chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 78.0
Sex: F
Vaccine: COVID19-2
Symptoms: Electrocardiogram normal, Essential hypertension, Fluid intake restriction, Glycosylated haemoglobin increased, Gravitational oedema
Clinical narrative: Patient is a 79 y.o. female patient of MD with history of Guillain-Barre Syndrome, COPD, type 2 diabetes presented to Medical Center with shortness of breath and fluid overload on chest imaging found to have  Acute HFpEF, Acute Respiratory failure. Hospitalization complicated by COVID.   Acute on chronic hypoxic respiratory failure COVID-19 Infection, URI  COPD OSA Dyspnea, orthopnea, hypoxia >3LNC from home 2LNC Due to COVID-19 infection and acute on chronic HFpEF exacerbation In setting of recent GBS, but no suspicion for GBS recurrence, NIF's -40 and appropriate Symptoms POA, symptom start date 7/21, + COVID test 7/23 Patient is vaccinated End isolation date: 8/2  Pulmonology consul Pulmonology consulted: continue decadron x 10 days and azithromycin (now finished), signed off 7/27 BiPAP nightly, will need OP sleep study and CPAP titration OP Weaned back to home 2L NC, unlabored, feels breathing is stable (7/31) 10d quarantine ended on 8/1 before return to SNF 8/2/23 AMPAC 21, discussed with case management, patient, ok for home at discharge with HHC Acute on chronic HFpEF (Resolved) Dependent edema (Improved) Mild AS BNP 800's, CXR: pulmonary edema Echo (7/19/23): LVEF 60%, mild AS Has been on PO Lasix for 20 years Started on IV Lasix > now on Lasix 40 mg daily  Wrap lower ext and keep elevated prn BiPAP initiated on admission> now PRN only  Cardiology consulted: diuresis, fluid restriction, and prn BiPAP Decreased home Norvasc to help with LE swelling, but BP trending up so resumed home dose (7/31) Continue home ASA, losartan, coreg, and lasix   Recent Guillain-Barre Syndrome Admitted to MC in June, received 5 days of IVIG Discharged to IPR and has been residing at a SNF Pt feels her leg/arm numbness and weakness is improving Was not able to make her neurology f/u appointment due to being at SNF for rehab Neurology consulted NIF -40 and reassuring against respiratory neuromuscular weakness.  Pulm/CC followed, plan outpatient follow-up with neuromuscular re-scheduled for 8/22/23  PT/OT consulted - improving, AMPAC 21    HTN, Essential Benign, controlled Cont Norvasc, coreg and Cozaar Norvasc originally lowered for LE edema but resumed home dose (7/31) due to highs Coreg dose increased due to continued highs (8/1) Seems to have improved somewhat (8/2) - awaiting repeat before discharge but if still high might add scheduled hydralazine at discharge. Encouraged PCP F/u and will provide BP kit script   Elevated troponin Mild elevation to 26 EKG is without ischemic changes No chest pain at admission Likely demand ischemia from respiratory failure Cardiology consulted-no further ischemic workup anticipated   Right Otitis Externa (Resolved) Right ear pain and drainage Significant swelling and TTP of ear canal unable to visualize inner ear Ciprodex otic drops with significant improvement since 7/26   Type 2 diabetes Hgb A1c (6/8/23): 7.6 Home regimen: basaglar 8 units nights, SSI
Age: 78.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hypertension, Hypervolaemia, Hypoaesthesia, Hypoxia, Immunoglobulin therapy
Clinical narrative: Patient is a 79 y.o. female patient of MD with history of Guillain-Barre Syndrome, COPD, type 2 diabetes presented to Medical Center with shortness of breath and fluid overload on chest imaging found to have  Acute HFpEF, Acute Respiratory failure. Hospitalization complicated by COVID.   Acute on chronic hypoxic respiratory failure COVID-19 Infection, URI  COPD OSA Dyspnea, orthopnea, hypoxia >3LNC from home 2LNC Due to COVID-19 infection and acute on chronic HFpEF exacerbation In setting of recent GBS, but no suspicion for GBS recurrence, NIF's -40 and appropriate Symptoms POA, symptom start date 7/21, + COVID test 7/23 Patient is vaccinated End isolation date: 8/2  Pulmonology consul Pulmonology consulted: continue decadron x 10 days and azithromycin (now finished), signed off 7/27 BiPAP nightly, will need OP sleep study and CPAP titration OP Weaned back to home 2L NC, unlabored, feels breathing is stable (7/31) 10d quarantine ended on 8/1 before return to SNF 8/2/23 AMPAC 21, discussed with case management, patient, ok for home at discharge with HHC Acute on chronic HFpEF (Resolved) Dependent edema (Improved) Mild AS BNP 800's, CXR: pulmonary edema Echo (7/19/23): LVEF 60%, mild AS Has been on PO Lasix for 20 years Started on IV Lasix > now on Lasix 40 mg daily  Wrap lower ext and keep elevated prn BiPAP initiated on admission> now PRN only  Cardiology consulted: diuresis, fluid restriction, and prn BiPAP Decreased home Norvasc to help with LE swelling, but BP trending up so resumed home dose (7/31) Continue home ASA, losartan, coreg, and lasix   Recent Guillain-Barre Syndrome Admitted to MC in June, received 5 days of IVIG Discharged to IPR and has been residing at a SNF Pt feels her leg/arm numbness and weakness is improving Was not able to make her neurology f/u appointment due to being at SNF for rehab Neurology consulted NIF -40 and reassuring against respiratory neuromuscular weakness.  Pulm/CC followed, plan outpatient follow-up with neuromuscular re-scheduled for 8/22/23  PT/OT consulted - improving, AMPAC 21    HTN, Essential Benign, controlled Cont Norvasc, coreg and Cozaar Norvasc originally lowered for LE edema but resumed home dose (7/31) due to highs Coreg dose increased due to continued highs (8/1) Seems to have improved somewhat (8/2) - awaiting repeat before discharge but if still high might add scheduled hydralazine at discharge. Encouraged PCP F/u and will provide BP kit script   Elevated troponin Mild elevation to 26 EKG is without ischemic changes No chest pain at admission Likely demand ischemia from respiratory failure Cardiology consulted-no further ischemic workup anticipated   Right Otitis Externa (Resolved) Right ear pain and drainage Significant swelling and TTP of ear canal unable to visualize inner ear Ciprodex otic drops with significant improvement since 7/26   Type 2 diabetes Hgb A1c (6/8/23): 7.6 Home regimen: basaglar 8 units nights, SSI
Age: 78.0
Sex: F
Vaccine: COVID19-2
Symptoms: Muscular weakness, Myocardial ischaemia, Obstructive sleep apnoea syndrome, Orthopnoea, Otitis externa
Clinical narrative: Patient is a 79 y.o. female patient of MD with history of Guillain-Barre Syndrome, COPD, type 2 diabetes presented to Medical Center with shortness of breath and fluid overload on chest imaging found to have  Acute HFpEF, Acute Respiratory failure. Hospitalization complicated by COVID.   Acute on chronic hypoxic respiratory failure COVID-19 Infection, URI  COPD OSA Dyspnea, orthopnea, hypoxia >3LNC from home 2LNC Due to COVID-19 infection and acute on chronic HFpEF exacerbation In setting of recent GBS, but no suspicion for GBS recurrence, NIF's -40 and appropriate Symptoms POA, symptom start date 7/21, + COVID test 7/23 Patient is vaccinated End isolation date: 8/2  Pulmonology consul Pulmonology consulted: continue decadron x 10 days and azithromycin (now finished), signed off 7/27 BiPAP nightly, will need OP sleep study and CPAP titration OP Weaned back to home 2L NC, unlabored, feels breathing is stable (7/31) 10d quarantine ended on 8/1 before return to SNF 8/2/23 AMPAC 21, discussed with case management, patient, ok for home at discharge with HHC Acute on chronic HFpEF (Resolved) Dependent edema (Improved) Mild AS BNP 800's, CXR: pulmonary edema Echo (7/19/23): LVEF 60%, mild AS Has been on PO Lasix for 20 years Started on IV Lasix > now on Lasix 40 mg daily  Wrap lower ext and keep elevated prn BiPAP initiated on admission> now PRN only  Cardiology consulted: diuresis, fluid restriction, and prn BiPAP Decreased home Norvasc to help with LE swelling, but BP trending up so resumed home dose (7/31) Continue home ASA, losartan, coreg, and lasix   Recent Guillain-Barre Syndrome Admitted to MC in June, received 5 days of IVIG Discharged to IPR and has been residing at a SNF Pt feels her leg/arm numbness and weakness is improving Was not able to make her neurology f/u appointment due to being at SNF for rehab Neurology consulted NIF -40 and reassuring against respiratory neuromuscular weakness.  Pulm/CC followed, plan outpatient follow-up with neuromuscular re-scheduled for 8/22/23  PT/OT consulted - improving, AMPAC 21    HTN, Essential Benign, controlled Cont Norvasc, coreg and Cozaar Norvasc originally lowered for LE edema but resumed home dose (7/31) due to highs Coreg dose increased due to continued highs (8/1) Seems to have improved somewhat (8/2) - awaiting repeat before discharge but if still high might add scheduled hydralazine at discharge. Encouraged PCP F/u and will provide BP kit script   Elevated troponin Mild elevation to 26 EKG is without ischemic changes No chest pain at admission Likely demand ischemia from respiratory failure Cardiology consulted-no further ischemic workup anticipated   Right Otitis Externa (Resolved) Right ear pain and drainage Significant swelling and TTP of ear canal unable to visualize inner ear Ciprodex otic drops with significant improvement since 7/26   Type 2 diabetes Hgb A1c (6/8/23): 7.6 Home regimen: basaglar 8 units nights, SSI
Age: 78.0
Sex: F
Vaccine: COVID19-2
Symptoms: Otorrhoea, Peripheral swelling, Positive airway pressure therapy, Pulmonary imaging procedure abnormal, Pulmonary oedema
Clinical narrative: Patient is a 79 y.o. female patient of MD with history of Guillain-Barre Syndrome, COPD, type 2 diabetes presented to Medical Center with shortness of breath and fluid overload on chest imaging found to have  Acute HFpEF, Acute Respiratory failure. Hospitalization complicated by COVID.   Acute on chronic hypoxic respiratory failure COVID-19 Infection, URI  COPD OSA Dyspnea, orthopnea, hypoxia >3LNC from home 2LNC Due to COVID-19 infection and acute on chronic HFpEF exacerbation In setting of recent GBS, but no suspicion for GBS recurrence, NIF's -40 and appropriate Symptoms POA, symptom start date 7/21, + COVID test 7/23 Patient is vaccinated End isolation date: 8/2  Pulmonology consul Pulmonology consulted: continue decadron x 10 days and azithromycin (now finished), signed off 7/27 BiPAP nightly, will need OP sleep study and CPAP titration OP Weaned back to home 2L NC, unlabored, feels breathing is stable (7/31) 10d quarantine ended on 8/1 before return to SNF 8/2/23 AMPAC 21, discussed with case management, patient, ok for home at discharge with HHC Acute on chronic HFpEF (Resolved) Dependent edema (Improved) Mild AS BNP 800's, CXR: pulmonary edema Echo (7/19/23): LVEF 60%, mild AS Has been on PO Lasix for 20 years Started on IV Lasix > now on Lasix 40 mg daily  Wrap lower ext and keep elevated prn BiPAP initiated on admission> now PRN only  Cardiology consulted: diuresis, fluid restriction, and prn BiPAP Decreased home Norvasc to help with LE swelling, but BP trending up so resumed home dose (7/31) Continue home ASA, losartan, coreg, and lasix   Recent Guillain-Barre Syndrome Admitted to MC in June, received 5 days of IVIG Discharged to IPR and has been residing at a SNF Pt feels her leg/arm numbness and weakness is improving Was not able to make her neurology f/u appointment due to being at SNF for rehab Neurology consulted NIF -40 and reassuring against respiratory neuromuscular weakness.  Pulm/CC followed, plan outpatient follow-up with neuromuscular re-scheduled for 8/22/23  PT/OT consulted - improving, AMPAC 21    HTN, Essential Benign, controlled Cont Norvasc, coreg and Cozaar Norvasc originally lowered for LE edema but resumed home dose (7/31) due to highs Coreg dose increased due to continued highs (8/1) Seems to have improved somewhat (8/2) - awaiting repeat before discharge but if still high might add scheduled hydralazine at discharge. Encouraged PCP F/u and will provide BP kit script   Elevated troponin Mild elevation to 26 EKG is without ischemic changes No chest pain at admission Likely demand ischemia from respiratory failure Cardiology consulted-no further ischemic workup anticipated   Right Otitis Externa (Resolved) Right ear pain and drainage Significant swelling and TTP of ear canal unable to visualize inner ear Ciprodex otic drops with significant improvement since 7/26   Type 2 diabetes Hgb A1c (6/8/23): 7.6 Home regimen: basaglar 8 units nights, SSI
Age: 78.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Troponin increased, Tympanometry, Type 2 diabetes mellitus
Clinical narrative: Patient is a 79 y.o. female patient of MD with history of Guillain-Barre Syndrome, COPD, type 2 diabetes presented to Medical Center with shortness of breath and fluid overload on chest imaging found to have  Acute HFpEF, Acute Respiratory failure. Hospitalization complicated by COVID.   Acute on chronic hypoxic respiratory failure COVID-19 Infection, URI  COPD OSA Dyspnea, orthopnea, hypoxia >3LNC from home 2LNC Due to COVID-19 infection and acute on chronic HFpEF exacerbation In setting of recent GBS, but no suspicion for GBS recurrence, NIF's -40 and appropriate Symptoms POA, symptom start date 7/21, + COVID test 7/23 Patient is vaccinated End isolation date: 8/2  Pulmonology consul Pulmonology consulted: continue decadron x 10 days and azithromycin (now finished), signed off 7/27 BiPAP nightly, will need OP sleep study and CPAP titration OP Weaned back to home 2L NC, unlabored, feels breathing is stable (7/31) 10d quarantine ended on 8/1 before return to SNF 8/2/23 AMPAC 21, discussed with case management, patient, ok for home at discharge with HHC Acute on chronic HFpEF (Resolved) Dependent edema (Improved) Mild AS BNP 800's, CXR: pulmonary edema Echo (7/19/23): LVEF 60%, mild AS Has been on PO Lasix for 20 years Started on IV Lasix > now on Lasix 40 mg daily  Wrap lower ext and keep elevated prn BiPAP initiated on admission> now PRN only  Cardiology consulted: diuresis, fluid restriction, and prn BiPAP Decreased home Norvasc to help with LE swelling, but BP trending up so resumed home dose (7/31) Continue home ASA, losartan, coreg, and lasix   Recent Guillain-Barre Syndrome Admitted to MC in June, received 5 days of IVIG Discharged to IPR and has been residing at a SNF Pt feels her leg/arm numbness and weakness is improving Was not able to make her neurology f/u appointment due to being at SNF for rehab Neurology consulted NIF -40 and reassuring against respiratory neuromuscular weakness.  Pulm/CC followed, plan outpatient follow-up with neuromuscular re-scheduled for 8/22/23  PT/OT consulted - improving, AMPAC 21    HTN, Essential Benign, controlled Cont Norvasc, coreg and Cozaar Norvasc originally lowered for LE edema but resumed home dose (7/31) due to highs Coreg dose increased due to continued highs (8/1) Seems to have improved somewhat (8/2) - awaiting repeat before discharge but if still high might add scheduled hydralazine at discharge. Encouraged PCP F/u and will provide BP kit script   Elevated troponin Mild elevation to 26 EKG is without ischemic changes No chest pain at admission Likely demand ischemia from respiratory failure Cardiology consulted-no further ischemic workup anticipated   Right Otitis Externa (Resolved) Right ear pain and drainage Significant swelling and TTP of ear canal unable to visualize inner ear Ciprodex otic drops with significant improvement since 7/26   Type 2 diabetes Hgb A1c (6/8/23): 7.6 Home regimen: basaglar 8 units nights, SSI
Age: 78.0
Sex: F
Vaccine: COVID19-2
Symptoms: Upper respiratory tract infection
Clinical narrative: Patient is a 79 y.o. female patient of MD with history of Guillain-Barre Syndrome, COPD, type 2 diabetes presented to Medical Center with shortness of breath and fluid overload on chest imaging found to have  Acute HFpEF, Acute Respiratory failure. Hospitalization complicated by COVID.   Acute on chronic hypoxic respiratory failure COVID-19 Infection, URI  COPD OSA Dyspnea, orthopnea, hypoxia >3LNC from home 2LNC Due to COVID-19 infection and acute on chronic HFpEF exacerbation In setting of recent GBS, but no suspicion for GBS recurrence, NIF's -40 and appropriate Symptoms POA, symptom start date 7/21, + COVID test 7/23 Patient is vaccinated End isolation date: 8/2  Pulmonology consul Pulmonology consulted: continue decadron x 10 days and azithromycin (now finished), signed off 7/27 BiPAP nightly, will need OP sleep study and CPAP titration OP Weaned back to home 2L NC, unlabored, feels breathing is stable (7/31) 10d quarantine ended on 8/1 before return to SNF 8/2/23 AMPAC 21, discussed with case management, patient, ok for home at discharge with HHC Acute on chronic HFpEF (Resolved) Dependent edema (Improved) Mild AS BNP 800's, CXR: pulmonary edema Echo (7/19/23): LVEF 60%, mild AS Has been on PO Lasix for 20 years Started on IV Lasix > now on Lasix 40 mg daily  Wrap lower ext and keep elevated prn BiPAP initiated on admission> now PRN only  Cardiology consulted: diuresis, fluid restriction, and prn BiPAP Decreased home Norvasc to help with LE swelling, but BP trending up so resumed home dose (7/31) Continue home ASA, losartan, coreg, and lasix   Recent Guillain-Barre Syndrome Admitted to MC in June, received 5 days of IVIG Discharged to IPR and has been residing at a SNF Pt feels her leg/arm numbness and weakness is improving Was not able to make her neurology f/u appointment due to being at SNF for rehab Neurology consulted NIF -40 and reassuring against respiratory neuromuscular weakness.  Pulm/CC followed, plan outpatient follow-up with neuromuscular re-scheduled for 8/22/23  PT/OT consulted - improving, AMPAC 21    HTN, Essential Benign, controlled Cont Norvasc, coreg and Cozaar Norvasc originally lowered for LE edema but resumed home dose (7/31) due to highs Coreg dose increased due to continued highs (8/1) Seems to have improved somewhat (8/2) - awaiting repeat before discharge but if still high might add scheduled hydralazine at discharge. Encouraged PCP F/u and will provide BP kit script   Elevated troponin Mild elevation to 26 EKG is without ischemic changes No chest pain at admission Likely demand ischemia from respiratory failure Cardiology consulted-no further ischemic workup anticipated   Right Otitis Externa (Resolved) Right ear pain and drainage Significant swelling and TTP of ear canal unable to visualize inner ear Ciprodex otic drops with significant improvement since 7/26   Type 2 diabetes Hgb A1c (6/8/23): 7.6 Home regimen: basaglar 8 units nights, SSI
Age: 73.0
Sex: F
Vaccine: RSV
Symptoms: Injection site rash
Clinical narrative: rash on arm near injection site
Age: 1.67
Sex: F
Vaccine: IPV
Symptoms: No adverse event, Product storage error
Clinical narrative: Temp Excursion of 1.5 Degrees for a total of 34 minutes.   Vial was previously opened on 7/28/2023  No symptoms from patient.
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute respiratory failure, Agitation, Blood potassium decreased, C-reactive protein increased
Clinical narrative: 66 y.o. female patient of MD, with history of chronic pain, HTN, HLD, mood disorder, roux-en-Y, essential tremor, recent COVID-19 PNA on 7/20 requiring admission. Presented with hypoxia. Admitted for multifocal PNA superimposed on COVID PNA and acute respiratory failure. Clinically improved, now on NC at 4 L. Will finish course of antibiotics and steroids on discharge, home with services and portable oxygen.   Acute Hypoxic Respiratory Failure, improving Multifocal Pneumonia, likely bacterial COVID-19 Pneumonia COVID + 7/20/23, fully vaccinated S/p Paxlovid 7/21-26 Imaging demonstrated worsening ground glass opacities, multifocal PNA Ferritin 555, CRP 63.4 BiPAP initially, transitioned to HHFNC, then weaned to nasal cannula MRSA probe negative, urine antigens, procal negative Started on Zosyn 7/26, transitioned to oral Augmentin to complete 10-day course (7/26-8/4) Decadron 6mg IV daily, transitioned to PO on 8/2, to complete 10 day course (7/27-8/6) S/p lasix 20 mg PO 7/31, Lasix 20mg IV 8/1 given fluid overload on lung exam in the setting of persistent O2 requirements CXR 8/2 stable  Hypokalemia Potassium dropped to 2.9 on 8/3 likely iso Lasix Repleted with 60 mEq oral Kcl Repeat BMP with improvement to 3.2 Would recommend repeat labs on outpatient follow-up   Encephalopathy, resolving Waxing and waning, suspect 2/2 delirium likely in the setting of acute illness Patient also with multiple sedating/psychoactive home medications Now resolving with improved clinical status  Nightly quetiapine 50mg PRN haldol for agitation   HTN Held ARB in the setting of AKI  Amlodipine 10 mg AKI resolved, BP recovered, restart home ARB on discharge   Chronic Pain Home regimen: gabapentin 300mg TID, dilaudid 4mg q6h prn Follows with pain mgmt Hold metaxalone    Polypharmacy Patient on multiple serotonergic meds (held metaxalone) reglan (held) and pramipexole contraindicated Trazodone 100 mg Qtc 413 from EKG 7/25   Mood Disorder: Continued home buspar, venlafaxine, atarax Insomnia/RLS: Continued home trazodone prn, Ambien prn S/p roux-en-Y: In 2011, Continued home PPI, pepcid  Essential Tremor: Reduced home propranolol from 40 mg bid to 20 mg bid iso low HRs
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray, Condition aggravated, Delirium
Clinical narrative: 66 y.o. female patient of MD, with history of chronic pain, HTN, HLD, mood disorder, roux-en-Y, essential tremor, recent COVID-19 PNA on 7/20 requiring admission. Presented with hypoxia. Admitted for multifocal PNA superimposed on COVID PNA and acute respiratory failure. Clinically improved, now on NC at 4 L. Will finish course of antibiotics and steroids on discharge, home with services and portable oxygen.   Acute Hypoxic Respiratory Failure, improving Multifocal Pneumonia, likely bacterial COVID-19 Pneumonia COVID + 7/20/23, fully vaccinated S/p Paxlovid 7/21-26 Imaging demonstrated worsening ground glass opacities, multifocal PNA Ferritin 555, CRP 63.4 BiPAP initially, transitioned to HHFNC, then weaned to nasal cannula MRSA probe negative, urine antigens, procal negative Started on Zosyn 7/26, transitioned to oral Augmentin to complete 10-day course (7/26-8/4) Decadron 6mg IV daily, transitioned to PO on 8/2, to complete 10 day course (7/27-8/6) S/p lasix 20 mg PO 7/31, Lasix 20mg IV 8/1 given fluid overload on lung exam in the setting of persistent O2 requirements CXR 8/2 stable  Hypokalemia Potassium dropped to 2.9 on 8/3 likely iso Lasix Repleted with 60 mEq oral Kcl Repeat BMP with improvement to 3.2 Would recommend repeat labs on outpatient follow-up   Encephalopathy, resolving Waxing and waning, suspect 2/2 delirium likely in the setting of acute illness Patient also with multiple sedating/psychoactive home medications Now resolving with improved clinical status  Nightly quetiapine 50mg PRN haldol for agitation   HTN Held ARB in the setting of AKI  Amlodipine 10 mg AKI resolved, BP recovered, restart home ARB on discharge   Chronic Pain Home regimen: gabapentin 300mg TID, dilaudid 4mg q6h prn Follows with pain mgmt Hold metaxalone    Polypharmacy Patient on multiple serotonergic meds (held metaxalone) reglan (held) and pramipexole contraindicated Trazodone 100 mg Qtc 413 from EKG 7/25   Mood Disorder: Continued home buspar, venlafaxine, atarax Insomnia/RLS: Continued home trazodone prn, Ambien prn S/p roux-en-Y: In 2011, Continued home PPI, pepcid  Essential Tremor: Reduced home propranolol from 40 mg bid to 20 mg bid iso low HRs
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Electrocardiogram, Electrocardiogram QT interval, Encephalopathy, Hypervolaemia, Hypokalaemia
Clinical narrative: 66 y.o. female patient of MD, with history of chronic pain, HTN, HLD, mood disorder, roux-en-Y, essential tremor, recent COVID-19 PNA on 7/20 requiring admission. Presented with hypoxia. Admitted for multifocal PNA superimposed on COVID PNA and acute respiratory failure. Clinically improved, now on NC at 4 L. Will finish course of antibiotics and steroids on discharge, home with services and portable oxygen.   Acute Hypoxic Respiratory Failure, improving Multifocal Pneumonia, likely bacterial COVID-19 Pneumonia COVID + 7/20/23, fully vaccinated S/p Paxlovid 7/21-26 Imaging demonstrated worsening ground glass opacities, multifocal PNA Ferritin 555, CRP 63.4 BiPAP initially, transitioned to HHFNC, then weaned to nasal cannula MRSA probe negative, urine antigens, procal negative Started on Zosyn 7/26, transitioned to oral Augmentin to complete 10-day course (7/26-8/4) Decadron 6mg IV daily, transitioned to PO on 8/2, to complete 10 day course (7/27-8/6) S/p lasix 20 mg PO 7/31, Lasix 20mg IV 8/1 given fluid overload on lung exam in the setting of persistent O2 requirements CXR 8/2 stable  Hypokalemia Potassium dropped to 2.9 on 8/3 likely iso Lasix Repleted with 60 mEq oral Kcl Repeat BMP with improvement to 3.2 Would recommend repeat labs on outpatient follow-up   Encephalopathy, resolving Waxing and waning, suspect 2/2 delirium likely in the setting of acute illness Patient also with multiple sedating/psychoactive home medications Now resolving with improved clinical status  Nightly quetiapine 50mg PRN haldol for agitation   HTN Held ARB in the setting of AKI  Amlodipine 10 mg AKI resolved, BP recovered, restart home ARB on discharge   Chronic Pain Home regimen: gabapentin 300mg TID, dilaudid 4mg q6h prn Follows with pain mgmt Hold metaxalone    Polypharmacy Patient on multiple serotonergic meds (held metaxalone) reglan (held) and pramipexole contraindicated Trazodone 100 mg Qtc 413 from EKG 7/25   Mood Disorder: Continued home buspar, venlafaxine, atarax Insomnia/RLS: Continued home trazodone prn, Ambien prn S/p roux-en-Y: In 2011, Continued home PPI, pepcid  Essential Tremor: Reduced home propranolol from 40 mg bid to 20 mg bid iso low HRs
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hypoxia, Illness, Lung opacity, Metabolic function test abnormal, Pneumonia bacterial
Clinical narrative: 66 y.o. female patient of MD, with history of chronic pain, HTN, HLD, mood disorder, roux-en-Y, essential tremor, recent COVID-19 PNA on 7/20 requiring admission. Presented with hypoxia. Admitted for multifocal PNA superimposed on COVID PNA and acute respiratory failure. Clinically improved, now on NC at 4 L. Will finish course of antibiotics and steroids on discharge, home with services and portable oxygen.   Acute Hypoxic Respiratory Failure, improving Multifocal Pneumonia, likely bacterial COVID-19 Pneumonia COVID + 7/20/23, fully vaccinated S/p Paxlovid 7/21-26 Imaging demonstrated worsening ground glass opacities, multifocal PNA Ferritin 555, CRP 63.4 BiPAP initially, transitioned to HHFNC, then weaned to nasal cannula MRSA probe negative, urine antigens, procal negative Started on Zosyn 7/26, transitioned to oral Augmentin to complete 10-day course (7/26-8/4) Decadron 6mg IV daily, transitioned to PO on 8/2, to complete 10 day course (7/27-8/6) S/p lasix 20 mg PO 7/31, Lasix 20mg IV 8/1 given fluid overload on lung exam in the setting of persistent O2 requirements CXR 8/2 stable  Hypokalemia Potassium dropped to 2.9 on 8/3 likely iso Lasix Repleted with 60 mEq oral Kcl Repeat BMP with improvement to 3.2 Would recommend repeat labs on outpatient follow-up   Encephalopathy, resolving Waxing and waning, suspect 2/2 delirium likely in the setting of acute illness Patient also with multiple sedating/psychoactive home medications Now resolving with improved clinical status  Nightly quetiapine 50mg PRN haldol for agitation   HTN Held ARB in the setting of AKI  Amlodipine 10 mg AKI resolved, BP recovered, restart home ARB on discharge   Chronic Pain Home regimen: gabapentin 300mg TID, dilaudid 4mg q6h prn Follows with pain mgmt Hold metaxalone    Polypharmacy Patient on multiple serotonergic meds (held metaxalone) reglan (held) and pramipexole contraindicated Trazodone 100 mg Qtc 413 from EKG 7/25   Mood Disorder: Continued home buspar, venlafaxine, atarax Insomnia/RLS: Continued home trazodone prn, Ambien prn S/p roux-en-Y: In 2011, Continued home PPI, pepcid  Essential Tremor: Reduced home propranolol from 40 mg bid to 20 mg bid iso low HRs
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Positive airway pressure therapy, Procalcitonin normal, Pulmonary imaging procedure abnormal, SARS-CoV-2 test positive, Serum ferritin increased
Clinical narrative: 66 y.o. female patient of MD, with history of chronic pain, HTN, HLD, mood disorder, roux-en-Y, essential tremor, recent COVID-19 PNA on 7/20 requiring admission. Presented with hypoxia. Admitted for multifocal PNA superimposed on COVID PNA and acute respiratory failure. Clinically improved, now on NC at 4 L. Will finish course of antibiotics and steroids on discharge, home with services and portable oxygen.   Acute Hypoxic Respiratory Failure, improving Multifocal Pneumonia, likely bacterial COVID-19 Pneumonia COVID + 7/20/23, fully vaccinated S/p Paxlovid 7/21-26 Imaging demonstrated worsening ground glass opacities, multifocal PNA Ferritin 555, CRP 63.4 BiPAP initially, transitioned to HHFNC, then weaned to nasal cannula MRSA probe negative, urine antigens, procal negative Started on Zosyn 7/26, transitioned to oral Augmentin to complete 10-day course (7/26-8/4) Decadron 6mg IV daily, transitioned to PO on 8/2, to complete 10 day course (7/27-8/6) S/p lasix 20 mg PO 7/31, Lasix 20mg IV 8/1 given fluid overload on lung exam in the setting of persistent O2 requirements CXR 8/2 stable  Hypokalemia Potassium dropped to 2.9 on 8/3 likely iso Lasix Repleted with 60 mEq oral Kcl Repeat BMP with improvement to 3.2 Would recommend repeat labs on outpatient follow-up   Encephalopathy, resolving Waxing and waning, suspect 2/2 delirium likely in the setting of acute illness Patient also with multiple sedating/psychoactive home medications Now resolving with improved clinical status  Nightly quetiapine 50mg PRN haldol for agitation   HTN Held ARB in the setting of AKI  Amlodipine 10 mg AKI resolved, BP recovered, restart home ARB on discharge   Chronic Pain Home regimen: gabapentin 300mg TID, dilaudid 4mg q6h prn Follows with pain mgmt Hold metaxalone    Polypharmacy Patient on multiple serotonergic meds (held metaxalone) reglan (held) and pramipexole contraindicated Trazodone 100 mg Qtc 413 from EKG 7/25   Mood Disorder: Continued home buspar, venlafaxine, atarax Insomnia/RLS: Continued home trazodone prn, Ambien prn S/p roux-en-Y: In 2011, Continued home PPI, pepcid  Essential Tremor: Reduced home propranolol from 40 mg bid to 20 mg bid iso low HRs
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Staphylococcus test negative, Superinfection, Urine antigen test
Clinical narrative: 66 y.o. female patient of MD, with history of chronic pain, HTN, HLD, mood disorder, roux-en-Y, essential tremor, recent COVID-19 PNA on 7/20 requiring admission. Presented with hypoxia. Admitted for multifocal PNA superimposed on COVID PNA and acute respiratory failure. Clinically improved, now on NC at 4 L. Will finish course of antibiotics and steroids on discharge, home with services and portable oxygen.   Acute Hypoxic Respiratory Failure, improving Multifocal Pneumonia, likely bacterial COVID-19 Pneumonia COVID + 7/20/23, fully vaccinated S/p Paxlovid 7/21-26 Imaging demonstrated worsening ground glass opacities, multifocal PNA Ferritin 555, CRP 63.4 BiPAP initially, transitioned to HHFNC, then weaned to nasal cannula MRSA probe negative, urine antigens, procal negative Started on Zosyn 7/26, transitioned to oral Augmentin to complete 10-day course (7/26-8/4) Decadron 6mg IV daily, transitioned to PO on 8/2, to complete 10 day course (7/27-8/6) S/p lasix 20 mg PO 7/31, Lasix 20mg IV 8/1 given fluid overload on lung exam in the setting of persistent O2 requirements CXR 8/2 stable  Hypokalemia Potassium dropped to 2.9 on 8/3 likely iso Lasix Repleted with 60 mEq oral Kcl Repeat BMP with improvement to 3.2 Would recommend repeat labs on outpatient follow-up   Encephalopathy, resolving Waxing and waning, suspect 2/2 delirium likely in the setting of acute illness Patient also with multiple sedating/psychoactive home medications Now resolving with improved clinical status  Nightly quetiapine 50mg PRN haldol for agitation   HTN Held ARB in the setting of AKI  Amlodipine 10 mg AKI resolved, BP recovered, restart home ARB on discharge   Chronic Pain Home regimen: gabapentin 300mg TID, dilaudid 4mg q6h prn Follows with pain mgmt Hold metaxalone    Polypharmacy Patient on multiple serotonergic meds (held metaxalone) reglan (held) and pramipexole contraindicated Trazodone 100 mg Qtc 413 from EKG 7/25   Mood Disorder: Continued home buspar, venlafaxine, atarax Insomnia/RLS: Continued home trazodone prn, Ambien prn S/p roux-en-Y: In 2011, Continued home PPI, pepcid  Essential Tremor: Reduced home propranolol from 40 mg bid to 20 mg bid iso low HRs
Age: 6.0
Sex: F
Vaccine: DTAPIPV, MMRV
Symptoms: No adverse event
Clinical narrative: No adverse events, treatment of signs and symptoms indicated after administration
Age: 36.0
Sex: F
Vaccine: MMR
Symptoms: Dyspnoea, Erythema, Pruritus, Rash erythematous, Swelling
Clinical narrative: - Localized erythema and swelling, upper body pruritus and mild erythemic rash, throat itchiness, mild shortness of breath. - Employee self treated with Benadryl and Zyrtec: Improving symptoms
Age: 36.0
Sex: F
Vaccine: MMR
Symptoms: Throat irritation
Clinical narrative: - Localized erythema and swelling, upper body pruritus and mild erythemic rash, throat itchiness, mild shortness of breath. - Employee self treated with Benadryl and Zyrtec: Improving symptoms
Age: 3.0
Sex: F
Vaccine: COVID19-2, VARZOS
Symptoms: Intercepted product administration error
Clinical narrative: Pharmacist had vaccine present in immunization room for patient where error occured and her father. The vaccine intended for the father was Shingrix. The pharmacist poked patient with the Shingrix syringe/needle and immediately noticed it was the wrong vaccine. The pharmacist did not push the plunger to administer any vaccine. The pharmacist immediately withdrew the needle from the patient's arm and discarded vaccine. The correct COVID19 vaccine was then administered. The parents were in the room and were notified of the issue.
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Blood test normal, Hypoaesthesia, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal normal, Neurological examination normal
Clinical narrative: Tingling and numbness from left elbow down to left hand. 2 days later, tingling and numbness in left foot. 2 days later, tingling and numbness from right elbow down to right hand. 2 days later tingling and numbness in right foot. 2 days later, tingling and numbness down calves and shins of both legs. 2 days later, numbness and tingling in left thigh. All symptoms built upon one another. Nothing has reversed.
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Paraesthesia, Scan with contrast normal
Clinical narrative: Tingling and numbness from left elbow down to left hand. 2 days later, tingling and numbness in left foot. 2 days later, tingling and numbness from right elbow down to right hand. 2 days later tingling and numbness in right foot. 2 days later, tingling and numbness down calves and shins of both legs. 2 days later, numbness and tingling in left thigh. All symptoms built upon one another. Nothing has reversed.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Patient received vaccine after BUD
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Patient received vaccine after BUD
Age: 0.33
Sex: M
Vaccine: UNK
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: child had no adverse effects or symptoms at this time. child did not require additional treatment.
Age: 52.0
Sex: F
Vaccine: HEP
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: No adverse effects. Vaccine was administered 1 month early.
Age: 4.0
Sex: M
Vaccine: DTPPVHBHPB
Symptoms: Extra dose administered, Wrong product administered
Clinical narrative: Patient was administered Vaxelis instead of Quadracel giving the patient an extra Hep B and HIB
Sex: M
Vaccine: MMRV
Symptoms: Product storage error
Clinical narrative: No Additional AE; patient received a dose of PROQUAD that has suffered a TE; This spontaneous report was received from a nurse and refers to a 4-year-old male patient. Information regarding the patient's concurrent conditions and medical history was not provided. Concomitant medications included salbutamol (ALBUTEROL).  On 15-AUG-2023, the patient was vaccinated with an improperly stored dose of measles, mumps, rubella and varicella (oka-merck) virus vaccine live (PROQUAD) subcutaneous injection, 0.5ml/ series, lot #X007355, expiration date: 08-SEP-2024, administered subcutaneously in the left arm for prophylaxis.  The vaccine was stored in a temperature of -14.3 C for 13 minutes. There was no previous temperature excursion reported. No Additional adverse events reported.
Age: 16.0
Sex: F
Vaccine: MNQ
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: her nurses reconstituted lyophilized Menveo vial with saline instead of the supplied liquid CYW-135 component.; her nurses reconstituted lyophilized Menveo vial with saline instead of the supplied liquid CYW-135 component.; This non-serious case was reported by a nurse via call center representative and described the occurrence of wrong solution used in drug reconstitution in a 16-year-old female patient who received Men ACWY-CRM NVS (Menveo) (batch number AMVA946A, expiry date 31-JUL-2024) for prophylaxis.   On 22-AUG-2023, the patient received Menveo. On 22-AUG-2023, an unknown time after receiving Menveo, the patient experienced wrong solution used in drug reconstitution (Verbatim: her nurses reconstituted lyophilized Menveo vial with saline instead of the supplied liquid CYW-135 component) and inappropriate dose of vaccine administered (Verbatim: her nurses reconstituted lyophilized Menveo vial with saline instead of the supplied liquid CYW-135 component).  The outcome of the wrong solution used in drug reconstitution and inappropriate dose of vaccine administered were unknown.   Additional Information: GSK receipt date: 23-Aug-2023 Nurse supervisor reported that one of her nurses reconstituted lyophilized Menveo vial with saline instead of the supplied liquid CYW-135 component.   At the time of reporting, the dose has not been repeated. The Vaccine Administration Facility was the same as Primary Reporter. The reporter gave permission for follow-up. The lyophilized vial of Menveo was reconstituted with saline instead of the supplied liquid CYW-135 component and administered to the patient, which led to wrong solution used in drug reconstitution and inappropriate dose of vaccine administered.
Age: 17.0
Sex: M
Vaccine: MENB
Symptoms: Expired product administered
Clinical narrative: Bexsero expired dose administered; This non-serious case was reported by a pharmacist via call center representative and described the occurrence of expired vaccine used in a 17-year-old male patient who received Men B NVS (Bexsero) (batch number M7455, expiry date 31-DEC-2022) for prophylaxis.   On 22-AUG-2023, the patient received Bexsero. On 22-AUG-2023, an unknown time after receiving Bexsero, the patient experienced expired vaccine used (Verbatim: Bexsero expired dose administered).  The outcome of the expired vaccine used was unknown.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK Receipt Date: 23-AUG-2023 The pharmacist reported that an expired vaccine was administered to a patient. The reporter asked what would be the next step and requested safety data. The patient received Bexsero vaccine beyond the expiration date, which led to expired vaccine used. The reporter consented to follow up.
Age: 22.0
Sex: M
Vaccine: TDAP
Symptoms: Extra dose administered
Clinical narrative: he remembered receiving Boostrix in May this year.; This non-serious case was reported by a pharmacist via call center representative and described the occurrence of extra dose administered in a 22-year-old male patient who received DTPa (Reduced antigen) (Boostrix) (batch number 32D42, expiry date 26-SEP-2025) for prophylaxis.   Previously administered products included Shingrix (received a dose of Boostrix in May 2023).   On 23-AUG-2023, the patient received the 2nd dose of Boostrix. On 23-AUG-2023, an unknown time after receiving Boostrix, the patient experienced extra dose administered (Verbatim: he remembered receiving Boostrix in May this year.).  The outcome of the extra dose administered was unknown.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK receipt date: 23-Aug-2023 The pharmacist who stated that a patient went to the pharmacy on the day of reporting and received a dose of Boostrix.  According to reporter the patient told the reporter that he was due for the vaccine and after getting the vaccine the patient went home and called back the pharmacy to report he remembered received Boostrix in May this year.  The Patient was doing alright.  The reporter was transferred to medical information for advise on this situation. The patient received additional dose of Boostrix, which led to extra dose administered.
Sex: F
Vaccine: MNQ
Symptoms: Wrong product administered
Clinical narrative: supposed to receive an injection of Bexsero and instead received Menveo; This non-serious case was reported by a physician via call center representative and described the occurrence of wrong vaccine administered in a 12-year-old female patient who received Men ACWY-CRM NVS (Menveo) for prophylaxis.   On an unknown date, the patient received Menveo. On an unknown date, an unknown time after receiving Menveo, the patient experienced wrong vaccine administered (Verbatim: supposed to receive an injection of Bexsero and instead received Menveo).  The outcome of the wrong vaccine administered was unknown.   Additional Information: GSK receipt date: 24-AUG-2023 The health care professional (HCP) was the reporter.   No further information was known The Bexsero was with lot 25db5 and expiry 31st July 2023. The patient was supposed to received an injection of Bexsero and instead received Menveo, which led to wrong vaccine administered. The reporter consented to follow up.
Age: 1.0
Sex: F
Vaccine: DTAP
Symptoms: Expired product administered
Clinical narrative: Female kid received Infanrix expired dose; This non-serious case was reported by a other health professional via call center representative and described the occurrence of expired vaccine used in a 18-month-old female patient who received DTPa (Infanrix) (batch number T753J, expiry date 01-FEB-2021) for prophylaxis.   On 21-MAY-2021, the patient received the 2nd dose of Infanrix. On 21-MAY-2021, an unknown time after receiving Infanrix, the patient experienced expired vaccine used (Verbatim: Female kid received Infanrix expired dose).  The outcome of the expired vaccine used was unknown.   This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences.   Additional Information: GSK Receipt Date: 23-AUG-2023. Medical Assistant reported that on 21st May 2021, a female kid received Infanrix expired dose which led to expired vaccine used. This shot was the second one in the Dtap series. The reporter consented to follow up. Call Notes was reported as follow up accepted.
Sex: M
Vaccine: VARZOS
Symptoms: Incomplete course of vaccination
Clinical narrative: 2nd dose not received yet; This non-serious case was reported by a pharmacist via call center representative and described the occurrence of incomplete course of vaccination in a male patient who received Herpes zoster (Shingrix) for prophylaxis.   Previously administered products included Shingrix (1st dose received in 2019).   On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, an unknown time after receiving Shingrix, the patient experienced incomplete course of vaccination (Verbatim: 2nd dose not received yet).  The outcome of the incomplete course of vaccination was unknown.   Additional Information: GSK Receipt Date: 23-AUG-2023 A pharmacist reported that a male patient received the 1st dose of Shingrix in 2019 and is late for the 2nd dose. Till the time of reporting, the patient did not receive 2nd dose of Shingrix, which led to incomplete course of vaccination. The reporter consented to follow up via email. The reporter did not have patient or vaccination details at the time of report.
Age: 79.0
Sex: F
Vaccine: VARZOS
Symptoms: Incorrect route of product administration
Clinical narrative: Shingrix by subcutaneous route instead of intramuscular; This non-serious case was reported by a other health professional via call center representative and described the occurrence of intramuscular formulation administered by other route in a 79-year-old female patient who received Herpes zoster (Shingrix) (batch number GY559, expiry date 15-AUG-2025) and (batch number 42KG3, expiry date 15-AUG-2025) for prophylaxis.   On 23-AUG-2023, the patient received the 2nd dose of Shingrix (subcutaneous, left deltoid). On 23-AUG-2023, an unknown time after receiving Shingrix, the patient experienced intramuscular formulation administered by other route (Verbatim: Shingrix by subcutaneous route instead of intramuscular).  The outcome of the intramuscular formulation administered by other route was unknown.   Additional Information: GSK Receipt Date: 24-AUG-2023 Pharmacy Intern reported she administered a dose of Shingrix by subcutaneous route in left upper arm instead of intramuscular, which led to intramuscular formulation administered by other route. The vaccine administration facility was the same as primary reporter. The reporter consented to follow up.
Sex: F
Vaccine: VARZOS
Symptoms: Incomplete course of vaccination
Clinical narrative: first dose of Shingrix back on 1/26/2023 and it is over the 6 months for the second dose; This non-serious case was reported by a pharmacist via call center representative and described the occurrence of incomplete course of vaccination in a 60-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Previously administered products included Shingrix (received 1st dose on 26 Jan 2023).   On an unknown date, the patient did not receive the 2nd dose of Shingrix. On an unknown date, an unknown time after receiving Shingrix, the patient experienced incomplete course of vaccination (Verbatim: first dose of Shingrix back on 1/26/2023 and it is over the 6 months for the second dose).  The outcome of the incomplete course of vaccination was unknown.   Additional Information: GSK receipt date 24 August 2023: The pharmacist called to inquire whether the patient had to restart the Shingrix series over?  The pharmacist reported a patient received the first dose of Shingrix back on 26 Jan 2023 and it was over the 6 months for the second dose, the patient was currently at 7 months.  The reporter asked if they could we administer the second dose?  The reporter did not consent to follow-up.  Till the time of reporting the patient did not received 2nd dose which led to incomplete course of vaccination.