poor eating for now, re started on dextrose 0.45 @ 75 ml/hr on 1/22  AKI on stage 3b chronic kidney disease (HCC) Creatinine on admission 1.47, it is 0.8 Resume home diuretics as able Follow-up labs
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Psychotic disorder, SARS-CoV-2 test positive, Vomiting
Clinical narrative: Hospital Course:  Patent is a 91 y.o. female with history of dementia, DM and HTN who presented to Hospital.  Patient presented with nausea vomiting and GI losses.  Patient nausea and vomiting has improved.  She was eating and tolerated diet.     During patient's stay the following problem addressed     COVID-19 infection Persistent nausea and vomiting Vaccination status unknown and date of onset unclear with confirmed positive on 1/10/23  GI symptoms present but no hypoxia or clear evidence of PNA on radiographic studies No indication for remdesivir and steroids.   Patient continued to have nausea vomiting despite treatment so far. She has been on PPI IV, Zofran PRN and Reglan scheduled per GI She is being discharged on a PPI and reglan LFT, Lipase normal  CT AP on 1/10 non acute.  Continue gentle hydration, advance diet as tolerated. Has been Monitor Qtc , GI following,  continue to slightly improve. Patient nausea has improved since yesterday.   Hypertension, benign. BP not controlled On metoprolol,   amlodipine was added BP still high but better than was yesterday. Needs to be further adjusted in ECF.     Dementia without behavioral disturbance, psychotic disturbance, mood disturbance, or anxiety Alzheimer's dementia Chronic presentation w/o evidence of acute delerium present  Continue established Namenda/Aricept and avoid Narc/Benzo therapy Maintain sleep/wake cycle and encouraged daytime cognitive therapy   Prolonged Qtc keep Mg > 2,  keep K > 4 S/p Mg IV 1 gm and IV KCL 40 Meq  Monitor on tele Repeat EKG, Qtc 493   Type 2 diabetes mellitus without complication, without long-term current use of insulin (HCC) A1c - 6.2  hold Lantus d/t hypoglycemia and poor eating for now, re started on dextrose 0.45 @ 75 ml/hr on 1/22  AKI on stage 3b chronic kidney disease (HCC) Creatinine on admission 1.47, it is 0.8 Resume home diuretics as able Follow-up labs
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal discomfort, Exercise tolerance decreased, Fatigue, Influenza like illness
Clinical narrative: Gastrointestinal upset, flulike symptoms, frozen hands, long term fatigue and exercise intolerance
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Bronchiolitis, COVID-19, Cardiac failure congestive, Chest X-ray abnormal, Chronic respiratory failure
Clinical narrative: Patient is a 64 y.o. male with PMH of COPD on 3-4L home O2, HFpEF, DM2, lung adenocarcinoma s/p chemoradiation 2018, rheumatoid arthritis who presented on 1/28/2023 with worsening LE edema, pain, numbness with worsening SOB.  COVID positive. Patient started on BiPAP and was admitted to ICU, transferred out on 1/30/2023     Acute on chronic hypoxic hypercapnic respiratory failure -On 3-4L O2 at home with h/o COPD and CHF.  -Acute exacerbation in setting of COVID, CAP, Hx of lung adenocarcinoma.  -CTA negative for PE and doppler US negative for DVT. -Required BiPAP on admission and weaned to O2 of 3-4L which is his baseline   COVID-19 infection  - Presented with: worsening SOB  - Symptom onset: unclear  - Positive COVID-19: 1/29 - Vaccination status: Vaccinated with Moderna with last dose 3/4//2021 - CT Chest on admission showed Right middle lobe pneumonia with bronchiolitis and pneumonitis in the right upper lobe and right lower lobe - Decadron: Yes. Expected end date 2/8   Pneumonia  - CXR shows Right lower lung haziness may suggest atelectasis or developing infiltrate - CTA chest RLL PNA with bronchiolitis and pneumonitis in the RUL and RLL - Possible viral PNA with COVID infection -Patient will need repeat CT chest 2 to 3 months after hospitalization for lymphadenopathy and right middle lobe opacification   COPD  -in the setting of continued smoking with a 105 pack year smoking  -Possible mild exacerbation in setting of COVD and PNA on admission -Home regimen including  albuterol Proventil nebulizer, albuterol ventolin,  Symbicort, Spiriva Respimat.  -We will complete Decadron for COVID after discharge  Hx of lung adenocarcinoma -s/p chemoradiation 2018. -Not currently receiving treatment.    Suspected metabolic alkalosis with compensatory respiratory acidosis, resolved -Per patient, had been discharged on lasix 60 mg BID and was supposed to transition back to his home 40 mg BID but did not. -Lasix initially held, now resumed   HFpEF -Per history. Follows with Dr.   -TTE 12/31/22 showed LVEF 63%, abnormal diastolic dysfunction indicative of elevated L atrial pressure. - BNP 1891 on admission, was 785 on 12/30  Lower extremity Dopplers negative for DVT -Lasix resumed at 40 mg twice daily   BLE edema -Acute on chronic problem related to CHF and venous stasis -Doppler US BI LE negative for DVT. ABI R 1.02, L 0.72, unchanged from 12/2022. -Keep leg elevated. Compression stocking if tolerated -Lasix resumed     DM2 -Hgb A1c 7.8  -A1c was 7% 1 year ago; will have patient carb restrict his diet and follow-up with PCP   CAD -Per history. Follows with Dr. -S/p recent PCI for OM1 and in-stent restenosis of mid RCA. -Continue at home Plavix 75 mg BID and ASA 81 mg.    Essential HTN -Continue home Toprol 25 mg.    HLD - Prescribed atorvastatin but nooncomplaint     GERD -Continue at home Protonix 40 mg daily.    RA -Per history. -Doesn't currently take anything.    Tobacco use disorder -Current smoker, 1 ppd with year smoking history. -Encourage cessation.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Condition aggravated, Diastolic dysfunction, Dyspnoea, Echocardiogram abnormal
Clinical narrative: Patient is a 64 y.o. male with PMH of COPD on 3-4L home O2, HFpEF, DM2, lung adenocarcinoma s/p chemoradiation 2018, rheumatoid arthritis who presented on 1/28/2023 with worsening LE edema, pain, numbness with worsening SOB.  COVID positive. Patient started on BiPAP and was admitted to ICU, transferred out on 1/30/2023     Acute on chronic hypoxic hypercapnic respiratory failure -On 3-4L O2 at home with h/o COPD and CHF.  -Acute exacerbation in setting of COVID, CAP, Hx of lung adenocarcinoma.  -CTA negative for PE and doppler US negative for DVT. -Required BiPAP on admission and weaned to O2 of 3-4L which is his baseline   COVID-19 infection  - Presented with: worsening SOB  - Symptom onset: unclear  - Positive COVID-19: 1/29 - Vaccination status: Vaccinated with Moderna with last dose 3/4//2021 - CT Chest on admission showed Right middle lobe pneumonia with bronchiolitis and pneumonitis in the right upper lobe and right lower lobe - Decadron: Yes. Expected end date 2/8   Pneumonia  - CXR shows Right lower lung haziness may suggest atelectasis or developing infiltrate - CTA chest RLL PNA with bronchiolitis and pneumonitis in the RUL and RLL - Possible viral PNA with COVID infection -Patient will need repeat CT chest 2 to 3 months after hospitalization for lymphadenopathy and right middle lobe opacification   COPD  -in the setting of continued smoking with a 105 pack year smoking  -Possible mild exacerbation in setting of COVD and PNA on admission -Home regimen including  albuterol Proventil nebulizer, albuterol ventolin,  Symbicort, Spiriva Respimat.  -We will complete Decadron for COVID after discharge  Hx of lung adenocarcinoma -s/p chemoradiation 2018. -Not currently receiving treatment.    Suspected metabolic alkalosis with compensatory respiratory acidosis, resolved -Per patient, had been discharged on lasix 60 mg BID and was supposed to transition back to his home 40 mg BID but did not. -Lasix initially held, now resumed   HFpEF -Per history. Follows with Dr.   -TTE 12/31/22 showed LVEF 63%, abnormal diastolic dysfunction indicative of elevated L atrial pressure. - BNP 1891 on admission, was 785 on 12/30  Lower extremity Dopplers negative for DVT -Lasix resumed at 40 mg twice daily   BLE edema -Acute on chronic problem related to CHF and venous stasis -Doppler US BI LE negative for DVT. ABI R 1.02, L 0.72, unchanged from 12/2022. -Keep leg elevated. Compression stocking if tolerated -Lasix resumed     DM2 -Hgb A1c 7.8  -A1c was 7% 1 year ago; will have patient carb restrict his diet and follow-up with PCP   CAD -Per history. Follows with Dr. -S/p recent PCI for OM1 and in-stent restenosis of mid RCA. -Continue at home Plavix 75 mg BID and ASA 81 mg.    Essential HTN -Continue home Toprol 25 mg.    HLD - Prescribed atorvastatin but nooncomplaint     GERD -Continue at home Protonix 40 mg daily.    RA -Per history. -Doesn't currently take anything.    Tobacco use disorder -Current smoker, 1 ppd with year smoking history. -Encourage cessation.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Ejection fraction, Glycosylated haemoglobin increased, Hypoaesthesia, Intensive care, Lung opacity
Clinical narrative: Patient is a 64 y.o. male with PMH of COPD on 3-4L home O2, HFpEF, DM2, lung adenocarcinoma s/p chemoradiation 2018, rheumatoid arthritis who presented on 1/28/2023 with worsening LE edema, pain, numbness with worsening SOB.  COVID positive. Patient started on BiPAP and was admitted to ICU, transferred out on 1/30/2023     Acute on chronic hypoxic hypercapnic respiratory failure -On 3-4L O2 at home with h/o COPD and CHF.  -Acute exacerbation in setting of COVID, CAP, Hx of lung adenocarcinoma.  -CTA negative for PE and doppler US negative for DVT. -Required BiPAP on admission and weaned to O2 of 3-4L which is his baseline   COVID-19 infection  - Presented with: worsening SOB  - Symptom onset: unclear  - Positive COVID-19: 1/29 - Vaccination status: Vaccinated with Moderna with last dose 3/4//2021 - CT Chest on admission showed Right middle lobe pneumonia with bronchiolitis and pneumonitis in the right upper lobe and right lower lobe - Decadron: Yes. Expected end date 2/8   Pneumonia  - CXR shows Right lower lung haziness may suggest atelectasis or developing infiltrate - CTA chest RLL PNA with bronchiolitis and pneumonitis in the RUL and RLL - Possible viral PNA with COVID infection -Patient will need repeat CT chest 2 to 3 months after hospitalization for lymphadenopathy and right middle lobe opacification   COPD  -in the setting of continued smoking with a 105 pack year smoking  -Possible mild exacerbation in setting of COVD and PNA on admission -Home regimen including  albuterol Proventil nebulizer, albuterol ventolin,  Symbicort, Spiriva Respimat.  -We will complete Decadron for COVID after discharge  Hx of lung adenocarcinoma -s/p chemoradiation 2018. -Not currently receiving treatment.    Suspected metabolic alkalosis with compensatory respiratory acidosis, resolved -Per patient, had been discharged on lasix 60 mg BID and was supposed to transition back to his home 40 mg BID but did not. -Lasix initially held, now resumed   HFpEF -Per history. Follows with Dr.   -TTE 12/31/22 showed LVEF 63%, abnormal diastolic dysfunction indicative of elevated L atrial pressure. - BNP 1891 on admission, was 785 on 12/30  Lower extremity Dopplers negative for DVT -Lasix resumed at 40 mg twice daily   BLE edema -Acute on chronic problem related to CHF and venous stasis -Doppler US BI LE negative for DVT. ABI R 1.02, L 0.72, unchanged from 12/2022. -Keep leg elevated. Compression stocking if tolerated -Lasix resumed     DM2 -Hgb A1c 7.8  -A1c was 7% 1 year ago; will have patient carb restrict his diet and follow-up with PCP   CAD -Per history. Follows with Dr. -S/p recent PCI for OM1 and in-stent restenosis of mid RCA. -Continue at home Plavix 75 mg BID and ASA 81 mg.    Essential HTN -Continue home Toprol 25 mg.    HLD - Prescribed atorvastatin but nooncomplaint     GERD -Continue at home Protonix 40 mg daily.    RA -Per history. -Doesn't currently take anything.    Tobacco use disorder -Current smoker, 1 ppd with year smoking history. -Encourage cessation.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphadenopathy, Malaise, Metabolic alkalosis, Oedema peripheral, Pain in extremity
Clinical narrative: Patient is a 64 y.o. male with PMH of COPD on 3-4L home O2, HFpEF, DM2, lung adenocarcinoma s/p chemoradiation 2018, rheumatoid arthritis who presented on 1/28/2023 with worsening LE edema, pain, numbness with worsening SOB.  COVID positive. Patient started on BiPAP and was admitted to ICU, transferred out on 1/30/2023     Acute on chronic hypoxic hypercapnic respiratory failure -On 3-4L O2 at home with h/o COPD and CHF.  -Acute exacerbation in setting of COVID, CAP, Hx of lung adenocarcinoma.  -CTA negative for PE and doppler US negative for DVT. -Required BiPAP on admission and weaned to O2 of 3-4L which is his baseline   COVID-19 infection  - Presented with: worsening SOB  - Symptom onset: unclear  - Positive COVID-19: 1/29 - Vaccination status: Vaccinated with Moderna with last dose 3/4//2021 - CT Chest on admission showed Right middle lobe pneumonia with bronchiolitis and pneumonitis in the right upper lobe and right lower lobe - Decadron: Yes. Expected end date 2/8   Pneumonia  - CXR shows Right lower lung haziness may suggest atelectasis or developing infiltrate - CTA chest RLL PNA with bronchiolitis and pneumonitis in the RUL and RLL - Possible viral PNA with COVID infection -Patient will need repeat CT chest 2 to 3 months after hospitalization for lymphadenopathy and right middle lobe opacification   COPD  -in the setting of continued smoking with a 105 pack year smoking  -Possible mild exacerbation in setting of COVD and PNA on admission -Home regimen including  albuterol Proventil nebulizer, albuterol ventolin,  Symbicort, Spiriva Respimat.  -We will complete Decadron for COVID after discharge  Hx of lung adenocarcinoma -s/p chemoradiation 2018. -Not currently receiving treatment.    Suspected metabolic alkalosis with compensatory respiratory acidosis, resolved -Per patient, had been discharged on lasix 60 mg BID and was supposed to transition back to his home 40 mg BID but did not. -Lasix initially held, now resumed   HFpEF -Per history. Follows with Dr.   -TTE 12/31/22 showed LVEF 63%, abnormal diastolic dysfunction indicative of elevated L atrial pressure. - BNP 1891 on admission, was 785 on 12/30  Lower extremity Dopplers negative for DVT -Lasix resumed at 40 mg twice daily   BLE edema -Acute on chronic problem related to CHF and venous stasis -Doppler US BI LE negative for DVT. ABI R 1.02, L 0.72, unchanged from 12/2022. -Keep leg elevated. Compression stocking if tolerated -Lasix resumed     DM2 -Hgb A1c 7.8  -A1c was 7% 1 year ago; will have patient carb restrict his diet and follow-up with PCP   CAD -Per history. Follows with Dr. -S/p recent PCI for OM1 and in-stent restenosis of mid RCA. -Continue at home Plavix 75 mg BID and ASA 81 mg.    Essential HTN -Continue home Toprol 25 mg.    HLD - Prescribed atorvastatin but nooncomplaint     GERD -Continue at home Protonix 40 mg daily.    RA -Per history. -Doesn't currently take anything.    Tobacco use disorder -Current smoker, 1 ppd with year smoking history. -Encourage cessation.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Peripheral venous disease, Pneumonia, Pneumonitis, Positive airway pressure therapy, Respiratory acidosis
Clinical narrative: Patient is a 64 y.o. male with PMH of COPD on 3-4L home O2, HFpEF, DM2, lung adenocarcinoma s/p chemoradiation 2018, rheumatoid arthritis who presented on 1/28/2023 with worsening LE edema, pain, numbness with worsening SOB.  COVID positive. Patient started on BiPAP and was admitted to ICU, transferred out on 1/30/2023     Acute on chronic hypoxic hypercapnic respiratory failure -On 3-4L O2 at home with h/o COPD and CHF.  -Acute exacerbation in setting of COVID, CAP, Hx of lung adenocarcinoma.  -CTA negative for PE and doppler US negative for DVT. -Required BiPAP on admission and weaned to O2 of 3-4L which is his baseline   COVID-19 infection  - Presented with: worsening SOB  - Symptom onset: unclear  - Positive COVID-19: 1/29 - Vaccination status: Vaccinated with Moderna with last dose 3/4//2021 - CT Chest on admission showed Right middle lobe pneumonia with bronchiolitis and pneumonitis in the right upper lobe and right lower lobe - Decadron: Yes. Expected end date 2/8   Pneumonia  - CXR shows Right lower lung haziness may suggest atelectasis or developing infiltrate - CTA chest RLL PNA with bronchiolitis and pneumonitis in the RUL and RLL - Possible viral PNA with COVID infection -Patient will need repeat CT chest 2 to 3 months after hospitalization for lymphadenopathy and right middle lobe opacification   COPD  -in the setting of continued smoking with a 105 pack year smoking  -Possible mild exacerbation in setting of COVD and PNA on admission -Home regimen including  albuterol Proventil nebulizer, albuterol ventolin,  Symbicort, Spiriva Respimat.  -We will complete Decadron for COVID after discharge  Hx of lung adenocarcinoma -s/p chemoradiation 2018. -Not currently receiving treatment.    Suspected metabolic alkalosis with compensatory respiratory acidosis, resolved -Per patient, had been discharged on lasix 60 mg BID and was supposed to transition back to his home 40 mg BID but did not. -Lasix initially held, now resumed   HFpEF -Per history. Follows with Dr.   -TTE 12/31/22 showed LVEF 63%, abnormal diastolic dysfunction indicative of elevated L atrial pressure. - BNP 1891 on admission, was 785 on 12/30  Lower extremity Dopplers negative for DVT -Lasix resumed at 40 mg twice daily   BLE edema -Acute on chronic problem related to CHF and venous stasis -Doppler US BI LE negative for DVT. ABI R 1.02, L 0.72, unchanged from 12/2022. -Keep leg elevated. Compression stocking if tolerated -Lasix resumed     DM2 -Hgb A1c 7.8  -A1c was 7% 1 year ago; will have patient carb restrict his diet and follow-up with PCP   CAD -Per history. Follows with Dr. -S/p recent PCI for OM1 and in-stent restenosis of mid RCA. -Continue at home Plavix 75 mg BID and ASA 81 mg.    Essential HTN -Continue home Toprol 25 mg.    HLD - Prescribed atorvastatin but nooncomplaint     GERD -Continue at home Protonix 40 mg daily.    RA -Per history. -Doesn't currently take anything.    Tobacco use disorder -Current smoker, 1 ppd with year smoking history. -Encourage cessation.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Ultrasound Doppler normal
Clinical narrative: Patient is a 64 y.o. male with PMH of COPD on 3-4L home O2, HFpEF, DM2, lung adenocarcinoma s/p chemoradiation 2018, rheumatoid arthritis who presented on 1/28/2023 with worsening LE edema, pain, numbness with worsening SOB.  COVID positive. Patient started on BiPAP and was admitted to ICU, transferred out on 1/30/2023     Acute on chronic hypoxic hypercapnic respiratory failure -On 3-4L O2 at home with h/o COPD and CHF.  -Acute exacerbation in setting of COVID, CAP, Hx of lung adenocarcinoma.  -CTA negative for PE and doppler US negative for DVT. -Required BiPAP on admission and weaned to O2 of 3-4L which is his baseline   COVID-19 infection  - Presented with: worsening SOB  - Symptom onset: unclear  - Positive COVID-19: 1/29 - Vaccination status: Vaccinated with Moderna with last dose 3/4//2021 - CT Chest on admission showed Right middle lobe pneumonia with bronchiolitis and pneumonitis in the right upper lobe and right lower lobe - Decadron: Yes. Expected end date 2/8   Pneumonia  - CXR shows Right lower lung haziness may suggest atelectasis or developing infiltrate - CTA chest RLL PNA with bronchiolitis and pneumonitis in the RUL and RLL - Possible viral PNA with COVID infection -Patient will need repeat CT chest 2 to 3 months after hospitalization for lymphadenopathy and right middle lobe opacification   COPD  -in the setting of continued smoking with a 105 pack year smoking  -Possible mild exacerbation in setting of COVD and PNA on admission -Home regimen including  albuterol Proventil nebulizer, albuterol ventolin,  Symbicort, Spiriva Respimat.  -We will complete Decadron for COVID after discharge  Hx of lung adenocarcinoma -s/p chemoradiation 2018. -Not currently receiving treatment.    Suspected metabolic alkalosis with compensatory respiratory acidosis, resolved -Per patient, had been discharged on lasix 60 mg BID and was supposed to transition back to his home 40 mg BID but did not. -Lasix initially held, now resumed   HFpEF -Per history. Follows with Dr.   -TTE 12/31/22 showed LVEF 63%, abnormal diastolic dysfunction indicative of elevated L atrial pressure. - BNP 1891 on admission, was 785 on 12/30  Lower extremity Dopplers negative for DVT -Lasix resumed at 40 mg twice daily   BLE edema -Acute on chronic problem related to CHF and venous stasis -Doppler US BI LE negative for DVT. ABI R 1.02, L 0.72, unchanged from 12/2022. -Keep leg elevated. Compression stocking if tolerated -Lasix resumed     DM2 -Hgb A1c 7.8  -A1c was 7% 1 year ago; will have patient carb restrict his diet and follow-up with PCP   CAD -Per history. Follows with Dr. -S/p recent PCI for OM1 and in-stent restenosis of mid RCA. -Continue at home Plavix 75 mg BID and ASA 81 mg.    Essential HTN -Continue home Toprol 25 mg.    HLD - Prescribed atorvastatin but nooncomplaint     GERD -Continue at home Protonix 40 mg daily.    RA -Per history. -Doesn't currently take anything.    Tobacco use disorder -Current smoker, 1 ppd with year smoking history. -Encourage cessation.
Age: 51.0
Sex: M
Vaccine: ANTH, TYP
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash, Injection site swelling
Clinical narrative: R UPPER ARM THREE RED RAISED QUARTER SIZE RASH THAT IS ITCHING.  STARTED 10 MINUTES AFTER VACCINE INJECTION.    INSTRUCTED CLIENT TO PLACE COLD COMPRESS ON AFFECTED AREA AND TAKE BENADRLY AS PACKAGED DIRECTED.    IF SYMPTOMS GETTING WORSE, NO IMPROVEMENT, OR SHORTNESS OF BREATH, SWELLING TO SEEK EMERGENCY OR CALL EMS.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site pain, Pain
Clinical narrative: Patient now reports (4.5 months after vaccination) pain in left shoulder, in addition to pain when lifting his left arm. Advised patient seek medical evaluation,.
Age: 11.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Axillary pain, Injected limb mobility decreased, Limb discomfort, Oedema peripheral, Pain in extremity
Clinical narrative: Left axillar/underarm swelling, pain and immobility due to discomfort of the left arm
Age: 11.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Peripheral swelling
Clinical narrative: Left axillar/underarm swelling, pain and immobility due to discomfort of the left arm
Age: 53.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site rash
Clinical narrative: rash around injection site
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Computerised tomogram normal, Influenza like illness, Magnetic resonance imaging normal, Migraine
Clinical narrative: Sick with flu-like symptoms for 5 days following the injection. Within 12 weeks I developed debilitating migraines and was placed on short term disability on 5/17/2022. Diagnosed with Occipital Neuralgia and Chronic Mixed Migraine Disorder. Daily migraines continue.
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Occipital neuralgia, Venogram normal
Clinical narrative: Sick with flu-like symptoms for 5 days following the injection. Within 12 weeks I developed debilitating migraines and was placed on short term disability on 5/17/2022. Diagnosed with Occipital Neuralgia and Chronic Mixed Migraine Disorder. Daily migraines continue.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Back pain, COVID-19, Impaired work ability, Injection site pain
Clinical narrative: Severe joint pain, muscle pain and nerve pain in low back, hips and legs began on day 2 of the second injection, along with full blown covid symptoms and pain at the injection site. Pain faded over the next few weeks until I caught covid the following January. The muscle, joint and nerve pain returned with a vengeance, causing so much pain over the last year that I cannot work and I'm applying  for disability. This has completely rerouted my life
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Myalgia, Neuralgia, Pain in extremity, X-ray
Clinical narrative: Severe joint pain, muscle pain and nerve pain in low back, hips and legs began on day 2 of the second injection, along with full blown covid symptoms and pain at the injection site. Pain faded over the next few weeks until I caught covid the following January. The muscle, joint and nerve pain returned with a vengeance, causing so much pain over the last year that I cannot work and I'm applying  for disability. This has completely rerouted my life
Age: 65.0
Sex: M
Vaccine: COVID19-2
Symptoms: Atrial fibrillation
Clinical narrative: AFib events lasting about 36 hours occurring at 5 day intervals
Age: 24.0
Sex: F
Vaccine: TDAP
Symptoms: Adverse reaction, Blood pressure decreased, Dyskinesia, Heart rate decreased, Hypotension
Clinical narrative: Patient received Boostrix vaccine at pharmacy today at approximately 1110am. Pharmacist intern administering the vaccine alarmed me to the patient having an adverse reaction or an episode where her eyes went open and dilated, but was unresponsive and went limp in the chair, First thought patient had a fainting spell until patient did "rocking convulsions" and while "moaning", then abruptly stopped, where it seemed she had blocked her breathing with tongue. Intern was attempting to lift her from chair into lying position when patient grabbed counter and came to. Event lasted approx. 1min following 1 to 2 minutes after vaccination. Patient came to slowly, and was able to respond again. Hands were cold and we monitored her BP periodically until 12p, which showed low blood pressure (baseline not known) and lower than usual pulse. Patient was monitored periodically by checking her BP and pulse. She was given water and a food bar to make sure she was recovering. Patient was asked to stay so we could make sure she was going to be safe before leaving. She stated her boyfriend would be coming to pick her up, and we suggested her go to medical provider at an emergency room or urgent care to be evaluated properly.  Patient seemed fully alert and oriented and was not having any difficulty speaking, vision problems or issues with her extremities, however we did not attempt to have the patient stand up since the BP readings were on the lower side. We continued monitoring her BP and noticed her BP was returning to normal but her pulse was lower than usual. Boyfriend talked to his mom and they asked us to call EMS. Paramedics arrived and took patient to ER.
Age: 24.0
Sex: F
Vaccine: TDAP
Symptoms: Hypotonia, Moaning, Mydriasis, Obstructive airways disorder, Peripheral coldness
Clinical narrative: Patient received Boostrix vaccine at pharmacy today at approximately 1110am. Pharmacist intern administering the vaccine alarmed me to the patient having an adverse reaction or an episode where her eyes went open and dilated, but was unresponsive and went limp in the chair, First thought patient had a fainting spell until patient did "rocking convulsions" and while "moaning", then abruptly stopped, where it seemed she had blocked her breathing with tongue. Intern was attempting to lift her from chair into lying position when patient grabbed counter and came to. Event lasted approx. 1min following 1 to 2 minutes after vaccination. Patient came to slowly, and was able to respond again. Hands were cold and we monitored her BP periodically until 12p, which showed low blood pressure (baseline not known) and lower than usual pulse. Patient was monitored periodically by checking her BP and pulse. She was given water and a food bar to make sure she was recovering. Patient was asked to stay so we could make sure she was going to be safe before leaving. She stated her boyfriend would be coming to pick her up, and we suggested her go to medical provider at an emergency room or urgent care to be evaluated properly.  Patient seemed fully alert and oriented and was not having any difficulty speaking, vision problems or issues with her extremities, however we did not attempt to have the patient stand up since the BP readings were on the lower side. We continued monitoring her BP and noticed her BP was returning to normal but her pulse was lower than usual. Boyfriend talked to his mom and they asked us to call EMS. Paramedics arrived and took patient to ER.
Age: 24.0
Sex: F
Vaccine: TDAP
Symptoms: Seizure, Unresponsive to stimuli
Clinical narrative: Patient received Boostrix vaccine at pharmacy today at approximately 1110am. Pharmacist intern administering the vaccine alarmed me to the patient having an adverse reaction or an episode where her eyes went open and dilated, but was unresponsive and went limp in the chair, First thought patient had a fainting spell until patient did "rocking convulsions" and while "moaning", then abruptly stopped, where it seemed she had blocked her breathing with tongue. Intern was attempting to lift her from chair into lying position when patient grabbed counter and came to. Event lasted approx. 1min following 1 to 2 minutes after vaccination. Patient came to slowly, and was able to respond again. Hands were cold and we monitored her BP periodically until 12p, which showed low blood pressure (baseline not known) and lower than usual pulse. Patient was monitored periodically by checking her BP and pulse. She was given water and a food bar to make sure she was recovering. Patient was asked to stay so we could make sure she was going to be safe before leaving. She stated her boyfriend would be coming to pick her up, and we suggested her go to medical provider at an emergency room or urgent care to be evaluated properly.  Patient seemed fully alert and oriented and was not having any difficulty speaking, vision problems or issues with her extremities, however we did not attempt to have the patient stand up since the BP readings were on the lower side. We continued monitoring her BP and noticed her BP was returning to normal but her pulse was lower than usual. Boyfriend talked to his mom and they asked us to call EMS. Paramedics arrived and took patient to ER.
Age: 79.0
Sex: M
Vaccine: FLU4, PNC20, VARZOS
Symptoms: Cerebrovascular accident
Clinical narrative: PATIENT RECEIVED 3 VACCINES ON SAME DAY 11/22/22, HE WENT TO VISIT FAMILY FOR CHRISTMAS AND ENDED UP IN HOSPITAL FOR STROKE ON CHRISTMAS EVE. HE FELT GOOD GETTING THE VACCINES TOGETHER. THE MD'S WERE CONCERNED HE GOT THEM SIMULTANEOUSLY.
Age: 62.0
Sex: M
Vaccine: VARZOS
Symptoms: Arthralgia, Diarrhoea, Flatulence, Headache, Injection site erythema
Clinical narrative: Pain, redness, and swelling at injection site.  Body aches, Headache, Continuous Gas and explosive diarrhea on late Wednesday, all day thursday and Friday.  Saturday headache, and  extreem neck and shoulder pain.  I have been taking pepto bismal, eating bland diet, and taking ibuprofen.  Neck and shoulder pain is the worst today.
Age: 62.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site pain, Injection site swelling, Neck pain, Pain
Clinical narrative: Pain, redness, and swelling at injection site.  Body aches, Headache, Continuous Gas and explosive diarrhea on late Wednesday, all day thursday and Friday.  Saturday headache, and  extreem neck and shoulder pain.  I have been taking pepto bismal, eating bland diet, and taking ibuprofen.  Neck and shoulder pain is the worst today.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Hypoaesthesia, Injection site hypoaesthesia, Joint swelling
Clinical narrative: Left arm goes numb from the injection site down. Both knees are swollen and painful
Age: 55.0
Sex: M
Vaccine: COVID19-2
Symptoms: Abdominal pain, Blood phosphorus increased, Computerised tomogram, Dyspnoea, Electrocardiogram
Clinical narrative: On 1/21 developed severe abdominal pain and intractable vomiting- went to a local Hospital and admitted with pancreatitis and leukocytosis . Developed into idiopathic acute necrotizing pancreatitis and developed bilateral pleural effusions and an ileus, required tertiary care center and was transferred to a local clinic on 1/26  for tachycardia with pulse reaching 170, respiratory distress requiring O2 at 6Liters. Was discharged 1/30/23 and on 2/5/2023 developed shortness of breath and severe abdominal pain and went to local ER and was found to have a large fluid collection around the pancreas requiring tertiary care center and he was transferred to another health care facility.  He required a NJ for nutrition. Had increased pain while there. Now has a second fluid collection. Has been in pain continuously. He also is now having left shoulder pain and is unable to lift/ move his arm. He is currently still inpatient
Age: 55.0
Sex: M
Vaccine: COVID19-2
Symptoms: Heart rate increased, Hypokalaemia, Ileus, Injected limb mobility decreased, Injection site pain
Clinical narrative: On 1/21 developed severe abdominal pain and intractable vomiting- went to a local Hospital and admitted with pancreatitis and leukocytosis . Developed into idiopathic acute necrotizing pancreatitis and developed bilateral pleural effusions and an ileus, required tertiary care center and was transferred to a local clinic on 1/26  for tachycardia with pulse reaching 170, respiratory distress requiring O2 at 6Liters. Was discharged 1/30/23 and on 2/5/2023 developed shortness of breath and severe abdominal pain and went to local ER and was found to have a large fluid collection around the pancreas requiring tertiary care center and he was transferred to another health care facility.  He required a NJ for nutrition. Had increased pain while there. Now has a second fluid collection. Has been in pain continuously. He also is now having left shoulder pain and is unable to lift/ move his arm. He is currently still inpatient