chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Amnesia, Feeding tube user, Injury, Paraplegia
Clinical narrative: 12 year old who was paralyzed/paralyzed from the waist down; seizures; Severely injured; memory loss; feeding tube; stomach ache; The initial case was missing the following minimum criteria: Reporter cannot be identified for direct/private contact (internet source). Upon receipt of follow-up information on [18Feb2023], this case now contains all required information to be considered valid.  This is a spontaneous report received from non-contactable reporter(s) (Consumer or other non HCP).  A 12-year-old female patient received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown) and as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient had no relevant medical history. The patient's concomitant medications were not reported. The following information was reported: PARAPLEGIA (medically significant), outcome "unknown", described as "12 year old who was paralyzed/paralyzed from the waist down"; SEIZURE (medically significant), outcome "unknown", described as "seizures"; INJURY (non-serious), outcome "unknown", described as "Severely injured"; AMNESIA (non-serious), outcome "unknown", described as "memory loss"; FEEDING TUBE USER (non-serious), outcome "unknown", described as "feeding tube"; ABDOMINAL PAIN UPPER (non-serious), outcome "unknown", described as "stomach ache". Clinical course: This reported was received from a Pfizer-sponsored program Corporate (Pfizer) Social Media Platforms. Patient was paralyzed by Pfizer vaccine in Pfizer trial doing, reporter asked for any update and would she walk again. Product was Pfizer Covid Vaccine - BNT162b2. It was reported that once- healthy 12yr old was volunteered by her family for Pfizer trial after 2 doses she was paralyzed from the waist down, in a wheelchair, had seizures & memory loss her remorse-filled mom said, "we just wanted to show we believed in The Science". Social Media Channel and report type stated as Pfizer AE. Upon follow-up query to RA, it was confirmed that Reporter was working on behalf of Vendor, the vendor was a measurable supplier and Supplier name (unspecified).  Follow-up attempts are completed. No further information is expected.
Sex: F
Vaccine: COVID19
Symptoms: Seizure
Clinical narrative: 12 year old who was paralyzed/paralyzed from the waist down; seizures; Severely injured; memory loss; feeding tube; stomach ache; The initial case was missing the following minimum criteria: Reporter cannot be identified for direct/private contact (internet source). Upon receipt of follow-up information on [18Feb2023], this case now contains all required information to be considered valid.  This is a spontaneous report received from non-contactable reporter(s) (Consumer or other non HCP).  A 12-year-old female patient received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown) and as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient had no relevant medical history. The patient's concomitant medications were not reported. The following information was reported: PARAPLEGIA (medically significant), outcome "unknown", described as "12 year old who was paralyzed/paralyzed from the waist down"; SEIZURE (medically significant), outcome "unknown", described as "seizures"; INJURY (non-serious), outcome "unknown", described as "Severely injured"; AMNESIA (non-serious), outcome "unknown", described as "memory loss"; FEEDING TUBE USER (non-serious), outcome "unknown", described as "feeding tube"; ABDOMINAL PAIN UPPER (non-serious), outcome "unknown", described as "stomach ache". Clinical course: This reported was received from a Pfizer-sponsored program Corporate (Pfizer) Social Media Platforms. Patient was paralyzed by Pfizer vaccine in Pfizer trial doing, reporter asked for any update and would she walk again. Product was Pfizer Covid Vaccine - BNT162b2. It was reported that once- healthy 12yr old was volunteered by her family for Pfizer trial after 2 doses she was paralyzed from the waist down, in a wheelchair, had seizures & memory loss her remorse-filled mom said, "we just wanted to show we believed in The Science". Social Media Channel and report type stated as Pfizer AE. Upon follow-up query to RA, it was confirmed that Reporter was working on behalf of Vendor, the vendor was a measurable supplier and Supplier name (unspecified).  Follow-up attempts are completed. No further information is expected.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Hypersomnia, Increased bronchial secretion, Posture abnormal, SARS-CoV-2 test positive
Clinical narrative: Patient is a 80 yo M w/ hx of dementia, HLD, GERD, CKD-3, pAflutter, BIBA for syncopal episodes x2. Majority of history from wife as pt is a very poor historian. States that he has been in usual state of health up until earlier today when he was sitting at the table and slumped over while waiting for his lunch. Episode was witnessed by his wife who noted he was making a gurgling sound but did not display any convulsive movements. At that point he regained consciousness and did not display any post-ictal signs. Wife called 911, paramedics checked vitals which were all wnl and pt declined coming to the hospital. He then took a 3h nap which is unusual for him. Upon awakening he had another syncopal episode witnessed by wife and called 911 to bring him to the hospital. Pt states he feels fine but is unable to provide any history about the events that occurred. Wife notes son who lives with them is also COVID+, pt found to be incidentally COVID+ in ED.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: Patient is a 80 yo M w/ hx of dementia, HLD, GERD, CKD-3, pAflutter, BIBA for syncopal episodes x2. Majority of history from wife as pt is a very poor historian. States that he has been in usual state of health up until earlier today when he was sitting at the table and slumped over while waiting for his lunch. Episode was witnessed by his wife who noted he was making a gurgling sound but did not display any convulsive movements. At that point he regained consciousness and did not display any post-ictal signs. Wife called 911, paramedics checked vitals which were all wnl and pt declined coming to the hospital. He then took a 3h nap which is unusual for him. Upon awakening he had another syncopal episode witnessed by wife and called 911 to bring him to the hospital. Pt states he feels fine but is unable to provide any history about the events that occurred. Wife notes son who lives with them is also COVID+, pt found to be incidentally COVID+ in ED.
Age: 23.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: i administered  the bivalent bood, I should of gave the second monovalent from primary series
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 91.0
Sex: U
Vaccine: COVID19
Symptoms: Asthenia, Asymptomatic COVID-19, Fall, Haematoma muscle, SARS-CoV-2 test positive
Clinical narrative: 93 year old male with PMHx CAD s/p CABG, HLD, Afib, HTN, recent hospitilization 1/25-2/4 for L femoral neck fracture after fall, hospitilization complicated by bleeding and anticoagulation was discontinued, recent IR biospy of R pleural mass, DC'ed to SNF 5 days ago, now presents w/ progressive weakness and fall at SNF, incidentialy COVID +, L gluteal hematoma.   Patient was admitted and ortho was consulted. Ortho believes patient has post surgical seroma. No interventions necessary. Patient has an appointment with ortho on 2/28/2023.  Patient was found to have COVID so was treated with Remdesivir.  Physical therapy evaluation was performed and recommended skilled nursing facility for rehab.    Patient remains clinically stable and asymptomatic so was discharged to skilled nursing facility.
Age: 91.0
Sex: U
Vaccine: COVID19
Symptoms: Seroma
Clinical narrative: 93 year old male with PMHx CAD s/p CABG, HLD, Afib, HTN, recent hospitilization 1/25-2/4 for L femoral neck fracture after fall, hospitilization complicated by bleeding and anticoagulation was discontinued, recent IR biospy of R pleural mass, DC'ed to SNF 5 days ago, now presents w/ progressive weakness and fall at SNF, incidentialy COVID +, L gluteal hematoma.   Patient was admitted and ortho was consulted. Ortho believes patient has post surgical seroma. No interventions necessary. Patient has an appointment with ortho on 2/28/2023.  Patient was found to have COVID so was treated with Remdesivir.  Physical therapy evaluation was performed and recommended skilled nursing facility for rehab.    Patient remains clinically stable and asymptomatic so was discharged to skilled nursing facility.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Hypersensitivity
Clinical narrative: severe allergic reactions
Age: 50.0
Sex: F
Vaccine: FLU4, HEP, PNC20, VARZOS
Symptoms: Underdose
Clinical narrative: Patient was given the pediatric dose of Engerix-B instead for the adult dose (20mcg/mL).  -Per GSK and provider, the patient will need to be vaccinated with the correct dose.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, COVID-19, Cellulitis, Dehydration, Hypotension
Clinical narrative: Hospital Course and Significant Findings: PMH sig for OSA / CPAP, CAD, DM2, Gout, HTN.   Pt presents to the ED c/o fever and muscle aches since last pm. Has head congestion beginning this am. No cough. No SOB. Pt scraped his LLE a few days ago while cutting wood and thinks it's infected. Pt found to have Hypotension & AKI d/t dehydration. Also found to have COVID and LLE Cellulitis
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Myalgia, Pyrexia, Respiratory tract congestion, Skin laceration, Wound infection
Clinical narrative: Hospital Course and Significant Findings: PMH sig for OSA / CPAP, CAD, DM2, Gout, HTN.   Pt presents to the ED c/o fever and muscle aches since last pm. Has head congestion beginning this am. No cough. No SOB. Pt scraped his LLE a few days ago while cutting wood and thinks it's infected. Pt found to have Hypotension & AKI d/t dehydration. Also found to have COVID and LLE Cellulitis
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Patient came in requesting the "new" covid Moderna booster. I observed his card and could see he had received the primary series along with what looked like on his card to be the two recommended doses for his age group. He stated he and his wife had tried to stay up to date with what was recommended but wondered since there was no room left on their cards if they could get the newest recommended shot. We explained their age group was recommended to receive two booster shots in addition to the primary series and now should receive the bivalent series to complete the recommended doses for their age group and would be recorded on an additional card they would keep with their first card. Dose was administered to patient and was observed for the recommended time. When later entering them into the system, it was discovered they had previously received the bivalent series and had actually only received one booster dose of the original Moderna vaccine. I called person as soon as we discovered the incident and also called the patient to inform him of the situation.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Circumstance or information capable of leading to medication error
Clinical narrative: Patient received one dose of Pfizer in the left arm. Vaccinator incorrectly documented vaccine site as left bicep instead of left deltoid. Medical record on state reporting system was fixed and correct documentation was added stating patient received vaccine in the left deltoid.
Age: 52.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site mass, Injection site pain
Clinical narrative: Patient described as lump at injection site, approx 2 inches in diameter.  Patient also described it as red and sore, but not itchy.  Patient was recommended to apply cold compress and to monitor for any worsening of condition.  Patient was told to take Benadryl if it became itchy.  Patient was also instructed to seek medical attention if it continued to worsen severely.
Age: 38.0
Sex: F
Vaccine: COVID19-2
Symptoms: Circumstance or information capable of leading to medication error
Clinical narrative: Patient received one dose of Moderna Bivalent in the left arm. Vaccinator incorrectly documented vaccine site as left bicep instead of left deltoid. Medical record on state reporting system was fixed and correct documentation was added stating patient received vaccine in the left deltoid.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Circumstance or information capable of leading to medication error
Clinical narrative: Patient received one dose of Pfizer in the left arm. Vaccinator incorrectly documented vaccine site as left bicep instead of left deltoid. Medical record on state reporting system was fixed and correct documentation was added stating patient received vaccine in the left deltoid.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Brain natriuretic peptide increased, COVID-19, Chest X-ray abnormal, Condition aggravated, Dyspnoea
Clinical narrative: Patient is a 84 Y  male with a history of hypertension, hyperlipidemia, CKD stage 4, prostate cancer, peripheral artery disease (s/p bypass), polymyalgia rheumatica, recurrent left pleural effusion s/p left pleurodesis on 5/2022 recent left hip replacement 2/1, presents with shortness of breath for 1 day. Per patient he was with his son over the weekend who tested positive for COVID-19. He states that his weight has been increasing. He previously was 200lbs then lost weight to 170s then now increased back to 185lb due to poor diet? Patient reports since his hip surgery he has not watched his diet. He endorses PND and orthopnea but denies chest pain, fever, shakes, chills, cough, nausea, vomiting, diarrhea, chest pain, abdominal pain. He has productive white phlegm. Patient found to have SpO2 88-89% on room air improved with 1L oxygen. Hypertensive 199/76. COVID+. Chest x-ray with mild pulmonary edema and left sided pleural effusion. BNP elevated 2061. He received IV Lasix 40mg X 1. Consulted for hypoxemia.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea paroxysmal nocturnal, Exposure to SARS-CoV-2, Hip arthroplasty, Hypertension, Hypoxia
Clinical narrative: Patient is a 84 Y  male with a history of hypertension, hyperlipidemia, CKD stage 4, prostate cancer, peripheral artery disease (s/p bypass), polymyalgia rheumatica, recurrent left pleural effusion s/p left pleurodesis on 5/2022 recent left hip replacement 2/1, presents with shortness of breath for 1 day. Per patient he was with his son over the weekend who tested positive for COVID-19. He states that his weight has been increasing. He previously was 200lbs then lost weight to 170s then now increased back to 185lb due to poor diet? Patient reports since his hip surgery he has not watched his diet. He endorses PND and orthopnea but denies chest pain, fever, shakes, chills, cough, nausea, vomiting, diarrhea, chest pain, abdominal pain. He has productive white phlegm. Patient found to have SpO2 88-89% on room air improved with 1L oxygen. Hypertensive 199/76. COVID+. Chest x-ray with mild pulmonary edema and left sided pleural effusion. BNP elevated 2061. He received IV Lasix 40mg X 1. Consulted for hypoxemia.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Inadequate diet, Orthopnoea, Pleural effusion, Pleurodesis, Pulmonary oedema
Clinical narrative: Patient is a 84 Y  male with a history of hypertension, hyperlipidemia, CKD stage 4, prostate cancer, peripheral artery disease (s/p bypass), polymyalgia rheumatica, recurrent left pleural effusion s/p left pleurodesis on 5/2022 recent left hip replacement 2/1, presents with shortness of breath for 1 day. Per patient he was with his son over the weekend who tested positive for COVID-19. He states that his weight has been increasing. He previously was 200lbs then lost weight to 170s then now increased back to 185lb due to poor diet? Patient reports since his hip surgery he has not watched his diet. He endorses PND and orthopnea but denies chest pain, fever, shakes, chills, cough, nausea, vomiting, diarrhea, chest pain, abdominal pain. He has productive white phlegm. Patient found to have SpO2 88-89% on room air improved with 1L oxygen. Hypertensive 199/76. COVID+. Chest x-ray with mild pulmonary edema and left sided pleural effusion. BNP elevated 2061. He received IV Lasix 40mg X 1. Consulted for hypoxemia.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Sputum discoloured, Thoracic operation, Weight decreased, Weight increased
Clinical narrative: Patient is a 84 Y  male with a history of hypertension, hyperlipidemia, CKD stage 4, prostate cancer, peripheral artery disease (s/p bypass), polymyalgia rheumatica, recurrent left pleural effusion s/p left pleurodesis on 5/2022 recent left hip replacement 2/1, presents with shortness of breath for 1 day. Per patient he was with his son over the weekend who tested positive for COVID-19. He states that his weight has been increasing. He previously was 200lbs then lost weight to 170s then now increased back to 185lb due to poor diet? Patient reports since his hip surgery he has not watched his diet. He endorses PND and orthopnea but denies chest pain, fever, shakes, chills, cough, nausea, vomiting, diarrhea, chest pain, abdominal pain. He has productive white phlegm. Patient found to have SpO2 88-89% on room air improved with 1L oxygen. Hypertensive 199/76. COVID+. Chest x-ray with mild pulmonary edema and left sided pleural effusion. BNP elevated 2061. He received IV Lasix 40mg X 1. Consulted for hypoxemia.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Patient came in requesting the "new" covid Moderna booster. I observed her card and could see he had received the primary series along with what looked like on his card to be the two recommended doses for his age group. stated she had tried to stay up to date with what was recommended but wondered since there was no room left on their cards if they could get the newest recommended shot. We explained their age group was recommended to receive two booster shots in addition to the primary series and now should receive the bivalent series to complete the recommended doses for their age group and would be recorded on an additional card they would keep with their first card. Dose was administered to patient and was observed for the recommended time. When later entering them into the system, it was discovered they had previously received the bivalent series and had actually only received one booster dose of the original Moderna vaccine. I called person as soon as we discovered the incident and also called the patient to inform him of the situation.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dyspnoea, Feeling abnormal, Sputum increased, Wheezing
Clinical narrative: Pt is a 79F with hx of copd, lung ca, cad, ckd3, presenting to ED for gradually worsening sob. She notes that around the 8th of Feb she noticed increase in sob and cough. She took a course of prednisone and azithromycin prescribed by her pulmonologist but she began feeling worse. Denies any fevers or sick contacts, no travel. Denies any chest pain or pressure. She has O2 at home which she uses prn. This past week she has felt like she needed it constantly and has been using her nebs often which she normally doesn't. Does have slightly increased sputum and wheezing.
Age: 63.0
Sex: M
Vaccine: COVID19-2
Symptoms: Facial paralysis, Incontinence, Neurological symptom
Clinical narrative: facial drooping, loss of continece, stroke symptoms
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Cough, Dysstasia
Clinical narrative: History of Present Illness: Patient is a 89 Y  female with a history of heart failure on Bumex(EF 2021 60-65%), hypothyroidism, hypertension, GERD, diabetes type 2 (not on any current antidiabetic medication), COPD(not on inhalers), pulmonary hypertension who presents to the emergency department after being found down in the garage by daughter.  History was provided by patient.  Patient states 1 week ago she attended a birthday-funeral event.  During this event patient interacted with approximately 17 other individuals, most of them who were young.  Subsequently, patient states she started to have episodes of cough with generalized weakness starting on Friday/Saturday.  At baseline patient ambulates with a walker.  Patient attempted to ambulate in the garage yesterday, however, was extremely weak and sat down on the garage floor.  Patient states she cannot get up and laid on the floor for approximately 16 hours.  Patient states daughter was attempted to call patient, however, patient was not reachable thus daughter came to patient's house.  Patient denies any loss of consciousness, denies hitting head.  Patient states she takes all of her medications as prescribed.
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Headache, Rash, Rhinorrhoea
Clinical narrative: My daughter was diagnosed with COVID-19 infection on 08/08/2022. She had slight cough, runny nose, and headaches. I thought she probably caught cold, and she also had rashes on both of her thighs so, I took her to the urgent care on the same day. At the ER they tested her for COVID-19 which turned out to be positive. They didn't prescribe her any medications but suggested to take over the counter medications. I gave her TYLENOL later that day for headaches.
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: My daughter was diagnosed with COVID-19 infection on 08/08/2022. She had slight cough, runny nose, and headaches. I thought she probably caught cold, and she also had rashes on both of her thighs so, I took her to the urgent care on the same day. At the ER they tested her for COVID-19 which turned out to be positive. They didn't prescribe her any medications but suggested to take over the counter medications. I gave her TYLENOL later that day for headaches.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Alanine aminotransferase increased, Alcohol use, Aspartate aminotransferase increased, Bladder catheterisation
Clinical narrative: History of Present Illness: The patient is a 54-year-old woman with a past medical history significant for depression and hyperlipidemia who presents to the emergency department 2/18/2023 after cardiac arrest.  The patient's cardiac arrest was witnessed.  In the field, the patient was found to be in V-fib and was shocked.  The patient remained in V-fib and was treated with lidocaine and shocked again.  The patient then was felt to be in PEA arrest.  The patient received 7 mg epinephrine in the field prior to arrival in the emergency department.  On arrival to the emergency department, the patient was found to have a pulse.  CPR time was 36 minutes.  According to the patient's boyfriend, the patient had consumed alcohol but denied any drug use.  The patient's urine drug screen, however, was preliminarily positive for cocaine.  The boyfriend had accompanied the patient to the emergency department but then left.   The patient had been ventilated with a King tube prior to presentation.  Shortly after arrival, the patient was intubated.  The patient, however, had a lot of blood in the trachea and required frequent suctioning.  A Foley catheter was placed.  The patient was treated with amiodarone 150 mg IV, lorazepam 2 mg IV, a bolus of lactated Ringer's solution, and started on propofol & Precedex.  The patient's EKG was consistent with an inferior wall STEMI.  The case was reviewed with the interventional cardiologist on-call who felt the patient was too unstable for cardiac catheterization.  A CT angiogram of the chest was ordered to rule out PE, but, however, the patient was again too unstable for CT scan.  The 36 C cooling protocol was ordered.  The patient, however, was hypothermic on presentation.  The patient's initial troponin I was 13.  The ALT and AST were 43 and 452.  D-dimer was elevated at 2.68.  An ABG was performed that showed an arterial pH of 7.09/PCO2 38/PO2 88.  The glucose level was 364.   No family contacts in the chart -will consult medical social worker.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Blood glucose increased, Blood pH decreased, Cardiac arrest, Cardioversion, Drug use disorder
Clinical narrative: History of Present Illness: The patient is a 54-year-old woman with a past medical history significant for depression and hyperlipidemia who presents to the emergency department 2/18/2023 after cardiac arrest.  The patient's cardiac arrest was witnessed.  In the field, the patient was found to be in V-fib and was shocked.  The patient remained in V-fib and was treated with lidocaine and shocked again.  The patient then was felt to be in PEA arrest.  The patient received 7 mg epinephrine in the field prior to arrival in the emergency department.  On arrival to the emergency department, the patient was found to have a pulse.  CPR time was 36 minutes.  According to the patient's boyfriend, the patient had consumed alcohol but denied any drug use.  The patient's urine drug screen, however, was preliminarily positive for cocaine.  The boyfriend had accompanied the patient to the emergency department but then left.   The patient had been ventilated with a King tube prior to presentation.  Shortly after arrival, the patient was intubated.  The patient, however, had a lot of blood in the trachea and required frequent suctioning.  A Foley catheter was placed.  The patient was treated with amiodarone 150 mg IV, lorazepam 2 mg IV, a bolus of lactated Ringer's solution, and started on propofol & Precedex.  The patient's EKG was consistent with an inferior wall STEMI.  The case was reviewed with the interventional cardiologist on-call who felt the patient was too unstable for cardiac catheterization.  A CT angiogram of the chest was ordered to rule out PE, but, however, the patient was again too unstable for CT scan.  The 36 C cooling protocol was ordered.  The patient, however, was hypothermic on presentation.  The patient's initial troponin I was 13.  The ALT and AST were 43 and 452.  D-dimer was elevated at 2.68.  An ABG was performed that showed an arterial pH of 7.09/PCO2 38/PO2 88.  The glucose level was 364.   No family contacts in the chart -will consult medical social worker.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Endotracheal intubation, Fibrin D dimer increased, Hypothermia, Mechanical ventilation
Clinical narrative: History of Present Illness: The patient is a 54-year-old woman with a past medical history significant for depression and hyperlipidemia who presents to the emergency department 2/18/2023 after cardiac arrest.  The patient's cardiac arrest was witnessed.  In the field, the patient was found to be in V-fib and was shocked.  The patient remained in V-fib and was treated with lidocaine and shocked again.  The patient then was felt to be in PEA arrest.  The patient received 7 mg epinephrine in the field prior to arrival in the emergency department.  On arrival to the emergency department, the patient was found to have a pulse.  CPR time was 36 minutes.  According to the patient's boyfriend, the patient had consumed alcohol but denied any drug use.  The patient's urine drug screen, however, was preliminarily positive for cocaine.  The boyfriend had accompanied the patient to the emergency department but then left.   The patient had been ventilated with a King tube prior to presentation.  Shortly after arrival, the patient was intubated.  The patient, however, had a lot of blood in the trachea and required frequent suctioning.  A Foley catheter was placed.  The patient was treated with amiodarone 150 mg IV, lorazepam 2 mg IV, a bolus of lactated Ringer's solution, and started on propofol & Precedex.  The patient's EKG was consistent with an inferior wall STEMI.  The case was reviewed with the interventional cardiologist on-call who felt the patient was too unstable for cardiac catheterization.  A CT angiogram of the chest was ordered to rule out PE, but, however, the patient was again too unstable for CT scan.  The 36 C cooling protocol was ordered.  The patient, however, was hypothermic on presentation.  The patient's initial troponin I was 13.  The ALT and AST were 43 and 452.  D-dimer was elevated at 2.68.  An ABG was performed that showed an arterial pH of 7.09/PCO2 38/PO2 88.  The glucose level was 364.   No family contacts in the chart -will consult medical social worker.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal suctioning, PCO2 normal, PO2 normal, Pulseless electrical activity, Resuscitation
Clinical narrative: History of Present Illness: The patient is a 54-year-old woman with a past medical history significant for depression and hyperlipidemia who presents to the emergency department 2/18/2023 after cardiac arrest.  The patient's cardiac arrest was witnessed.  In the field, the patient was found to be in V-fib and was shocked.  The patient remained in V-fib and was treated with lidocaine and shocked again.  The patient then was felt to be in PEA arrest.  The patient received 7 mg epinephrine in the field prior to arrival in the emergency department.  On arrival to the emergency department, the patient was found to have a pulse.  CPR time was 36 minutes.  According to the patient's boyfriend, the patient had consumed alcohol but denied any drug use.  The patient's urine drug screen, however, was preliminarily positive for cocaine.  The boyfriend had accompanied the patient to the emergency department but then left.   The patient had been ventilated with a King tube prior to presentation.  Shortly after arrival, the patient was intubated.  The patient, however, had a lot of blood in the trachea and required frequent suctioning.  A Foley catheter was placed.  The patient was treated with amiodarone 150 mg IV, lorazepam 2 mg IV, a bolus of lactated Ringer's solution, and started on propofol & Precedex.  The patient's EKG was consistent with an inferior wall STEMI.  The case was reviewed with the interventional cardiologist on-call who felt the patient was too unstable for cardiac catheterization.  A CT angiogram of the chest was ordered to rule out PE, but, however, the patient was again too unstable for CT scan.  The 36 C cooling protocol was ordered.  The patient, however, was hypothermic on presentation.  The patient's initial troponin I was 13.  The ALT and AST were 43 and 452.  D-dimer was elevated at 2.68.  An ABG was performed that showed an arterial pH of 7.09/PCO2 38/PO2 88.  The glucose level was 364.   No family contacts in the chart -will consult medical social worker.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Tracheal haemorrhage, Troponin I increased, Ventricular fibrillation
Clinical narrative: History of Present Illness: The patient is a 54-year-old woman with a past medical history significant for depression and hyperlipidemia who presents to the emergency department 2/18/2023 after cardiac arrest.  The patient's cardiac arrest was witnessed.  In the field, the patient was found to be in V-fib and was shocked.  The patient remained in V-fib and was treated with lidocaine and shocked again.  The patient then was felt to be in PEA arrest.  The patient received 7 mg epinephrine in the field prior to arrival in the emergency department.  On arrival to the emergency department, the patient was found to have a pulse.  CPR time was 36 minutes.  According to the patient's boyfriend, the patient had consumed alcohol but denied any drug use.  The patient's urine drug screen, however, was preliminarily positive for cocaine.  The boyfriend had accompanied the patient to the emergency department but then left.   The patient had been ventilated with a King tube prior to presentation.  Shortly after arrival, the patient was intubated.  The patient, however, had a lot of blood in the trachea and required frequent suctioning.  A Foley catheter was placed.  The patient was treated with amiodarone 150 mg IV, lorazepam 2 mg IV, a bolus of lactated Ringer's solution, and started on propofol & Precedex.  The patient's EKG was consistent with an inferior wall STEMI.  The case was reviewed with the interventional cardiologist on-call who felt the patient was too unstable for cardiac catheterization.  A CT angiogram of the chest was ordered to rule out PE, but, however, the patient was again too unstable for CT scan.  The 36 C cooling protocol was ordered.  The patient, however, was hypothermic on presentation.  The patient's initial troponin I was 13.  The ALT and AST were 43 and 452.  D-dimer was elevated at 2.68.  An ABG was performed that showed an arterial pH of 7.09/PCO2 38/PO2 88.  The glucose level was 364.   No family contacts in the chart -will consult medical social worker.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Atrial fibrillation, Atrioventricular block second degree, Bradycardia, Cardiac telemetry abnormal
Clinical narrative: The patient is 76F with PMH of HTN, HLD, CKD4-5 followed by doctor, GERD, gout who presents to KP VAL for dizziness. Patient unclear when she first noticed it. It happens any time she moves her head. The room is not spinning. She does feel lightheaded.  She feels nauseous though no vomiting. She otherwise has no acute complaints.When she arrived to ER she was noted to have bradycardia in the 30s and pads were placed on her. Patient is taking atenolol and has hx of CKD4-5 so likely this is culprit but work up with CT head is in process to rule out stroke/hemorrhage.--Per Admitting MD               Hospitalization notable for stoppage of BB with increase in HR, intermittent non-sustained episodes in 30's. Reviewed with cardiology currently not further recommendations.  Will refer for Zio-patch for monitoring outpatient, however patient has had 8 days of monitoring inpatient. All AV nodal blocking agents should be avoided. Wekebach was noted on telemetry, no action required per curbside with on-call cardiologist. ECHO with normal EF.  No current dizziness               UTI--Treated with CTX x 5 days               The patient was also started on dialysis this hospitalization. Permacath was placed and she has outpatient HD site selected.                Patient qualifies for HHPT               Pafib--She was started on heparin gtt, no active bleeding. Can transition to warfarin without bridging. No Hx of stroke/No mechanical valves.                She is anticipated DC on 2/21 if remains hemodynamically stable and tolerated HD in chair today.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Central venous catheterisation, Computerised tomogram head, Dialysis, Dizziness, Dizziness postural
Clinical narrative: The patient is 76F with PMH of HTN, HLD, CKD4-5 followed by doctor, GERD, gout who presents to KP VAL for dizziness. Patient unclear when she first noticed it. It happens any time she moves her head. The room is not spinning. She does feel lightheaded.  She feels nauseous though no vomiting. She otherwise has no acute complaints.When she arrived to ER she was noted to have bradycardia in the 30s and pads were placed on her. Patient is taking atenolol and has hx of CKD4-5 so likely this is culprit but work up with CT head is in process to rule out stroke/hemorrhage.--Per Admitting MD               Hospitalization notable for stoppage of BB with increase in HR, intermittent non-sustained episodes in 30's. Reviewed with cardiology currently not further recommendations.  Will refer for Zio-patch for monitoring outpatient, however patient has had 8 days of monitoring inpatient. All AV nodal blocking agents should be avoided. Wekebach was noted on telemetry, no action required per curbside with on-call cardiologist. ECHO with normal EF.  No current dizziness               UTI--Treated with CTX x 5 days               The patient was also started on dialysis this hospitalization. Permacath was placed and she has outpatient HD site selected.                Patient qualifies for HHPT               Pafib--She was started on heparin gtt, no active bleeding. Can transition to warfarin without bridging. No Hx of stroke/No mechanical valves.                She is anticipated DC on 2/21 if remains hemodynamically stable and tolerated HD in chair today.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram normal, Ejection fraction normal, Haemodialysis, Heart rate increased, Nausea
Clinical narrative: The patient is 76F with PMH of HTN, HLD, CKD4-5 followed by doctor, GERD, gout who presents to KP VAL for dizziness. Patient unclear when she first noticed it. It happens any time she moves her head. The room is not spinning. She does feel lightheaded.  She feels nauseous though no vomiting. She otherwise has no acute complaints.When she arrived to ER she was noted to have bradycardia in the 30s and pads were placed on her. Patient is taking atenolol and has hx of CKD4-5 so likely this is culprit but work up with CT head is in process to rule out stroke/hemorrhage.--Per Admitting MD               Hospitalization notable for stoppage of BB with increase in HR, intermittent non-sustained episodes in 30's. Reviewed with cardiology currently not further recommendations.  Will refer for Zio-patch for monitoring outpatient, however patient has had 8 days of monitoring inpatient. All AV nodal blocking agents should be avoided. Wekebach was noted on telemetry, no action required per curbside with on-call cardiologist. ECHO with normal EF.  No current dizziness               UTI--Treated with CTX x 5 days               The patient was also started on dialysis this hospitalization. Permacath was placed and she has outpatient HD site selected.                Patient qualifies for HHPT               Pafib--She was started on heparin gtt, no active bleeding. Can transition to warfarin without bridging. No Hx of stroke/No mechanical valves.                She is anticipated DC on 2/21 if remains hemodynamically stable and tolerated HD in chair today.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection
Clinical narrative: The patient is 76F with PMH of HTN, HLD, CKD4-5 followed by doctor, GERD, gout who presents to KP VAL for dizziness. Patient unclear when she first noticed it. It happens any time she moves her head. The room is not spinning. She does feel lightheaded.  She feels nauseous though no vomiting. She otherwise has no acute complaints.When she arrived to ER she was noted to have bradycardia in the 30s and pads were placed on her. Patient is taking atenolol and has hx of CKD4-5 so likely this is culprit but work up with CT head is in process to rule out stroke/hemorrhage.--Per Admitting MD               Hospitalization notable for stoppage of BB with increase in HR, intermittent non-sustained episodes in 30's. Reviewed with cardiology currently not further recommendations.  Will refer for Zio-patch for monitoring outpatient, however patient has had 8 days of monitoring inpatient. All AV nodal blocking agents should be avoided. Wekebach was noted on telemetry, no action required per curbside with on-call cardiologist. ECHO with normal EF.  No current dizziness               UTI--Treated with CTX x 5 days               The patient was also started on dialysis this hospitalization. Permacath was placed and she has outpatient HD site selected.                Patient qualifies for HHPT               Pafib--She was started on heparin gtt, no active bleeding. Can transition to warfarin without bridging. No Hx of stroke/No mechanical valves.                She is anticipated DC on 2/21 if remains hemodynamically stable and tolerated HD in chair today.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram, Electrocardiogram ambulatory, Palpitations, Ultrasound scan, Ventricular extrasystoles
Clinical narrative: PVCs (heart palpitations) started a month after booster dose.  Subsided a few months later but started again very frequently and continue to happen numerous times daily
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, Chills, Fatigue, Feeling hot, Headache
Clinical narrative: ? Injection site pain ? Tiredness ? Headache ? Muscle pain ? Chills ? Joint pain ? Fever ? Injection site swelling ? Injection site redness ? Nausea ? Feeling unwell ? Vomiting I threw up at 8:15 pm on the night of the 23rd (day of injection). I woke up about 8:00 am with full body aches. I had a physical therapy appointment at 10:00 am and dental appointment at 1:30 pm. I was experiencing fever and hot body followed by chills, repeating. I came home, ate a meal, and went to sleep at 3:00 pm for several hours.
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Malaise, Myalgia
Clinical narrative: ? Injection site pain ? Tiredness ? Headache ? Muscle pain ? Chills ? Joint pain ? Fever ? Injection site swelling ? Injection site redness ? Nausea ? Feeling unwell ? Vomiting I threw up at 8:15 pm on the night of the 23rd (day of injection). I woke up about 8:00 am with full body aches. I had a physical therapy appointment at 10:00 am and dental appointment at 1:30 pm. I was experiencing fever and hot body followed by chills, repeating. I came home, ate a meal, and went to sleep at 3:00 pm for several hours.
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: Nausea, Pain, Pyrexia, Vomiting
Clinical narrative: ? Injection site pain ? Tiredness ? Headache ? Muscle pain ? Chills ? Joint pain ? Fever ? Injection site swelling ? Injection site redness ? Nausea ? Feeling unwell ? Vomiting I threw up at 8:15 pm on the night of the 23rd (day of injection). I woke up about 8:00 am with full body aches. I had a physical therapy appointment at 10:00 am and dental appointment at 1:30 pm. I was experiencing fever and hot body followed by chills, repeating. I came home, ate a meal, and went to sleep at 3:00 pm for several hours.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Culture, Decreased appetite, Drainage, Induration
Clinical narrative: Concern for PD catheter cuff infection. She was sent in by surgeon.  Seeing for dialysis needs   History of Present Illness: Seen/examined. She and I have met before She was seen 2 days ago; notes reviewed C/o back pain and was back on Gabapentin EDW 48.5 kg Poor appetite, daily Reglan Told staff that she had "drainage" from abdomen opposite side of exit site Seen for exam (photos in chart) , +purulent drainage   Per colleague: " There is an indurated swelling with openings on the skin. Pus came out when pressed. It's very close to the current exit site which has no external cuff(thus, tunnel is no longer sealed. No pus coming from the tunnel even though it's no longer sealed and therefore, it seems the abscess is not connected to the tunnel. " Culture from that time:
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Purulent discharge, Pustule, Swelling, Wound
Clinical narrative: Concern for PD catheter cuff infection. She was sent in by surgeon.  Seeing for dialysis needs   History of Present Illness: Seen/examined. She and I have met before She was seen 2 days ago; notes reviewed C/o back pain and was back on Gabapentin EDW 48.5 kg Poor appetite, daily Reglan Told staff that she had "drainage" from abdomen opposite side of exit site Seen for exam (photos in chart) , +purulent drainage   Per colleague: " There is an indurated swelling with openings on the skin. Pus came out when pressed. It's very close to the current exit site which has no external cuff(thus, tunnel is no longer sealed. No pus coming from the tunnel even though it's no longer sealed and therefore, it seems the abscess is not connected to the tunnel. " Culture from that time:
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Aphasia, Emotional disorder, Immediate post-injection reaction, Mental disorder
Clinical narrative: Intense and overwhelming paranoia, psychological, emotional mental health problems. Overwhelming anxiety inability to speak, psychosis, suicidal ideation requiring hospitalization. Onset immediately following administration of injection.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Paranoia, Psychotic disorder, Suicidal ideation
Clinical narrative: Intense and overwhelming paranoia, psychological, emotional mental health problems. Overwhelming anxiety inability to speak, psychosis, suicidal ideation requiring hospitalization. Onset immediately following administration of injection.
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Fall, Femur fracture, Fracture displacement, SARS-CoV-2 test negative
Clinical narrative: Right hip pain   History of Present Illness: 90 year old female sustained mechanical fall on am 2/22/2023.  Radiographs apparently demonstrated a displaced  right intertrochanteric hip fracture . Patient last ate last night.  Was seen at hospital.  covid test taken there was negative.    Medications Prior to Admission: No outpatient medications have been marked as taking for the 2/22/23 encounter (Hospital Encounter).     Current Hospital Medications:   No current facility-administered medications for this encounter.     No current facility-administered medications for this encounter.     No current facility-administered medications for this encounter
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: X-ray of pelvis and hip abnormal
Clinical narrative: Right hip pain   History of Present Illness: 90 year old female sustained mechanical fall on am 2/22/2023.  Radiographs apparently demonstrated a displaced  right intertrochanteric hip fracture . Patient last ate last night.  Was seen at hospital.  covid test taken there was negative.    Medications Prior to Admission: No outpatient medications have been marked as taking for the 2/22/23 encounter (Hospital Encounter).     Current Hospital Medications:   No current facility-administered medications for this encounter.     No current facility-administered medications for this encounter.     No current facility-administered medications for this encounter
Age: 45.0
Sex: U
Vaccine: COVID19
Symptoms: Abdominal wall mass, Contusion, Gingival bleeding, Influenza like illness, Laboratory test abnormal
Clinical narrative: Chief Complaint: abnl labs   HPI: 47-year-old male with history of illness with idiopathic neutropenia around age 12 (records not available, per patient had no diagnosis with bone marrow biopsy),  in childhood, eczema, atopic dermatitis, obesity, hypertriglyceridemia, current smoker, OSA.  Outpatient lab checks in 2018 and 2019 showed platelets of 88 and 96 K respectively. He had a febrile flu like illness in early February with negative covid 19 test and recovered well. About a week ago he was moving a pergola with is hands over his head and then developed a lump on his LUQ abd wall. On 2/23 he saw his PCP regarding the left abdominal mass. Outpatient labs found plts of 2K. He was directed to the local ED and labs were normal other than plts of 1K. He endorsed gum bleeding with tooth brushing 1 week prior. He has a few spontaneous bruises on his legs and neck and abdomen.    Baseline Mobility: independent of ADLs