chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 17.0
Sex: F
Vaccine: MENB, MNQ
Symptoms: Blood glucose, Dizziness, Feeling of body temperature change, Hyperhidrosis, Pallor
Clinical narrative: Patient received vaccinations without incident.  However, she returned to clinic several hours later complaining of feeling dizzy and lightheaded.  She also reports that her she'd feel cold one moment and then hot another.  Patient did not eat anything all day.   Blood sugar was 83.  Pulse: 83, Blood pressure: 102/70, Resp Rate: 18, Temp: 97.9.  She was diaphoretic and pale when she first returned.  Otherwise, physical exam was unremarkable.   She stayed with us for ~45 min.  Was given graham crackers and water.  After sitting and eating, her coloring appeared more at baseline.  She reported feeling better.  Family was called and notified.  She left clinic for home with instructions to monitor closely.
Age: 62.0
Sex: M
Vaccine: COVID19-2
Symptoms: Deafness unilateral, Full blood count, Tinnitus
Clinical narrative: In my left ear I had Tinnitus and lost of hearing it was pretty significant loss of hearing and the doctor did a Tympanic injection with steroids. I had those symptoms for about 3 days before going to the doctor and today I have gotten better but still have reduced hearing. I have another doctors appointment on 9/30/22.
Age: 17.0
Sex: F
Vaccine: COVID19, UNK, UNK, UNK, UNK
Symptoms: Alopecia, Anxiety, Blood 25-hydroxycholecalciferol, Blood thyroid stimulating hormone, Depression
Clinical narrative: I was a perfectly healthy teenage girl with absolutely no health conditions at all. I was in college and graduating high school and then I got high blood pressure first and then that ended up turning into anxiety, depression, tremors, muscle pain, weak arms, hair loss, really scared of dying, really fast heart rate. I havent been able to drive my car in months and it has depleted most of my vitamins.
Age: 17.0
Sex: F
Vaccine: COVID19, UNK, UNK, UNK, UNK
Symptoms: Fear of death, Full blood count, Hypertension, Impaired driving ability, Lipids
Clinical narrative: I was a perfectly healthy teenage girl with absolutely no health conditions at all. I was in college and graduating high school and then I got high blood pressure first and then that ended up turning into anxiety, depression, tremors, muscle pain, weak arms, hair loss, really scared of dying, really fast heart rate. I havent been able to drive my car in months and it has depleted most of my vitamins.
Age: 17.0
Sex: F
Vaccine: COVID19, UNK, UNK, UNK, UNK
Symptoms: Metabolic function test, Multi-vitamin deficiency, Muscular weakness, Myalgia, Red blood cell sedimentation rate
Clinical narrative: I was a perfectly healthy teenage girl with absolutely no health conditions at all. I was in college and graduating high school and then I got high blood pressure first and then that ended up turning into anxiety, depression, tremors, muscle pain, weak arms, hair loss, really scared of dying, really fast heart rate. I havent been able to drive my car in months and it has depleted most of my vitamins.
Age: 17.0
Sex: F
Vaccine: COVID19, UNK, UNK, UNK, UNK
Symptoms: Thyroxine free, Tremor
Clinical narrative: I was a perfectly healthy teenage girl with absolutely no health conditions at all. I was in college and graduating high school and then I got high blood pressure first and then that ended up turning into anxiety, depression, tremors, muscle pain, weak arms, hair loss, really scared of dying, really fast heart rate. I havent been able to drive my car in months and it has depleted most of my vitamins.
Age: 90.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Anticoagulant therapy, Asthenia, Atrial fibrillation, Blood bilirubin increased, Blood thyroid stimulating hormone increased
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD  Discharge Date: 9/21/2022 HOSPITAL COURSE: Patient is a 91-year-old female with history of hypertension, hypothyroidism, hyperlipidemia and anxiety who presented to the emergency department with chest pain and palpitations.  She reported increasing fatigue and weakness for about 1 week prior to presentation, and developed chest pain on evening of presentation.  In the emergency department, she was hypertensive, but otherwise hemodynamically stable.  Lab workup showed bilirubin of 1.8 and hemoglobin 9.2 g/dL.  Pro-BNP was found to be elevated to 2768 and troponin was 34, then 36. Chest x-ray showed cardiomyopathy without evidence of heart failure.  EKG showed sinus tachycardia with PACs.  She was found to be positive for COVID-19.  She was admitted to the hospitalist service for further evaluation of COVID-19 and chest pain.   Upon admission, the patient remained hemodynamically stable on room air.  She did not report shortness of breath, but did report sore throat, cough and minimal sputum production.  She remained afebrile.  Given unclear duration of symptoms and lack of hypoxemia, she was not treated with IV remdesivir or Decadron.   She developed acute onset of atrial fibrillation with rapid ventricular response on the afternoon of 9/20.  Heart rates reached as high as the 180s.  EKG confirmed atrial fibrillation with rapid ventricular response.  She was given 2 doses of IV Cardizem, and started on oral Toprol-XL and oral Cardizem for rate control.  Later that evening, she converted back to normal sinus rhythm, and was continued on Toprol-XL 50 mg daily.  Oral Cardizem was discontinued.  She was found to have a CHADS-VASc score of 4, so was recommended to start Eliquis 2.5 mg PO BID for stroke risk reduction.  She remained in normal sinus rhythm overnight and into the next day.  Echocardiogram was performed, and showed preserved ejection fraction with no wall motion abnormalities.  Of note, her TSH returned at 0.02, although this was markedly different from TSH value of 11.8 on 8/5/22.  She may benefit from outpatient referral to endocrinology given significant lability in TSH values over the last couple of months.   She was felt stable for discharge home on the afternoon of 9/21/2022.  She will be discharged on Toprol-XL 50 mg daily and Eliquis 2.5 mg PO BID.  Due to addition of Toprol-XL, losartan will be decreased to 50 mg daily (from twice daily).  I would recommend outpatient follow-up with Cardiology, given new onset of atrial fibrillation.  She should follow-up with her PCP in 1 week.  Could consider outpatient referral to endocrinology due to lability in TSH values over the last few months, but will defer to PCP.  DISCHARGE DIAGNOSES: 1. COVID-19 pneumonia 2. Atrial fibrillation with RVR 3. Acute on chronic macrocytic anemia 4. Lower extremity edema 5. Benign essential hypertension 6. Hypothyroidism 7. Hyperlipidemia 8. Anxiety
Age: 90.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: COVID-19, COVID-19 pneumonia, Cardiomyopathy, Chest X-ray abnormal, Chest pain
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD  Discharge Date: 9/21/2022 HOSPITAL COURSE: Patient is a 91-year-old female with history of hypertension, hypothyroidism, hyperlipidemia and anxiety who presented to the emergency department with chest pain and palpitations.  She reported increasing fatigue and weakness for about 1 week prior to presentation, and developed chest pain on evening of presentation.  In the emergency department, she was hypertensive, but otherwise hemodynamically stable.  Lab workup showed bilirubin of 1.8 and hemoglobin 9.2 g/dL.  Pro-BNP was found to be elevated to 2768 and troponin was 34, then 36. Chest x-ray showed cardiomyopathy without evidence of heart failure.  EKG showed sinus tachycardia with PACs.  She was found to be positive for COVID-19.  She was admitted to the hospitalist service for further evaluation of COVID-19 and chest pain.   Upon admission, the patient remained hemodynamically stable on room air.  She did not report shortness of breath, but did report sore throat, cough and minimal sputum production.  She remained afebrile.  Given unclear duration of symptoms and lack of hypoxemia, she was not treated with IV remdesivir or Decadron.   She developed acute onset of atrial fibrillation with rapid ventricular response on the afternoon of 9/20.  Heart rates reached as high as the 180s.  EKG confirmed atrial fibrillation with rapid ventricular response.  She was given 2 doses of IV Cardizem, and started on oral Toprol-XL and oral Cardizem for rate control.  Later that evening, she converted back to normal sinus rhythm, and was continued on Toprol-XL 50 mg daily.  Oral Cardizem was discontinued.  She was found to have a CHADS-VASc score of 4, so was recommended to start Eliquis 2.5 mg PO BID for stroke risk reduction.  She remained in normal sinus rhythm overnight and into the next day.  Echocardiogram was performed, and showed preserved ejection fraction with no wall motion abnormalities.  Of note, her TSH returned at 0.02, although this was markedly different from TSH value of 11.8 on 8/5/22.  She may benefit from outpatient referral to endocrinology given significant lability in TSH values over the last couple of months.   She was felt stable for discharge home on the afternoon of 9/21/2022.  She will be discharged on Toprol-XL 50 mg daily and Eliquis 2.5 mg PO BID.  Due to addition of Toprol-XL, losartan will be decreased to 50 mg daily (from twice daily).  I would recommend outpatient follow-up with Cardiology, given new onset of atrial fibrillation.  She should follow-up with her PCP in 1 week.  Could consider outpatient referral to endocrinology due to lability in TSH values over the last few months, but will defer to PCP.  DISCHARGE DIAGNOSES: 1. COVID-19 pneumonia 2. Atrial fibrillation with RVR 3. Acute on chronic macrocytic anemia 4. Lower extremity edema 5. Benign essential hypertension 6. Hypothyroidism 7. Hyperlipidemia 8. Anxiety
Age: 90.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Condition aggravated, Cough, Echocardiogram normal, Electrocardiogram abnormal, Fatigue
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD  Discharge Date: 9/21/2022 HOSPITAL COURSE: Patient is a 91-year-old female with history of hypertension, hypothyroidism, hyperlipidemia and anxiety who presented to the emergency department with chest pain and palpitations.  She reported increasing fatigue and weakness for about 1 week prior to presentation, and developed chest pain on evening of presentation.  In the emergency department, she was hypertensive, but otherwise hemodynamically stable.  Lab workup showed bilirubin of 1.8 and hemoglobin 9.2 g/dL.  Pro-BNP was found to be elevated to 2768 and troponin was 34, then 36. Chest x-ray showed cardiomyopathy without evidence of heart failure.  EKG showed sinus tachycardia with PACs.  She was found to be positive for COVID-19.  She was admitted to the hospitalist service for further evaluation of COVID-19 and chest pain.   Upon admission, the patient remained hemodynamically stable on room air.  She did not report shortness of breath, but did report sore throat, cough and minimal sputum production.  She remained afebrile.  Given unclear duration of symptoms and lack of hypoxemia, she was not treated with IV remdesivir or Decadron.   She developed acute onset of atrial fibrillation with rapid ventricular response on the afternoon of 9/20.  Heart rates reached as high as the 180s.  EKG confirmed atrial fibrillation with rapid ventricular response.  She was given 2 doses of IV Cardizem, and started on oral Toprol-XL and oral Cardizem for rate control.  Later that evening, she converted back to normal sinus rhythm, and was continued on Toprol-XL 50 mg daily.  Oral Cardizem was discontinued.  She was found to have a CHADS-VASc score of 4, so was recommended to start Eliquis 2.5 mg PO BID for stroke risk reduction.  She remained in normal sinus rhythm overnight and into the next day.  Echocardiogram was performed, and showed preserved ejection fraction with no wall motion abnormalities.  Of note, her TSH returned at 0.02, although this was markedly different from TSH value of 11.8 on 8/5/22.  She may benefit from outpatient referral to endocrinology given significant lability in TSH values over the last couple of months.   She was felt stable for discharge home on the afternoon of 9/21/2022.  She will be discharged on Toprol-XL 50 mg daily and Eliquis 2.5 mg PO BID.  Due to addition of Toprol-XL, losartan will be decreased to 50 mg daily (from twice daily).  I would recommend outpatient follow-up with Cardiology, given new onset of atrial fibrillation.  She should follow-up with her PCP in 1 week.  Could consider outpatient referral to endocrinology due to lability in TSH values over the last few months, but will defer to PCP.  DISCHARGE DIAGNOSES: 1. COVID-19 pneumonia 2. Atrial fibrillation with RVR 3. Acute on chronic macrocytic anemia 4. Lower extremity edema 5. Benign essential hypertension 6. Hypothyroidism 7. Hyperlipidemia 8. Anxiety
Age: 90.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Haemoglobin decreased, Hypertension, Laboratory test, Oedema peripheral, Oropharyngeal pain
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD  Discharge Date: 9/21/2022 HOSPITAL COURSE: Patient is a 91-year-old female with history of hypertension, hypothyroidism, hyperlipidemia and anxiety who presented to the emergency department with chest pain and palpitations.  She reported increasing fatigue and weakness for about 1 week prior to presentation, and developed chest pain on evening of presentation.  In the emergency department, she was hypertensive, but otherwise hemodynamically stable.  Lab workup showed bilirubin of 1.8 and hemoglobin 9.2 g/dL.  Pro-BNP was found to be elevated to 2768 and troponin was 34, then 36. Chest x-ray showed cardiomyopathy without evidence of heart failure.  EKG showed sinus tachycardia with PACs.  She was found to be positive for COVID-19.  She was admitted to the hospitalist service for further evaluation of COVID-19 and chest pain.   Upon admission, the patient remained hemodynamically stable on room air.  She did not report shortness of breath, but did report sore throat, cough and minimal sputum production.  She remained afebrile.  Given unclear duration of symptoms and lack of hypoxemia, she was not treated with IV remdesivir or Decadron.   She developed acute onset of atrial fibrillation with rapid ventricular response on the afternoon of 9/20.  Heart rates reached as high as the 180s.  EKG confirmed atrial fibrillation with rapid ventricular response.  She was given 2 doses of IV Cardizem, and started on oral Toprol-XL and oral Cardizem for rate control.  Later that evening, she converted back to normal sinus rhythm, and was continued on Toprol-XL 50 mg daily.  Oral Cardizem was discontinued.  She was found to have a CHADS-VASc score of 4, so was recommended to start Eliquis 2.5 mg PO BID for stroke risk reduction.  She remained in normal sinus rhythm overnight and into the next day.  Echocardiogram was performed, and showed preserved ejection fraction with no wall motion abnormalities.  Of note, her TSH returned at 0.02, although this was markedly different from TSH value of 11.8 on 8/5/22.  She may benefit from outpatient referral to endocrinology given significant lability in TSH values over the last couple of months.   She was felt stable for discharge home on the afternoon of 9/21/2022.  She will be discharged on Toprol-XL 50 mg daily and Eliquis 2.5 mg PO BID.  Due to addition of Toprol-XL, losartan will be decreased to 50 mg daily (from twice daily).  I would recommend outpatient follow-up with Cardiology, given new onset of atrial fibrillation.  She should follow-up with her PCP in 1 week.  Could consider outpatient referral to endocrinology due to lability in TSH values over the last few months, but will defer to PCP.  DISCHARGE DIAGNOSES: 1. COVID-19 pneumonia 2. Atrial fibrillation with RVR 3. Acute on chronic macrocytic anemia 4. Lower extremity edema 5. Benign essential hypertension 6. Hypothyroidism 7. Hyperlipidemia 8. Anxiety
Age: 90.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Palpitations, Productive cough, Prohormone brain natriuretic peptide increased, SARS-CoV-2 test positive, Sinus tachycardia
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD  Discharge Date: 9/21/2022 HOSPITAL COURSE: Patient is a 91-year-old female with history of hypertension, hypothyroidism, hyperlipidemia and anxiety who presented to the emergency department with chest pain and palpitations.  She reported increasing fatigue and weakness for about 1 week prior to presentation, and developed chest pain on evening of presentation.  In the emergency department, she was hypertensive, but otherwise hemodynamically stable.  Lab workup showed bilirubin of 1.8 and hemoglobin 9.2 g/dL.  Pro-BNP was found to be elevated to 2768 and troponin was 34, then 36. Chest x-ray showed cardiomyopathy without evidence of heart failure.  EKG showed sinus tachycardia with PACs.  She was found to be positive for COVID-19.  She was admitted to the hospitalist service for further evaluation of COVID-19 and chest pain.   Upon admission, the patient remained hemodynamically stable on room air.  She did not report shortness of breath, but did report sore throat, cough and minimal sputum production.  She remained afebrile.  Given unclear duration of symptoms and lack of hypoxemia, she was not treated with IV remdesivir or Decadron.   She developed acute onset of atrial fibrillation with rapid ventricular response on the afternoon of 9/20.  Heart rates reached as high as the 180s.  EKG confirmed atrial fibrillation with rapid ventricular response.  She was given 2 doses of IV Cardizem, and started on oral Toprol-XL and oral Cardizem for rate control.  Later that evening, she converted back to normal sinus rhythm, and was continued on Toprol-XL 50 mg daily.  Oral Cardizem was discontinued.  She was found to have a CHADS-VASc score of 4, so was recommended to start Eliquis 2.5 mg PO BID for stroke risk reduction.  She remained in normal sinus rhythm overnight and into the next day.  Echocardiogram was performed, and showed preserved ejection fraction with no wall motion abnormalities.  Of note, her TSH returned at 0.02, although this was markedly different from TSH value of 11.8 on 8/5/22.  She may benefit from outpatient referral to endocrinology given significant lability in TSH values over the last couple of months.   She was felt stable for discharge home on the afternoon of 9/21/2022.  She will be discharged on Toprol-XL 50 mg daily and Eliquis 2.5 mg PO BID.  Due to addition of Toprol-XL, losartan will be decreased to 50 mg daily (from twice daily).  I would recommend outpatient follow-up with Cardiology, given new onset of atrial fibrillation.  She should follow-up with her PCP in 1 week.  Could consider outpatient referral to endocrinology due to lability in TSH values over the last few months, but will defer to PCP.  DISCHARGE DIAGNOSES: 1. COVID-19 pneumonia 2. Atrial fibrillation with RVR 3. Acute on chronic macrocytic anemia 4. Lower extremity edema 5. Benign essential hypertension 6. Hypothyroidism 7. Hyperlipidemia 8. Anxiety
Age: 90.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Supraventricular extrasystoles, Troponin increased
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD  Discharge Date: 9/21/2022 HOSPITAL COURSE: Patient is a 91-year-old female with history of hypertension, hypothyroidism, hyperlipidemia and anxiety who presented to the emergency department with chest pain and palpitations.  She reported increasing fatigue and weakness for about 1 week prior to presentation, and developed chest pain on evening of presentation.  In the emergency department, she was hypertensive, but otherwise hemodynamically stable.  Lab workup showed bilirubin of 1.8 and hemoglobin 9.2 g/dL.  Pro-BNP was found to be elevated to 2768 and troponin was 34, then 36. Chest x-ray showed cardiomyopathy without evidence of heart failure.  EKG showed sinus tachycardia with PACs.  She was found to be positive for COVID-19.  She was admitted to the hospitalist service for further evaluation of COVID-19 and chest pain.   Upon admission, the patient remained hemodynamically stable on room air.  She did not report shortness of breath, but did report sore throat, cough and minimal sputum production.  She remained afebrile.  Given unclear duration of symptoms and lack of hypoxemia, she was not treated with IV remdesivir or Decadron.   She developed acute onset of atrial fibrillation with rapid ventricular response on the afternoon of 9/20.  Heart rates reached as high as the 180s.  EKG confirmed atrial fibrillation with rapid ventricular response.  She was given 2 doses of IV Cardizem, and started on oral Toprol-XL and oral Cardizem for rate control.  Later that evening, she converted back to normal sinus rhythm, and was continued on Toprol-XL 50 mg daily.  Oral Cardizem was discontinued.  She was found to have a CHADS-VASc score of 4, so was recommended to start Eliquis 2.5 mg PO BID for stroke risk reduction.  She remained in normal sinus rhythm overnight and into the next day.  Echocardiogram was performed, and showed preserved ejection fraction with no wall motion abnormalities.  Of note, her TSH returned at 0.02, although this was markedly different from TSH value of 11.8 on 8/5/22.  She may benefit from outpatient referral to endocrinology given significant lability in TSH values over the last couple of months.   She was felt stable for discharge home on the afternoon of 9/21/2022.  She will be discharged on Toprol-XL 50 mg daily and Eliquis 2.5 mg PO BID.  Due to addition of Toprol-XL, losartan will be decreased to 50 mg daily (from twice daily).  I would recommend outpatient follow-up with Cardiology, given new onset of atrial fibrillation.  She should follow-up with her PCP in 1 week.  Could consider outpatient referral to endocrinology due to lability in TSH values over the last few months, but will defer to PCP.  DISCHARGE DIAGNOSES: 1. COVID-19 pneumonia 2. Atrial fibrillation with RVR 3. Acute on chronic macrocytic anemia 4. Lower extremity edema 5. Benign essential hypertension 6. Hypothyroidism 7. Hyperlipidemia 8. Anxiety
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chills, Fatigue, Illness, Nausea
Clinical narrative: PT CALLED TODAY AND STATES SHE IS VERY SICK. C/O SEVERE NAUSEA, FATIGUE, AND CHILLS. DENIES VOMITING/DIARRHEA AND LOCALIZED S/S AT THE INJECTION SITE. HAS BEEN TREATING S/S WITH PHENERGAN. STATES S/S BEGAN ON SATURDAY 9-24-2022. PT HAS AN APPT 9-28 WITH HER PCP UNRELATED FOLLOW UP, BUT PLANS TO ADDRESS THIS WITH THE PROVIDER AS WELL.   NO KNOWN CONTACT WITH ANYONE SICK.   PT HAS HAD NO VACCINES IN THE MONTHE PRECEEDING THIUS DOSE, BUT DOSE HAVE 3 DOSES OF MODERNA MONOVALENT ON 1-13-21, 2-10-21, 10-27-21.
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, Asymptomatic COVID-19, Bedridden, Blood creatinine increased
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 9/17/2022 Discharge Date: 09/22/2022  PRESENTING PROBLEM: Hyperkalemia [E87.5] Severe sepsis  [A41.9, R65.20] Acute kidney injury  [N17.9] Acute renal failure superimposed on stage 4 chronic kidney disease, unspecified acute renal failure type [N17.9, N18.4]   HOSPITAL COURSE: Patient is a 93-year-old with a past medical history of atrial fibrillation not on anticoagulation, hypertension, CKD stage 4, recent GI bleed, duodenal ulcers, MDS, osteoarthritis, colostomy due to previous small-bowel obstruction presented to emergency department due to shortness of breath and productive cough and weakness and fatigue.  She was recently discharged from local Health Hospital due to concern for acute on chronic kidney disease and GI bleeding.  Patient has been bedridden since that time she was discharged on extremely weak without able to do her ADLs.  Patient is at baseline alert and oriented x4.  Hence patient's family decided to bring her to the hospital.  At the time of presentation patient was COVID positive.  Chest x-ray was consistent with the right lower lung patchy opacity.  Also patient was found to have acute kidney injury with creatinine of 3.5 to at the time of admission.  She was started on IV fluids which improved her creatinine slowly.  Patient remained asymptomatic in terms of COVID.  She was started on Rocephin and doxycycline for community-acquired pneumonia coverage.  She did exhibit lactic acidosis which is most likely secondary to renal failure.  Renal ultrasound done during this admission did not show any hydronephrosis .  Sputum cultures were positive for moderate Staphylococcus aureus.  Cefepime was discontinued and she was transitioned to oral doxycycline alone.  She was evaluated by physical and occupational therapy as well as speech language pathology and underwent video swallow study.  The patient's fatigue persisted and her appetite remained poor.  She developed hypernatremia due to poor oral intake and required IV fluids.  Goals of care conversations were initiated and the patient ultimately determined that she would like to discharge home with hospice.  She was transitioned to comfort care and subsequently discharged in stable condition on 09/22 with plans for hospice sign on as soon as she arrives home.  Family was in agreement with the patient's decision.  She was discharged to complete 2 additional days of oral doxycycline for 7 day total course for MSSA pneumonia.
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic kidney disease, Condition aggravated, Decreased appetite, Dyspnoea
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 9/17/2022 Discharge Date: 09/22/2022  PRESENTING PROBLEM: Hyperkalemia [E87.5] Severe sepsis  [A41.9, R65.20] Acute kidney injury  [N17.9] Acute renal failure superimposed on stage 4 chronic kidney disease, unspecified acute renal failure type [N17.9, N18.4]   HOSPITAL COURSE: Patient is a 93-year-old with a past medical history of atrial fibrillation not on anticoagulation, hypertension, CKD stage 4, recent GI bleed, duodenal ulcers, MDS, osteoarthritis, colostomy due to previous small-bowel obstruction presented to emergency department due to shortness of breath and productive cough and weakness and fatigue.  She was recently discharged from local Health Hospital due to concern for acute on chronic kidney disease and GI bleeding.  Patient has been bedridden since that time she was discharged on extremely weak without able to do her ADLs.  Patient is at baseline alert and oriented x4.  Hence patient's family decided to bring her to the hospital.  At the time of presentation patient was COVID positive.  Chest x-ray was consistent with the right lower lung patchy opacity.  Also patient was found to have acute kidney injury with creatinine of 3.5 to at the time of admission.  She was started on IV fluids which improved her creatinine slowly.  Patient remained asymptomatic in terms of COVID.  She was started on Rocephin and doxycycline for community-acquired pneumonia coverage.  She did exhibit lactic acidosis which is most likely secondary to renal failure.  Renal ultrasound done during this admission did not show any hydronephrosis .  Sputum cultures were positive for moderate Staphylococcus aureus.  Cefepime was discontinued and she was transitioned to oral doxycycline alone.  She was evaluated by physical and occupational therapy as well as speech language pathology and underwent video swallow study.  The patient's fatigue persisted and her appetite remained poor.  She developed hypernatremia due to poor oral intake and required IV fluids.  Goals of care conversations were initiated and the patient ultimately determined that she would like to discharge home with hospice.  She was transitioned to comfort care and subsequently discharged in stable condition on 09/22 with plans for hospice sign on as soon as she arrives home.  Family was in agreement with the patient's decision.  She was discharged to complete 2 additional days of oral doxycycline for 7 day total course for MSSA pneumonia.
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Hyperkalaemia, Hypernatraemia, Hypophagia, Lactic acidosis
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 9/17/2022 Discharge Date: 09/22/2022  PRESENTING PROBLEM: Hyperkalemia [E87.5] Severe sepsis  [A41.9, R65.20] Acute kidney injury  [N17.9] Acute renal failure superimposed on stage 4 chronic kidney disease, unspecified acute renal failure type [N17.9, N18.4]   HOSPITAL COURSE: Patient is a 93-year-old with a past medical history of atrial fibrillation not on anticoagulation, hypertension, CKD stage 4, recent GI bleed, duodenal ulcers, MDS, osteoarthritis, colostomy due to previous small-bowel obstruction presented to emergency department due to shortness of breath and productive cough and weakness and fatigue.  She was recently discharged from local Health Hospital due to concern for acute on chronic kidney disease and GI bleeding.  Patient has been bedridden since that time she was discharged on extremely weak without able to do her ADLs.  Patient is at baseline alert and oriented x4.  Hence patient's family decided to bring her to the hospital.  At the time of presentation patient was COVID positive.  Chest x-ray was consistent with the right lower lung patchy opacity.  Also patient was found to have acute kidney injury with creatinine of 3.5 to at the time of admission.  She was started on IV fluids which improved her creatinine slowly.  Patient remained asymptomatic in terms of COVID.  She was started on Rocephin and doxycycline for community-acquired pneumonia coverage.  She did exhibit lactic acidosis which is most likely secondary to renal failure.  Renal ultrasound done during this admission did not show any hydronephrosis .  Sputum cultures were positive for moderate Staphylococcus aureus.  Cefepime was discontinued and she was transitioned to oral doxycycline alone.  She was evaluated by physical and occupational therapy as well as speech language pathology and underwent video swallow study.  The patient's fatigue persisted and her appetite remained poor.  She developed hypernatremia due to poor oral intake and required IV fluids.  Goals of care conversations were initiated and the patient ultimately determined that she would like to discharge home with hospice.  She was transitioned to comfort care and subsequently discharged in stable condition on 09/22 with plans for hospice sign on as soon as she arrives home.  Family was in agreement with the patient's decision.  She was discharged to complete 2 additional days of oral doxycycline for 7 day total course for MSSA pneumonia.
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of personal independence in daily activities, Lung opacity, Productive cough, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 9/17/2022 Discharge Date: 09/22/2022  PRESENTING PROBLEM: Hyperkalemia [E87.5] Severe sepsis  [A41.9, R65.20] Acute kidney injury  [N17.9] Acute renal failure superimposed on stage 4 chronic kidney disease, unspecified acute renal failure type [N17.9, N18.4]   HOSPITAL COURSE: Patient is a 93-year-old with a past medical history of atrial fibrillation not on anticoagulation, hypertension, CKD stage 4, recent GI bleed, duodenal ulcers, MDS, osteoarthritis, colostomy due to previous small-bowel obstruction presented to emergency department due to shortness of breath and productive cough and weakness and fatigue.  She was recently discharged from local Health Hospital due to concern for acute on chronic kidney disease and GI bleeding.  Patient has been bedridden since that time she was discharged on extremely weak without able to do her ADLs.  Patient is at baseline alert and oriented x4.  Hence patient's family decided to bring her to the hospital.  At the time of presentation patient was COVID positive.  Chest x-ray was consistent with the right lower lung patchy opacity.  Also patient was found to have acute kidney injury with creatinine of 3.5 to at the time of admission.  She was started on IV fluids which improved her creatinine slowly.  Patient remained asymptomatic in terms of COVID.  She was started on Rocephin and doxycycline for community-acquired pneumonia coverage.  She did exhibit lactic acidosis which is most likely secondary to renal failure.  Renal ultrasound done during this admission did not show any hydronephrosis .  Sputum cultures were positive for moderate Staphylococcus aureus.  Cefepime was discontinued and she was transitioned to oral doxycycline alone.  She was evaluated by physical and occupational therapy as well as speech language pathology and underwent video swallow study.  The patient's fatigue persisted and her appetite remained poor.  She developed hypernatremia due to poor oral intake and required IV fluids.  Goals of care conversations were initiated and the patient ultimately determined that she would like to discharge home with hospice.  She was transitioned to comfort care and subsequently discharged in stable condition on 09/22 with plans for hospice sign on as soon as she arrives home.  Family was in agreement with the patient's decision.  She was discharged to complete 2 additional days of oral doxycycline for 7 day total course for MSSA pneumonia.
Age: 93.0
Sex: F
Vaccine: COVID19
Symptoms: Sputum culture positive, Staphylococcus test positive, Swallow study, Ultrasound kidney normal
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 9/17/2022 Discharge Date: 09/22/2022  PRESENTING PROBLEM: Hyperkalemia [E87.5] Severe sepsis  [A41.9, R65.20] Acute kidney injury  [N17.9] Acute renal failure superimposed on stage 4 chronic kidney disease, unspecified acute renal failure type [N17.9, N18.4]   HOSPITAL COURSE: Patient is a 93-year-old with a past medical history of atrial fibrillation not on anticoagulation, hypertension, CKD stage 4, recent GI bleed, duodenal ulcers, MDS, osteoarthritis, colostomy due to previous small-bowel obstruction presented to emergency department due to shortness of breath and productive cough and weakness and fatigue.  She was recently discharged from local Health Hospital due to concern for acute on chronic kidney disease and GI bleeding.  Patient has been bedridden since that time she was discharged on extremely weak without able to do her ADLs.  Patient is at baseline alert and oriented x4.  Hence patient's family decided to bring her to the hospital.  At the time of presentation patient was COVID positive.  Chest x-ray was consistent with the right lower lung patchy opacity.  Also patient was found to have acute kidney injury with creatinine of 3.5 to at the time of admission.  She was started on IV fluids which improved her creatinine slowly.  Patient remained asymptomatic in terms of COVID.  She was started on Rocephin and doxycycline for community-acquired pneumonia coverage.  She did exhibit lactic acidosis which is most likely secondary to renal failure.  Renal ultrasound done during this admission did not show any hydronephrosis .  Sputum cultures were positive for moderate Staphylococcus aureus.  Cefepime was discontinued and she was transitioned to oral doxycycline alone.  She was evaluated by physical and occupational therapy as well as speech language pathology and underwent video swallow study.  The patient's fatigue persisted and her appetite remained poor.  She developed hypernatremia due to poor oral intake and required IV fluids.  Goals of care conversations were initiated and the patient ultimately determined that she would like to discharge home with hospice.  She was transitioned to comfort care and subsequently discharged in stable condition on 09/22 with plans for hospice sign on as soon as she arrives home.  Family was in agreement with the patient's decision.  She was discharged to complete 2 additional days of oral doxycycline for 7 day total course for MSSA pneumonia.
Age: 87.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, No adverse event
Clinical narrative: Covid 19 Bivalent Pfizer 0.5 ml administered instead of 0.3 ml. Monitored for 30 minutes. No adverse reaction noted at this time. Instructed daughter on what symptoms to observe for.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Antinuclear antibody, Condition aggravated, Eczema, Erythema, Grip strength decreased
Clinical narrative: Written to doctor on 11/4/21 - I received my 2nd Covid vaccine (on Oct 11) and since then, some unusual things have been happening. The first is that shortly after, all of my eczema issues started flaring at the same time (I have different types and they started to flare. It is mostly under control now). And secondly, my left hand started aching terribly around the middle, ring and pinky fingers about a week later (took both shots in left arm).  After about a week, the pain shifted to my thumb, where it is hard to grip things bc the pressure pushing my thumb outward hurts. Just making note because the flare ups don't normally happen at the same time and the hand pain has never happened. I have photos of all these random red, raised, itchy areas that showed up on my hands, neck, etc. April 2022 I had an abnormal WITH TITER AND PATTERN tests that were unusual and unexpected. I met with a Rheumatoid doctor to figure out if I was at the beginning stages of Lupus or Rheumatoid Arthritis. This was weird because those don't run in my family.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Peripheral swelling, Pruritus, Rheumatoid arthritis, Swelling
Clinical narrative: Written to doctor on 11/4/21 - I received my 2nd Covid vaccine (on Oct 11) and since then, some unusual things have been happening. The first is that shortly after, all of my eczema issues started flaring at the same time (I have different types and they started to flare. It is mostly under control now). And secondly, my left hand started aching terribly around the middle, ring and pinky fingers about a week later (took both shots in left arm).  After about a week, the pain shifted to my thumb, where it is hard to grip things bc the pressure pushing my thumb outward hurts. Just making note because the flare ups don't normally happen at the same time and the hand pain has never happened. I have photos of all these random red, raised, itchy areas that showed up on my hands, neck, etc. April 2022 I had an abnormal WITH TITER AND PATTERN tests that were unusual and unexpected. I met with a Rheumatoid doctor to figure out if I was at the beginning stages of Lupus or Rheumatoid Arthritis. This was weird because those don't run in my family.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Systemic lupus erythematosus
Clinical narrative: Written to doctor on 11/4/21 - I received my 2nd Covid vaccine (on Oct 11) and since then, some unusual things have been happening. The first is that shortly after, all of my eczema issues started flaring at the same time (I have different types and they started to flare. It is mostly under control now). And secondly, my left hand started aching terribly around the middle, ring and pinky fingers about a week later (took both shots in left arm).  After about a week, the pain shifted to my thumb, where it is hard to grip things bc the pressure pushing my thumb outward hurts. Just making note because the flare ups don't normally happen at the same time and the hand pain has never happened. I have photos of all these random red, raised, itchy areas that showed up on my hands, neck, etc. April 2022 I had an abnormal WITH TITER AND PATTERN tests that were unusual and unexpected. I met with a Rheumatoid doctor to figure out if I was at the beginning stages of Lupus or Rheumatoid Arthritis. This was weird because those don't run in my family.
Age: 31.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient order for 1st dose COVID vaccine (monovalent) , but was administered Pfizer bivalent vaccine.
Age: 3.0
Sex: F
Vaccine: FLU4
Symptoms: Urticaria
Clinical narrative: Hives and welts on upper thighs and abdomen, treated with benedryl successfully over the course of 48 hours
Age: 27.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Delivery, Maternal exposure before pregnancy
Clinical narrative: Childbirth - first pregnancy, full term delivery at 39 weeks 2 days gestation on May 13, 2022, birth weight 7lbs 7oz, length 20.5in, head circumference 34cm.
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, SARS-CoV-2 test negative
Clinical narrative: About 2 weeks after her booster, patient lost her senses of taste and smell. They still have not returned. She said she tested negative for Covid-19
Age: 69.0
Sex: F
Vaccine: FLU4, MMR
Symptoms: Expired product administered
Clinical narrative: Patient was given last year's flu vaccine, flu vaccine expired 30 JUne 2022
Age: 31.0
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered
Clinical narrative: Patient was given expired flu vaccine. Expiration was 7/2022.  Error was noted the following day. No reaction present. Currently working closely with our medical director to determine the best next course of action.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Nausea, Retching
Clinical narrative: Intense nausea approx 12 hours after immunization and dry-heaving for about 8-9 hours after.
Age: 0.75
Sex: M
Vaccine: COVID19
Symptoms: Dermatitis diaper, Diarrhoea, Vomiting
Clinical narrative: He had diarrhea, a diaper rash and vomiting. It lasted for about 5 days.
Age: 101.0
Sex: F
Vaccine: COVID19-2
Symptoms: Muscular weakness, Unresponsive to stimuli
Clinical narrative: Unresponsive episode, with upper extremity weakness by 9:00 PM resident more responsive
Age: 51.0
Sex: F
Vaccine: COVID19-2
Symptoms: Abdominal pain upper, Chest pain, Condition aggravated, Diarrhoea, Hypertension
Clinical narrative: Everytime I have had one of the injections, I had chest pain and heart palpitations. Starts right after I have the shot and continue for days. But I could feel my stomach hurting after the shot, maybe 3 hours later, I didn't eat anything until 6 hours later. And then after I ate,  a cake mix muffin, then within 30 mins or so, my stomach started bubbling really bad, went to the bathroom. Last night I went about 6-7-8 times. I thought It was over until I got up this morining and I had diahrea again. It wasnt making me throw up. I have ibs, so I usually suffer from constipation. Thats how I know it's the vaccine.  I usually suffer from high blood pressure, from the 4 vaccines I received, my blood pressure would get high. The 2nd shot, my bp got extreamly high, and I had to go to the er. But last night my bp was 105/67.  This was around 2am.
Age: 51.0
Sex: F
Vaccine: COVID19-2
Symptoms: Palpitations
Clinical narrative: Everytime I have had one of the injections, I had chest pain and heart palpitations. Starts right after I have the shot and continue for days. But I could feel my stomach hurting after the shot, maybe 3 hours later, I didn't eat anything until 6 hours later. And then after I ate,  a cake mix muffin, then within 30 mins or so, my stomach started bubbling really bad, went to the bathroom. Last night I went about 6-7-8 times. I thought It was over until I got up this morining and I had diahrea again. It wasnt making me throw up. I have ibs, so I usually suffer from constipation. Thats how I know it's the vaccine.  I usually suffer from high blood pressure, from the 4 vaccines I received, my blood pressure would get high. The 2nd shot, my bp got extreamly high, and I had to go to the er. But last night my bp was 105/67.  This was around 2am.
Age: 22.0
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered
Clinical narrative: Pt was given Flu  Vaccine from last year exp date 06302022
Age: 39.0
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered
Clinical narrative: Patient was given expired flu vaccine. Expiration was 7/2022.  Error was noted the following day. No reaction present. Currently working closely with our medical director to determine the best next course of action.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, SARS-CoV-2 test positive
Clinical narrative: Started having a dry hacking cough and fatigue on the 08/28/2022. Call Dr and was prescribed Tessalon Perles and Paxlovid.  Tested negative 10 days after.
Age: 42.0
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered
Clinical narrative: Patient was given expired flu vaccine. Expiration was 7/2022.  Error was noted the following day. No reaction present. Currently working closely with our medical director to determine the best next course of action.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Hospitalization with Covid after being fully vaccinated with booster.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Hospitalized with Covid; fully vaccinated,
Age: 92.0
Sex: F
Vaccine: SMALLMNK
Symptoms: Incorrect route of product administration
Clinical narrative: Patient was administered a subcutaneous 0.5 ml Jynneos injection to her right arm. Patient was unable to receive the injection intradermally. No adverse reactions occurred. Reporting due to administered subcutaneously.
Age: 72.0
Sex: M
Vaccine: COVID19-2, COVID19
Symptoms: Arthralgia, Chills, Fatigue, Headache, Injection site pain
Clinical narrative: injection site pain; tiredness; headache; muscle pain; chills; joint pain; fever; feeling unwell.  Began on day 6 after injection; lasted 2 days
Age: 72.0
Sex: M
Vaccine: COVID19-2, COVID19
Symptoms: Malaise, Myalgia, Pyrexia
Clinical narrative: injection site pain; tiredness; headache; muscle pain; chills; joint pain; fever; feeling unwell.  Began on day 6 after injection; lasted 2 days
Age: 72.0
Sex: M
Vaccine: COVID19-2, COVID19
Symptoms: Arthralgia, Chills, Fatigue, Headache, Malaise
Clinical narrative: injection site pain; tiredness; headache; muscle pain; chills; joint pain; fever; feeling unwell.  Began on day 6 after injection; lasted 2 days
Age: 72.0
Sex: M
Vaccine: COVID19-2, COVID19
Symptoms: Myalgia, Pyrexia, SARS-CoV-2 test, Vaccination site pain
Clinical narrative: injection site pain; tiredness; headache; muscle pain; chills; joint pain; fever; feeling unwell.  Began on day 6 after injection; lasted 2 days
Age: 53.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chest discomfort, Feeling hot, Hyperhidrosis, Urticaria
Clinical narrative: PATIENT SITTING IN OBSERVATION AREA, AT 15MINUTES HE STATES HE'S READY TO CHECK OUT. STAFF NOTED THAT CLIENT HAS HIVES ON HIS FACE AND IS SWEATING. ADVISED HIM TO SIT DOWN, FAN AND COLD WATER BROUGHT TO HIM RN NOTIFIED. CLIENT CONTINUES TO STATE HE JUST FEELS HOT BUT FINEOTHERWISE. PT TRANSFERRED TO ANOTHER ROOM, 911 CALLED AND VS TAKEN. PT C/O OF SOME TIGHTNESS IN CHEST. CLIENT WAS GIVEN EPINEPHRINE BY EMERGENCY RESCUE SQUAD.
Age: 30.0
Sex: F
Vaccine: SMALLMNK
Symptoms: Unevaluable event
Clinical narrative: intradermal dose given no wheel. subcutaneous dose given in left arm successfully