chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Atrial fibrillation, Blood culture negative, Blood lactic acid, Blood pressure abnormal
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of diastolic heart failure with severe TR and chronic pericardial effusion presented with lower extremity edema   Sepsis, 10/30 possibly due to COVID-19, resolved Lactic acidemia, resolved  MRSA swab negative.    sputum urine and blood cultures.  Negative CT CAP reviewed?no acute etiology identified. Status post 3 L bolus with some improvement in blood pressure. Lactic acid improved Consult ID for comanagement recommendation continue steroids, and remdesivir started on 11/1, patient finished remdesivir course on 11/5, patient had empirical cefepime course finished on 11/5 Cleared by ID from isolation on day of discharge   Acute decompensation of diastolic heart failure. Bilateral extremity edema worse on the left side Severe pulmonary hypertension Severe tricuspid valve regurgitation Right-sided systolic dysfunction Pulmonary vascular congestion Echo 10/25 reviewed?EF 65%, diastolic function normal, RV severely enlarged and moderate systolic dysfunction, RV volume and pressure overload, severe TR and significant pulm hypertension. DVT ultrasound with no acute DVT Diuresed with IV Bumex and switched to torsemide. Patient required dobutamine drip this hospitalization Seen by cardiology no further recommendations at this time. Bumex 1mg BID     Acute on Chronic hypoxic respiratory failure On 2 L at home. On 4L at discharge Wean off oxygen for saturation greater than 90  Chronic Afib with RVR On admission was rate controlled. Went into RVR 10/30 when she spiked a fever. Was on Cardizem drip briefly now discontinued due to low blood pressure. On metoprolol (at reduced dose) for Afib with additional midodrine due to hypotension  Xarelto. Echo limited.  Section fraction 60 to 65%, lung pressure 85    diabetes type 2 Hyperglycemia this hospitalization due to steroids Discharge insulin as below   gout Continue on allopurinol. Ankle x-ray without any fracture.  Moderate degeneration of the midfoot.   CKD stage III 1.29 on discharge, at baseline   Obstructive sleep apnea Resume home CPAP at 9 mmHg   Constipation Laxatives as needed Stool softener
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cardiac failure acute, Chronic kidney disease, Computerised tomogram thorax abnormal, Condition aggravated
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of diastolic heart failure with severe TR and chronic pericardial effusion presented with lower extremity edema   Sepsis, 10/30 possibly due to COVID-19, resolved Lactic acidemia, resolved  MRSA swab negative.    sputum urine and blood cultures.  Negative CT CAP reviewed?no acute etiology identified. Status post 3 L bolus with some improvement in blood pressure. Lactic acid improved Consult ID for comanagement recommendation continue steroids, and remdesivir started on 11/1, patient finished remdesivir course on 11/5, patient had empirical cefepime course finished on 11/5 Cleared by ID from isolation on day of discharge   Acute decompensation of diastolic heart failure. Bilateral extremity edema worse on the left side Severe pulmonary hypertension Severe tricuspid valve regurgitation Right-sided systolic dysfunction Pulmonary vascular congestion Echo 10/25 reviewed?EF 65%, diastolic function normal, RV severely enlarged and moderate systolic dysfunction, RV volume and pressure overload, severe TR and significant pulm hypertension. DVT ultrasound with no acute DVT Diuresed with IV Bumex and switched to torsemide. Patient required dobutamine drip this hospitalization Seen by cardiology no further recommendations at this time. Bumex 1mg BID     Acute on Chronic hypoxic respiratory failure On 2 L at home. On 4L at discharge Wean off oxygen for saturation greater than 90  Chronic Afib with RVR On admission was rate controlled. Went into RVR 10/30 when she spiked a fever. Was on Cardizem drip briefly now discontinued due to low blood pressure. On metoprolol (at reduced dose) for Afib with additional midodrine due to hypotension  Xarelto. Echo limited.  Section fraction 60 to 65%, lung pressure 85    diabetes type 2 Hyperglycemia this hospitalization due to steroids Discharge insulin as below   gout Continue on allopurinol. Ankle x-ray without any fracture.  Moderate degeneration of the midfoot.   CKD stage III 1.29 on discharge, at baseline   Obstructive sleep apnea Resume home CPAP at 9 mmHg   Constipation Laxatives as needed Stool softener
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Constipation, Culture urine negative, Diuretic therapy, Echocardiogram abnormal, Ejection fraction normal
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of diastolic heart failure with severe TR and chronic pericardial effusion presented with lower extremity edema   Sepsis, 10/30 possibly due to COVID-19, resolved Lactic acidemia, resolved  MRSA swab negative.    sputum urine and blood cultures.  Negative CT CAP reviewed?no acute etiology identified. Status post 3 L bolus with some improvement in blood pressure. Lactic acid improved Consult ID for comanagement recommendation continue steroids, and remdesivir started on 11/1, patient finished remdesivir course on 11/5, patient had empirical cefepime course finished on 11/5 Cleared by ID from isolation on day of discharge   Acute decompensation of diastolic heart failure. Bilateral extremity edema worse on the left side Severe pulmonary hypertension Severe tricuspid valve regurgitation Right-sided systolic dysfunction Pulmonary vascular congestion Echo 10/25 reviewed?EF 65%, diastolic function normal, RV severely enlarged and moderate systolic dysfunction, RV volume and pressure overload, severe TR and significant pulm hypertension. DVT ultrasound with no acute DVT Diuresed with IV Bumex and switched to torsemide. Patient required dobutamine drip this hospitalization Seen by cardiology no further recommendations at this time. Bumex 1mg BID     Acute on Chronic hypoxic respiratory failure On 2 L at home. On 4L at discharge Wean off oxygen for saturation greater than 90  Chronic Afib with RVR On admission was rate controlled. Went into RVR 10/30 when she spiked a fever. Was on Cardizem drip briefly now discontinued due to low blood pressure. On metoprolol (at reduced dose) for Afib with additional midodrine due to hypotension  Xarelto. Echo limited.  Section fraction 60 to 65%, lung pressure 85    diabetes type 2 Hyperglycemia this hospitalization due to steroids Discharge insulin as below   gout Continue on allopurinol. Ankle x-ray without any fracture.  Moderate degeneration of the midfoot.   CKD stage III 1.29 on discharge, at baseline   Obstructive sleep apnea Resume home CPAP at 9 mmHg   Constipation Laxatives as needed Stool softener
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Gout, Hyperglycaemia, Hypervolaemia, Hypotension, Lactic acidosis
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of diastolic heart failure with severe TR and chronic pericardial effusion presented with lower extremity edema   Sepsis, 10/30 possibly due to COVID-19, resolved Lactic acidemia, resolved  MRSA swab negative.    sputum urine and blood cultures.  Negative CT CAP reviewed?no acute etiology identified. Status post 3 L bolus with some improvement in blood pressure. Lactic acid improved Consult ID for comanagement recommendation continue steroids, and remdesivir started on 11/1, patient finished remdesivir course on 11/5, patient had empirical cefepime course finished on 11/5 Cleared by ID from isolation on day of discharge   Acute decompensation of diastolic heart failure. Bilateral extremity edema worse on the left side Severe pulmonary hypertension Severe tricuspid valve regurgitation Right-sided systolic dysfunction Pulmonary vascular congestion Echo 10/25 reviewed?EF 65%, diastolic function normal, RV severely enlarged and moderate systolic dysfunction, RV volume and pressure overload, severe TR and significant pulm hypertension. DVT ultrasound with no acute DVT Diuresed with IV Bumex and switched to torsemide. Patient required dobutamine drip this hospitalization Seen by cardiology no further recommendations at this time. Bumex 1mg BID     Acute on Chronic hypoxic respiratory failure On 2 L at home. On 4L at discharge Wean off oxygen for saturation greater than 90  Chronic Afib with RVR On admission was rate controlled. Went into RVR 10/30 when she spiked a fever. Was on Cardizem drip briefly now discontinued due to low blood pressure. On metoprolol (at reduced dose) for Afib with additional midodrine due to hypotension  Xarelto. Echo limited.  Section fraction 60 to 65%, lung pressure 85    diabetes type 2 Hyperglycemia this hospitalization due to steroids Discharge insulin as below   gout Continue on allopurinol. Ankle x-ray without any fracture.  Moderate degeneration of the midfoot.   CKD stage III 1.29 on discharge, at baseline   Obstructive sleep apnea Resume home CPAP at 9 mmHg   Constipation Laxatives as needed Stool softener
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Left ventricular failure, Obstructive sleep apnoea syndrome, Oedema peripheral, Pneumonia, Positive airway pressure therapy
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of diastolic heart failure with severe TR and chronic pericardial effusion presented with lower extremity edema   Sepsis, 10/30 possibly due to COVID-19, resolved Lactic acidemia, resolved  MRSA swab negative.    sputum urine and blood cultures.  Negative CT CAP reviewed?no acute etiology identified. Status post 3 L bolus with some improvement in blood pressure. Lactic acid improved Consult ID for comanagement recommendation continue steroids, and remdesivir started on 11/1, patient finished remdesivir course on 11/5, patient had empirical cefepime course finished on 11/5 Cleared by ID from isolation on day of discharge   Acute decompensation of diastolic heart failure. Bilateral extremity edema worse on the left side Severe pulmonary hypertension Severe tricuspid valve regurgitation Right-sided systolic dysfunction Pulmonary vascular congestion Echo 10/25 reviewed?EF 65%, diastolic function normal, RV severely enlarged and moderate systolic dysfunction, RV volume and pressure overload, severe TR and significant pulm hypertension. DVT ultrasound with no acute DVT Diuresed with IV Bumex and switched to torsemide. Patient required dobutamine drip this hospitalization Seen by cardiology no further recommendations at this time. Bumex 1mg BID     Acute on Chronic hypoxic respiratory failure On 2 L at home. On 4L at discharge Wean off oxygen for saturation greater than 90  Chronic Afib with RVR On admission was rate controlled. Went into RVR 10/30 when she spiked a fever. Was on Cardizem drip briefly now discontinued due to low blood pressure. On metoprolol (at reduced dose) for Afib with additional midodrine due to hypotension  Xarelto. Echo limited.  Section fraction 60 to 65%, lung pressure 85    diabetes type 2 Hyperglycemia this hospitalization due to steroids Discharge insulin as below   gout Continue on allopurinol. Ankle x-ray without any fracture.  Moderate degeneration of the midfoot.   CKD stage III 1.29 on discharge, at baseline   Obstructive sleep apnea Resume home CPAP at 9 mmHg   Constipation Laxatives as needed Stool softener
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pulmonary congestion, Pulmonary hypertension, Pyrexia, Respiratory failure, Right ventricular enlargement
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of diastolic heart failure with severe TR and chronic pericardial effusion presented with lower extremity edema   Sepsis, 10/30 possibly due to COVID-19, resolved Lactic acidemia, resolved  MRSA swab negative.    sputum urine and blood cultures.  Negative CT CAP reviewed?no acute etiology identified. Status post 3 L bolus with some improvement in blood pressure. Lactic acid improved Consult ID for comanagement recommendation continue steroids, and remdesivir started on 11/1, patient finished remdesivir course on 11/5, patient had empirical cefepime course finished on 11/5 Cleared by ID from isolation on day of discharge   Acute decompensation of diastolic heart failure. Bilateral extremity edema worse on the left side Severe pulmonary hypertension Severe tricuspid valve regurgitation Right-sided systolic dysfunction Pulmonary vascular congestion Echo 10/25 reviewed?EF 65%, diastolic function normal, RV severely enlarged and moderate systolic dysfunction, RV volume and pressure overload, severe TR and significant pulm hypertension. DVT ultrasound with no acute DVT Diuresed with IV Bumex and switched to torsemide. Patient required dobutamine drip this hospitalization Seen by cardiology no further recommendations at this time. Bumex 1mg BID     Acute on Chronic hypoxic respiratory failure On 2 L at home. On 4L at discharge Wean off oxygen for saturation greater than 90  Chronic Afib with RVR On admission was rate controlled. Went into RVR 10/30 when she spiked a fever. Was on Cardizem drip briefly now discontinued due to low blood pressure. On metoprolol (at reduced dose) for Afib with additional midodrine due to hypotension  Xarelto. Echo limited.  Section fraction 60 to 65%, lung pressure 85    diabetes type 2 Hyperglycemia this hospitalization due to steroids Discharge insulin as below   gout Continue on allopurinol. Ankle x-ray without any fracture.  Moderate degeneration of the midfoot.   CKD stage III 1.29 on discharge, at baseline   Obstructive sleep apnea Resume home CPAP at 9 mmHg   Constipation Laxatives as needed Stool softener
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Sepsis, Sputum culture, Staphylococcus test negative, Systolic dysfunction, Tricuspid valve incompetence
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of diastolic heart failure with severe TR and chronic pericardial effusion presented with lower extremity edema   Sepsis, 10/30 possibly due to COVID-19, resolved Lactic acidemia, resolved  MRSA swab negative.    sputum urine and blood cultures.  Negative CT CAP reviewed?no acute etiology identified. Status post 3 L bolus with some improvement in blood pressure. Lactic acid improved Consult ID for comanagement recommendation continue steroids, and remdesivir started on 11/1, patient finished remdesivir course on 11/5, patient had empirical cefepime course finished on 11/5 Cleared by ID from isolation on day of discharge   Acute decompensation of diastolic heart failure. Bilateral extremity edema worse on the left side Severe pulmonary hypertension Severe tricuspid valve regurgitation Right-sided systolic dysfunction Pulmonary vascular congestion Echo 10/25 reviewed?EF 65%, diastolic function normal, RV severely enlarged and moderate systolic dysfunction, RV volume and pressure overload, severe TR and significant pulm hypertension. DVT ultrasound with no acute DVT Diuresed with IV Bumex and switched to torsemide. Patient required dobutamine drip this hospitalization Seen by cardiology no further recommendations at this time. Bumex 1mg BID     Acute on Chronic hypoxic respiratory failure On 2 L at home. On 4L at discharge Wean off oxygen for saturation greater than 90  Chronic Afib with RVR On admission was rate controlled. Went into RVR 10/30 when she spiked a fever. Was on Cardizem drip briefly now discontinued due to low blood pressure. On metoprolol (at reduced dose) for Afib with additional midodrine due to hypotension  Xarelto. Echo limited.  Section fraction 60 to 65%, lung pressure 85    diabetes type 2 Hyperglycemia this hospitalization due to steroids Discharge insulin as below   gout Continue on allopurinol. Ankle x-ray without any fracture.  Moderate degeneration of the midfoot.   CKD stage III 1.29 on discharge, at baseline   Obstructive sleep apnea Resume home CPAP at 9 mmHg   Constipation Laxatives as needed Stool softener
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Type 2 diabetes mellitus, Ultrasound Doppler normal, X-ray limb abnormal
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of diastolic heart failure with severe TR and chronic pericardial effusion presented with lower extremity edema   Sepsis, 10/30 possibly due to COVID-19, resolved Lactic acidemia, resolved  MRSA swab negative.    sputum urine and blood cultures.  Negative CT CAP reviewed?no acute etiology identified. Status post 3 L bolus with some improvement in blood pressure. Lactic acid improved Consult ID for comanagement recommendation continue steroids, and remdesivir started on 11/1, patient finished remdesivir course on 11/5, patient had empirical cefepime course finished on 11/5 Cleared by ID from isolation on day of discharge   Acute decompensation of diastolic heart failure. Bilateral extremity edema worse on the left side Severe pulmonary hypertension Severe tricuspid valve regurgitation Right-sided systolic dysfunction Pulmonary vascular congestion Echo 10/25 reviewed?EF 65%, diastolic function normal, RV severely enlarged and moderate systolic dysfunction, RV volume and pressure overload, severe TR and significant pulm hypertension. DVT ultrasound with no acute DVT Diuresed with IV Bumex and switched to torsemide. Patient required dobutamine drip this hospitalization Seen by cardiology no further recommendations at this time. Bumex 1mg BID     Acute on Chronic hypoxic respiratory failure On 2 L at home. On 4L at discharge Wean off oxygen for saturation greater than 90  Chronic Afib with RVR On admission was rate controlled. Went into RVR 10/30 when she spiked a fever. Was on Cardizem drip briefly now discontinued due to low blood pressure. On metoprolol (at reduced dose) for Afib with additional midodrine due to hypotension  Xarelto. Echo limited.  Section fraction 60 to 65%, lung pressure 85    diabetes type 2 Hyperglycemia this hospitalization due to steroids Discharge insulin as below   gout Continue on allopurinol. Ankle x-ray without any fracture.  Moderate degeneration of the midfoot.   CKD stage III 1.29 on discharge, at baseline   Obstructive sleep apnea Resume home CPAP at 9 mmHg   Constipation Laxatives as needed Stool softener
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Antinuclear antibody, Eye pruritus, Giant papillary conjunctivitis, Immunology test, Lacrimation increased
Clinical narrative: Developed itching in both eyes. Constant tearing. Treated with antibiotics for eyes:. Loteprednol, zylet, Pataday for 6 months. Seen by  Optometrist and Specialist Optometrist. Also tested for Sjogrens syndrome which was negative. PFIZER COVID-19  BIVALENT (12+) mRNA,  LNP-S, PF, 30 MCG/0.3  ML DOSE
Age: 55.0
Sex: M
Vaccine: VARZOS
Symptoms: Extra dose administered
Clinical narrative: There was only one shingrix listed on vaccine registry when it was checked. Upon finishing the paperwork and double checking  our records, the patient inadvertently received 3 doses of Shingrix.
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest X-ray normal, Chest pain
Clinical narrative: Patient is a 77-year-old male with past medical history of coronary artery disease status post DES to the RCA, essential hypertension, subclavian artery stenosis, bleeding duodenal ulcer, type 2 diabetes, BPH who presented to the emergency department via squad from home due to increased cough and burning in the chest.  Oxygen was noted to be 87% on room air and 2 L per nasal cannula was placed.   Clinical Summary   Clinical course Include/ Problem list Acute hypoxic respiratory failure secondary to Covid 19 pneumonia: -Last Vaccination: 11/2022; Symptom onset: 3 day PTA; Test positive: 11/4. -ED representation (11/4): CXR negative, 2.5 L oxygen->Now on 1L -Decadron: 11/5 -Remdesivir: 11/5 -Continue:  albuterol inh qid, mucinex -Monitor daily CBC and BMP   Mild thrombocytopenia -Secondary to COVID infection -Plt 125 -No evidence of bleeding bruising oozing   Coronary artery disease -History of DES to the RCA.  Documented 100% occlusion to the circumflex.  Appears to be pending outpatient left heart catheterization with IFR to evaluate the LAD. -Continue aspirin and Plavix   Essential hypertension -Recent addition of lisinopril 10 mg daily by cardiology. Stopped by PCP due to cough. Change to ARB and monitor. -Continue metoprolol 25   Subclavian artery stenosis -Follows with cardiology, apparent asymptomatic   History of bleeding duodenal ulcer -Occurred after initiating dual antiplatelet therapy -On lifelong PPI twice daily. Type 2 diabetes -Levemir -Wound Sitagliptin?metformin   BPH -ContinueFlomax, finasteride     11/6/2023 patient seen and examined at bedside.  He is on room air is oxygen saturations with continuous pulse oximeter is 95 to 96%.  Patient states that he has not been up much over the course the last day and a half but he is able to walk to the bathroom before walker has been placed.  We will plan to discharge patient home today with a 3-day course of dexamethasone, will cover him with doxycycline for the next 5 days as well as send orders for inhalers x2.  Patient declines home health care.  He is instructed to return the emergency department if he feels that he needs to be evaluated or his condition worsens.
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Cough, Full blood count abnormal, Metabolic function test abnormal, Mobility decreased, Platelet count decreased
Clinical narrative: Patient is a 77-year-old male with past medical history of coronary artery disease status post DES to the RCA, essential hypertension, subclavian artery stenosis, bleeding duodenal ulcer, type 2 diabetes, BPH who presented to the emergency department via squad from home due to increased cough and burning in the chest.  Oxygen was noted to be 87% on room air and 2 L per nasal cannula was placed.   Clinical Summary   Clinical course Include/ Problem list Acute hypoxic respiratory failure secondary to Covid 19 pneumonia: -Last Vaccination: 11/2022; Symptom onset: 3 day PTA; Test positive: 11/4. -ED representation (11/4): CXR negative, 2.5 L oxygen->Now on 1L -Decadron: 11/5 -Remdesivir: 11/5 -Continue:  albuterol inh qid, mucinex -Monitor daily CBC and BMP   Mild thrombocytopenia -Secondary to COVID infection -Plt 125 -No evidence of bleeding bruising oozing   Coronary artery disease -History of DES to the RCA.  Documented 100% occlusion to the circumflex.  Appears to be pending outpatient left heart catheterization with IFR to evaluate the LAD. -Continue aspirin and Plavix   Essential hypertension -Recent addition of lisinopril 10 mg daily by cardiology. Stopped by PCP due to cough. Change to ARB and monitor. -Continue metoprolol 25   Subclavian artery stenosis -Follows with cardiology, apparent asymptomatic   History of bleeding duodenal ulcer -Occurred after initiating dual antiplatelet therapy -On lifelong PPI twice daily. Type 2 diabetes -Levemir -Wound Sitagliptin?metformin   BPH -ContinueFlomax, finasteride     11/6/2023 patient seen and examined at bedside.  He is on room air is oxygen saturations with continuous pulse oximeter is 95 to 96%.  Patient states that he has not been up much over the course the last day and a half but he is able to walk to the bathroom before walker has been placed.  We will plan to discharge patient home today with a 3-day course of dexamethasone, will cover him with doxycycline for the next 5 days as well as send orders for inhalers x2.  Patient declines home health care.  He is instructed to return the emergency department if he feels that he needs to be evaluated or his condition worsens.
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Thrombocytopenia, Walking aid user
Clinical narrative: Patient is a 77-year-old male with past medical history of coronary artery disease status post DES to the RCA, essential hypertension, subclavian artery stenosis, bleeding duodenal ulcer, type 2 diabetes, BPH who presented to the emergency department via squad from home due to increased cough and burning in the chest.  Oxygen was noted to be 87% on room air and 2 L per nasal cannula was placed.   Clinical Summary   Clinical course Include/ Problem list Acute hypoxic respiratory failure secondary to Covid 19 pneumonia: -Last Vaccination: 11/2022; Symptom onset: 3 day PTA; Test positive: 11/4. -ED representation (11/4): CXR negative, 2.5 L oxygen->Now on 1L -Decadron: 11/5 -Remdesivir: 11/5 -Continue:  albuterol inh qid, mucinex -Monitor daily CBC and BMP   Mild thrombocytopenia -Secondary to COVID infection -Plt 125 -No evidence of bleeding bruising oozing   Coronary artery disease -History of DES to the RCA.  Documented 100% occlusion to the circumflex.  Appears to be pending outpatient left heart catheterization with IFR to evaluate the LAD. -Continue aspirin and Plavix   Essential hypertension -Recent addition of lisinopril 10 mg daily by cardiology. Stopped by PCP due to cough. Change to ARB and monitor. -Continue metoprolol 25   Subclavian artery stenosis -Follows with cardiology, apparent asymptomatic   History of bleeding duodenal ulcer -Occurred after initiating dual antiplatelet therapy -On lifelong PPI twice daily. Type 2 diabetes -Levemir -Wound Sitagliptin?metformin   BPH -ContinueFlomax, finasteride     11/6/2023 patient seen and examined at bedside.  He is on room air is oxygen saturations with continuous pulse oximeter is 95 to 96%.  Patient states that he has not been up much over the course the last day and a half but he is able to walk to the bathroom before walker has been placed.  We will plan to discharge patient home today with a 3-day course of dexamethasone, will cover him with doxycycline for the next 5 days as well as send orders for inhalers x2.  Patient declines home health care.  He is instructed to return the emergency department if he feels that he needs to be evaluated or his condition worsens.
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Blood culture, COVID-19, Chest X-ray, Computerised tomogram abdomen abnormal
Clinical narrative: Patient is a 82 y.o. male patient of MD with history of dyslipidemia, hypertension, paraplegia, history of DVT, history of stroke presented to Hospital with shortness of breath, fever and cough since Tuesday Patient report runny nose associated with dry cough without sore throat or difficulty swallowing, fever multiple times get tested positive for COVID on Wednesday and was discharged home on Paxlovid without significant improvement Reported one-time diarrhea yesterday without nausea or vomiting or abdominal pain Patient denies any shortness of breath or chest pain     COVID-19 pneumonia Covid-19 Virus Infection SIRS criteria temperature 100.9 Date of onset of symptoms: 11/15 Symptoms present on admission: Shortness of breath, cough and fever Date of covid positive test: 11/16 Vaccination status: vaccinated Imaging: Chest x-ray Oxygen requirements on admission: Nasal cannula 3 L Current oxygen requirements: room air  Medical therapy: remdesivir and steroids Consultants following: ID Anticipated special isolation end date: 11/26  Order Legionella antigen, Streptococcus pneumonia antigen, respiratory PCR Order sputum culture Blood culture x2 CT chest no pneumonia  Tylenol as needed for management of fever   Acute respiratory failure hypoxia due to COVID Oxygen therapy per protocol Breathing treatment as needed   Paraplegia History of lower extremity DVT years ago History of stroke years ago Continue home dose of Eliquis   Hypertension blood pressure is okay Continue home dose of hydrochlorothiazide and lisinopril Dyslipidemia Continue statin   Obesity with BMI 30.4 due to excessive calories Weight loss Residence prior to admission: house or apartment Was patient transferred from outlying hospital or ED no   Renal Mass  CT a/p  1. Partially exophytic 5.7 cm mass arising from the upper pole cortex of the left kidney with imaging features compatible with renal cell carcinoma until proven otherwise.  Follow with urology
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Computerised tomogram thorax normal, Cough, Diarrhoea, Dyspnoea, Hypoxia
Clinical narrative: Patient is a 82 y.o. male patient of MD with history of dyslipidemia, hypertension, paraplegia, history of DVT, history of stroke presented to Hospital with shortness of breath, fever and cough since Tuesday Patient report runny nose associated with dry cough without sore throat or difficulty swallowing, fever multiple times get tested positive for COVID on Wednesday and was discharged home on Paxlovid without significant improvement Reported one-time diarrhea yesterday without nausea or vomiting or abdominal pain Patient denies any shortness of breath or chest pain     COVID-19 pneumonia Covid-19 Virus Infection SIRS criteria temperature 100.9 Date of onset of symptoms: 11/15 Symptoms present on admission: Shortness of breath, cough and fever Date of covid positive test: 11/16 Vaccination status: vaccinated Imaging: Chest x-ray Oxygen requirements on admission: Nasal cannula 3 L Current oxygen requirements: room air  Medical therapy: remdesivir and steroids Consultants following: ID Anticipated special isolation end date: 11/26  Order Legionella antigen, Streptococcus pneumonia antigen, respiratory PCR Order sputum culture Blood culture x2 CT chest no pneumonia  Tylenol as needed for management of fever   Acute respiratory failure hypoxia due to COVID Oxygen therapy per protocol Breathing treatment as needed   Paraplegia History of lower extremity DVT years ago History of stroke years ago Continue home dose of Eliquis   Hypertension blood pressure is okay Continue home dose of hydrochlorothiazide and lisinopril Dyslipidemia Continue statin   Obesity with BMI 30.4 due to excessive calories Weight loss Residence prior to admission: house or apartment Was patient transferred from outlying hospital or ED no   Renal Mass  CT a/p  1. Partially exophytic 5.7 cm mass arising from the upper pole cortex of the left kidney with imaging features compatible with renal cell carcinoma until proven otherwise.  Follow with urology
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pyrexia, Renal cell carcinoma, Renal mass, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: Patient is a 82 y.o. male patient of MD with history of dyslipidemia, hypertension, paraplegia, history of DVT, history of stroke presented to Hospital with shortness of breath, fever and cough since Tuesday Patient report runny nose associated with dry cough without sore throat or difficulty swallowing, fever multiple times get tested positive for COVID on Wednesday and was discharged home on Paxlovid without significant improvement Reported one-time diarrhea yesterday without nausea or vomiting or abdominal pain Patient denies any shortness of breath or chest pain     COVID-19 pneumonia Covid-19 Virus Infection SIRS criteria temperature 100.9 Date of onset of symptoms: 11/15 Symptoms present on admission: Shortness of breath, cough and fever Date of covid positive test: 11/16 Vaccination status: vaccinated Imaging: Chest x-ray Oxygen requirements on admission: Nasal cannula 3 L Current oxygen requirements: room air  Medical therapy: remdesivir and steroids Consultants following: ID Anticipated special isolation end date: 11/26  Order Legionella antigen, Streptococcus pneumonia antigen, respiratory PCR Order sputum culture Blood culture x2 CT chest no pneumonia  Tylenol as needed for management of fever   Acute respiratory failure hypoxia due to COVID Oxygen therapy per protocol Breathing treatment as needed   Paraplegia History of lower extremity DVT years ago History of stroke years ago Continue home dose of Eliquis   Hypertension blood pressure is okay Continue home dose of hydrochlorothiazide and lisinopril Dyslipidemia Continue statin   Obesity with BMI 30.4 due to excessive calories Weight loss Residence prior to admission: house or apartment Was patient transferred from outlying hospital or ED no   Renal Mass  CT a/p  1. Partially exophytic 5.7 cm mass arising from the upper pole cortex of the left kidney with imaging features compatible with renal cell carcinoma until proven otherwise.  Follow with urology
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Weight decreased
Clinical narrative: Patient is a 82 y.o. male patient of MD with history of dyslipidemia, hypertension, paraplegia, history of DVT, history of stroke presented to Hospital with shortness of breath, fever and cough since Tuesday Patient report runny nose associated with dry cough without sore throat or difficulty swallowing, fever multiple times get tested positive for COVID on Wednesday and was discharged home on Paxlovid without significant improvement Reported one-time diarrhea yesterday without nausea or vomiting or abdominal pain Patient denies any shortness of breath or chest pain     COVID-19 pneumonia Covid-19 Virus Infection SIRS criteria temperature 100.9 Date of onset of symptoms: 11/15 Symptoms present on admission: Shortness of breath, cough and fever Date of covid positive test: 11/16 Vaccination status: vaccinated Imaging: Chest x-ray Oxygen requirements on admission: Nasal cannula 3 L Current oxygen requirements: room air  Medical therapy: remdesivir and steroids Consultants following: ID Anticipated special isolation end date: 11/26  Order Legionella antigen, Streptococcus pneumonia antigen, respiratory PCR Order sputum culture Blood culture x2 CT chest no pneumonia  Tylenol as needed for management of fever   Acute respiratory failure hypoxia due to COVID Oxygen therapy per protocol Breathing treatment as needed   Paraplegia History of lower extremity DVT years ago History of stroke years ago Continue home dose of Eliquis   Hypertension blood pressure is okay Continue home dose of hydrochlorothiazide and lisinopril Dyslipidemia Continue statin   Obesity with BMI 30.4 due to excessive calories Weight loss Residence prior to admission: house or apartment Was patient transferred from outlying hospital or ED no   Renal Mass  CT a/p  1. Partially exophytic 5.7 cm mass arising from the upper pole cortex of the left kidney with imaging features compatible with renal cell carcinoma until proven otherwise.  Follow with urology
Age: 7.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: The child received a dose meant for a 6m-5y instead of the 5-11y dose.
Age: 61.0
Sex: F
Vaccine: COVID19, UNK
Symptoms: Colitis microscopic, Colonoscopy abnormal, Diarrhoea
Clinical narrative: Ongoing severe diarrhea. Very watery, very severe. I had a colonoscopy and was diagnosed with lymphocytic colitis.
Age: 76.0
Sex: F
Vaccine: RSV
Symptoms: Lymphadenopathy
Clinical narrative: patient reported swollen lymph node under her left arm pit that appeared a few weeks after vaccine
Age: 9.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: The child received the formula for 6m-5y in lieu of the correct formula for 5y-11y.
Age: 16.0
Sex: F
Vaccine: UNK
Symptoms: Erythema, Peripheral swelling, Skin warm
Clinical narrative: L arm red, warm to touch, and swollen 3 inches by 2 inches.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoaesthesia, Magnetic resonance imaging, Myelitis transverse
Clinical narrative: Numbness in feet, legs and abdomen up to chest. Neurologist  diagnosed as Transverse  Myelitits.
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Resident received Spikevax vaccine on 12/29/23. Resident had previously received Spikevax vaccine on 11/1/2023. Resident was inadvertently given second dose of vaccine. Resident tolerated vaccine well, denies any side effects or adverse effects.
Age: 66.0
Sex: F
Vaccine: RSV
Symptoms: Dizziness
Clinical narrative: Today, 12/29/23, patient reports dizziness that started the night of her vaccine. She seems able to continue daily  activities of living.
Age: 57.0
Sex: F
Vaccine: RSV
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: PATIENT NOT ELIGIBLE FOR RSV VACCINE. NOT 60 YEARS OF AGE
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site bruising, Injection site inflammation
Clinical narrative: Patient developed two large hematomas (large bruising) above and below the injection site 2 days after injection. Patient used Aquaphor and Aloe vera to help with the bruising/ inflammation. Also used a topical CBD product.  Patient did not go into the doctor to be seen. Patient still reports pain near the injection site, but bruising has subsided.
Age: 51.0
Sex: F
Vaccine: RSV
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: PATIENT NOT ELIGIBLE FOR VACCINE. NOT 60 YEARS OF AGE
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute myocardial infarction, Acute respiratory failure, Atrial fibrillation, Blood creatinine increased
Clinical narrative: Patient is a 83 y.o. male patient of DO with history of CHF and COPD who presented with a 3-day complaint of SOB, subjective fever, dry cough and fatigue.  His wife was admitted to the hospital 2 days prior with COVID-19 infection.  Patient tested positive for COVID-19. CXR showed stable cardiomegaly with no acute pulmonary disease.  He was admitted for further evaluation and management of shortness of breath.   Acute on chronic systolic CHF Limited 2D echo on 11/20 Showed global hypokinesis of LV, EF of 34%.  RV is enlarged.   Noted elevated proBNP 2194 -> 1822 Exacerbation likely triggered by acute infection. He was diuresed and held due to hypotension. Appreciate cardiology input. Continue medical management as permitted by BP.   Elevated troponin Troponin I was 99-95-85. Likely type II MI event from acute systolic dysfunction. Troponin essentially flat. Denies chest pain. Continue to monitor.   Chronic A. Fib  HR is controlled. Continue Coreg. INR 2.3.   Pharmacy assisting with warfarin adjustments. Covid-19 Virus Infection COPD Date of onset of symptoms: 11/15 Symptoms present on admission: Cough and SOB Date of covid positive test: 11/18 Vaccination status: unvaccinated Imaging: CXR with no acute infiltrates. Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: Bronchodilators. Consultants following: ID Anticipated special isolation end date: 11/26 Worsening oxygenation requiring 2 L NC but now on room air 96% Pox. Appreciate ID input, on remdesivir, monitor renal function. Wean Solu-Medrol.   Acute respiratory failure Due to COVID-19. Improved. Continue bronchodilators. Add scheduled Albuterol MDI. Wean O2 as able to. Albuterol MDI scheduled.   Diabetes mellitus II Last HbA1c was 7.7 in May 2023. At home he was on Humulin 70/30, Lantus and Humalog. Discussed with endocrinology, insulin adjustments will be made.   AKI on CKD III Cr 2.26 -> 1.76. He is nonoliguric. Avoid nephrotoxins. Monitor Cr while on diuretics..   BLE stasis dermatitis No sign of acute infection. Continue to monitor.
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Cardiac failure acute, Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal
Clinical narrative: Patient is a 83 y.o. male patient of DO with history of CHF and COPD who presented with a 3-day complaint of SOB, subjective fever, dry cough and fatigue.  His wife was admitted to the hospital 2 days prior with COVID-19 infection.  Patient tested positive for COVID-19. CXR showed stable cardiomegaly with no acute pulmonary disease.  He was admitted for further evaluation and management of shortness of breath.   Acute on chronic systolic CHF Limited 2D echo on 11/20 Showed global hypokinesis of LV, EF of 34%.  RV is enlarged.   Noted elevated proBNP 2194 -> 1822 Exacerbation likely triggered by acute infection. He was diuresed and held due to hypotension. Appreciate cardiology input. Continue medical management as permitted by BP.   Elevated troponin Troponin I was 99-95-85. Likely type II MI event from acute systolic dysfunction. Troponin essentially flat. Denies chest pain. Continue to monitor.   Chronic A. Fib  HR is controlled. Continue Coreg. INR 2.3.   Pharmacy assisting with warfarin adjustments. Covid-19 Virus Infection COPD Date of onset of symptoms: 11/15 Symptoms present on admission: Cough and SOB Date of covid positive test: 11/18 Vaccination status: unvaccinated Imaging: CXR with no acute infiltrates. Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: Bronchodilators. Consultants following: ID Anticipated special isolation end date: 11/26 Worsening oxygenation requiring 2 L NC but now on room air 96% Pox. Appreciate ID input, on remdesivir, monitor renal function. Wean Solu-Medrol.   Acute respiratory failure Due to COVID-19. Improved. Continue bronchodilators. Add scheduled Albuterol MDI. Wean O2 as able to. Albuterol MDI scheduled.   Diabetes mellitus II Last HbA1c was 7.7 in May 2023. At home he was on Humulin 70/30, Lantus and Humalog. Discussed with endocrinology, insulin adjustments will be made.   AKI on CKD III Cr 2.26 -> 1.76. He is nonoliguric. Avoid nephrotoxins. Monitor Cr while on diuretics..   BLE stasis dermatitis No sign of acute infection. Continue to monitor.
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chronic kidney disease, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Diuretic therapy
Clinical narrative: Patient is a 83 y.o. male patient of DO with history of CHF and COPD who presented with a 3-day complaint of SOB, subjective fever, dry cough and fatigue.  His wife was admitted to the hospital 2 days prior with COVID-19 infection.  Patient tested positive for COVID-19. CXR showed stable cardiomegaly with no acute pulmonary disease.  He was admitted for further evaluation and management of shortness of breath.   Acute on chronic systolic CHF Limited 2D echo on 11/20 Showed global hypokinesis of LV, EF of 34%.  RV is enlarged.   Noted elevated proBNP 2194 -> 1822 Exacerbation likely triggered by acute infection. He was diuresed and held due to hypotension. Appreciate cardiology input. Continue medical management as permitted by BP.   Elevated troponin Troponin I was 99-95-85. Likely type II MI event from acute systolic dysfunction. Troponin essentially flat. Denies chest pain. Continue to monitor.   Chronic A. Fib  HR is controlled. Continue Coreg. INR 2.3.   Pharmacy assisting with warfarin adjustments. Covid-19 Virus Infection COPD Date of onset of symptoms: 11/15 Symptoms present on admission: Cough and SOB Date of covid positive test: 11/18 Vaccination status: unvaccinated Imaging: CXR with no acute infiltrates. Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: Bronchodilators. Consultants following: ID Anticipated special isolation end date: 11/26 Worsening oxygenation requiring 2 L NC but now on room air 96% Pox. Appreciate ID input, on remdesivir, monitor renal function. Wean Solu-Medrol.   Acute respiratory failure Due to COVID-19. Improved. Continue bronchodilators. Add scheduled Albuterol MDI. Wean O2 as able to. Albuterol MDI scheduled.   Diabetes mellitus II Last HbA1c was 7.7 in May 2023. At home he was on Humulin 70/30, Lantus and Humalog. Discussed with endocrinology, insulin adjustments will be made.   AKI on CKD III Cr 2.26 -> 1.76. He is nonoliguric. Avoid nephrotoxins. Monitor Cr while on diuretics..   BLE stasis dermatitis No sign of acute infection. Continue to monitor.
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dyspnoea, Ejection fraction decreased, Fatigue, Glycosylated haemoglobin increased, Hypotension
Clinical narrative: Patient is a 83 y.o. male patient of DO with history of CHF and COPD who presented with a 3-day complaint of SOB, subjective fever, dry cough and fatigue.  His wife was admitted to the hospital 2 days prior with COVID-19 infection.  Patient tested positive for COVID-19. CXR showed stable cardiomegaly with no acute pulmonary disease.  He was admitted for further evaluation and management of shortness of breath.   Acute on chronic systolic CHF Limited 2D echo on 11/20 Showed global hypokinesis of LV, EF of 34%.  RV is enlarged.   Noted elevated proBNP 2194 -> 1822 Exacerbation likely triggered by acute infection. He was diuresed and held due to hypotension. Appreciate cardiology input. Continue medical management as permitted by BP.   Elevated troponin Troponin I was 99-95-85. Likely type II MI event from acute systolic dysfunction. Troponin essentially flat. Denies chest pain. Continue to monitor.   Chronic A. Fib  HR is controlled. Continue Coreg. INR 2.3.   Pharmacy assisting with warfarin adjustments. Covid-19 Virus Infection COPD Date of onset of symptoms: 11/15 Symptoms present on admission: Cough and SOB Date of covid positive test: 11/18 Vaccination status: unvaccinated Imaging: CXR with no acute infiltrates. Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: Bronchodilators. Consultants following: ID Anticipated special isolation end date: 11/26 Worsening oxygenation requiring 2 L NC but now on room air 96% Pox. Appreciate ID input, on remdesivir, monitor renal function. Wean Solu-Medrol.   Acute respiratory failure Due to COVID-19. Improved. Continue bronchodilators. Add scheduled Albuterol MDI. Wean O2 as able to. Albuterol MDI scheduled.   Diabetes mellitus II Last HbA1c was 7.7 in May 2023. At home he was on Humulin 70/30, Lantus and Humalog. Discussed with endocrinology, insulin adjustments will be made.   AKI on CKD III Cr 2.26 -> 1.76. He is nonoliguric. Avoid nephrotoxins. Monitor Cr while on diuretics..   BLE stasis dermatitis No sign of acute infection. Continue to monitor.
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Infection, International normalised ratio increased, Left ventricular failure, Prohormone brain natriuretic peptide increased, Pyrexia
Clinical narrative: Patient is a 83 y.o. male patient of DO with history of CHF and COPD who presented with a 3-day complaint of SOB, subjective fever, dry cough and fatigue.  His wife was admitted to the hospital 2 days prior with COVID-19 infection.  Patient tested positive for COVID-19. CXR showed stable cardiomegaly with no acute pulmonary disease.  He was admitted for further evaluation and management of shortness of breath.   Acute on chronic systolic CHF Limited 2D echo on 11/20 Showed global hypokinesis of LV, EF of 34%.  RV is enlarged.   Noted elevated proBNP 2194 -> 1822 Exacerbation likely triggered by acute infection. He was diuresed and held due to hypotension. Appreciate cardiology input. Continue medical management as permitted by BP.   Elevated troponin Troponin I was 99-95-85. Likely type II MI event from acute systolic dysfunction. Troponin essentially flat. Denies chest pain. Continue to monitor.   Chronic A. Fib  HR is controlled. Continue Coreg. INR 2.3.   Pharmacy assisting with warfarin adjustments. Covid-19 Virus Infection COPD Date of onset of symptoms: 11/15 Symptoms present on admission: Cough and SOB Date of covid positive test: 11/18 Vaccination status: unvaccinated Imaging: CXR with no acute infiltrates. Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: Bronchodilators. Consultants following: ID Anticipated special isolation end date: 11/26 Worsening oxygenation requiring 2 L NC but now on room air 96% Pox. Appreciate ID input, on remdesivir, monitor renal function. Wean Solu-Medrol.   Acute respiratory failure Due to COVID-19. Improved. Continue bronchodilators. Add scheduled Albuterol MDI. Wean O2 as able to. Albuterol MDI scheduled.   Diabetes mellitus II Last HbA1c was 7.7 in May 2023. At home he was on Humulin 70/30, Lantus and Humalog. Discussed with endocrinology, insulin adjustments will be made.   AKI on CKD III Cr 2.26 -> 1.76. He is nonoliguric. Avoid nephrotoxins. Monitor Cr while on diuretics..   BLE stasis dermatitis No sign of acute infection. Continue to monitor.