chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dizziness, Flushing, Headache, Pruritus
Clinical narrative: At 11:40 am, the patient had the injection. Patient had been advised by her allergist to wait in the waiting area of the health department for 1 hour, instead of the usual 15 minutes. Patient made this nurse aware. After the injection was given, patient sat in the immunization room with this nurse and was monitored. At 11:45, patient stood to go into lobby waiting area. Patient stated that she felt fine at this time, no changes were noted by the patient. At 11:55, this nurse went into the lobby to check on the patient. The patient was coloring and stated she felt fine, nothing had changed and she had no concerns. At 12:05, as this nurse was getting ready to check on patient again, the front desk staff came around the corner and notified me that she was beginning to have a reaction. I grabbed a pair of gloves and our epinephrine pen and went into the lobby. The patient's face was flushed, she stated she was beginning to cough, clear her throat more and that it was getting scratchy. She also stated she had developed a headache, felt "woozy," and was beginning to itch.  Patient brought back into the immunization room, a pulse oximeter was put on the patient's pointer finger, 911 was called and patient administered Epinephrine to herself in her right thigh. Patient had a pulse of 76-82 and an oxygen level of 97-98% on room air throughout the event. Patient stated that she felt worse, throat tightening, becoming more scratchy, and more coughing, once she reached the immunization room, which is what prompted me to tell her to administer the Epinephrine.  The local ER was called, I did advise them that I had Benadryl. They advised me to go ahead and give 50 mg of the Benadryl. EMS then arrived and patient was transported to our local ER.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Throat clearing, Throat irritation, Throat tightness
Clinical narrative: At 11:40 am, the patient had the injection. Patient had been advised by her allergist to wait in the waiting area of the health department for 1 hour, instead of the usual 15 minutes. Patient made this nurse aware. After the injection was given, patient sat in the immunization room with this nurse and was monitored. At 11:45, patient stood to go into lobby waiting area. Patient stated that she felt fine at this time, no changes were noted by the patient. At 11:55, this nurse went into the lobby to check on the patient. The patient was coloring and stated she felt fine, nothing had changed and she had no concerns. At 12:05, as this nurse was getting ready to check on patient again, the front desk staff came around the corner and notified me that she was beginning to have a reaction. I grabbed a pair of gloves and our epinephrine pen and went into the lobby. The patient's face was flushed, she stated she was beginning to cough, clear her throat more and that it was getting scratchy. She also stated she had developed a headache, felt "woozy," and was beginning to itch.  Patient brought back into the immunization room, a pulse oximeter was put on the patient's pointer finger, 911 was called and patient administered Epinephrine to herself in her right thigh. Patient had a pulse of 76-82 and an oxygen level of 97-98% on room air throughout the event. Patient stated that she felt worse, throat tightening, becoming more scratchy, and more coughing, once she reached the immunization room, which is what prompted me to tell her to administer the Epinephrine.  The local ER was called, I did advise them that I had Benadryl. They advised me to go ahead and give 50 mg of the Benadryl. EMS then arrived and patient was transported to our local ER.
Age: 60.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against then tested positive for COVID-19
Age: 66.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Blood culture positive, Cellulitis, Corynebacterium test positive, Intensive care, Limb injury
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 1/30/2023 Discharge Date: Feb 7, 2023  PRESENTING PROBLEM: Septic shock [A41.9, R65.21] Cellulitis [L03.90]   HOSPITAL COURSE: Patient is a 67 year old woman with PMH significant for DLBCL s/p chemotherapy in remission, RA on chronic prednisone, HFpEF, asthma, history of VTE in the setting of factor V Leiden on Eliquis, hypothyroidism, bipolar disorder, hyperlipidemia, and rheumatoid arthritis who presented to our institution on 01/30/2023.  She was diagnosed with septic shock secondary to left lower extremity cellulitis and admitted to the intensive care unit.  She was started on intravenous Vancomycin and Zosyn as well as stress dose steroids. MRI of LLE shows cellulitis with no osteomyelitis. The wound care team was asked to follow for chronic left lower extremity wound. Blood cultures showing corynebacterium on one of two sets no susceptibilities studies available.  Repeat blood cultures collected on 02/02/2023 revealed no growth. On 02/03/2023 antibiotics were deescalated to unasyn, and subsequently changed to Augmentin in preparation for discharge.  The patient required pressor support briefly while in intensive care as well as stress dose steroids, upon transfer out of the intensive care unit on 01/31/2023 stress dose steroids were discontinued and her home dose of prednisone 10 mg daily (as part of her rheumatoid arthritis therapy) was resumed. The patient was on 2l of oxygen via nasal canula prior to admission has been weaned off nasal oxygen to room air through this admission.   Noted pulmonary hypertension history, pulmonology team felt likely group 3 and group 4 with history of VT and factor 5 laden and recommended continuation of Eliquis twice daily   On 02/06/2023 the patient was determined to be medically stable to transfer back to these skilled nursing facility from which she came, however they were unable to accommodate transportation on this date and therefore she was discharged on 02/07/23  with labs and vitals stable condition and instructions to follow-up with her primary care physician within 1 week to monitor potassium and volume status.
Age: 66.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Magnetic resonance imaging abnormal, Septic shock
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 1/30/2023 Discharge Date: Feb 7, 2023  PRESENTING PROBLEM: Septic shock [A41.9, R65.21] Cellulitis [L03.90]   HOSPITAL COURSE: Patient is a 67 year old woman with PMH significant for DLBCL s/p chemotherapy in remission, RA on chronic prednisone, HFpEF, asthma, history of VTE in the setting of factor V Leiden on Eliquis, hypothyroidism, bipolar disorder, hyperlipidemia, and rheumatoid arthritis who presented to our institution on 01/30/2023.  She was diagnosed with septic shock secondary to left lower extremity cellulitis and admitted to the intensive care unit.  She was started on intravenous Vancomycin and Zosyn as well as stress dose steroids. MRI of LLE shows cellulitis with no osteomyelitis. The wound care team was asked to follow for chronic left lower extremity wound. Blood cultures showing corynebacterium on one of two sets no susceptibilities studies available.  Repeat blood cultures collected on 02/02/2023 revealed no growth. On 02/03/2023 antibiotics were deescalated to unasyn, and subsequently changed to Augmentin in preparation for discharge.  The patient required pressor support briefly while in intensive care as well as stress dose steroids, upon transfer out of the intensive care unit on 01/31/2023 stress dose steroids were discontinued and her home dose of prednisone 10 mg daily (as part of her rheumatoid arthritis therapy) was resumed. The patient was on 2l of oxygen via nasal canula prior to admission has been weaned off nasal oxygen to room air through this admission.   Noted pulmonary hypertension history, pulmonology team felt likely group 3 and group 4 with history of VT and factor 5 laden and recommended continuation of Eliquis twice daily   On 02/06/2023 the patient was determined to be medically stable to transfer back to these skilled nursing facility from which she came, however they were unable to accommodate transportation on this date and therefore she was discharged on 02/07/23  with labs and vitals stable condition and instructions to follow-up with her primary care physician within 1 week to monitor potassium and volume status.
Age: 79.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against then tested positive for COVID-19
Age: 15.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against then tested positive for COVID-19
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Condition aggravated, Dysphagia, Encephalopathy, Imaging procedure
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/4/2023 Discharge Date: 2/8/2023  PRESENTING PROBLEM: Encephalopathy COVID-19   HOSPITAL COURSE: Patient is a 71 y.o. female with PMHx of vascular dementia (axO x1 at baseline), essential hypertension, GERD from a memory care facility who presented 2/4/23 with encephalopathy. Patient more lethargic at baseline. In the ED found to be COVID positive. Vitals stable and imaging negative. She was admitted for encephalopathy likely 2/2 COVID. She was symptomatically treated for COVID. Neurology consulted for further potential workup and stated to treat underlying infection and added aspirin to regimen. Patient with oropharyngeal phase dysphagia did improve and was able to tolerate a diet. Patient started to return to baseline cognitive function and was discharged back to memory care unit on 2/8/2023.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Lethargy, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/4/2023 Discharge Date: 2/8/2023  PRESENTING PROBLEM: Encephalopathy COVID-19   HOSPITAL COURSE: Patient is a 71 y.o. female with PMHx of vascular dementia (axO x1 at baseline), essential hypertension, GERD from a memory care facility who presented 2/4/23 with encephalopathy. Patient more lethargic at baseline. In the ED found to be COVID positive. Vitals stable and imaging negative. She was admitted for encephalopathy likely 2/2 COVID. She was symptomatically treated for COVID. Neurology consulted for further potential workup and stated to treat underlying infection and added aspirin to regimen. Patient with oropharyngeal phase dysphagia did improve and was able to tolerate a diet. Patient started to return to baseline cognitive function and was discharged back to memory care unit on 2/8/2023.
Age: 63.0
Sex: F
Vaccine: COVID19-2
Symptoms: Electrocardiogram normal, Feeling abnormal, Headache, Hypertension
Clinical narrative: First week of January I started feeling off. I was having headaches. I took my blood pressure which was really high. I logged my blood pressure and saw my doctor about a week later. He ordered an EKG and started me on losartan. The EKG was normal. Presently my blood pressure has improved but is not back to normal.
Sex: M
Vaccine: FLU4, MNQ
Symptoms: Injection site erythema, Injection site inflammation, Injection site warmth
Clinical narrative: Dad says "The right arm is inflamed, red and warm when touched. Father brings him to the clinic, I observed red area, inflamed and hot to the touch. I refer to tele consultation with pediatrician.
Age: 24.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chest pain, Dizziness, Dyspnoea, Nausea, Neck pain
Clinical narrative: light headedness,fever, racing heart,sob,chest pain,neck pain, nausea as reported to pharmacy by patients mother
Age: 24.0
Sex: F
Vaccine: COVID19-2
Symptoms: Palpitations, Pyrexia
Clinical narrative: light headedness,fever, racing heart,sob,chest pain,neck pain, nausea as reported to pharmacy by patients mother
Age: 53.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient was given 4th dose of Moderna Monovalent vaccine.  Patient should have received Moderna Bivalent vaccine.  Patient was notified by phone of incident and made aware that he can still receive the Moderna Bivalent booster at a later date.
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Contusion, Epistaxis, Rash
Clinical narrative: He experienced easily bruising, rash on his shoulders and stomach and bloody nose.
Age: 40.0
Sex: F
Vaccine: HEP, HEP
Symptoms: No adverse event, Underdose
Clinical narrative: Engerix b 0.5ml ped dose administered to 37yo patient. No adverse effects noted.  Patient is aware. Upon consultation with provider, Engerix B 1.0ml administered to patient . No adverse effects noted.
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Pt did not have an adverse event but a vaccine was administered in error by someone else (state worker) on 2/8/23. Pt received his 1st Bivalent booster on 11/9/22 and another bivalent booster on 2/8/23.  Pt made aware of error,  did not have any reactions while waiting his 15 min after vaccination in clinic. Pt instructed to make us aware if any adverse reactions should occur after vaccination.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against then tested positive for COVID-19
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, Chest X-ray abnormal, Cough, Diarrhoea
Clinical narrative: Discharge Provider:  DO; Primary Care Provider: MD; Admission Date: 2/1/2023; Discharge Date: 2/6/2023.  PRESENTING PROBLEM: Shortness of breath [R06.02] Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00]  HOSPITAL COURSE: The patient is an 83-year-old female with history of PE, hypertension, CKD stage 3, diastolic heart failure, chronic obstructive pulmonary disease, and chronic back pain who presented to the emergency department with complaint of sore throat, malaise, cough, and shortness of breath.  On arrival to the emergency department she was hypoxic to 83% on room air requiring 2 L of oxygen via nasal cannula.  COVID was positive.  Chest x-ray showed mild pulmonary vascular congestion.  She was started on IV antibiotics for pneumonia and IV Solu-Medrol.  The patient was admitted to the hospitalist group.  Further antibiotics were held.  She completed three day course of remdesivir and a few days of oral dexamethasone before weaning to room air. She developed diarrhea which was treated with Imodium. Diarrhea improved and manageable on day of discharge.  PT/OT evaluated the patient and recommended home with home healthcare.  She showed clinical improvement and discharged home in stable condition on 2/6/2023.
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea, Hypoxia, Malaise, Oropharyngeal pain, Pneumonia
Clinical narrative: Discharge Provider:  DO; Primary Care Provider: MD; Admission Date: 2/1/2023; Discharge Date: 2/6/2023.  PRESENTING PROBLEM: Shortness of breath [R06.02] Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00]  HOSPITAL COURSE: The patient is an 83-year-old female with history of PE, hypertension, CKD stage 3, diastolic heart failure, chronic obstructive pulmonary disease, and chronic back pain who presented to the emergency department with complaint of sore throat, malaise, cough, and shortness of breath.  On arrival to the emergency department she was hypoxic to 83% on room air requiring 2 L of oxygen via nasal cannula.  COVID was positive.  Chest x-ray showed mild pulmonary vascular congestion.  She was started on IV antibiotics for pneumonia and IV Solu-Medrol.  The patient was admitted to the hospitalist group.  Further antibiotics were held.  She completed three day course of remdesivir and a few days of oral dexamethasone before weaning to room air. She developed diarrhea which was treated with Imodium. Diarrhea improved and manageable on day of discharge.  PT/OT evaluated the patient and recommended home with home healthcare.  She showed clinical improvement and discharged home in stable condition on 2/6/2023.
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pulmonary congestion, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider:  DO; Primary Care Provider: MD; Admission Date: 2/1/2023; Discharge Date: 2/6/2023.  PRESENTING PROBLEM: Shortness of breath [R06.02] Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00]  HOSPITAL COURSE: The patient is an 83-year-old female with history of PE, hypertension, CKD stage 3, diastolic heart failure, chronic obstructive pulmonary disease, and chronic back pain who presented to the emergency department with complaint of sore throat, malaise, cough, and shortness of breath.  On arrival to the emergency department she was hypoxic to 83% on room air requiring 2 L of oxygen via nasal cannula.  COVID was positive.  Chest x-ray showed mild pulmonary vascular congestion.  She was started on IV antibiotics for pneumonia and IV Solu-Medrol.  The patient was admitted to the hospitalist group.  Further antibiotics were held.  She completed three day course of remdesivir and a few days of oral dexamethasone before weaning to room air. She developed diarrhea which was treated with Imodium. Diarrhea improved and manageable on day of discharge.  PT/OT evaluated the patient and recommended home with home healthcare.  She showed clinical improvement and discharged home in stable condition on 2/6/2023.
Age: 0.58
Sex: M
Vaccine: HEP
Symptoms: Incorrect dose administered, Product administered to patient of inappropriate age
Clinical narrative: child received an adult dose of hep B i
Age: 1.58
Sex: M
Vaccine: HEPA
Symptoms: Abnormal behaviour, Decreased interest, Incorrect dose administered, Lethargy, Product administered to patient of inappropriate age
Clinical narrative: Pt given adult dose of vaccine versus peds dosing. No issues with 15 minutes of vaccine. Per Father patient did have fever at home, was whiney and did more hand holding than normal, was "unlike himself".  Per Mother patient was feverish and lethargic, disinterested in stuff similar to past vaccinations, no reaction at injection site.  Per Father and Mother fever controlled with Tylenol.
Age: 1.58
Sex: M
Vaccine: HEPA
Symptoms: Pyrexia
Clinical narrative: Pt given adult dose of vaccine versus peds dosing. No issues with 15 minutes of vaccine. Per Father patient did have fever at home, was whiney and did more hand holding than normal, was "unlike himself".  Per Mother patient was feverish and lethargic, disinterested in stuff similar to past vaccinations, no reaction at injection site.  Per Father and Mother fever controlled with Tylenol.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Asthenia, Atrial flutter, CHA2DS2-VASc-score, COVID-19
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 1/31/2023 Discharge Date: 2/3/2023 PRESENTING PROBLEM: Diarrhea of presumed infectious origin  Elevated troponin  Nonspecific chest pain  COVID-19  HOSPITAL COURSE: Patient 86-year-old gentleman with past medical history significant for prostate cancer status post radiation complicated by hemorrhagic cystitis , presented to the emergency department on 01/31/2020 with chief complain of weakness and recurrent falls x3, with bilateral knee laceration.  Patient had symptoms of rhinorrhea and diarrhea for 6 weeks prior to current admission.  Associated symptoms of dry cough with chest pain and exertional dyspnea.  In the emergency department was noted have tachycardia, troponin was slightly elevated at 144, COVID-19 was positive.  EKG did not show any significant changes.  Cardiology was informed who recommended admission to internal medicine for continued care.   Post admission patient had an echo which showed a reduced ejection fraction of 39%.  Cardiology pursued stress echo which was done on 02/02/2023.  On the stress echo patient was noted to have no signs of MRI and an EF of 49%.  Blood pressures were controlled by starting patient on metoprolol XL 50 mg orally 3 times a day along with losartan 50 mg orally 2 times a day.   For his a flutter with RVR patient was loaded with 0.5 of binge followed by 0.25 mg. Patient converted to normal sinus rhythm.  Cardiology initially recommended digoxin 0.125 mg orally daily.  However given improved rate control with just metoprolol digoxin was discontinued.  Patient being started on Eliquis for a an elevated Chad Vasc 2 score of 3.   Patient did not require any directed therapy for COVID-19.  Remained stable on room air.  Discharge cautiously with recommendations to follow-up with PCP and Cardiology post discharge.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Cardioversion, Chest pain, Cough, Diarrhoea, Diarrhoea infectious
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 1/31/2023 Discharge Date: 2/3/2023 PRESENTING PROBLEM: Diarrhea of presumed infectious origin  Elevated troponin  Nonspecific chest pain  COVID-19  HOSPITAL COURSE: Patient 86-year-old gentleman with past medical history significant for prostate cancer status post radiation complicated by hemorrhagic cystitis , presented to the emergency department on 01/31/2020 with chief complain of weakness and recurrent falls x3, with bilateral knee laceration.  Patient had symptoms of rhinorrhea and diarrhea for 6 weeks prior to current admission.  Associated symptoms of dry cough with chest pain and exertional dyspnea.  In the emergency department was noted have tachycardia, troponin was slightly elevated at 144, COVID-19 was positive.  EKG did not show any significant changes.  Cardiology was informed who recommended admission to internal medicine for continued care.   Post admission patient had an echo which showed a reduced ejection fraction of 39%.  Cardiology pursued stress echo which was done on 02/02/2023.  On the stress echo patient was noted to have no signs of MRI and an EF of 49%.  Blood pressures were controlled by starting patient on metoprolol XL 50 mg orally 3 times a day along with losartan 50 mg orally 2 times a day.   For his a flutter with RVR patient was loaded with 0.5 of binge followed by 0.25 mg. Patient converted to normal sinus rhythm.  Cardiology initially recommended digoxin 0.125 mg orally daily.  However given improved rate control with just metoprolol digoxin was discontinued.  Patient being started on Eliquis for a an elevated Chad Vasc 2 score of 3.   Patient did not require any directed therapy for COVID-19.  Remained stable on room air.  Discharge cautiously with recommendations to follow-up with PCP and Cardiology post discharge.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram normal, Fall
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 1/31/2023 Discharge Date: 2/3/2023 PRESENTING PROBLEM: Diarrhea of presumed infectious origin  Elevated troponin  Nonspecific chest pain  COVID-19  HOSPITAL COURSE: Patient 86-year-old gentleman with past medical history significant for prostate cancer status post radiation complicated by hemorrhagic cystitis , presented to the emergency department on 01/31/2020 with chief complain of weakness and recurrent falls x3, with bilateral knee laceration.  Patient had symptoms of rhinorrhea and diarrhea for 6 weeks prior to current admission.  Associated symptoms of dry cough with chest pain and exertional dyspnea.  In the emergency department was noted have tachycardia, troponin was slightly elevated at 144, COVID-19 was positive.  EKG did not show any significant changes.  Cardiology was informed who recommended admission to internal medicine for continued care.   Post admission patient had an echo which showed a reduced ejection fraction of 39%.  Cardiology pursued stress echo which was done on 02/02/2023.  On the stress echo patient was noted to have no signs of MRI and an EF of 49%.  Blood pressures were controlled by starting patient on metoprolol XL 50 mg orally 3 times a day along with losartan 50 mg orally 2 times a day.   For his a flutter with RVR patient was loaded with 0.5 of binge followed by 0.25 mg. Patient converted to normal sinus rhythm.  Cardiology initially recommended digoxin 0.125 mg orally daily.  However given improved rate control with just metoprolol digoxin was discontinued.  Patient being started on Eliquis for a an elevated Chad Vasc 2 score of 3.   Patient did not require any directed therapy for COVID-19.  Remained stable on room air.  Discharge cautiously with recommendations to follow-up with PCP and Cardiology post discharge.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive, Skin laceration, Stress echocardiogram, Tachycardia
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 1/31/2023 Discharge Date: 2/3/2023 PRESENTING PROBLEM: Diarrhea of presumed infectious origin  Elevated troponin  Nonspecific chest pain  COVID-19  HOSPITAL COURSE: Patient 86-year-old gentleman with past medical history significant for prostate cancer status post radiation complicated by hemorrhagic cystitis , presented to the emergency department on 01/31/2020 with chief complain of weakness and recurrent falls x3, with bilateral knee laceration.  Patient had symptoms of rhinorrhea and diarrhea for 6 weeks prior to current admission.  Associated symptoms of dry cough with chest pain and exertional dyspnea.  In the emergency department was noted have tachycardia, troponin was slightly elevated at 144, COVID-19 was positive.  EKG did not show any significant changes.  Cardiology was informed who recommended admission to internal medicine for continued care.   Post admission patient had an echo which showed a reduced ejection fraction of 39%.  Cardiology pursued stress echo which was done on 02/02/2023.  On the stress echo patient was noted to have no signs of MRI and an EF of 49%.  Blood pressures were controlled by starting patient on metoprolol XL 50 mg orally 3 times a day along with losartan 50 mg orally 2 times a day.   For his a flutter with RVR patient was loaded with 0.5 of binge followed by 0.25 mg. Patient converted to normal sinus rhythm.  Cardiology initially recommended digoxin 0.125 mg orally daily.  However given improved rate control with just metoprolol digoxin was discontinued.  Patient being started on Eliquis for a an elevated Chad Vasc 2 score of 3.   Patient did not require any directed therapy for COVID-19.  Remained stable on room air.  Discharge cautiously with recommendations to follow-up with PCP and Cardiology post discharge.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Troponin increased
Clinical narrative: Discharge Provider: MD Primary Care Provider: DO Admission Date: 1/31/2023 Discharge Date: 2/3/2023 PRESENTING PROBLEM: Diarrhea of presumed infectious origin  Elevated troponin  Nonspecific chest pain  COVID-19  HOSPITAL COURSE: Patient 86-year-old gentleman with past medical history significant for prostate cancer status post radiation complicated by hemorrhagic cystitis , presented to the emergency department on 01/31/2020 with chief complain of weakness and recurrent falls x3, with bilateral knee laceration.  Patient had symptoms of rhinorrhea and diarrhea for 6 weeks prior to current admission.  Associated symptoms of dry cough with chest pain and exertional dyspnea.  In the emergency department was noted have tachycardia, troponin was slightly elevated at 144, COVID-19 was positive.  EKG did not show any significant changes.  Cardiology was informed who recommended admission to internal medicine for continued care.   Post admission patient had an echo which showed a reduced ejection fraction of 39%.  Cardiology pursued stress echo which was done on 02/02/2023.  On the stress echo patient was noted to have no signs of MRI and an EF of 49%.  Blood pressures were controlled by starting patient on metoprolol XL 50 mg orally 3 times a day along with losartan 50 mg orally 2 times a day.   For his a flutter with RVR patient was loaded with 0.5 of binge followed by 0.25 mg. Patient converted to normal sinus rhythm.  Cardiology initially recommended digoxin 0.125 mg orally daily.  However given improved rate control with just metoprolol digoxin was discontinued.  Patient being started on Eliquis for a an elevated Chad Vasc 2 score of 3.   Patient did not require any directed therapy for COVID-19.  Remained stable on room air.  Discharge cautiously with recommendations to follow-up with PCP and Cardiology post discharge.
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest pain, SARS-CoV-2 test positive
Clinical narrative: 01/13/23 presents to ED for "chest pain". PMHx of "hypertension depression osteoarthritis"
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Anticoagulant therapy, Aspiration pleural cavity, COVID-19 pneumonia, Central venous catheterisation, Computerised tomogram thorax abnormal
Clinical narrative: Discharge Provider:   Primary Care Provider: MD Admission Date: 1/19/2023 Discharge Date: Feb 7, 2023 PRESENTING PROBLEM: Bilateral pulmonary embolism [I26.99]   HOSPITAL COURSE: Patient is a is a 77-year-old female with a past medical history of hypertension, diabetes mellitus type 2, CKD stage IIIB, recurrent falls, recent fracture of her right patella status post ORIF in August of 2022 with recurrent infections who presented to the emergency department with infection of her right knee.  Patient had an I&D and hardware removal by Orthopedic surgery.  Cultures grew Cutibacterium acnes and MSSA. She was treated with ancef.  A PICC line was placed.  She developed hypoxic respiratory failure.  She was found on CT of the thorax to have bilateral large effusions and bilateral PE. She started on a heparin drip. CAse was discussed with PERT team and she was transferred to facility for further intervention.  A 2D echo on 01/18/2023 showed a preserved ejection fraction of 65% and no significant right-sided disease.  For COVID-19 pneumonia she was started on Decadron for a 10 day course oral. IR advised patient not candidate for thrombectomy or thrombolytics.  Hospitalist procedure team did perform left thoracentesis.  Fluid was transudative.  Cultures were negative.  Echo with normal EF.  On reexamination of left knee wound had dehisced.  Ortho was consulted and took patient back to the OR on 1/27, underwent I&D and VAC placement.  Was taken to OR again on 01/31, underwent right knee wound debridement, perforator flap, split-thickness skin graft.  Patient will need follow-up with Ortho in 2 weeks post discharge.  Infectious Disease followed along, patient was ultimately switched from IV to oral antibiotics with plan to finish the course on 02/22 with Keflex and plan to extend C difficile prophylaxis with daily vancomycin until 2/27.  Patient was also discharged on oral Xarelto, likely duration 3 months. Discharge to subacute rehab on 02/07 PDMP 210
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Culture positive, Debridement, Echocardiogram normal, Effusion, Ejection fraction normal
Clinical narrative: Discharge Provider:   Primary Care Provider: MD Admission Date: 1/19/2023 Discharge Date: Feb 7, 2023 PRESENTING PROBLEM: Bilateral pulmonary embolism [I26.99]   HOSPITAL COURSE: Patient is a is a 77-year-old female with a past medical history of hypertension, diabetes mellitus type 2, CKD stage IIIB, recurrent falls, recent fracture of her right patella status post ORIF in August of 2022 with recurrent infections who presented to the emergency department with infection of her right knee.  Patient had an I&D and hardware removal by Orthopedic surgery.  Cultures grew Cutibacterium acnes and MSSA. She was treated with ancef.  A PICC line was placed.  She developed hypoxic respiratory failure.  She was found on CT of the thorax to have bilateral large effusions and bilateral PE. She started on a heparin drip. CAse was discussed with PERT team and she was transferred to facility for further intervention.  A 2D echo on 01/18/2023 showed a preserved ejection fraction of 65% and no significant right-sided disease.  For COVID-19 pneumonia she was started on Decadron for a 10 day course oral. IR advised patient not candidate for thrombectomy or thrombolytics.  Hospitalist procedure team did perform left thoracentesis.  Fluid was transudative.  Cultures were negative.  Echo with normal EF.  On reexamination of left knee wound had dehisced.  Ortho was consulted and took patient back to the OR on 1/27, underwent I&D and VAC placement.  Was taken to OR again on 01/31, underwent right knee wound debridement, perforator flap, split-thickness skin graft.  Patient will need follow-up with Ortho in 2 weeks post discharge.  Infectious Disease followed along, patient was ultimately switched from IV to oral antibiotics with plan to finish the course on 02/22 with Keflex and plan to extend C difficile prophylaxis with daily vancomycin until 2/27.  Patient was also discharged on oral Xarelto, likely duration 3 months. Discharge to subacute rehab on 02/07 PDMP 210
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incisional drainage, Infection, Medical device removal, Plastic surgery, Propionibacterium test positive
Clinical narrative: Discharge Provider:   Primary Care Provider: MD Admission Date: 1/19/2023 Discharge Date: Feb 7, 2023 PRESENTING PROBLEM: Bilateral pulmonary embolism [I26.99]   HOSPITAL COURSE: Patient is a is a 77-year-old female with a past medical history of hypertension, diabetes mellitus type 2, CKD stage IIIB, recurrent falls, recent fracture of her right patella status post ORIF in August of 2022 with recurrent infections who presented to the emergency department with infection of her right knee.  Patient had an I&D and hardware removal by Orthopedic surgery.  Cultures grew Cutibacterium acnes and MSSA. She was treated with ancef.  A PICC line was placed.  She developed hypoxic respiratory failure.  She was found on CT of the thorax to have bilateral large effusions and bilateral PE. She started on a heparin drip. CAse was discussed with PERT team and she was transferred to facility for further intervention.  A 2D echo on 01/18/2023 showed a preserved ejection fraction of 65% and no significant right-sided disease.  For COVID-19 pneumonia she was started on Decadron for a 10 day course oral. IR advised patient not candidate for thrombectomy or thrombolytics.  Hospitalist procedure team did perform left thoracentesis.  Fluid was transudative.  Cultures were negative.  Echo with normal EF.  On reexamination of left knee wound had dehisced.  Ortho was consulted and took patient back to the OR on 1/27, underwent I&D and VAC placement.  Was taken to OR again on 01/31, underwent right knee wound debridement, perforator flap, split-thickness skin graft.  Patient will need follow-up with Ortho in 2 weeks post discharge.  Infectious Disease followed along, patient was ultimately switched from IV to oral antibiotics with plan to finish the course on 02/22 with Keflex and plan to extend C difficile prophylaxis with daily vancomycin until 2/27.  Patient was also discharged on oral Xarelto, likely duration 3 months. Discharge to subacute rehab on 02/07 PDMP 210
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pulmonary embolism, Respiratory failure, Skin graft, Staphylococcus test positive, Wound closure
Clinical narrative: Discharge Provider:   Primary Care Provider: MD Admission Date: 1/19/2023 Discharge Date: Feb 7, 2023 PRESENTING PROBLEM: Bilateral pulmonary embolism [I26.99]   HOSPITAL COURSE: Patient is a is a 77-year-old female with a past medical history of hypertension, diabetes mellitus type 2, CKD stage IIIB, recurrent falls, recent fracture of her right patella status post ORIF in August of 2022 with recurrent infections who presented to the emergency department with infection of her right knee.  Patient had an I&D and hardware removal by Orthopedic surgery.  Cultures grew Cutibacterium acnes and MSSA. She was treated with ancef.  A PICC line was placed.  She developed hypoxic respiratory failure.  She was found on CT of the thorax to have bilateral large effusions and bilateral PE. She started on a heparin drip. CAse was discussed with PERT team and she was transferred to facility for further intervention.  A 2D echo on 01/18/2023 showed a preserved ejection fraction of 65% and no significant right-sided disease.  For COVID-19 pneumonia she was started on Decadron for a 10 day course oral. IR advised patient not candidate for thrombectomy or thrombolytics.  Hospitalist procedure team did perform left thoracentesis.  Fluid was transudative.  Cultures were negative.  Echo with normal EF.  On reexamination of left knee wound had dehisced.  Ortho was consulted and took patient back to the OR on 1/27, underwent I&D and VAC placement.  Was taken to OR again on 01/31, underwent right knee wound debridement, perforator flap, split-thickness skin graft.  Patient will need follow-up with Ortho in 2 weeks post discharge.  Infectious Disease followed along, patient was ultimately switched from IV to oral antibiotics with plan to finish the course on 02/22 with Keflex and plan to extend C difficile prophylaxis with daily vancomycin until 2/27.  Patient was also discharged on oral Xarelto, likely duration 3 months. Discharge to subacute rehab on 02/07 PDMP 210
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Wound dehiscence
Clinical narrative: Discharge Provider:   Primary Care Provider: MD Admission Date: 1/19/2023 Discharge Date: Feb 7, 2023 PRESENTING PROBLEM: Bilateral pulmonary embolism [I26.99]   HOSPITAL COURSE: Patient is a is a 77-year-old female with a past medical history of hypertension, diabetes mellitus type 2, CKD stage IIIB, recurrent falls, recent fracture of her right patella status post ORIF in August of 2022 with recurrent infections who presented to the emergency department with infection of her right knee.  Patient had an I&D and hardware removal by Orthopedic surgery.  Cultures grew Cutibacterium acnes and MSSA. She was treated with ancef.  A PICC line was placed.  She developed hypoxic respiratory failure.  She was found on CT of the thorax to have bilateral large effusions and bilateral PE. She started on a heparin drip. CAse was discussed with PERT team and she was transferred to facility for further intervention.  A 2D echo on 01/18/2023 showed a preserved ejection fraction of 65% and no significant right-sided disease.  For COVID-19 pneumonia she was started on Decadron for a 10 day course oral. IR advised patient not candidate for thrombectomy or thrombolytics.  Hospitalist procedure team did perform left thoracentesis.  Fluid was transudative.  Cultures were negative.  Echo with normal EF.  On reexamination of left knee wound had dehisced.  Ortho was consulted and took patient back to the OR on 1/27, underwent I&D and VAC placement.  Was taken to OR again on 01/31, underwent right knee wound debridement, perforator flap, split-thickness skin graft.  Patient will need follow-up with Ortho in 2 weeks post discharge.  Infectious Disease followed along, patient was ultimately switched from IV to oral antibiotics with plan to finish the course on 02/22 with Keflex and plan to extend C difficile prophylaxis with daily vancomycin until 2/27.  Patient was also discharged on oral Xarelto, likely duration 3 months. Discharge to subacute rehab on 02/07 PDMP 210
Age: 56.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chills, Fear, Injection site pain, Myalgia, Oral herpes
Clinical narrative: Extreme muscle ache/pain, fever, chills, pain at injection site for 36 hours.  Took Tylenol beginning on 1/28/23 at 7:00 and every 4 hours after.  Also, I've had a cold sore each week (clear up, come back in a different spot) following this last injection.
Age: 81.0
Sex: F
Vaccine: PNC20
Symptoms: Erythema, Local reaction, Oedema, Skin warm
Clinical narrative: Local reaction:  redness, slight edema, warmth to touch.  Fairly well-demarcated.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chills, Cough, SARS-CoV-2 test positive
Clinical narrative: 01/13/23 presents to ED for "chills, rigors, cough". PMHx of "multiple myeloma"
Age: 38.0
Sex: F
Vaccine: TDAP
Symptoms: Hypoaesthesia, Injection site pain, Mobility decreased, Myalgia, Paraesthesia
Clinical narrative: Left shoulder pain, numbness and tingling to finger tips, bicep pain, difficulty lifting arm. First reported to staff on 2/8/23. states symptoms have been improving with time.
Age: 3.0
Sex: F
Vaccine: COVID19-2
Symptoms: Unevaluable event
Clinical narrative: Patient primed with Moderna received Pfizer bivalent booster.
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, COVID-19 pneumonia, Chest X-ray abnormal, Hypoxia, Lung opacity
Clinical narrative: 4/21/2022-Transfer from SNF. Hypoxia since 8am. Placed on 6L NRB o2 sat 89%.  T: 101, P-105 and RR-26. CXR-perihilar intersitial and patchy alveolar opacities. Admit sepsis with acute hypoxic respiratory failure Covid pneumonia. Start Decadron, remedesivir, Unasyn and Vanco.  4/23/2022-D/C vanco continue unasyn as pt improved more likely aspiration pneumonia. Afebrile. VSS. Now on 2l via NC 96% 02.  4/25/2022-Sepsis resolved. VSS.  4/27/2022- VSS, improved. D/C to SNF.
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pneumonia aspiration, Sepsis
Clinical narrative: 4/21/2022-Transfer from SNF. Hypoxia since 8am. Placed on 6L NRB o2 sat 89%.  T: 101, P-105 and RR-26. CXR-perihilar intersitial and patchy alveolar opacities. Admit sepsis with acute hypoxic respiratory failure Covid pneumonia. Start Decadron, remedesivir, Unasyn and Vanco.  4/23/2022-D/C vanco continue unasyn as pt improved more likely aspiration pneumonia. Afebrile. VSS. Now on 2l via NC 96% 02.  4/25/2022-Sepsis resolved. VSS.  4/27/2022- VSS, improved. D/C to SNF.
Age: 60.0
Sex: M
Vaccine: COVID19-2
Symptoms: Anxiety, Impaired work ability, Insomnia, Tinnitus
Clinical narrative: I got tinnitus a month after the vaccine. I was not able to sleep for two weeks and a half, and I had to ask my employer for a semester medical leave because I was going mad, with crisis of anxiety and insomnia, I saw 2 audiologists  and they said the my ear was ok. I saw to ear and nose doctors , and they confirm I have tinnitus. They told me there is not cure for that, and that I should learn to live with it. I am now working with doctors here. The tinnitus is permanent. The first week, a doctor prescribe my medication for anxiety and insomnia, clonazepan and quetiapine, and was able to sleep. I am taking Quetiapine now and taking classes to control my mind.
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered
Clinical narrative: Inadvertent administration of 4th dose Pfizer vaccine to a child under 5 years. No signs or symptoms reported. Child left clinic with parent.
Age: 70.0
Sex: F
Vaccine: VARZOS
Symptoms: Fatigue, Feeling abnormal, Headache, Myalgia, Pain in extremity
Clinical narrative: Sore arm, muscle aches, headache, fatigue, brain fog
Age: 66.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, Blood test abnormal, Electromyogram normal, Fatigue, Feeling abnormal
Clinical narrative: About a week after receiving the Pfizer vaccine, it was my first time. I usually get Moderna, I had severe vertigo and felt sick for a month. I had more joint pain than normal in my knees and lower legs.  I had leg weakness and fatigue. Rest helped and it just kept coming back. The vertigo I went in the end of November, and I was sent to physical therapy, but I still was having joint pain and low-grade fevers and go and come back for a few days. The day after Christmas I had sever joint point and tingling down my legs and extreme joint pain. I felt as if I was recovering from Mono.  I went to my doctor, and I was put on Sim Valta, it helped tremendously.
Age: 66.0
Sex: F
Vaccine: COVID19-2
Symptoms: Full blood count normal, Malaise, Muscular weakness, Pain in extremity, Paraesthesia
Clinical narrative: About a week after receiving the Pfizer vaccine, it was my first time. I usually get Moderna, I had severe vertigo and felt sick for a month. I had more joint pain than normal in my knees and lower legs.  I had leg weakness and fatigue. Rest helped and it just kept coming back. The vertigo I went in the end of November, and I was sent to physical therapy, but I still was having joint pain and low-grade fevers and go and come back for a few days. The day after Christmas I had sever joint point and tingling down my legs and extreme joint pain. I felt as if I was recovering from Mono.  I went to my doctor, and I was put on Sim Valta, it helped tremendously.
Age: 66.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, Rheumatic disorder, Rheumatoid factor positive, Vertigo
Clinical narrative: About a week after receiving the Pfizer vaccine, it was my first time. I usually get Moderna, I had severe vertigo and felt sick for a month. I had more joint pain than normal in my knees and lower legs.  I had leg weakness and fatigue. Rest helped and it just kept coming back. The vertigo I went in the end of November, and I was sent to physical therapy, but I still was having joint pain and low-grade fevers and go and come back for a few days. The day after Christmas I had sever joint point and tingling down my legs and extreme joint pain. I felt as if I was recovering from Mono.  I went to my doctor, and I was put on Sim Valta, it helped tremendously.
Age: 43.0
Sex: F
Vaccine: PPV
Symptoms: Chest pain, Dyspnoea, Erythema, Pain in extremity, Peripheral swelling
Clinical narrative: Major arm swelling, painful, red speckled, shortness of breath and chest pain started about 2hours after vaccine. By 12:30pm my arm had tripled in size.
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: Confusional state, Pyrexia, Seizure
Clinical narrative: The next day, fevering, confused, seizure.
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Pt did not have an adverse event but a vaccine was administered in error by someone else (worker) on 2/8/23. Pt received her 1st Bivalent booster on 11/9/22 and another bivalent booster on 2/8/23.  Pt made aware of error,  did not have any reactions while waiting her 15 min after vaccination in clinic. Pt instructed to make us aware if any adverse reactions should occur after vaccination.
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Cough, Death, Pain
Clinical narrative: 3RD DOSE PFIZER COVID VACCINE GIVEN 12/20/21, LOT #33030BD; 8/15/22 pt was seen by NP for c/o weakness, cough, body aches; tested positive for COVID; given Azithromycin to take x 6 days; went home where he passed away on 8/24/22
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 3RD DOSE PFIZER COVID VACCINE GIVEN 12/20/21, LOT #33030BD; 8/15/22 pt was seen by NP for c/o weakness, cough, body aches; tested positive for COVID; given Azithromycin to take x 6 days; went home where he passed away on 8/24/22
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, Illness
Clinical narrative: Pt was diagnosed with Covid on 12/23/22 at the long term care facility (LTCF) where he resided and subsequently died on 1/5/23 due to complications from his illness.