chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Chemotherapy, Computerised tomogram abdomen abnormal, Condition aggravated, Deep vein thrombosis, Discharge
Clinical narrative: Date of Admission:  2/19/2022   Chief Complaint:  Abdominal pain    Source of Information:  Spouse / chart review   History of Present Illness:  This is a 75y.o. female with past medical history of hypothyroidism, stage IIIb T2N2 metastatic pancreatic adenocarcinoma status post Whipple procedure with Dr. 5/24/2021 status post gemcitabine chemo (stopped last September due to unable to tolerate), essential hypertension, type 2 diabetes, DVTs of the lower extremities (8/25) was placed on Eliquis (January 2022), stasis dermatitis.  Patient presenting to the emergency department via EMS from home given worsening abdominal comfort and wish for a second opinion for her pancreatic adenocarcinoma.    Patient's husband states that his wife has been experiencing pain that is not new.  Pancreatic cancer, but yesterday was much worse.   EMS was called to try to see if there is anything else that could be done for pancreatic cancer given excruciating pain she is experiencing.  Patient's husband states that patient underwent surgery back in May 2021 for the pancreatic cancer.  After that patient was started on chemotherapy which had to be stopped in September due to patient not being able to tolerate it and patient presenting with blood clots in her legs at the end of August.  At this time patient was enrolled in hospice due to poor prognosis and due to husband not being able to fully care for her at home (unclear timeline of what type of facility/when patient returned back to current residence).  Patient was then treated for her lower extremity DVTs with Eliquis until around January 2022.  Patient's husband states that over this time his wife started experiencing more problems with her legs, ulcerations and fluid leakage had she frequently need to see the doctor for.  Patient states that recently her oncologist stated that she had 2 months to live he wanted to get a second opinion to see if there is anything else that could be done.    ED course  Vitals: BP 104/70, heart rate 111, temperature 97.9, SPO2 98% on room air       Labs: Sodium 123, chloride 93, bicarb 10, anion gap 20, creatinine 1.71, albumin 2.0 and then alk phos 1889, AST 107, ALT 64, lipase 4, troponin 0.04, pH 7.18 Imaging: CT of the abdomen pelvis showing moderate volume of abdominal and pelvic ascites, postsurgical changes of the small bowel and pancreas without evidence of obstruction, bilateral inguinal lymphadenopathy, small left right pleural effusions, hypoattenuation involving the hepatic segment IV, postsurgical changes with drain localized in the head and body of the pancreas Meds: Dilaudid 1 mg x 2, Zofran, 500 mL normal saline bolus x4 Consultants: GI/interventional radiology/oncology
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza A virus test negative, Influenza B virus test, Lipase normal, Lymphadenopathy, Pain
Clinical narrative: Date of Admission:  2/19/2022   Chief Complaint:  Abdominal pain    Source of Information:  Spouse / chart review   History of Present Illness:  This is a 75y.o. female with past medical history of hypothyroidism, stage IIIb T2N2 metastatic pancreatic adenocarcinoma status post Whipple procedure with Dr. 5/24/2021 status post gemcitabine chemo (stopped last September due to unable to tolerate), essential hypertension, type 2 diabetes, DVTs of the lower extremities (8/25) was placed on Eliquis (January 2022), stasis dermatitis.  Patient presenting to the emergency department via EMS from home given worsening abdominal comfort and wish for a second opinion for her pancreatic adenocarcinoma.    Patient's husband states that his wife has been experiencing pain that is not new.  Pancreatic cancer, but yesterday was much worse.   EMS was called to try to see if there is anything else that could be done for pancreatic cancer given excruciating pain she is experiencing.  Patient's husband states that patient underwent surgery back in May 2021 for the pancreatic cancer.  After that patient was started on chemotherapy which had to be stopped in September due to patient not being able to tolerate it and patient presenting with blood clots in her legs at the end of August.  At this time patient was enrolled in hospice due to poor prognosis and due to husband not being able to fully care for her at home (unclear timeline of what type of facility/when patient returned back to current residence).  Patient was then treated for her lower extremity DVTs with Eliquis until around January 2022.  Patient's husband states that over this time his wife started experiencing more problems with her legs, ulcerations and fluid leakage had she frequently need to see the doctor for.  Patient states that recently her oncologist stated that she had 2 months to live he wanted to get a second opinion to see if there is anything else that could be done.    ED course  Vitals: BP 104/70, heart rate 111, temperature 97.9, SPO2 98% on room air       Labs: Sodium 123, chloride 93, bicarb 10, anion gap 20, creatinine 1.71, albumin 2.0 and then alk phos 1889, AST 107, ALT 64, lipase 4, troponin 0.04, pH 7.18 Imaging: CT of the abdomen pelvis showing moderate volume of abdominal and pelvic ascites, postsurgical changes of the small bowel and pancreas without evidence of obstruction, bilateral inguinal lymphadenopathy, small left right pleural effusions, hypoattenuation involving the hepatic segment IV, postsurgical changes with drain localized in the head and body of the pancreas Meds: Dilaudid 1 mg x 2, Zofran, 500 mL normal saline bolus x4 Consultants: GI/interventional radiology/oncology
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Pancreatic carcinoma, Pleural effusion, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Skin ulcer
Clinical narrative: Date of Admission:  2/19/2022   Chief Complaint:  Abdominal pain    Source of Information:  Spouse / chart review   History of Present Illness:  This is a 75y.o. female with past medical history of hypothyroidism, stage IIIb T2N2 metastatic pancreatic adenocarcinoma status post Whipple procedure with Dr. 5/24/2021 status post gemcitabine chemo (stopped last September due to unable to tolerate), essential hypertension, type 2 diabetes, DVTs of the lower extremities (8/25) was placed on Eliquis (January 2022), stasis dermatitis.  Patient presenting to the emergency department via EMS from home given worsening abdominal comfort and wish for a second opinion for her pancreatic adenocarcinoma.    Patient's husband states that his wife has been experiencing pain that is not new.  Pancreatic cancer, but yesterday was much worse.   EMS was called to try to see if there is anything else that could be done for pancreatic cancer given excruciating pain she is experiencing.  Patient's husband states that patient underwent surgery back in May 2021 for the pancreatic cancer.  After that patient was started on chemotherapy which had to be stopped in September due to patient not being able to tolerate it and patient presenting with blood clots in her legs at the end of August.  At this time patient was enrolled in hospice due to poor prognosis and due to husband not being able to fully care for her at home (unclear timeline of what type of facility/when patient returned back to current residence).  Patient was then treated for her lower extremity DVTs with Eliquis until around January 2022.  Patient's husband states that over this time his wife started experiencing more problems with her legs, ulcerations and fluid leakage had she frequently need to see the doctor for.  Patient states that recently her oncologist stated that she had 2 months to live he wanted to get a second opinion to see if there is anything else that could be done.    ED course  Vitals: BP 104/70, heart rate 111, temperature 97.9, SPO2 98% on room air       Labs: Sodium 123, chloride 93, bicarb 10, anion gap 20, creatinine 1.71, albumin 2.0 and then alk phos 1889, AST 107, ALT 64, lipase 4, troponin 0.04, pH 7.18 Imaging: CT of the abdomen pelvis showing moderate volume of abdominal and pelvic ascites, postsurgical changes of the small bowel and pancreas without evidence of obstruction, bilateral inguinal lymphadenopathy, small left right pleural effusions, hypoattenuation involving the hepatic segment IV, postsurgical changes with drain localized in the head and body of the pancreas Meds: Dilaudid 1 mg x 2, Zofran, 500 mL normal saline bolus x4 Consultants: GI/interventional radiology/oncology
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin
Clinical narrative: Date of Admission:  2/19/2022   Chief Complaint:  Abdominal pain    Source of Information:  Spouse / chart review   History of Present Illness:  This is a 75y.o. female with past medical history of hypothyroidism, stage IIIb T2N2 metastatic pancreatic adenocarcinoma status post Whipple procedure with Dr. 5/24/2021 status post gemcitabine chemo (stopped last September due to unable to tolerate), essential hypertension, type 2 diabetes, DVTs of the lower extremities (8/25) was placed on Eliquis (January 2022), stasis dermatitis.  Patient presenting to the emergency department via EMS from home given worsening abdominal comfort and wish for a second opinion for her pancreatic adenocarcinoma.    Patient's husband states that his wife has been experiencing pain that is not new.  Pancreatic cancer, but yesterday was much worse.   EMS was called to try to see if there is anything else that could be done for pancreatic cancer given excruciating pain she is experiencing.  Patient's husband states that patient underwent surgery back in May 2021 for the pancreatic cancer.  After that patient was started on chemotherapy which had to be stopped in September due to patient not being able to tolerate it and patient presenting with blood clots in her legs at the end of August.  At this time patient was enrolled in hospice due to poor prognosis and due to husband not being able to fully care for her at home (unclear timeline of what type of facility/when patient returned back to current residence).  Patient was then treated for her lower extremity DVTs with Eliquis until around January 2022.  Patient's husband states that over this time his wife started experiencing more problems with her legs, ulcerations and fluid leakage had she frequently need to see the doctor for.  Patient states that recently her oncologist stated that she had 2 months to live he wanted to get a second opinion to see if there is anything else that could be done.    ED course  Vitals: BP 104/70, heart rate 111, temperature 97.9, SPO2 98% on room air       Labs: Sodium 123, chloride 93, bicarb 10, anion gap 20, creatinine 1.71, albumin 2.0 and then alk phos 1889, AST 107, ALT 64, lipase 4, troponin 0.04, pH 7.18 Imaging: CT of the abdomen pelvis showing moderate volume of abdominal and pelvic ascites, postsurgical changes of the small bowel and pancreas without evidence of obstruction, bilateral inguinal lymphadenopathy, small left right pleural effusions, hypoattenuation involving the hepatic segment IV, postsurgical changes with drain localized in the head and body of the pancreas Meds: Dilaudid 1 mg x 2, Zofran, 500 mL normal saline bolus x4 Consultants: GI/interventional radiology/oncology
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Nasal congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: Extreme sinus drainage and stuffiness.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood cholesterol increased, Blood pressure increased, Breast tenderness, Oedema peripheral, Swelling
Clinical narrative: Marked swelling under the arms, around the jaw and neck, and breast tissue tenderness, increasing in severity during menstrual cycle, but present pretty much constantly. Have also noticed an increase in cholesterol and blood pressure per scans and tests at doctor's office, though no changes in vegan diet have been made. Increased water intake and use of OTC ibuprofen.  Saw, PA-C in May of 2021 and Jan of 2022 but was told that it was not anything to worry about. Saw current primary care doctor, who referred me to Dr., an ENT who expressed concern and has ordered a CT scan.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Swelling face
Clinical narrative: Marked swelling under the arms, around the jaw and neck, and breast tissue tenderness, increasing in severity during menstrual cycle, but present pretty much constantly. Have also noticed an increase in cholesterol and blood pressure per scans and tests at doctor's office, though no changes in vegan diet have been made. Increased water intake and use of OTC ibuprofen.  Saw, PA-C in May of 2021 and Jan of 2022 but was told that it was not anything to worry about. Saw current primary care doctor, who referred me to Dr., an ENT who expressed concern and has ordered a CT scan.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Lung infiltration
Clinical narrative: Right lower lobe pulmonary infiltrate. prescribed azithromycin tablets to take for the next 6 days 250 mg/day and I ordered albuterol inhaler to take only as needed and she will monitor her oxygen saturation at home with her pulse ox. ED visit to hospital admission within 6 weeks of receiving the COVID vaccine.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Blister, Blood test, Fatigue, Herpes zoster, Pain
Clinical narrative: I had shingles. I had pain and rash. Then, I had fever and bluster are my eye where I had the shingle infection. I was fatigue and very tired. These lasted for about 3 to 4 weeks. I seen a doctor at my work place and he did an exam. He also did blood work.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Rash
Clinical narrative: I had shingles. I had pain and rash. Then, I had fever and bluster are my eye where I had the shingle infection. I was fatigue and very tired. These lasted for about 3 to 4 weeks. I seen a doctor at my work place and he did an exam. He also did blood work.
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Dizziness, Fall, Fluid intake reduced, Hypophagia
Clinical narrative: Patient fully vaccinated and boosted with Pfizer on 2/4/21, 2/25/21, and 10/8/21. Previously diagnosed with COVID on 12/30/21. Patient presented to  ED with a fall on 1/13/22. Previously was seen in the ED on 1/11/22 for pneumonia, however sent home on doxycycline. Patient was not eating or drinking, felt light headed, and fell. Patient admitted on 1/13/22 and discharged 1/16/22.
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pneumonia
Clinical narrative: Patient fully vaccinated and boosted with Pfizer on 2/4/21, 2/25/21, and 10/8/21. Previously diagnosed with COVID on 12/30/21. Patient presented to  ED with a fall on 1/13/22. Previously was seen in the ED on 1/11/22 for pneumonia, however sent home on doxycycline. Patient was not eating or drinking, felt light headed, and fell. Patient admitted on 1/13/22 and discharged 1/16/22.
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test positive, Stent placement
Clinical narrative: Case reported no Covid symptoms at all, (asymptomatic).  Case was tested prior to the insertion of a heart Stent 02/11/2022. Case remained in hospital 1 day following the heart procedure.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure abnormal, COVID-19, Cardiac function test normal, Chest pain, Haemoptysis
Clinical narrative: After the vaccine I had soreness of the arm and a headache that would not go away. In January of 2022 on the 12th, it was the first sign of the symptoms of Covid so I went to go get tested and 3 days later, the result came back as positive. I was hospitalized for severe chest pains and blood coughing. My blood pressure was at borderline stroke.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Malaise, Pain in extremity, SARS-CoV-2 test positive, Ventilation/perfusion scan
Clinical narrative: After the vaccine I had soreness of the arm and a headache that would not go away. In January of 2022 on the 12th, it was the first sign of the symptoms of Covid so I went to go get tested and 3 days later, the result came back as positive. I was hospitalized for severe chest pains and blood coughing. My blood pressure was at borderline stroke.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea
Clinical narrative: Client received Janssen Covid Vaccine on 05/16/2021 at 10:32am. At approximately 5pm reported diarrhea which lasted for approximately 2 hours and went to the local hospital. Client was admitted and inpatient for 3 days.  Cause of diarrhea was undetermined and patient was released.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Abscess management, Biopsy, Oral dysplasia, Tongue abscess
Clinical narrative: At the beginning of Jan I had a number of abscesses on my tongue for about 2 weeks and at the end of that time there was one last issue under my tongue that turned out to be epithelial dysplasia. I was referred to a oral surgeon who found more than one and removed these on Feb 17. I am currently fit and healthy and have recovered 3/15.
Age: 0.33
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Rash
Clinical narrative: 1:00 PM on 1/20/22 mom reports patient began breaking out in rash on bilateral hands, gave infant's tylenol at that time. 1/20/22 at 4:40 pm mom reports rash is now spreading up bilateral arms
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy, Computerised tomogram, Condition aggravated, Ovarian cyst, Peripheral swelling
Clinical narrative: Patient with history of ovarian cyst and endometrial atypia..  gets yearly exams. This year in February, mass has grown significantly from previous years.  From 6cm to 20cm. Possible ovarian cancer.  Also leg swelling has increased
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound scan
Clinical narrative: Patient with history of ovarian cyst and endometrial atypia..  gets yearly exams. This year in February, mass has grown significantly from previous years.  From 6cm to 20cm. Possible ovarian cancer.  Also leg swelling has increased
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Aphasia, Arthralgia, Back pain, Blood test normal, Bone pain
Clinical narrative: She got her vaccine, the first day she was feeling tired which was expected. She went to bed, felt very cold, believes she had a fever, did not record it as she could not get herself to walk or get a thermometer. The next day she was sleeping the whole day, sleeping and waking up, get up for about a half an hour and fall back to sleep and could not move at all and wiped out. The next day she started having some pain in her muscles, body aches were really, really bad. From there she was so tired from that point on, and her body never really recovered. She has a lot of pains in her body out of no where or if she does anything she is not able to do her normal daily things that she does as she gets so easily. This did not happen before receiving the vaccine. She saw her PCP several times where she did extensive blood work and did not find anything. She went to a rheumatologist where he diagnosed her with fibromyalgia, which she never had problems before, and does not know if the vaccine caused it. She has had back pain since then and feels that her nerves are move sensitive to pain now. She has never had back pain like this before the vaccine. She now has a different life than it was before, and does not remember what a normal life is. She cannot clean her house now without limping on one leg, and has joint and bone pain that was not there prior to the vaccine. After her vaccine she started loosing her words, which is strange to her. She has had a lot of brain fog, and not able to go back to her normal sharpness that she had. This was very shocking and has made a difference in her life as she cannot find the words that she wants to say.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Feeling abnormal, Feeling cold, Fibromyalgia, Gait disturbance
Clinical narrative: She got her vaccine, the first day she was feeling tired which was expected. She went to bed, felt very cold, believes she had a fever, did not record it as she could not get herself to walk or get a thermometer. The next day she was sleeping the whole day, sleeping and waking up, get up for about a half an hour and fall back to sleep and could not move at all and wiped out. The next day she started having some pain in her muscles, body aches were really, really bad. From there she was so tired from that point on, and her body never really recovered. She has a lot of pains in her body out of no where or if she does anything she is not able to do her normal daily things that she does as she gets so easily. This did not happen before receiving the vaccine. She saw her PCP several times where she did extensive blood work and did not find anything. She went to a rheumatologist where he diagnosed her with fibromyalgia, which she never had problems before, and does not know if the vaccine caused it. She has had back pain since then and feels that her nerves are move sensitive to pain now. She has never had back pain like this before the vaccine. She now has a different life than it was before, and does not remember what a normal life is. She cannot clean her house now without limping on one leg, and has joint and bone pain that was not there prior to the vaccine. After her vaccine she started loosing her words, which is strange to her. She has had a lot of brain fog, and not able to go back to her normal sharpness that she had. This was very shocking and has made a difference in her life as she cannot find the words that she wants to say.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of personal independence in daily activities, Mobility decreased, Myalgia, Neuralgia, Pain
Clinical narrative: She got her vaccine, the first day she was feeling tired which was expected. She went to bed, felt very cold, believes she had a fever, did not record it as she could not get herself to walk or get a thermometer. The next day she was sleeping the whole day, sleeping and waking up, get up for about a half an hour and fall back to sleep and could not move at all and wiped out. The next day she started having some pain in her muscles, body aches were really, really bad. From there she was so tired from that point on, and her body never really recovered. She has a lot of pains in her body out of no where or if she does anything she is not able to do her normal daily things that she does as she gets so easily. This did not happen before receiving the vaccine. She saw her PCP several times where she did extensive blood work and did not find anything. She went to a rheumatologist where he diagnosed her with fibromyalgia, which she never had problems before, and does not know if the vaccine caused it. She has had back pain since then and feels that her nerves are move sensitive to pain now. She has never had back pain like this before the vaccine. She now has a different life than it was before, and does not remember what a normal life is. She cannot clean her house now without limping on one leg, and has joint and bone pain that was not there prior to the vaccine. After her vaccine she started loosing her words, which is strange to her. She has had a lot of brain fog, and not able to go back to her normal sharpness that she had. This was very shocking and has made a difference in her life as she cannot find the words that she wants to say.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Somnolence
Clinical narrative: She got her vaccine, the first day she was feeling tired which was expected. She went to bed, felt very cold, believes she had a fever, did not record it as she could not get herself to walk or get a thermometer. The next day she was sleeping the whole day, sleeping and waking up, get up for about a half an hour and fall back to sleep and could not move at all and wiped out. The next day she started having some pain in her muscles, body aches were really, really bad. From there she was so tired from that point on, and her body never really recovered. She has a lot of pains in her body out of no where or if she does anything she is not able to do her normal daily things that she does as she gets so easily. This did not happen before receiving the vaccine. She saw her PCP several times where she did extensive blood work and did not find anything. She went to a rheumatologist where he diagnosed her with fibromyalgia, which she never had problems before, and does not know if the vaccine caused it. She has had back pain since then and feels that her nerves are move sensitive to pain now. She has never had back pain like this before the vaccine. She now has a different life than it was before, and does not remember what a normal life is. She cannot clean her house now without limping on one leg, and has joint and bone pain that was not there prior to the vaccine. After her vaccine she started loosing her words, which is strange to her. She has had a lot of brain fog, and not able to go back to her normal sharpness that she had. This was very shocking and has made a difference in her life as she cannot find the words that she wants to say.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Rash, Rash pruritic
Clinical narrative: Two days after my vaccination a rash appeared on top of my hands. It started to spread to both of my hands, and then it went all the way to the top of my arm. It was many small bumps that looked like ant bites. They were very itchy. I took Allegra and some allergy pills. I put on topical ointment hydrocortisone. The rash lasted about two weeks.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Squamous cell carcinoma of the tongue
Clinical narrative: Patient with history of tongue cancer several years ago with partial glossectomy but NED; in January 2022, developed new SSC of tongue on same side as last time.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Cellulitis, Feeling abnormal, Limb discomfort
Clinical narrative: At first I had the expected side effects. Nothing too bad and that took about a week to feel better afterwards. Then on day 10 or 11 I noticed my arm was bothering me. I didn?t look at it until the next day (Sunday) and noticed what I at first thought might be cellulitis. I restarted the Claritin and used a hydrocortisone cream on it but it kept growing for several days taking up a large portion of my upper arm. I called my allergist (Dr) and reported what was going on and they said it?s ?covid arm?. It is mostly better now but I missed a Claritin dose and it?s coming back. On Friday I messaged my primary care Dr office (Dr in city,state) and they just called back today after looking at the photos and my dr called in antibiotics for cellulitis. Apparently multiple providers there have never heard of this delayed reaction ?covid arm? so it would be great if the CDC could provide more awareness about this.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Impaired healing, Vaccination site reaction
Clinical narrative: SORE THAT WON'T HEAL IN THE AREA THAT THE VACCINE WAS GIVEN, SHE HAS TRIED CORTISONE CREAM AND ANTIBIOTIC OINTMENT
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Abdominal pain upper, Alanine aminotransferase increased, Aspartate aminotransferase increased, Back pain
Clinical narrative: Attending Physician:    Date of Admission: 2/21/2022 Date of Visit: 2/22/2022   Chief Complaint:    Fatigue Source of Information:  Patient, Available medical record and sister-in-law   History of Present Illness:  This is a 68y.o. female  with a PMHx significant for Breast CA with metastasis, GERD, neuropathy presented to the ED 02/22/22 with complaints of fatigue, nausea, and vomiting. Patient reports that she had her last radiation treatment on 2/20. She states that she has been feeling fatigued with nausea and vomiting since. Patient reports that she had 2 radiation treatments back to back this week. She states that was supposed to have 5 treatments consecutively but she physically could not withstand. Patient reports that she has had over 3 episodes of nausea and vomiting. She states that her emesis is clear, nonbloody, and nonbilious. She reports that she has not been able to keep anything down and 3 days. She states her last bowel movement was 2/20. She states that her home pain regimen and antiemetics have not been helping her. Patient reports that she has increasingly worse generalized aching with back pain, epigastric abdominal pain, and bilateral feet pins-and-needles. Patient follows with the oncologist Dr. who works out of a HCF. Patient also reports that she has had difficulty with shortness of breath since she had Covid in January, patient wears 2 L of oxygen at all times at home At time of exam, sister-in-law's at bedside. Patient is feeling better. ED Course: Vital Signs: T 97.5, HR 103?115, RR 18, BP 144/82, and SPO2 98% on 3 L/nasal cannula Labs: Hyponatremia (129), elevated transaminases (ALP 152, AST 118, ALT 68), elevated beta hydroxybutyrate (2.19), normocytic anemia (H/H 10.8/32.8), UA positive ketones, UDS positive opiates and cannabinoids Diagnostics: EKG?ST, HR 117, nonspecific ST segments, no acute ischemic changes noted
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Blood alkaline phosphatase increased, Blood ketone body, Blood sodium decreased, COVID-19, Drug screen positive
Clinical narrative: Attending Physician:    Date of Admission: 2/21/2022 Date of Visit: 2/22/2022   Chief Complaint:    Fatigue Source of Information:  Patient, Available medical record and sister-in-law   History of Present Illness:  This is a 68y.o. female  with a PMHx significant for Breast CA with metastasis, GERD, neuropathy presented to the ED 02/22/22 with complaints of fatigue, nausea, and vomiting. Patient reports that she had her last radiation treatment on 2/20. She states that she has been feeling fatigued with nausea and vomiting since. Patient reports that she had 2 radiation treatments back to back this week. She states that was supposed to have 5 treatments consecutively but she physically could not withstand. Patient reports that she has had over 3 episodes of nausea and vomiting. She states that her emesis is clear, nonbloody, and nonbilious. She reports that she has not been able to keep anything down and 3 days. She states her last bowel movement was 2/20. She states that her home pain regimen and antiemetics have not been helping her. Patient reports that she has increasingly worse generalized aching with back pain, epigastric abdominal pain, and bilateral feet pins-and-needles. Patient follows with the oncologist Dr. who works out of a HCF. Patient also reports that she has had difficulty with shortness of breath since she had Covid in January, patient wears 2 L of oxygen at all times at home At time of exam, sister-in-law's at bedside. Patient is feeling better. ED Course: Vital Signs: T 97.5, HR 103?115, RR 18, BP 144/82, and SPO2 98% on 3 L/nasal cannula Labs: Hyponatremia (129), elevated transaminases (ALP 152, AST 118, ALT 68), elevated beta hydroxybutyrate (2.19), normocytic anemia (H/H 10.8/32.8), UA positive ketones, UDS positive opiates and cannabinoids Diagnostics: EKG?ST, HR 117, nonspecific ST segments, no acute ischemic changes noted
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Electrocardiogram ST segment abnormal, Electrocardiogram abnormal, Fatigue, Haematocrit decreased
Clinical narrative: Attending Physician:    Date of Admission: 2/21/2022 Date of Visit: 2/22/2022   Chief Complaint:    Fatigue Source of Information:  Patient, Available medical record and sister-in-law   History of Present Illness:  This is a 68y.o. female  with a PMHx significant for Breast CA with metastasis, GERD, neuropathy presented to the ED 02/22/22 with complaints of fatigue, nausea, and vomiting. Patient reports that she had her last radiation treatment on 2/20. She states that she has been feeling fatigued with nausea and vomiting since. Patient reports that she had 2 radiation treatments back to back this week. She states that was supposed to have 5 treatments consecutively but she physically could not withstand. Patient reports that she has had over 3 episodes of nausea and vomiting. She states that her emesis is clear, nonbloody, and nonbilious. She reports that she has not been able to keep anything down and 3 days. She states her last bowel movement was 2/20. She states that her home pain regimen and antiemetics have not been helping her. Patient reports that she has increasingly worse generalized aching with back pain, epigastric abdominal pain, and bilateral feet pins-and-needles. Patient follows with the oncologist Dr. who works out of a HCF. Patient also reports that she has had difficulty with shortness of breath since she had Covid in January, patient wears 2 L of oxygen at all times at home At time of exam, sister-in-law's at bedside. Patient is feeling better. ED Course: Vital Signs: T 97.5, HR 103?115, RR 18, BP 144/82, and SPO2 98% on 3 L/nasal cannula Labs: Hyponatremia (129), elevated transaminases (ALP 152, AST 118, ALT 68), elevated beta hydroxybutyrate (2.19), normocytic anemia (H/H 10.8/32.8), UA positive ketones, UDS positive opiates and cannabinoids Diagnostics: EKG?ST, HR 117, nonspecific ST segments, no acute ischemic changes noted
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Hyponatraemia, Influenza A virus test negative, Influenza B virus test, Nausea
Clinical narrative: Attending Physician:    Date of Admission: 2/21/2022 Date of Visit: 2/22/2022   Chief Complaint:    Fatigue Source of Information:  Patient, Available medical record and sister-in-law   History of Present Illness:  This is a 68y.o. female  with a PMHx significant for Breast CA with metastasis, GERD, neuropathy presented to the ED 02/22/22 with complaints of fatigue, nausea, and vomiting. Patient reports that she had her last radiation treatment on 2/20. She states that she has been feeling fatigued with nausea and vomiting since. Patient reports that she had 2 radiation treatments back to back this week. She states that was supposed to have 5 treatments consecutively but she physically could not withstand. Patient reports that she has had over 3 episodes of nausea and vomiting. She states that her emesis is clear, nonbloody, and nonbilious. She reports that she has not been able to keep anything down and 3 days. She states her last bowel movement was 2/20. She states that her home pain regimen and antiemetics have not been helping her. Patient reports that she has increasingly worse generalized aching with back pain, epigastric abdominal pain, and bilateral feet pins-and-needles. Patient follows with the oncologist Dr. who works out of a HCF. Patient also reports that she has had difficulty with shortness of breath since she had Covid in January, patient wears 2 L of oxygen at all times at home At time of exam, sister-in-law's at bedside. Patient is feeling better. ED Course: Vital Signs: T 97.5, HR 103?115, RR 18, BP 144/82, and SPO2 98% on 3 L/nasal cannula Labs: Hyponatremia (129), elevated transaminases (ALP 152, AST 118, ALT 68), elevated beta hydroxybutyrate (2.19), normocytic anemia (H/H 10.8/32.8), UA positive ketones, UDS positive opiates and cannabinoids Diagnostics: EKG?ST, HR 117, nonspecific ST segments, no acute ischemic changes noted
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Normocytic anaemia, Opiates positive, Pain, Paraesthesia, Radiotherapy
Clinical narrative: Attending Physician:    Date of Admission: 2/21/2022 Date of Visit: 2/22/2022   Chief Complaint:    Fatigue Source of Information:  Patient, Available medical record and sister-in-law   History of Present Illness:  This is a 68y.o. female  with a PMHx significant for Breast CA with metastasis, GERD, neuropathy presented to the ED 02/22/22 with complaints of fatigue, nausea, and vomiting. Patient reports that she had her last radiation treatment on 2/20. She states that she has been feeling fatigued with nausea and vomiting since. Patient reports that she had 2 radiation treatments back to back this week. She states that was supposed to have 5 treatments consecutively but she physically could not withstand. Patient reports that she has had over 3 episodes of nausea and vomiting. She states that her emesis is clear, nonbloody, and nonbilious. She reports that she has not been able to keep anything down and 3 days. She states her last bowel movement was 2/20. She states that her home pain regimen and antiemetics have not been helping her. Patient reports that she has increasingly worse generalized aching with back pain, epigastric abdominal pain, and bilateral feet pins-and-needles. Patient follows with the oncologist Dr. who works out of a HCF. Patient also reports that she has had difficulty with shortness of breath since she had Covid in January, patient wears 2 L of oxygen at all times at home At time of exam, sister-in-law's at bedside. Patient is feeling better. ED Course: Vital Signs: T 97.5, HR 103?115, RR 18, BP 144/82, and SPO2 98% on 3 L/nasal cannula Labs: Hyponatremia (129), elevated transaminases (ALP 152, AST 118, ALT 68), elevated beta hydroxybutyrate (2.19), normocytic anemia (H/H 10.8/32.8), UA positive ketones, UDS positive opiates and cannabinoids Diagnostics: EKG?ST, HR 117, nonspecific ST segments, no acute ischemic changes noted
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory syncytial virus test negative, SARS-CoV-2 test negative, Transaminases increased, Urine cannabinoids increased, Urine ketone body present
Clinical narrative: Attending Physician:    Date of Admission: 2/21/2022 Date of Visit: 2/22/2022   Chief Complaint:    Fatigue Source of Information:  Patient, Available medical record and sister-in-law   History of Present Illness:  This is a 68y.o. female  with a PMHx significant for Breast CA with metastasis, GERD, neuropathy presented to the ED 02/22/22 with complaints of fatigue, nausea, and vomiting. Patient reports that she had her last radiation treatment on 2/20. She states that she has been feeling fatigued with nausea and vomiting since. Patient reports that she had 2 radiation treatments back to back this week. She states that was supposed to have 5 treatments consecutively but she physically could not withstand. Patient reports that she has had over 3 episodes of nausea and vomiting. She states that her emesis is clear, nonbloody, and nonbilious. She reports that she has not been able to keep anything down and 3 days. She states her last bowel movement was 2/20. She states that her home pain regimen and antiemetics have not been helping her. Patient reports that she has increasingly worse generalized aching with back pain, epigastric abdominal pain, and bilateral feet pins-and-needles. Patient follows with the oncologist Dr. who works out of a HCF. Patient also reports that she has had difficulty with shortness of breath since she had Covid in January, patient wears 2 L of oxygen at all times at home At time of exam, sister-in-law's at bedside. Patient is feeling better. ED Course: Vital Signs: T 97.5, HR 103?115, RR 18, BP 144/82, and SPO2 98% on 3 L/nasal cannula Labs: Hyponatremia (129), elevated transaminases (ALP 152, AST 118, ALT 68), elevated beta hydroxybutyrate (2.19), normocytic anemia (H/H 10.8/32.8), UA positive ketones, UDS positive opiates and cannabinoids Diagnostics: EKG?ST, HR 117, nonspecific ST segments, no acute ischemic changes noted
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Attending Physician:    Date of Admission: 2/21/2022 Date of Visit: 2/22/2022   Chief Complaint:    Fatigue Source of Information:  Patient, Available medical record and sister-in-law   History of Present Illness:  This is a 68y.o. female  with a PMHx significant for Breast CA with metastasis, GERD, neuropathy presented to the ED 02/22/22 with complaints of fatigue, nausea, and vomiting. Patient reports that she had her last radiation treatment on 2/20. She states that she has been feeling fatigued with nausea and vomiting since. Patient reports that she had 2 radiation treatments back to back this week. She states that was supposed to have 5 treatments consecutively but she physically could not withstand. Patient reports that she has had over 3 episodes of nausea and vomiting. She states that her emesis is clear, nonbloody, and nonbilious. She reports that she has not been able to keep anything down and 3 days. She states her last bowel movement was 2/20. She states that her home pain regimen and antiemetics have not been helping her. Patient reports that she has increasingly worse generalized aching with back pain, epigastric abdominal pain, and bilateral feet pins-and-needles. Patient follows with the oncologist Dr. who works out of a HCF. Patient also reports that she has had difficulty with shortness of breath since she had Covid in January, patient wears 2 L of oxygen at all times at home At time of exam, sister-in-law's at bedside. Patient is feeling better. ED Course: Vital Signs: T 97.5, HR 103?115, RR 18, BP 144/82, and SPO2 98% on 3 L/nasal cannula Labs: Hyponatremia (129), elevated transaminases (ALP 152, AST 118, ALT 68), elevated beta hydroxybutyrate (2.19), normocytic anemia (H/H 10.8/32.8), UA positive ketones, UDS positive opiates and cannabinoids Diagnostics: EKG?ST, HR 117, nonspecific ST segments, no acute ischemic changes noted
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray, Injection site pain, Pyrexia, Skin warm, Urticaria
Clinical narrative: Hives, Fever, entire arm was hot to the touch pain at injection site
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: The COVID-19 vaccine (Lot number FH8028 with expiration of 2/28/22) was given after it's beyond use date of 1/15/2022. Outcomes of giving the vaccine after the BUD unknown.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperpyrexia
Clinical narrative: Hyperpyrexia: 106.3. Treated with 1000mg Tylenol orally.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Anaemia, Anticoagulant therapy, Blood loss anaemia, COVID-19
Clinical narrative: Patient received moderna vaccine on 3/10/21, 4/9/21, and 11/12/21. Found to be COVID19 positive on 1/20/22. transferred for worsening respiratory failure secondary to COVID-19 pneumonia.  Patient is vaccinated, he did test positive on 01/20/2022, symptom onset was 01/17/2022 and was hospitalized on once 01/26/2022.  He also did develop Aki on CKD stage IIIA.  Was being treated with remdesivir baricitinib, Decadron.  He did have a V/Q scan which did reveal low probability of PE.  After transfer patient was placed on BiPAP, continued to have worsening respiratory failure and eventually required intubation on 02/02/2022.  Eventually was pegged and trached on 2 15 2022.  Ultrasound of lower extremities did reveal a right lower extremity DVT therefore was started on therapeutic anticoagulation after which she did develop bleeding with acute blood loss anemia likely secondary to retroperitoneal hemorrhage.  Anticoagulation was withheld the resumed after which he did develop anemia again.  He required multiple PRBC transfusions.  He eventually had IVC filter placed on 02/14/2022.  Patient did have superimposed bacterial pneumonia and was treated with broad-spectrum antibiotic therapy, restarted having fevers on 02/10/2022.  Repeat cultures did reveal growth of yeast in sputum.  He did develop she shock likely a combination secondary to sepsis as well as hemorrhage from the retroperitoneal bleed and required pressors transiently.  Did complete course of vancomycin, Zosyn and micafungin.  Nephrology was consulted for the Aki on CKD stage IIIA which improved and was likely secondary to medications, shock.  Hemoglobins have remained stable, blood pressure is low normal and has required intermittent boluses of normal saline.  He was weaned of sedation and is able to follow commands and does not have any focal neurological deficits.  Will be transferred in stable condition to LTAC in hopes of weaning off ventilator.  At time of discharge patient's ventilator requirements were FiO2 of 35% and PEEP of 8. His anti-platelet therapy was discontinued which include aspirin and Plavix, patient may be resumed on prophylactic Lovenox for DVT while monitoring hemoglobins.  His antihypertensives were also discontinued due to borderline low blood pressures. Discharged on 2/25/22
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chest X-ray abnormal, Chronic kidney disease, Condition aggravated, Culture positive
Clinical narrative: Patient received moderna vaccine on 3/10/21, 4/9/21, and 11/12/21. Found to be COVID19 positive on 1/20/22. transferred for worsening respiratory failure secondary to COVID-19 pneumonia.  Patient is vaccinated, he did test positive on 01/20/2022, symptom onset was 01/17/2022 and was hospitalized on once 01/26/2022.  He also did develop Aki on CKD stage IIIA.  Was being treated with remdesivir baricitinib, Decadron.  He did have a V/Q scan which did reveal low probability of PE.  After transfer patient was placed on BiPAP, continued to have worsening respiratory failure and eventually required intubation on 02/02/2022.  Eventually was pegged and trached on 2 15 2022.  Ultrasound of lower extremities did reveal a right lower extremity DVT therefore was started on therapeutic anticoagulation after which she did develop bleeding with acute blood loss anemia likely secondary to retroperitoneal hemorrhage.  Anticoagulation was withheld the resumed after which he did develop anemia again.  He required multiple PRBC transfusions.  He eventually had IVC filter placed on 02/14/2022.  Patient did have superimposed bacterial pneumonia and was treated with broad-spectrum antibiotic therapy, restarted having fevers on 02/10/2022.  Repeat cultures did reveal growth of yeast in sputum.  He did develop she shock likely a combination secondary to sepsis as well as hemorrhage from the retroperitoneal bleed and required pressors transiently.  Did complete course of vancomycin, Zosyn and micafungin.  Nephrology was consulted for the Aki on CKD stage IIIA which improved and was likely secondary to medications, shock.  Hemoglobins have remained stable, blood pressure is low normal and has required intermittent boluses of normal saline.  He was weaned of sedation and is able to follow commands and does not have any focal neurological deficits.  Will be transferred in stable condition to LTAC in hopes of weaning off ventilator.  At time of discharge patient's ventilator requirements were FiO2 of 35% and PEEP of 8. His anti-platelet therapy was discontinued which include aspirin and Plavix, patient may be resumed on prophylactic Lovenox for DVT while monitoring hemoglobins.  His antihypertensives were also discontinued due to borderline low blood pressures. Discharged on 2/25/22