chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 36.0
Sex: F
Vaccine: FLU4
Symptoms: No adverse event, Poor quality product administered, Product storage error
Clinical narrative: vaccine was administered post excursion to patient with no reported adverse event; Initial information received on 20-Sep-2022 regarding an unsolicited valid non-serious case received via Pediatrician. Agency number: 01286178.  This case involves a 36-year-old female patient whom INFLUENZA QUADRIVAL A-B VACCINE [FLUZONE QIV] vaccine was administered post excursion to patient with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  This case is linked to cases 2022SA390611, 2022SA392303, 2022SA391393, 2022SA390948 and 2022SA392531.  On 19-Sep-2022, the patient administered post excursion suspect FLUZONE QIV at dose 0.5ml once via intramuscular route in the left upper arm (lot: UT7695JA, expiry: 30-Jun-2023) for immunization with no reported adverse event (poor quality product administered) same day latency.  It was reported that "Pediatrician reported the administration of FLUZONE QIV NP to 6 patients after it was not suitable to use post temperature excursion. Caller states she previously reported a temperature excursion and products were determined to be not suitable to use and the product was still placed back in the refrigerator. Caller states that another physician used the products and administered them to patients post excursion."   Action taken: Not applicable.  At time of reporting, the outcome was Unknown.     This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 16.0
Sex: F
Vaccine: DTAPIPV
Symptoms: Medication error, No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Quadracel vaccine was inadvertently administered to a person who was 16 years of age with no reported adverse event; Initial information regarding an unsolicited valid non-serious case received fvia Medical assistant on 20-Sep-2022. number: 01286642.  This case involves a 16-year-old female patient to whom Diphtheria-15/Tetanus/5 Hybrid AC Pertussis/IPV (MRC5) Vaccine [Quadracel] was inadvertently administered with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  Concomitant medications included MENINGOCOCCAL VACCINE A/C/Y/W CONJ (TET TOX) (MENQUADFI) for Immunization.  On 23-Aug-2022, the 16-year patient was inadvertently administered suspect Quadracel vaccine at dose 0.5ml once via intramuscular route in the left deltoid (lot: C5916AA, expiry date: 06-Jul-2023) for Immunization with no reported adverse event (product administered to patient of inappropriate age) at same day latency.   Action taken: Not applicable.  At time of reporting, the outcome was Unknown.    This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Sex: U
Vaccine: FLU4
Symptoms: Expired product administered
Clinical narrative: received a box of expired Fluzone High Dose for Jun 30, 2022 and gave all 10 doses. with no reported adverse event; Initial information received on 21-Sep-2022 regarding an unsolicited valid non-serious case received from a other health professional.  This case is linked to cases 2022SA400131(CLUSTER), 2022SA400367(CLUSTER), 2022SA400987(CLUSTER), 2022SA400369(CLUSTER), 2022SA400371(CLUSTER), 2022SA400976(CLUSTER), 2022SA401056(CLUSTER), 2022SA400981(CLUSTER) and 2022SA401104(CLUSTER).  This case involves unknown gender elderly patient who was given expired INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT] for with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  On an unknown date, the patient received a dose of suspect INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE (lot UJ772AA, exp date: 30-Jun-2022) via unknown route in unknown administration site for Immunization.  On an unknown date the patients developed a non-serious "received a box of expired Fluzone high dose for Jun 30, 2022 and gave all 10 doses. with no reported adverse event" (expired product administered) (latency: same day).  Action taken: not applicable.  At time of reporting, the outcome was Unknown for the event.   This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 7.0
Sex: F
Vaccine: FLUR3
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: FLUBLOK was given to two patients under 18 years of age with no reported adverse event; Initial information received on 21-Sep-2022 regarding an unsolicited valid non-serious case received from a other health professional.  This case is linked to case 2022SA393474(CLUSTER).  This case involves a 7 years old female patient who was under 18 years of age and given INFLUENZA QUADRIVALENT RECOMBINANT VACCINE [FLUBLOK] with no reported adverse event.   The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.   On 21-Sep-2022, the patient received 0.5 ml, once dose of suspect INFLUENZA QUADRIVALENT RECOMBINANT VACCINE (lot UJ887AA, exp: 09-Jun-2023) via intramuscular route in the left deltoid for immunisation.  On 21-Sep-2022 the patient developed a non-serious "Flublok was given to two patients under 18 years of age with no reported adverse event" (product administered to patient of inappropriate age) (latency: same day) following the administration of INFLUENZA QUADRIVALENT RECOMBINANT VACCINE.  Action taken: not applicable.  At time of reporting, the outcome was unknown for the event.   This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 65.0
Sex: F
Vaccine: FLUR3
Symptoms: Lymph node pain, Lymphadenopathy, Oedema peripheral, Vaccination site pain
Clinical narrative: swelling in her lymph nodes in her left armpit; lymph nodes were sore and tender/ lymph nodes were tender; Left arm, tenderness of armpit; Initial information received on 22-Sep-2022 regarding an unsolicited valid  non-serious case received from a consumer/non-hcp.  This case is linked to case 2022SA400984(CLUSTER).  This case involves a 65 years old female patient who experienced swelling in her lymph nodes in her left armpit, lymph nodes were sore and tender/ lymph nodes were tender and left arm, tenderness of armpit after receiving vaccine influenza quadrivalent recombinant vaccine [Flublok].  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.   On unknown date in October 2021, the patient received a  dose of suspect  influenza quadrivalent recombinant vaccine (dose, formulation, strength, lot number and expiry date not reported) via unknown route in the left arm for Immunization.  On an unknown date the patient developed swelling in her lymph nodes in her left armpit (lymphadenopathy), lymph nodes were sore and tender/ lymph nodes were tender (lymph node pain), and left arm, tenderness of armpit (vaccination site pain) (latency: 24 hours). Patient is asking  if she can receive FLUBLOK again since she did have that reaction last year and is also wanting to know if there is any information on swollen lymph nodes being a side effect. Also stated she did not want to get the FLUZONE QIV vaccine. Patient asking if swollen lymph nodes have been reported as a side effect with FLUBLOK. Patient states that she never had a reaction like that (swollen lymph nodes in her armpit) to any other vaccine in her life. Patient states that the swollen lymph nodes in her left armpit happened within 24 hours of receiving her FLUBLOK injection last year in her left arm. Patient states that her lymph nodes were sore and tender, and her left armpit was swollen. Patient states that it took a good week to calm down and for the tenderness to subside and nothing helped, not even Tylenol. Patient states that she asked a couple doctors and pharmacists if they had heard of swollen lymph nodes with the flu shot and they said that they had only heard of that with the Covid shots. Patient states that she had sore arms with the Covid vaccine and booster.  Action taken : not applicable.  The patient was treated with PARACETAMOL (TYLENOL) for Lymphadenopathy, Vaccination site pain and Lymph node pain.  Outcome : Recovered / Resolved on an unknown date after one week.; Sender's Comments:  01292145: 01292148: 01292155: Please see related inquiry number: 01290623: Please see related inquiry number: 01292148: Please see related inquiry number: 01292155: Clone made of inquiry number: 01290623 regarding FLUZONE HIGH-DOSE QUADRIVALENT:
Sex: U
Vaccine: YF
Symptoms: Expired product administered, Medication error, No adverse event
Clinical narrative: receiving expired YF-VAX, with no reported adverse event; Initial information received on 22-Sep-2022 regarding an unsolicited valid non-serious case received from a pharmacist.  This case involves 3 patients of unknown age and unknown gender who was receiving expired YELLOW FEVER VACCINE - [YF-VAX], with no reported adverse event.  The patient's past medical history, medical treatment(s), Concomitant medication, vaccination(s) and family history were not provided.   Patients received the vaccine between 20-Sep-2022 and 21-Sep-2022, with an unknown dose of suspect YELLOW FEVER VACCINE - (strength, formulation was unknown,  lot UJ397AA and expiry date: 22-Sep-2022) via unknown route in unknown administration site for Immunization.  On 20-Sep-2022 and 21-Sep-2022 the patient developed a non-serious event of receiving expired yf-vax, with no reported adverse event (expired product administered) (latency: same day or 1 day) following the administration of YELLOW FEVER VACCINE - . Reporter was asking if the patients needed to be re-vaccinated and when they should be re-vaccinated.  Action taken : not applicable.  Outcome: Unknown  This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 73.0
Sex: M
Vaccine: FLU3, FLU4
Symptoms: Medication error, Wrong product administered
Clinical narrative: Administered Fluarix instead of Fluzone High-Dose Quadrivalent vaccine with no reported adverse event; Initial information received on 23-Sep-2022 regarding an unsolicited valid  non-serious case received from a other health professional.  This case involves a 73 years old male patient who was administered fluarix instead of fluzone high-dose quadrivalent vaccine with no reported adverse event while receiving vaccines FLUARIX and INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT].  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.   On an unknown date, the patient received 0.5 mL dose of suspect FLUARIX not produced by Sanofi Pasteur (lot EE3E2 and expiry date: 30-Jun-2023) (formulation, strength, route and administration site not reported) for prophylactic immunization instead of INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE.  On an unknown date, (latency: same day) the patient was administered fluarix instead of fluzone high-dose quadrivalent vaccine with no reported adverse event (wrong product administered).  Action taken was not applicable for both the suspects.  At time of reporting, the outcome was Unknown for the event.  This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.; Sender's Comments:  01292129: 01292108: 01291872:
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered, No adverse event
Clinical narrative: administration of an expired dose of FLUZONE QIV NP to a patient who was pregnant with no reported adverse event; administration of an expired dose of FLUZONE QIV NP to a patient who was pregnant with no reported adverse event; Initial information received on 23-Sep-2022 regarding an unsolicited valid non-serious case received from a other health professional.  This case involves an unknown age female patient who was exposed to vaccine INFLUENZA QUADRIVAL A-B VACCINE [FLUZONE QIV] in context of administration of an expired dose of FLUZONE QIVNP to a patient who was pregnant with no reported adverse event. Data regarding this pregnancy were received prospectively, i.e. before pregnancy outcome was known. The reported adverse event occurred at unknown gestation period.  The date of last menstrual period was not reported. The estimated due date was not reported. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. The patient had unknown previous pregnancy/ies.  On an unknown date nurse reporting the administration of an expired dose of FLUZONE QIV (lot UT7336LA,30-Jun-2022) to patient who was pregnant (exposure during pregnancy) (expired product administered) (latency: same day). This situation is reported as a medication error due to a pregnant patient being administered FLUZONE QIV NP after the expiration date.   Action taken: not applicable.  At time of reporting, the outcome was Unknown for the event.   This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 27.0
Sex: M
Vaccine: FLU4
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: 27 years patient received FLUZONE HD with no reported adverse event; Initial information received on 26-Sep-2022 regarding an unsolicited valid non-serious case received from a physician.  This case involves a 27 years old male patient who received vaccine influenza quadrival a-b high dose hv vaccine [Fluzone High-Dose Quadrivalent] with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.   On 26-Sep-2022, the patient had received a dose of 0.7 mL total of suspect influenza quadrival a-b high dose hv vaccine (lot number-UT7729CA, expiry date- 30-Jun-2023) (with an unknown strength, formulation) via intramuscular route in the arm NOS (not otherwise specified) for Immunization.  On 26-Sep-2022, (latency same day) the patient developed a non-serious event 27 years old patient had received fluzone HD with no reported adverse event (product administered to patient of inappropriate age) following the administration of influenza quadrival a-b high dose hv vaccine.  No lab data was reported  Action taken with quadrivalent influenza vaccine was not applicable.  At time of reporting, the outcome was Unknown for the event 27 years patient received fluzone HD with no reported adverse event.  This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 3.0
Sex: M
Vaccine: DTAP
Symptoms: Expired product administered, Medication error, No adverse event
Clinical narrative: DAPTACEL given to a patient when the product was 28 days past expiration with no reported AE; Initial information received on 26-Sep-2022 regarding an unsolicited valid  non-serious case received from a pharmacist.  This case involves a 3 years old male patient who took Diphtheria-15/tetanus/5 AC pertussis vaccine [Daptacel] when the product was 28 days past expiration with no reported adverse event.  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.  On 26-Sep-2022, the patient received a 0.5 ml 1X dose of suspect Diphtheria-15/tetanus/5 AC pertussis vaccine (lot number: C5765BA) (Expiry date: 28-AUG-2022) (strength, formulation not reported) via unknown route in unknown administration site for prophylactic vaccination.  On 26-Sep-2022, the patient took Diphtheria-15/tetanus/5 AC pertussis vaccine when the product was 28 days past expiration with no reported adverse event (expired product administered) (latency: same day).  Action taken: Not applicable.  It was not reported if the patient received a corrective treatment.  outcome: Unknown  This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Sex: U
Vaccine: FLU4
Symptoms: Poor quality product administered, Product storage error
Clinical narrative: Temperature excursion at unknown temperature for 5 hours due to human error with no reported adverse event; Vaccine administered post temperature excursion with no reported adverse event; Initial information received on 27-Sep-2022 regarding an unsolicited valid  non-serious case received from a other health professional.  This case involves an unknown age and unknown gender patients who were administered vaccine post temperature excursion at unknown temperature for 5 hours due to human error with no reported adverse event while receiving vaccine INFLUENZA QUADRIVAL A-B VACCINE [FLUZONE QUADRIVALENT].  The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided.   On an unknown date, the suspect INFLUENZA QUADRIVAL A-B VACCINE was exposed to a temperature excursion at unknown temperature for 5 hours due to human error with no reported adverse event (product storage error).  On an unknown date, the patients received a dose of suspect INFLUENZA QUADRIVAL A-B VACCINE (lot UT7682LA and expiry date: 30-Jun-2023; formulation, strength, dose, route and administration site not reported) for prophylactic vaccination.  On an unknown date, the patients were administered vaccine post temperature excursion with no reported adverse event (poor quality product administered) (unknown latency) following the administration of INFLUENZA QUADRIVAL A-B VACCINE.  It was reported, "Home health service were training someone new, they took 2 vaccines out of the refrigerator drove it to 2 patients houses and administered them but didn't take the typical transport device for storage".   Action taken was not applicable.  At time of reporting, the outcome was Unknown for both the events.   This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Chest X-ray normal, Fall, Fatigue
Clinical narrative: Discharge Provider: DO; Primary Care Provider :  PA; Admission Date: 9/27/2022; Discharge Date: 09/29/2022 PRESENTING PROBLEM: Weakness; HOSPITAL COURSE: A 64 y.o. male with past medical history significant for traumatic brain injury, cognitive decline, hypertension, type 2 diabetes mellitus, CAD status post CABG who lives at  home presents today with complaints of generalized weakness. In ER COVID-19 PCR came back positive, chest x-ray negative for any significant findings. Due to generalized weakness recent multiple falls for further evaluation and management placed as observation under hospitalist service. No hypoxia during admission and no respiratory symptoms. Fatigue improved with supportive care. PT recommended DC back to home.    Close follow up advised as noted below including following up with Network 180 & primary care provider, PA.  Guardian  expressed understanding and agreement with this plan.  Guardian in agreement with discharge on 09/29/2022.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: DO; Primary Care Provider :  PA; Admission Date: 9/27/2022; Discharge Date: 09/29/2022 PRESENTING PROBLEM: Weakness; HOSPITAL COURSE: A 64 y.o. male with past medical history significant for traumatic brain injury, cognitive decline, hypertension, type 2 diabetes mellitus, CAD status post CABG who lives at  home presents today with complaints of generalized weakness. In ER COVID-19 PCR came back positive, chest x-ray negative for any significant findings. Due to generalized weakness recent multiple falls for further evaluation and management placed as observation under hospitalist service. No hypoxia during admission and no respiratory symptoms. Fatigue improved with supportive care. PT recommended DC back to home.    Close follow up advised as noted below including following up with Network 180 & primary care provider, PA.  Guardian  expressed understanding and agreement with this plan.  Guardian in agreement with discharge on 09/29/2022.
Age: 89.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Acute kidney injury, Anticoagulant therapy, Atrial fibrillation, COVID-19, Chest X-ray abnormal
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 9/26/2022 Discharge Date: Sep 28, 2022  PRESENTING PROBLEM: COVID-19    HOSPITAL COURSE: 89-year-old female with PMH significant for hypertension presenting for shortness of breath and some sputum production found to be in AFib with RVR (new onset A fib) and COVID positive.  Mild AKI upon presentation.    In the ED, received one dose 40 mg Lasix due to elevated NT proBNP and possible pulmonary vascular congestion on CXR. Elevated troponin was likely secondary to demand ischemia in setting of AFib with RVR, astropes normalized. Echo on 9/26 : EF = 55%; decreased from 60% on 4/30/21.   Patient was started on metoprolol for atrial fibrillation, titrated up to metoprolol XL 100 mg BID upon discharge. Heart rate remained stable in low 90s. Expect this will continue to improve as her COVID symptoms improve.    Patient's home hypertension medications were held - losartan and novasc - due to AKI on admission that has since resolved. Did not restart these medications going home, now that patient will be on metoprolol XL 100 mg BID. Should follow up outpatient with PCP for continued medication management.    Patient first started on Eliquis 5 mg BID for anticoagulation for atrial fibrillation, but had increased bruising on her arms, so was switched to Eliquis 2.5 mg BID. Patient was near the age and weight cut off for the dosing. Patient to only take meloxicam (home medication) as needed for pain, not daily, due to increase risk of bleeds.    Patient also receiving prescription upon discharge for an anti-viral medication for COVID (molnupiravir).    Patient stable upon discharge, back to patient's assisted living facility
Age: 89.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Contusion, Dyspnoea, Echocardiogram, Myocardial ischaemia, N-terminal prohormone brain natriuretic peptide increased
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 9/26/2022 Discharge Date: Sep 28, 2022  PRESENTING PROBLEM: COVID-19    HOSPITAL COURSE: 89-year-old female with PMH significant for hypertension presenting for shortness of breath and some sputum production found to be in AFib with RVR (new onset A fib) and COVID positive.  Mild AKI upon presentation.    In the ED, received one dose 40 mg Lasix due to elevated NT proBNP and possible pulmonary vascular congestion on CXR. Elevated troponin was likely secondary to demand ischemia in setting of AFib with RVR, astropes normalized. Echo on 9/26 : EF = 55%; decreased from 60% on 4/30/21.   Patient was started on metoprolol for atrial fibrillation, titrated up to metoprolol XL 100 mg BID upon discharge. Heart rate remained stable in low 90s. Expect this will continue to improve as her COVID symptoms improve.    Patient's home hypertension medications were held - losartan and novasc - due to AKI on admission that has since resolved. Did not restart these medications going home, now that patient will be on metoprolol XL 100 mg BID. Should follow up outpatient with PCP for continued medication management.    Patient first started on Eliquis 5 mg BID for anticoagulation for atrial fibrillation, but had increased bruising on her arms, so was switched to Eliquis 2.5 mg BID. Patient was near the age and weight cut off for the dosing. Patient to only take meloxicam (home medication) as needed for pain, not daily, due to increase risk of bleeds.    Patient also receiving prescription upon discharge for an anti-viral medication for COVID (molnupiravir).    Patient stable upon discharge, back to patient's assisted living facility
Age: 89.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Productive cough, SARS-CoV-2 test positive, Troponin increased
Clinical narrative: Discharge Provider: DO Primary Care Provider: DO Admission Date: 9/26/2022 Discharge Date: Sep 28, 2022  PRESENTING PROBLEM: COVID-19    HOSPITAL COURSE: 89-year-old female with PMH significant for hypertension presenting for shortness of breath and some sputum production found to be in AFib with RVR (new onset A fib) and COVID positive.  Mild AKI upon presentation.    In the ED, received one dose 40 mg Lasix due to elevated NT proBNP and possible pulmonary vascular congestion on CXR. Elevated troponin was likely secondary to demand ischemia in setting of AFib with RVR, astropes normalized. Echo on 9/26 : EF = 55%; decreased from 60% on 4/30/21.   Patient was started on metoprolol for atrial fibrillation, titrated up to metoprolol XL 100 mg BID upon discharge. Heart rate remained stable in low 90s. Expect this will continue to improve as her COVID symptoms improve.    Patient's home hypertension medications were held - losartan and novasc - due to AKI on admission that has since resolved. Did not restart these medications going home, now that patient will be on metoprolol XL 100 mg BID. Should follow up outpatient with PCP for continued medication management.    Patient first started on Eliquis 5 mg BID for anticoagulation for atrial fibrillation, but had increased bruising on her arms, so was switched to Eliquis 2.5 mg BID. Patient was near the age and weight cut off for the dosing. Patient to only take meloxicam (home medication) as needed for pain, not daily, due to increase risk of bleeds.    Patient also receiving prescription upon discharge for an anti-viral medication for COVID (molnupiravir).    Patient stable upon discharge, back to patient's assisted living facility
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Fall, Gait disturbance, Loss of personal independence in daily activities
Clinical narrative: Discharge Provider:  MD Primary Care Provider at Discharge: MD  Admission Date: 9/26/2022 Discharge Date:  09/28/2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: General weakness  Generalized weakness  COVID-19    HOSPITAL COURSE: Patient is a 78 y.o. female who presents today with weakness becoming progressively worse.  Patient normally is ambulatory and able to complete her ADLs with minimal assistance.  This has become increasingly difficult this past week and she fell out of bed and get up last night.  Her husband brought her to the emergency department for evaluation she was found to have acute urinary tract infection and COVID positive.  In the face of her Parkinson's it is likely that we may be able to bring her back with some fluids and antibiotics, however, it is also possible she may require rehab in the form of home health care or subacute rehab.  We will order physical and occupational therapy evaluations and continue Rocephin therapy started in the emergency department..   9/28:  Patient had an uneventful hospital stay.  She did not show any respiratory issues related to her COVID positive test.  The fluids were hep-locked, patient was tolerating oral.  Patient was transition to Keflex to complete 3 days of therapy for urinary tract infection.  She will follow-up with her primary care provider.  Patient was seen by Physical therapy and Occupational therapy with arrangements for home therapies.  Patient otherwise has remained hemodynamically stable, afebrile, room air oxygen.  I discussed the case with the patient's husband who is wanting to take her home.  Patient is stable for discharge.  Patient was given COVID-19 discharge instructions.   Patient will continue Sinemet, and follow-up with her primary care provider, also consider neurology referral as well.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Urinary tract infection
Clinical narrative: Discharge Provider:  MD Primary Care Provider at Discharge: MD  Admission Date: 9/26/2022 Discharge Date:  09/28/2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: General weakness  Generalized weakness  COVID-19    HOSPITAL COURSE: Patient is a 78 y.o. female who presents today with weakness becoming progressively worse.  Patient normally is ambulatory and able to complete her ADLs with minimal assistance.  This has become increasingly difficult this past week and she fell out of bed and get up last night.  Her husband brought her to the emergency department for evaluation she was found to have acute urinary tract infection and COVID positive.  In the face of her Parkinson's it is likely that we may be able to bring her back with some fluids and antibiotics, however, it is also possible she may require rehab in the form of home health care or subacute rehab.  We will order physical and occupational therapy evaluations and continue Rocephin therapy started in the emergency department..   9/28:  Patient had an uneventful hospital stay.  She did not show any respiratory issues related to her COVID positive test.  The fluids were hep-locked, patient was tolerating oral.  Patient was transition to Keflex to complete 3 days of therapy for urinary tract infection.  She will follow-up with her primary care provider.  Patient was seen by Physical therapy and Occupational therapy with arrangements for home therapies.  Patient otherwise has remained hemodynamically stable, afebrile, room air oxygen.  I discussed the case with the patient's husband who is wanting to take her home.  Patient is stable for discharge.  Patient was given COVID-19 discharge instructions.   Patient will continue Sinemet, and follow-up with her primary care provider, also consider neurology referral as well.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Bronchial wall thickening, COVID-19, COVID-19 pneumonia, Cardiac failure acute, Cardiac failure congestive
Clinical narrative: Admission Date: 9/26/2022 Discharge Date: 9/29/2022 ? Pneumonia due to COVID-19 virus  HOSPITAL COURSE: Patient is a 69 y.o. male with past medical history significant for paroxysmal Afib on eliquis, CHF, PVD, T2DM, liver cirrhosis, Parkinson's disease who presented to the ED for concern of chest pain and shortness of breath. Associated cough, rhinorrhea, and nasal congestion. In the emergency department, vital signs were stable. Labs significant for WBC 15, Pro BNP 2600 (previous 2000), procal 0.04. COVID-19 PCR positive. CXR showed severe congestive changes and bronchial thickening concerning for CHF versus inflammatory infection process worse in the left lung than the right.  He was started on azithromycin and Rocephin. He was admitted for further evaluation and management.    With negative procal, antibiotics were discontinued. Decadron started for covid and possible CXR findings. He was continued on IV diuresis for acute on chronic diastolic heart failure. Repeat echo showed EF 57% (down from 67% previously) with findings consistent with RV pressure overload. He was transitioned back to home torsemide. Oxygen was weaned off. He was discharged home in stable condition with upcoming cardiology appointment scheduled.    Of note, leukocytosis increasing, suspect steroid induced as infectious symptoms improving, no fever. Patient did not want to stay to be monitored further, return precautions given.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chest pain, Condition aggravated, Cough, Dyspnoea
Clinical narrative: Admission Date: 9/26/2022 Discharge Date: 9/29/2022 ? Pneumonia due to COVID-19 virus  HOSPITAL COURSE: Patient is a 69 y.o. male with past medical history significant for paroxysmal Afib on eliquis, CHF, PVD, T2DM, liver cirrhosis, Parkinson's disease who presented to the ED for concern of chest pain and shortness of breath. Associated cough, rhinorrhea, and nasal congestion. In the emergency department, vital signs were stable. Labs significant for WBC 15, Pro BNP 2600 (previous 2000), procal 0.04. COVID-19 PCR positive. CXR showed severe congestive changes and bronchial thickening concerning for CHF versus inflammatory infection process worse in the left lung than the right.  He was started on azithromycin and Rocephin. He was admitted for further evaluation and management.    With negative procal, antibiotics were discontinued. Decadron started for covid and possible CXR findings. He was continued on IV diuresis for acute on chronic diastolic heart failure. Repeat echo showed EF 57% (down from 67% previously) with findings consistent with RV pressure overload. He was transitioned back to home torsemide. Oxygen was weaned off. He was discharged home in stable condition with upcoming cardiology appointment scheduled.    Of note, leukocytosis increasing, suspect steroid induced as infectious symptoms improving, no fever. Patient did not want to stay to be monitored further, return precautions given.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, Ejection fraction normal, Left ventricular failure, Leukocytosis, Nasal congestion
Clinical narrative: Admission Date: 9/26/2022 Discharge Date: 9/29/2022 ? Pneumonia due to COVID-19 virus  HOSPITAL COURSE: Patient is a 69 y.o. male with past medical history significant for paroxysmal Afib on eliquis, CHF, PVD, T2DM, liver cirrhosis, Parkinson's disease who presented to the ED for concern of chest pain and shortness of breath. Associated cough, rhinorrhea, and nasal congestion. In the emergency department, vital signs were stable. Labs significant for WBC 15, Pro BNP 2600 (previous 2000), procal 0.04. COVID-19 PCR positive. CXR showed severe congestive changes and bronchial thickening concerning for CHF versus inflammatory infection process worse in the left lung than the right.  He was started on azithromycin and Rocephin. He was admitted for further evaluation and management.    With negative procal, antibiotics were discontinued. Decadron started for covid and possible CXR findings. He was continued on IV diuresis for acute on chronic diastolic heart failure. Repeat echo showed EF 57% (down from 67% previously) with findings consistent with RV pressure overload. He was transitioned back to home torsemide. Oxygen was weaned off. He was discharged home in stable condition with upcoming cardiology appointment scheduled.    Of note, leukocytosis increasing, suspect steroid induced as infectious symptoms improving, no fever. Patient did not want to stay to be monitored further, return precautions given.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia, Pneumonitis, Polyuria, Procalcitonin, Prohormone brain natriuretic peptide increased
Clinical narrative: Admission Date: 9/26/2022 Discharge Date: 9/29/2022 ? Pneumonia due to COVID-19 virus  HOSPITAL COURSE: Patient is a 69 y.o. male with past medical history significant for paroxysmal Afib on eliquis, CHF, PVD, T2DM, liver cirrhosis, Parkinson's disease who presented to the ED for concern of chest pain and shortness of breath. Associated cough, rhinorrhea, and nasal congestion. In the emergency department, vital signs were stable. Labs significant for WBC 15, Pro BNP 2600 (previous 2000), procal 0.04. COVID-19 PCR positive. CXR showed severe congestive changes and bronchial thickening concerning for CHF versus inflammatory infection process worse in the left lung than the right.  He was started on azithromycin and Rocephin. He was admitted for further evaluation and management.    With negative procal, antibiotics were discontinued. Decadron started for covid and possible CXR findings. He was continued on IV diuresis for acute on chronic diastolic heart failure. Repeat echo showed EF 57% (down from 67% previously) with findings consistent with RV pressure overload. He was transitioned back to home torsemide. Oxygen was weaned off. He was discharged home in stable condition with upcoming cardiology appointment scheduled.    Of note, leukocytosis increasing, suspect steroid induced as infectious symptoms improving, no fever. Patient did not want to stay to be monitored further, return precautions given.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Rhinorrhoea, Right ventricular failure, SARS-CoV-2 test positive, White blood cell count increased
Clinical narrative: Admission Date: 9/26/2022 Discharge Date: 9/29/2022 ? Pneumonia due to COVID-19 virus  HOSPITAL COURSE: Patient is a 69 y.o. male with past medical history significant for paroxysmal Afib on eliquis, CHF, PVD, T2DM, liver cirrhosis, Parkinson's disease who presented to the ED for concern of chest pain and shortness of breath. Associated cough, rhinorrhea, and nasal congestion. In the emergency department, vital signs were stable. Labs significant for WBC 15, Pro BNP 2600 (previous 2000), procal 0.04. COVID-19 PCR positive. CXR showed severe congestive changes and bronchial thickening concerning for CHF versus inflammatory infection process worse in the left lung than the right.  He was started on azithromycin and Rocephin. He was admitted for further evaluation and management.    With negative procal, antibiotics were discontinued. Decadron started for covid and possible CXR findings. He was continued on IV diuresis for acute on chronic diastolic heart failure. Repeat echo showed EF 57% (down from 67% previously) with findings consistent with RV pressure overload. He was transitioned back to home torsemide. Oxygen was weaned off. He was discharged home in stable condition with upcoming cardiology appointment scheduled.    Of note, leukocytosis increasing, suspect steroid induced as infectious symptoms improving, no fever. Patient did not want to stay to be monitored further, return precautions given.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Error: Wrong Vaccine/Product Administered-
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Anticoagulation drug level below therapeutic, Asthenia, Bradycardia, COVID-19
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 9/25/2022 Discharge Date: 9/29/2022   PRESENTING PROBLEM: Weakness [R53.1]   HOSPITAL COURSE:   Patient is 87-year-old male with history of combine systolic and diastolic heart failure with EF of 20%, CVA with left-sided residual, atrial flutter on warfarin, and seizure disorder, who presented to hospital with increasing weakness difficulty walking, low appetite cough and was found to be COVID positive.  He also was found to be in acute on chronic combine systolic and diastolic heart failure exacerbation.  He was not a candidate for antiviral medication.  He was treated with doxycycline, prednisone and antitussives medication. He was also treated with IV lasix for acute on chronic systolic and diastolic heart failure.  He was recommended for subacute rehab, but patient declined as he have extensive home health services arranged and also have a caregiver. His wife have dementia. Note that he was subtherapeutic on INR, warfarin increase to 4 mg daily.  He will need to follow up with warfarin Clinic for further management.  He also need to follow up with primary care doctor and cardiologist to assess indication for beta-blocker and spironolactone.  These medications were not started during this hospitalization due to somewhat low blood pressure and bradycardia.  COVID Assessment & Plan Oxygen at home baseline Not a candidate for anti-virals Treated with prednisone 40 mg daily; discharged with 2 more days His CXR did have basilar opacity (likely viral PNA, but could be superinfected with bacteria), sputum is dark brown  Treated with and discharged on robitussin as needed and doxycycline for 6 additional days
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure acute, Chest X-ray abnormal, Condition aggravated, Cough, Decreased appetite
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 9/25/2022 Discharge Date: 9/29/2022   PRESENTING PROBLEM: Weakness [R53.1]   HOSPITAL COURSE:   Patient is 87-year-old male with history of combine systolic and diastolic heart failure with EF of 20%, CVA with left-sided residual, atrial flutter on warfarin, and seizure disorder, who presented to hospital with increasing weakness difficulty walking, low appetite cough and was found to be COVID positive.  He also was found to be in acute on chronic combine systolic and diastolic heart failure exacerbation.  He was not a candidate for antiviral medication.  He was treated with doxycycline, prednisone and antitussives medication. He was also treated with IV lasix for acute on chronic systolic and diastolic heart failure.  He was recommended for subacute rehab, but patient declined as he have extensive home health services arranged and also have a caregiver. His wife have dementia. Note that he was subtherapeutic on INR, warfarin increase to 4 mg daily.  He will need to follow up with warfarin Clinic for further management.  He also need to follow up with primary care doctor and cardiologist to assess indication for beta-blocker and spironolactone.  These medications were not started during this hospitalization due to somewhat low blood pressure and bradycardia.  COVID Assessment & Plan Oxygen at home baseline Not a candidate for anti-virals Treated with prednisone 40 mg daily; discharged with 2 more days His CXR did have basilar opacity (likely viral PNA, but could be superinfected with bacteria), sputum is dark brown  Treated with and discharged on robitussin as needed and doxycycline for 6 additional days
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Gait disturbance, Hypotension, Left ventricular failure, Lung opacity, Pneumonia viral
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  MD Admission Date: 9/25/2022 Discharge Date: 9/29/2022   PRESENTING PROBLEM: Weakness [R53.1]   HOSPITAL COURSE:   Patient is 87-year-old male with history of combine systolic and diastolic heart failure with EF of 20%, CVA with left-sided residual, atrial flutter on warfarin, and seizure disorder, who presented to hospital with increasing weakness difficulty walking, low appetite cough and was found to be COVID positive.  He also was found to be in acute on chronic combine systolic and diastolic heart failure exacerbation.  He was not a candidate for antiviral medication.  He was treated with doxycycline, prednisone and antitussives medication. He was also treated with IV lasix for acute on chronic systolic and diastolic heart failure.  He was recommended for subacute rehab, but patient declined as he have extensive home health services arranged and also have a caregiver. His wife have dementia. Note that he was subtherapeutic on INR, warfarin increase to 4 mg daily.  He will need to follow up with warfarin Clinic for further management.  He also need to follow up with primary care doctor and cardiologist to assess indication for beta-blocker and spironolactone.  These medications were not started during this hospitalization due to somewhat low blood pressure and bradycardia.  COVID Assessment & Plan Oxygen at home baseline Not a candidate for anti-virals Treated with prednisone 40 mg daily; discharged with 2 more days His CXR did have basilar opacity (likely viral PNA, but could be superinfected with bacteria), sputum is dark brown  Treated with and discharged on robitussin as needed and doxycycline for 6 additional days