chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 52.0
Sex: F
Vaccine: COVID19, PNC15
Symptoms: Condition aggravated, Device malfunction, Device power source issue, Diabetic ketoacidosis, Electrolyte substitution therapy
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD  Admission Date: 1/30/2023 Discharge Date: ?2/1/2023   PRESENTING PROBLEM: DKA, type 1, not at goal  Diabetic ketoacidosis without coma associated with type 1 diabetes mellitus COVID-19    HOSPITAL COURSE: Patient is a 53-year-old woman with complex past medical history including type 1 diabetes with insulin pump, combined heart failure, hypertension, atrial fibrillation, coronary artery disease status post stenting who presented with 2 weeks of upper respiratory infection symptoms and difficulty monitoring her blood sugars.  Patient's Dexcom meter malfunctioned and she did not have any more sensors at home.  She was unable to refill the sensors early.  She still continued to use her insulin pump, but was unable to check sugars at all because her home fingerstick glucometer was out of batteries.  She stated that life was busy lately and she did not have time to get batteries for the glucometer.  When she presented to the emergency department her blood glucose was 525, pH was 7.07, beta hydroxybutyrate greater than 9, and bicarbonate of 7. She was found to be COVID positive.  Patient was admitted to the intensive care unit for insulin drip.  She required electrolyte replacement on the drip and was also given IV fluids.  Patient was taken off the insulin drip and transitioned to subcutaneous Lantus 15 units in the early afternoon on 01/31.  Her blood sugars remained well controlled and by the following day she was feeling well. She was set up with a new glucometer and discharged on basal bolus insulin. She has an appointment with her endocrinologist next week and was encouraged to keep that appointment and to follow up with her PCP after discharge. The patient verbalized understanding of these instructions and discharged home in stable condition.
Age: 52.0
Sex: F
Vaccine: COVID19, PNC15
Symptoms: Intensive care, Respiratory symptom, SARS-CoV-2 test positive, Type 1 diabetes mellitus, Upper respiratory tract infection
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD  Admission Date: 1/30/2023 Discharge Date: ?2/1/2023   PRESENTING PROBLEM: DKA, type 1, not at goal  Diabetic ketoacidosis without coma associated with type 1 diabetes mellitus COVID-19    HOSPITAL COURSE: Patient is a 53-year-old woman with complex past medical history including type 1 diabetes with insulin pump, combined heart failure, hypertension, atrial fibrillation, coronary artery disease status post stenting who presented with 2 weeks of upper respiratory infection symptoms and difficulty monitoring her blood sugars.  Patient's Dexcom meter malfunctioned and she did not have any more sensors at home.  She was unable to refill the sensors early.  She still continued to use her insulin pump, but was unable to check sugars at all because her home fingerstick glucometer was out of batteries.  She stated that life was busy lately and she did not have time to get batteries for the glucometer.  When she presented to the emergency department her blood glucose was 525, pH was 7.07, beta hydroxybutyrate greater than 9, and bicarbonate of 7. She was found to be COVID positive.  Patient was admitted to the intensive care unit for insulin drip.  She required electrolyte replacement on the drip and was also given IV fluids.  Patient was taken off the insulin drip and transitioned to subcutaneous Lantus 15 units in the early afternoon on 01/31.  Her blood sugars remained well controlled and by the following day she was feeling well. She was set up with a new glucometer and discharged on basal bolus insulin. She has an appointment with her endocrinologist next week and was encouraged to keep that appointment and to follow up with her PCP after discharge. The patient verbalized understanding of these instructions and discharged home in stable condition.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Asthma, COVID-19, Chest X-ray normal, Condition aggravated, Dyspnoea
Clinical narrative: Discharge Provider: PA-C Attending Physician: MD Primary Care Provider at Discharge:  MD  Admission Date: 1/29/2023 Discharge Date: 01/31/2023  PRESENTING PROBLEM: Dyspnea [R06.00] Moderate persistent asthma with acute exacerbation [J45.41] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 86-year-old female with a history of asthma, hypertension and CKD stage 3 who presented with difficulty breathing x 5 days.  Labs with leukocytosis, known CKD 3, and COVID-19 positive.  Chest x-ray was clear.  EKG showed normal sinus rhythm.   The patient was admitted for an acute asthma exacerbation and acute COVID-19 viral infection. She was started on high-dose IV Solu-Medrol and transitioned to dexamethasone, nebulizers and supportive therapy. She did not require supplemental oxygen and remained stable on room air. She had been using her albuterol inhaler as needed at home prior to admission and did not get much relief from this. She utilized albuterol nebulizers in the hospital with good response. Pulm rehab consulted and arranged for home nebulizer machine, with albuterol neb solution to be prescribed to be utilized as needed upon return home. Given lack of wheezing and stability on room air, she will not be continued on steroids upon discharge.    PT and OT evaluated and recommended return home with family assistance once medically stable. She resides at home with her daughter who is able to assist upon return home. She remained stable on room air and was feeling symptomatically improved on 1/31. She was tolerating a diet and ambulating in her room. Recommend she arrange post-hospital follow up appointment with her PCP to ensure ongoing stability and improvement after hospitalization. Given smoking history, could consider obtaining PFTs to rule out underlying COPD. She was discharged home in stable condition with her daughter on 1/31/23.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Laboratory test normal, Leukocytosis, SARS-CoV-2 test positive, Sinus rhythm
Clinical narrative: Discharge Provider: PA-C Attending Physician: MD Primary Care Provider at Discharge:  MD  Admission Date: 1/29/2023 Discharge Date: 01/31/2023  PRESENTING PROBLEM: Dyspnea [R06.00] Moderate persistent asthma with acute exacerbation [J45.41] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 86-year-old female with a history of asthma, hypertension and CKD stage 3 who presented with difficulty breathing x 5 days.  Labs with leukocytosis, known CKD 3, and COVID-19 positive.  Chest x-ray was clear.  EKG showed normal sinus rhythm.   The patient was admitted for an acute asthma exacerbation and acute COVID-19 viral infection. She was started on high-dose IV Solu-Medrol and transitioned to dexamethasone, nebulizers and supportive therapy. She did not require supplemental oxygen and remained stable on room air. She had been using her albuterol inhaler as needed at home prior to admission and did not get much relief from this. She utilized albuterol nebulizers in the hospital with good response. Pulm rehab consulted and arranged for home nebulizer machine, with albuterol neb solution to be prescribed to be utilized as needed upon return home. Given lack of wheezing and stability on room air, she will not be continued on steroids upon discharge.    PT and OT evaluated and recommended return home with family assistance once medically stable. She resides at home with her daughter who is able to assist upon return home. She remained stable on room air and was feeling symptomatically improved on 1/31. She was tolerating a diet and ambulating in her room. Recommend she arrange post-hospital follow up appointment with her PCP to ensure ongoing stability and improvement after hospitalization. Given smoking history, could consider obtaining PFTs to rule out underlying COPD. She was discharged home in stable condition with her daughter on 1/31/23.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Aortic valve incompetence, COVID-19, Dyspnoea, Echocardiogram abnormal, Ejection fraction abnormal
Clinical narrative: Admission Date: 1/28/2023 Discharge Date: Jan 30, 2023  PRESENTING PROBLEM: Elevated troponin  HOSPITAL COURSE: The patient is a 67 y.o. female with past medical history significant for nonischemic cardiomyopathy, diet controlled DMT2, PVD who present to the ED on 01/27/2023 with shortness of breath.  Patient found to have hypoxia from mild CHF, lactic acidosis and was COVID positive.  She also had elevated troponin that increased to 120. She improved quickly while still at the hospital  but was transferred to another hospital for Cardiology consult and echo. Echo showed worsening EF of 30 along with moderate mitral regurgitation and aortic regurgitation.  Cardiology recommended cardiac MRI and right heart catheterization but due to active COVID plan to arrange as outpatient. She was discharged on Lasix 40 mg daily with close cardiology follow-up.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoxia, Lactic acidosis, Mitral valve incompetence, SARS-CoV-2 test positive, Troponin increased
Clinical narrative: Admission Date: 1/28/2023 Discharge Date: Jan 30, 2023  PRESENTING PROBLEM: Elevated troponin  HOSPITAL COURSE: The patient is a 67 y.o. female with past medical history significant for nonischemic cardiomyopathy, diet controlled DMT2, PVD who present to the ED on 01/27/2023 with shortness of breath.  Patient found to have hypoxia from mild CHF, lactic acidosis and was COVID positive.  She also had elevated troponin that increased to 120. She improved quickly while still at the hospital  but was transferred to another hospital for Cardiology consult and echo. Echo showed worsening EF of 30 along with moderate mitral regurgitation and aortic regurgitation.  Cardiology recommended cardiac MRI and right heart catheterization but due to active COVID plan to arrange as outpatient. She was discharged on Lasix 40 mg daily with close cardiology follow-up.
Age: 49.0
Sex: M
Vaccine: COVID19-2
Symptoms: Injection site pain, Pain
Clinical narrative: After I got the injection I waited the thirty minutes due to previous hives I had only soreness at the injection site but then I had a dull throbbing from my shoulder to my elbow it feels internal like but not muscle related but it is not sore to the touch this has persisted for five weeks. My doctor said he did not think it was related to the injection and put me on anti-inflammatory medicine which has not seemed to help and I have taken four doses so far.
Age: 35.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, Autoimmune disorder, Blood test abnormal, Echocardiogram abnormal, Laboratory test
Clinical narrative: I went to doctor in December, my joints hurt, and did a lot of tests, they sent me to Cardiologist, I went back in January, and they detected an auto immune, and due to the Echo results the doctor sent me to the cardiologist, I still have to go to see him.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Discomfort, Lymphadenopathy, Respiratory tract infection viral
Clinical narrative: My lymphoid under my arms were swollen for weeks. I went to the doctor to see what was going on. I used warm compresses to relieve the discomfort. I got sick with a respiratory virus on 01/25/2023. I went to a clinic and got a prescription for prednisone. As of today, I continue to have a cough.
Age: 36.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Client was given a bivalent booster without having completed the primary series of the COVID vaccine
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Headache, Hip arthroplasty, Inflammatory marker test, Laboratory test
Clinical narrative: Consulted 3 local doctors , all of who ran tests and concluded their field of expertise could not help me (GP, ORTHOPEDIC, PAIN MANAGEMENT.  I WAS ON A WALKER FOR 3 MONTHS with acute and debilitating pain in all limbs.  Finally made it to Dr., rheumatologist at facility and diagnosis was PMR, and began prednisone on September 2, 2022, 5 months after reaction to 4th COVID shot (2nd booster).  I am down to 3 mg prednisone today, and if inflammation markers are holding good on next blood draw next week, will go down to 1 mg.  During this time, I have had a hip replacement, and am awaiting cardiology appointment for blood pressure issues (headaches started 12/28/22.  I BELIEVE THE PMR WAS A DIRECT RESULT OF THAT LAST COVID SHOT and while some of the doctors I consulted opted to say NO OPINION, several said they indeed have seen many patients who developed complications after the 4th shot.  I have lost the last 10 months of my life SO FAR  to illnesses resulting from the COVID shot, the instant development of PMR, and subsequent issues.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Polymyalgia rheumatica, Walking aid user
Clinical narrative: Consulted 3 local doctors , all of who ran tests and concluded their field of expertise could not help me (GP, ORTHOPEDIC, PAIN MANAGEMENT.  I WAS ON A WALKER FOR 3 MONTHS with acute and debilitating pain in all limbs.  Finally made it to Dr., rheumatologist at facility and diagnosis was PMR, and began prednisone on September 2, 2022, 5 months after reaction to 4th COVID shot (2nd booster).  I am down to 3 mg prednisone today, and if inflammation markers are holding good on next blood draw next week, will go down to 1 mg.  During this time, I have had a hip replacement, and am awaiting cardiology appointment for blood pressure issues (headaches started 12/28/22.  I BELIEVE THE PMR WAS A DIRECT RESULT OF THAT LAST COVID SHOT and while some of the doctors I consulted opted to say NO OPINION, several said they indeed have seen many patients who developed complications after the 4th shot.  I have lost the last 10 months of my life SO FAR  to illnesses resulting from the COVID shot, the instant development of PMR, and subsequent issues.
Age: 46.0
Sex: F
Vaccine: COVID19-2, VARZOS
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Patient presented to clinic and aid asked for the SHINGRIX vaccine. The Pharmacist failed to recognize her DOB as 46 y/o
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Cardiac arrest, Coronary artery occlusion, Deep vein thrombosis, Ejection fraction decreased
Clinical narrative: Guillan Barre- May 2021 Myositis DVT/PE cardiac arrest  NSTEMI with 100% LAD occlusion EF 10-15%
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Guillain-Barre syndrome, Myositis
Clinical narrative: Guillan Barre- May 2021 Myositis DVT/PE cardiac arrest  NSTEMI with 100% LAD occlusion EF 10-15%
Age: 11.0
Sex: F
Vaccine: MENB
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: there was no adverse reaction, the vaccine ordered, and vaccine given has the same generic name Bexsero and different age group, education was given.
Age: 32.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient given Pfizer bivalent as 1st in primary series
Age: 37.0
Sex: F
Vaccine: HEP
Symptoms: Incorrect dose administered, No adverse event, Underdose
Clinical narrative: Pt was administered Engerix-B pediatric dose instead of the Engerix-B adult dose.  Once the nurse realized the error, she informed the patient's physician and informed patient. Pt did not experience an adverse reaction to pediatric dose. Pt was given option to repeat first dose with correct Engerix-B adult dose. Pt chose to restart series and was given first adult dose on 02/03/2023.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: PATIENT RECEIVED PFIZER MONOVALENT VACCINE INSTEAD OF PFIZER BIVALENT VACCINE BOOSTER
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Flushing, Heart rate increased, Malaise, Pyrexia
Clinical narrative: Patient was given her 1st COVID/Janssen  dose of 0.5ml @ 2:45pm. Patient states @2:52pm she was breaking out with a rash. Patient showed me her rash. Patient began to feel flush. Supervisor was notified. Steps were taken to monitor and relieve symptoms from the reaction. 50mg of Benadryl was given orally with water in tablet form at 2:55pm. Vitals were monitored over 30min time period and collected 3 times before patient was released. Patients rash subsided vitals returned to normal range. BP 120/84, Pulse 99, Resp. 12, O2- 99%, Temp. 98.9.  Patient was releases at 3:35pm 2-1-23. Follow up call was attempted 2-2-23 no answer, message left to return call to Health Dept.. Attempt #2 for follow call was made 2-3-23. Message was left to return call to Health Dept. Patient returned call to Health Dept. @ 8:55am 2-3-23.  Patient states on 2-2-23 she wasn't feeling well and spiked a fever along with an elevated heartrate.  Patient states she was seen by a Dr. at work an EKG was performed and results were normal. Patient states her fever was 101 degrees. Patient states she feels well today and is having no complications. Advised Patient if any new issues arise contact the Health Dept and seek medical attention if needed.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: Patient was given her 1st COVID/Janssen  dose of 0.5ml @ 2:45pm. Patient states @2:52pm she was breaking out with a rash. Patient showed me her rash. Patient began to feel flush. Supervisor was notified. Steps were taken to monitor and relieve symptoms from the reaction. 50mg of Benadryl was given orally with water in tablet form at 2:55pm. Vitals were monitored over 30min time period and collected 3 times before patient was released. Patients rash subsided vitals returned to normal range. BP 120/84, Pulse 99, Resp. 12, O2- 99%, Temp. 98.9.  Patient was releases at 3:35pm 2-1-23. Follow up call was attempted 2-2-23 no answer, message left to return call to Health Dept.. Attempt #2 for follow call was made 2-3-23. Message was left to return call to Health Dept. Patient returned call to Health Dept. @ 8:55am 2-3-23.  Patient states on 2-2-23 she wasn't feeling well and spiked a fever along with an elevated heartrate.  Patient states she was seen by a Dr. at work an EKG was performed and results were normal. Patient states her fever was 101 degrees. Patient states she feels well today and is having no complications. Advised Patient if any new issues arise contact the Health Dept and seek medical attention if needed.
Age: 40.0
Sex: M
Vaccine: COVID19-2
Symptoms: Palpitations
Clinical narrative: Pt reported health palpitations post vaccine around 3:45PM (vax administered at 3:12PM). Pt states HP was present until next morning and resolved on its own.
Age: 0.5
Sex: F
Vaccine: DTAP
Symptoms: Wrong product administered
Clinical narrative: Patient had vaccine ordered: pediarix (DTaP-IPV-Hep B).  Infanrix (DTaP) was given by staff.  No scanning for vaccines currently at location.  Family notified.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Abdominal X-ray, Abdominal pain upper, Computerised tomogram abnormal, Diverticulitis
Clinical narrative: I received my Pfizer Bivalent Booster on 11/03/2022. My adverse event started on 01/14/2023 in the morning as soon as I woke up around 07:00AM. I had severe pain in my stomach. It wasn't like a normal pain. It was on my left side. I tried to go to my doctor's office on the 01/16/2023 but since it was a holiday I had to schedule it for 01/17/2023 at 11:00AM. They asked me what was going on and about different issues I had with my stomach. They told me to get a X-ray done. It was normal. They also asked me to get a CT scan on 01/18/2023. When the results came in they diagnosed me with diverticulitis. They gave me IV with saline solution and also antibiotics. I went back for the rest of the week for IV infusion. They gave me an oral antibiotics to take as well. They prescribed with clindamycin which I started taking on 01/21/2023 for 10 days. They also told me to take probiotics over the counter.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: PATIENT RECEIVED PFIZER MONOVALENT VACCINE INSTEAD OF PFIZER BIVALENT VACCINE BOOSTER
Age: 73.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Acute kidney injury, Acute respiratory failure, Autopsy, Bacterial test negative, Blood gases abnormal
Clinical narrative: Discharge Provider:  Primary Care Physician at Discharge:  MD  Admission Date: 1/13/2023  PRESENTING PROBLEM: Lung abnormality [J98.4] Acute on chronic respiratory failure [J96.20]   HOSPITAL COURSE: Patient was a 73 y.o. male who is s/p bilateral lung transplant 7/25/18 for IPF, complicated by MDS with pancytopenia, systolic and diastolic heart failure (currently compensated), CAD s/p CABG, then stent (7/2022), atrial flutter. He had COVID-19 infection 12/2022 which was not treated. He presented on 1/13/2023 with worsening respiratory symptoms (dyspnea, cough, wheezing, increased work of breathing, mild desaturation and 1 L drop in home spirometry), CT showing bilateral nodular pulmonary infiltrates. He underwent bronchoscopy 1/13/22 and was admitted to the lung transplant service for IV antibiotics and ID consultation.    During bronchoscopy he had bloody secretions on initial bronch, hemoptysis and worsening infiltrates post bronchoscopy. Bronchoscopy with negative bacterial cutlures, empiric abx stopped 1/17.  CXR worsening,  ECHO obtained and EF down to 30%, previously 60%,  with basal to mid anterolateral and apical segments severely hypokinetic, moderate MR. BNP over 37,000. Heart failure team were consulted. 1/18 RHC with Swan placement demonstrated biventricular failure- lasix and Milrinone gtt started per AHF team. 1/21 CT thorax with worsening perihilar infiltrates. Course further complicated by worsening AKI for which nephrology was consulted.  Underwent RHC 1/30 on milrinone 0.1, with low filling pressures and normal CO.  Milrinone was weaned off.     He had worsening respiratory failure 2/1 and didn't tolerate attempts at BiPAP even with Precedex gtt.  He had worsening mental status with ABG showing only hypoxemia.  CT head without new acute abnormality. Ct thorax showed extensive bilateral ground-glass opacities, worse from prior study.  GOC discussion with wife, daughter, and son at bedside with concern for need for intubation.  They decided to transition to comfort care.  At 1745, he passed away   Per Lung Transplant team request, a limited chest autopsy was requested.  Family consented.   Date of Death: 2/2/23 Time of Death:  5:45 PM Preliminary Cause of Death: Acute respiratory failure
Age: 73.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Brain natriuretic peptide increased, Bronchoscopy abnormal, COVID-19, Cardiac failure congestive, Catheterisation cardiac
Clinical narrative: Discharge Provider:  Primary Care Physician at Discharge:  MD  Admission Date: 1/13/2023  PRESENTING PROBLEM: Lung abnormality [J98.4] Acute on chronic respiratory failure [J96.20]   HOSPITAL COURSE: Patient was a 73 y.o. male who is s/p bilateral lung transplant 7/25/18 for IPF, complicated by MDS with pancytopenia, systolic and diastolic heart failure (currently compensated), CAD s/p CABG, then stent (7/2022), atrial flutter. He had COVID-19 infection 12/2022 which was not treated. He presented on 1/13/2023 with worsening respiratory symptoms (dyspnea, cough, wheezing, increased work of breathing, mild desaturation and 1 L drop in home spirometry), CT showing bilateral nodular pulmonary infiltrates. He underwent bronchoscopy 1/13/22 and was admitted to the lung transplant service for IV antibiotics and ID consultation.    During bronchoscopy he had bloody secretions on initial bronch, hemoptysis and worsening infiltrates post bronchoscopy. Bronchoscopy with negative bacterial cutlures, empiric abx stopped 1/17.  CXR worsening,  ECHO obtained and EF down to 30%, previously 60%,  with basal to mid anterolateral and apical segments severely hypokinetic, moderate MR. BNP over 37,000. Heart failure team were consulted. 1/18 RHC with Swan placement demonstrated biventricular failure- lasix and Milrinone gtt started per AHF team. 1/21 CT thorax with worsening perihilar infiltrates. Course further complicated by worsening AKI for which nephrology was consulted.  Underwent RHC 1/30 on milrinone 0.1, with low filling pressures and normal CO.  Milrinone was weaned off.     He had worsening respiratory failure 2/1 and didn't tolerate attempts at BiPAP even with Precedex gtt.  He had worsening mental status with ABG showing only hypoxemia.  CT head without new acute abnormality. Ct thorax showed extensive bilateral ground-glass opacities, worse from prior study.  GOC discussion with wife, daughter, and son at bedside with concern for need for intubation.  They decided to transition to comfort care.  At 1745, he passed away   Per Lung Transplant team request, a limited chest autopsy was requested.  Family consented.   Date of Death: 2/2/23 Time of Death:  5:45 PM Preliminary Cause of Death: Acute respiratory failure
Age: 73.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Chest X-ray abnormal, Computerised tomogram head abnormal, Computerised tomogram thorax abnormal, Cough, Death
Clinical narrative: Discharge Provider:  Primary Care Physician at Discharge:  MD  Admission Date: 1/13/2023  PRESENTING PROBLEM: Lung abnormality [J98.4] Acute on chronic respiratory failure [J96.20]   HOSPITAL COURSE: Patient was a 73 y.o. male who is s/p bilateral lung transplant 7/25/18 for IPF, complicated by MDS with pancytopenia, systolic and diastolic heart failure (currently compensated), CAD s/p CABG, then stent (7/2022), atrial flutter. He had COVID-19 infection 12/2022 which was not treated. He presented on 1/13/2023 with worsening respiratory symptoms (dyspnea, cough, wheezing, increased work of breathing, mild desaturation and 1 L drop in home spirometry), CT showing bilateral nodular pulmonary infiltrates. He underwent bronchoscopy 1/13/22 and was admitted to the lung transplant service for IV antibiotics and ID consultation.    During bronchoscopy he had bloody secretions on initial bronch, hemoptysis and worsening infiltrates post bronchoscopy. Bronchoscopy with negative bacterial cutlures, empiric abx stopped 1/17.  CXR worsening,  ECHO obtained and EF down to 30%, previously 60%,  with basal to mid anterolateral and apical segments severely hypokinetic, moderate MR. BNP over 37,000. Heart failure team were consulted. 1/18 RHC with Swan placement demonstrated biventricular failure- lasix and Milrinone gtt started per AHF team. 1/21 CT thorax with worsening perihilar infiltrates. Course further complicated by worsening AKI for which nephrology was consulted.  Underwent RHC 1/30 on milrinone 0.1, with low filling pressures and normal CO.  Milrinone was weaned off.     He had worsening respiratory failure 2/1 and didn't tolerate attempts at BiPAP even with Precedex gtt.  He had worsening mental status with ABG showing only hypoxemia.  CT head without new acute abnormality. Ct thorax showed extensive bilateral ground-glass opacities, worse from prior study.  GOC discussion with wife, daughter, and son at bedside with concern for need for intubation.  They decided to transition to comfort care.  At 1745, he passed away   Per Lung Transplant team request, a limited chest autopsy was requested.  Family consented.   Date of Death: 2/2/23 Time of Death:  5:45 PM Preliminary Cause of Death: Acute respiratory failure
Age: 73.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Haemoptysis, Hypokinesia
Clinical narrative: Discharge Provider:  Primary Care Physician at Discharge:  MD  Admission Date: 1/13/2023  PRESENTING PROBLEM: Lung abnormality [J98.4] Acute on chronic respiratory failure [J96.20]   HOSPITAL COURSE: Patient was a 73 y.o. male who is s/p bilateral lung transplant 7/25/18 for IPF, complicated by MDS with pancytopenia, systolic and diastolic heart failure (currently compensated), CAD s/p CABG, then stent (7/2022), atrial flutter. He had COVID-19 infection 12/2022 which was not treated. He presented on 1/13/2023 with worsening respiratory symptoms (dyspnea, cough, wheezing, increased work of breathing, mild desaturation and 1 L drop in home spirometry), CT showing bilateral nodular pulmonary infiltrates. He underwent bronchoscopy 1/13/22 and was admitted to the lung transplant service for IV antibiotics and ID consultation.    During bronchoscopy he had bloody secretions on initial bronch, hemoptysis and worsening infiltrates post bronchoscopy. Bronchoscopy with negative bacterial cutlures, empiric abx stopped 1/17.  CXR worsening,  ECHO obtained and EF down to 30%, previously 60%,  with basal to mid anterolateral and apical segments severely hypokinetic, moderate MR. BNP over 37,000. Heart failure team were consulted. 1/18 RHC with Swan placement demonstrated biventricular failure- lasix and Milrinone gtt started per AHF team. 1/21 CT thorax with worsening perihilar infiltrates. Course further complicated by worsening AKI for which nephrology was consulted.  Underwent RHC 1/30 on milrinone 0.1, with low filling pressures and normal CO.  Milrinone was weaned off.     He had worsening respiratory failure 2/1 and didn't tolerate attempts at BiPAP even with Precedex gtt.  He had worsening mental status with ABG showing only hypoxemia.  CT head without new acute abnormality. Ct thorax showed extensive bilateral ground-glass opacities, worse from prior study.  GOC discussion with wife, daughter, and son at bedside with concern for need for intubation.  They decided to transition to comfort care.  At 1745, he passed away   Per Lung Transplant team request, a limited chest autopsy was requested.  Family consented.   Date of Death: 2/2/23 Time of Death:  5:45 PM Preliminary Cause of Death: Acute respiratory failure
Age: 73.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Hypoxia, Lung disorder, Lung infiltration, Lung opacity, Mental status changes
Clinical narrative: Discharge Provider:  Primary Care Physician at Discharge:  MD  Admission Date: 1/13/2023  PRESENTING PROBLEM: Lung abnormality [J98.4] Acute on chronic respiratory failure [J96.20]   HOSPITAL COURSE: Patient was a 73 y.o. male who is s/p bilateral lung transplant 7/25/18 for IPF, complicated by MDS with pancytopenia, systolic and diastolic heart failure (currently compensated), CAD s/p CABG, then stent (7/2022), atrial flutter. He had COVID-19 infection 12/2022 which was not treated. He presented on 1/13/2023 with worsening respiratory symptoms (dyspnea, cough, wheezing, increased work of breathing, mild desaturation and 1 L drop in home spirometry), CT showing bilateral nodular pulmonary infiltrates. He underwent bronchoscopy 1/13/22 and was admitted to the lung transplant service for IV antibiotics and ID consultation.    During bronchoscopy he had bloody secretions on initial bronch, hemoptysis and worsening infiltrates post bronchoscopy. Bronchoscopy with negative bacterial cutlures, empiric abx stopped 1/17.  CXR worsening,  ECHO obtained and EF down to 30%, previously 60%,  with basal to mid anterolateral and apical segments severely hypokinetic, moderate MR. BNP over 37,000. Heart failure team were consulted. 1/18 RHC with Swan placement demonstrated biventricular failure- lasix and Milrinone gtt started per AHF team. 1/21 CT thorax with worsening perihilar infiltrates. Course further complicated by worsening AKI for which nephrology was consulted.  Underwent RHC 1/30 on milrinone 0.1, with low filling pressures and normal CO.  Milrinone was weaned off.     He had worsening respiratory failure 2/1 and didn't tolerate attempts at BiPAP even with Precedex gtt.  He had worsening mental status with ABG showing only hypoxemia.  CT head without new acute abnormality. Ct thorax showed extensive bilateral ground-glass opacities, worse from prior study.  GOC discussion with wife, daughter, and son at bedside with concern for need for intubation.  They decided to transition to comfort care.  At 1745, he passed away   Per Lung Transplant team request, a limited chest autopsy was requested.  Family consented.   Date of Death: 2/2/23 Time of Death:  5:45 PM Preliminary Cause of Death: Acute respiratory failure
Age: 73.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Mitral valve incompetence, Oxygen saturation decreased, Pulmonary mass, Respiratory failure, Respiratory symptom
Clinical narrative: Discharge Provider:  Primary Care Physician at Discharge:  MD  Admission Date: 1/13/2023  PRESENTING PROBLEM: Lung abnormality [J98.4] Acute on chronic respiratory failure [J96.20]   HOSPITAL COURSE: Patient was a 73 y.o. male who is s/p bilateral lung transplant 7/25/18 for IPF, complicated by MDS with pancytopenia, systolic and diastolic heart failure (currently compensated), CAD s/p CABG, then stent (7/2022), atrial flutter. He had COVID-19 infection 12/2022 which was not treated. He presented on 1/13/2023 with worsening respiratory symptoms (dyspnea, cough, wheezing, increased work of breathing, mild desaturation and 1 L drop in home spirometry), CT showing bilateral nodular pulmonary infiltrates. He underwent bronchoscopy 1/13/22 and was admitted to the lung transplant service for IV antibiotics and ID consultation.    During bronchoscopy he had bloody secretions on initial bronch, hemoptysis and worsening infiltrates post bronchoscopy. Bronchoscopy with negative bacterial cutlures, empiric abx stopped 1/17.  CXR worsening,  ECHO obtained and EF down to 30%, previously 60%,  with basal to mid anterolateral and apical segments severely hypokinetic, moderate MR. BNP over 37,000. Heart failure team were consulted. 1/18 RHC with Swan placement demonstrated biventricular failure- lasix and Milrinone gtt started per AHF team. 1/21 CT thorax with worsening perihilar infiltrates. Course further complicated by worsening AKI for which nephrology was consulted.  Underwent RHC 1/30 on milrinone 0.1, with low filling pressures and normal CO.  Milrinone was weaned off.     He had worsening respiratory failure 2/1 and didn't tolerate attempts at BiPAP even with Precedex gtt.  He had worsening mental status with ABG showing only hypoxemia.  CT head without new acute abnormality. Ct thorax showed extensive bilateral ground-glass opacities, worse from prior study.  GOC discussion with wife, daughter, and son at bedside with concern for need for intubation.  They decided to transition to comfort care.  At 1745, he passed away   Per Lung Transplant team request, a limited chest autopsy was requested.  Family consented.   Date of Death: 2/2/23 Time of Death:  5:45 PM Preliminary Cause of Death: Acute respiratory failure
Age: 73.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Spirometry, Swan ganz catheter placement, Wheezing
Clinical narrative: Discharge Provider:  Primary Care Physician at Discharge:  MD  Admission Date: 1/13/2023  PRESENTING PROBLEM: Lung abnormality [J98.4] Acute on chronic respiratory failure [J96.20]   HOSPITAL COURSE: Patient was a 73 y.o. male who is s/p bilateral lung transplant 7/25/18 for IPF, complicated by MDS with pancytopenia, systolic and diastolic heart failure (currently compensated), CAD s/p CABG, then stent (7/2022), atrial flutter. He had COVID-19 infection 12/2022 which was not treated. He presented on 1/13/2023 with worsening respiratory symptoms (dyspnea, cough, wheezing, increased work of breathing, mild desaturation and 1 L drop in home spirometry), CT showing bilateral nodular pulmonary infiltrates. He underwent bronchoscopy 1/13/22 and was admitted to the lung transplant service for IV antibiotics and ID consultation.    During bronchoscopy he had bloody secretions on initial bronch, hemoptysis and worsening infiltrates post bronchoscopy. Bronchoscopy with negative bacterial cutlures, empiric abx stopped 1/17.  CXR worsening,  ECHO obtained and EF down to 30%, previously 60%,  with basal to mid anterolateral and apical segments severely hypokinetic, moderate MR. BNP over 37,000. Heart failure team were consulted. 1/18 RHC with Swan placement demonstrated biventricular failure- lasix and Milrinone gtt started per AHF team. 1/21 CT thorax with worsening perihilar infiltrates. Course further complicated by worsening AKI for which nephrology was consulted.  Underwent RHC 1/30 on milrinone 0.1, with low filling pressures and normal CO.  Milrinone was weaned off.     He had worsening respiratory failure 2/1 and didn't tolerate attempts at BiPAP even with Precedex gtt.  He had worsening mental status with ABG showing only hypoxemia.  CT head without new acute abnormality. Ct thorax showed extensive bilateral ground-glass opacities, worse from prior study.  GOC discussion with wife, daughter, and son at bedside with concern for need for intubation.  They decided to transition to comfort care.  At 1745, he passed away   Per Lung Transplant team request, a limited chest autopsy was requested.  Family consented.   Date of Death: 2/2/23 Time of Death:  5:45 PM Preliminary Cause of Death: Acute respiratory failure
Age: 1.0
Sex: M
Vaccine: HEPA, MMR, VARCEL
Symptoms: Pruritus, Rash
Clinical narrative: Rash to torso with itching
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: PATIENT RECEIVED PFIZER MONOVALENT VACCINE INSTEAD OF PFIZER BIVALENT VACCINE BOOSTER
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Fatigue, Headache, Nasal congestion
Clinical narrative: I experienced a breakthrough case of COVID-19 with fever, sore throat, headache, nasal congestion, runny nose, cough, and fatigue.
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: I experienced a breakthrough case of COVID-19 with fever, sore throat, headache, nasal congestion, runny nose, cough, and fatigue.
Age: 60.0
Sex: M
Vaccine: COVID19-2, VARZOS
Symptoms: Extra dose administered
Clinical narrative: The patient presented to a vaccination clinic at the local Human services building hosted by local Pharmacy. The aid that was responsible for the patient indicated that the patient was to get a SHINGRIX vaccine. Upon billing to the patient's insurance, the claim rejected saying that 2 doses were already received previously. Upon follow-up with the Nurse Manager, she confirmed that the patient did already receive 2 doses of SHINGRIX and the aid was incorrect to request the 3rd dose. There was no history of SHINGRIX vaccines found in the local data tracking system.
Age: 3.0
Sex: F
Vaccine: COVID19
Symptoms: Antibody test, Blood glucose increased, Blood test abnormal, Glucose urine present, Glycosylated haemoglobin increased
Clinical narrative: 2 months ago we noticed that she was urinating frequently and asking for water a lot. We also noticed that she was dribbling and thought she had a UTI and took her to her primary doctor. The doctor found glucose in her urine and her blood sugar was 472. She was admitted to the hospital on January 30, 2023 and discharged on Tuesday. They provided insulin and prescribed HUMALOG and LANTUS. She was diagnosed with Type 1 diabetes which is a chronic illness. Her symptoms have not improved.
Age: 3.0
Sex: F
Vaccine: COVID19
Symptoms: Pollakiuria, Thirst, Type 1 diabetes mellitus, Urinary incontinence, Urine analysis abnormal
Clinical narrative: 2 months ago we noticed that she was urinating frequently and asking for water a lot. We also noticed that she was dribbling and thought she had a UTI and took her to her primary doctor. The doctor found glucose in her urine and her blood sugar was 472. She was admitted to the hospital on January 30, 2023 and discharged on Tuesday. They provided insulin and prescribed HUMALOG and LANTUS. She was diagnosed with Type 1 diabetes which is a chronic illness. Her symptoms have not improved.
Age: 1.0
Sex: M
Vaccine: VARCEL
Symptoms: Pyrexia, Rash, Rash erythematous
Clinical narrative: The child had a low grade fever of about 100 during the first 24 hours. Following the fever the child had a small red rash (no lesions) on his back.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: PATIENT RECEIVED PFIZER MONOVALENT VACCINE INSTEAD OF PFIZER BIVALENT VACCINE BOOSTER
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chills, Dysphagia, Headache, Malaise
Clinical narrative: I had some chills and low-grade fever for one day after receiving the vaccine. I began not feeling well on 11/24/2022 with a headache and just didn't feel good. I thought I was coming down with a cold. My symptoms got worse, and I went to the emergency room. I had difficulty swallowing and I had a high fever. I tested positive COVID-19 on 11/26/2022. I got a prescription for PAXLOVID and a pain medication. I tolerated PAXLOVID.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I had some chills and low-grade fever for one day after receiving the vaccine. I began not feeling well on 11/24/2022 with a headache and just didn't feel good. I thought I was coming down with a cold. My symptoms got worse, and I went to the emergency room. I had difficulty swallowing and I had a high fever. I tested positive COVID-19 on 11/26/2022. I got a prescription for PAXLOVID and a pain medication. I tolerated PAXLOVID.
Age: 4.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Was due for dose number 3 of Pfizer series for 6mo-4yr. Dose should have been bivalent and was given a monovalent.
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: PATIENT RECEIVED PFIZER MONOVALENT VACCINE INSTEAD OF PFIZER BIVALENT VACCINE BOOSTER
Age: 80.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Patient immunization registry did not reflect Moderna bivalent vaccine that was administered by pharmacy on 9/19/22.  Patient did not have COVID card.  Bivalent and education provided to patient.  Patient's spouse went to pharmacy to receive her bivalent vaccine and was told she was not eligible as it was noted in her immunization registry.  Pharmacy pulled patient's immunization registry and updated administration of vaccine given on 9/19/22.
Age: 6.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Patient was given a fourth dose of Pfizer on 07/30/2022, which was 28 days after a dose was administered on 07/02/22
Age: 62.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Discomfort, Dyspnoea, Paranasal sinus discomfort
Clinical narrative: My first symptom was a sinus infection, a pressure on my nasal and cheek. Started on Dec 16, on Dec 17th I tested positive with a home COVID-19 test. On Monday I had a call with my doctor and prescribed medication to start taking, I took the medication, my symptoms start to get better, but by the first of the year, I was coughing, kind of felt like bronchitis & breathing problems. On January I scheduled a visit about my breathing and coughing. He prescribed more medication and antibiotics. After the 2nd round of medication, I was feeling normal, but a couple of times a week I do inhaler to help with my breathing, up to this point. I never had a fever above 99.5. The first time I did not take all the medication (PAXLOVID) because when I was reading the description it had a problem with my other medications. I had other home COVID-19 tests.
Age: 62.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pyrexia, SARS-CoV-2 test positive, Sinusitis
Clinical narrative: My first symptom was a sinus infection, a pressure on my nasal and cheek. Started on Dec 16, on Dec 17th I tested positive with a home COVID-19 test. On Monday I had a call with my doctor and prescribed medication to start taking, I took the medication, my symptoms start to get better, but by the first of the year, I was coughing, kind of felt like bronchitis & breathing problems. On January I scheduled a visit about my breathing and coughing. He prescribed more medication and antibiotics. After the 2nd round of medication, I was feeling normal, but a couple of times a week I do inhaler to help with my breathing, up to this point. I never had a fever above 99.5. The first time I did not take all the medication (PAXLOVID) because when I was reading the description it had a problem with my other medications. I had other home COVID-19 tests.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Chills, Cough, Decreased appetite, Ear pain
Clinical narrative: On 1/8/2023, it was very late at night, my hands were shaking very bad, I could not take a test. I had chills, no appetite, sore throat, earache, sinus pressure filled with mucus. I had a terrible headache and a lot of nausea, body aches, and a lingering and painful cough. I tested positive on the next day. I was sleeping in the extra bedroom, my left foot was having severe pain, I could not walk for 4 days. I would take ADVIL to relieve the pain. It was really extreme. I called my doctor and got prescribed PAXLOVID and promethazine. I also had a fever.  My sense of smell was great, I still cough in the morning with congestion. I don't need to take my cough medicine until I go to bed.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: Gait inability, Headache, Nausea, Oropharyngeal pain, Pain
Clinical narrative: On 1/8/2023, it was very late at night, my hands were shaking very bad, I could not take a test. I had chills, no appetite, sore throat, earache, sinus pressure filled with mucus. I had a terrible headache and a lot of nausea, body aches, and a lingering and painful cough. I tested positive on the next day. I was sleeping in the extra bedroom, my left foot was having severe pain, I could not walk for 4 days. I would take ADVIL to relieve the pain. It was really extreme. I called my doctor and got prescribed PAXLOVID and promethazine. I also had a fever.  My sense of smell was great, I still cough in the morning with congestion. I don't need to take my cough medicine until I go to bed.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pain in extremity, Paranasal sinus discomfort, Pyrexia, Respiratory tract congestion, Rhinorrhoea
Clinical narrative: On 1/8/2023, it was very late at night, my hands were shaking very bad, I could not take a test. I had chills, no appetite, sore throat, earache, sinus pressure filled with mucus. I had a terrible headache and a lot of nausea, body aches, and a lingering and painful cough. I tested positive on the next day. I was sleeping in the extra bedroom, my left foot was having severe pain, I could not walk for 4 days. I would take ADVIL to relieve the pain. It was really extreme. I called my doctor and got prescribed PAXLOVID and promethazine. I also had a fever.  My sense of smell was great, I still cough in the morning with congestion. I don't need to take my cough medicine until I go to bed.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Tremor
Clinical narrative: On 1/8/2023, it was very late at night, my hands were shaking very bad, I could not take a test. I had chills, no appetite, sore throat, earache, sinus pressure filled with mucus. I had a terrible headache and a lot of nausea, body aches, and a lingering and painful cough. I tested positive on the next day. I was sleeping in the extra bedroom, my left foot was having severe pain, I could not walk for 4 days. I would take ADVIL to relieve the pain. It was really extreme. I called my doctor and got prescribed PAXLOVID and promethazine. I also had a fever.  My sense of smell was great, I still cough in the morning with congestion. I don't need to take my cough medicine until I go to bed.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: PATIENT RECEIVED PFIZER MONOVALENT VACCINE INSTEAD OF PFIZER BIVALENT VACCINE BOOSTER
Age: 11.0
Sex: F
Vaccine: MENB
Symptoms: No adverse event, Wrong product administered
Clinical narrative: no adverse reaction, vaccine ordered, and vaccine given have the same generic name Bexsero, education given to staff and immunization schedule reviewed.
Age: 40.0
Sex: M
Vaccine: HEP
Symptoms: No adverse event, Underdose
Clinical narrative: Gave Hep-B pediatrics dose instead of Hep-B adult. 1/6/2023 at 11:35am Called patient back to let him know and never received a call back regarding the immunization.  No reaction from the patient.
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMR
Symptoms: Erythema
Clinical narrative: large red area without induration. Advised benadryl and monitoring