chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Malaise, Pain, Physical deconditioning, Pneumonia viral, Pollakiuria
Clinical narrative: Pfizer Dose 1 3/19/21 (EN6208) Pfizer Dose 2 4/21/21 (ER8731) COVID Positive 12/27/21  12/27/21: The patient is an 88-year-old male past medical history significant for generalize osteoarthritis, essential hypertension, lumbar radiculopathy, obesity, spinal stenosis.   Patient Presented urinary frequency and incontinence of 1 week duration  Patient endorses that since 1 week back started to have urinary frequency with wetting himself.  He also felt generalized weakness and not feeling well.  Patient also has associated nonproductive cough with loss of taste and decreased appetite as well as generalized body aches.  Patient has had generalized osteoarthritis with lumbar radiculopathy taking medications.  In the emergency room patient was noted to be hypoxic on room air of 85% and required oxygen supplementation 4 LPM to have acceptable saturation.  Patient also noted to have atrial fibrillation hypokalemia of 2.5, elevated blood glucose of 160, lactic acidosis 2.6 with elevated proBNP of 27 31.  CBC showed lymphopenia and D-dimer was elevated 0.6 to; rapid COVID antigen test was positive.  CT angio of the chest did not show any pulmonary embolism but shows ground-glass infiltrate on both lung consistent with viral pneumonitis as well as cardiomegaly  1/17/22: Patient is an 88-year-old male with prolonged hospitalization for COVID requiring intubation.  He was extubated on 01/07/2022.  He is severely deconditioned and undergoing PT/OT.  On 3 L nasal cannula.  During his hospitalization patient also developed retroperitoneal hematoma with hemorrhagic shock.  All the anticoagulation has been stopped due to that.  Patient is saturating well on 2-3 L of nasal cannula oxygen and his breathing is much better.  During his hospitalization patient's Lantus was discontinued as he was developing episodes of hypoglycemia overnight.  It should be noted that the patient's insulin demand should be adjusted to the patient's needs once he arrives at skilled nursing facility.  Patient was discharged from the hospital on 01/17/2022 in a stable medical condition.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Prohormone brain natriuretic peptide increased, Retroperitoneal haematoma, SARS-CoV-2 test positive, Shock haemorrhagic, Urinary incontinence
Clinical narrative: Pfizer Dose 1 3/19/21 (EN6208) Pfizer Dose 2 4/21/21 (ER8731) COVID Positive 12/27/21  12/27/21: The patient is an 88-year-old male past medical history significant for generalize osteoarthritis, essential hypertension, lumbar radiculopathy, obesity, spinal stenosis.   Patient Presented urinary frequency and incontinence of 1 week duration  Patient endorses that since 1 week back started to have urinary frequency with wetting himself.  He also felt generalized weakness and not feeling well.  Patient also has associated nonproductive cough with loss of taste and decreased appetite as well as generalized body aches.  Patient has had generalized osteoarthritis with lumbar radiculopathy taking medications.  In the emergency room patient was noted to be hypoxic on room air of 85% and required oxygen supplementation 4 LPM to have acceptable saturation.  Patient also noted to have atrial fibrillation hypokalemia of 2.5, elevated blood glucose of 160, lactic acidosis 2.6 with elevated proBNP of 27 31.  CBC showed lymphopenia and D-dimer was elevated 0.6 to; rapid COVID antigen test was positive.  CT angio of the chest did not show any pulmonary embolism but shows ground-glass infiltrate on both lung consistent with viral pneumonitis as well as cardiomegaly  1/17/22: Patient is an 88-year-old male with prolonged hospitalization for COVID requiring intubation.  He was extubated on 01/07/2022.  He is severely deconditioned and undergoing PT/OT.  On 3 L nasal cannula.  During his hospitalization patient also developed retroperitoneal hematoma with hemorrhagic shock.  All the anticoagulation has been stopped due to that.  Patient is saturating well on 2-3 L of nasal cannula oxygen and his breathing is much better.  During his hospitalization patient's Lantus was discontinued as he was developing episodes of hypoglycemia overnight.  It should be noted that the patient's insulin demand should be adjusted to the patient's needs once he arrives at skilled nursing facility.  Patient was discharged from the hospital on 01/17/2022 in a stable medical condition.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Inappropriate schedule of product administration, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case admission after third vaccine Pfizer 3/18/21 Lot# En6202 Pfizer 10/28/21 Lot# 30155BA Pfizer 6/10/22 Lot# FM9992
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Cough, Headache, Infection, Polymerase chain reaction
Clinical narrative: Breakthrough infection began with mild cough led by fever, chills, headache and congestion.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Respiratory tract congestion
Clinical narrative: Breakthrough infection began with mild cough led by fever, chills, headache and congestion.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatinine increased, Blood pressure increased, Blood urea increased, COVID-19, Chest X-ray normal
Clinical narrative: Moderna Dose 1 5/26/21 (lot NA) Moderna Dose 2 6/23/21 (lot NA) COVID Positive 1/25/22  1/25/22: Patient is a 57 year old who presented to ED with complaints of elevated blood pressure. The patient reports chest discomfort and dry cough for the past several days.  He was seen at urgent care with a blood pressure reading of 240/140.  He was referred to the emergency department for further evaluation and treatment. He endorses complaisance with B/P medications. Has seen a nephrologist in the past but doesn't accurately recall why. He denies any recent fevers.  No nausea, vomiting or diarrhea.  He has been fully vaccinated against COVID-19, has not received booster.  He is unsure when he has followed up with the Veteran's Administration last.  He does state that he follows with two Drs. regularly. He has a past medical history significant for hypertension, CKD, type 2 diabetes mellitus with diabetic nephropathy, PVD, CAD s/p PCI, former tobacco use, right lower lobe nodule (followed by Dr.) and right transmetatarsal amputation.   On arrival to ED the patient was hypertensive 240/132.  He received hydralazine 10 mg IV x1 dose, patient's repeat blood pressure 181/90.  Patient's laboratory findings were significant for CKD stage G5 BUN 44 and creatinine 5.39. It appears per chart review back in 2020 the patient's baseline creatinine was around 2.6.  Troponin 0.04. D-dimer 0.80.  Chest x-ray unremarkable.  2/3/22: 57-year-old man who presented to emergency department from urgent care on account of markedly elevated blood pressures.  He had presented to urgent care with symptoms of sinus pressure, cough and shortness of breath and was found to have a blood pressure of 240/140.  He will to the emergency department where labs remarkable for abnormal renal function with creatinine of 5.29, COVID-19 PCR was also positive.  Was admitted to the hospitalist Service, started on oral anti hypertensives and bicarb drip.  Nephrology was consulted, despite IV fluid hydration and serial monitoring of renal function worsening renal function was noted with evidence of progressing renal disease.  He has been started on hemodialysis per Nephrology, apart from an occasional coffee as remains minimally symptomatic for COVID-19 infection.  Having obtained an outpatient hemodialysis chair he has been discharged in stable medical condition to continue outpatient follow-up.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Chest discomfort, Cough, Dyspnoea, End stage renal disease, Fibrin D dimer
Clinical narrative: Moderna Dose 1 5/26/21 (lot NA) Moderna Dose 2 6/23/21 (lot NA) COVID Positive 1/25/22  1/25/22: Patient is a 57 year old who presented to ED with complaints of elevated blood pressure. The patient reports chest discomfort and dry cough for the past several days.  He was seen at urgent care with a blood pressure reading of 240/140.  He was referred to the emergency department for further evaluation and treatment. He endorses complaisance with B/P medications. Has seen a nephrologist in the past but doesn't accurately recall why. He denies any recent fevers.  No nausea, vomiting or diarrhea.  He has been fully vaccinated against COVID-19, has not received booster.  He is unsure when he has followed up with the Veteran's Administration last.  He does state that he follows with two Drs. regularly. He has a past medical history significant for hypertension, CKD, type 2 diabetes mellitus with diabetic nephropathy, PVD, CAD s/p PCI, former tobacco use, right lower lobe nodule (followed by Dr.) and right transmetatarsal amputation.   On arrival to ED the patient was hypertensive 240/132.  He received hydralazine 10 mg IV x1 dose, patient's repeat blood pressure 181/90.  Patient's laboratory findings were significant for CKD stage G5 BUN 44 and creatinine 5.39. It appears per chart review back in 2020 the patient's baseline creatinine was around 2.6.  Troponin 0.04. D-dimer 0.80.  Chest x-ray unremarkable.  2/3/22: 57-year-old man who presented to emergency department from urgent care on account of markedly elevated blood pressures.  He had presented to urgent care with symptoms of sinus pressure, cough and shortness of breath and was found to have a blood pressure of 240/140.  He will to the emergency department where labs remarkable for abnormal renal function with creatinine of 5.29, COVID-19 PCR was also positive.  Was admitted to the hospitalist Service, started on oral anti hypertensives and bicarb drip.  Nephrology was consulted, despite IV fluid hydration and serial monitoring of renal function worsening renal function was noted with evidence of progressing renal disease.  He has been started on hemodialysis per Nephrology, apart from an occasional coffee as remains minimally symptomatic for COVID-19 infection.  Having obtained an outpatient hemodialysis chair he has been discharged in stable medical condition to continue outpatient follow-up.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Haemodialysis, Hypertension, Paranasal sinus discomfort, Renal impairment, SARS-CoV-2 test positive
Clinical narrative: Moderna Dose 1 5/26/21 (lot NA) Moderna Dose 2 6/23/21 (lot NA) COVID Positive 1/25/22  1/25/22: Patient is a 57 year old who presented to ED with complaints of elevated blood pressure. The patient reports chest discomfort and dry cough for the past several days.  He was seen at urgent care with a blood pressure reading of 240/140.  He was referred to the emergency department for further evaluation and treatment. He endorses complaisance with B/P medications. Has seen a nephrologist in the past but doesn't accurately recall why. He denies any recent fevers.  No nausea, vomiting or diarrhea.  He has been fully vaccinated against COVID-19, has not received booster.  He is unsure when he has followed up with the Veteran's Administration last.  He does state that he follows with two Drs. regularly. He has a past medical history significant for hypertension, CKD, type 2 diabetes mellitus with diabetic nephropathy, PVD, CAD s/p PCI, former tobacco use, right lower lobe nodule (followed by Dr.) and right transmetatarsal amputation.   On arrival to ED the patient was hypertensive 240/132.  He received hydralazine 10 mg IV x1 dose, patient's repeat blood pressure 181/90.  Patient's laboratory findings were significant for CKD stage G5 BUN 44 and creatinine 5.39. It appears per chart review back in 2020 the patient's baseline creatinine was around 2.6.  Troponin 0.04. D-dimer 0.80.  Chest x-ray unremarkable.  2/3/22: 57-year-old man who presented to emergency department from urgent care on account of markedly elevated blood pressures.  He had presented to urgent care with symptoms of sinus pressure, cough and shortness of breath and was found to have a blood pressure of 240/140.  He will to the emergency department where labs remarkable for abnormal renal function with creatinine of 5.29, COVID-19 PCR was also positive.  Was admitted to the hospitalist Service, started on oral anti hypertensives and bicarb drip.  Nephrology was consulted, despite IV fluid hydration and serial monitoring of renal function worsening renal function was noted with evidence of progressing renal disease.  He has been started on hemodialysis per Nephrology, apart from an occasional coffee as remains minimally symptomatic for COVID-19 infection.  Having obtained an outpatient hemodialysis chair he has been discharged in stable medical condition to continue outpatient follow-up.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Troponin
Clinical narrative: Moderna Dose 1 5/26/21 (lot NA) Moderna Dose 2 6/23/21 (lot NA) COVID Positive 1/25/22  1/25/22: Patient is a 57 year old who presented to ED with complaints of elevated blood pressure. The patient reports chest discomfort and dry cough for the past several days.  He was seen at urgent care with a blood pressure reading of 240/140.  He was referred to the emergency department for further evaluation and treatment. He endorses complaisance with B/P medications. Has seen a nephrologist in the past but doesn't accurately recall why. He denies any recent fevers.  No nausea, vomiting or diarrhea.  He has been fully vaccinated against COVID-19, has not received booster.  He is unsure when he has followed up with the Veteran's Administration last.  He does state that he follows with two Drs. regularly. He has a past medical history significant for hypertension, CKD, type 2 diabetes mellitus with diabetic nephropathy, PVD, CAD s/p PCI, former tobacco use, right lower lobe nodule (followed by Dr.) and right transmetatarsal amputation.   On arrival to ED the patient was hypertensive 240/132.  He received hydralazine 10 mg IV x1 dose, patient's repeat blood pressure 181/90.  Patient's laboratory findings were significant for CKD stage G5 BUN 44 and creatinine 5.39. It appears per chart review back in 2020 the patient's baseline creatinine was around 2.6.  Troponin 0.04. D-dimer 0.80.  Chest x-ray unremarkable.  2/3/22: 57-year-old man who presented to emergency department from urgent care on account of markedly elevated blood pressures.  He had presented to urgent care with symptoms of sinus pressure, cough and shortness of breath and was found to have a blood pressure of 240/140.  He will to the emergency department where labs remarkable for abnormal renal function with creatinine of 5.29, COVID-19 PCR was also positive.  Was admitted to the hospitalist Service, started on oral anti hypertensives and bicarb drip.  Nephrology was consulted, despite IV fluid hydration and serial monitoring of renal function worsening renal function was noted with evidence of progressing renal disease.  He has been started on hemodialysis per Nephrology, apart from an occasional coffee as remains minimally symptomatic for COVID-19 infection.  Having obtained an outpatient hemodialysis chair he has been discharged in stable medical condition to continue outpatient follow-up.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Computerised tomogram, Headache, Lumbar puncture, Magnetic resonance imaging
Clinical narrative: Headaches, optic nerve swelling unknown cause
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Papilloedema
Clinical narrative: Headaches, optic nerve swelling unknown cause
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cardiac function test, Chest pain, Erythema, Herpes zoster, Myocardial infarction
Clinical narrative: Diagnosed with Shingles on 3/14/2022 by Dr. .  She prescribed Acyclovir, 800 MG tablets, 5x a day for 10 days.  Don't know if it helped because I had 5 weeks of Shingles that was really bad.  Horrid large red sores that were very painful.  Nerve pain that would fire off even in the middle of the night.  Shingles also caused chest pain and heart attack systems.  Dr. number 2 sent me to ER.  Had multiple heart tests at a local medical center Hospital. COVID vaccination series on 2-12-2021, 3-12-2021, 10-27-2021.  Even had a second booster on 6/1/2022 (hope that was not a big mistake).
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Neuralgia, Pain
Clinical narrative: Diagnosed with Shingles on 3/14/2022 by Dr. .  She prescribed Acyclovir, 800 MG tablets, 5x a day for 10 days.  Don't know if it helped because I had 5 weeks of Shingles that was really bad.  Horrid large red sores that were very painful.  Nerve pain that would fire off even in the middle of the night.  Shingles also caused chest pain and heart attack systems.  Dr. number 2 sent me to ER.  Had multiple heart tests at a local medical center Hospital. COVID vaccination series on 2-12-2021, 3-12-2021, 10-27-2021.  Even had a second booster on 6/1/2022 (hope that was not a big mistake).
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: unknown pt called but unable to reach. Pt received the orange cap of the undiluted Covid vaccine 0.3ml
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Asymptomatic COVID-19, Atrial fibrillation, Back pain, Bladder catheterisation
Clinical narrative: Pfizer Dose 1 2/28/21 (EN6203 Pfizer Dose 2 3/22/21 (EN6208) Pfizer Dose 3 9/30/21 (ew0177) Covid Positive 1/20/2022  1/20/22: Patient is 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA   Presented to the ED with generalized weakness of 1 week duration.  Patient endorses the progressively started to feel generalized weakness to the extent not able to do her daily activities.  Patient also has associated feeling of "warms crawling under her skin"  Patient went to her PCP and dose of gabapentin was increased to 300 mg 3 times daily   Currently patient complains of severe neck and back pain scale 6-7/10  In the emergency room patient was found to have low sodium of 116, potassium of 1.9.  Urine sodium need be less than 20 and urine osmolality 168.  Nephrology consult was obtained by ED and recommended to give 3% of 50 cc normal saline and admitted to the floor  1/27/22: Pt is an 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA  Presented to the ED with generalized weakness of 1 week duration.  Patient was then admitted with severe hypotonic hyponatremia, severe hypokalemia, essential hypertension, chronic AFib, s/p ppm, history of OSA, history of chronic neck and back pain as well as advanced degenerative lumbar spine disease.  Nephrology consult was obtained in the ED and patient was given 5% normal saline in the ED; patient was then progressively monitor for sodium correction; serum sodium corrected appropriately.  Patient carvedilol was changed to metoprolol per Renal recommendations.  Patient had urinary retention and was required to be catheterized and failed voiding trial requiring indwelling catheter.  Patient found to be physically deconditioned and discharged to SNF we with the recommendation to follow with PCP, Cardiology as outpatient  FSA showed Zenker's Diverticulum.  Patient has been having difficulty swallowing for the past few months.  Patient wants to follow up with GI outpatient.  Continue soft diet.  Patient also had COVID-19 with no symptoms. Repeat COVID test has been negative
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Blood potassium decreased, Blood sodium decreased, Condition aggravated, Dysphagia, Essential hypertension
Clinical narrative: Pfizer Dose 1 2/28/21 (EN6203 Pfizer Dose 2 3/22/21 (EN6208) Pfizer Dose 3 9/30/21 (ew0177) Covid Positive 1/20/2022  1/20/22: Patient is 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA   Presented to the ED with generalized weakness of 1 week duration.  Patient endorses the progressively started to feel generalized weakness to the extent not able to do her daily activities.  Patient also has associated feeling of "warms crawling under her skin"  Patient went to her PCP and dose of gabapentin was increased to 300 mg 3 times daily   Currently patient complains of severe neck and back pain scale 6-7/10  In the emergency room patient was found to have low sodium of 116, potassium of 1.9.  Urine sodium need be less than 20 and urine osmolality 168.  Nephrology consult was obtained by ED and recommended to give 3% of 50 cc normal saline and admitted to the floor  1/27/22: Pt is an 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA  Presented to the ED with generalized weakness of 1 week duration.  Patient was then admitted with severe hypotonic hyponatremia, severe hypokalemia, essential hypertension, chronic AFib, s/p ppm, history of OSA, history of chronic neck and back pain as well as advanced degenerative lumbar spine disease.  Nephrology consult was obtained in the ED and patient was given 5% normal saline in the ED; patient was then progressively monitor for sodium correction; serum sodium corrected appropriately.  Patient carvedilol was changed to metoprolol per Renal recommendations.  Patient had urinary retention and was required to be catheterized and failed voiding trial requiring indwelling catheter.  Patient found to be physically deconditioned and discharged to SNF we with the recommendation to follow with PCP, Cardiology as outpatient  FSA showed Zenker's Diverticulum.  Patient has been having difficulty swallowing for the past few months.  Patient wants to follow up with GI outpatient.  Continue soft diet.  Patient also had COVID-19 with no symptoms. Repeat COVID test has been negative
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Formication, Hypokalaemia, Hyponatraemia, Hypotonia, Inappropriate schedule of product administration
Clinical narrative: Pfizer Dose 1 2/28/21 (EN6203 Pfizer Dose 2 3/22/21 (EN6208) Pfizer Dose 3 9/30/21 (ew0177) Covid Positive 1/20/2022  1/20/22: Patient is 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA   Presented to the ED with generalized weakness of 1 week duration.  Patient endorses the progressively started to feel generalized weakness to the extent not able to do her daily activities.  Patient also has associated feeling of "warms crawling under her skin"  Patient went to her PCP and dose of gabapentin was increased to 300 mg 3 times daily   Currently patient complains of severe neck and back pain scale 6-7/10  In the emergency room patient was found to have low sodium of 116, potassium of 1.9.  Urine sodium need be less than 20 and urine osmolality 168.  Nephrology consult was obtained by ED and recommended to give 3% of 50 cc normal saline and admitted to the floor  1/27/22: Pt is an 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA  Presented to the ED with generalized weakness of 1 week duration.  Patient was then admitted with severe hypotonic hyponatremia, severe hypokalemia, essential hypertension, chronic AFib, s/p ppm, history of OSA, history of chronic neck and back pain as well as advanced degenerative lumbar spine disease.  Nephrology consult was obtained in the ED and patient was given 5% normal saline in the ED; patient was then progressively monitor for sodium correction; serum sodium corrected appropriately.  Patient carvedilol was changed to metoprolol per Renal recommendations.  Patient had urinary retention and was required to be catheterized and failed voiding trial requiring indwelling catheter.  Patient found to be physically deconditioned and discharged to SNF we with the recommendation to follow with PCP, Cardiology as outpatient  FSA showed Zenker's Diverticulum.  Patient has been having difficulty swallowing for the past few months.  Patient wants to follow up with GI outpatient.  Continue soft diet.  Patient also had COVID-19 with no symptoms. Repeat COVID test has been negative
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of personal independence in daily activities, Neck pain, Pharyngo-oesophageal diverticulum, Physical deconditioning, SARS-CoV-2 test negative
Clinical narrative: Pfizer Dose 1 2/28/21 (EN6203 Pfizer Dose 2 3/22/21 (EN6208) Pfizer Dose 3 9/30/21 (ew0177) Covid Positive 1/20/2022  1/20/22: Patient is 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA   Presented to the ED with generalized weakness of 1 week duration.  Patient endorses the progressively started to feel generalized weakness to the extent not able to do her daily activities.  Patient also has associated feeling of "warms crawling under her skin"  Patient went to her PCP and dose of gabapentin was increased to 300 mg 3 times daily   Currently patient complains of severe neck and back pain scale 6-7/10  In the emergency room patient was found to have low sodium of 116, potassium of 1.9.  Urine sodium need be less than 20 and urine osmolality 168.  Nephrology consult was obtained by ED and recommended to give 3% of 50 cc normal saline and admitted to the floor  1/27/22: Pt is an 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA  Presented to the ED with generalized weakness of 1 week duration.  Patient was then admitted with severe hypotonic hyponatremia, severe hypokalemia, essential hypertension, chronic AFib, s/p ppm, history of OSA, history of chronic neck and back pain as well as advanced degenerative lumbar spine disease.  Nephrology consult was obtained in the ED and patient was given 5% normal saline in the ED; patient was then progressively monitor for sodium correction; serum sodium corrected appropriately.  Patient carvedilol was changed to metoprolol per Renal recommendations.  Patient had urinary retention and was required to be catheterized and failed voiding trial requiring indwelling catheter.  Patient found to be physically deconditioned and discharged to SNF we with the recommendation to follow with PCP, Cardiology as outpatient  FSA showed Zenker's Diverticulum.  Patient has been having difficulty swallowing for the past few months.  Patient wants to follow up with GI outpatient.  Continue soft diet.  Patient also had COVID-19 with no symptoms. Repeat COVID test has been negative
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary retention, Urine osmolarity decreased, Urine sodium
Clinical narrative: Pfizer Dose 1 2/28/21 (EN6203 Pfizer Dose 2 3/22/21 (EN6208) Pfizer Dose 3 9/30/21 (ew0177) Covid Positive 1/20/2022  1/20/22: Patient is 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA   Presented to the ED with generalized weakness of 1 week duration.  Patient endorses the progressively started to feel generalized weakness to the extent not able to do her daily activities.  Patient also has associated feeling of "warms crawling under her skin"  Patient went to her PCP and dose of gabapentin was increased to 300 mg 3 times daily   Currently patient complains of severe neck and back pain scale 6-7/10  In the emergency room patient was found to have low sodium of 116, potassium of 1.9.  Urine sodium need be less than 20 and urine osmolality 168.  Nephrology consult was obtained by ED and recommended to give 3% of 50 cc normal saline and admitted to the floor  1/27/22: Pt is an 80-year-old female past medical history significant for chronic AFib, status post ppm, chronic venous insufficiency, essential hypertension, chronic back pain, OSA  Presented to the ED with generalized weakness of 1 week duration.  Patient was then admitted with severe hypotonic hyponatremia, severe hypokalemia, essential hypertension, chronic AFib, s/p ppm, history of OSA, history of chronic neck and back pain as well as advanced degenerative lumbar spine disease.  Nephrology consult was obtained in the ED and patient was given 5% normal saline in the ED; patient was then progressively monitor for sodium correction; serum sodium corrected appropriately.  Patient carvedilol was changed to metoprolol per Renal recommendations.  Patient had urinary retention and was required to be catheterized and failed voiding trial requiring indwelling catheter.  Patient found to be physically deconditioned and discharged to SNF we with the recommendation to follow with PCP, Cardiology as outpatient  FSA showed Zenker's Diverticulum.  Patient has been having difficulty swallowing for the past few months.  Patient wants to follow up with GI outpatient.  Continue soft diet.  Patient also had COVID-19 with no symptoms. Repeat COVID test has been negative
Age: 65.0
Sex: F
Vaccine: UNK
Symptoms: Rash
Clinical narrative: PATIENT EXPERIENCED A LOCALIZED RASH SHORTLY AFTER HAVING THE VACCINATION. I RECOMMENDED THAT THE PATIENT TAKE SOME BENADRYL TO HELP WITH THE RASH AND TO DISCUSS WITH HER PRIMARY CARE PHYSICIAN SINCE IT WAS A VACCINE AND MAY REQUIRE A STEROID DOSE PACK TO TREAT.
Age: 27.0
Sex: F
Vaccine: HPV9
Symptoms: Headache, Injection site erythema, Injection site pain, Injection site swelling, Pain
Clinical narrative: Got the first HPV vaccine on Friday 6/17/22.  Developed bodyaches and subjective fever about 4 hours after the shot.  Developed headache 4 days after vaccine.  She took ibuprofen and used heating pad for bodyaches.  Mild soreness, swelling, redness at the site of injection right deltoid the first 3 days and resolved on day 4.
Age: 27.0
Sex: F
Vaccine: HPV9
Symptoms: Pyrexia
Clinical narrative: Got the first HPV vaccine on Friday 6/17/22.  Developed bodyaches and subjective fever about 4 hours after the shot.  Developed headache 4 days after vaccine.  She took ibuprofen and used heating pad for bodyaches.  Mild soreness, swelling, redness at the site of injection right deltoid the first 3 days and resolved on day 4.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Cyst, Lymphadenopathy, Mass, Ultrasound scan abnormal
Clinical narrative: Patient developed large lump near left clavicle a couple of days after vaccination. Patient scheduled an E-visit and primary care visit. Primary care provider originally referred patient to Dermatology for large lump (cyst) removal, then recommended patient receive ultrasound of the large lump. Ultrasound showed several enlarged lymph nodes. Team determined that patient did not need further treatment unless the large lump became worse. Large lump has since resolved.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Acidosis, Acute respiratory failure, Angiogram cerebral, Aphasia, Arthralgia
Clinical narrative: Moderna Dose 1 7/6/21 (038C21A) Moderna Dose 2 8/3/21 (021C21A) COVID Positive 1/25/22  1/25/22: Patient is 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders. Patient is poor historian and history obtained from the ED provider patient apparently fell next to her car and crawled back to her house where she was found by bystanders   Patient stated that she experienced in the past multiple falls this time fell on the ice and feels pain on her knees bilaterally.  Patient stated lives alone and had also fell from the bed few days back  Patient stated that she has not seen her PCP for long time   In the emergency department patient was noted to be hypoxic sign 6% and required oxygen supplementation 8 LPM via face mask.  Lab was significant for elevated sodium of 146, creatinine of 1.77, lactic acid of 2.9, troponin of 0.05.  ABG noted to to be acidotic with hypoxia.  White cell count was elevated 10 point a 3 without any left shift; hemoglobin 9.5.  Urinalysis was remarkable for infection; D-dimer elevated 2.1 1 and V/Q scan pending  1/29/22: Patient is a 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders.  Patient admitted for acute encephalopathy and COVID-19 pneumonia. Initial CVA work was negative. Patient was noted to have very high TSH and low T4 so was started on IV Synthroid for possible myxedema coma.  Patient's symptom was improving. Patient was also being treated for acute hypoxic respiratory failure secondary to severe COVID pneumonia on 15 L facemask.  Patient was receiving antibiotics, remdesivir and was started on Barictinib.  Patient's mentation and symptom was improving.  On 01/29/2022 patient started having acute left-sided weakness, aphasic speech and right-sided facial droop. NIH 17. Stroke alert was called.  Stat CT head and CT angio ordered.  Neurology has been consulted.  CT head negative.  CT angio of the head below.  Patient was transferred to the ED for evaluation of tPA. Case was discussed with the stroke team at local facility who recommended no tPA and transferring patient to alternate local facility for further evaluation
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Blood creatinine increased, Blood gases abnormal, Blood lactic acid, Blood sodium increased, Blood thyroid stimulating hormone increased
Clinical narrative: Moderna Dose 1 7/6/21 (038C21A) Moderna Dose 2 8/3/21 (021C21A) COVID Positive 1/25/22  1/25/22: Patient is 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders. Patient is poor historian and history obtained from the ED provider patient apparently fell next to her car and crawled back to her house where she was found by bystanders   Patient stated that she experienced in the past multiple falls this time fell on the ice and feels pain on her knees bilaterally.  Patient stated lives alone and had also fell from the bed few days back  Patient stated that she has not seen her PCP for long time   In the emergency department patient was noted to be hypoxic sign 6% and required oxygen supplementation 8 LPM via face mask.  Lab was significant for elevated sodium of 146, creatinine of 1.77, lactic acid of 2.9, troponin of 0.05.  ABG noted to to be acidotic with hypoxia.  White cell count was elevated 10 point a 3 without any left shift; hemoglobin 9.5.  Urinalysis was remarkable for infection; D-dimer elevated 2.1 1 and V/Q scan pending  1/29/22: Patient is a 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders.  Patient admitted for acute encephalopathy and COVID-19 pneumonia. Initial CVA work was negative. Patient was noted to have very high TSH and low T4 so was started on IV Synthroid for possible myxedema coma.  Patient's symptom was improving. Patient was also being treated for acute hypoxic respiratory failure secondary to severe COVID pneumonia on 15 L facemask.  Patient was receiving antibiotics, remdesivir and was started on Barictinib.  Patient's mentation and symptom was improving.  On 01/29/2022 patient started having acute left-sided weakness, aphasic speech and right-sided facial droop. NIH 17. Stroke alert was called.  Stat CT head and CT angio ordered.  Neurology has been consulted.  CT head negative.  CT angio of the head below.  Patient was transferred to the ED for evaluation of tPA. Case was discussed with the stroke team at local facility who recommended no tPA and transferring patient to alternate local facility for further evaluation
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Computerised tomogram head normal, Encephalopathy, Facial paralysis
Clinical narrative: Moderna Dose 1 7/6/21 (038C21A) Moderna Dose 2 8/3/21 (021C21A) COVID Positive 1/25/22  1/25/22: Patient is 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders. Patient is poor historian and history obtained from the ED provider patient apparently fell next to her car and crawled back to her house where she was found by bystanders   Patient stated that she experienced in the past multiple falls this time fell on the ice and feels pain on her knees bilaterally.  Patient stated lives alone and had also fell from the bed few days back  Patient stated that she has not seen her PCP for long time   In the emergency department patient was noted to be hypoxic sign 6% and required oxygen supplementation 8 LPM via face mask.  Lab was significant for elevated sodium of 146, creatinine of 1.77, lactic acid of 2.9, troponin of 0.05.  ABG noted to to be acidotic with hypoxia.  White cell count was elevated 10 point a 3 without any left shift; hemoglobin 9.5.  Urinalysis was remarkable for infection; D-dimer elevated 2.1 1 and V/Q scan pending  1/29/22: Patient is a 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders.  Patient admitted for acute encephalopathy and COVID-19 pneumonia. Initial CVA work was negative. Patient was noted to have very high TSH and low T4 so was started on IV Synthroid for possible myxedema coma.  Patient's symptom was improving. Patient was also being treated for acute hypoxic respiratory failure secondary to severe COVID pneumonia on 15 L facemask.  Patient was receiving antibiotics, remdesivir and was started on Barictinib.  Patient's mentation and symptom was improving.  On 01/29/2022 patient started having acute left-sided weakness, aphasic speech and right-sided facial droop. NIH 17. Stroke alert was called.  Stat CT head and CT angio ordered.  Neurology has been consulted.  CT head negative.  CT angio of the head below.  Patient was transferred to the ED for evaluation of tPA. Case was discussed with the stroke team at local facility who recommended no tPA and transferring patient to alternate local facility for further evaluation
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Fall, Fibrin D dimer increased, Haemoglobin decreased, Hemiparesis, Hypoxia
Clinical narrative: Moderna Dose 1 7/6/21 (038C21A) Moderna Dose 2 8/3/21 (021C21A) COVID Positive 1/25/22  1/25/22: Patient is 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders. Patient is poor historian and history obtained from the ED provider patient apparently fell next to her car and crawled back to her house where she was found by bystanders   Patient stated that she experienced in the past multiple falls this time fell on the ice and feels pain on her knees bilaterally.  Patient stated lives alone and had also fell from the bed few days back  Patient stated that she has not seen her PCP for long time   In the emergency department patient was noted to be hypoxic sign 6% and required oxygen supplementation 8 LPM via face mask.  Lab was significant for elevated sodium of 146, creatinine of 1.77, lactic acid of 2.9, troponin of 0.05.  ABG noted to to be acidotic with hypoxia.  White cell count was elevated 10 point a 3 without any left shift; hemoglobin 9.5.  Urinalysis was remarkable for infection; D-dimer elevated 2.1 1 and V/Q scan pending  1/29/22: Patient is a 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders.  Patient admitted for acute encephalopathy and COVID-19 pneumonia. Initial CVA work was negative. Patient was noted to have very high TSH and low T4 so was started on IV Synthroid for possible myxedema coma.  Patient's symptom was improving. Patient was also being treated for acute hypoxic respiratory failure secondary to severe COVID pneumonia on 15 L facemask.  Patient was receiving antibiotics, remdesivir and was started on Barictinib.  Patient's mentation and symptom was improving.  On 01/29/2022 patient started having acute left-sided weakness, aphasic speech and right-sided facial droop. NIH 17. Stroke alert was called.  Stat CT head and CT angio ordered.  Neurology has been consulted.  CT head negative.  CT angio of the head below.  Patient was transferred to the ED for evaluation of tPA. Case was discussed with the stroke team at local facility who recommended no tPA and transferring patient to alternate local facility for further evaluation
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Infection, Laboratory test normal, Mental status changes, NIH stroke scale, SARS-CoV-2 test positive
Clinical narrative: Moderna Dose 1 7/6/21 (038C21A) Moderna Dose 2 8/3/21 (021C21A) COVID Positive 1/25/22  1/25/22: Patient is 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders. Patient is poor historian and history obtained from the ED provider patient apparently fell next to her car and crawled back to her house where she was found by bystanders   Patient stated that she experienced in the past multiple falls this time fell on the ice and feels pain on her knees bilaterally.  Patient stated lives alone and had also fell from the bed few days back  Patient stated that she has not seen her PCP for long time   In the emergency department patient was noted to be hypoxic sign 6% and required oxygen supplementation 8 LPM via face mask.  Lab was significant for elevated sodium of 146, creatinine of 1.77, lactic acid of 2.9, troponin of 0.05.  ABG noted to to be acidotic with hypoxia.  White cell count was elevated 10 point a 3 without any left shift; hemoglobin 9.5.  Urinalysis was remarkable for infection; D-dimer elevated 2.1 1 and V/Q scan pending  1/29/22: Patient is a 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders.  Patient admitted for acute encephalopathy and COVID-19 pneumonia. Initial CVA work was negative. Patient was noted to have very high TSH and low T4 so was started on IV Synthroid for possible myxedema coma.  Patient's symptom was improving. Patient was also being treated for acute hypoxic respiratory failure secondary to severe COVID pneumonia on 15 L facemask.  Patient was receiving antibiotics, remdesivir and was started on Barictinib.  Patient's mentation and symptom was improving.  On 01/29/2022 patient started having acute left-sided weakness, aphasic speech and right-sided facial droop. NIH 17. Stroke alert was called.  Stat CT head and CT angio ordered.  Neurology has been consulted.  CT head negative.  CT angio of the head below.  Patient was transferred to the ED for evaluation of tPA. Case was discussed with the stroke team at local facility who recommended no tPA and transferring patient to alternate local facility for further evaluation
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Thyroxine decreased, Troponin, Urine analysis abnormal, White blood cell count increased
Clinical narrative: Moderna Dose 1 7/6/21 (038C21A) Moderna Dose 2 8/3/21 (021C21A) COVID Positive 1/25/22  1/25/22: Patient is 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders. Patient is poor historian and history obtained from the ED provider patient apparently fell next to her car and crawled back to her house where she was found by bystanders   Patient stated that she experienced in the past multiple falls this time fell on the ice and feels pain on her knees bilaterally.  Patient stated lives alone and had also fell from the bed few days back  Patient stated that she has not seen her PCP for long time   In the emergency department patient was noted to be hypoxic sign 6% and required oxygen supplementation 8 LPM via face mask.  Lab was significant for elevated sodium of 146, creatinine of 1.77, lactic acid of 2.9, troponin of 0.05.  ABG noted to to be acidotic with hypoxia.  White cell count was elevated 10 point a 3 without any left shift; hemoglobin 9.5.  Urinalysis was remarkable for infection; D-dimer elevated 2.1 1 and V/Q scan pending  1/29/22: Patient is a 61-year-old female past medical history significant for back pain, hypothyroidism with no recent follow-up with PCP was brought by EMS after she was found on the ground by bystanders.  Patient admitted for acute encephalopathy and COVID-19 pneumonia. Initial CVA work was negative. Patient was noted to have very high TSH and low T4 so was started on IV Synthroid for possible myxedema coma.  Patient's symptom was improving. Patient was also being treated for acute hypoxic respiratory failure secondary to severe COVID pneumonia on 15 L facemask.  Patient was receiving antibiotics, remdesivir and was started on Barictinib.  Patient's mentation and symptom was improving.  On 01/29/2022 patient started having acute left-sided weakness, aphasic speech and right-sided facial droop. NIH 17. Stroke alert was called.  Stat CT head and CT angio ordered.  Neurology has been consulted.  CT head negative.  CT angio of the head below.  Patient was transferred to the ED for evaluation of tPA. Case was discussed with the stroke team at local facility who recommended no tPA and transferring patient to alternate local facility for further evaluation
Age: 4.0
Sex: F
Vaccine: COVID19
Symptoms: Product preparation error
Clinical narrative: Pt was given Pfizer dose that did not have enough diluent. Only diluted with 1mL of saline instead of 2.2 mL of saline.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure decreased, Loss of consciousness
Clinical narrative: This was patients first dose of pfizer had been given on 11/2/21 without adverse rxn today she received pfizer and within minutes she began to pass out. We got her sitting, put cold clothes on her neck, and got her a lemonade to drink. We took her blood pressure 3 times and all three readings were low. Patient after an hour and half was able to walk around the store and came back to be observed and for a final reading. At that time her blood pressure was still lower then normal but much higher then the first reading. Patient refused EMS services and stated she was feeling ok and stated she would go if anything changed. Her mother was with her the whole time and would be driving her home.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Product preparation error, Wrong product administered
Clinical narrative: Pt received the orange cap pediatric  undiluted 0.3 ml  covid vaccine instead of the gray cap
Age: 4.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: The patient was given the wrong diluted COVID vaccine. The pediatric COVID vaccine for 6 months to  4 years of age was diluted with only 1 ml of Normal Saline versus the 2.2 ml that is required. Patient received .2 ml of this wrong diluted vaccine.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Abdominal pain lower, Colonoscopy normal, Faeces soft
Clinical narrative: One week it was extremely mild upset tight feeling and pain in lower abdomen. The GI upset feeling was there and sometimes not. I ignored it at first. It lingered for weeks, like over a month. It was quick that the symptoms change around the 8th or 10th day. My stools became too soft and barely formed. It was not diarrhea, it was not there to that point.  I called my GI doctor, and got a appointment a month later and the symptoms continued. It last easily a month. I had done nothing or different than ever before.  The pain was not consistent, just like upset stomach. I ate more fiber to make it go away.  Now I am fine, I made my appointment and had a telehealth appoint and the symptoms were gone by the time I had the appointment. I was recommended to take Metamucil, but did not. I had a colonoscopy and my symptoms were fine and there was nothing unusual found, but a poly that was a 3 millimeters. I was good to go.