chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Fatigue, Hypophagia, Mobility decreased, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD, MPH Primary Care Provider:  MD Admission Date: 7/3/2022 Discharge Date: Jul 5, 2022  PRESENTING PROBLEM: ARF (acute renal failure)  Diarrhea, unspecified type COVID    HOSPITAL COURSE: Patient is a 81 y.o. female who presents today with fatigue and diarrhea. pmh copd,htn,pad presenting with co extreme fatigue and generalized weakness. States onset loose stools one week ago . Since that time has been having 2-3 loose not watery stools per day . Initially taking stool softer now stopped . Tested positive for covid 4 days ago and now today completed course of Paxlovid today . No co abdominal  Pain , no blood in stool or black stools . Denies fever or chills . She has continued to take medications including cozaar. Co progressive generalized weakness and fatigue. Able to stand and walk short distances . Denies focal weakness , no paraesthesias. Note mild non productive cough . Feels oral intake has declined due to decreased mobility though appetite at baseline . No loss of taste or smell. Feels breathing and her copd are at baseline . Denies dysuria.    In ed vitals stable , afebrile , bp was elevated to 240/77 . Given iv hydralazine and ativan with improvement. Per patient she is highly anxious in hospital and not uncommon for her. Labs showing sodium 125.k 3.0,creat 1.65 , nml wbc of 7.47. ua with no infectious findings, tested pos for covid 19. Given x2 liter fluid bolus,zofran , 40 meq kcl  Patient symptoms of weakness, shortness of breath are improved by day 2 of admission.  Does feel good to ambulate on her own, agreeable to the plan per home with outpatient follow-up.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Urine analysis normal, White blood cell count normal
Clinical narrative: Discharge Provider: MD, MPH Primary Care Provider:  MD Admission Date: 7/3/2022 Discharge Date: Jul 5, 2022  PRESENTING PROBLEM: ARF (acute renal failure)  Diarrhea, unspecified type COVID    HOSPITAL COURSE: Patient is a 81 y.o. female who presents today with fatigue and diarrhea. pmh copd,htn,pad presenting with co extreme fatigue and generalized weakness. States onset loose stools one week ago . Since that time has been having 2-3 loose not watery stools per day . Initially taking stool softer now stopped . Tested positive for covid 4 days ago and now today completed course of Paxlovid today . No co abdominal  Pain , no blood in stool or black stools . Denies fever or chills . She has continued to take medications including cozaar. Co progressive generalized weakness and fatigue. Able to stand and walk short distances . Denies focal weakness , no paraesthesias. Note mild non productive cough . Feels oral intake has declined due to decreased mobility though appetite at baseline . No loss of taste or smell. Feels breathing and her copd are at baseline . Denies dysuria.    In ed vitals stable , afebrile , bp was elevated to 240/77 . Given iv hydralazine and ativan with improvement. Per patient she is highly anxious in hospital and not uncommon for her. Labs showing sodium 125.k 3.0,creat 1.65 , nml wbc of 7.47. ua with no infectious findings, tested pos for covid 19. Given x2 liter fluid bolus,zofran , 40 meq kcl  Patient symptoms of weakness, shortness of breath are improved by day 2 of admission.  Does feel good to ambulate on her own, agreeable to the plan per home with outpatient follow-up.
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dote administered beyond-use date
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Acoustic stimulation tests abnormal, Asthenia, Body temperature increased, Bronchitis, Chest pain
Clinical narrative: This was a booster to my J&J COVID-19 vaccine that was received 4/9/2021 at the same pharmacy. On 1/6/22 I began with difficulty breathing and coughing followed by a temp of 102+ that lasted two days. Symp worsened and by 1/10, I called urgent care. At appoint on 1/11/22, COVID-19 test (rapid via nostril) was negative and no meds given.  Throughout the next week the symptoms worsened (body aches, diaphragm was bruised making it difficult to breathe/move, headache, coughing, low energy, increased hearing loss and intermittent fever). Without improvement, on 1/17 called for additional testing and follow-up appointment. Additional information for Item 18:  (CONT)  At the Urgent Care I got a negative rapid test, however, this time, the Urgent Care Dr. diagnosed me with severe bronchitis and prescribed antibiotic and decongestant.  On that same day, at a different location, I took a 48 hour COVID-19 test.  That test also came back negative for COVID-19.  Even with the new medication, I continued to be limited on my ability to move due to the soreness of the diaphragm and chest.  I was out of work from 1/7 through aprox 2/10/2022. Though my health improved slowly with diaphragm pain ceasing aprox Feb 12, coughing continued until May 2022.  Although my hearing had initially been deteriorating starting in aprox Oct 2021, after this booster, the hearing loss was significant, so my Primary Care Physician referred me to an audiologist. On Feb 09, 2022 I received a hearing test from Audiologist, which revealed substantial hearing loss in Left ear while Right ear was 100% healthy.  PCP also ordered a head/brain MRI with contrast that was conducted 2/28/22 and revealed no abnormalities.   July 2022: Breathing has returned, though not to my pre vaccine levels.  I experience shortness of breath from routine exercise - a reduction from pre-vaccination.  Hearing continues to be reduced, but perhaps not as bad as in the first half of 2022.  Headaches continue more frequently than prior to COVID vaccines.   I participated in the V-Safe Program for each of my COVID vaccines, however due to the dates of status check, this info wasn't reported until  July 2022.  * All of this is provided as information.  I am not medically qualified to associate these issues with the vaccine, however my health has been impacted by the vaccines in the ways described above.   **I had a severe reaction to the J&J vaccine in Apr 2021. IF an adverse report should be completed to describe the reaction, please notify me.  Thank you. <<<end of message>>>
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Contusion, Cough, Deafness, Diaphragmalgia, Dyspnoea
Clinical narrative: This was a booster to my J&J COVID-19 vaccine that was received 4/9/2021 at the same pharmacy. On 1/6/22 I began with difficulty breathing and coughing followed by a temp of 102+ that lasted two days. Symp worsened and by 1/10, I called urgent care. At appoint on 1/11/22, COVID-19 test (rapid via nostril) was negative and no meds given.  Throughout the next week the symptoms worsened (body aches, diaphragm was bruised making it difficult to breathe/move, headache, coughing, low energy, increased hearing loss and intermittent fever). Without improvement, on 1/17 called for additional testing and follow-up appointment. Additional information for Item 18:  (CONT)  At the Urgent Care I got a negative rapid test, however, this time, the Urgent Care Dr. diagnosed me with severe bronchitis and prescribed antibiotic and decongestant.  On that same day, at a different location, I took a 48 hour COVID-19 test.  That test also came back negative for COVID-19.  Even with the new medication, I continued to be limited on my ability to move due to the soreness of the diaphragm and chest.  I was out of work from 1/7 through aprox 2/10/2022. Though my health improved slowly with diaphragm pain ceasing aprox Feb 12, coughing continued until May 2022.  Although my hearing had initially been deteriorating starting in aprox Oct 2021, after this booster, the hearing loss was significant, so my Primary Care Physician referred me to an audiologist. On Feb 09, 2022 I received a hearing test from Audiologist, which revealed substantial hearing loss in Left ear while Right ear was 100% healthy.  PCP also ordered a head/brain MRI with contrast that was conducted 2/28/22 and revealed no abnormalities.   July 2022: Breathing has returned, though not to my pre vaccine levels.  I experience shortness of breath from routine exercise - a reduction from pre-vaccination.  Hearing continues to be reduced, but perhaps not as bad as in the first half of 2022.  Headaches continue more frequently than prior to COVID vaccines.   I participated in the V-Safe Program for each of my COVID vaccines, however due to the dates of status check, this info wasn't reported until  July 2022.  * All of this is provided as information.  I am not medically qualified to associate these issues with the vaccine, however my health has been impacted by the vaccines in the ways described above.   **I had a severe reaction to the J&J vaccine in Apr 2021. IF an adverse report should be completed to describe the reaction, please notify me.  Thank you. <<<end of message>>>
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea exertional, Headache, Impaired work ability, Magnetic resonance imaging head normal, Mobility decreased
Clinical narrative: This was a booster to my J&J COVID-19 vaccine that was received 4/9/2021 at the same pharmacy. On 1/6/22 I began with difficulty breathing and coughing followed by a temp of 102+ that lasted two days. Symp worsened and by 1/10, I called urgent care. At appoint on 1/11/22, COVID-19 test (rapid via nostril) was negative and no meds given.  Throughout the next week the symptoms worsened (body aches, diaphragm was bruised making it difficult to breathe/move, headache, coughing, low energy, increased hearing loss and intermittent fever). Without improvement, on 1/17 called for additional testing and follow-up appointment. Additional information for Item 18:  (CONT)  At the Urgent Care I got a negative rapid test, however, this time, the Urgent Care Dr. diagnosed me with severe bronchitis and prescribed antibiotic and decongestant.  On that same day, at a different location, I took a 48 hour COVID-19 test.  That test also came back negative for COVID-19.  Even with the new medication, I continued to be limited on my ability to move due to the soreness of the diaphragm and chest.  I was out of work from 1/7 through aprox 2/10/2022. Though my health improved slowly with diaphragm pain ceasing aprox Feb 12, coughing continued until May 2022.  Although my hearing had initially been deteriorating starting in aprox Oct 2021, after this booster, the hearing loss was significant, so my Primary Care Physician referred me to an audiologist. On Feb 09, 2022 I received a hearing test from Audiologist, which revealed substantial hearing loss in Left ear while Right ear was 100% healthy.  PCP also ordered a head/brain MRI with contrast that was conducted 2/28/22 and revealed no abnormalities.   July 2022: Breathing has returned, though not to my pre vaccine levels.  I experience shortness of breath from routine exercise - a reduction from pre-vaccination.  Hearing continues to be reduced, but perhaps not as bad as in the first half of 2022.  Headaches continue more frequently than prior to COVID vaccines.   I participated in the V-Safe Program for each of my COVID vaccines, however due to the dates of status check, this info wasn't reported until  July 2022.  * All of this is provided as information.  I am not medically qualified to associate these issues with the vaccine, however my health has been impacted by the vaccines in the ways described above.   **I had a severe reaction to the J&J vaccine in Apr 2021. IF an adverse report should be completed to describe the reaction, please notify me.  Thank you. <<<end of message>>>
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: This was a booster to my J&J COVID-19 vaccine that was received 4/9/2021 at the same pharmacy. On 1/6/22 I began with difficulty breathing and coughing followed by a temp of 102+ that lasted two days. Symp worsened and by 1/10, I called urgent care. At appoint on 1/11/22, COVID-19 test (rapid via nostril) was negative and no meds given.  Throughout the next week the symptoms worsened (body aches, diaphragm was bruised making it difficult to breathe/move, headache, coughing, low energy, increased hearing loss and intermittent fever). Without improvement, on 1/17 called for additional testing and follow-up appointment. Additional information for Item 18:  (CONT)  At the Urgent Care I got a negative rapid test, however, this time, the Urgent Care Dr. diagnosed me with severe bronchitis and prescribed antibiotic and decongestant.  On that same day, at a different location, I took a 48 hour COVID-19 test.  That test also came back negative for COVID-19.  Even with the new medication, I continued to be limited on my ability to move due to the soreness of the diaphragm and chest.  I was out of work from 1/7 through aprox 2/10/2022. Though my health improved slowly with diaphragm pain ceasing aprox Feb 12, coughing continued until May 2022.  Although my hearing had initially been deteriorating starting in aprox Oct 2021, after this booster, the hearing loss was significant, so my Primary Care Physician referred me to an audiologist. On Feb 09, 2022 I received a hearing test from Audiologist, which revealed substantial hearing loss in Left ear while Right ear was 100% healthy.  PCP also ordered a head/brain MRI with contrast that was conducted 2/28/22 and revealed no abnormalities.   July 2022: Breathing has returned, though not to my pre vaccine levels.  I experience shortness of breath from routine exercise - a reduction from pre-vaccination.  Hearing continues to be reduced, but perhaps not as bad as in the first half of 2022.  Headaches continue more frequently than prior to COVID vaccines.   I participated in the V-Safe Program for each of my COVID vaccines, however due to the dates of status check, this info wasn't reported until  July 2022.  * All of this is provided as information.  I am not medically qualified to associate these issues with the vaccine, however my health has been impacted by the vaccines in the ways described above.   **I had a severe reaction to the J&J vaccine in Apr 2021. IF an adverse report should be completed to describe the reaction, please notify me.  Thank you. <<<end of message>>>
Age: 67.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Amnesia, Cough, Dyspnoea, Fatigue, Feeling abnormal
Clinical narrative: High fever developed within 24 hours of initial vaccine. Body aches, cough, shortness of breath, brain fog, short term memory loss, chronic and severe fatigue.
Age: 67.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: High fever developed within 24 hours of initial vaccine. Body aches, cough, shortness of breath, brain fog, short term memory loss, chronic and severe fatigue.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Exposure to SARS-CoV-2, Respiratory tract congestion, SARS-CoV-2 test positive, Sinus operation
Clinical narrative: Starting 07/01/2022, I had sinus drainage and family members informed me they were positive. So, I tested myself for COVID-19 and it was positive. Shortly after testing positive, I started sneezing and having symptoms resembling a bad cold: Congestion, sneezing and sinus drainage. I called my doctor the same day and I was prescribed Paxlovid. I took it as prescribed for 5 days. My oxygen levels were fine and I was not running a fever. On 07/02/2022, my symptoms were much less but I still was sneezing and had congestion. With each day, I got gradually better. On 07/10/2022, I tested myself again and I was negative. I stayed home but I felt mostly fine during this entire event and it was a very mild case.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Sneezing
Clinical narrative: Starting 07/01/2022, I had sinus drainage and family members informed me they were positive. So, I tested myself for COVID-19 and it was positive. Shortly after testing positive, I started sneezing and having symptoms resembling a bad cold: Congestion, sneezing and sinus drainage. I called my doctor the same day and I was prescribed Paxlovid. I took it as prescribed for 5 days. My oxygen levels were fine and I was not running a fever. On 07/02/2022, my symptoms were much less but I still was sneezing and had congestion. With each day, I got gradually better. On 07/10/2022, I tested myself again and I was negative. I stayed home but I felt mostly fine during this entire event and it was a very mild case.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Vaccine invalid due to a possible temperature issue CDC recommendation to repeat vaccine
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dose administered beyond use date
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: received expired vaccine
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dose administered beyond use date
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Bacterial infection, COVID-19 pneumonia, Chest X-ray abnormal, Coinfection
Clinical narrative: Patient presented to Medical Center on 01/31/2022 with severe fatigue, worsening of his nonproductive cough and SOB.  CXR showed multifocal PNA.  He was given a dose of vancomycin, cefepime, IV steroids and fluids, and supplemental oxygen.  Patient was admitted to hospital for treatment of acute hypoxic respiratory failure and sepsis secondary to Covid-19 PNA.  He was placed on dexamethasone, but remdesivir was not administered d/t kidney function.  Empiric treatment for bacterial coinfection with ceftriaxone an azithromycin was started.  Started on bicarbonate drip for metabolic acidosis.  On 02/04/2022 he began requiring high glow nasal cannula.  He was then transferred to CCU.   He required intubation and  intermittent HD.  On 02/23/2022 comfort care measures initiated and patient expired.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Death, Dyspnoea, Endotracheal intubation, Fatigue
Clinical narrative: Patient presented to Medical Center on 01/31/2022 with severe fatigue, worsening of his nonproductive cough and SOB.  CXR showed multifocal PNA.  He was given a dose of vancomycin, cefepime, IV steroids and fluids, and supplemental oxygen.  Patient was admitted to hospital for treatment of acute hypoxic respiratory failure and sepsis secondary to Covid-19 PNA.  He was placed on dexamethasone, but remdesivir was not administered d/t kidney function.  Empiric treatment for bacterial coinfection with ceftriaxone an azithromycin was started.  Started on bicarbonate drip for metabolic acidosis.  On 02/04/2022 he began requiring high glow nasal cannula.  He was then transferred to CCU.   He required intubation and  intermittent HD.  On 02/23/2022 comfort care measures initiated and patient expired.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Haemodialysis, Intensive care, Metabolic acidosis, Pneumonia, Renal impairment
Clinical narrative: Patient presented to Medical Center on 01/31/2022 with severe fatigue, worsening of his nonproductive cough and SOB.  CXR showed multifocal PNA.  He was given a dose of vancomycin, cefepime, IV steroids and fluids, and supplemental oxygen.  Patient was admitted to hospital for treatment of acute hypoxic respiratory failure and sepsis secondary to Covid-19 PNA.  He was placed on dexamethasone, but remdesivir was not administered d/t kidney function.  Empiric treatment for bacterial coinfection with ceftriaxone an azithromycin was started.  Started on bicarbonate drip for metabolic acidosis.  On 02/04/2022 he began requiring high glow nasal cannula.  He was then transferred to CCU.   He required intubation and  intermittent HD.  On 02/23/2022 comfort care measures initiated and patient expired.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Sepsis
Clinical narrative: Patient presented to Medical Center on 01/31/2022 with severe fatigue, worsening of his nonproductive cough and SOB.  CXR showed multifocal PNA.  He was given a dose of vancomycin, cefepime, IV steroids and fluids, and supplemental oxygen.  Patient was admitted to hospital for treatment of acute hypoxic respiratory failure and sepsis secondary to Covid-19 PNA.  He was placed on dexamethasone, but remdesivir was not administered d/t kidney function.  Empiric treatment for bacterial coinfection with ceftriaxone an azithromycin was started.  Started on bicarbonate drip for metabolic acidosis.  On 02/04/2022 he began requiring high glow nasal cannula.  He was then transferred to CCU.   He required intubation and  intermittent HD.  On 02/23/2022 comfort care measures initiated and patient expired.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dose administered beyond use date.
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dote administered beyond-use date
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, COVID-19, Dry throat, Fatigue, Malaise
Clinical narrative: When I caught COVID-19 I had mild symptoms. In the afternoon I felt tired more so than I normally would. I had a tiny bit of an upset stomach, but I had no vomiting. I just felt queasy. I had a runny nose and a dry throat. I called my doctor, and I was prescribed Paxlovid. I took the 5 day course, and I feel fine.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: When I caught COVID-19 I had mild symptoms. In the afternoon I felt tired more so than I normally would. I had a tiny bit of an upset stomach, but I had no vomiting. I just felt queasy. I had a runny nose and a dry throat. I called my doctor, and I was prescribed Paxlovid. I took the 5 day course, and I feel fine.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Behaviour disorder, Blood glucose increased, COVID-19, Cognitive disorder
Clinical narrative: Discharge Provider:  Primary Care Provider: Admission Date: 7/3/2022 Discharge Date: 7/6/2022  PRESENTING PROBLEM: Weakness [R53.1] Vascular dementia with behavior disturbance (HCC) [F01.51] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 66 y.o. male who presented to the ED for physical deconditioning and hyperglycemia. The patient was hospitalized 2 weeks ago for multiple subacute lacunar infarct together with cognitive impairment and vascular dementia.  There was initially some discussion of hospice but the patient's clinical status improved and he was discharged home with his wife. Unfortunately, there was difficulty obtaining pt's toujeo due to supply chain/pharmacy stock. Upon finally obtaining the toujeo, wife realized there were not needles given to administer the insulin. Pt had been off his long acting insulin for about a week which likely contributed to his overall weakness and increased urination. Wife tested positive for COVID three days prior to pt's admission. He tested positive for COVID on admission.   In the emergency department the patient's vitals were hemodynamically stable.  Laboratory workup notable for hyperglycemia with glucose 393 otherwise unremarkable.  He was admitted for PT/OT eval. Basal bolus insulin was resumed with quick improvement in blood sugar.  PT/OT recommended home with assist. Discussed at length with spouse who feels comfortable with the patient returning home as long as diabetes supplies are obtained so she can continue insulin dosing as instructed. Was consulted for assistance with diabetes supplies which were reviewed and rx sent at discharge.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Exposure to SARS-CoV-2, Hyperglycaemia, Laboratory test abnormal, Lacunar infarction
Clinical narrative: Discharge Provider:  Primary Care Provider: Admission Date: 7/3/2022 Discharge Date: 7/6/2022  PRESENTING PROBLEM: Weakness [R53.1] Vascular dementia with behavior disturbance (HCC) [F01.51] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 66 y.o. male who presented to the ED for physical deconditioning and hyperglycemia. The patient was hospitalized 2 weeks ago for multiple subacute lacunar infarct together with cognitive impairment and vascular dementia.  There was initially some discussion of hospice but the patient's clinical status improved and he was discharged home with his wife. Unfortunately, there was difficulty obtaining pt's toujeo due to supply chain/pharmacy stock. Upon finally obtaining the toujeo, wife realized there were not needles given to administer the insulin. Pt had been off his long acting insulin for about a week which likely contributed to his overall weakness and increased urination. Wife tested positive for COVID three days prior to pt's admission. He tested positive for COVID on admission.   In the emergency department the patient's vitals were hemodynamically stable.  Laboratory workup notable for hyperglycemia with glucose 393 otherwise unremarkable.  He was admitted for PT/OT eval. Basal bolus insulin was resumed with quick improvement in blood sugar.  PT/OT recommended home with assist. Discussed at length with spouse who feels comfortable with the patient returning home as long as diabetes supplies are obtained so she can continue insulin dosing as instructed. Was consulted for assistance with diabetes supplies which were reviewed and rx sent at discharge.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Physical deconditioning, Pollakiuria, Product supply issue, Product use issue, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider:  Primary Care Provider: Admission Date: 7/3/2022 Discharge Date: 7/6/2022  PRESENTING PROBLEM: Weakness [R53.1] Vascular dementia with behavior disturbance (HCC) [F01.51] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 66 y.o. male who presented to the ED for physical deconditioning and hyperglycemia. The patient was hospitalized 2 weeks ago for multiple subacute lacunar infarct together with cognitive impairment and vascular dementia.  There was initially some discussion of hospice but the patient's clinical status improved and he was discharged home with his wife. Unfortunately, there was difficulty obtaining pt's toujeo due to supply chain/pharmacy stock. Upon finally obtaining the toujeo, wife realized there were not needles given to administer the insulin. Pt had been off his long acting insulin for about a week which likely contributed to his overall weakness and increased urination. Wife tested positive for COVID three days prior to pt's admission. He tested positive for COVID on admission.   In the emergency department the patient's vitals were hemodynamically stable.  Laboratory workup notable for hyperglycemia with glucose 393 otherwise unremarkable.  He was admitted for PT/OT eval. Basal bolus insulin was resumed with quick improvement in blood sugar.  PT/OT recommended home with assist. Discussed at length with spouse who feels comfortable with the patient returning home as long as diabetes supplies are obtained so she can continue insulin dosing as instructed. Was consulted for assistance with diabetes supplies which were reviewed and rx sent at discharge.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Vascular dementia
Clinical narrative: Discharge Provider:  Primary Care Provider: Admission Date: 7/3/2022 Discharge Date: 7/6/2022  PRESENTING PROBLEM: Weakness [R53.1] Vascular dementia with behavior disturbance (HCC) [F01.51] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 66 y.o. male who presented to the ED for physical deconditioning and hyperglycemia. The patient was hospitalized 2 weeks ago for multiple subacute lacunar infarct together with cognitive impairment and vascular dementia.  There was initially some discussion of hospice but the patient's clinical status improved and he was discharged home with his wife. Unfortunately, there was difficulty obtaining pt's toujeo due to supply chain/pharmacy stock. Upon finally obtaining the toujeo, wife realized there were not needles given to administer the insulin. Pt had been off his long acting insulin for about a week which likely contributed to his overall weakness and increased urination. Wife tested positive for COVID three days prior to pt's admission. He tested positive for COVID on admission.   In the emergency department the patient's vitals were hemodynamically stable.  Laboratory workup notable for hyperglycemia with glucose 393 otherwise unremarkable.  He was admitted for PT/OT eval. Basal bolus insulin was resumed with quick improvement in blood sugar.  PT/OT recommended home with assist. Discussed at length with spouse who feels comfortable with the patient returning home as long as diabetes supplies are obtained so she can continue insulin dosing as instructed. Was consulted for assistance with diabetes supplies which were reviewed and rx sent at discharge.
Age: 35.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Rash pruritic, Urticaria
Clinical narrative: Urticaria. I got rash that was very itchy almost everyday starting from 04/21. I need to take certirizine for a relief while it comes back immediately after stoping the medcine.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dose Administered beyond use date
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dote administered beyond-use date
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dose administered beyond use date
Age: 2.0
Sex: F
Vaccine: DTAP, HIBV
Symptoms: Injection site bruising, Injection site pain, Injection site rash
Clinical narrative: Mom reports that patient had about 30 little bumps around the upper injection site the size of her thumb Friday morning and got worse Saturday. Mom just applied topical Benadryl Friday. Saturday she gave her oral Benadryl and put on topical Benadryl cream. mom reports that it improved significantly Sunday. Today mom reports that its mostly gone but does report some bruise like spots around the injection site and is sensitive to touch
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, COVID-19, Cough, Feeling abnormal, Feeling cold
Clinical narrative: The day before my COVID-19 test I started feeling cold symptoms, I felt really cold and my taste was different, my knee also hurt. I took a home COVID-19 test and it came back positive. Then I confirmed it by going to Urgent Care. Decided to have the infusion that Tuesday 07/05/2022. Started to feel a little better before the Infusion. Then after the Infusion I felt worse. Have been taking medicine on my own, but still having congestion with coughing a lot.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Nasopharyngitis, Respiratory tract congestion, SARS-CoV-2 test positive, Taste disorder
Clinical narrative: The day before my COVID-19 test I started feeling cold symptoms, I felt really cold and my taste was different, my knee also hurt. I took a home COVID-19 test and it came back positive. Then I confirmed it by going to Urgent Care. Decided to have the infusion that Tuesday 07/05/2022. Started to feel a little better before the Infusion. Then after the Infusion I felt worse. Have been taking medicine on my own, but still having congestion with coughing a lot.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Diarrhoea, Exposure to SARS-CoV-2, Headache, Nasal congestion
Clinical narrative: I was alerted that on June 26, 2022 that I had been exposed to COVID-19, I took a home COVID-19 test and it was negative. The next day I had a sore throat but my test was negative. On June 30, 2022 I had a positive COVID-19 test, called my doctor, had a telehealth visit, she prescribed Paxlovid. I started taking it that night, I noticed my symptoms, were mostly a small headache, congestion, nausea and diarrhea. None of this lasted long. My nose is still a little stuffy today (day 13) but otherwise I feel good.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: I was alerted that on June 26, 2022 that I had been exposed to COVID-19, I took a home COVID-19 test and it was negative. The next day I had a sore throat but my test was negative. On June 30, 2022 I had a positive COVID-19 test, called my doctor, had a telehealth visit, she prescribed Paxlovid. I started taking it that night, I noticed my symptoms, were mostly a small headache, congestion, nausea and diarrhea. None of this lasted long. My nose is still a little stuffy today (day 13) but otherwise I feel good.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Antinuclear antibody negative, Chest X-ray, Chest discomfort
Clinical narrative: Feb/March 2022 - began having some shortness of breath and occasional chest pain that was not normal for me, also felt more tired than usual 5/22/22 - Woke up around 1230 am having some discomfort in my right lower chest and it worsened over the next few hours while i was in bed. Became very uncomfortable lying down, especially lying supine and flat. I went to the ER and by the time I arrived it was very difficult and very painful to inhale and I was not able to lie flat at all due to pain and shortness of breath in that position. Labs, EKG, and CXR were obtained. D-Dimer came back elevated at 0.66. CTA was obtained. The original radiologist report was pleural effusion.  5/31/22 - Followed up with my PCP. see below Performed peak flow meter at visit with result of 250. PFT and repeat CTA ordered. 6/2/22 - Second radiologist reviewed CTA from 5/22/22. He called and spoke with ER provider and i was sent to ER for dx pulmonary infarct and pulmonary embolism. Labs and EKG were obtained. After discussion with ER provider i was determined to be stable enough for outpatient treatment. i was started on Eliquis 10 mg PO BID for 1 week, then started Eliquis 5 mg PO BID for minimum 6 months. i have continued to have some shortness of breath and occasional chest pain. Both seem to occur more with exertion.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Discomfort, Dyspnoea, Dyspnoea exertional, Electrocardiogram
Clinical narrative: Feb/March 2022 - began having some shortness of breath and occasional chest pain that was not normal for me, also felt more tired than usual 5/22/22 - Woke up around 1230 am having some discomfort in my right lower chest and it worsened over the next few hours while i was in bed. Became very uncomfortable lying down, especially lying supine and flat. I went to the ER and by the time I arrived it was very difficult and very painful to inhale and I was not able to lie flat at all due to pain and shortness of breath in that position. Labs, EKG, and CXR were obtained. D-Dimer came back elevated at 0.66. CTA was obtained. The original radiologist report was pleural effusion.  5/31/22 - Followed up with my PCP. see below Performed peak flow meter at visit with result of 250. PFT and repeat CTA ordered. 6/2/22 - Second radiologist reviewed CTA from 5/22/22. He called and spoke with ER provider and i was sent to ER for dx pulmonary infarct and pulmonary embolism. Labs and EKG were obtained. After discussion with ER provider i was determined to be stable enough for outpatient treatment. i was started on Eliquis 10 mg PO BID for 1 week, then started Eliquis 5 mg PO BID for minimum 6 months. i have continued to have some shortness of breath and occasional chest pain. Both seem to occur more with exertion.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Fibrin D dimer increased, Laboratory test normal, Pain, Painful respiration
Clinical narrative: Feb/March 2022 - began having some shortness of breath and occasional chest pain that was not normal for me, also felt more tired than usual 5/22/22 - Woke up around 1230 am having some discomfort in my right lower chest and it worsened over the next few hours while i was in bed. Became very uncomfortable lying down, especially lying supine and flat. I went to the ER and by the time I arrived it was very difficult and very painful to inhale and I was not able to lie flat at all due to pain and shortness of breath in that position. Labs, EKG, and CXR were obtained. D-Dimer came back elevated at 0.66. CTA was obtained. The original radiologist report was pleural effusion.  5/31/22 - Followed up with my PCP. see below Performed peak flow meter at visit with result of 250. PFT and repeat CTA ordered. 6/2/22 - Second radiologist reviewed CTA from 5/22/22. He called and spoke with ER provider and i was sent to ER for dx pulmonary infarct and pulmonary embolism. Labs and EKG were obtained. After discussion with ER provider i was determined to be stable enough for outpatient treatment. i was started on Eliquis 10 mg PO BID for 1 week, then started Eliquis 5 mg PO BID for minimum 6 months. i have continued to have some shortness of breath and occasional chest pain. Both seem to occur more with exertion.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Peak expiratory flow rate, Pleural effusion, Pulmonary embolism, Pulmonary function test abnormal, Pulmonary infarction
Clinical narrative: Feb/March 2022 - began having some shortness of breath and occasional chest pain that was not normal for me, also felt more tired than usual 5/22/22 - Woke up around 1230 am having some discomfort in my right lower chest and it worsened over the next few hours while i was in bed. Became very uncomfortable lying down, especially lying supine and flat. I went to the ER and by the time I arrived it was very difficult and very painful to inhale and I was not able to lie flat at all due to pain and shortness of breath in that position. Labs, EKG, and CXR were obtained. D-Dimer came back elevated at 0.66. CTA was obtained. The original radiologist report was pleural effusion.  5/31/22 - Followed up with my PCP. see below Performed peak flow meter at visit with result of 250. PFT and repeat CTA ordered. 6/2/22 - Second radiologist reviewed CTA from 5/22/22. He called and spoke with ER provider and i was sent to ER for dx pulmonary infarct and pulmonary embolism. Labs and EKG were obtained. After discussion with ER provider i was determined to be stable enough for outpatient treatment. i was started on Eliquis 10 mg PO BID for 1 week, then started Eliquis 5 mg PO BID for minimum 6 months. i have continued to have some shortness of breath and occasional chest pain. Both seem to occur more with exertion.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Sleep disorder
Clinical narrative: Feb/March 2022 - began having some shortness of breath and occasional chest pain that was not normal for me, also felt more tired than usual 5/22/22 - Woke up around 1230 am having some discomfort in my right lower chest and it worsened over the next few hours while i was in bed. Became very uncomfortable lying down, especially lying supine and flat. I went to the ER and by the time I arrived it was very difficult and very painful to inhale and I was not able to lie flat at all due to pain and shortness of breath in that position. Labs, EKG, and CXR were obtained. D-Dimer came back elevated at 0.66. CTA was obtained. The original radiologist report was pleural effusion.  5/31/22 - Followed up with my PCP. see below Performed peak flow meter at visit with result of 250. PFT and repeat CTA ordered. 6/2/22 - Second radiologist reviewed CTA from 5/22/22. He called and spoke with ER provider and i was sent to ER for dx pulmonary infarct and pulmonary embolism. Labs and EKG were obtained. After discussion with ER provider i was determined to be stable enough for outpatient treatment. i was started on Eliquis 10 mg PO BID for 1 week, then started Eliquis 5 mg PO BID for minimum 6 months. i have continued to have some shortness of breath and occasional chest pain. Both seem to occur more with exertion.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dose administered beyond use date
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Dote administered beyond-use date
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: patient hospitalized
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Ear discomfort, Fatigue, Headache, Nasal congestion
Clinical narrative: On May 27, 2022 in the evening, I started with a scratchy throat that turned into a very sore throat, high fever, headache. I was given Paxlovid which I took May 28, finished the full dose and felt better within 48 hours. June 11, I started to get very tired.  June 12, we flew home and my ears were bothering me so I took a COVID-19 test and tested positive again.  I had a lot of nasal congestion, tiredness, scratchy throat.  3-5 days later, the symptoms began to subside, with the help of Flonase, Tylenol and Advil and stayed in bed.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: On May 27, 2022 in the evening, I started with a scratchy throat that turned into a very sore throat, high fever, headache. I was given Paxlovid which I took May 28, finished the full dose and felt better within 48 hours. June 11, I started to get very tired.  June 12, we flew home and my ears were bothering me so I took a COVID-19 test and tested positive again.  I had a lot of nasal congestion, tiredness, scratchy throat.  3-5 days later, the symptoms began to subside, with the help of Flonase, Tylenol and Advil and stayed in bed.
Sex: U
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: Employee diluted vaccine with wrong amount of diluent. The vaccine was not administered to any patient and was promptly reported to clinical leadership.
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: patient hospitalized
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: dose administered beyond use date
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Nasal congestion, Nasal discharge discolouration, Productive cough
Clinical narrative: On July 7, 2022 my throat felt a little scratchy, then the next morning I woke up with stuffy nose, yellow drainage and irritated throat. I took a home test which was positive. I called my doctor on 07/09/2022 and was prescribed Paxlovid. I started taking medication on 07/09/2022. Today I am still having irritated throat, productive and non-productive coughing and runny nose.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: On July 7, 2022 my throat felt a little scratchy, then the next morning I woke up with stuffy nose, yellow drainage and irritated throat. I took a home test which was positive. I called my doctor on 07/09/2022 and was prescribed Paxlovid. I started taking medication on 07/09/2022. Today I am still having irritated throat, productive and non-productive coughing and runny nose.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, Blood creatine phosphokinase increased, COVID-19, Chest X-ray abnormal
Clinical narrative: Pfizer Dose 1 1/25/21 (EN5318) Pfizer Dose 2 2/17/21 (EN5318) COVID Positive 1/29/22  1/29/22: Patient is a 92-year-old male who presents to the emergency room via EMS with complaints of generalized weakness and a fall at home.  Patient states that he fell at home and laid on the ground for roughly 5+ hours.  There had been some complaints of chest pain which the patient is currently denying.  He denies any shortness of breath or dyspnea on exertion with no cough or sputum production symptoms.  He denies any abdominal pain complaints. Patient states that the weakness complaints are ongoing and are not new.  Patient did not hit his head and states that the reason for his fall was that he just weak in general. The only changes to his medical regimen have been that 1 of his blood pressure medications discontinued.  Patient is a do not resuscitate and had actually been considering hospice care recently.  In reviewing his chart it does look like a palliative care referral was made.  Patient's code status was clarified and he confirms that he is a do not resuscitate.  The patient's medical history, current medications, imaging studies, vital signs, laboratory studies and emergency records were personally reviewed. Case was also discussed read with the emergency room provider.  Patient was treated recently for pneumonia with today's chest x-ray showing worsening pneumonia.  2/3/22: 92-year-old male patient with a history of chronic atrial fibrillation, BPH, chronic back pain, hypertension, type 2 diabetes, depression, dementia would to the hospital on 1/29/2022 after he sustained a fall at home due to generalized weakness.  Patient was at home for more than 5 hours prior to the arrival to the emergency room.  Patient was noted to have pneumonia and started on antibiotics. Patient was given IV fluids for elevated CK levels which significantly improved.  Patient has chronic renal failure which is superimposed with acute renal failure due to his fall.  Patient was going to fluids and his kidney function returned to his baseline at the time of discharge.  Patient was tested positive for SARS-CoV-2 virus.  He did not require any at the time of discharge.  Patient was recommended to be transferred to a skilled nursing facility upon evaluation by PT/OT.  Patient will be transferred to the nursing home. He will follow up with primary care physician in 1 week.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Fall, Inappropriate schedule of product administration, Mobility decreased, Pneumonia
Clinical narrative: Pfizer Dose 1 1/25/21 (EN5318) Pfizer Dose 2 2/17/21 (EN5318) COVID Positive 1/29/22  1/29/22: Patient is a 92-year-old male who presents to the emergency room via EMS with complaints of generalized weakness and a fall at home.  Patient states that he fell at home and laid on the ground for roughly 5+ hours.  There had been some complaints of chest pain which the patient is currently denying.  He denies any shortness of breath or dyspnea on exertion with no cough or sputum production symptoms.  He denies any abdominal pain complaints. Patient states that the weakness complaints are ongoing and are not new.  Patient did not hit his head and states that the reason for his fall was that he just weak in general. The only changes to his medical regimen have been that 1 of his blood pressure medications discontinued.  Patient is a do not resuscitate and had actually been considering hospice care recently.  In reviewing his chart it does look like a palliative care referral was made.  Patient's code status was clarified and he confirms that he is a do not resuscitate.  The patient's medical history, current medications, imaging studies, vital signs, laboratory studies and emergency records were personally reviewed. Case was also discussed read with the emergency room provider.  Patient was treated recently for pneumonia with today's chest x-ray showing worsening pneumonia.  2/3/22: 92-year-old male patient with a history of chronic atrial fibrillation, BPH, chronic back pain, hypertension, type 2 diabetes, depression, dementia would to the hospital on 1/29/2022 after he sustained a fall at home due to generalized weakness.  Patient was at home for more than 5 hours prior to the arrival to the emergency room.  Patient was noted to have pneumonia and started on antibiotics. Patient was given IV fluids for elevated CK levels which significantly improved.  Patient has chronic renal failure which is superimposed with acute renal failure due to his fall.  Patient was going to fluids and his kidney function returned to his baseline at the time of discharge.  Patient was tested positive for SARS-CoV-2 virus.  He did not require any at the time of discharge.  Patient was recommended to be transferred to a skilled nursing facility upon evaluation by PT/OT.  Patient will be transferred to the nursing home. He will follow up with primary care physician in 1 week.