chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Fatigue, Mobility decreased, Pneumonia bacterial, Superinfection
Clinical narrative: Admit date: 10/26/2023 Discharge date: 12/5/2023  Admitting Physician: MD   Attending Physician at the Time of Discharge: No att. providers found  Primary Care Physician: MD,  Reason for Admission: Acute hypoxic respiratory failure  Brief Summary of Hospital Stay:  Per HPI, a 85 YO male with PMHx of CKD 3A, CLL ibrutinib, hypertension, hyperlipidemia, cardiomyopathy, paroxysmal Afib, and history prostate cancer and squamous cell carcinoma of skin who presents to the emergency department for 1 day of fatigue and shortness of breath found to be COVID-19 positive.  Patient states that he has been feelingFatigued for the past day, and was unable to get up out of chair earlier today which prompted him to come to the emergency department.  He also states that he has been feeling short of breath for the past day.  He endorses weakness, shortness of breath, dizziness, and nonproductive cough.  He denies any dizziness/headaches, nausea/vomiting, chest pain, abdominal pain, changes in bowel habits, dysuria, and numbness/tingling. Hospital Course: Acute hypoxic respiratory failure secondary to COVID Infection with likely superimposed bacterial pneumonia likely resolved, patient now using supplemental oxygen at rest for comfort Discharged to home.
Age: 12.0
Sex: F
Vaccine: COVID19, HPV9
Symptoms: Incorrect dose administered
Clinical narrative: Moderna vaccine for 6mo-11yr was administered to pt instead of the Monderna 12+ vaccine
Age: 1.25
Sex: M
Vaccine: DTAPHEPBIP
Symptoms: Urticaria
Clinical narrative: Within that day hives
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Cough, Diarrhoea, Fall
Clinical narrative: Admit date: 12/1/2023  Discharge date: 12/06/23   Admitting Physician: MD   Attending Physician at the Time of Discharge: No att. providers found  Primary Care Physician: MD  Reason for Admission:  Acute diarrhea and COVID  Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures)  "This is a 80 YO male with h/o parkinsons, diabetes, hypertension, anxiety who presented to the emergency department today with persistent diarrhea and continued recent diagnosis of COVID.  Patient was discharged recently for similar symptoms on the 28th 4 days ago.  Patient was diagnosed with COVID at that time and was having some mobility issues with some light diarrhea.  Patient states the diarrhea is brown and loose and happens 3 to 4 times a day.  He has been feeling weak due to that reason.  Denies any respiratory distress.  Denies any fevers or chills or nausea or vomiting.  Otherwise patient is stable and has no concerns.  They have done a PCR GI stool panel in the emergency department and is pending.  History of present illness from admission 4 days ago ""This is a 80 YO male with h/o parkinsons, diabetes, hypertension, anxiety who presented to the emergency department today with a prominent cough and fatigue.  Patient states 2 days after holiday started experiencing these symptoms.  Patient denies any other upper respiratory symptoms at this time.  Patient currently lives with his wife at home.  Patient has no history of respiratory issues, no history of chronic obstructive pulmonary disease or asthma.  Patient does not use an inhaler at this time.  Patient states he is a nonsmoker and a nondrinker.  Patient is not on oxygen at home.  So far patient has not done anything over-the-counter for his symptoms.  Per emergency department note wife has seen him fall many times at home and has been unable to help him.  For that reason they would also like therapy to make sure patient is able to live on his own. "Patient had a PCR GI stool panel that was completely negative and patient was trialed on a more solid diet.  Between admission and today he says his stools are still a little loose however more solid than they were when he was admitted.  He denies any nausea or vomiting that he had the 1st 2 days.  Patient is coming towards the end of his COVID isolation as well and has had no dyspnea.  He was Saturday saturating better over the course of the last 3 days and today 95% on room air.  Patient states he usually lives with his wife and there was some home concern about being by himself however he states he is able to care for himself today and would like to go home and was deemed medically stable to continue his home medications and go back to his home. Discharged to home.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Gastrointestinal pathogen panel, Mobility decreased, Stool analysis normal
Clinical narrative: Admit date: 12/1/2023  Discharge date: 12/06/23   Admitting Physician: MD   Attending Physician at the Time of Discharge: No att. providers found  Primary Care Physician: MD  Reason for Admission:  Acute diarrhea and COVID  Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures)  "This is a 80 YO male with h/o parkinsons, diabetes, hypertension, anxiety who presented to the emergency department today with persistent diarrhea and continued recent diagnosis of COVID.  Patient was discharged recently for similar symptoms on the 28th 4 days ago.  Patient was diagnosed with COVID at that time and was having some mobility issues with some light diarrhea.  Patient states the diarrhea is brown and loose and happens 3 to 4 times a day.  He has been feeling weak due to that reason.  Denies any respiratory distress.  Denies any fevers or chills or nausea or vomiting.  Otherwise patient is stable and has no concerns.  They have done a PCR GI stool panel in the emergency department and is pending.  History of present illness from admission 4 days ago ""This is a 80 YO male with h/o parkinsons, diabetes, hypertension, anxiety who presented to the emergency department today with a prominent cough and fatigue.  Patient states 2 days after holiday started experiencing these symptoms.  Patient denies any other upper respiratory symptoms at this time.  Patient currently lives with his wife at home.  Patient has no history of respiratory issues, no history of chronic obstructive pulmonary disease or asthma.  Patient does not use an inhaler at this time.  Patient states he is a nonsmoker and a nondrinker.  Patient is not on oxygen at home.  So far patient has not done anything over-the-counter for his symptoms.  Per emergency department note wife has seen him fall many times at home and has been unable to help him.  For that reason they would also like therapy to make sure patient is able to live on his own. "Patient had a PCR GI stool panel that was completely negative and patient was trialed on a more solid diet.  Between admission and today he says his stools are still a little loose however more solid than they were when he was admitted.  He denies any nausea or vomiting that he had the 1st 2 days.  Patient is coming towards the end of his COVID isolation as well and has had no dyspnea.  He was Saturday saturating better over the course of the last 3 days and today 95% on room air.  Patient states he usually lives with his wife and there was some home concern about being by himself however he states he is able to care for himself today and would like to go home and was deemed medically stable to continue his home medications and go back to his home. Discharged to home.
Age: 70.0
Sex: F
Vaccine: RSV
Symptoms: Ear pain
Clinical narrative: Left ear pain the next day like an ear ache.  No other complications.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Anxiety, Blood creatinine increased, Blood sodium decreased, COVID-19
Clinical narrative: Admit date: 12/2/2023  Discharge date: 12/05/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge:  DO  Primary Care Physician: MD, Reason for Admission: Acute hypoxic respiratory failure secondary to covid infection Brief Summary of Hospital Stay: As per H&P Patient is a 80 YO female with a past medical history of PPM, COPD, T2DM, HTN, Atrial fibrillation on Xarelto, HLD, asthma and obesity that presents to the emergency department with complaints of worsening dyspnea and shortness of breath over the past 2 days. Patient's husband is COVID positive and is currently admitted to the hospital. Patient notes that she has had increased coughing with congestion that was worse today than previous days. She has felt some chills and fever though did not check temperature. She called EMS today because she could not catch her breath and became very anxious. She had 2 episodes of diarrhea prior to arrival. EMS noted that patient's SpO2 was 85% on RA. Patient was also given 125 mg of Solu-medrol and a Duoneb treatment. They placed her on non-rebreathing Patient denies any diaphoresis, numbness, tingling, unilateral muscle weakness, headache, dizziness, dysphagia, chest pain, sputum production, hemoptysis, nausea, vomiting, abdominal pain, dysuria, change in bowel regimen, hematochezia or melena.  In the ED,  patient presented hypertensive with BP 187/91. Was placed on BiPap momentarily for 88% and was weaned to 2L nasal canula. Labs notable for Na 128, serum creatinine 1.4. COVID PCR positive. CXR showing cardiomegaly and pulmonary vascular congestion with small bilateral pleural effusions and bibasilar airspace disease could be due to atelectasis/scarring. Patient is being admitted under general medicine service for further work-up and management Hospital Course: Patient was started on steroids, Remdesivir was not given, as patient declined. She continued her home medication, as well as prn duonebs. Symptoms improved. She was weaned off O2. PT recommends home independently.  Upon exam this morning, patient feeling overall better. Cough persists but has improved since admission. Patient was medically optimized. Vital signs were stable for discharge.  Discharged to Home Health Care.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cardiomegaly, Chest X-ray abnormal, Chills, Cough, Diarrhoea
Clinical narrative: Admit date: 12/2/2023  Discharge date: 12/05/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge:  DO  Primary Care Physician: MD, Reason for Admission: Acute hypoxic respiratory failure secondary to covid infection Brief Summary of Hospital Stay: As per H&P Patient is a 80 YO female with a past medical history of PPM, COPD, T2DM, HTN, Atrial fibrillation on Xarelto, HLD, asthma and obesity that presents to the emergency department with complaints of worsening dyspnea and shortness of breath over the past 2 days. Patient's husband is COVID positive and is currently admitted to the hospital. Patient notes that she has had increased coughing with congestion that was worse today than previous days. She has felt some chills and fever though did not check temperature. She called EMS today because she could not catch her breath and became very anxious. She had 2 episodes of diarrhea prior to arrival. EMS noted that patient's SpO2 was 85% on RA. Patient was also given 125 mg of Solu-medrol and a Duoneb treatment. They placed her on non-rebreathing Patient denies any diaphoresis, numbness, tingling, unilateral muscle weakness, headache, dizziness, dysphagia, chest pain, sputum production, hemoptysis, nausea, vomiting, abdominal pain, dysuria, change in bowel regimen, hematochezia or melena.  In the ED,  patient presented hypertensive with BP 187/91. Was placed on BiPap momentarily for 88% and was weaned to 2L nasal canula. Labs notable for Na 128, serum creatinine 1.4. COVID PCR positive. CXR showing cardiomegaly and pulmonary vascular congestion with small bilateral pleural effusions and bibasilar airspace disease could be due to atelectasis/scarring. Patient is being admitted under general medicine service for further work-up and management Hospital Course: Patient was started on steroids, Remdesivir was not given, as patient declined. She continued her home medication, as well as prn duonebs. Symptoms improved. She was weaned off O2. PT recommends home independently.  Upon exam this morning, patient feeling overall better. Cough persists but has improved since admission. Patient was medically optimized. Vital signs were stable for discharge.  Discharged to Home Health Care.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea, Hypertension, Lung disorder, Pleural effusion, Positive airway pressure therapy
Clinical narrative: Admit date: 12/2/2023  Discharge date: 12/05/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge:  DO  Primary Care Physician: MD, Reason for Admission: Acute hypoxic respiratory failure secondary to covid infection Brief Summary of Hospital Stay: As per H&P Patient is a 80 YO female with a past medical history of PPM, COPD, T2DM, HTN, Atrial fibrillation on Xarelto, HLD, asthma and obesity that presents to the emergency department with complaints of worsening dyspnea and shortness of breath over the past 2 days. Patient's husband is COVID positive and is currently admitted to the hospital. Patient notes that she has had increased coughing with congestion that was worse today than previous days. She has felt some chills and fever though did not check temperature. She called EMS today because she could not catch her breath and became very anxious. She had 2 episodes of diarrhea prior to arrival. EMS noted that patient's SpO2 was 85% on RA. Patient was also given 125 mg of Solu-medrol and a Duoneb treatment. They placed her on non-rebreathing Patient denies any diaphoresis, numbness, tingling, unilateral muscle weakness, headache, dizziness, dysphagia, chest pain, sputum production, hemoptysis, nausea, vomiting, abdominal pain, dysuria, change in bowel regimen, hematochezia or melena.  In the ED,  patient presented hypertensive with BP 187/91. Was placed on BiPap momentarily for 88% and was weaned to 2L nasal canula. Labs notable for Na 128, serum creatinine 1.4. COVID PCR positive. CXR showing cardiomegaly and pulmonary vascular congestion with small bilateral pleural effusions and bibasilar airspace disease could be due to atelectasis/scarring. Patient is being admitted under general medicine service for further work-up and management Hospital Course: Patient was started on steroids, Remdesivir was not given, as patient declined. She continued her home medication, as well as prn duonebs. Symptoms improved. She was weaned off O2. PT recommends home independently.  Upon exam this morning, patient feeling overall better. Cough persists but has improved since admission. Patient was medically optimized. Vital signs were stable for discharge.  Discharged to Home Health Care.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pulmonary congestion, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Admit date: 12/2/2023  Discharge date: 12/05/2023  Admitting Physician: DO   Attending Physician at the Time of Discharge:  DO  Primary Care Physician: MD, Reason for Admission: Acute hypoxic respiratory failure secondary to covid infection Brief Summary of Hospital Stay: As per H&P Patient is a 80 YO female with a past medical history of PPM, COPD, T2DM, HTN, Atrial fibrillation on Xarelto, HLD, asthma and obesity that presents to the emergency department with complaints of worsening dyspnea and shortness of breath over the past 2 days. Patient's husband is COVID positive and is currently admitted to the hospital. Patient notes that she has had increased coughing with congestion that was worse today than previous days. She has felt some chills and fever though did not check temperature. She called EMS today because she could not catch her breath and became very anxious. She had 2 episodes of diarrhea prior to arrival. EMS noted that patient's SpO2 was 85% on RA. Patient was also given 125 mg of Solu-medrol and a Duoneb treatment. They placed her on non-rebreathing Patient denies any diaphoresis, numbness, tingling, unilateral muscle weakness, headache, dizziness, dysphagia, chest pain, sputum production, hemoptysis, nausea, vomiting, abdominal pain, dysuria, change in bowel regimen, hematochezia or melena.  In the ED,  patient presented hypertensive with BP 187/91. Was placed on BiPap momentarily for 88% and was weaned to 2L nasal canula. Labs notable for Na 128, serum creatinine 1.4. COVID PCR positive. CXR showing cardiomegaly and pulmonary vascular congestion with small bilateral pleural effusions and bibasilar airspace disease could be due to atelectasis/scarring. Patient is being admitted under general medicine service for further work-up and management Hospital Course: Patient was started on steroids, Remdesivir was not given, as patient declined. She continued her home medication, as well as prn duonebs. Symptoms improved. She was weaned off O2. PT recommends home independently.  Upon exam this morning, patient feeling overall better. Cough persists but has improved since admission. Patient was medically optimized. Vital signs were stable for discharge.  Discharged to Home Health Care.
Age: 5.0
Sex: F
Vaccine: DTAP, HEP
Symptoms: Injection site swelling
Clinical narrative: No adverse events noted at the time of injection. On 12/7 the mother called and said that the right arm had some swelling at the injection site, which is a known side effect.
Age: 50.0
Sex: F
Vaccine: VARZOS
Symptoms: Arthralgia, Back pain, Blister, Cellulitis, Chills
Clinical narrative: The morning after, I had body aches and a little redness at the injection site. I had fatigue. The next day my arm is red, warm, swollen, and tender. I went to the ER and they said it was cellulitis which is very painful. I was given Keflex antibiotics 4 times a day. My face has blisters now too. Today my back and limbs and joints are really hurting. I have chills too. Hydrocortisone for the face blisters.
Age: 50.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Fatigue, Injection site erythema, Pain, Pain in extremity
Clinical narrative: The morning after, I had body aches and a little redness at the injection site. I had fatigue. The next day my arm is red, warm, swollen, and tender. I went to the ER and they said it was cellulitis which is very painful. I was given Keflex antibiotics 4 times a day. My face has blisters now too. Today my back and limbs and joints are really hurting. I have chills too. Hydrocortisone for the face blisters.
Age: 50.0
Sex: F
Vaccine: VARZOS
Symptoms: Peripheral swelling, Skin warm, Tenderness
Clinical narrative: The morning after, I had body aches and a little redness at the injection site. I had fatigue. The next day my arm is red, warm, swollen, and tender. I went to the ER and they said it was cellulitis which is very painful. I was given Keflex antibiotics 4 times a day. My face has blisters now too. Today my back and limbs and joints are really hurting. I have chills too. Hydrocortisone for the face blisters.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Arrhythmia, Cardiac pacemaker insertion, Cerebral infarction, Dysarthria, Embolic cerebral infarction
Clinical narrative: Admit date: 11/24/2023  Discharge date: 12/6/2023   Admitting Physician:  DO   Attending Physician at the Time of Discharge:  MD  Primary Care Physician:  MD,  Reason for Admission: Acute right frontal lobe infarcts  Hospital Course: 90 yo M with a history of CAD status post PCI in 1997, HTN, HLD, BPH, and chronic irregular heart rate (atrial fibrillation with intermittent bradycardia and pauses) not previously on anticoagulation, and recent history of GI bleeding suspected diverticular who presented to ED on 11/24 with complaints of slurred speech.   During the admission, stroke work up revealed small acute right frontal lobe infarcts suspected embolic in nature given aberrant cardiac rhythms. Patient underwent a permanent pacemaker placement on 12/01, following which his heart rate has been regular without recurrent episodes of bradycardia or pauses. He is being discharged in a stable condition to Rehab.   Prior to discharge, patient was started on apixaban 5 mg twice daily after a benefit vs risk discussion with the patient, determined benefit outweighs the risk. He was also started on daily furosemide with potassium maintenance. Patient was instructed to stop aspirin and avoid any NSAID use in the future.  Discharged to Rehab Facility.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test abnormal
Clinical narrative: Admit date: 11/24/2023  Discharge date: 12/6/2023   Admitting Physician:  DO   Attending Physician at the Time of Discharge:  MD  Primary Care Physician:  MD,  Reason for Admission: Acute right frontal lobe infarcts  Hospital Course: 90 yo M with a history of CAD status post PCI in 1997, HTN, HLD, BPH, and chronic irregular heart rate (atrial fibrillation with intermittent bradycardia and pauses) not previously on anticoagulation, and recent history of GI bleeding suspected diverticular who presented to ED on 11/24 with complaints of slurred speech.   During the admission, stroke work up revealed small acute right frontal lobe infarcts suspected embolic in nature given aberrant cardiac rhythms. Patient underwent a permanent pacemaker placement on 12/01, following which his heart rate has been regular without recurrent episodes of bradycardia or pauses. He is being discharged in a stable condition to Rehab.   Prior to discharge, patient was started on apixaban 5 mg twice daily after a benefit vs risk discussion with the patient, determined benefit outweighs the risk. He was also started on daily furosemide with potassium maintenance. Patient was instructed to stop aspirin and avoid any NSAID use in the future.  Discharged to Rehab Facility.
Age: 8.0
Sex: M
Vaccine: DTAP, HEP
Symptoms: No adverse event, Wrong product administered
Clinical narrative: The wrong vaccine was given. No adverse events.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Brain stem infarction, COVID-19, Cerebral small vessel ischaemic disease, Cerebrovascular accident, Cognitive disorder
Clinical narrative: Admission Date and Time: 11/24/2023  4:14 PM Discharge Date: 12/7/2023 Attending Physicians: DO, MD, DO, MD Discharge Physician: PA Admission Diagnosis: Acute cerebrovascular accident (CVA) (HCC) Discharge Diagnosis: Acute cerebrovascular accident (CVA) (HCC)  Diagnosis ? Acute cerebrovascular accident (CVA) (HCC) ? Thrombocytopenia (HCC) ? Falls frequently ? COVID-19 This is a 87 YO female with past medical history of thrombocytopenia, falls, tobacco use now abstaining for several years.  She presented to the Hospital emergency department on 11/20/23 due to right sided weakness and slurred speech x 3 days.  The patient initially did not want to be evaluated in the hospital however because of progression of her weakness the patient ultimately decided to seek evaluation.  At that point she was no longer able to walk.  The patient was found by MRI head to have an acute to subacute infarct in the ventral paramedian pons.   Neurology was consulted with recommendation for aspirin and statin daily.  Etiology of CVA was felt to be secondary to small vessel disease and less likely to be embolic. When medically stable, the patient was discharged to facility for  acute inpatient rehabilitation of functional and cognitive deficits.  Symptoms related to these abovementioned conditions and events were well-controlled, and the patient was discharged medically stable and improved. There were no significant acute episodes that affected length of stay or tolerance to therapies.  The patient was found to be positive for COVID on 12/5/23 after developing a fever and non-productive cough.   Her son was able to pick up a prescription for Paxlovid from the pharmacy and brought that in on 12/6/23.    The patient was also provided orthotics / durable medical equipment to ensure improved function and safety in the rehabilitation and home setting.  Occupational, Physical and Speech Language Pathology therapists and a Neuropsychologist were consulted for evaluation and treatment so as to best determine the amount and extent of services required for cognitive and functional optimization. The patient received a minimum of 180 minutes of therapy per day for 5 out of 7 days, or more than 15 hours of intensive therapy over the course of a week.   While in the unit, the acute rehabilitation service also held interdisciplinary team conferences on a weekly basis to establish specific short- and long-term goals during rehabilitation, and for discharge. Barriers to discharge were also noted and updated as they were addressed. Plans to assure continuity and coordination of care after discharge from the acute rehabilitation unit were also established and explained to the patient and care provider(s).  While on the unit, the patient was monitored on a daily basis by a physician who evaluated and managed co-morbidities and medical conditions, as necessary.  Discharged to home.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dysarthria, Fall, Gait inability, Hemiparesis
Clinical narrative: Admission Date and Time: 11/24/2023  4:14 PM Discharge Date: 12/7/2023 Attending Physicians: DO, MD, DO, MD Discharge Physician: PA Admission Diagnosis: Acute cerebrovascular accident (CVA) (HCC) Discharge Diagnosis: Acute cerebrovascular accident (CVA) (HCC)  Diagnosis ? Acute cerebrovascular accident (CVA) (HCC) ? Thrombocytopenia (HCC) ? Falls frequently ? COVID-19 This is a 87 YO female with past medical history of thrombocytopenia, falls, tobacco use now abstaining for several years.  She presented to the Hospital emergency department on 11/20/23 due to right sided weakness and slurred speech x 3 days.  The patient initially did not want to be evaluated in the hospital however because of progression of her weakness the patient ultimately decided to seek evaluation.  At that point she was no longer able to walk.  The patient was found by MRI head to have an acute to subacute infarct in the ventral paramedian pons.   Neurology was consulted with recommendation for aspirin and statin daily.  Etiology of CVA was felt to be secondary to small vessel disease and less likely to be embolic. When medically stable, the patient was discharged to facility for  acute inpatient rehabilitation of functional and cognitive deficits.  Symptoms related to these abovementioned conditions and events were well-controlled, and the patient was discharged medically stable and improved. There were no significant acute episodes that affected length of stay or tolerance to therapies.  The patient was found to be positive for COVID on 12/5/23 after developing a fever and non-productive cough.   Her son was able to pick up a prescription for Paxlovid from the pharmacy and brought that in on 12/6/23.    The patient was also provided orthotics / durable medical equipment to ensure improved function and safety in the rehabilitation and home setting.  Occupational, Physical and Speech Language Pathology therapists and a Neuropsychologist were consulted for evaluation and treatment so as to best determine the amount and extent of services required for cognitive and functional optimization. The patient received a minimum of 180 minutes of therapy per day for 5 out of 7 days, or more than 15 hours of intensive therapy over the course of a week.   While in the unit, the acute rehabilitation service also held interdisciplinary team conferences on a weekly basis to establish specific short- and long-term goals during rehabilitation, and for discharge. Barriers to discharge were also noted and updated as they were addressed. Plans to assure continuity and coordination of care after discharge from the acute rehabilitation unit were also established and explained to the patient and care provider(s).  While on the unit, the patient was monitored on a daily basis by a physician who evaluated and managed co-morbidities and medical conditions, as necessary.  Discharged to home.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging head abnormal, Pyrexia, SARS-CoV-2 test positive, Thrombocytopenia
Clinical narrative: Admission Date and Time: 11/24/2023  4:14 PM Discharge Date: 12/7/2023 Attending Physicians: DO, MD, DO, MD Discharge Physician: PA Admission Diagnosis: Acute cerebrovascular accident (CVA) (HCC) Discharge Diagnosis: Acute cerebrovascular accident (CVA) (HCC)  Diagnosis ? Acute cerebrovascular accident (CVA) (HCC) ? Thrombocytopenia (HCC) ? Falls frequently ? COVID-19 This is a 87 YO female with past medical history of thrombocytopenia, falls, tobacco use now abstaining for several years.  She presented to the Hospital emergency department on 11/20/23 due to right sided weakness and slurred speech x 3 days.  The patient initially did not want to be evaluated in the hospital however because of progression of her weakness the patient ultimately decided to seek evaluation.  At that point she was no longer able to walk.  The patient was found by MRI head to have an acute to subacute infarct in the ventral paramedian pons.   Neurology was consulted with recommendation for aspirin and statin daily.  Etiology of CVA was felt to be secondary to small vessel disease and less likely to be embolic. When medically stable, the patient was discharged to facility for  acute inpatient rehabilitation of functional and cognitive deficits.  Symptoms related to these abovementioned conditions and events were well-controlled, and the patient was discharged medically stable and improved. There were no significant acute episodes that affected length of stay or tolerance to therapies.  The patient was found to be positive for COVID on 12/5/23 after developing a fever and non-productive cough.   Her son was able to pick up a prescription for Paxlovid from the pharmacy and brought that in on 12/6/23.    The patient was also provided orthotics / durable medical equipment to ensure improved function and safety in the rehabilitation and home setting.  Occupational, Physical and Speech Language Pathology therapists and a Neuropsychologist were consulted for evaluation and treatment so as to best determine the amount and extent of services required for cognitive and functional optimization. The patient received a minimum of 180 minutes of therapy per day for 5 out of 7 days, or more than 15 hours of intensive therapy over the course of a week.   While in the unit, the acute rehabilitation service also held interdisciplinary team conferences on a weekly basis to establish specific short- and long-term goals during rehabilitation, and for discharge. Barriers to discharge were also noted and updated as they were addressed. Plans to assure continuity and coordination of care after discharge from the acute rehabilitation unit were also established and explained to the patient and care provider(s).  While on the unit, the patient was monitored on a daily basis by a physician who evaluated and managed co-morbidities and medical conditions, as necessary.  Discharged to home.
Age: 52.0
Sex: F
Vaccine: PNC20
Symptoms: Axillary pain, Cystoid macular oedema, Inflammation, Iritis, Neck pain
Clinical narrative: After the vaccination I had an inflammatory response under my right arm pit, that extended upwards into my neck for about a week, very sore and tender.  11 days after the vaccine I developed Iritis in my right eye. I was properly diagnosed on the 19th for Iritis. I am still dealing with it and now have cystoid macular edema.  i have trouble not connecting this to the vaccine considering the inflammatory response under my arm and neck , and I have no underlying issue that would cause this.
Age: 52.0
Sex: F
Vaccine: PNC20
Symptoms: Tenderness
Clinical narrative: After the vaccination I had an inflammatory response under my right arm pit, that extended upwards into my neck for about a week, very sore and tender.  11 days after the vaccine I developed Iritis in my right eye. I was properly diagnosed on the 19th for Iritis. I am still dealing with it and now have cystoid macular edema.  i have trouble not connecting this to the vaccine considering the inflammatory response under my arm and neck , and I have no underlying issue that would cause this.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anion gap, Blood creatinine decreased, Blood glucose normal, Blood urea increased
Clinical narrative: Pt is a 78 YO female with PMHx of AFib, HLD, coronary artery disease, depression and anxiety, chronic obstructive pulmonary disease that presented to the ED with c/o difficulty breathing.  Patient reports progressively worsening cough for the past week. She reports associated shortness of breath and difficulty laying flat.  Patient is chronically on home 2.5 liters of oxygen.  Patient reports increasing oxygen to 3 liters without any relief hence the ER visit. Patient reports decrease in appetite. She reports chronic leg swelling. Patient reports diarrhea for the past two days. She denies recent abx use. Patient denies changes in weight. Patient denies sick contacts. Patient denies chest pain, shortness of breath, abdominal pain, nausea, vomiting,  headache, dizziness or lightheadedness. Patient is urinating without difficulty or pain and bowels are moving appropriately.     In the ED, patient is tachycardic.  Labs reviewed and notes glucose 192, creatinine 0.4, BUN/Cr ratio 43, CO2 43, anion gap 4, BNP 638, up trending troponin.  Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes Principal Problem:Acute hypoxic respiratory failure likely multifactorial.  Patient is COVID positive, history of chronic obstructive pulmonary disease vs CHF exacerbation. Last echo in 2022 noted HFpEF with EF at 60-65%.  Patient is chronically on 2.5 liters of oxygen at home.  Bilateral lower extremity pitting edema. Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes. Hypoxic in the ER and en route.  Discharged to Skilled Nursing Facility.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Blood urea nitrogen/creatinine ratio, COVID-19, Carbon dioxide, Chest X-ray abnormal, Cough
Clinical narrative: Pt is a 78 YO female with PMHx of AFib, HLD, coronary artery disease, depression and anxiety, chronic obstructive pulmonary disease that presented to the ED with c/o difficulty breathing.  Patient reports progressively worsening cough for the past week. She reports associated shortness of breath and difficulty laying flat.  Patient is chronically on home 2.5 liters of oxygen.  Patient reports increasing oxygen to 3 liters without any relief hence the ER visit. Patient reports decrease in appetite. She reports chronic leg swelling. Patient reports diarrhea for the past two days. She denies recent abx use. Patient denies changes in weight. Patient denies sick contacts. Patient denies chest pain, shortness of breath, abdominal pain, nausea, vomiting,  headache, dizziness or lightheadedness. Patient is urinating without difficulty or pain and bowels are moving appropriately.     In the ED, patient is tachycardic.  Labs reviewed and notes glucose 192, creatinine 0.4, BUN/Cr ratio 43, CO2 43, anion gap 4, BNP 638, up trending troponin.  Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes Principal Problem:Acute hypoxic respiratory failure likely multifactorial.  Patient is COVID positive, history of chronic obstructive pulmonary disease vs CHF exacerbation. Last echo in 2022 noted HFpEF with EF at 60-65%.  Patient is chronically on 2.5 liters of oxygen at home.  Bilateral lower extremity pitting edema. Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes. Hypoxic in the ER and en route.  Discharged to Skilled Nursing Facility.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Diarrhoea, Dyspnoea, Echocardiogram abnormal, Ejection fraction
Clinical narrative: Pt is a 78 YO female with PMHx of AFib, HLD, coronary artery disease, depression and anxiety, chronic obstructive pulmonary disease that presented to the ED with c/o difficulty breathing.  Patient reports progressively worsening cough for the past week. She reports associated shortness of breath and difficulty laying flat.  Patient is chronically on home 2.5 liters of oxygen.  Patient reports increasing oxygen to 3 liters without any relief hence the ER visit. Patient reports decrease in appetite. She reports chronic leg swelling. Patient reports diarrhea for the past two days. She denies recent abx use. Patient denies changes in weight. Patient denies sick contacts. Patient denies chest pain, shortness of breath, abdominal pain, nausea, vomiting,  headache, dizziness or lightheadedness. Patient is urinating without difficulty or pain and bowels are moving appropriately.     In the ED, patient is tachycardic.  Labs reviewed and notes glucose 192, creatinine 0.4, BUN/Cr ratio 43, CO2 43, anion gap 4, BNP 638, up trending troponin.  Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes Principal Problem:Acute hypoxic respiratory failure likely multifactorial.  Patient is COVID positive, history of chronic obstructive pulmonary disease vs CHF exacerbation. Last echo in 2022 noted HFpEF with EF at 60-65%.  Patient is chronically on 2.5 liters of oxygen at home.  Bilateral lower extremity pitting edema. Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes. Hypoxic in the ER and en route.  Discharged to Skilled Nursing Facility.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoxia, Left ventricular failure, Lung disorder, Lung opacity, Oedema
Clinical narrative: Pt is a 78 YO female with PMHx of AFib, HLD, coronary artery disease, depression and anxiety, chronic obstructive pulmonary disease that presented to the ED with c/o difficulty breathing.  Patient reports progressively worsening cough for the past week. She reports associated shortness of breath and difficulty laying flat.  Patient is chronically on home 2.5 liters of oxygen.  Patient reports increasing oxygen to 3 liters without any relief hence the ER visit. Patient reports decrease in appetite. She reports chronic leg swelling. Patient reports diarrhea for the past two days. She denies recent abx use. Patient denies changes in weight. Patient denies sick contacts. Patient denies chest pain, shortness of breath, abdominal pain, nausea, vomiting,  headache, dizziness or lightheadedness. Patient is urinating without difficulty or pain and bowels are moving appropriately.     In the ED, patient is tachycardic.  Labs reviewed and notes glucose 192, creatinine 0.4, BUN/Cr ratio 43, CO2 43, anion gap 4, BNP 638, up trending troponin.  Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes Principal Problem:Acute hypoxic respiratory failure likely multifactorial.  Patient is COVID positive, history of chronic obstructive pulmonary disease vs CHF exacerbation. Last echo in 2022 noted HFpEF with EF at 60-65%.  Patient is chronically on 2.5 liters of oxygen at home.  Bilateral lower extremity pitting edema. Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes. Hypoxic in the ER and en route.  Discharged to Skilled Nursing Facility.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling, SARS-CoV-2 test positive, Tachycardia, Troponin increased
Clinical narrative: Pt is a 78 YO female with PMHx of AFib, HLD, coronary artery disease, depression and anxiety, chronic obstructive pulmonary disease that presented to the ED with c/o difficulty breathing.  Patient reports progressively worsening cough for the past week. She reports associated shortness of breath and difficulty laying flat.  Patient is chronically on home 2.5 liters of oxygen.  Patient reports increasing oxygen to 3 liters without any relief hence the ER visit. Patient reports decrease in appetite. She reports chronic leg swelling. Patient reports diarrhea for the past two days. She denies recent abx use. Patient denies changes in weight. Patient denies sick contacts. Patient denies chest pain, shortness of breath, abdominal pain, nausea, vomiting,  headache, dizziness or lightheadedness. Patient is urinating without difficulty or pain and bowels are moving appropriately.     In the ED, patient is tachycardic.  Labs reviewed and notes glucose 192, creatinine 0.4, BUN/Cr ratio 43, CO2 43, anion gap 4, BNP 638, up trending troponin.  Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes Principal Problem:Acute hypoxic respiratory failure likely multifactorial.  Patient is COVID positive, history of chronic obstructive pulmonary disease vs CHF exacerbation. Last echo in 2022 noted HFpEF with EF at 60-65%.  Patient is chronically on 2.5 liters of oxygen at home.  Bilateral lower extremity pitting edema. Chest x-ray notes new hazy density at the level of the right mid lung may reflect progressive fluid collection along with the fissure versus developing pneumonia, otherwise stable appearance of the chest diffusely prominent interstitial opacities likely reflecting changes. Hypoxic in the ER and en route.  Discharged to Skilled Nursing Facility.
Age: 61.0
Sex: M
Vaccine: VARZOS
Symptoms: Product preparation error
Clinical narrative: Patient received only the diluent.  vaccine was not diluted with the diluent.
Age: 56.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site cellulitis, Injection site erythema, Injection site pain
Clinical narrative: Patient described having a localized redness and tenderness at the injection site, which over the course of the 48 hours post-vaccination spread down her arm. At a routine primary care visit, her physician diagnosed her with cellulitis pertinent to the injection. The patient was treated by her physician and is recovering.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia
Clinical narrative: Weakness
Age: 65.0
Sex: M
Vaccine: RSV
Symptoms: Arthralgia, Fatigue, Injection site pain, Myalgia, Pruritus
Clinical narrative: Injection site pain, fatigue, myalgia (especially the entire right arm), arthralgia.  Syncope (BP was 105/56), fever (38.4C), and pruritus.  The pruritus was primarily located in: palms of hands, bottom of feet, and axilla. I took Benadryl (single tablet) for the pruritus. I also took Advil for the fever and myalgia.  It is now 27 hours after the injection and I'm feeling generally okay but with some mild persistent fatigue, pruritus, and myalgia.
Age: 65.0
Sex: M
Vaccine: RSV
Symptoms: Pyrexia, Syncope
Clinical narrative: Injection site pain, fatigue, myalgia (especially the entire right arm), arthralgia.  Syncope (BP was 105/56), fever (38.4C), and pruritus.  The pruritus was primarily located in: palms of hands, bottom of feet, and axilla. I took Benadryl (single tablet) for the pruritus. I also took Advil for the fever and myalgia.  It is now 27 hours after the injection and I'm feeling generally okay but with some mild persistent fatigue, pruritus, and myalgia.
Age: 24.0
Sex: F
Vaccine: TDAP
Symptoms: Poor quality product administered, Product storage error
Clinical narrative: Refrigerator temperature was out of range sporadically with the lowest temperature reaching 23.6 degrees F in the five days prior to the vaccine being given. GSK was contacted and stated the vaccine is no longer valid and a repeat dose will be needed.
Age: 4.0
Sex: F
Vaccine: DTAPIPV, MMRV
Symptoms: Pyrexia, Urticaria
Clinical narrative: Urticarial rash  fever began 24 hours later followed by urticaria
Age: 0.5
Sex: M
Vaccine: DTAPHEPBIP, DTAPIPVHIB, PNC20
Symptoms: Extra dose administered, No adverse event, Wrong product administered
Clinical narrative: Pentacil (instead of HIB) and Pediarix provided at the same time.  This was realized when doing vaccine counts the day after.  Discussion with manufacturing companies and CDC- no adverse reactions found in literature but to discuss with MOC and place in VAERS.  Discussion with MOC- no adverse reactions after vaccination observed 5 days later and to this day as well
Age: 80.0
Sex: F
Vaccine: FLU4
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Pt received a 2nd dose of flu shot in the same season in error. 1st dose was received on 9/15/2023 and the second dose was 12/8/23. Both doses for the high dose listed above.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chills, Cough, Malaise, Nasal congestion
Clinical narrative: General malaise, congestion, rhinorrhea, cough, fever/chills
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: General malaise, congestion, rhinorrhea, cough, fever/chills
Age: 65.0
Sex: F
Vaccine: RSV
Symptoms: Arthralgia, Bursitis, Pain, Stenosis, Vocal cord inflammation
Clinical narrative: BURSITIS, SEVERE SHOULDER PAIN, STENOSIS, CORDITIS TREATED WITH TYLENOL, IBUPROFEN, HYDROCODONE, METHYLPREDNISOLONE, METHOCARBAMOL, BACLOFEN, PHYSICAL THERAPY STILL HAVING PAIN AND SYMPTOMS 3 MONTHS LATER
Age: 83.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chills, Cough, Malaise, Nasal congestion
Clinical narrative: General malaise, fever/chills, congestion, rhinorrhea, cough
Age: 83.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: General malaise, fever/chills, congestion, rhinorrhea, cough
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Immunisation reaction, Throat irritation, Throat tightness
Clinical narrative: On 12/06/2023, the patient consented to receive the 2023-2024 Moderna monovalent COVID vaccine during a immunization clinic. The Public Health Nurse who administered the vaccine, RN, was call by a agent that an the individual was having a reaction to the vaccine he received about 15 minutes prior. He stated that his throat was closing and that it felt itchy/scratchy. Nurse returned to the unit and observed him making sounds with his throat like he was trying to clear it.  The housing unit officer called a medical emergency.  The code team arrived, assessed him, out and escorted him to the medical housing unit for observation.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebrovascular accident, Death, Thrombosis
Clinical narrative: My husband passed away from more than 15 strokes due to blood clots from the Covid shot
Age: 6.0
Sex: F
Vaccine: FLUC4
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Client with similar name to intended client was called to the School-Based Health Center (SBHC) for a flu vaccination. Wrong client received Flucelvax vaccine on 12/8/2023 at SBHC. When client's mother became aware that her daughter received vaccine immediately notified the SBHC. Client already received previous vaccine on 9/21/23 (flumist, lot TH2108, intranasal, manufactuer = medimmune). Per consultation with Medical Director, VAERS recommended to include that 2 doses of different manufacturer flu vaccine including 2 different routes were given in error to same patient). At this time, client has no symptoms, known health outcomes, and is without incident.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Expired vaccine administered to patient; no known patient adverse events; patient notified of error