chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 60.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Lower urinary tract symptoms, Urinary tract infection
Clinical narrative: I had a UTI starting November 2021 and went to the clinic on 11/17/21, I received antibiotics (Cephalexin 500mg)    December 18th went back to the clinic confimed UTI, cultured E.Coli given Macrobid.    1/13/22 UTI symptoms returned I was unable to seek care due to having covid.  1/26 I went to a walk in clinic got Nitrification after UTI confirmed.  I completed each round of antibiotics as prescribed.  I had a negative CT and ruled out a kidney stone. I was put on Sulfamethaxazole 3/9 because positive for e. coli on another culture. Then on 3/14 I saw a urologist did cystoscopy and it was negative.   I have been using colloidal silver to keep the UTI at bay, if I discontinue use then the symptoms come back. I have decided to use alternative treatments to ensure I don't have issues related to long term antibiotic use.   7/14 Specialist "Clean test" done via catheter and found positive for e. coli again.  I was started Macrobid (Nitrification)
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Arrhythmia, Atrial fibrillation, Blood test, Cardiac monitoring abnormal
Clinical narrative: High grade arrhythmia including V tach. Saw Cardiology, and Electrophysiology. Elected observation. Subsequent developed afib requiring Eliquis
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Ventricular tachycardia
Clinical narrative: High grade arrhythmia including V tach. Saw Cardiology, and Electrophysiology. Elected observation. Subsequent developed afib requiring Eliquis
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Antiplatelet therapy, COVID-19, Catheterisation cardiac abnormal, Cerebral venous sinus thrombosis
Clinical narrative: PRESENTING PROBLEM: Stroke-like symptoms [R29.90] Stroke determined by clinical assessment (HCC) [I63.9] COVID-19 [U07.1]   HOSPITAL COURSE: Recrudescence of Prior Left MCA Infarct in Light of + COVID-19  48 y.o. female w/PMH of HLD, Obesity (BMI 44.29), T2DM, Esophageal spasm, Constipation, and COVID-19 (+) 06-2022 (is Vaccinated w/Medorna w/booster), who was hospitalized in 06-2022 w/Chronic Non-Occlusive dural sinus thrombosis (MRV) w/late subacute venous infarcts Echo had showed Left Apical Thrombus s/p Eliquis 5 mg BID, pt also had undergone heart cath w/Stent placement s/p Plavix, during that hospitalization pt also had one reported witnessed seizure at home but negative EEG thus, started on Vimpat 100 mg BID, pt follows cardiology. This pt presented again on 8/19/2022 w/20 Hour R. U/L Ex and R. Face paresthesia which then resolved. Advanced imaging including MRI were negative for any acute new findings. Pt was (+) again for COVID-19 but without symptoms, is in room air and denies SOB, chest pain. Pt states she is back to her baseline and would like to go home. Pt's home pantoprazole was discontinued due to pt being on Plavix. Famotidine was ordered instead.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Coronary arterial stent insertion, Echocardiogram abnormal, Electroencephalogram normal, Infarction, Magnetic resonance imaging normal
Clinical narrative: PRESENTING PROBLEM: Stroke-like symptoms [R29.90] Stroke determined by clinical assessment (HCC) [I63.9] COVID-19 [U07.1]   HOSPITAL COURSE: Recrudescence of Prior Left MCA Infarct in Light of + COVID-19  48 y.o. female w/PMH of HLD, Obesity (BMI 44.29), T2DM, Esophageal spasm, Constipation, and COVID-19 (+) 06-2022 (is Vaccinated w/Medorna w/booster), who was hospitalized in 06-2022 w/Chronic Non-Occlusive dural sinus thrombosis (MRV) w/late subacute venous infarcts Echo had showed Left Apical Thrombus s/p Eliquis 5 mg BID, pt also had undergone heart cath w/Stent placement s/p Plavix, during that hospitalization pt also had one reported witnessed seizure at home but negative EEG thus, started on Vimpat 100 mg BID, pt follows cardiology. This pt presented again on 8/19/2022 w/20 Hour R. U/L Ex and R. Face paresthesia which then resolved. Advanced imaging including MRI were negative for any acute new findings. Pt was (+) again for COVID-19 but without symptoms, is in room air and denies SOB, chest pain. Pt states she is back to her baseline and would like to go home. Pt's home pantoprazole was discontinued due to pt being on Plavix. Famotidine was ordered instead.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Seizure
Clinical narrative: PRESENTING PROBLEM: Stroke-like symptoms [R29.90] Stroke determined by clinical assessment (HCC) [I63.9] COVID-19 [U07.1]   HOSPITAL COURSE: Recrudescence of Prior Left MCA Infarct in Light of + COVID-19  48 y.o. female w/PMH of HLD, Obesity (BMI 44.29), T2DM, Esophageal spasm, Constipation, and COVID-19 (+) 06-2022 (is Vaccinated w/Medorna w/booster), who was hospitalized in 06-2022 w/Chronic Non-Occlusive dural sinus thrombosis (MRV) w/late subacute venous infarcts Echo had showed Left Apical Thrombus s/p Eliquis 5 mg BID, pt also had undergone heart cath w/Stent placement s/p Plavix, during that hospitalization pt also had one reported witnessed seizure at home but negative EEG thus, started on Vimpat 100 mg BID, pt follows cardiology. This pt presented again on 8/19/2022 w/20 Hour R. U/L Ex and R. Face paresthesia which then resolved. Advanced imaging including MRI were negative for any acute new findings. Pt was (+) again for COVID-19 but without symptoms, is in room air and denies SOB, chest pain. Pt states she is back to her baseline and would like to go home. Pt's home pantoprazole was discontinued due to pt being on Plavix. Famotidine was ordered instead.
Age: 5.0
Sex: M
Vaccine: HEPA
Symptoms: Unevaluable event
Clinical narrative: NONE
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Atelectasis, Blood culture, COVID-19, COVID-19 pneumonia, Cerebral atrophy
Clinical narrative: Admission Date: 8/19/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Delirium [R41.0] UTI (urinary tract infection) [N39.0] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1] Pneumonia due to COVID-19 virus [U07.1, J12.82]   HOSPITAL COURSE: Patient is a 88 y.o. female with past medical history of dementia, bed bound at baseline, hypertension, presented to the emergency department from assisted living with chief complaint of fever and fatigue, rectal temperature was 38.6° with mild tachycardia of 101 which has improved with Tylenol, workup was significant for positive COVID-19 PCR, and urinalysis was positive for white cells of 22.7 and red cells 25.5 with moderate leukocytes and negative nitrite.  Blood cultures and urine cultures were sent. Urine cx grew resident flora. Patient was given 1 dose of IV Rocephin after which abx were d'ced.    Chest x-ray showed atelectasis without focal infiltrate.  CT head showed mild atrophy and moderate white matter changes with findings of old infarct in the left basal ganglia without acute abnormalities or hemorrhage.       She briefly required 1-2 L oxygen but quickly weaned off. She discharged home without incident.
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebral infarction, Chest X-ray abnormal, Computerised tomogram head abnormal, Culture urine positive, Cystitis
Clinical narrative: Admission Date: 8/19/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Delirium [R41.0] UTI (urinary tract infection) [N39.0] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1] Pneumonia due to COVID-19 virus [U07.1, J12.82]   HOSPITAL COURSE: Patient is a 88 y.o. female with past medical history of dementia, bed bound at baseline, hypertension, presented to the emergency department from assisted living with chief complaint of fever and fatigue, rectal temperature was 38.6° with mild tachycardia of 101 which has improved with Tylenol, workup was significant for positive COVID-19 PCR, and urinalysis was positive for white cells of 22.7 and red cells 25.5 with moderate leukocytes and negative nitrite.  Blood cultures and urine cultures were sent. Urine cx grew resident flora. Patient was given 1 dose of IV Rocephin after which abx were d'ced.    Chest x-ray showed atelectasis without focal infiltrate.  CT head showed mild atrophy and moderate white matter changes with findings of old infarct in the left basal ganglia without acute abnormalities or hemorrhage.       She briefly required 1-2 L oxygen but quickly weaned off. She discharged home without incident.
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Delirium, Fatigue, Nitrite urine present, Pyrexia, Red blood cells urine positive
Clinical narrative: Admission Date: 8/19/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Delirium [R41.0] UTI (urinary tract infection) [N39.0] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1] Pneumonia due to COVID-19 virus [U07.1, J12.82]   HOSPITAL COURSE: Patient is a 88 y.o. female with past medical history of dementia, bed bound at baseline, hypertension, presented to the emergency department from assisted living with chief complaint of fever and fatigue, rectal temperature was 38.6° with mild tachycardia of 101 which has improved with Tylenol, workup was significant for positive COVID-19 PCR, and urinalysis was positive for white cells of 22.7 and red cells 25.5 with moderate leukocytes and negative nitrite.  Blood cultures and urine cultures were sent. Urine cx grew resident flora. Patient was given 1 dose of IV Rocephin after which abx were d'ced.    Chest x-ray showed atelectasis without focal infiltrate.  CT head showed mild atrophy and moderate white matter changes with findings of old infarct in the left basal ganglia without acute abnormalities or hemorrhage.       She briefly required 1-2 L oxygen but quickly weaned off. She discharged home without incident.
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Tachycardia, Urinary tract infection, Urine analysis abnormal, Urine leukocyte esterase positive
Clinical narrative: Admission Date: 8/19/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Delirium [R41.0] UTI (urinary tract infection) [N39.0] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1] Pneumonia due to COVID-19 virus [U07.1, J12.82]   HOSPITAL COURSE: Patient is a 88 y.o. female with past medical history of dementia, bed bound at baseline, hypertension, presented to the emergency department from assisted living with chief complaint of fever and fatigue, rectal temperature was 38.6° with mild tachycardia of 101 which has improved with Tylenol, workup was significant for positive COVID-19 PCR, and urinalysis was positive for white cells of 22.7 and red cells 25.5 with moderate leukocytes and negative nitrite.  Blood cultures and urine cultures were sent. Urine cx grew resident flora. Patient was given 1 dose of IV Rocephin after which abx were d'ced.    Chest x-ray showed atelectasis without focal infiltrate.  CT head showed mild atrophy and moderate white matter changes with findings of old infarct in the left basal ganglia without acute abnormalities or hemorrhage.       She briefly required 1-2 L oxygen but quickly weaned off. She discharged home without incident.
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: White blood cells urine positive, White matter lesion
Clinical narrative: Admission Date: 8/19/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Delirium [R41.0] UTI (urinary tract infection) [N39.0] Acute cystitis without hematuria [N30.00] COVID-19 [U07.1] Pneumonia due to COVID-19 virus [U07.1, J12.82]   HOSPITAL COURSE: Patient is a 88 y.o. female with past medical history of dementia, bed bound at baseline, hypertension, presented to the emergency department from assisted living with chief complaint of fever and fatigue, rectal temperature was 38.6° with mild tachycardia of 101 which has improved with Tylenol, workup was significant for positive COVID-19 PCR, and urinalysis was positive for white cells of 22.7 and red cells 25.5 with moderate leukocytes and negative nitrite.  Blood cultures and urine cultures were sent. Urine cx grew resident flora. Patient was given 1 dose of IV Rocephin after which abx were d'ced.    Chest x-ray showed atelectasis without focal infiltrate.  CT head showed mild atrophy and moderate white matter changes with findings of old infarct in the left basal ganglia without acute abnormalities or hemorrhage.       She briefly required 1-2 L oxygen but quickly weaned off. She discharged home without incident.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure measurement, Hypotension
Clinical narrative: 8/26/2022 hypotension: vitals checked on 8/26/22 at 1PM - BP was 57/43 w/ MAP 48 - given midodrine 10 mg x 1 at 2PM - vitals rechecked at 2:30 PM - BP was 92/56 MAP 68 - vitals rechecked at 3PM - BP was 83/58 MAP 66.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received vaccine that was beyond it's use date of 7/22/2022
Age: 11.0
Sex: M
Vaccine: MENB, TDAP
Symptoms: Wrong product administered
Clinical narrative: No adverse reaction.  wrong immunization given.
Age: 97.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Blood potassium increased, Blood urine present, COVID-19, Dyspnoea
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  NP Admission Date: 8/19/2022 Discharge Date: 8/22/2022  PRESENTING PROBLEM: COVID-19  Acute kidney injury (HCC)  AKI (acute kidney injury) (HCC)  COVID    HOSPITAL COURSE: Patient is a 97 y.o. male who presents today with a history of hypertension, hyperlipidemia, chronic obstructive pulmonary disease, coronary artery disease, a flutter.  Patient presented to a local emergency department from a residential facility after staff noted patient was somewhat short of breath.  Patient was given a nebulized breathing treatment with no improvement.  When EMS was called they noted patient was not wheezing and found him to have no respiratory distress.  They then proceeded to bring patient to emergency department for further evaluation.  Upon arrival to the emergency department patient was not showing any signs of respiratory distress.  Initial workup showed patient tested positive for COVID-19.  Lab work showed acute kidney injury with decreased GFR of 34 with previous readings normal.  ProBNP was 26 44. WBC 12.8, potassium 5.7.  UA showed large leukocytes, large blood, urine WBC >180.  Patient was then started on IV Rocephin.  Patient was given 20 mg IV Lasix for the elevated BNP and elevated potassium level.  Emergency department provider did talk to patient's daughter and she confirmed patient as a do not resuscitate.  Hospital Services was contacted and accepted patient for admission for acute kidney injury and hyperkalemia.
Age: 97.0
Sex: M
Vaccine: COVID19
Symptoms: Glomerular filtration rate decreased, Hyperkalaemia, Laboratory test, Prohormone brain natriuretic peptide, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  NP Admission Date: 8/19/2022 Discharge Date: 8/22/2022  PRESENTING PROBLEM: COVID-19  Acute kidney injury (HCC)  AKI (acute kidney injury) (HCC)  COVID    HOSPITAL COURSE: Patient is a 97 y.o. male who presents today with a history of hypertension, hyperlipidemia, chronic obstructive pulmonary disease, coronary artery disease, a flutter.  Patient presented to a local emergency department from a residential facility after staff noted patient was somewhat short of breath.  Patient was given a nebulized breathing treatment with no improvement.  When EMS was called they noted patient was not wheezing and found him to have no respiratory distress.  They then proceeded to bring patient to emergency department for further evaluation.  Upon arrival to the emergency department patient was not showing any signs of respiratory distress.  Initial workup showed patient tested positive for COVID-19.  Lab work showed acute kidney injury with decreased GFR of 34 with previous readings normal.  ProBNP was 26 44. WBC 12.8, potassium 5.7.  UA showed large leukocytes, large blood, urine WBC >180.  Patient was then started on IV Rocephin.  Patient was given 20 mg IV Lasix for the elevated BNP and elevated potassium level.  Emergency department provider did talk to patient's daughter and she confirmed patient as a do not resuscitate.  Hospital Services was contacted and accepted patient for admission for acute kidney injury and hyperkalemia.
Age: 97.0
Sex: M
Vaccine: COVID19
Symptoms: Urine analysis abnormal, Urine leukocyte esterase positive, White blood cell count increased, White blood cells urine positive
Clinical narrative: Discharge Provider:  DO Primary Care Provider:  NP Admission Date: 8/19/2022 Discharge Date: 8/22/2022  PRESENTING PROBLEM: COVID-19  Acute kidney injury (HCC)  AKI (acute kidney injury) (HCC)  COVID    HOSPITAL COURSE: Patient is a 97 y.o. male who presents today with a history of hypertension, hyperlipidemia, chronic obstructive pulmonary disease, coronary artery disease, a flutter.  Patient presented to a local emergency department from a residential facility after staff noted patient was somewhat short of breath.  Patient was given a nebulized breathing treatment with no improvement.  When EMS was called they noted patient was not wheezing and found him to have no respiratory distress.  They then proceeded to bring patient to emergency department for further evaluation.  Upon arrival to the emergency department patient was not showing any signs of respiratory distress.  Initial workup showed patient tested positive for COVID-19.  Lab work showed acute kidney injury with decreased GFR of 34 with previous readings normal.  ProBNP was 26 44. WBC 12.8, potassium 5.7.  UA showed large leukocytes, large blood, urine WBC >180.  Patient was then started on IV Rocephin.  Patient was given 20 mg IV Lasix for the elevated BNP and elevated potassium level.  Emergency department provider did talk to patient's daughter and she confirmed patient as a do not resuscitate.  Hospital Services was contacted and accepted patient for admission for acute kidney injury and hyperkalemia.
Age: 92.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Fully vaccinated and boosted twice.   COVID breakthrough infection
Age: 10.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient was given a vaccine that was beyond it's use date of 7/22/2022
Age: 39.0
Sex: F
Vaccine: COVID19, FLU4, COVID19, COVID19, COVID19
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Asthma, COVID-19, Complication of pregnancy
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/20/2022 Discharge Date: 8/23/2022   PRESENTING PROBLEM: COVID-19 affecting pregnancy, antepartum [O98.519, U07.1] Asthma during pregnancy [O99.519, J45.909] INTRAPARTUM COMPLICATIONS: Medical Problems (from 08/20/22 to present)      No problems associated with this episode.         PROCEDURES PERFORMED:   none   HOSPITAL COURSE: Patient presented at 23 weeks and 1 day gestation with an acute asthma exacerbation and COVID 19 infection. CTA showed patch ground glass opacities, no central PE. She required 6L O2 NC to maintian SpO2>95%. She was given 2 days total of betamethasone for treatment of her asthma and for fetal lung maturity and then transitioned to solumedrol.  She was started on Paxlovid and Aspirin for her covid infection as well as lovenox for anticoagulation while inpatient. Pulmonology was consulted and patient was started on Symbicort BID and Albuterol nebulizers PRN q 4 hours. Patient's symptoms improved significantly over the course of 3 days and her O2 requirements dropped completely until she was satting appropriately on room air.  It seems that the most significant factor contributing to her clinical picture was her uncontrolled asthma and not her acute COVID infection.    She had a detailed MFM US done on 8/22 to assess cervical length given her history of a cervical laceration.  The US found her cervical length appropriate at 36.4mm with a left cervical fibroid measuring 3 x 3 x 4 cm. She had reassuring fetal heart tones daily throughout her stay.    She was able to be discharged home on 8/23/22 with the following medications per pulmonolgy recommendation.s Symbicort 2 puffs BID, Albuterol as needed, Prednisone taper (20mg daily x3 days, 10mg daily x 3 days).  She is to followup with her established pulmonologist this week.  If her symptoms return during the steroid taper, the dose may need to be increased and tapered more slowly. She is to continue aspirin, but not lovenox.    She is to continue her scheduled prenatal care with her established OB.
Age: 39.0
Sex: F
Vaccine: COVID19, FLU4, COVID19, COVID19, COVID19
Symptoms: Condition aggravated, Lung opacity, Maternal exposure before pregnancy, Ultrasound antenatal screen abnormal, Uterine leiomyoma
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/20/2022 Discharge Date: 8/23/2022   PRESENTING PROBLEM: COVID-19 affecting pregnancy, antepartum [O98.519, U07.1] Asthma during pregnancy [O99.519, J45.909] INTRAPARTUM COMPLICATIONS: Medical Problems (from 08/20/22 to present)      No problems associated with this episode.         PROCEDURES PERFORMED:   none   HOSPITAL COURSE: Patient presented at 23 weeks and 1 day gestation with an acute asthma exacerbation and COVID 19 infection. CTA showed patch ground glass opacities, no central PE. She required 6L O2 NC to maintian SpO2>95%. She was given 2 days total of betamethasone for treatment of her asthma and for fetal lung maturity and then transitioned to solumedrol.  She was started on Paxlovid and Aspirin for her covid infection as well as lovenox for anticoagulation while inpatient. Pulmonology was consulted and patient was started on Symbicort BID and Albuterol nebulizers PRN q 4 hours. Patient's symptoms improved significantly over the course of 3 days and her O2 requirements dropped completely until she was satting appropriately on room air.  It seems that the most significant factor contributing to her clinical picture was her uncontrolled asthma and not her acute COVID infection.    She had a detailed MFM US done on 8/22 to assess cervical length given her history of a cervical laceration.  The US found her cervical length appropriate at 36.4mm with a left cervical fibroid measuring 3 x 3 x 4 cm. She had reassuring fetal heart tones daily throughout her stay.    She was able to be discharged home on 8/23/22 with the following medications per pulmonolgy recommendation.s Symbicort 2 puffs BID, Albuterol as needed, Prednisone taper (20mg daily x3 days, 10mg daily x 3 days).  She is to followup with her established pulmonologist this week.  If her symptoms return during the steroid taper, the dose may need to be increased and tapered more slowly. She is to continue aspirin, but not lovenox.    She is to continue her scheduled prenatal care with her established OB.
Age: 39.0
Sex: F
Vaccine: COVID19, FLU4, COVID19, COVID19, COVID19
Symptoms: Angiogram pulmonary abnormal, COVID-19, Cough, Dyspnoea, Fibrin D dimer increased
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/20/2022 Discharge Date: 8/23/2022   PRESENTING PROBLEM: COVID-19 affecting pregnancy, antepartum [O98.519, U07.1] Asthma during pregnancy [O99.519, J45.909] INTRAPARTUM COMPLICATIONS: Medical Problems (from 08/20/22 to present)      No problems associated with this episode.         PROCEDURES PERFORMED:   none   HOSPITAL COURSE: Patient presented at 23 weeks and 1 day gestation with an acute asthma exacerbation and COVID 19 infection. CTA showed patch ground glass opacities, no central PE. She required 6L O2 NC to maintian SpO2>95%. She was given 2 days total of betamethasone for treatment of her asthma and for fetal lung maturity and then transitioned to solumedrol.  She was started on Paxlovid and Aspirin for her covid infection as well as lovenox for anticoagulation while inpatient. Pulmonology was consulted and patient was started on Symbicort BID and Albuterol nebulizers PRN q 4 hours. Patient's symptoms improved significantly over the course of 3 days and her O2 requirements dropped completely until she was satting appropriately on room air.  It seems that the most significant factor contributing to her clinical picture was her uncontrolled asthma and not her acute COVID infection.    She had a detailed MFM US done on 8/22 to assess cervical length given her history of a cervical laceration.  The US found her cervical length appropriate at 36.4mm with a left cervical fibroid measuring 3 x 3 x 4 cm. She had reassuring fetal heart tones daily throughout her stay.    She was able to be discharged home on 8/23/22 with the following medications per pulmonolgy recommendation.s Symbicort 2 puffs BID, Albuterol as needed, Prednisone taper (20mg daily x3 days, 10mg daily x 3 days).  She is to followup with her established pulmonologist this week.  If her symptoms return during the steroid taper, the dose may need to be increased and tapered more slowly. She is to continue aspirin, but not lovenox.    She is to continue her scheduled prenatal care with her established OB.
Age: 39.0
Sex: F
Vaccine: COVID19, FLU4, COVID19, COVID19, COVID19
Symptoms: Laboratory test, Lung opacity, Maternal exposure before pregnancy, SARS-CoV-2 test positive, Troponin normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/20/2022 Discharge Date: 8/23/2022   PRESENTING PROBLEM: COVID-19 affecting pregnancy, antepartum [O98.519, U07.1] Asthma during pregnancy [O99.519, J45.909] INTRAPARTUM COMPLICATIONS: Medical Problems (from 08/20/22 to present)      No problems associated with this episode.         PROCEDURES PERFORMED:   none   HOSPITAL COURSE: Patient presented at 23 weeks and 1 day gestation with an acute asthma exacerbation and COVID 19 infection. CTA showed patch ground glass opacities, no central PE. She required 6L O2 NC to maintian SpO2>95%. She was given 2 days total of betamethasone for treatment of her asthma and for fetal lung maturity and then transitioned to solumedrol.  She was started on Paxlovid and Aspirin for her covid infection as well as lovenox for anticoagulation while inpatient. Pulmonology was consulted and patient was started on Symbicort BID and Albuterol nebulizers PRN q 4 hours. Patient's symptoms improved significantly over the course of 3 days and her O2 requirements dropped completely until she was satting appropriately on room air.  It seems that the most significant factor contributing to her clinical picture was her uncontrolled asthma and not her acute COVID infection.    She had a detailed MFM US done on 8/22 to assess cervical length given her history of a cervical laceration.  The US found her cervical length appropriate at 36.4mm with a left cervical fibroid measuring 3 x 3 x 4 cm. She had reassuring fetal heart tones daily throughout her stay.    She was able to be discharged home on 8/23/22 with the following medications per pulmonolgy recommendation.s Symbicort 2 puffs BID, Albuterol as needed, Prednisone taper (20mg daily x3 days, 10mg daily x 3 days).  She is to followup with her established pulmonologist this week.  If her symptoms return during the steroid taper, the dose may need to be increased and tapered more slowly. She is to continue aspirin, but not lovenox.    She is to continue her scheduled prenatal care with her established OB.
Age: 52.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
Clinical narrative: 08/25/222 Patient called clinic describing  he was having  increase swelling, redness, itching, and pain in the injection site. RN advice patient  to go to PCP or urgent care/ emergency room for further evaluation.   08/26/2022 RN called patient for follow-up. Patient stated he was evaluated by his PCP and was given antihistamine, corticosteroid cream and antibiotics for possible allergic reaction to the vaccine.  Patient inform to ask PCP if able to receives Jynneos vaccine in the future and when receiving vaccines in the future to inform staff of his reaction to the Jynneos vaccine. Patient verbalized understanding.
Age: 6.0
Sex: F
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: Patient received 0.2ml of undiluted Pfizer vaccine for 5-11 years
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: Fully vaccinated and boosted twice
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Product administration error
Clinical narrative: This is an administration error in which the patient did not report any adverse events. The patient's first covid vaccine was Janssen administered on 03/25/2021 and she received Pfizer on 06/28/2021.  Patient received 0.3 mL of Pfizer (booster) after receiving J&J as primary series before booster had been approved for the general population. On the consent form, the patient had indicated that she had never received a covid19 vaccine prior.
Age: 55.0
Sex: F
Vaccine: VARZOS
Symptoms: Incorrect route of product administration, Injection site swelling
Clinical narrative: Vaccine was potentially administered subcutaneously. Patient reports bubbling under the skin and a large bump at the injection site. She applied ice and took acetaminophen for the pain. We explained that while a subcutaneous injection is an error, her dose is still considered valid and does not need to be repeated.
Age: 16.0
Sex: F
Vaccine: HEPA
Symptoms: No adverse event, Vaccination error, Wrong product administered
Clinical narrative: Administered Hepatitis A vaccine instead of HPV vaccine. Patient and patient mother notified of vaccine error, both voiced understanding. Patient remained in clinic 30 minutes post vaccine administration without adverse reactions.
Age: 11.0
Sex: M
Vaccine: MNQ
Symptoms: Diarrhoea, Headache, Urticaria, Vomiting
Clinical narrative: 3 days post vaccination developed hives to chest, vomiting, diarrhea, and headache.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Bacteraemia, Bacterial test positive, COVID-19, Computerised tomogram abdomen abnormal
Clinical narrative: Discharge Provider: DO Primary Care Provider: MD Admission Date: 8/20/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Acute cystitis without hematuria [N30.00] Recurrent UTI (urinary tract infection) [N39.0] Sepsis without acute organ dysfunction, due to unspecified organism (HCC) [A41.9] COVID-19 [U07.1]   This is an 82 years old lady who was presented yesterday to the emergency department after complaining of nausea, vomiting, coughing, lower pelvic discomfort, and urinary urgency.  She is known to have history of recurrent urinary tract infection in the past.  Her urinalysis showed evidence of urine tract infection the patient was given a prescription of Ceftin, and discharged home.  The patient's symptoms did not improve and she came back later the same day in the evening for evaluation.  On presentation she was found to have fever 39.1.  IV antibiotic was started and the patient got admitted to the hospital for further evaluation treatment.  Shortly after she got admitted, the patient bacterial culture came back positive for Klebsiella pneumonia.   1. Urine tract infection with bacteremia Klebsiella pneumonia.  Present admission.  Associated with tachycardia on presentation and fever 39.1.  Will continue Rocephin IV while awaiting sensitivity report.  A follow-up blood culture needs to be done after 24 hours.   2. Sepsis.  Present admission.  Associated with tachycardia, fever, bacteremia.  Tylenol p.r.n. for fever.  Will avoid giving excessive hydration because of the patient diagnosis with COVID-19.   3. COVID-19 infection.  The patient initially had COVID infection in June 2022 when she had only some weakness and coughing related to that.  She did not have at that time any difficulty breathing.  This time also the patient denied any difficulty breathing and she does not have any severe respiratory symptoms.  She has only some mild coughing.  No need for any specific intervention in this regard.  Will monitor clinically her respiratory status.   4.  Hypertension.  Blood pressure is controlled 160/51.  Will continue losartan.   5. History of diabetes mellitus.  The patient does not take any hypoglycemic medication.  We will put the patient on 20/4 corrective insulin.   6. Suspected ileum inflammation on the CT scan of the abdomen pelvis with IV contrast.  The patient low abdominal discomfort is related to her bladder infection.  The patient denies any diarrhea.  The radiology signs seems to be clinically relevant at this point.  No need for further workup.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Cystitis, Enteritis, Hypertension
Clinical narrative: Discharge Provider: DO Primary Care Provider: MD Admission Date: 8/20/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Acute cystitis without hematuria [N30.00] Recurrent UTI (urinary tract infection) [N39.0] Sepsis without acute organ dysfunction, due to unspecified organism (HCC) [A41.9] COVID-19 [U07.1]   This is an 82 years old lady who was presented yesterday to the emergency department after complaining of nausea, vomiting, coughing, lower pelvic discomfort, and urinary urgency.  She is known to have history of recurrent urinary tract infection in the past.  Her urinalysis showed evidence of urine tract infection the patient was given a prescription of Ceftin, and discharged home.  The patient's symptoms did not improve and she came back later the same day in the evening for evaluation.  On presentation she was found to have fever 39.1.  IV antibiotic was started and the patient got admitted to the hospital for further evaluation treatment.  Shortly after she got admitted, the patient bacterial culture came back positive for Klebsiella pneumonia.   1. Urine tract infection with bacteremia Klebsiella pneumonia.  Present admission.  Associated with tachycardia on presentation and fever 39.1.  Will continue Rocephin IV while awaiting sensitivity report.  A follow-up blood culture needs to be done after 24 hours.   2. Sepsis.  Present admission.  Associated with tachycardia, fever, bacteremia.  Tylenol p.r.n. for fever.  Will avoid giving excessive hydration because of the patient diagnosis with COVID-19.   3. COVID-19 infection.  The patient initially had COVID infection in June 2022 when she had only some weakness and coughing related to that.  She did not have at that time any difficulty breathing.  This time also the patient denied any difficulty breathing and she does not have any severe respiratory symptoms.  She has only some mild coughing.  No need for any specific intervention in this regard.  Will monitor clinically her respiratory status.   4.  Hypertension.  Blood pressure is controlled 160/51.  Will continue losartan.   5. History of diabetes mellitus.  The patient does not take any hypoglycemic medication.  We will put the patient on 20/4 corrective insulin.   6. Suspected ileum inflammation on the CT scan of the abdomen pelvis with IV contrast.  The patient low abdominal discomfort is related to her bladder infection.  The patient denies any diarrhea.  The radiology signs seems to be clinically relevant at this point.  No need for further workup.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Klebsiella test positive, Micturition urgency, Nausea, Pelvic discomfort, Pneumonia klebsiella
Clinical narrative: Discharge Provider: DO Primary Care Provider: MD Admission Date: 8/20/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Acute cystitis without hematuria [N30.00] Recurrent UTI (urinary tract infection) [N39.0] Sepsis without acute organ dysfunction, due to unspecified organism (HCC) [A41.9] COVID-19 [U07.1]   This is an 82 years old lady who was presented yesterday to the emergency department after complaining of nausea, vomiting, coughing, lower pelvic discomfort, and urinary urgency.  She is known to have history of recurrent urinary tract infection in the past.  Her urinalysis showed evidence of urine tract infection the patient was given a prescription of Ceftin, and discharged home.  The patient's symptoms did not improve and she came back later the same day in the evening for evaluation.  On presentation she was found to have fever 39.1.  IV antibiotic was started and the patient got admitted to the hospital for further evaluation treatment.  Shortly after she got admitted, the patient bacterial culture came back positive for Klebsiella pneumonia.   1. Urine tract infection with bacteremia Klebsiella pneumonia.  Present admission.  Associated with tachycardia on presentation and fever 39.1.  Will continue Rocephin IV while awaiting sensitivity report.  A follow-up blood culture needs to be done after 24 hours.   2. Sepsis.  Present admission.  Associated with tachycardia, fever, bacteremia.  Tylenol p.r.n. for fever.  Will avoid giving excessive hydration because of the patient diagnosis with COVID-19.   3. COVID-19 infection.  The patient initially had COVID infection in June 2022 when she had only some weakness and coughing related to that.  She did not have at that time any difficulty breathing.  This time also the patient denied any difficulty breathing and she does not have any severe respiratory symptoms.  She has only some mild coughing.  No need for any specific intervention in this regard.  Will monitor clinically her respiratory status.   4.  Hypertension.  Blood pressure is controlled 160/51.  Will continue losartan.   5. History of diabetes mellitus.  The patient does not take any hypoglycemic medication.  We will put the patient on 20/4 corrective insulin.   6. Suspected ileum inflammation on the CT scan of the abdomen pelvis with IV contrast.  The patient low abdominal discomfort is related to her bladder infection.  The patient denies any diarrhea.  The radiology signs seems to be clinically relevant at this point.  No need for further workup.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Scan with contrast abnormal, Sepsis, Tachycardia, Urinary tract infection
Clinical narrative: Discharge Provider: DO Primary Care Provider: MD Admission Date: 8/20/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Acute cystitis without hematuria [N30.00] Recurrent UTI (urinary tract infection) [N39.0] Sepsis without acute organ dysfunction, due to unspecified organism (HCC) [A41.9] COVID-19 [U07.1]   This is an 82 years old lady who was presented yesterday to the emergency department after complaining of nausea, vomiting, coughing, lower pelvic discomfort, and urinary urgency.  She is known to have history of recurrent urinary tract infection in the past.  Her urinalysis showed evidence of urine tract infection the patient was given a prescription of Ceftin, and discharged home.  The patient's symptoms did not improve and she came back later the same day in the evening for evaluation.  On presentation she was found to have fever 39.1.  IV antibiotic was started and the patient got admitted to the hospital for further evaluation treatment.  Shortly after she got admitted, the patient bacterial culture came back positive for Klebsiella pneumonia.   1. Urine tract infection with bacteremia Klebsiella pneumonia.  Present admission.  Associated with tachycardia on presentation and fever 39.1.  Will continue Rocephin IV while awaiting sensitivity report.  A follow-up blood culture needs to be done after 24 hours.   2. Sepsis.  Present admission.  Associated with tachycardia, fever, bacteremia.  Tylenol p.r.n. for fever.  Will avoid giving excessive hydration because of the patient diagnosis with COVID-19.   3. COVID-19 infection.  The patient initially had COVID infection in June 2022 when she had only some weakness and coughing related to that.  She did not have at that time any difficulty breathing.  This time also the patient denied any difficulty breathing and she does not have any severe respiratory symptoms.  She has only some mild coughing.  No need for any specific intervention in this regard.  Will monitor clinically her respiratory status.   4.  Hypertension.  Blood pressure is controlled 160/51.  Will continue losartan.   5. History of diabetes mellitus.  The patient does not take any hypoglycemic medication.  We will put the patient on 20/4 corrective insulin.   6. Suspected ileum inflammation on the CT scan of the abdomen pelvis with IV contrast.  The patient low abdominal discomfort is related to her bladder infection.  The patient denies any diarrhea.  The radiology signs seems to be clinically relevant at this point.  No need for further workup.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Urine analysis abnormal, Vomiting
Clinical narrative: Discharge Provider: DO Primary Care Provider: MD Admission Date: 8/20/2022 Discharge Date: Aug 22, 2022  PRESENTING PROBLEM: Acute cystitis without hematuria [N30.00] Recurrent UTI (urinary tract infection) [N39.0] Sepsis without acute organ dysfunction, due to unspecified organism (HCC) [A41.9] COVID-19 [U07.1]   This is an 82 years old lady who was presented yesterday to the emergency department after complaining of nausea, vomiting, coughing, lower pelvic discomfort, and urinary urgency.  She is known to have history of recurrent urinary tract infection in the past.  Her urinalysis showed evidence of urine tract infection the patient was given a prescription of Ceftin, and discharged home.  The patient's symptoms did not improve and she came back later the same day in the evening for evaluation.  On presentation she was found to have fever 39.1.  IV antibiotic was started and the patient got admitted to the hospital for further evaluation treatment.  Shortly after she got admitted, the patient bacterial culture came back positive for Klebsiella pneumonia.   1. Urine tract infection with bacteremia Klebsiella pneumonia.  Present admission.  Associated with tachycardia on presentation and fever 39.1.  Will continue Rocephin IV while awaiting sensitivity report.  A follow-up blood culture needs to be done after 24 hours.   2. Sepsis.  Present admission.  Associated with tachycardia, fever, bacteremia.  Tylenol p.r.n. for fever.  Will avoid giving excessive hydration because of the patient diagnosis with COVID-19.   3. COVID-19 infection.  The patient initially had COVID infection in June 2022 when she had only some weakness and coughing related to that.  She did not have at that time any difficulty breathing.  This time also the patient denied any difficulty breathing and she does not have any severe respiratory symptoms.  She has only some mild coughing.  No need for any specific intervention in this regard.  Will monitor clinically her respiratory status.   4.  Hypertension.  Blood pressure is controlled 160/51.  Will continue losartan.   5. History of diabetes mellitus.  The patient does not take any hypoglycemic medication.  We will put the patient on 20/4 corrective insulin.   6. Suspected ileum inflammation on the CT scan of the abdomen pelvis with IV contrast.  The patient low abdominal discomfort is related to her bladder infection.  The patient denies any diarrhea.  The radiology signs seems to be clinically relevant at this point.  No need for further workup.
Age: 36.0
Sex: U
Vaccine: COVID19
Symptoms: Laboratory test, Pyrexia, Weight decreased
Clinical narrative: Shortly after receiving the shot, the next day or so started getting a fever. Fever lasted a few months. Lost somewhere around 35 pounds. Had to be admitted to the ER and sent in for many more tests over the last year
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Product administration error
Clinical narrative: This is an administration error in which the patient did not report any adverse events. The patient's first covid vaccine was Janssen administered on 03/25/2021 and she received Pfizer on 06/28/2021.  Patient received 0.3 mL of Pfizer (booster) after receiving J&J as primary series before booster had been approved for the general population. On the consent form, the patient had indicated that she had never received a covid19 vaccine prior. Patient then returned on 10/31/2021 to complete the pfizer series (prior J&J vaccine still unknown by pharmacy staff) to which she did receive a 2nd dose. It was disclosed to the pharmacy today, 8/26/22, that she had originally received her first vaccine in March of 2021 resulting in 2 administration errors and patient receiving a booster at 2 separate occasions in which they were not yet approved.
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: Received a booster 0.2ml of undiluted Pfizer vaccine for ages 5-11.  Child has already received 2 dose series.   Family notified and will symptom monitor.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site bruising, Injection site swelling, Pain, Pyrexia
Clinical narrative: The day after her 2nd dose of Novavax the patient experienced a fever of 101 degrees and body aches.  The patient called me 8/24 and I told her to take some Tylenol or Ibuprofen, rest and push fluids.  I called the patient on 8/26 to ask how she was doing, she explained that the fever and body aches were gone, but she had a bruise at the injection site and the arm was a bit swollen.  She came in and I was able to visualize the swelling and the bruising.  Placement of vaccine looked good.  She stated that the swelling has started to subside.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient given vaccine that was beyond it's use date of 7/22/2022
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Abscess drainage, Abscess limb, Blood culture negative, Bone abscess, COVID-19
Clinical narrative: Discharge Provider:  MD; Primary Care Provider: DO; Admission Date: 8/22/2022; Discharge Date: Aug 25, 2022 PRESENTING PROBLEM: COVID-19 [U07.1] HOSPITAL COURSE: Sixty-nine year old male with past medical history significant for obesity, nonambulatory at baseline, hypertension, hyperlipidemia, recent admissions for E coli bacteremia related to diskitis/osteomyelitis from L3-S1 as well as suspected vertebral abscess at the level of S1 that was drained.  He was readmitted in May for altered mental status found to have large gluteal abscess was also drained.  He presents to emergency department on 08/22 with worsening fatigue and lethargy.  He is mildly hypotensive on admission and otherwise stable.  Labs were notable for elevated inflammatory markers.  He did test positive for COVID-19.  His checks x-ray was normal.  Admitted to Medicine Service further assessment and management. As far as COVID-19 goes, patient was treated supportively.  He did not develop respiratory failure and did not require steroids or other treatments.  Improved over the course of the days he was hospitalized. In regards to his hypotension, this resolved with IV fluids.  We did switch his home Lasix to p.r.n. basis.  Blood pressure normalized by the day of discharge. Patient was on Coumadin for history of DVT.  This was continued in the hospital setting and started on a bridge with Lovenox which he will continue at his facility for  infra-therapeutic INR. Interventional Radiology and surgical specialist evaluated patient is drains from prior diskitis/osteomyelitis and gluteal abscess.  Blood cultures were obtained and remained negative.  It did not feel there was any issue with the drains and recommended outpatient follow-up. Patient is discharged back to his facility in stable and improved condition.