chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 20.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Breakthrough case of COVID-19 after fully vaccinated with 2 doses of mRNA vaccine.
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: General symptom
Clinical narrative: Sx onset 8/2/22. Treatment includes oxygen monitoring and Paxlovid.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine was given past the beyond use date
Age: 6.0
Sex: M
Vaccine: DTAPHEPBIP
Symptoms: Feeling abnormal, Rash
Clinical narrative: Mother states that the child had a systemic rash all over his body and seemed to "Zone out"
Age: 10.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: hospitalization
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against and then tested positive for COVID19
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered past date of use
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered, No adverse event, Product storage error
Clinical narrative: Vaccine administered past date of use
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Breakthrough case of COVID-19 after fully vaccinated with one dose of viral vector vaccine.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Malaise, Nasal congestion, No adverse event
Clinical narrative: I did not have an adverse reaction to the vaccine. I tested positive for COVID-19 on 07/24/2022 while on a vacation on a cruise. I had stuffy nose, no fever, sore throat, like of energy and overall mild symptoms. I was given cough drops and cough syrup from the cruise. I was isolated in our cabin for the last few days of our cruise.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: I did not have an adverse reaction to the vaccine. I tested positive for COVID-19 on 07/24/2022 while on a vacation on a cruise. I had stuffy nose, no fever, sore throat, like of energy and overall mild symptoms. I was given cough drops and cough syrup from the cruise. I was isolated in our cabin for the last few days of our cruise.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Dizziness, Fatigue, Full blood count, Gait disturbance
Clinical narrative: Patients own words:   I felt fine until 4/11/22. For the next two weeks I experienced low grade temps of about 100 degrees, a temp for me as my baseline temp is 97.8. On 4/11 started the extreme dizziness?had to hang into the walls to walk for about a week although the dizziness persisted for a full six weeks. I avoided driving. Muscle exhaustion (legs tired after doing one set of stairs) and extreme general fatigue lasted a full six weeks also. My body would shut down and multiple naps were needed each day to function at all. I am finally getting back some energy and stamina after two months.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Hypersomnia, Impaired driving ability, Metabolic function test, Muscular weakness, Pyrexia
Clinical narrative: Patients own words:   I felt fine until 4/11/22. For the next two weeks I experienced low grade temps of about 100 degrees, a temp for me as my baseline temp is 97.8. On 4/11 started the extreme dizziness?had to hang into the walls to walk for about a week although the dizziness persisted for a full six weeks. I avoided driving. Muscle exhaustion (legs tired after doing one set of stairs) and extreme general fatigue lasted a full six weeks also. My body would shut down and multiple naps were needed each day to function at all. I am finally getting back some energy and stamina after two months.
Age: 22.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered past date of use
Age: 22.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered, No adverse event, Product storage error
Clinical narrative: Vaccine administered past date of use
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Alcohol abuse, Alcoholic ketoacidosis, Angiogram pulmonary abnormal, Anion gap, Anticoagulant therapy
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 7/27/2022 Discharge Date: 08/01/2022 PRESENTING PROBLEM: Lactic acidosis [E87.2]- Alcoholic ketoacidosis [E87.2]- Hypomagnesemia [E83.42]- Alcohol abuse [F10.10]- Microcytic anemia [D50.9]- Generalized weakness [R53.1]- Polysubstance abuse (HCC) [F19.10]- Typical atrial flutter (HCC) [I48.3]- COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 53-year-old male with PMH significant for severe esophagitis (EGD 6/19 and 2/16), Mallory-Weiss tear in past, history of duodenal ulcer, chronic microcytic anemia, iron deficiency, chronic alcohol abuse, history of DVT/PE (02/2022), depression/anxiety and homelessness who presents to the ED for generalized malaise, cough and SOB. Found to be Covid positive. CXR is negative and SPO2 stable on RA. While in the ER he was noted to have transient a flutter/RVR with HR 140s, otherwise vitals within normal limits, labs consistent with anion gap metabolic acidosis with gap 25, bicarb 13, lactate 4.2. D-dimer elevated at 1100. He was also hypoglycemic at 55, elevated beta hydroxybutyrate 5.2 UA was negative overall but positive for ketones. Blood alcohol level at 0.045. He was started on IVF for alcoholic ketoacidosis and admitted to internal medicine service for supportive treatment. CTA thorax was obtained and revealed acute subsegmental pulmonary embolism in the left upper lobe, no evidence of right heart strain. He had PE/DVT and 02/2022. Was previously on Eliquis but was poorly compliant. During admission in June previous PE noted to have resolved but had residual small chronic DVT in posterior tibial vein. Hypercoagulable workup revealed--low protein C 62% and low AT III 49 %. Hematology recommended continued prophylactic dosing of Eliquis which the patient refused at discharge. Discussed with hematology again this admission who advised life long anticoagulation given recurrence. He was started back on Eliquis at starter dose. He had no further episodes of AFib/flutter in her heart rate remained stable. Echo obtained and was unremarkable. Acidosis quickly resolved with IV fluids and anion gap closed. IV fluids are stopped and he tolerated diet although notably has poor appetite. He had some mild hypokalemia and hypomagnesemia which were replaced. Patient continued to feel poorly due to COVID 19 symptoms but vitals remained hemodynamically stable on room air. He received 1 dose of remdesivir but declined further dosing because patient advocate had concerns about side effects.  He was otherwise treated with supportive care. Discharged was delayed due to homeless status until he completed 5 day isolation period, at which point he could be discharged back to local shelter. Patient was strongly advised to be compliant with Eliquis and follow up with PCP for refills of this medication. Patient in agreement with discharge plan and discharged in stable condition.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Antithrombin III decreased, Asthenia, Atrial fibrillation, Atrial flutter, Blood alcohol normal
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 7/27/2022 Discharge Date: 08/01/2022 PRESENTING PROBLEM: Lactic acidosis [E87.2]- Alcoholic ketoacidosis [E87.2]- Hypomagnesemia [E83.42]- Alcohol abuse [F10.10]- Microcytic anemia [D50.9]- Generalized weakness [R53.1]- Polysubstance abuse (HCC) [F19.10]- Typical atrial flutter (HCC) [I48.3]- COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 53-year-old male with PMH significant for severe esophagitis (EGD 6/19 and 2/16), Mallory-Weiss tear in past, history of duodenal ulcer, chronic microcytic anemia, iron deficiency, chronic alcohol abuse, history of DVT/PE (02/2022), depression/anxiety and homelessness who presents to the ED for generalized malaise, cough and SOB. Found to be Covid positive. CXR is negative and SPO2 stable on RA. While in the ER he was noted to have transient a flutter/RVR with HR 140s, otherwise vitals within normal limits, labs consistent with anion gap metabolic acidosis with gap 25, bicarb 13, lactate 4.2. D-dimer elevated at 1100. He was also hypoglycemic at 55, elevated beta hydroxybutyrate 5.2 UA was negative overall but positive for ketones. Blood alcohol level at 0.045. He was started on IVF for alcoholic ketoacidosis and admitted to internal medicine service for supportive treatment. CTA thorax was obtained and revealed acute subsegmental pulmonary embolism in the left upper lobe, no evidence of right heart strain. He had PE/DVT and 02/2022. Was previously on Eliquis but was poorly compliant. During admission in June previous PE noted to have resolved but had residual small chronic DVT in posterior tibial vein. Hypercoagulable workup revealed--low protein C 62% and low AT III 49 %. Hematology recommended continued prophylactic dosing of Eliquis which the patient refused at discharge. Discussed with hematology again this admission who advised life long anticoagulation given recurrence. He was started back on Eliquis at starter dose. He had no further episodes of AFib/flutter in her heart rate remained stable. Echo obtained and was unremarkable. Acidosis quickly resolved with IV fluids and anion gap closed. IV fluids are stopped and he tolerated diet although notably has poor appetite. He had some mild hypokalemia and hypomagnesemia which were replaced. Patient continued to feel poorly due to COVID 19 symptoms but vitals remained hemodynamically stable on room air. He received 1 dose of remdesivir but declined further dosing because patient advocate had concerns about side effects.  He was otherwise treated with supportive care. Discharged was delayed due to homeless status until he completed 5 day isolation period, at which point he could be discharged back to local shelter. Patient was strongly advised to be compliant with Eliquis and follow up with PCP for refills of this medication. Patient in agreement with discharge plan and discharged in stable condition.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Blood bicarbonate decreased, Blood glucose decreased, Blood ketone body, Blood lactic acid, COVID-19
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 7/27/2022 Discharge Date: 08/01/2022 PRESENTING PROBLEM: Lactic acidosis [E87.2]- Alcoholic ketoacidosis [E87.2]- Hypomagnesemia [E83.42]- Alcohol abuse [F10.10]- Microcytic anemia [D50.9]- Generalized weakness [R53.1]- Polysubstance abuse (HCC) [F19.10]- Typical atrial flutter (HCC) [I48.3]- COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 53-year-old male with PMH significant for severe esophagitis (EGD 6/19 and 2/16), Mallory-Weiss tear in past, history of duodenal ulcer, chronic microcytic anemia, iron deficiency, chronic alcohol abuse, history of DVT/PE (02/2022), depression/anxiety and homelessness who presents to the ED for generalized malaise, cough and SOB. Found to be Covid positive. CXR is negative and SPO2 stable on RA. While in the ER he was noted to have transient a flutter/RVR with HR 140s, otherwise vitals within normal limits, labs consistent with anion gap metabolic acidosis with gap 25, bicarb 13, lactate 4.2. D-dimer elevated at 1100. He was also hypoglycemic at 55, elevated beta hydroxybutyrate 5.2 UA was negative overall but positive for ketones. Blood alcohol level at 0.045. He was started on IVF for alcoholic ketoacidosis and admitted to internal medicine service for supportive treatment. CTA thorax was obtained and revealed acute subsegmental pulmonary embolism in the left upper lobe, no evidence of right heart strain. He had PE/DVT and 02/2022. Was previously on Eliquis but was poorly compliant. During admission in June previous PE noted to have resolved but had residual small chronic DVT in posterior tibial vein. Hypercoagulable workup revealed--low protein C 62% and low AT III 49 %. Hematology recommended continued prophylactic dosing of Eliquis which the patient refused at discharge. Discussed with hematology again this admission who advised life long anticoagulation given recurrence. He was started back on Eliquis at starter dose. He had no further episodes of AFib/flutter in her heart rate remained stable. Echo obtained and was unremarkable. Acidosis quickly resolved with IV fluids and anion gap closed. IV fluids are stopped and he tolerated diet although notably has poor appetite. He had some mild hypokalemia and hypomagnesemia which were replaced. Patient continued to feel poorly due to COVID 19 symptoms but vitals remained hemodynamically stable on room air. He received 1 dose of remdesivir but declined further dosing because patient advocate had concerns about side effects.  He was otherwise treated with supportive care. Discharged was delayed due to homeless status until he completed 5 day isolation period, at which point he could be discharged back to local shelter. Patient was strongly advised to be compliant with Eliquis and follow up with PCP for refills of this medication. Patient in agreement with discharge plan and discharged in stable condition.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Coagulation test abnormal, Condition aggravated, Cough, Decreased appetite
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 7/27/2022 Discharge Date: 08/01/2022 PRESENTING PROBLEM: Lactic acidosis [E87.2]- Alcoholic ketoacidosis [E87.2]- Hypomagnesemia [E83.42]- Alcohol abuse [F10.10]- Microcytic anemia [D50.9]- Generalized weakness [R53.1]- Polysubstance abuse (HCC) [F19.10]- Typical atrial flutter (HCC) [I48.3]- COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 53-year-old male with PMH significant for severe esophagitis (EGD 6/19 and 2/16), Mallory-Weiss tear in past, history of duodenal ulcer, chronic microcytic anemia, iron deficiency, chronic alcohol abuse, history of DVT/PE (02/2022), depression/anxiety and homelessness who presents to the ED for generalized malaise, cough and SOB. Found to be Covid positive. CXR is negative and SPO2 stable on RA. While in the ER he was noted to have transient a flutter/RVR with HR 140s, otherwise vitals within normal limits, labs consistent with anion gap metabolic acidosis with gap 25, bicarb 13, lactate 4.2. D-dimer elevated at 1100. He was also hypoglycemic at 55, elevated beta hydroxybutyrate 5.2 UA was negative overall but positive for ketones. Blood alcohol level at 0.045. He was started on IVF for alcoholic ketoacidosis and admitted to internal medicine service for supportive treatment. CTA thorax was obtained and revealed acute subsegmental pulmonary embolism in the left upper lobe, no evidence of right heart strain. He had PE/DVT and 02/2022. Was previously on Eliquis but was poorly compliant. During admission in June previous PE noted to have resolved but had residual small chronic DVT in posterior tibial vein. Hypercoagulable workup revealed--low protein C 62% and low AT III 49 %. Hematology recommended continued prophylactic dosing of Eliquis which the patient refused at discharge. Discussed with hematology again this admission who advised life long anticoagulation given recurrence. He was started back on Eliquis at starter dose. He had no further episodes of AFib/flutter in her heart rate remained stable. Echo obtained and was unremarkable. Acidosis quickly resolved with IV fluids and anion gap closed. IV fluids are stopped and he tolerated diet although notably has poor appetite. He had some mild hypokalemia and hypomagnesemia which were replaced. Patient continued to feel poorly due to COVID 19 symptoms but vitals remained hemodynamically stable on room air. He received 1 dose of remdesivir but declined further dosing because patient advocate had concerns about side effects.  He was otherwise treated with supportive care. Discharged was delayed due to homeless status until he completed 5 day isolation period, at which point he could be discharged back to local shelter. Patient was strongly advised to be compliant with Eliquis and follow up with PCP for refills of this medication. Patient in agreement with discharge plan and discharged in stable condition.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Dyspnoea, Echocardiogram normal, Feeling abnormal, Fibrin D dimer increased
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 7/27/2022 Discharge Date: 08/01/2022 PRESENTING PROBLEM: Lactic acidosis [E87.2]- Alcoholic ketoacidosis [E87.2]- Hypomagnesemia [E83.42]- Alcohol abuse [F10.10]- Microcytic anemia [D50.9]- Generalized weakness [R53.1]- Polysubstance abuse (HCC) [F19.10]- Typical atrial flutter (HCC) [I48.3]- COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 53-year-old male with PMH significant for severe esophagitis (EGD 6/19 and 2/16), Mallory-Weiss tear in past, history of duodenal ulcer, chronic microcytic anemia, iron deficiency, chronic alcohol abuse, history of DVT/PE (02/2022), depression/anxiety and homelessness who presents to the ED for generalized malaise, cough and SOB. Found to be Covid positive. CXR is negative and SPO2 stable on RA. While in the ER he was noted to have transient a flutter/RVR with HR 140s, otherwise vitals within normal limits, labs consistent with anion gap metabolic acidosis with gap 25, bicarb 13, lactate 4.2. D-dimer elevated at 1100. He was also hypoglycemic at 55, elevated beta hydroxybutyrate 5.2 UA was negative overall but positive for ketones. Blood alcohol level at 0.045. He was started on IVF for alcoholic ketoacidosis and admitted to internal medicine service for supportive treatment. CTA thorax was obtained and revealed acute subsegmental pulmonary embolism in the left upper lobe, no evidence of right heart strain. He had PE/DVT and 02/2022. Was previously on Eliquis but was poorly compliant. During admission in June previous PE noted to have resolved but had residual small chronic DVT in posterior tibial vein. Hypercoagulable workup revealed--low protein C 62% and low AT III 49 %. Hematology recommended continued prophylactic dosing of Eliquis which the patient refused at discharge. Discussed with hematology again this admission who advised life long anticoagulation given recurrence. He was started back on Eliquis at starter dose. He had no further episodes of AFib/flutter in her heart rate remained stable. Echo obtained and was unremarkable. Acidosis quickly resolved with IV fluids and anion gap closed. IV fluids are stopped and he tolerated diet although notably has poor appetite. He had some mild hypokalemia and hypomagnesemia which were replaced. Patient continued to feel poorly due to COVID 19 symptoms but vitals remained hemodynamically stable on room air. He received 1 dose of remdesivir but declined further dosing because patient advocate had concerns about side effects.  He was otherwise treated with supportive care. Discharged was delayed due to homeless status until he completed 5 day isolation period, at which point he could be discharged back to local shelter. Patient was strongly advised to be compliant with Eliquis and follow up with PCP for refills of this medication. Patient in agreement with discharge plan and discharged in stable condition.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoglycaemia, Hypokalaemia, Hypomagnesaemia, Laboratory test abnormal, Lactic acidosis
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 7/27/2022 Discharge Date: 08/01/2022 PRESENTING PROBLEM: Lactic acidosis [E87.2]- Alcoholic ketoacidosis [E87.2]- Hypomagnesemia [E83.42]- Alcohol abuse [F10.10]- Microcytic anemia [D50.9]- Generalized weakness [R53.1]- Polysubstance abuse (HCC) [F19.10]- Typical atrial flutter (HCC) [I48.3]- COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 53-year-old male with PMH significant for severe esophagitis (EGD 6/19 and 2/16), Mallory-Weiss tear in past, history of duodenal ulcer, chronic microcytic anemia, iron deficiency, chronic alcohol abuse, history of DVT/PE (02/2022), depression/anxiety and homelessness who presents to the ED for generalized malaise, cough and SOB. Found to be Covid positive. CXR is negative and SPO2 stable on RA. While in the ER he was noted to have transient a flutter/RVR with HR 140s, otherwise vitals within normal limits, labs consistent with anion gap metabolic acidosis with gap 25, bicarb 13, lactate 4.2. D-dimer elevated at 1100. He was also hypoglycemic at 55, elevated beta hydroxybutyrate 5.2 UA was negative overall but positive for ketones. Blood alcohol level at 0.045. He was started on IVF for alcoholic ketoacidosis and admitted to internal medicine service for supportive treatment. CTA thorax was obtained and revealed acute subsegmental pulmonary embolism in the left upper lobe, no evidence of right heart strain. He had PE/DVT and 02/2022. Was previously on Eliquis but was poorly compliant. During admission in June previous PE noted to have resolved but had residual small chronic DVT in posterior tibial vein. Hypercoagulable workup revealed--low protein C 62% and low AT III 49 %. Hematology recommended continued prophylactic dosing of Eliquis which the patient refused at discharge. Discussed with hematology again this admission who advised life long anticoagulation given recurrence. He was started back on Eliquis at starter dose. He had no further episodes of AFib/flutter in her heart rate remained stable. Echo obtained and was unremarkable. Acidosis quickly resolved with IV fluids and anion gap closed. IV fluids are stopped and he tolerated diet although notably has poor appetite. He had some mild hypokalemia and hypomagnesemia which were replaced. Patient continued to feel poorly due to COVID 19 symptoms but vitals remained hemodynamically stable on room air. He received 1 dose of remdesivir but declined further dosing because patient advocate had concerns about side effects.  He was otherwise treated with supportive care. Discharged was delayed due to homeless status until he completed 5 day isolation period, at which point he could be discharged back to local shelter. Patient was strongly advised to be compliant with Eliquis and follow up with PCP for refills of this medication. Patient in agreement with discharge plan and discharged in stable condition.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Malaise, Metabolic acidosis, Microcytic anaemia, Oesophagitis, Protein C decreased
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 7/27/2022 Discharge Date: 08/01/2022 PRESENTING PROBLEM: Lactic acidosis [E87.2]- Alcoholic ketoacidosis [E87.2]- Hypomagnesemia [E83.42]- Alcohol abuse [F10.10]- Microcytic anemia [D50.9]- Generalized weakness [R53.1]- Polysubstance abuse (HCC) [F19.10]- Typical atrial flutter (HCC) [I48.3]- COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 53-year-old male with PMH significant for severe esophagitis (EGD 6/19 and 2/16), Mallory-Weiss tear in past, history of duodenal ulcer, chronic microcytic anemia, iron deficiency, chronic alcohol abuse, history of DVT/PE (02/2022), depression/anxiety and homelessness who presents to the ED for generalized malaise, cough and SOB. Found to be Covid positive. CXR is negative and SPO2 stable on RA. While in the ER he was noted to have transient a flutter/RVR with HR 140s, otherwise vitals within normal limits, labs consistent with anion gap metabolic acidosis with gap 25, bicarb 13, lactate 4.2. D-dimer elevated at 1100. He was also hypoglycemic at 55, elevated beta hydroxybutyrate 5.2 UA was negative overall but positive for ketones. Blood alcohol level at 0.045. He was started on IVF for alcoholic ketoacidosis and admitted to internal medicine service for supportive treatment. CTA thorax was obtained and revealed acute subsegmental pulmonary embolism in the left upper lobe, no evidence of right heart strain. He had PE/DVT and 02/2022. Was previously on Eliquis but was poorly compliant. During admission in June previous PE noted to have resolved but had residual small chronic DVT in posterior tibial vein. Hypercoagulable workup revealed--low protein C 62% and low AT III 49 %. Hematology recommended continued prophylactic dosing of Eliquis which the patient refused at discharge. Discussed with hematology again this admission who advised life long anticoagulation given recurrence. He was started back on Eliquis at starter dose. He had no further episodes of AFib/flutter in her heart rate remained stable. Echo obtained and was unremarkable. Acidosis quickly resolved with IV fluids and anion gap closed. IV fluids are stopped and he tolerated diet although notably has poor appetite. He had some mild hypokalemia and hypomagnesemia which were replaced. Patient continued to feel poorly due to COVID 19 symptoms but vitals remained hemodynamically stable on room air. He received 1 dose of remdesivir but declined further dosing because patient advocate had concerns about side effects.  He was otherwise treated with supportive care. Discharged was delayed due to homeless status until he completed 5 day isolation period, at which point he could be discharged back to local shelter. Patient was strongly advised to be compliant with Eliquis and follow up with PCP for refills of this medication. Patient in agreement with discharge plan and discharged in stable condition.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary embolism, SARS-CoV-2 test positive, Substance abuse, Treatment noncompliance, Urine analysis abnormal
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 7/27/2022 Discharge Date: 08/01/2022 PRESENTING PROBLEM: Lactic acidosis [E87.2]- Alcoholic ketoacidosis [E87.2]- Hypomagnesemia [E83.42]- Alcohol abuse [F10.10]- Microcytic anemia [D50.9]- Generalized weakness [R53.1]- Polysubstance abuse (HCC) [F19.10]- Typical atrial flutter (HCC) [I48.3]- COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 53-year-old male with PMH significant for severe esophagitis (EGD 6/19 and 2/16), Mallory-Weiss tear in past, history of duodenal ulcer, chronic microcytic anemia, iron deficiency, chronic alcohol abuse, history of DVT/PE (02/2022), depression/anxiety and homelessness who presents to the ED for generalized malaise, cough and SOB. Found to be Covid positive. CXR is negative and SPO2 stable on RA. While in the ER he was noted to have transient a flutter/RVR with HR 140s, otherwise vitals within normal limits, labs consistent with anion gap metabolic acidosis with gap 25, bicarb 13, lactate 4.2. D-dimer elevated at 1100. He was also hypoglycemic at 55, elevated beta hydroxybutyrate 5.2 UA was negative overall but positive for ketones. Blood alcohol level at 0.045. He was started on IVF for alcoholic ketoacidosis and admitted to internal medicine service for supportive treatment. CTA thorax was obtained and revealed acute subsegmental pulmonary embolism in the left upper lobe, no evidence of right heart strain. He had PE/DVT and 02/2022. Was previously on Eliquis but was poorly compliant. During admission in June previous PE noted to have resolved but had residual small chronic DVT in posterior tibial vein. Hypercoagulable workup revealed--low protein C 62% and low AT III 49 %. Hematology recommended continued prophylactic dosing of Eliquis which the patient refused at discharge. Discussed with hematology again this admission who advised life long anticoagulation given recurrence. He was started back on Eliquis at starter dose. He had no further episodes of AFib/flutter in her heart rate remained stable. Echo obtained and was unremarkable. Acidosis quickly resolved with IV fluids and anion gap closed. IV fluids are stopped and he tolerated diet although notably has poor appetite. He had some mild hypokalemia and hypomagnesemia which were replaced. Patient continued to feel poorly due to COVID 19 symptoms but vitals remained hemodynamically stable on room air. He received 1 dose of remdesivir but declined further dosing because patient advocate had concerns about side effects.  He was otherwise treated with supportive care. Discharged was delayed due to homeless status until he completed 5 day isolation period, at which point he could be discharged back to local shelter. Patient was strongly advised to be compliant with Eliquis and follow up with PCP for refills of this medication. Patient in agreement with discharge plan and discharged in stable condition.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Urine ketone body present
Clinical narrative: Discharge Provider: Private MD Primary Care Provider: Private, MD Admission Date: 7/27/2022 Discharge Date: 08/01/2022 PRESENTING PROBLEM: Lactic acidosis [E87.2]- Alcoholic ketoacidosis [E87.2]- Hypomagnesemia [E83.42]- Alcohol abuse [F10.10]- Microcytic anemia [D50.9]- Generalized weakness [R53.1]- Polysubstance abuse (HCC) [F19.10]- Typical atrial flutter (HCC) [I48.3]- COVID-19 virus infection [U07.1] HOSPITAL COURSE: Patient is a 53-year-old male with PMH significant for severe esophagitis (EGD 6/19 and 2/16), Mallory-Weiss tear in past, history of duodenal ulcer, chronic microcytic anemia, iron deficiency, chronic alcohol abuse, history of DVT/PE (02/2022), depression/anxiety and homelessness who presents to the ED for generalized malaise, cough and SOB. Found to be Covid positive. CXR is negative and SPO2 stable on RA. While in the ER he was noted to have transient a flutter/RVR with HR 140s, otherwise vitals within normal limits, labs consistent with anion gap metabolic acidosis with gap 25, bicarb 13, lactate 4.2. D-dimer elevated at 1100. He was also hypoglycemic at 55, elevated beta hydroxybutyrate 5.2 UA was negative overall but positive for ketones. Blood alcohol level at 0.045. He was started on IVF for alcoholic ketoacidosis and admitted to internal medicine service for supportive treatment. CTA thorax was obtained and revealed acute subsegmental pulmonary embolism in the left upper lobe, no evidence of right heart strain. He had PE/DVT and 02/2022. Was previously on Eliquis but was poorly compliant. During admission in June previous PE noted to have resolved but had residual small chronic DVT in posterior tibial vein. Hypercoagulable workup revealed--low protein C 62% and low AT III 49 %. Hematology recommended continued prophylactic dosing of Eliquis which the patient refused at discharge. Discussed with hematology again this admission who advised life long anticoagulation given recurrence. He was started back on Eliquis at starter dose. He had no further episodes of AFib/flutter in her heart rate remained stable. Echo obtained and was unremarkable. Acidosis quickly resolved with IV fluids and anion gap closed. IV fluids are stopped and he tolerated diet although notably has poor appetite. He had some mild hypokalemia and hypomagnesemia which were replaced. Patient continued to feel poorly due to COVID 19 symptoms but vitals remained hemodynamically stable on room air. He received 1 dose of remdesivir but declined further dosing because patient advocate had concerns about side effects.  He was otherwise treated with supportive care. Discharged was delayed due to homeless status until he completed 5 day isolation period, at which point he could be discharged back to local shelter. Patient was strongly advised to be compliant with Eliquis and follow up with PCP for refills of this medication. Patient in agreement with discharge plan and discharged in stable condition.
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: Pediatric Pfizer opened. Dose given with no dilution.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine was given after beyond use date
Age: 18.0
Sex: M
Vaccine: MNQ
Symptoms: Extra dose administered, No adverse event
Clinical narrative: No adverse events, but received 3 dose
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case COVID-19 after fully vaccinated with 2 doses Pfizer.
Age: 3.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: Vaccine administered without diluent. This was noticed the next patient that came in. We immediately called Pfizer  and looked at the protocol. We called the patient's mom and let her know the guidelines are to monitor for increased side effects and contact health professionals if needed.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against, then tested positive for COVID-19.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Pyrexia
Clinical narrative: Pt presented to the hospital with SOB and fever. The pt was given remdesivir and steroids
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute myocardial infarction, Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, COVID-19 pneumonia
Clinical narrative: Pt presented to the hospital with SOB and fever. The pt was given remdesivir and steroids
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest pain, Chronic obstructive pulmonary disease, Condition aggravated, Culture negative, Dyspnoea
Clinical narrative: Pt presented to the hospital with SOB and fever. The pt was given remdesivir and steroids
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lung opacity, Positive airway pressure therapy, Pyrexia, Respiratory distress, SARS-CoV-2 test positive
Clinical narrative: Pt presented to the hospital with SOB and fever. The pt was given remdesivir and steroids
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Sepsis, Tachycardia, Tachypnoea, Troponin I increased, Troponin increased
Clinical narrative: Pt presented to the hospital with SOB and fever. The pt was given remdesivir and steroids
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine given beyond-use-date.
Age: 10.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case COVID-19 after fully vaccinated 2 doses
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered past date of use
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered, No adverse event, Product storage error
Clinical narrative: Vaccine administered past date of use
Age: 8.0
Sex: F
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: Pt received undiluted vaccine. No adverse reactions at time of report.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Asthenia, Atrial fibrillation, Blood creatinine increased, Blood sodium decreased
Clinical narrative: Discharge Provider: Medical doctor Primary Care Provider : Medical doctor    Admission Date: 7/26/2022 Discharge Date: 07/30/2022  PRESENTING PROBLEM:  Acute hyponatremia Hypochromic microcytic anemia Hyponatremia Paroxysmal atrial fibrillation Acute cystitis without hematuria   HOSPITAL COURSE:   Patient is a 85 y.o. female with past medical history significant for pancreatic cancer, status post chemo and radiation, atrial fibrillation, on Xarelto who presented to the emergency department for severe fatigue, and dyspnea with exertion, lightheadedness and weakness. She had a hgb of 6 on arrival. She had no symptoms of GI bleeding.  She had a positive COVID-19 PCR, did not require any oxygen, treated with supportive care.  She was found to be hyponatremic and denied diarrhea, nausea or vomiting. Na+ 121 on admission with Cr 1.15.  Sodium level gradually improved with gentle IV hydration, sodium level upon discharge was 136  Urine chemistry showed low urine osmolality and low urine sodium.  Her home med of hydrochlorothiazide /triamterene was discontinued, started on losartan 25 mg daily.  Hemoglobin remained relatively stable after 1 unit PRBC transfusion, GI did not plan for EGD, recommended Protonix 2 times a day and resuming back Xarelto, hemoglobin upon discharge was 7.6  Was also treated with empiric Rocephin for 3 days for urinary tract infection.  PT and OT recommended home with assist.  Eventually discharged on 07/30/2022 in stable condition, recommended follow-up with PCP in 1 week to get hemoglobin and sodium level checked.  Instructions discussed in detail with patient and husband, they verbalized understanding.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cystitis, Dizziness, Dyspnoea exertional, Fatigue
Clinical narrative: Discharge Provider: Medical doctor Primary Care Provider : Medical doctor    Admission Date: 7/26/2022 Discharge Date: 07/30/2022  PRESENTING PROBLEM:  Acute hyponatremia Hypochromic microcytic anemia Hyponatremia Paroxysmal atrial fibrillation Acute cystitis without hematuria   HOSPITAL COURSE:   Patient is a 85 y.o. female with past medical history significant for pancreatic cancer, status post chemo and radiation, atrial fibrillation, on Xarelto who presented to the emergency department for severe fatigue, and dyspnea with exertion, lightheadedness and weakness. She had a hgb of 6 on arrival. She had no symptoms of GI bleeding.  She had a positive COVID-19 PCR, did not require any oxygen, treated with supportive care.  She was found to be hyponatremic and denied diarrhea, nausea or vomiting. Na+ 121 on admission with Cr 1.15.  Sodium level gradually improved with gentle IV hydration, sodium level upon discharge was 136  Urine chemistry showed low urine osmolality and low urine sodium.  Her home med of hydrochlorothiazide /triamterene was discontinued, started on losartan 25 mg daily.  Hemoglobin remained relatively stable after 1 unit PRBC transfusion, GI did not plan for EGD, recommended Protonix 2 times a day and resuming back Xarelto, hemoglobin upon discharge was 7.6  Was also treated with empiric Rocephin for 3 days for urinary tract infection.  PT and OT recommended home with assist.  Eventually discharged on 07/30/2022 in stable condition, recommended follow-up with PCP in 1 week to get hemoglobin and sodium level checked.  Instructions discussed in detail with patient and husband, they verbalized understanding.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Hypochromic anaemia, Hyponatraemia, Red blood cell transfusion, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: Medical doctor Primary Care Provider : Medical doctor    Admission Date: 7/26/2022 Discharge Date: 07/30/2022  PRESENTING PROBLEM:  Acute hyponatremia Hypochromic microcytic anemia Hyponatremia Paroxysmal atrial fibrillation Acute cystitis without hematuria   HOSPITAL COURSE:   Patient is a 85 y.o. female with past medical history significant for pancreatic cancer, status post chemo and radiation, atrial fibrillation, on Xarelto who presented to the emergency department for severe fatigue, and dyspnea with exertion, lightheadedness and weakness. She had a hgb of 6 on arrival. She had no symptoms of GI bleeding.  She had a positive COVID-19 PCR, did not require any oxygen, treated with supportive care.  She was found to be hyponatremic and denied diarrhea, nausea or vomiting. Na+ 121 on admission with Cr 1.15.  Sodium level gradually improved with gentle IV hydration, sodium level upon discharge was 136  Urine chemistry showed low urine osmolality and low urine sodium.  Her home med of hydrochlorothiazide /triamterene was discontinued, started on losartan 25 mg daily.  Hemoglobin remained relatively stable after 1 unit PRBC transfusion, GI did not plan for EGD, recommended Protonix 2 times a day and resuming back Xarelto, hemoglobin upon discharge was 7.6  Was also treated with empiric Rocephin for 3 days for urinary tract infection.  PT and OT recommended home with assist.  Eventually discharged on 07/30/2022 in stable condition, recommended follow-up with PCP in 1 week to get hemoglobin and sodium level checked.  Instructions discussed in detail with patient and husband, they verbalized understanding.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection, Urine analysis abnormal, Urine osmolarity decreased, Urine sodium decreased
Clinical narrative: Discharge Provider: Medical doctor Primary Care Provider : Medical doctor    Admission Date: 7/26/2022 Discharge Date: 07/30/2022  PRESENTING PROBLEM:  Acute hyponatremia Hypochromic microcytic anemia Hyponatremia Paroxysmal atrial fibrillation Acute cystitis without hematuria   HOSPITAL COURSE:   Patient is a 85 y.o. female with past medical history significant for pancreatic cancer, status post chemo and radiation, atrial fibrillation, on Xarelto who presented to the emergency department for severe fatigue, and dyspnea with exertion, lightheadedness and weakness. She had a hgb of 6 on arrival. She had no symptoms of GI bleeding.  She had a positive COVID-19 PCR, did not require any oxygen, treated with supportive care.  She was found to be hyponatremic and denied diarrhea, nausea or vomiting. Na+ 121 on admission with Cr 1.15.  Sodium level gradually improved with gentle IV hydration, sodium level upon discharge was 136  Urine chemistry showed low urine osmolality and low urine sodium.  Her home med of hydrochlorothiazide /triamterene was discontinued, started on losartan 25 mg daily.  Hemoglobin remained relatively stable after 1 unit PRBC transfusion, GI did not plan for EGD, recommended Protonix 2 times a day and resuming back Xarelto, hemoglobin upon discharge was 7.6  Was also treated with empiric Rocephin for 3 days for urinary tract infection.  PT and OT recommended home with assist.  Eventually discharged on 07/30/2022 in stable condition, recommended follow-up with PCP in 1 week to get hemoglobin and sodium level checked.  Instructions discussed in detail with patient and husband, they verbalized understanding.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram abnormal, Nephrolithiasis
Clinical narrative: Kidney stones
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered past date of use
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered, No adverse event, Product storage error
Clinical narrative: Vaccine administered past date of use
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case COVID-19 after fully vaccinated (2 doses mRNA vaccine ).
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered past date of use
Age: 41.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Expired product administered, No adverse event, Product storage error
Clinical narrative: Vaccine administered past date of use
Age: 12.0
Sex: F
Vaccine: MNQ
Symptoms: Asthenia, Loss of consciousness, Nausea, Syncope, Vomiting
Clinical narrative: Pt became nauseated and vomitted 4-5 mins after receiving the vaccine.  Pt. begin to feel weak then loss conciousness and slumped over in chair.  Pt. regained consciousness in less than 30 seconds and was able to respond to the nurse.  Pt. was monitored until symptoms completely resolved.  Pt. was stable and ambulatory with a gaurdian upon leaving the health department.
Age: 45.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered past date of use
Age: 45.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Expired product administered, No adverse event, Product storage error
Clinical narrative: Vaccine administered past date of use
Age: 18.0
Sex: M
Vaccine: MENB
Symptoms: Chills, Cold sweat, Dizziness, Eye movement disorder, Fall
Clinical narrative: Call took two Advil at 1:00 PM. He said that his arm hurt. While driving on the highway to an eye doctors appointment, he complained of dizziness and nausea. Then he slumped against the car door and his eyes rolled back into his head. I had to punch him and scream to get him awake. This happened three times. He said he was sleeping but this was not sleep. Then his teeth began to chatter and he was in a cold sweat.  Maybe the Advil kicked in because he settled down.  After some water in about another 20 minutes, he began to feel better
Age: 18.0
Sex: M
Vaccine: MENB
Symptoms: Nausea, Pain in extremity, Somnolence
Clinical narrative: Call took two Advil at 1:00 PM. He said that his arm hurt. While driving on the highway to an eye doctors appointment, he complained of dizziness and nausea. Then he slumped against the car door and his eyes rolled back into his head. I had to punch him and scream to get him awake. This happened three times. He said he was sleeping but this was not sleep. Then his teeth began to chatter and he was in a cold sweat.  Maybe the Advil kicked in because he settled down.  After some water in about another 20 minutes, he began to feel better
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine was given beyond use date
Age: 76.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: Pt admitted to the hospital with worsening SOB with COVID + diagnosis. Patient on 2L O2 she was started on decadron 6mg for 10 days and continued with home symbicort, Spiriva, and albuterol. She was given Molnupiravir.
Age: 86.0
Sex: U
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered past date of use
Age: 86.0
Sex: U
Vaccine: COVID19, COVID19
Symptoms: Expired product administered, No adverse event, Product storage error
Clinical narrative: Vaccine administered past date of use
Age: 79.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Product use issue
Clinical narrative: Vaccine administered past date-of-use.
Age: 79.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered, No adverse event, Product storage error
Clinical narrative: Vaccine administered past date-of-use.
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Circumstance or information capable of leading to medication error, Product administered to patient of inappropriate age
Clinical narrative: Parents put wrong birthday of patient so that they could get vaccine? Did not know until Immunization Registry called to verify birthday. Called mom and she stated that she did not know why they put incorrect year as birth year, should have been the corrected year. At that time the pediatric version was not available and likely wrong year was put in so patient would qualify for vaccine.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered
Clinical narrative: Patient given an extra Covid-19 booster immunization by mistake.