chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Inappropriate schedule of product administration, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after 2nd vaccine;  Moderna 3/16/21 Lot# 040A21A;  Moderna 4/15/21 Lot# 038B21A
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, Interchange of vaccine products, No adverse event, Wrong product administered
Clinical narrative: NO Adverse Drug Event to report, however, the incorrect Covid-19 vaccine was drawn up and administerd.  The wrong dose was administered.  Patient had received the Moderna vaccine for dose #1  and was appropriate for second dose in primary series.  Moderna vaccine (0.5ml) was ordered, but erroneously, 0.5ml of Pfizer vaccine was drawn up and administered.  No adverse reaction or event reported.  Nurse notified.  Prescriber will be notified. Patient will be notified.
Age: 60.0
Sex: F
Vaccine: UNK
Symptoms: Abdominal discomfort, Asthenia, Blood pressure fluctuation, Fatigue, Influenza like illness
Clinical narrative: flu like symptoms, body ache, temp, naseau, upset stomach, weakness, fatigue, fluctuating blood pressure, lawer face swelling
Age: 60.0
Sex: F
Vaccine: UNK
Symptoms: Nausea, Pain, Swelling face
Clinical narrative: flu like symptoms, body ache, temp, naseau, upset stomach, weakness, fatigue, fluctuating blood pressure, lawer face swelling
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, Blood lactic acid, COVID-19, Chest X-ray abnormal, Condition aggravated
Clinical narrative: Pfizer Dose 1 3/1/21 (EN6200) Pfizer Dose 2 3/24/21 (ER2613) Pfizer Dose 3 10/2/21 (EW0171) COVID Positive 4/12/22  4/12/22: Patient is a 76 year old female with a past medical history significant for paroxysmal atrial fibrillation status post ablation anticoagulated on Coumadin, history of CVA, iron deficiency anemia, cecum AV malformation, hyperlipidemia, mild aortic stenosis, CHF LVEF 40%, coronary artery disease status post stenting and pulmonary fibrosis on 2 L oxygen. She presented to ED with complaints of increased shortness of breath for the past week.  Shortness of breath is present with exertion but at rest on occasion.  She reports a productive cough with yellowish sputum production.  She has had decreased appetite and oral intake.  No fevers, chills or body aches. Patient reports tachycardia but has discontinued her sotalol due to side effects that she read on the bottle. No chest pain. Denies nausea or vomiting.   Patient is hypotensive in ER 89/52 and hypoxic on room air at 89%, supplemental oxygen was applied with improvement oxygen saturations.  Patient was noted to be in atrial fibrillation with RVR at a rate of 169. She was given diltiazem 10 mg IV.  IV fluid resuscitation was given with NS 0.9% 2 L. Subtherapeutic INR 1.7.  Leukocytosis 19.09. Normocytic anemia HGB 9.4.  Lactic acidosis 3.0.  ProBNP 90807. chest x-ray showed extensive interstitial changes consistent with known pulmonary fibrosis.  Perihilar areas of consolidation similar to prior CT could be overlying infection/pneumonia. She received Decadron 10 mg, magnesium sulfate 2 g and was started on Levaquin in ED.  4/16/22: Patient is a 76-year-old female who was admitted to the hospital secondary to increasing shortness of breath for the last 1 week prior to arrival.  Along with this the patient had a productive cough and had some decreased appetite and decreased oral intake.  There had been some tachycardia initially but her sotalol was discontinued due to some side effects.  Patient was hypotensive in the emergency room and was hypoxic on room air and 89%.  Heart rates were in the 160-170 range and the patient is known to have atrial fibrillation.  Patient did receive IV of diltiazem along with IV fluids.  Patient went on to test positive for COVID and was treated appropriately for this with IV remdesivir, vitamin-C, vitamin-D and zinc.  On the morning of 04/16/2022 the patient was back to her regular 2 L of oxygen via nasal cannula and was feeling noticeably better.  Patient was enquiring and asking about discharge. Patient appears to be medically stable for discharge as long as she has close follow-up with her primary care provider as well as ongoing follow-up with her pulmonologist due to her history of pulmonary fibrosis. Patient is in agreement with this approach.  We discussed reviewed her vital signs, laboratory studies, current medications and overall plan of care as well as the plan for follow-up.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Dyspnoea, Dyspnoea at rest, Dyspnoea exertional, Haemoglobin decreased
Clinical narrative: Pfizer Dose 1 3/1/21 (EN6200) Pfizer Dose 2 3/24/21 (ER2613) Pfizer Dose 3 10/2/21 (EW0171) COVID Positive 4/12/22  4/12/22: Patient is a 76 year old female with a past medical history significant for paroxysmal atrial fibrillation status post ablation anticoagulated on Coumadin, history of CVA, iron deficiency anemia, cecum AV malformation, hyperlipidemia, mild aortic stenosis, CHF LVEF 40%, coronary artery disease status post stenting and pulmonary fibrosis on 2 L oxygen. She presented to ED with complaints of increased shortness of breath for the past week.  Shortness of breath is present with exertion but at rest on occasion.  She reports a productive cough with yellowish sputum production.  She has had decreased appetite and oral intake.  No fevers, chills or body aches. Patient reports tachycardia but has discontinued her sotalol due to side effects that she read on the bottle. No chest pain. Denies nausea or vomiting.   Patient is hypotensive in ER 89/52 and hypoxic on room air at 89%, supplemental oxygen was applied with improvement oxygen saturations.  Patient was noted to be in atrial fibrillation with RVR at a rate of 169. She was given diltiazem 10 mg IV.  IV fluid resuscitation was given with NS 0.9% 2 L. Subtherapeutic INR 1.7.  Leukocytosis 19.09. Normocytic anemia HGB 9.4.  Lactic acidosis 3.0.  ProBNP 90807. chest x-ray showed extensive interstitial changes consistent with known pulmonary fibrosis.  Perihilar areas of consolidation similar to prior CT could be overlying infection/pneumonia. She received Decadron 10 mg, magnesium sulfate 2 g and was started on Levaquin in ED.  4/16/22: Patient is a 76-year-old female who was admitted to the hospital secondary to increasing shortness of breath for the last 1 week prior to arrival.  Along with this the patient had a productive cough and had some decreased appetite and decreased oral intake.  There had been some tachycardia initially but her sotalol was discontinued due to some side effects.  Patient was hypotensive in the emergency room and was hypoxic on room air and 89%.  Heart rates were in the 160-170 range and the patient is known to have atrial fibrillation.  Patient did receive IV of diltiazem along with IV fluids.  Patient went on to test positive for COVID and was treated appropriately for this with IV remdesivir, vitamin-C, vitamin-D and zinc.  On the morning of 04/16/2022 the patient was back to her regular 2 L of oxygen via nasal cannula and was feeling noticeably better.  Patient was enquiring and asking about discharge. Patient appears to be medically stable for discharge as long as she has close follow-up with her primary care provider as well as ongoing follow-up with her pulmonologist due to her history of pulmonary fibrosis. Patient is in agreement with this approach.  We discussed reviewed her vital signs, laboratory studies, current medications and overall plan of care as well as the plan for follow-up.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Hypophagia, Hypotension, Hypoxia, Inappropriate schedule of product administration, International normalised ratio increased
Clinical narrative: Pfizer Dose 1 3/1/21 (EN6200) Pfizer Dose 2 3/24/21 (ER2613) Pfizer Dose 3 10/2/21 (EW0171) COVID Positive 4/12/22  4/12/22: Patient is a 76 year old female with a past medical history significant for paroxysmal atrial fibrillation status post ablation anticoagulated on Coumadin, history of CVA, iron deficiency anemia, cecum AV malformation, hyperlipidemia, mild aortic stenosis, CHF LVEF 40%, coronary artery disease status post stenting and pulmonary fibrosis on 2 L oxygen. She presented to ED with complaints of increased shortness of breath for the past week.  Shortness of breath is present with exertion but at rest on occasion.  She reports a productive cough with yellowish sputum production.  She has had decreased appetite and oral intake.  No fevers, chills or body aches. Patient reports tachycardia but has discontinued her sotalol due to side effects that she read on the bottle. No chest pain. Denies nausea or vomiting.   Patient is hypotensive in ER 89/52 and hypoxic on room air at 89%, supplemental oxygen was applied with improvement oxygen saturations.  Patient was noted to be in atrial fibrillation with RVR at a rate of 169. She was given diltiazem 10 mg IV.  IV fluid resuscitation was given with NS 0.9% 2 L. Subtherapeutic INR 1.7.  Leukocytosis 19.09. Normocytic anemia HGB 9.4.  Lactic acidosis 3.0.  ProBNP 90807. chest x-ray showed extensive interstitial changes consistent with known pulmonary fibrosis.  Perihilar areas of consolidation similar to prior CT could be overlying infection/pneumonia. She received Decadron 10 mg, magnesium sulfate 2 g and was started on Levaquin in ED.  4/16/22: Patient is a 76-year-old female who was admitted to the hospital secondary to increasing shortness of breath for the last 1 week prior to arrival.  Along with this the patient had a productive cough and had some decreased appetite and decreased oral intake.  There had been some tachycardia initially but her sotalol was discontinued due to some side effects.  Patient was hypotensive in the emergency room and was hypoxic on room air and 89%.  Heart rates were in the 160-170 range and the patient is known to have atrial fibrillation.  Patient did receive IV of diltiazem along with IV fluids.  Patient went on to test positive for COVID and was treated appropriately for this with IV remdesivir, vitamin-C, vitamin-D and zinc.  On the morning of 04/16/2022 the patient was back to her regular 2 L of oxygen via nasal cannula and was feeling noticeably better.  Patient was enquiring and asking about discharge. Patient appears to be medically stable for discharge as long as she has close follow-up with her primary care provider as well as ongoing follow-up with her pulmonologist due to her history of pulmonary fibrosis. Patient is in agreement with this approach.  We discussed reviewed her vital signs, laboratory studies, current medications and overall plan of care as well as the plan for follow-up.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Lactic acidosis, Leukocytosis, Lung consolidation, Normocytic anaemia, Productive cough
Clinical narrative: Pfizer Dose 1 3/1/21 (EN6200) Pfizer Dose 2 3/24/21 (ER2613) Pfizer Dose 3 10/2/21 (EW0171) COVID Positive 4/12/22  4/12/22: Patient is a 76 year old female with a past medical history significant for paroxysmal atrial fibrillation status post ablation anticoagulated on Coumadin, history of CVA, iron deficiency anemia, cecum AV malformation, hyperlipidemia, mild aortic stenosis, CHF LVEF 40%, coronary artery disease status post stenting and pulmonary fibrosis on 2 L oxygen. She presented to ED with complaints of increased shortness of breath for the past week.  Shortness of breath is present with exertion but at rest on occasion.  She reports a productive cough with yellowish sputum production.  She has had decreased appetite and oral intake.  No fevers, chills or body aches. Patient reports tachycardia but has discontinued her sotalol due to side effects that she read on the bottle. No chest pain. Denies nausea or vomiting.   Patient is hypotensive in ER 89/52 and hypoxic on room air at 89%, supplemental oxygen was applied with improvement oxygen saturations.  Patient was noted to be in atrial fibrillation with RVR at a rate of 169. She was given diltiazem 10 mg IV.  IV fluid resuscitation was given with NS 0.9% 2 L. Subtherapeutic INR 1.7.  Leukocytosis 19.09. Normocytic anemia HGB 9.4.  Lactic acidosis 3.0.  ProBNP 90807. chest x-ray showed extensive interstitial changes consistent with known pulmonary fibrosis.  Perihilar areas of consolidation similar to prior CT could be overlying infection/pneumonia. She received Decadron 10 mg, magnesium sulfate 2 g and was started on Levaquin in ED.  4/16/22: Patient is a 76-year-old female who was admitted to the hospital secondary to increasing shortness of breath for the last 1 week prior to arrival.  Along with this the patient had a productive cough and had some decreased appetite and decreased oral intake.  There had been some tachycardia initially but her sotalol was discontinued due to some side effects.  Patient was hypotensive in the emergency room and was hypoxic on room air and 89%.  Heart rates were in the 160-170 range and the patient is known to have atrial fibrillation.  Patient did receive IV of diltiazem along with IV fluids.  Patient went on to test positive for COVID and was treated appropriately for this with IV remdesivir, vitamin-C, vitamin-D and zinc.  On the morning of 04/16/2022 the patient was back to her regular 2 L of oxygen via nasal cannula and was feeling noticeably better.  Patient was enquiring and asking about discharge. Patient appears to be medically stable for discharge as long as she has close follow-up with her primary care provider as well as ongoing follow-up with her pulmonologist due to her history of pulmonary fibrosis. Patient is in agreement with this approach.  We discussed reviewed her vital signs, laboratory studies, current medications and overall plan of care as well as the plan for follow-up.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Prohormone brain natriuretic peptide increased, Pulmonary fibrosis, SARS-CoV-2 test positive, Sputum discoloured, Tachycardia
Clinical narrative: Pfizer Dose 1 3/1/21 (EN6200) Pfizer Dose 2 3/24/21 (ER2613) Pfizer Dose 3 10/2/21 (EW0171) COVID Positive 4/12/22  4/12/22: Patient is a 76 year old female with a past medical history significant for paroxysmal atrial fibrillation status post ablation anticoagulated on Coumadin, history of CVA, iron deficiency anemia, cecum AV malformation, hyperlipidemia, mild aortic stenosis, CHF LVEF 40%, coronary artery disease status post stenting and pulmonary fibrosis on 2 L oxygen. She presented to ED with complaints of increased shortness of breath for the past week.  Shortness of breath is present with exertion but at rest on occasion.  She reports a productive cough with yellowish sputum production.  She has had decreased appetite and oral intake.  No fevers, chills or body aches. Patient reports tachycardia but has discontinued her sotalol due to side effects that she read on the bottle. No chest pain. Denies nausea or vomiting.   Patient is hypotensive in ER 89/52 and hypoxic on room air at 89%, supplemental oxygen was applied with improvement oxygen saturations.  Patient was noted to be in atrial fibrillation with RVR at a rate of 169. She was given diltiazem 10 mg IV.  IV fluid resuscitation was given with NS 0.9% 2 L. Subtherapeutic INR 1.7.  Leukocytosis 19.09. Normocytic anemia HGB 9.4.  Lactic acidosis 3.0.  ProBNP 90807. chest x-ray showed extensive interstitial changes consistent with known pulmonary fibrosis.  Perihilar areas of consolidation similar to prior CT could be overlying infection/pneumonia. She received Decadron 10 mg, magnesium sulfate 2 g and was started on Levaquin in ED.  4/16/22: Patient is a 76-year-old female who was admitted to the hospital secondary to increasing shortness of breath for the last 1 week prior to arrival.  Along with this the patient had a productive cough and had some decreased appetite and decreased oral intake.  There had been some tachycardia initially but her sotalol was discontinued due to some side effects.  Patient was hypotensive in the emergency room and was hypoxic on room air and 89%.  Heart rates were in the 160-170 range and the patient is known to have atrial fibrillation.  Patient did receive IV of diltiazem along with IV fluids.  Patient went on to test positive for COVID and was treated appropriately for this with IV remdesivir, vitamin-C, vitamin-D and zinc.  On the morning of 04/16/2022 the patient was back to her regular 2 L of oxygen via nasal cannula and was feeling noticeably better.  Patient was enquiring and asking about discharge. Patient appears to be medically stable for discharge as long as she has close follow-up with her primary care provider as well as ongoing follow-up with her pulmonologist due to her history of pulmonary fibrosis. Patient is in agreement with this approach.  We discussed reviewed her vital signs, laboratory studies, current medications and overall plan of care as well as the plan for follow-up.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: White blood cell count increased
Clinical narrative: Pfizer Dose 1 3/1/21 (EN6200) Pfizer Dose 2 3/24/21 (ER2613) Pfizer Dose 3 10/2/21 (EW0171) COVID Positive 4/12/22  4/12/22: Patient is a 76 year old female with a past medical history significant for paroxysmal atrial fibrillation status post ablation anticoagulated on Coumadin, history of CVA, iron deficiency anemia, cecum AV malformation, hyperlipidemia, mild aortic stenosis, CHF LVEF 40%, coronary artery disease status post stenting and pulmonary fibrosis on 2 L oxygen. She presented to ED with complaints of increased shortness of breath for the past week.  Shortness of breath is present with exertion but at rest on occasion.  She reports a productive cough with yellowish sputum production.  She has had decreased appetite and oral intake.  No fevers, chills or body aches. Patient reports tachycardia but has discontinued her sotalol due to side effects that she read on the bottle. No chest pain. Denies nausea or vomiting.   Patient is hypotensive in ER 89/52 and hypoxic on room air at 89%, supplemental oxygen was applied with improvement oxygen saturations.  Patient was noted to be in atrial fibrillation with RVR at a rate of 169. She was given diltiazem 10 mg IV.  IV fluid resuscitation was given with NS 0.9% 2 L. Subtherapeutic INR 1.7.  Leukocytosis 19.09. Normocytic anemia HGB 9.4.  Lactic acidosis 3.0.  ProBNP 90807. chest x-ray showed extensive interstitial changes consistent with known pulmonary fibrosis.  Perihilar areas of consolidation similar to prior CT could be overlying infection/pneumonia. She received Decadron 10 mg, magnesium sulfate 2 g and was started on Levaquin in ED.  4/16/22: Patient is a 76-year-old female who was admitted to the hospital secondary to increasing shortness of breath for the last 1 week prior to arrival.  Along with this the patient had a productive cough and had some decreased appetite and decreased oral intake.  There had been some tachycardia initially but her sotalol was discontinued due to some side effects.  Patient was hypotensive in the emergency room and was hypoxic on room air and 89%.  Heart rates were in the 160-170 range and the patient is known to have atrial fibrillation.  Patient did receive IV of diltiazem along with IV fluids.  Patient went on to test positive for COVID and was treated appropriately for this with IV remdesivir, vitamin-C, vitamin-D and zinc.  On the morning of 04/16/2022 the patient was back to her regular 2 L of oxygen via nasal cannula and was feeling noticeably better.  Patient was enquiring and asking about discharge. Patient appears to be medically stable for discharge as long as she has close follow-up with her primary care provider as well as ongoing follow-up with her pulmonologist due to her history of pulmonary fibrosis. Patient is in agreement with this approach.  We discussed reviewed her vital signs, laboratory studies, current medications and overall plan of care as well as the plan for follow-up.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Cardiac monitoring, Chest X-ray, Computerised tomogram head, Electrocardiogram
Clinical narrative: Aches (full body) and fainted. Admitted to emergency room at a local medical center (stayed 1 day) then transferred to a second medical center.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Syncope, Ultrasound Doppler
Clinical narrative: Aches (full body) and fainted. Admitted to emergency room at a local medical center (stayed 1 day) then transferred to a second medical center.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received outdated COVID-19 vaccine, patient was contacted and returned to clinic a couple of days later for re-vaccination.
Age: 28.0
Sex: F
Vaccine: MMRV
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: MMRV given instead of MMR to adult
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Reading disorder, Vision blurred
Clinical narrative: Pt had blurry vision on the second day after immunization was given. It was blurry enough that she cannot read.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Aggression, Agitation, Anger, Anticoagulant therapy, Anxiety
Clinical narrative: Pfizer Dose 1 2/1/21 (EL3302) Pfizer Dose 2 2/19/21 (EC9261) Pfizer Dose 3 10/26/21 (30145BA) COVID Positive 1/18/22  1/18/22: 80-year-old lady with history of dementia presented to the emergency room from Nursing Home with a history of agitation and aggressive behavior.  The patient was just recently admitted to that nursing home on January 7, 2022.  Apparently, she has been very angry, anxious, and agitated and was transferred to local facility for possible admission to behavioral health.  However, admission could not be processed, and she was sent to the emergency department where she was noted to be in atrial fibrillation.  The patient is demented and in poor health with some episode of aggressive behavior.  She was given antipsychotic in the emergency room and has become slightly obtunded.  Family member reports that the patient has been in multiple nursing homes because of agitation. In the emergency department, given a dose of metoprolol IV to control the heart rate and the CT of the chest was done that shows some possibility of interstitial edema in both lungs.  The chest x-ray was reported with no acute findings.  The CT head was noted to have no acute or suspicious intracranial findings.  The patient has a history of AFib and has been off her medication for several days, as she has not been cooperative.  Family member is requesting care coordination to be involved so that we can find a new placement for the patient.  2/17/22: Patient is a 80-year-old lady with history of dementia, HTN, AFib, depression presented to the emergency room from Nursing Home with a history of agitation and aggressive behavior. Patient was admitted for AFib RVR.  Cardiology was consulted.  Medication was recommended.  Ventricular rate has been well controlled. Will continue amiodarone and Eliquis.  During hospitalization patient had acute urinary retention requiring Foley, this is been removed and patient is voiding.  Patient also admitted for acute encephalopathy in the setting of dementia and agitated behavior.  Will continue current regimen.  Will discharge patient to long-term care.  Follow-up with PCP as needed.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, Bladder catheterisation, COVID-19, Catheter removal, Chest X-ray normal
Clinical narrative: Pfizer Dose 1 2/1/21 (EL3302) Pfizer Dose 2 2/19/21 (EC9261) Pfizer Dose 3 10/26/21 (30145BA) COVID Positive 1/18/22  1/18/22: 80-year-old lady with history of dementia presented to the emergency room from Nursing Home with a history of agitation and aggressive behavior.  The patient was just recently admitted to that nursing home on January 7, 2022.  Apparently, she has been very angry, anxious, and agitated and was transferred to local facility for possible admission to behavioral health.  However, admission could not be processed, and she was sent to the emergency department where she was noted to be in atrial fibrillation.  The patient is demented and in poor health with some episode of aggressive behavior.  She was given antipsychotic in the emergency room and has become slightly obtunded.  Family member reports that the patient has been in multiple nursing homes because of agitation. In the emergency department, given a dose of metoprolol IV to control the heart rate and the CT of the chest was done that shows some possibility of interstitial edema in both lungs.  The chest x-ray was reported with no acute findings.  The CT head was noted to have no acute or suspicious intracranial findings.  The patient has a history of AFib and has been off her medication for several days, as she has not been cooperative.  Family member is requesting care coordination to be involved so that we can find a new placement for the patient.  2/17/22: Patient is a 80-year-old lady with history of dementia, HTN, AFib, depression presented to the emergency room from Nursing Home with a history of agitation and aggressive behavior. Patient was admitted for AFib RVR.  Cardiology was consulted.  Medication was recommended.  Ventricular rate has been well controlled. Will continue amiodarone and Eliquis.  During hospitalization patient had acute urinary retention requiring Foley, this is been removed and patient is voiding.  Patient also admitted for acute encephalopathy in the setting of dementia and agitated behavior.  Will continue current regimen.  Will discharge patient to long-term care.  Follow-up with PCP as needed.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram head normal, Computerised tomogram thorax abnormal, Condition aggravated, Depressed level of consciousness, Encephalopathy
Clinical narrative: Pfizer Dose 1 2/1/21 (EL3302) Pfizer Dose 2 2/19/21 (EC9261) Pfizer Dose 3 10/26/21 (30145BA) COVID Positive 1/18/22  1/18/22: 80-year-old lady with history of dementia presented to the emergency room from Nursing Home with a history of agitation and aggressive behavior.  The patient was just recently admitted to that nursing home on January 7, 2022.  Apparently, she has been very angry, anxious, and agitated and was transferred to local facility for possible admission to behavioral health.  However, admission could not be processed, and she was sent to the emergency department where she was noted to be in atrial fibrillation.  The patient is demented and in poor health with some episode of aggressive behavior.  She was given antipsychotic in the emergency room and has become slightly obtunded.  Family member reports that the patient has been in multiple nursing homes because of agitation. In the emergency department, given a dose of metoprolol IV to control the heart rate and the CT of the chest was done that shows some possibility of interstitial edema in both lungs.  The chest x-ray was reported with no acute findings.  The CT head was noted to have no acute or suspicious intracranial findings.  The patient has a history of AFib and has been off her medication for several days, as she has not been cooperative.  Family member is requesting care coordination to be involved so that we can find a new placement for the patient.  2/17/22: Patient is a 80-year-old lady with history of dementia, HTN, AFib, depression presented to the emergency room from Nursing Home with a history of agitation and aggressive behavior. Patient was admitted for AFib RVR.  Cardiology was consulted.  Medication was recommended.  Ventricular rate has been well controlled. Will continue amiodarone and Eliquis.  During hospitalization patient had acute urinary retention requiring Foley, this is been removed and patient is voiding.  Patient also admitted for acute encephalopathy in the setting of dementia and agitated behavior.  Will continue current regimen.  Will discharge patient to long-term care.  Follow-up with PCP as needed.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Patient uncooperative, SARS-CoV-2 test positive, Urinary retention
Clinical narrative: Pfizer Dose 1 2/1/21 (EL3302) Pfizer Dose 2 2/19/21 (EC9261) Pfizer Dose 3 10/26/21 (30145BA) COVID Positive 1/18/22  1/18/22: 80-year-old lady with history of dementia presented to the emergency room from Nursing Home with a history of agitation and aggressive behavior.  The patient was just recently admitted to that nursing home on January 7, 2022.  Apparently, she has been very angry, anxious, and agitated and was transferred to local facility for possible admission to behavioral health.  However, admission could not be processed, and she was sent to the emergency department where she was noted to be in atrial fibrillation.  The patient is demented and in poor health with some episode of aggressive behavior.  She was given antipsychotic in the emergency room and has become slightly obtunded.  Family member reports that the patient has been in multiple nursing homes because of agitation. In the emergency department, given a dose of metoprolol IV to control the heart rate and the CT of the chest was done that shows some possibility of interstitial edema in both lungs.  The chest x-ray was reported with no acute findings.  The CT head was noted to have no acute or suspicious intracranial findings.  The patient has a history of AFib and has been off her medication for several days, as she has not been cooperative.  Family member is requesting care coordination to be involved so that we can find a new placement for the patient.  2/17/22: Patient is a 80-year-old lady with history of dementia, HTN, AFib, depression presented to the emergency room from Nursing Home with a history of agitation and aggressive behavior. Patient was admitted for AFib RVR.  Cardiology was consulted.  Medication was recommended.  Ventricular rate has been well controlled. Will continue amiodarone and Eliquis.  During hospitalization patient had acute urinary retention requiring Foley, this is been removed and patient is voiding.  Patient also admitted for acute encephalopathy in the setting of dementia and agitated behavior.  Will continue current regimen.  Will discharge patient to long-term care.  Follow-up with PCP as needed.
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: The patient was scheduled for his second Pfizer booster due to a stated history of asthma. The patient was administered Pfizer 0.2mL instead of the recommended Pfizer 0.3mL booster dose.
Age: 62.0
Sex: F
Vaccine: HEPA
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient was due for her second Hep A and Hep B vaccines. I had patient fill out the vaccines consent form, and administered both of the vaccines in the patient's right deltoid.  She did not report any adverse reactions. Patient left after receiving vaccines, and I noticed the vaccine was expired while charting that they were given.
Age: 54.0
Sex: M
Vaccine: FLU4
Symptoms: Guillain-Barre syndrome
Clinical narrative: PATIENT REPORTED TO HAVE GOT GUILLAIN-BARRE SYNDROME POST VACCINATION.
Age: 4.0
Sex: M
Vaccine: DTAPIPV, MMRV
Symptoms: Cellulitis, Hypersensitivity, Injection site bruising, Injection site erythema, Injection site swelling
Clinical narrative: ALLERGIC REACTION TO VACCINE ON 06/21/2022, CHILD PRESENTED WITH RED, SWELLING IN ANT THIGH AFTER VACCINATION, SUSPECTED  IS REACTION VS CELLULITIS,  ANTIBIOTIC ORDERED ON 06/22/2022 TODAY IS DAY 3 OF 10  AND IMPROVED SITE IS NOTED, REDNESS IS ALMOST RESOLVED, SWELLING IS RESOLVED, THERE IS ONLY BRUISING TO ON SITE. PLAN TO CONTINUE MEDS AS INSTRUCTED AND IF ALL GOOD DO NOT NEED TO RETURN.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Rash, Rash pruritic
Clinical narrative: Itchy Rashes on and around chest area after a couple of hours of vaccination
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Chills, Hyperhidrosis, Nasal congestion, Oropharyngeal pain
Clinical narrative: Breakthrough case of COVID, sore throat, nasal congestion, chills, fever, sweating, body aches.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Pyrexia, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case of COVID, sore throat, nasal congestion, chills, fever, sweating, body aches.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cardio-respiratory arrest, Death, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: 12/29/21 pt had a positive COVID test ordered by Agency; per death certificate pt died at his home with the manner of death being natural and the causes being:  cardiopulmonary arrest, respiratory failure, COVID
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Anticoagulant therapy, Arthralgia, Asthenia, Blood culture negative
Clinical narrative: Pfizer Dose 1 2/17/21 (EN9581) Pfizer Dose 2 3/10/21 (EN6204) Pfizer Dose 3 10/26/21 (FF2588) COVID Positive 1/26/22 COVID Positive 2/18/22  2/18/22: This is a 77-year-old female with history of hypertension, rheumatoid arthritis, deconditioning, chronic dementia and multiple recent fractures, recent C diff colitis and sepsis who presented to the emergency department with right shoulder pain and swelling. Patient is demented and cannot provide history. History was obtained from patient's daughter in-law. She states that patient has been complaining of pain and swelling in right shoulder. Her pain is moderate to severe in intensity and worse with movement. Patient is from a nursing facility. Patient had a recent humeral neck fracture on the right side which was deemed nonsurgical.   In the emergency department, patient was noted to be in sinus tachycardia. Labs showed a proBNP level of 941, WBC count of 1.2, hemoglobin of 7.5. Patient had a positive COVID-19 PCR test. Patient was given a dose of IV Zofran.  3/1/22: The patient presented to the hospital with generalized weakness and decreased p.o. intake, severe right shoulder pain and lower abdominal discomfort with diarrhea, she had dry oral mucosa and initially she was lethargic due to hypovolemia and sepsis, the patient she was diagnosed with C diff colitis and COVID-19 infection on January 26, later she developed bloody diarrhea due to severe C diff colitis, she require p.o. vancomycin and IV antibiotic and IV hydration, hemoglobin dropped and require total of 3 units of blood to be transfused, the patient was on Eliquis due to bilateral lower limbs DVT, the gastroenterologist consulted and recommend conservative management and no intervention due to high risk of perforation and general deconditioning, the patient had IVC filter placed. Her diarrhea improved while she is on vancomycin. The patient had chest CT show bilateral pleural effusion, CT abdomen show colitis. Blood cultures are negative. The patient does have severe difficult to control arthritis pain, she does have severe deconditioning and severe protein calories malnutrition, discussed with the patient and her family and decided to pursue with comfort measures and hospice care.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Clostridium difficile colitis, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Condition aggravated
Clinical narrative: Pfizer Dose 1 2/17/21 (EN9581) Pfizer Dose 2 3/10/21 (EN6204) Pfizer Dose 3 10/26/21 (FF2588) COVID Positive 1/26/22 COVID Positive 2/18/22  2/18/22: This is a 77-year-old female with history of hypertension, rheumatoid arthritis, deconditioning, chronic dementia and multiple recent fractures, recent C diff colitis and sepsis who presented to the emergency department with right shoulder pain and swelling. Patient is demented and cannot provide history. History was obtained from patient's daughter in-law. She states that patient has been complaining of pain and swelling in right shoulder. Her pain is moderate to severe in intensity and worse with movement. Patient is from a nursing facility. Patient had a recent humeral neck fracture on the right side which was deemed nonsurgical.   In the emergency department, patient was noted to be in sinus tachycardia. Labs showed a proBNP level of 941, WBC count of 1.2, hemoglobin of 7.5. Patient had a positive COVID-19 PCR test. Patient was given a dose of IV Zofran.  3/1/22: The patient presented to the hospital with generalized weakness and decreased p.o. intake, severe right shoulder pain and lower abdominal discomfort with diarrhea, she had dry oral mucosa and initially she was lethargic due to hypovolemia and sepsis, the patient she was diagnosed with C diff colitis and COVID-19 infection on January 26, later she developed bloody diarrhea due to severe C diff colitis, she require p.o. vancomycin and IV antibiotic and IV hydration, hemoglobin dropped and require total of 3 units of blood to be transfused, the patient was on Eliquis due to bilateral lower limbs DVT, the gastroenterologist consulted and recommend conservative management and no intervention due to high risk of perforation and general deconditioning, the patient had IVC filter placed. Her diarrhea improved while she is on vancomycin. The patient had chest CT show bilateral pleural effusion, CT abdomen show colitis. Blood cultures are negative. The patient does have severe difficult to control arthritis pain, she does have severe deconditioning and severe protein calories malnutrition, discussed with the patient and her family and decided to pursue with comfort measures and hospice care.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Diarrhoea, Diarrhoea haemorrhagic, Haemoglobin decreased, Hypophagia
Clinical narrative: Pfizer Dose 1 2/17/21 (EN9581) Pfizer Dose 2 3/10/21 (EN6204) Pfizer Dose 3 10/26/21 (FF2588) COVID Positive 1/26/22 COVID Positive 2/18/22  2/18/22: This is a 77-year-old female with history of hypertension, rheumatoid arthritis, deconditioning, chronic dementia and multiple recent fractures, recent C diff colitis and sepsis who presented to the emergency department with right shoulder pain and swelling. Patient is demented and cannot provide history. History was obtained from patient's daughter in-law. She states that patient has been complaining of pain and swelling in right shoulder. Her pain is moderate to severe in intensity and worse with movement. Patient is from a nursing facility. Patient had a recent humeral neck fracture on the right side which was deemed nonsurgical.   In the emergency department, patient was noted to be in sinus tachycardia. Labs showed a proBNP level of 941, WBC count of 1.2, hemoglobin of 7.5. Patient had a positive COVID-19 PCR test. Patient was given a dose of IV Zofran.  3/1/22: The patient presented to the hospital with generalized weakness and decreased p.o. intake, severe right shoulder pain and lower abdominal discomfort with diarrhea, she had dry oral mucosa and initially she was lethargic due to hypovolemia and sepsis, the patient she was diagnosed with C diff colitis and COVID-19 infection on January 26, later she developed bloody diarrhea due to severe C diff colitis, she require p.o. vancomycin and IV antibiotic and IV hydration, hemoglobin dropped and require total of 3 units of blood to be transfused, the patient was on Eliquis due to bilateral lower limbs DVT, the gastroenterologist consulted and recommend conservative management and no intervention due to high risk of perforation and general deconditioning, the patient had IVC filter placed. Her diarrhea improved while she is on vancomycin. The patient had chest CT show bilateral pleural effusion, CT abdomen show colitis. Blood cultures are negative. The patient does have severe difficult to control arthritis pain, she does have severe deconditioning and severe protein calories malnutrition, discussed with the patient and her family and decided to pursue with comfort measures and hospice care.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Hypovolaemia, Laboratory test, Lethargy, Malnutrition, Mucosal dryness
Clinical narrative: Pfizer Dose 1 2/17/21 (EN9581) Pfizer Dose 2 3/10/21 (EN6204) Pfizer Dose 3 10/26/21 (FF2588) COVID Positive 1/26/22 COVID Positive 2/18/22  2/18/22: This is a 77-year-old female with history of hypertension, rheumatoid arthritis, deconditioning, chronic dementia and multiple recent fractures, recent C diff colitis and sepsis who presented to the emergency department with right shoulder pain and swelling. Patient is demented and cannot provide history. History was obtained from patient's daughter in-law. She states that patient has been complaining of pain and swelling in right shoulder. Her pain is moderate to severe in intensity and worse with movement. Patient is from a nursing facility. Patient had a recent humeral neck fracture on the right side which was deemed nonsurgical.   In the emergency department, patient was noted to be in sinus tachycardia. Labs showed a proBNP level of 941, WBC count of 1.2, hemoglobin of 7.5. Patient had a positive COVID-19 PCR test. Patient was given a dose of IV Zofran.  3/1/22: The patient presented to the hospital with generalized weakness and decreased p.o. intake, severe right shoulder pain and lower abdominal discomfort with diarrhea, she had dry oral mucosa and initially she was lethargic due to hypovolemia and sepsis, the patient she was diagnosed with C diff colitis and COVID-19 infection on January 26, later she developed bloody diarrhea due to severe C diff colitis, she require p.o. vancomycin and IV antibiotic and IV hydration, hemoglobin dropped and require total of 3 units of blood to be transfused, the patient was on Eliquis due to bilateral lower limbs DVT, the gastroenterologist consulted and recommend conservative management and no intervention due to high risk of perforation and general deconditioning, the patient had IVC filter placed. Her diarrhea improved while she is on vancomycin. The patient had chest CT show bilateral pleural effusion, CT abdomen show colitis. Blood cultures are negative. The patient does have severe difficult to control arthritis pain, she does have severe deconditioning and severe protein calories malnutrition, discussed with the patient and her family and decided to pursue with comfort measures and hospice care.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Physical deconditioning, Pleural effusion, Prohormone brain natriuretic peptide increased, SARS-CoV-2 test positive
Clinical narrative: Pfizer Dose 1 2/17/21 (EN9581) Pfizer Dose 2 3/10/21 (EN6204) Pfizer Dose 3 10/26/21 (FF2588) COVID Positive 1/26/22 COVID Positive 2/18/22  2/18/22: This is a 77-year-old female with history of hypertension, rheumatoid arthritis, deconditioning, chronic dementia and multiple recent fractures, recent C diff colitis and sepsis who presented to the emergency department with right shoulder pain and swelling. Patient is demented and cannot provide history. History was obtained from patient's daughter in-law. She states that patient has been complaining of pain and swelling in right shoulder. Her pain is moderate to severe in intensity and worse with movement. Patient is from a nursing facility. Patient had a recent humeral neck fracture on the right side which was deemed nonsurgical.   In the emergency department, patient was noted to be in sinus tachycardia. Labs showed a proBNP level of 941, WBC count of 1.2, hemoglobin of 7.5. Patient had a positive COVID-19 PCR test. Patient was given a dose of IV Zofran.  3/1/22: The patient presented to the hospital with generalized weakness and decreased p.o. intake, severe right shoulder pain and lower abdominal discomfort with diarrhea, she had dry oral mucosa and initially she was lethargic due to hypovolemia and sepsis, the patient she was diagnosed with C diff colitis and COVID-19 infection on January 26, later she developed bloody diarrhea due to severe C diff colitis, she require p.o. vancomycin and IV antibiotic and IV hydration, hemoglobin dropped and require total of 3 units of blood to be transfused, the patient was on Eliquis due to bilateral lower limbs DVT, the gastroenterologist consulted and recommend conservative management and no intervention due to high risk of perforation and general deconditioning, the patient had IVC filter placed. Her diarrhea improved while she is on vancomycin. The patient had chest CT show bilateral pleural effusion, CT abdomen show colitis. Blood cultures are negative. The patient does have severe difficult to control arthritis pain, she does have severe deconditioning and severe protein calories malnutrition, discussed with the patient and her family and decided to pursue with comfort measures and hospice care.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Sepsis, Sinus tachycardia, Swelling, Transfusion, Vena cava filter insertion
Clinical narrative: Pfizer Dose 1 2/17/21 (EN9581) Pfizer Dose 2 3/10/21 (EN6204) Pfizer Dose 3 10/26/21 (FF2588) COVID Positive 1/26/22 COVID Positive 2/18/22  2/18/22: This is a 77-year-old female with history of hypertension, rheumatoid arthritis, deconditioning, chronic dementia and multiple recent fractures, recent C diff colitis and sepsis who presented to the emergency department with right shoulder pain and swelling. Patient is demented and cannot provide history. History was obtained from patient's daughter in-law. She states that patient has been complaining of pain and swelling in right shoulder. Her pain is moderate to severe in intensity and worse with movement. Patient is from a nursing facility. Patient had a recent humeral neck fracture on the right side which was deemed nonsurgical.   In the emergency department, patient was noted to be in sinus tachycardia. Labs showed a proBNP level of 941, WBC count of 1.2, hemoglobin of 7.5. Patient had a positive COVID-19 PCR test. Patient was given a dose of IV Zofran.  3/1/22: The patient presented to the hospital with generalized weakness and decreased p.o. intake, severe right shoulder pain and lower abdominal discomfort with diarrhea, she had dry oral mucosa and initially she was lethargic due to hypovolemia and sepsis, the patient she was diagnosed with C diff colitis and COVID-19 infection on January 26, later she developed bloody diarrhea due to severe C diff colitis, she require p.o. vancomycin and IV antibiotic and IV hydration, hemoglobin dropped and require total of 3 units of blood to be transfused, the patient was on Eliquis due to bilateral lower limbs DVT, the gastroenterologist consulted and recommend conservative management and no intervention due to high risk of perforation and general deconditioning, the patient had IVC filter placed. Her diarrhea improved while she is on vancomycin. The patient had chest CT show bilateral pleural effusion, CT abdomen show colitis. Blood cultures are negative. The patient does have severe difficult to control arthritis pain, she does have severe deconditioning and severe protein calories malnutrition, discussed with the patient and her family and decided to pursue with comfort measures and hospice care.