chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Flank pain, Hypokalaemia, Hypomagnesaemia, Malaise
Clinical narrative: COVId Vaccine Breakthrough CAse  Pfizer Dose 1 3/11/21 (EN6205) Pfizer Dose 2 4/1/21 (EP7533) COVID Positive 12/3/21  12/3/21: History is obtained from patient as well as by personal review of records.  Patient is 75-year-old gentleman with known history of coronary artery disease, congestive heart failure, AICD, COPD, chronic kidney disease and other medical problems. Presented to emergency department with generalized muscle pain, neck pain, left lower chest pain radiating to flank, and feeling of being unwell for 1 week following a gathering.  Denied subjective fevers.  Denied shortness of air or hemoptysis.  Denied firing of pacemaker.  Denied recent weight gain or weight loss. Denied orthopnea or paroxysmal nocturnal dyspnea.  EKG showed paced rhythm.  He tested positive for  SARS-CoV-2.  12/7/21: Patient is a 75 year old male with a history of CKD, CAD, CHF, and AFib on AC.  He was admitted on 12/4/2021 with left lower lobe community-acquired pneumonia, COVID positivity, AKI on CKD, hypokalemia, hypomagnesemia, and elevated cardiac enzymes.  Cardiology was consulted.  And they ruled out ACS.  They did make some cardiac med changes to control bursts of tachycardia.  His electrolytes were repleted.  He was started on courses of Azithromycin, Rocephin, and remdesivir.  He has not required any supplemental oxygen.  His vitals have been grossly stable over the last 48 hours his kidney injury has resolved.  He is back to his baseline renal function.  He has not had a fever or cough.  Reports that he feels great today.  Wants to go home.  We discussed the benefits of staying to complete his 5th dose of remdesivir, and the patient opted to go home today after his 4th.  He denies shortness of breath at rest, dyspnea on exertion, chest pain, palpitations.  He was evaluated by Physical therapy, and they felt the patient would benefit from visiting nurse services. The patient was agreeable. Patient is being discharged home with visiting nurse services for nursing and physical therapy.  He also enrolled in a safe at home program.  Those nurses will follow-up with him at discharge.  He should discontinue Coreg.  He should continue Toprol XL 100 mg p.o. b.i.d. and Azithromycin 250 g p.o. daily x4 days.  He should continue to self-quarantine x7 days.  He should follow-up with his primary care provider in 1-2 weeks.  He should follow-up with his primary cardiologist in 2 weeks. He has been provided patient education for community-acquired pneumonia, acute kidney injury, hypokalemia, COVID, Azithromycin, and Toprol XL.  I have answered all of his questions and addressed all of his concerns.  The patient is being discharged in improved and stable condition.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Myalgia, Myocardial necrosis marker increased, Neck pain, Pain, Pneumonia
Clinical narrative: COVId Vaccine Breakthrough CAse  Pfizer Dose 1 3/11/21 (EN6205) Pfizer Dose 2 4/1/21 (EP7533) COVID Positive 12/3/21  12/3/21: History is obtained from patient as well as by personal review of records.  Patient is 75-year-old gentleman with known history of coronary artery disease, congestive heart failure, AICD, COPD, chronic kidney disease and other medical problems. Presented to emergency department with generalized muscle pain, neck pain, left lower chest pain radiating to flank, and feeling of being unwell for 1 week following a gathering.  Denied subjective fevers.  Denied shortness of air or hemoptysis.  Denied firing of pacemaker.  Denied recent weight gain or weight loss. Denied orthopnea or paroxysmal nocturnal dyspnea.  EKG showed paced rhythm.  He tested positive for  SARS-CoV-2.  12/7/21: Patient is a 75 year old male with a history of CKD, CAD, CHF, and AFib on AC.  He was admitted on 12/4/2021 with left lower lobe community-acquired pneumonia, COVID positivity, AKI on CKD, hypokalemia, hypomagnesemia, and elevated cardiac enzymes.  Cardiology was consulted.  And they ruled out ACS.  They did make some cardiac med changes to control bursts of tachycardia.  His electrolytes were repleted.  He was started on courses of Azithromycin, Rocephin, and remdesivir.  He has not required any supplemental oxygen.  His vitals have been grossly stable over the last 48 hours his kidney injury has resolved.  He is back to his baseline renal function.  He has not had a fever or cough.  Reports that he feels great today.  Wants to go home.  We discussed the benefits of staying to complete his 5th dose of remdesivir, and the patient opted to go home today after his 4th.  He denies shortness of breath at rest, dyspnea on exertion, chest pain, palpitations.  He was evaluated by Physical therapy, and they felt the patient would benefit from visiting nurse services. The patient was agreeable. Patient is being discharged home with visiting nurse services for nursing and physical therapy.  He also enrolled in a safe at home program.  Those nurses will follow-up with him at discharge.  He should discontinue Coreg.  He should continue Toprol XL 100 mg p.o. b.i.d. and Azithromycin 250 g p.o. daily x4 days.  He should continue to self-quarantine x7 days.  He should follow-up with his primary care provider in 1-2 weeks.  He should follow-up with his primary cardiologist in 2 weeks. He has been provided patient education for community-acquired pneumonia, acute kidney injury, hypokalemia, COVID, Azithromycin, and Toprol XL.  I have answered all of his questions and addressed all of his concerns.  The patient is being discharged in improved and stable condition.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Tachycardia, Vaccine breakthrough infection
Clinical narrative: COVId Vaccine Breakthrough CAse  Pfizer Dose 1 3/11/21 (EN6205) Pfizer Dose 2 4/1/21 (EP7533) COVID Positive 12/3/21  12/3/21: History is obtained from patient as well as by personal review of records.  Patient is 75-year-old gentleman with known history of coronary artery disease, congestive heart failure, AICD, COPD, chronic kidney disease and other medical problems. Presented to emergency department with generalized muscle pain, neck pain, left lower chest pain radiating to flank, and feeling of being unwell for 1 week following a gathering.  Denied subjective fevers.  Denied shortness of air or hemoptysis.  Denied firing of pacemaker.  Denied recent weight gain or weight loss. Denied orthopnea or paroxysmal nocturnal dyspnea.  EKG showed paced rhythm.  He tested positive for  SARS-CoV-2.  12/7/21: Patient is a 75 year old male with a history of CKD, CAD, CHF, and AFib on AC.  He was admitted on 12/4/2021 with left lower lobe community-acquired pneumonia, COVID positivity, AKI on CKD, hypokalemia, hypomagnesemia, and elevated cardiac enzymes.  Cardiology was consulted.  And they ruled out ACS.  They did make some cardiac med changes to control bursts of tachycardia.  His electrolytes were repleted.  He was started on courses of Azithromycin, Rocephin, and remdesivir.  He has not required any supplemental oxygen.  His vitals have been grossly stable over the last 48 hours his kidney injury has resolved.  He is back to his baseline renal function.  He has not had a fever or cough.  Reports that he feels great today.  Wants to go home.  We discussed the benefits of staying to complete his 5th dose of remdesivir, and the patient opted to go home today after his 4th.  He denies shortness of breath at rest, dyspnea on exertion, chest pain, palpitations.  He was evaluated by Physical therapy, and they felt the patient would benefit from visiting nurse services. The patient was agreeable. Patient is being discharged home with visiting nurse services for nursing and physical therapy.  He also enrolled in a safe at home program.  Those nurses will follow-up with him at discharge.  He should discontinue Coreg.  He should continue Toprol XL 100 mg p.o. b.i.d. and Azithromycin 250 g p.o. daily x4 days.  He should continue to self-quarantine x7 days.  He should follow-up with his primary care provider in 1-2 weeks.  He should follow-up with his primary cardiologist in 2 weeks. He has been provided patient education for community-acquired pneumonia, acute kidney injury, hypokalemia, COVID, Azithromycin, and Toprol XL.  I have answered all of his questions and addressed all of his concerns.  The patient is being discharged in improved and stable condition.
Age: 4.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age, Product preparation issue
Clinical narrative: Error: Incorrect Reconstitution-
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was Cardinal refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved by State of Colorado for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was a refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 58.0
Sex: U
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved by State for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood glucose increased, Blood lactate dehydrogenase increased, Blood lactic acid, Blood sodium decreased
Clinical narrative: COvId Vaccine Breakthrough Case  J&J Dose 5/8/21 (203A21A) COVID Positive 12/1/21  12/6/21: Patient is a 46-year-old male, only medical history is new onset diabetes which was diagnosed 5 days ago.  He was vaccinated (J&J) for COVID 7 months ago.  He does not smoke/vape.  Pt presented to the ED on 12/1/2021 and was diagnosed with COVID pneumonia.  He was discharged with Rx for Azithromycin.  Reports he has been at home self-quarantining and resting over the last 5 days. Complains of fatigue and weakness x5 days, SOB and persistent cough started this AM.  Came to the ED.  On arrival, the patient's SpO2 was 77% on room air.  He was tachypneic 20-30s.  Heart rate 90-110s.  Labs were significant for sodium 128, glucose 296, lactic acid 3.1, LDH 334. CXR showed patchy infiltrates throughout both lungs, worse since 12/1.  In the ED he was given 1 L of normal saline, 125 mg Solu-Medrol, 1g Rocephin, and 500 mg Azithromycin. He was also given an extended DuoNeb.  I discussed the patient with Dr., and he recommended admission to ICU. Nursing supervisor notified. Dr. also recommended adding a CRP, and if the CRP is greater than 15, he will be given Actemra. Same ordered.  12/11/21: Patient is a 46-year-old male who was admitted in hospital on 12/06/2021 and treated COVID-19 pneumonia. On arrival to the ED, the patient's SpO2 was 77% on room air. He was noted with respiration 20-30s along with tachycardia. He was initiated on supplemental oxygen requiring up to 11 L. Patient's blood work was significant for sodium 128, glucose 296, lactic acid 3.1, LDH 334. CXR showed patchy infiltrates throughout both lungs. Patient was admitted into ICU and pulmonology consulted. Patient was treated with Actemra, remdesivir, dexamethasone and IV antibiotics. Patient's symptom improved and he was able to transfer to the medical unit. Completed a home oxygen walk and will require 1 L at rest and 3 with activities. RN care coordination set up patient with visiting nurses and patient to discharge with COVID safe home.  Patient completed his remdesivir and IV antibiotics treatment. Today patient denies shortness of breath, palpitation, abdominal pain, chest pain and states feeling much better. Patient has a new onset diabetes and was recently metformin. Patient's current over A1c 13, will resume his metformin and add Lantus.  Advised patient to follow-up with his primary care provider for repeat A1c. He voiced understanding and he was provided with education diabetes management. I reviewed test findings with the patient and answered all of his questions.  He is being discharged in improved and stable condition.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough
Clinical narrative: COvId Vaccine Breakthrough Case  J&J Dose 5/8/21 (203A21A) COVID Positive 12/1/21  12/6/21: Patient is a 46-year-old male, only medical history is new onset diabetes which was diagnosed 5 days ago.  He was vaccinated (J&J) for COVID 7 months ago.  He does not smoke/vape.  Pt presented to the ED on 12/1/2021 and was diagnosed with COVID pneumonia.  He was discharged with Rx for Azithromycin.  Reports he has been at home self-quarantining and resting over the last 5 days. Complains of fatigue and weakness x5 days, SOB and persistent cough started this AM.  Came to the ED.  On arrival, the patient's SpO2 was 77% on room air.  He was tachypneic 20-30s.  Heart rate 90-110s.  Labs were significant for sodium 128, glucose 296, lactic acid 3.1, LDH 334. CXR showed patchy infiltrates throughout both lungs, worse since 12/1.  In the ED he was given 1 L of normal saline, 125 mg Solu-Medrol, 1g Rocephin, and 500 mg Azithromycin. He was also given an extended DuoNeb.  I discussed the patient with Dr., and he recommended admission to ICU. Nursing supervisor notified. Dr. also recommended adding a CRP, and if the CRP is greater than 15, he will be given Actemra. Same ordered.  12/11/21: Patient is a 46-year-old male who was admitted in hospital on 12/06/2021 and treated COVID-19 pneumonia. On arrival to the ED, the patient's SpO2 was 77% on room air. He was noted with respiration 20-30s along with tachycardia. He was initiated on supplemental oxygen requiring up to 11 L. Patient's blood work was significant for sodium 128, glucose 296, lactic acid 3.1, LDH 334. CXR showed patchy infiltrates throughout both lungs. Patient was admitted into ICU and pulmonology consulted. Patient was treated with Actemra, remdesivir, dexamethasone and IV antibiotics. Patient's symptom improved and he was able to transfer to the medical unit. Completed a home oxygen walk and will require 1 L at rest and 3 with activities. RN care coordination set up patient with visiting nurses and patient to discharge with COVID safe home.  Patient completed his remdesivir and IV antibiotics treatment. Today patient denies shortness of breath, palpitation, abdominal pain, chest pain and states feeling much better. Patient has a new onset diabetes and was recently metformin. Patient's current over A1c 13, will resume his metformin and add Lantus.  Advised patient to follow-up with his primary care provider for repeat A1c. He voiced understanding and he was provided with education diabetes management. I reviewed test findings with the patient and answered all of his questions.  He is being discharged in improved and stable condition.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Fatigue, Glycosylated haemoglobin increased, Intensive care, Laboratory test
Clinical narrative: COvId Vaccine Breakthrough Case  J&J Dose 5/8/21 (203A21A) COVID Positive 12/1/21  12/6/21: Patient is a 46-year-old male, only medical history is new onset diabetes which was diagnosed 5 days ago.  He was vaccinated (J&J) for COVID 7 months ago.  He does not smoke/vape.  Pt presented to the ED on 12/1/2021 and was diagnosed with COVID pneumonia.  He was discharged with Rx for Azithromycin.  Reports he has been at home self-quarantining and resting over the last 5 days. Complains of fatigue and weakness x5 days, SOB and persistent cough started this AM.  Came to the ED.  On arrival, the patient's SpO2 was 77% on room air.  He was tachypneic 20-30s.  Heart rate 90-110s.  Labs were significant for sodium 128, glucose 296, lactic acid 3.1, LDH 334. CXR showed patchy infiltrates throughout both lungs, worse since 12/1.  In the ED he was given 1 L of normal saline, 125 mg Solu-Medrol, 1g Rocephin, and 500 mg Azithromycin. He was also given an extended DuoNeb.  I discussed the patient with Dr., and he recommended admission to ICU. Nursing supervisor notified. Dr. also recommended adding a CRP, and if the CRP is greater than 15, he will be given Actemra. Same ordered.  12/11/21: Patient is a 46-year-old male who was admitted in hospital on 12/06/2021 and treated COVID-19 pneumonia. On arrival to the ED, the patient's SpO2 was 77% on room air. He was noted with respiration 20-30s along with tachycardia. He was initiated on supplemental oxygen requiring up to 11 L. Patient's blood work was significant for sodium 128, glucose 296, lactic acid 3.1, LDH 334. CXR showed patchy infiltrates throughout both lungs. Patient was admitted into ICU and pulmonology consulted. Patient was treated with Actemra, remdesivir, dexamethasone and IV antibiotics. Patient's symptom improved and he was able to transfer to the medical unit. Completed a home oxygen walk and will require 1 L at rest and 3 with activities. RN care coordination set up patient with visiting nurses and patient to discharge with COVID safe home.  Patient completed his remdesivir and IV antibiotics treatment. Today patient denies shortness of breath, palpitation, abdominal pain, chest pain and states feeling much better. Patient has a new onset diabetes and was recently metformin. Patient's current over A1c 13, will resume his metformin and add Lantus.  Advised patient to follow-up with his primary care provider for repeat A1c. He voiced understanding and he was provided with education diabetes management. I reviewed test findings with the patient and answered all of his questions.  He is being discharged in improved and stable condition.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Lung infiltration, SARS-CoV-2 test positive, Tachycardia, Tachypnoea, Vaccine breakthrough infection
Clinical narrative: COvId Vaccine Breakthrough Case  J&J Dose 5/8/21 (203A21A) COVID Positive 12/1/21  12/6/21: Patient is a 46-year-old male, only medical history is new onset diabetes which was diagnosed 5 days ago.  He was vaccinated (J&J) for COVID 7 months ago.  He does not smoke/vape.  Pt presented to the ED on 12/1/2021 and was diagnosed with COVID pneumonia.  He was discharged with Rx for Azithromycin.  Reports he has been at home self-quarantining and resting over the last 5 days. Complains of fatigue and weakness x5 days, SOB and persistent cough started this AM.  Came to the ED.  On arrival, the patient's SpO2 was 77% on room air.  He was tachypneic 20-30s.  Heart rate 90-110s.  Labs were significant for sodium 128, glucose 296, lactic acid 3.1, LDH 334. CXR showed patchy infiltrates throughout both lungs, worse since 12/1.  In the ED he was given 1 L of normal saline, 125 mg Solu-Medrol, 1g Rocephin, and 500 mg Azithromycin. He was also given an extended DuoNeb.  I discussed the patient with Dr., and he recommended admission to ICU. Nursing supervisor notified. Dr. also recommended adding a CRP, and if the CRP is greater than 15, he will be given Actemra. Same ordered.  12/11/21: Patient is a 46-year-old male who was admitted in hospital on 12/06/2021 and treated COVID-19 pneumonia. On arrival to the ED, the patient's SpO2 was 77% on room air. He was noted with respiration 20-30s along with tachycardia. He was initiated on supplemental oxygen requiring up to 11 L. Patient's blood work was significant for sodium 128, glucose 296, lactic acid 3.1, LDH 334. CXR showed patchy infiltrates throughout both lungs. Patient was admitted into ICU and pulmonology consulted. Patient was treated with Actemra, remdesivir, dexamethasone and IV antibiotics. Patient's symptom improved and he was able to transfer to the medical unit. Completed a home oxygen walk and will require 1 L at rest and 3 with activities. RN care coordination set up patient with visiting nurses and patient to discharge with COVID safe home.  Patient completed his remdesivir and IV antibiotics treatment. Today patient denies shortness of breath, palpitation, abdominal pain, chest pain and states feeling much better. Patient has a new onset diabetes and was recently metformin. Patient's current over A1c 13, will resume his metformin and add Lantus.  Advised patient to follow-up with his primary care provider for repeat A1c. He voiced understanding and he was provided with education diabetes management. I reviewed test findings with the patient and answered all of his questions.  He is being discharged in improved and stable condition.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Inflammation, Laboratory test, Portal vein thrombosis
Clinical narrative: RARE PORTAL VEIN THROMBOSIS ,  EXTREM INFLAMMATION,  DISCOVERED AFTER RARE AND NEVER EXPERIENCED GASTROINTESTINAL EVENT TOOK ME TO HOSPITAL   ENTIRELY HEALTH 57 YEAR OLD WOMAN NO HISTORY OF ANY HEALTH ISSUES
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was  refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved by COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Blood lactic acid increased, C-reactive protein increased, COVID-19
Clinical narrative: COVID Vaccine Breakthrough CAse  Moderna Dose 1  11/15/21 (033F21A) COVID Positive 11/30/21  12/1/21: Patient has dementia.  He also has myasthenia gravis and hypothyroidism.Not a very reliable historian.   He reportedly tested positive for  SARS-CoV-2 10 days ago. Having cough with yellowish expectoration.  Family think that he may have aspirated in a.m.  Family noticed increased work of breathing in last 1 day.      He had temperature of 100.3° F in emergency department.  Was hypoxic and was requiring up to 5 L of oxygen in emergency department.   Had elevated lactic acid level.  CRP was 16.25.  His D-dimer was very very high at 35.2.  CT pulmonary angiogram showed bilateral pulmonary emboli.  12/10/21: 85-year-old male patient with a history of severe dementia, myasthenia gravis and hypothyroidism was admitted the hospital with complaints of cough.  The patient was diagnosed with COVID-19 infection obtained side to admission to the hospital on 12/2/2021.  Patient was noted to have some shortness of breath and elevated body temperature is 100.3° F. He was also hypoxic requiring 5 L of oxygen in the emergency room on admission.  CT of the chest showed evidence of bilateral PE E the patient was admitted for further care.  Acute hypoxic respiratory failure the the  -secondary due to COVID-19 and pneumonia  -patient maintained on oxygen  -patient completed treatment with steroids, remdesivir and antibiotics treating COVID-19 infection   Bilateral PE with right lower extremity superficial thrombus  -patient nt on ay medications as he is discharged home on no medication  -Pt under palliative care at home now and then hospice care eventually after d/c to home per the son   Dysphagia  -patient followed by dietitian, recommend puree diet with honey thickened fluids, continue   Severe dementia  -patient son is the power of attorney   Catheter associated trauma, off antibiotics at the time of discharge.   Discussed the patient's case with care coordination again this morning.  The son, power of attorney wishes for the patient to be transferred home.  Patient will have a 24 hour attendant/nurse at home.  Outpatient palliative care to follow the patient at home.  The son will consider hospice at a later point after the patient is discharged home. All questions answered.  12/13/21: Patient deceased
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Complication associated with device, Computerised tomogram thorax abnormal, Death, Dysphagia, Dyspnoea
Clinical narrative: COVID Vaccine Breakthrough CAse  Moderna Dose 1  11/15/21 (033F21A) COVID Positive 11/30/21  12/1/21: Patient has dementia.  He also has myasthenia gravis and hypothyroidism.Not a very reliable historian.   He reportedly tested positive for  SARS-CoV-2 10 days ago. Having cough with yellowish expectoration.  Family think that he may have aspirated in a.m.  Family noticed increased work of breathing in last 1 day.      He had temperature of 100.3° F in emergency department.  Was hypoxic and was requiring up to 5 L of oxygen in emergency department.   Had elevated lactic acid level.  CRP was 16.25.  His D-dimer was very very high at 35.2.  CT pulmonary angiogram showed bilateral pulmonary emboli.  12/10/21: 85-year-old male patient with a history of severe dementia, myasthenia gravis and hypothyroidism was admitted the hospital with complaints of cough.  The patient was diagnosed with COVID-19 infection obtained side to admission to the hospital on 12/2/2021.  Patient was noted to have some shortness of breath and elevated body temperature is 100.3° F. He was also hypoxic requiring 5 L of oxygen in the emergency room on admission.  CT of the chest showed evidence of bilateral PE E the patient was admitted for further care.  Acute hypoxic respiratory failure the the  -secondary due to COVID-19 and pneumonia  -patient maintained on oxygen  -patient completed treatment with steroids, remdesivir and antibiotics treating COVID-19 infection   Bilateral PE with right lower extremity superficial thrombus  -patient nt on ay medications as he is discharged home on no medication  -Pt under palliative care at home now and then hospice care eventually after d/c to home per the son   Dysphagia  -patient followed by dietitian, recommend puree diet with honey thickened fluids, continue   Severe dementia  -patient son is the power of attorney   Catheter associated trauma, off antibiotics at the time of discharge.   Discussed the patient's case with care coordination again this morning.  The son, power of attorney wishes for the patient to be transferred home.  Patient will have a 24 hour attendant/nurse at home.  Outpatient palliative care to follow the patient at home.  The son will consider hospice at a later point after the patient is discharged home. All questions answered.  12/13/21: Patient deceased
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Fibrin D dimer increased, Hypoxia, Pneumonia, Productive cough, Pulmonary embolism
Clinical narrative: COVID Vaccine Breakthrough CAse  Moderna Dose 1  11/15/21 (033F21A) COVID Positive 11/30/21  12/1/21: Patient has dementia.  He also has myasthenia gravis and hypothyroidism.Not a very reliable historian.   He reportedly tested positive for  SARS-CoV-2 10 days ago. Having cough with yellowish expectoration.  Family think that he may have aspirated in a.m.  Family noticed increased work of breathing in last 1 day.      He had temperature of 100.3° F in emergency department.  Was hypoxic and was requiring up to 5 L of oxygen in emergency department.   Had elevated lactic acid level.  CRP was 16.25.  His D-dimer was very very high at 35.2.  CT pulmonary angiogram showed bilateral pulmonary emboli.  12/10/21: 85-year-old male patient with a history of severe dementia, myasthenia gravis and hypothyroidism was admitted the hospital with complaints of cough.  The patient was diagnosed with COVID-19 infection obtained side to admission to the hospital on 12/2/2021.  Patient was noted to have some shortness of breath and elevated body temperature is 100.3° F. He was also hypoxic requiring 5 L of oxygen in the emergency room on admission.  CT of the chest showed evidence of bilateral PE E the patient was admitted for further care.  Acute hypoxic respiratory failure the the  -secondary due to COVID-19 and pneumonia  -patient maintained on oxygen  -patient completed treatment with steroids, remdesivir and antibiotics treating COVID-19 infection   Bilateral PE with right lower extremity superficial thrombus  -patient nt on ay medications as he is discharged home on no medication  -Pt under palliative care at home now and then hospice care eventually after d/c to home per the son   Dysphagia  -patient followed by dietitian, recommend puree diet with honey thickened fluids, continue   Severe dementia  -patient son is the power of attorney   Catheter associated trauma, off antibiotics at the time of discharge.   Discussed the patient's case with care coordination again this morning.  The son, power of attorney wishes for the patient to be transferred home.  Patient will have a 24 hour attendant/nurse at home.  Outpatient palliative care to follow the patient at home.  The son will consider hospice at a later point after the patient is discharged home. All questions answered.  12/13/21: Patient deceased
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Sputum discoloured, Superficial vein thrombosis, Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough CAse  Moderna Dose 1  11/15/21 (033F21A) COVID Positive 11/30/21  12/1/21: Patient has dementia.  He also has myasthenia gravis and hypothyroidism.Not a very reliable historian.   He reportedly tested positive for  SARS-CoV-2 10 days ago. Having cough with yellowish expectoration.  Family think that he may have aspirated in a.m.  Family noticed increased work of breathing in last 1 day.      He had temperature of 100.3° F in emergency department.  Was hypoxic and was requiring up to 5 L of oxygen in emergency department.   Had elevated lactic acid level.  CRP was 16.25.  His D-dimer was very very high at 35.2.  CT pulmonary angiogram showed bilateral pulmonary emboli.  12/10/21: 85-year-old male patient with a history of severe dementia, myasthenia gravis and hypothyroidism was admitted the hospital with complaints of cough.  The patient was diagnosed with COVID-19 infection obtained side to admission to the hospital on 12/2/2021.  Patient was noted to have some shortness of breath and elevated body temperature is 100.3° F. He was also hypoxic requiring 5 L of oxygen in the emergency room on admission.  CT of the chest showed evidence of bilateral PE E the patient was admitted for further care.  Acute hypoxic respiratory failure the the  -secondary due to COVID-19 and pneumonia  -patient maintained on oxygen  -patient completed treatment with steroids, remdesivir and antibiotics treating COVID-19 infection   Bilateral PE with right lower extremity superficial thrombus  -patient nt on ay medications as he is discharged home on no medication  -Pt under palliative care at home now and then hospice care eventually after d/c to home per the son   Dysphagia  -patient followed by dietitian, recommend puree diet with honey thickened fluids, continue   Severe dementia  -patient son is the power of attorney   Catheter associated trauma, off antibiotics at the time of discharge.   Discussed the patient's case with care coordination again this morning.  The son, power of attorney wishes for the patient to be transferred home.  Patient will have a 24 hour attendant/nurse at home.  Outpatient palliative care to follow the patient at home.  The son will consider hospice at a later point after the patient is discharged home. All questions answered.  12/13/21: Patient deceased
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Nervousness, Vision blurred
Clinical narrative: Pt was nervous about getting vaccine and stated she usually cries and hates needles.  5 minutes after vaccine she stated she feels dizzy and has blurry vision.   I had her sit down and gave her an instant cold pack which she applied to her forehead and neck.  After a few minutes she felt better.  She called her son in law to come pick her up.  I asked if we can call EMS and she stated she was feeling much better and she wants to go home
Age: 6.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Product preparation error
Clinical narrative: Error: Incorrect Reconstitution-
Age: 6.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Product preparation issue
Clinical narrative: Error: Incorrect Reconstitution-
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved by Regulatory Authority for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 94.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Condition aggravated, Cough, Inappropriate schedule of product administration
Clinical narrative: COVID Vaccine Breakthrough CAse  Moderna Dose 1 2/11/21 (024M20A) Moderna Dose 2 3/14/21 (002B21A) Moderna Dose 3 11/11/21 (065F21A) COVID Positive 12/10/21  12/10/21: History is obtained from patient as well as by personal review of records. Mr. is 94-year-old gentleman with known history of stage IV clear cell carcinoma of right kidney with bilateral lung metastasis, left-sided pleural effusion and bony metastasis.  He also has urothelial cancer in-situ of urinary bladder.  Patient developed diarrhea on axitinib and dose was reduced. Followed up with his oncologist on 11/29/2021 who noticed worsening left-sided pleural effusion. Patient reports worsening generalized weakness of 3 days duration.  Has noticed worsening cough.  Mostly nonproductive.  He tested positive for  SARS-CoV-2.  Urinalysis also showed pyuria. He has received antibiotics in emergency department. Patient denied focal motor weakness.  No focal sensory loss.  Denied double vision or other visual problems.  No difficulty with swallowing.  No difficulty with speech.  He previously underwent thoracentesis on 7/5/2021  12/15/21: Patient is being discharged home with his family and services for nursing, PT, and OT.  He has been enrolled in the safe at home program and the nurses will follow-up with him after discharge.  He should continue Levaquin 750 mg p.o. q.48h x2 more doses and dexamethasone 6 mg p.o. daily x5 days.  He should continue to self-quarantine x5 days.  He should follow-up with his primary care provider in 1-2 weeks.  He should follow-up with oncology as scheduled.  He has been provided patient education for COVID self-care, UTI, generalized weakness, Levaquin, and dexamethasone.  I have answered all of his questions and addressed all of his concerns.  The patient is being discharged in improved and will condition.
Age: 94.0
Sex: M
Vaccine: COVID19
Symptoms: Pleural effusion, Pyuria, SARS-CoV-2 test positive, Urinary tract infection, Urine analysis abnormal
Clinical narrative: COVID Vaccine Breakthrough CAse  Moderna Dose 1 2/11/21 (024M20A) Moderna Dose 2 3/14/21 (002B21A) Moderna Dose 3 11/11/21 (065F21A) COVID Positive 12/10/21  12/10/21: History is obtained from patient as well as by personal review of records. Mr. is 94-year-old gentleman with known history of stage IV clear cell carcinoma of right kidney with bilateral lung metastasis, left-sided pleural effusion and bony metastasis.  He also has urothelial cancer in-situ of urinary bladder.  Patient developed diarrhea on axitinib and dose was reduced. Followed up with his oncologist on 11/29/2021 who noticed worsening left-sided pleural effusion. Patient reports worsening generalized weakness of 3 days duration.  Has noticed worsening cough.  Mostly nonproductive.  He tested positive for  SARS-CoV-2.  Urinalysis also showed pyuria. He has received antibiotics in emergency department. Patient denied focal motor weakness.  No focal sensory loss.  Denied double vision or other visual problems.  No difficulty with swallowing.  No difficulty with speech.  He previously underwent thoracentesis on 7/5/2021  12/15/21: Patient is being discharged home with his family and services for nursing, PT, and OT.  He has been enrolled in the safe at home program and the nurses will follow-up with him after discharge.  He should continue Levaquin 750 mg p.o. q.48h x2 more doses and dexamethasone 6 mg p.o. daily x5 days.  He should continue to self-quarantine x5 days.  He should follow-up with his primary care provider in 1-2 weeks.  He should follow-up with oncology as scheduled.  He has been provided patient education for COVID self-care, UTI, generalized weakness, Levaquin, and dexamethasone.  I have answered all of his questions and addressed all of his concerns.  The patient is being discharged in improved and will condition.
Age: 94.0
Sex: M
Vaccine: COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough CAse  Moderna Dose 1 2/11/21 (024M20A) Moderna Dose 2 3/14/21 (002B21A) Moderna Dose 3 11/11/21 (065F21A) COVID Positive 12/10/21  12/10/21: History is obtained from patient as well as by personal review of records. Mr. is 94-year-old gentleman with known history of stage IV clear cell carcinoma of right kidney with bilateral lung metastasis, left-sided pleural effusion and bony metastasis.  He also has urothelial cancer in-situ of urinary bladder.  Patient developed diarrhea on axitinib and dose was reduced. Followed up with his oncologist on 11/29/2021 who noticed worsening left-sided pleural effusion. Patient reports worsening generalized weakness of 3 days duration.  Has noticed worsening cough.  Mostly nonproductive.  He tested positive for  SARS-CoV-2.  Urinalysis also showed pyuria. He has received antibiotics in emergency department. Patient denied focal motor weakness.  No focal sensory loss.  Denied double vision or other visual problems.  No difficulty with swallowing.  No difficulty with speech.  He previously underwent thoracentesis on 7/5/2021  12/15/21: Patient is being discharged home with his family and services for nursing, PT, and OT.  He has been enrolled in the safe at home program and the nurses will follow-up with him after discharge.  He should continue Levaquin 750 mg p.o. q.48h x2 more doses and dexamethasone 6 mg p.o. daily x5 days.  He should continue to self-quarantine x5 days.  He should follow-up with his primary care provider in 1-2 weeks.  He should follow-up with oncology as scheduled.  He has been provided patient education for COVID self-care, UTI, generalized weakness, Levaquin, and dexamethasone.  I have answered all of his questions and addressed all of his concerns.  The patient is being discharged in improved and will condition.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was refrigerated packaging tote to maintain a temperature of 36 F - 46 F. However, that is not approved by State for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 73.0
Sex: F
Vaccine: UNK
Symptoms: Erythema, Fatigue, Inflammation, Nausea, Pyrexia
Clinical narrative: Fever of 100.7 on May 20 Fatigue may 20, 21 Nausea May 20 Red, inflamed area on left arm, 2.75x4.5 inches, still there today May 22
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was a refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was a refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved by State for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was refrigerated packaging tote to maintain a temperature of 36 F - 46 F. However, that is not approved for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, Blood creatinine increased, Blood test, COVID-19
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/30/21 (EN6205 Pfizer Dose 2 4/20/21 (EM9809) COVID Positive 11/22/21  11/22/21: Patient is a 91 year male from home and recently discharged. He presents to the ER today with complaints of shortness of breath and generalized weakness. Patient's past medical history significant with CKD 3, diastolic CHF, anemia of CKD hyperlipidemia, hypertension and Hashimoto thyroiditis. Patient is fully vaccinated for COVID-19.  He had stable vital signs upon arrival to the ER. Chest x-ray showed cardiomegaly with mild pulmonary venous congestion and early pulmonary edema.  Blood work in ER showed proBNP 4305, creatinine 1.5, troponin positive x1 and hemoglobin 8.2. Patient was treated with 40 mg IV 1 time, aspirin and Nitro-Bid. Patient was transfer to the medical unit.   I met with the patient and the he was resting in bed and denies any discomfort at this time. Patient is currently 2 L oxygen nasal cannula with sats around 92%. Patient denies fever chills, abdominal pain, constipation, chest pain, palpitation, dizziness, headaches. Patient will be admitted and treated for CHF at exacerbation. And discussed the plan of care with the patient and she is agreeable to stay for further management. Patient reports having a caregiver twice a week  11/29/21: Patient is a 91 year male from home who presents to the ER today with complaints of shortness of breath and generalized weakness. Patient's past medical history significant with CKD 3, diastolic CHF, anemia of CKD hyperlipidemia, hypertension and Hashimoto thyroiditis. Patient is fully vaccinated for COVID-19.  He had stable vital signs upon arrival to the ER. Chest x-ray showed cardiomegaly with mild pulmonary venous congestion and early pulmonary edema. Blood work in ER showed proBNP 4305, creatinine 1.5, troponin positive x1 and hemoglobin 8.2. Patient was treated with 40 mg IV 1 time, aspirin and Nitro-Bid. Patient was transfer to the medical unit and treated for CHF exacerbation, Covid 19  pneumonia, acute kidney injury and hyperkalemia. He was treated with Remdesivir, dexamethasone and IV antibiotics. Nephrology was consulted for AKI and hyperkalemia. The patient's symptoms improved and he was able to transfer to Allure in Moline for skills nursing. Today patient denies fever chills, abdominal pain, constipation, chest pain, palpitation, dizziness, and headaches. he has stable vitals and will be transferred by EMS services.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Condition aggravated
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/30/21 (EN6205 Pfizer Dose 2 4/20/21 (EM9809) COVID Positive 11/22/21  11/22/21: Patient is a 91 year male from home and recently discharged. He presents to the ER today with complaints of shortness of breath and generalized weakness. Patient's past medical history significant with CKD 3, diastolic CHF, anemia of CKD hyperlipidemia, hypertension and Hashimoto thyroiditis. Patient is fully vaccinated for COVID-19.  He had stable vital signs upon arrival to the ER. Chest x-ray showed cardiomegaly with mild pulmonary venous congestion and early pulmonary edema.  Blood work in ER showed proBNP 4305, creatinine 1.5, troponin positive x1 and hemoglobin 8.2. Patient was treated with 40 mg IV 1 time, aspirin and Nitro-Bid. Patient was transfer to the medical unit.   I met with the patient and the he was resting in bed and denies any discomfort at this time. Patient is currently 2 L oxygen nasal cannula with sats around 92%. Patient denies fever chills, abdominal pain, constipation, chest pain, palpitation, dizziness, headaches. Patient will be admitted and treated for CHF at exacerbation. And discussed the plan of care with the patient and she is agreeable to stay for further management. Patient reports having a caregiver twice a week  11/29/21: Patient is a 91 year male from home who presents to the ER today with complaints of shortness of breath and generalized weakness. Patient's past medical history significant with CKD 3, diastolic CHF, anemia of CKD hyperlipidemia, hypertension and Hashimoto thyroiditis. Patient is fully vaccinated for COVID-19.  He had stable vital signs upon arrival to the ER. Chest x-ray showed cardiomegaly with mild pulmonary venous congestion and early pulmonary edema. Blood work in ER showed proBNP 4305, creatinine 1.5, troponin positive x1 and hemoglobin 8.2. Patient was treated with 40 mg IV 1 time, aspirin and Nitro-Bid. Patient was transfer to the medical unit and treated for CHF exacerbation, Covid 19  pneumonia, acute kidney injury and hyperkalemia. He was treated with Remdesivir, dexamethasone and IV antibiotics. Nephrology was consulted for AKI and hyperkalemia. The patient's symptoms improved and he was able to transfer to Allure in Moline for skills nursing. Today patient denies fever chills, abdominal pain, constipation, chest pain, palpitation, dizziness, and headaches. he has stable vitals and will be transferred by EMS services.