chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 54.0
Sex: F
Vaccine: SMALLMNK
Symptoms: Injection site pruritus, Injection site vesicles
Clinical narrative: Patient notified clinic on 11/21 of the following below.   Patient notes the following: 11/16: Minutes after vaccination, patient noticed pain and tenderness at site of injection. 11/17: The following day tenderness is still present and induration noted around site of injection with itchiness present. Patient made note not to scratch area. 11/17 Afternoon: Patient reports nodule rose from site of injection area with induration. Patient noted vesicle developing; reported to be superficial and less than 1 cm in diameter. 11/18: Patient noted vesicle and covered area with a dry, non-adherent dressing. 11/18 Afternoon: Patient noted induration from site of injection to elbow. 11/19: Patient noted primary vesicle ruptured, washed area with soap and water, wiped with alcohol and placed cover dressing. 11/20: Patient noted 2-3 more small vesicle development. Patient declines using any creams or antibiotic ointments. Patient places non-adherent island dressing. 11/21 (Today): Patient noted area of induration is decreasing. Patient states symptoms are all localized to site of injection area. Patient notes is still experiencing itchiness. Patient states has been taking oral Benadryl to help with itchiness. Patient declines any fever or warmness to injection site.   11/21: Patient attached photos of injection with showed development of bullae and visual induration noted. Patient encouraged to monitor for  any warmness, increase pain, fever, chills and/or signs/symptoms of infection. Patient advised to let Occupational Medicine know and/or seek urgent care depending on level of symptoms.  Patient encouraged to keep bullae covered with non-adherent dressing.   11/28: Checked in on patient. Patient noted site is still slowly improving.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Pt received first dose in primary series on 11/29/2022; however, the manufacturer's expiration date was 11/28/2022.  Physician and patient notified on 11/30/2022 as soon as staff was made aware of their error.  Pt states that he is not experiencing any adverse symptoms.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 92.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Blood culture positive, COVID-19, Cerebral atrophy, Cerebral small vessel ischaemic disease, Computerised tomogram head abnormal
Clinical narrative: COVID+ 11/25/2022  Vaccination Status - moderna x 4 + Pfizer bivalent x1 BRIEF OVERVIEW: Admission Date: 11/25/2022 Discharge Date: 11/29/2022   Active Hospital Problems   Diagnosis Date Noted POA ? Altered mental status, unspecified altered mental status type 11/26/2022 Unknown ? Late onset Alzheimer's disease without behavioral disturbance 12/30/2020 Yes ? Class 1 obesity in adult 12/07/2020 Unknown ? Type 2 diabetes mellitus with diabetic nephropathy 11/13/2017 Yes ? Hypertension, essential    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Altered mental status, unspecified altered mental status type COVID COVID-19   HOSPITAL COURSE: The patient is a 92 y.o. female who presented with a history of Alzheimer's, diabetes, obesity.  Patient sent in today to the emergency department because staff at other facility stated patient had increased confusion. Patient has had no complaints.  Patient was on 2 L nasal cannula but able to be weaned to room air but oxygen saturations kept dropping down into the 80s at that time.  Viral PCR did detect COVID-19 PCR. She had a positive test in August. Urinalysis was negative for urinary tract infection. EKG showed normal sinus rhythm.  CT head showed no acute intracranial process.  Mild chronic microvascular sugar white matter ischemic change.  Moderate generalized parenchymal atrophy. Blood cultures were drawn and first set of cultures were positive. She was started on IV vancomycin. According to Antimicrobial stewardship, these were most likely contaminants and antibiotics recommended to be Dc'd. She remained afebrile, labs improved. Mentation is at baseline per family. 2nd set of blood cultures are negative. Vitals are stable, with blood pressures soft, will recommend that lisinopril continued to be held until follow up. She has been discharged in a stable medical condition.
Age: 92.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Confusional state, Electrocardiogram normal, Mental status changes, SARS-CoV-2 test positive, Sinus rhythm
Clinical narrative: COVID+ 11/25/2022  Vaccination Status - moderna x 4 + Pfizer bivalent x1 BRIEF OVERVIEW: Admission Date: 11/25/2022 Discharge Date: 11/29/2022   Active Hospital Problems   Diagnosis Date Noted POA ? Altered mental status, unspecified altered mental status type 11/26/2022 Unknown ? Late onset Alzheimer's disease without behavioral disturbance 12/30/2020 Yes ? Class 1 obesity in adult 12/07/2020 Unknown ? Type 2 diabetes mellitus with diabetic nephropathy 11/13/2017 Yes ? Hypertension, essential    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Altered mental status, unspecified altered mental status type COVID COVID-19   HOSPITAL COURSE: The patient is a 92 y.o. female who presented with a history of Alzheimer's, diabetes, obesity.  Patient sent in today to the emergency department because staff at other facility stated patient had increased confusion. Patient has had no complaints.  Patient was on 2 L nasal cannula but able to be weaned to room air but oxygen saturations kept dropping down into the 80s at that time.  Viral PCR did detect COVID-19 PCR. She had a positive test in August. Urinalysis was negative for urinary tract infection. EKG showed normal sinus rhythm.  CT head showed no acute intracranial process.  Mild chronic microvascular sugar white matter ischemic change.  Moderate generalized parenchymal atrophy. Blood cultures were drawn and first set of cultures were positive. She was started on IV vancomycin. According to Antimicrobial stewardship, these were most likely contaminants and antibiotics recommended to be Dc'd. She remained afebrile, labs improved. Mentation is at baseline per family. 2nd set of blood cultures are negative. Vitals are stable, with blood pressures soft, will recommend that lisinopril continued to be held until follow up. She has been discharged in a stable medical condition.
Age: 92.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Urine analysis normal
Clinical narrative: COVID+ 11/25/2022  Vaccination Status - moderna x 4 + Pfizer bivalent x1 BRIEF OVERVIEW: Admission Date: 11/25/2022 Discharge Date: 11/29/2022   Active Hospital Problems   Diagnosis Date Noted POA ? Altered mental status, unspecified altered mental status type 11/26/2022 Unknown ? Late onset Alzheimer's disease without behavioral disturbance 12/30/2020 Yes ? Class 1 obesity in adult 12/07/2020 Unknown ? Type 2 diabetes mellitus with diabetic nephropathy 11/13/2017 Yes ? Hypertension, essential    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Altered mental status, unspecified altered mental status type COVID COVID-19   HOSPITAL COURSE: The patient is a 92 y.o. female who presented with a history of Alzheimer's, diabetes, obesity.  Patient sent in today to the emergency department because staff at other facility stated patient had increased confusion. Patient has had no complaints.  Patient was on 2 L nasal cannula but able to be weaned to room air but oxygen saturations kept dropping down into the 80s at that time.  Viral PCR did detect COVID-19 PCR. She had a positive test in August. Urinalysis was negative for urinary tract infection. EKG showed normal sinus rhythm.  CT head showed no acute intracranial process.  Mild chronic microvascular sugar white matter ischemic change.  Moderate generalized parenchymal atrophy. Blood cultures were drawn and first set of cultures were positive. She was started on IV vancomycin. According to Antimicrobial stewardship, these were most likely contaminants and antibiotics recommended to be Dc'd. She remained afebrile, labs improved. Mentation is at baseline per family. 2nd set of blood cultures are negative. Vitals are stable, with blood pressures soft, will recommend that lisinopril continued to be held until follow up. She has been discharged in a stable medical condition.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered, Product storage error
Clinical narrative: Patient received a third dose, first booster, of the covid bivalent vaccine on 12/1/2022 at 12:20pm. The dose the patient received was from a vial that was opened the day prior at 9:22 am and had expired as of 9:22 pm the night prior. The pharmacist called the Pfizer clinical line and spoke to a representative who advised that the efficacy of the vaccine is viable when left at room temperatures for up to 24 hours. The patient does not need another dose and is considered immunized. There are no expected negative symptoms or outcomes or necessary treatments at this time.
Age: 54.0
Sex: F
Vaccine: UNK
Symptoms: Incorrect product formulation administered, No adverse event, Product packaging confusion
Clinical narrative: Monovalent vaccine was administered in error when bivalent vaccine should have been. No harm to patient. No adverse effects from vaccine. Potential for errors is greater with multidose vials that look alike. Recommending changing the vials, creating single dose syringes that can be scanned to prevent errors.
Age: 70.0
Sex: F
Vaccine: FLUA4
Symptoms: Influenza, Influenza A virus test positive, Influenza B virus test, Malaise, SARS-CoV-2 test negative
Clinical narrative: Pt was vaccinated for Influenza on 10/28/2022 and presented to the office very ill with Influenza A on 12/1/2022. She tested positive for Influenza A in the office.
Age: 37.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Foreign travel, Lethargy, Oropharyngeal pain, Pain
Clinical narrative: As of November 18th,2022 I went traveling, returning home on November 27th, 2022. The next day my wife and I were ill with a sore throat and body aches. We contacted telehealth and they suggested strep throat was the cause. That Tuesday on the November 29th, 2022, we felt worse sore throat, body ache, lethargic and with a fever. On November 30th, 2002, we went to our doctor and tested positive for COVID-19. They told us to take cough medicine and medicine for sore throat.
Age: 37.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: As of November 18th,2022 I went traveling, returning home on November 27th, 2022. The next day my wife and I were ill with a sore throat and body aches. We contacted telehealth and they suggested strep throat was the cause. That Tuesday on the November 29th, 2022, we felt worse sore throat, body ache, lethargic and with a fever. On November 30th, 2002, we went to our doctor and tested positive for COVID-19. They told us to take cough medicine and medicine for sore throat.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Given expired vaccine--expiry date 11/28/2022 and given on 12-01-2022
Age: 4.0
Sex: M
Vaccine: COVID19-2, FLUX
Symptoms: Tic
Clinical narrative: Within 24 hours of receiving the Pfizer Bivalent vaccine, we noticed that he started having a tick in his face. The pediatrician said it's a facial tick/flinch. It's like he is having Tourette's. The doctor told us that it may be from the vaccine or it may just be something that is happening to him.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, Asthenia, Balance disorder, COVID-19, COVID-19 pneumonia
Clinical narrative: Patient brought to the ED on 10/22 for stroke like symptoms including weakness, slurred speech, and troubles balancing. He was diagnosed with a stroke and admitted to the ICU on 10/22. Additionally his admission screening test for COVID came back positive that day. He required supplemental oxygen due to acute hypoxic respiratory failure likely from COVID-19 pneumonia however was able to be weaned off oxygen. Patient was discharged 11/4 and admitted to inpatient rehabilitation.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cerebrovascular accident, Dysarthria, Intensive care, SARS-CoV-2 test positive
Clinical narrative: Patient brought to the ED on 10/22 for stroke like symptoms including weakness, slurred speech, and troubles balancing. He was diagnosed with a stroke and admitted to the ICU on 10/22. Additionally his admission screening test for COVID came back positive that day. He required supplemental oxygen due to acute hypoxic respiratory failure likely from COVID-19 pneumonia however was able to be weaned off oxygen. Patient was discharged 11/4 and admitted to inpatient rehabilitation.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Dyspepsia, Fatigue, Gastrooesophageal reflux disease, Pain
Clinical narrative: She got her vaccine, she was very tired and her arm was aching for a couple of days.  Then she had the tiredness, a lot of aches and pains, it was weird as it started on her neck and went down the left side of her shoulder to her waist, and never on the right side, like a severe toothache in her back.  She took Advil for the pain and it went on for a few days.  She did not have a cough or fever, but just the aches and pains.  Then severe days later she had a severe reaction to GERD, and her stomach was torn up with indigestion.  At first she did not think it was from the shot, but did not what else it would have been and had to double up on her stomach medicine.  She talked to her doctor on the phone and he's the one who increased her stomach medicine and had her take the Advil for the aches and pains and told her to rest until it passed.    She subsequently had the booster when she did ok, had a sore arm but did not have the acid reflux issue aggravated or the aches or pains with that.   She had the booster on 11/26/2021.      She did not suffer from COVID until 11/22/22 and feels that the vaccine had helped her not to get it until now.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Therapy change
Clinical narrative: She got her vaccine, she was very tired and her arm was aching for a couple of days.  Then she had the tiredness, a lot of aches and pains, it was weird as it started on her neck and went down the left side of her shoulder to her waist, and never on the right side, like a severe toothache in her back.  She took Advil for the pain and it went on for a few days.  She did not have a cough or fever, but just the aches and pains.  Then severe days later she had a severe reaction to GERD, and her stomach was torn up with indigestion.  At first she did not think it was from the shot, but did not what else it would have been and had to double up on her stomach medicine.  She talked to her doctor on the phone and he's the one who increased her stomach medicine and had her take the Advil for the aches and pains and told her to rest until it passed.    She subsequently had the booster when she did ok, had a sore arm but did not have the acid reflux issue aggravated or the aches or pains with that.   She had the booster on 11/26/2021.      She did not suffer from COVID until 11/22/22 and feels that the vaccine had helped her not to get it until now.
Age: 36.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood urine present, Laboratory test abnormal, Micturition urgency, Pollakiuria, Sexually transmitted disease test
Clinical narrative: I had increased frequency and urgency for urination. I also had blood in the urine with discomfort. Yesterday I went to get the health center to get tested for a UTI and it was confirmed that it was a UTI. I was prescribed generic MACROBID to treat my symptoms. I began to take the medication yesterday and I think there has been some improvements in the symptoms. I am not sure whether I have completed recovered as I have just begun the antibiotics.
Age: 36.0
Sex: F
Vaccine: COVID19-2
Symptoms: Urinary tract discomfort, Urinary tract infection
Clinical narrative: I had increased frequency and urgency for urination. I also had blood in the urine with discomfort. Yesterday I went to get the health center to get tested for a UTI and it was confirmed that it was a UTI. I was prescribed generic MACROBID to treat my symptoms. I began to take the medication yesterday and I think there has been some improvements in the symptoms. I am not sure whether I have completed recovered as I have just begun the antibiotics.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Blister, Hypoaesthesia, Neuralgia, Scar, Sensory loss
Clinical narrative: Patient called after approximately 1 and 1/2 months after receiving vaccine stating she's having issues with full-body hives that are forming blisters and leaving scarring/discoloration of her skin. She's also having issues with nerve pain along with sensation loss/loss of feeling in her extremities.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Skin discolouration, Urticaria
Clinical narrative: Patient called after approximately 1 and 1/2 months after receiving vaccine stating she's having issues with full-body hives that are forming blisters and leaving scarring/discoloration of her skin. She's also having issues with nerve pain along with sensation loss/loss of feeling in her extremities.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Abscess, Acute respiratory failure, Anticoagulant therapy, Aortic valve incompetence, Aortic valve replacement
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 11/22/2022 Discharge Date: 11/24/2022 COVID positive Date 11/22/2022 PRESENTING PROBLEM: Hypoxia  Acute hypoxemic respiratory failure (HCC) COVID-19   HOSPITAL COURSE: Patient w/ pmhx of bicuspid aortic valve with streptococcus mitis aortic valve endocarditis and aortic root abscess s/p aortic valve replacement and ICD in place, heart failure with reduced EF due to NICM and VF arrest, pAfib s/p LAA excision, HTN, DM who came in with decreased o2 saturation in outpatient setting with recent cough and dyspnea on exertion that was worsening who was found to be in Acute Hypoxemic Respiratory Failure. She was found to be COVID positive with pleural effusions.  She has complex recent medical history including infective endocarditis, aortic root abscess, severe aortic insufficiency s/p valve replacement, afib s/p LAAE and MAZE on warfarin, cardiac arrest 09/2022. Recently completed antibiotics last week prior to admission.  She was treated with remdesivir and decadron for COVID-19 pneumonia, diuresis was started with IV lasix due to HF and pleural effusions.  Pt had good response to 2 days of IV lasix and reached euvolemia.  Pt also achieved symptomatic response and endorsed significant improvement  Repeat CXRs showed improvement in bilateral pleural effusions.  During stay, pt was transitioned to Eliquis from Coumadin.  Pt was also started on empagliflozin 10 mg.  On 11/24, plan was made to discharge pt with these meds, along with furosemide 20 mg a day oral to maintain euvolemia.  Pt was discharged on 11/24 in stable condition with instructions to continue her home meds besides warfarin, start eliquis and empagliflozin, and present in 2 days for repeat basic labs, with possible initiation of spironolactone and discontinuation of furosemide.  Follow up also established with cardiology and pt has instructions to present to primary care physician as well.       CONSULTS / RECOMMENDATION: Cardiology: recommended starting eliquis and discontinuing warfarin.  Recommended empagliflozin as well as continuing the rest of home meds.  Also recommended a short course of 20mg oral furosemide along with follow up for possible initiation of spironolactone
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial appendage resection, Atrial fibrillation, COVID-19, COVID-19 pneumonia, Cardiac arrest
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 11/22/2022 Discharge Date: 11/24/2022 COVID positive Date 11/22/2022 PRESENTING PROBLEM: Hypoxia  Acute hypoxemic respiratory failure (HCC) COVID-19   HOSPITAL COURSE: Patient w/ pmhx of bicuspid aortic valve with streptococcus mitis aortic valve endocarditis and aortic root abscess s/p aortic valve replacement and ICD in place, heart failure with reduced EF due to NICM and VF arrest, pAfib s/p LAA excision, HTN, DM who came in with decreased o2 saturation in outpatient setting with recent cough and dyspnea on exertion that was worsening who was found to be in Acute Hypoxemic Respiratory Failure. She was found to be COVID positive with pleural effusions.  She has complex recent medical history including infective endocarditis, aortic root abscess, severe aortic insufficiency s/p valve replacement, afib s/p LAAE and MAZE on warfarin, cardiac arrest 09/2022. Recently completed antibiotics last week prior to admission.  She was treated with remdesivir and decadron for COVID-19 pneumonia, diuresis was started with IV lasix due to HF and pleural effusions.  Pt had good response to 2 days of IV lasix and reached euvolemia.  Pt also achieved symptomatic response and endorsed significant improvement  Repeat CXRs showed improvement in bilateral pleural effusions.  During stay, pt was transitioned to Eliquis from Coumadin.  Pt was also started on empagliflozin 10 mg.  On 11/24, plan was made to discharge pt with these meds, along with furosemide 20 mg a day oral to maintain euvolemia.  Pt was discharged on 11/24 in stable condition with instructions to continue her home meds besides warfarin, start eliquis and empagliflozin, and present in 2 days for repeat basic labs, with possible initiation of spironolactone and discontinuation of furosemide.  Follow up also established with cardiology and pt has instructions to present to primary care physician as well.       CONSULTS / RECOMMENDATION: Cardiology: recommended starting eliquis and discontinuing warfarin.  Recommended empagliflozin as well as continuing the rest of home meds.  Also recommended a short course of 20mg oral furosemide along with follow up for possible initiation of spironolactone
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac failure, Chest X-ray abnormal, Condition aggravated, Cough, Cox-Maze procedure
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 11/22/2022 Discharge Date: 11/24/2022 COVID positive Date 11/22/2022 PRESENTING PROBLEM: Hypoxia  Acute hypoxemic respiratory failure (HCC) COVID-19   HOSPITAL COURSE: Patient w/ pmhx of bicuspid aortic valve with streptococcus mitis aortic valve endocarditis and aortic root abscess s/p aortic valve replacement and ICD in place, heart failure with reduced EF due to NICM and VF arrest, pAfib s/p LAA excision, HTN, DM who came in with decreased o2 saturation in outpatient setting with recent cough and dyspnea on exertion that was worsening who was found to be in Acute Hypoxemic Respiratory Failure. She was found to be COVID positive with pleural effusions.  She has complex recent medical history including infective endocarditis, aortic root abscess, severe aortic insufficiency s/p valve replacement, afib s/p LAAE and MAZE on warfarin, cardiac arrest 09/2022. Recently completed antibiotics last week prior to admission.  She was treated with remdesivir and decadron for COVID-19 pneumonia, diuresis was started with IV lasix due to HF and pleural effusions.  Pt had good response to 2 days of IV lasix and reached euvolemia.  Pt also achieved symptomatic response and endorsed significant improvement  Repeat CXRs showed improvement in bilateral pleural effusions.  During stay, pt was transitioned to Eliquis from Coumadin.  Pt was also started on empagliflozin 10 mg.  On 11/24, plan was made to discharge pt with these meds, along with furosemide 20 mg a day oral to maintain euvolemia.  Pt was discharged on 11/24 in stable condition with instructions to continue her home meds besides warfarin, start eliquis and empagliflozin, and present in 2 days for repeat basic labs, with possible initiation of spironolactone and discontinuation of furosemide.  Follow up also established with cardiology and pt has instructions to present to primary care physician as well.       CONSULTS / RECOMMENDATION: Cardiology: recommended starting eliquis and discontinuing warfarin.  Recommended empagliflozin as well as continuing the rest of home meds.  Also recommended a short course of 20mg oral furosemide along with follow up for possible initiation of spironolactone
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Diuretic therapy, Dyspnoea exertional, Endocarditis, Hypoxia, Oxygen saturation decreased
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 11/22/2022 Discharge Date: 11/24/2022 COVID positive Date 11/22/2022 PRESENTING PROBLEM: Hypoxia  Acute hypoxemic respiratory failure (HCC) COVID-19   HOSPITAL COURSE: Patient w/ pmhx of bicuspid aortic valve with streptococcus mitis aortic valve endocarditis and aortic root abscess s/p aortic valve replacement and ICD in place, heart failure with reduced EF due to NICM and VF arrest, pAfib s/p LAA excision, HTN, DM who came in with decreased o2 saturation in outpatient setting with recent cough and dyspnea on exertion that was worsening who was found to be in Acute Hypoxemic Respiratory Failure. She was found to be COVID positive with pleural effusions.  She has complex recent medical history including infective endocarditis, aortic root abscess, severe aortic insufficiency s/p valve replacement, afib s/p LAAE and MAZE on warfarin, cardiac arrest 09/2022. Recently completed antibiotics last week prior to admission.  She was treated with remdesivir and decadron for COVID-19 pneumonia, diuresis was started with IV lasix due to HF and pleural effusions.  Pt had good response to 2 days of IV lasix and reached euvolemia.  Pt also achieved symptomatic response and endorsed significant improvement  Repeat CXRs showed improvement in bilateral pleural effusions.  During stay, pt was transitioned to Eliquis from Coumadin.  Pt was also started on empagliflozin 10 mg.  On 11/24, plan was made to discharge pt with these meds, along with furosemide 20 mg a day oral to maintain euvolemia.  Pt was discharged on 11/24 in stable condition with instructions to continue her home meds besides warfarin, start eliquis and empagliflozin, and present in 2 days for repeat basic labs, with possible initiation of spironolactone and discontinuation of furosemide.  Follow up also established with cardiology and pt has instructions to present to primary care physician as well.       CONSULTS / RECOMMENDATION: Cardiology: recommended starting eliquis and discontinuing warfarin.  Recommended empagliflozin as well as continuing the rest of home meds.  Also recommended a short course of 20mg oral furosemide along with follow up for possible initiation of spironolactone
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Pleural effusion, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 11/22/2022 Discharge Date: 11/24/2022 COVID positive Date 11/22/2022 PRESENTING PROBLEM: Hypoxia  Acute hypoxemic respiratory failure (HCC) COVID-19   HOSPITAL COURSE: Patient w/ pmhx of bicuspid aortic valve with streptococcus mitis aortic valve endocarditis and aortic root abscess s/p aortic valve replacement and ICD in place, heart failure with reduced EF due to NICM and VF arrest, pAfib s/p LAA excision, HTN, DM who came in with decreased o2 saturation in outpatient setting with recent cough and dyspnea on exertion that was worsening who was found to be in Acute Hypoxemic Respiratory Failure. She was found to be COVID positive with pleural effusions.  She has complex recent medical history including infective endocarditis, aortic root abscess, severe aortic insufficiency s/p valve replacement, afib s/p LAAE and MAZE on warfarin, cardiac arrest 09/2022. Recently completed antibiotics last week prior to admission.  She was treated with remdesivir and decadron for COVID-19 pneumonia, diuresis was started with IV lasix due to HF and pleural effusions.  Pt had good response to 2 days of IV lasix and reached euvolemia.  Pt also achieved symptomatic response and endorsed significant improvement  Repeat CXRs showed improvement in bilateral pleural effusions.  During stay, pt was transitioned to Eliquis from Coumadin.  Pt was also started on empagliflozin 10 mg.  On 11/24, plan was made to discharge pt with these meds, along with furosemide 20 mg a day oral to maintain euvolemia.  Pt was discharged on 11/24 in stable condition with instructions to continue her home meds besides warfarin, start eliquis and empagliflozin, and present in 2 days for repeat basic labs, with possible initiation of spironolactone and discontinuation of furosemide.  Follow up also established with cardiology and pt has instructions to present to primary care physician as well.       CONSULTS / RECOMMENDATION: Cardiology: recommended starting eliquis and discontinuing warfarin.  Recommended empagliflozin as well as continuing the rest of home meds.  Also recommended a short course of 20mg oral furosemide along with follow up for possible initiation of spironolactone
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, Diarrhoea, Dizziness, Hyperhidrosis, Loss of personal independence in daily activities
Clinical narrative: After waiting 15 minute observation, client left the facility and was transported by van to her facility. During the van ride, she started feeling sweaty, weak, and felt faint for about 5 minutes. She turned to administrator and said "I'm going to be sick". The van stopped and she vomited, it was" chunky" (she said it was her breakfast coming up).  She declined 911/EMS, she got back in the van and "felt better".  As she entered the facility, she also had an episode of diarrhea. The medical office came up to assess her, vitals were normal for her (bp 90/60) taken and she rested for the remainder of the day with no other instances of nausea/vomiting or diarrhea. Rested for the next day and did not participate in groups the next day. States today, Thursday, December 1, 2022, she feels fine.
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Nausea, Vomiting
Clinical narrative: After waiting 15 minute observation, client left the facility and was transported by van to her facility. During the van ride, she started feeling sweaty, weak, and felt faint for about 5 minutes. She turned to administrator and said "I'm going to be sick". The van stopped and she vomited, it was" chunky" (she said it was her breakfast coming up).  She declined 911/EMS, she got back in the van and "felt better".  As she entered the facility, she also had an episode of diarrhea. The medical office came up to assess her, vitals were normal for her (bp 90/60) taken and she rested for the remainder of the day with no other instances of nausea/vomiting or diarrhea. Rested for the next day and did not participate in groups the next day. States today, Thursday, December 1, 2022, she feels fine.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 55.0
Sex: F
Vaccine: COVID19-2
Symptoms: Angiogram pulmonary abnormal, Asthenia, COVID-19, COVID-19 pneumonia, Condition aggravated
Clinical narrative: COVID+ 11/17/2022.  Vaccination Status - Pfizer x3 + Pfizer BIVALENT BRIEF OVERVIEW: Admission Date: 11/21/2022 Discharge Date: Nov 23, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Pneumonia due to COVID-19 virus 11/21/2022 Yes ? Pulmonary hypertension 01/23/2020 Yes ? ILD (interstitial lung disease) 01/23/2014 Yes ? Stage 3a chronic kidney disease 06/30/2022 Yes ? PFO (patent foramen ovale) 09/02/2015 Yes ? Obesity 04/27/2015 Yes ? MCTD (mixed connective tissue disease)   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus   HOSPITAL COURSE: This patient was admitted on 11/21 with continued symptoms of acute COVID infection starting 11 days prior to admission.  Symptoms included fatigue, weakness, diarrhea, nausea, worsening hypoxia.  Patient tested positive for COVID 11/17.  Patient had had her initial COVID series of vaccinations but had not yet received a booster.  CT angiogram showed no evidence of PE and evidence of chronic interstitial lung disease with superimposed airspace opacities consistent with COVID.  She was treated with Decadron.  Pulmonary was consulted.  They recommended discontinuation of the patient's CellCept which has been prescribed for management of her interstitial lung disease.  There was the concern that that might be interfering with resolution of her COVID infection.  Additional is recommended that based on the patient's weight her Decadron dose be increased from the standard dose of 6 mg daily to 10 mg daily.  The patient demonstrates substantial improvement and was discharged in improving condition on 11/23.  She will take a 10 day course of Decadron 10 mg a day.  She will stay off CellCept for 4 weeks or restart after 7 days of baseline lung function.  She will see her pulmonologist in 2-3 weeks for follow-up to coordinate transition from treatment of acute COVID to ongoing management of her interstitial lung disease.. CONSULTS / RECOMMENDATION: pulmonary
Age: 55.0
Sex: F
Vaccine: COVID19-2
Symptoms: Diarrhoea, Fatigue, Hypoxia, Interstitial lung disease, Lung opacity
Clinical narrative: COVID+ 11/17/2022.  Vaccination Status - Pfizer x3 + Pfizer BIVALENT BRIEF OVERVIEW: Admission Date: 11/21/2022 Discharge Date: Nov 23, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Pneumonia due to COVID-19 virus 11/21/2022 Yes ? Pulmonary hypertension 01/23/2020 Yes ? ILD (interstitial lung disease) 01/23/2014 Yes ? Stage 3a chronic kidney disease 06/30/2022 Yes ? PFO (patent foramen ovale) 09/02/2015 Yes ? Obesity 04/27/2015 Yes ? MCTD (mixed connective tissue disease)   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus   HOSPITAL COURSE: This patient was admitted on 11/21 with continued symptoms of acute COVID infection starting 11 days prior to admission.  Symptoms included fatigue, weakness, diarrhea, nausea, worsening hypoxia.  Patient tested positive for COVID 11/17.  Patient had had her initial COVID series of vaccinations but had not yet received a booster.  CT angiogram showed no evidence of PE and evidence of chronic interstitial lung disease with superimposed airspace opacities consistent with COVID.  She was treated with Decadron.  Pulmonary was consulted.  They recommended discontinuation of the patient's CellCept which has been prescribed for management of her interstitial lung disease.  There was the concern that that might be interfering with resolution of her COVID infection.  Additional is recommended that based on the patient's weight her Decadron dose be increased from the standard dose of 6 mg daily to 10 mg daily.  The patient demonstrates substantial improvement and was discharged in improving condition on 11/23.  She will take a 10 day course of Decadron 10 mg a day.  She will stay off CellCept for 4 weeks or restart after 7 days of baseline lung function.  She will see her pulmonologist in 2-3 weeks for follow-up to coordinate transition from treatment of acute COVID to ongoing management of her interstitial lung disease.. CONSULTS / RECOMMENDATION: pulmonary
Age: 55.0
Sex: F
Vaccine: COVID19-2
Symptoms: Malaise, Nausea, SARS-CoV-2 test positive
Clinical narrative: COVID+ 11/17/2022.  Vaccination Status - Pfizer x3 + Pfizer BIVALENT BRIEF OVERVIEW: Admission Date: 11/21/2022 Discharge Date: Nov 23, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Pneumonia due to COVID-19 virus 11/21/2022 Yes ? Pulmonary hypertension 01/23/2020 Yes ? ILD (interstitial lung disease) 01/23/2014 Yes ? Stage 3a chronic kidney disease 06/30/2022 Yes ? PFO (patent foramen ovale) 09/02/2015 Yes ? Obesity 04/27/2015 Yes ? MCTD (mixed connective tissue disease)   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus   HOSPITAL COURSE: This patient was admitted on 11/21 with continued symptoms of acute COVID infection starting 11 days prior to admission.  Symptoms included fatigue, weakness, diarrhea, nausea, worsening hypoxia.  Patient tested positive for COVID 11/17.  Patient had had her initial COVID series of vaccinations but had not yet received a booster.  CT angiogram showed no evidence of PE and evidence of chronic interstitial lung disease with superimposed airspace opacities consistent with COVID.  She was treated with Decadron.  Pulmonary was consulted.  They recommended discontinuation of the patient's CellCept which has been prescribed for management of her interstitial lung disease.  There was the concern that that might be interfering with resolution of her COVID infection.  Additional is recommended that based on the patient's weight her Decadron dose be increased from the standard dose of 6 mg daily to 10 mg daily.  The patient demonstrates substantial improvement and was discharged in improving condition on 11/23.  She will take a 10 day course of Decadron 10 mg a day.  She will stay off CellCept for 4 weeks or restart after 7 days of baseline lung function.  She will see her pulmonologist in 2-3 weeks for follow-up to coordinate transition from treatment of acute COVID to ongoing management of her interstitial lung disease.. CONSULTS / RECOMMENDATION: pulmonary
Age: 75.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Hyporesponsive to stimuli, Lethargy, SARS-CoV-2 test positive
Clinical narrative: Patient brought to the ED by EMS on 10/23 after husband observed patient being minimally responsive. Patient also with generalized weakness and lethargy. En route to the hospital, patient's husband received a call from the patient's nursing facility confirming that the patient tested positive for COVID. Repeat COVID testing done on 10/23 was also positive. Patient admitted 10/23-10/26. Patient has received the COVID primary series and two booster doses.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 32.0
Sex: M
Vaccine: TDAP
Symptoms: Extra dose administered
Clinical narrative: PT RECEIVED 2 DOSES, ONE MONTH APART. NO REACTION NOTED
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Monovalent vaccine given as booster instead of bivalent vaccine.
Age: 19.0
Sex: F
Vaccine: FLUA4
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Gave flu Vaccine dose from children's stock to a 19 year old.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Monovalent vaccine given as booster instead of bivalent vaccine.
Age: 38.0
Sex: F
Vaccine: COVID19-2
Symptoms: Inappropriate schedule of product administration, Incorrect product formulation administered
Clinical narrative: Patient made appointment for Moderna Bivalent Booster. When she arrived she confirmed she was looking for Bivalent Booster. After administration of the IMZ and reporting to our immunization registry, it was discovered she was due for a second dose of the primary series with her first dose being 11 months ago. No adverse issues reported by patient. CDC was called for info and suggestion to offer pt the second dose was given.
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 8.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient was given Pfizer COVID-19 bivalent for ages 5 to 11 for primary dose instead of COVID- 19 monovalent. No adverse symptoms were noted, mother was notified of error.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 6.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: My daughter received her first Moderna booster for COVID-19 on 6/3/2022. On 7/27/2022, she tested positive on a home antigen test for COVID-19. During her bout with COVID-19, the only symptom she had was a mild fever, which was under 101 and lasted for 3-4 days. It was so mild that we did not even give her medicine for it.
Age: 98.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 51.0
Sex: M
Vaccine: FLUC4
Symptoms: Lip pain, Lip swelling, Skin lesion
Clinical narrative: Painful raised lesion on upper lip 24 hours after receiving flu vaccine
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: monovalent vaccine given as booster instead of bivalent vaccine
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cough, Dyspnoea, Mental status changes
Clinical narrative: Patient with history of CHF and COPD, wears 2 L O2 at baseline. Seen in the ED on 10/24 for shortness of breath, fever, cough, nausea, and vomiting. She requested a COVID test which was done in the ED, and she was discharged home. The COVID test came back positive. On 10/27, the patient returned to the ED via EMS with progressively worsening symptoms and was admitted 10/27 - 11/5. She was diagnosed with COVID pneumonia infection and started on dexamethasone 6 mg daily. Patient was discharged but readmitted hours after discharge due to sudden onset of altered mental status of unclear etiology en-route to hospital. Patient ultimately was discharged 11/9.
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Nausea, Pyrexia, SARS-CoV-2 test positive, Vomiting
Clinical narrative: Patient with history of CHF and COPD, wears 2 L O2 at baseline. Seen in the ED on 10/24 for shortness of breath, fever, cough, nausea, and vomiting. She requested a COVID test which was done in the ED, and she was discharged home. The COVID test came back positive. On 10/27, the patient returned to the ED via EMS with progressively worsening symptoms and was admitted 10/27 - 11/5. She was diagnosed with COVID pneumonia infection and started on dexamethasone 6 mg daily. Patient was discharged but readmitted hours after discharge due to sudden onset of altered mental status of unclear etiology en-route to hospital. Patient ultimately was discharged 11/9.
Age: 13.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Patient's date of birth was wrong in his chart and on his consent form. Patient's brother's DOB was listed. Patient received the Pfizer Bivalent booster for 5-11 year olds when he should have received the 12 years and older vaccine.
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Asthenia, COVID-19, Confusional state, Cough
Clinical narrative: On 10/23 patient developed difficulty breathing, cough, and fever. Patient's wife has had COVID for the past 5 days. He was seen in urgent care on 10/24 and tested positive for COVID. He was prescribed Lagevrio at his visit and took his first dose that today. Following the urgent care visit, patient developed weakness, confusion, and inability to stand which prompted his visit to the ED on 10/24. He was admitted 10/24 - 10/27 for COVID-19 infection, acute kidney injury, and hypokalemia. Patient did not require supplemental O2. Patient has received primary COVID vaccine series and one booster.
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Dyspnoea, Dysstasia, Hypokalaemia, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: On 10/23 patient developed difficulty breathing, cough, and fever. Patient's wife has had COVID for the past 5 days. He was seen in urgent care on 10/24 and tested positive for COVID. He was prescribed Lagevrio at his visit and took his first dose that today. Following the urgent care visit, patient developed weakness, confusion, and inability to stand which prompted his visit to the ED on 10/24. He was admitted 10/24 - 10/27 for COVID-19 infection, acute kidney injury, and hypokalemia. Patient did not require supplemental O2. Patient has received primary COVID vaccine series and one booster.
Age: 28.0
Sex: F
Vaccine: HEP
Symptoms: Dizziness, Malaise, Paraesthesia
Clinical narrative: Pt came up to pharmacy window 40 minutes after receiving vaccine stating she was feeling lightheaded, had some slight tingling in her left arm and side of her face.  Pt stated she wasn't feeling well. Patient did not have signs/symptoms of an allergic reaction. Patients condition maintained same level and patient left the pharmacy area on her own.  Patient was advised to seek medical treatment if she had any difficulty breathing or tightness in her chest or her condition worsened.
Age: 61.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Patient received the bivalent booster on 09/12/2022, but heard through a television advertisement that he needed a second bivalent booster and was confused.  The second bivalent booster dose was administered before the error was discovered.
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event
Clinical narrative: Patient was given moderna vaccine on 8/6/22 by another health care facility.  He was then given pfizer by our office on 9/29/22. Parents in office today requesting third dose as recommended by pfizer.  No adverse side effects noted in our office.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Blood glucose abnormal, Burning sensation, Diabetes mellitus inadequate control, Hypoaesthesia
Clinical narrative: Controlled Type 2 diabetes w/o complications became uncontrolled with erratic blood sugars causing nausea, weakness, involuntary shaking. Circulation to fingers and toes was affected by turning white, cold,  becoming numb, then burning and tingling when warmed and turned dusky and purple. Diagnosed with Raynaud's Syndrome.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Nausea, Paraesthesia, Peripheral coldness, Poor peripheral circulation, Raynaud's phenomenon
Clinical narrative: Controlled Type 2 diabetes w/o complications became uncontrolled with erratic blood sugars causing nausea, weakness, involuntary shaking. Circulation to fingers and toes was affected by turning white, cold,  becoming numb, then burning and tingling when warmed and turned dusky and purple. Diagnosed with Raynaud's Syndrome.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Skin discolouration, Tremor
Clinical narrative: Controlled Type 2 diabetes w/o complications became uncontrolled with erratic blood sugars causing nausea, weakness, involuntary shaking. Circulation to fingers and toes was affected by turning white, cold,  becoming numb, then burning and tingling when warmed and turned dusky and purple. Diagnosed with Raynaud's Syndrome.