chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 100.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Full blood count abnormal, Heart rate increased, Inflammatory marker increased, Leukocytosis
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/9/2023 Discharge Date: Feb 15, 2023  PRESENTING PROBLEM: Heart failure (HCC)  Acute systolic congestive heart failure (HCC) Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 101-year-old male with a past medical history of hypertension, hyperlipidemia, coronary artery disease, and severe aortic stenosis who presented with shortness of breath for the past couple of days.  He required 3 L of nasal cannula in the ER and was therefore started on Lasix 40 mg IV in the hospital with concern for acute on chronic diastolic heart failure exacerbation in the setting of severe aortic stenosis.  He was transitioned to lasix 40 mg PO on 02/11/2023.  He had good output on this regimen.  On 02/11/2023, patient was noted to have increased heart rates in the 120s to 130s.  His home dose of 12.5 mg Toprol was increased to 25 mg 2 times a day.  Chest x-ray in the morning of 12/11/2023 demonstrated decreased aeration, persistent mixed interstitial airspace opacities and small pleural effusions.  It appeared worse than prior x-ray performed on 02/09/2023.  An ultrasound of the lung was ordered that demonstrated bilateral pleural effusions.  A repeat chest x-ray on 02/12/2023 demonstrated worsening moderate pulmonary edema superimposed on bilateral pneumonia with increasing pleural effusion.  During this time, patient was also noted tab increasing oxygen requirements requiring venturi mask with FiO2 of 50%.  Diuresis was uptitrated with the assistance of Cardiology began patient on Lasix 80 mg twice a day.  Repeat complete blood count demonstrated leukocytosis with white blood cell count of 17.  Patient was also noted to have elevated inflammatory markers with CRP of 55.  Patient's COVID 19 PCR came back positive 2/11, and patient was subsequently started on remdesivir/Decadron for management of COVID-19.  Palliative Care also saw patient during his hospitalization and eventually contacted hospice in order to discuss goals of care with patient.  Patient eventually elected to sign on with home hospice after discharge from hospital. Patient's diuresis was continued Lasix 80 mg twice daily, and he was eventually able to wean completely off oxygen and tolerate ambulation on room air without oxygen desaturations.  He was subsequently discharged home with hospice on 02/15/2023 in stable condition.
Age: 100.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Pleural effusion, Pneumonia, Pulmonary oedema, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/9/2023 Discharge Date: Feb 15, 2023  PRESENTING PROBLEM: Heart failure (HCC)  Acute systolic congestive heart failure (HCC) Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 101-year-old male with a past medical history of hypertension, hyperlipidemia, coronary artery disease, and severe aortic stenosis who presented with shortness of breath for the past couple of days.  He required 3 L of nasal cannula in the ER and was therefore started on Lasix 40 mg IV in the hospital with concern for acute on chronic diastolic heart failure exacerbation in the setting of severe aortic stenosis.  He was transitioned to lasix 40 mg PO on 02/11/2023.  He had good output on this regimen.  On 02/11/2023, patient was noted to have increased heart rates in the 120s to 130s.  His home dose of 12.5 mg Toprol was increased to 25 mg 2 times a day.  Chest x-ray in the morning of 12/11/2023 demonstrated decreased aeration, persistent mixed interstitial airspace opacities and small pleural effusions.  It appeared worse than prior x-ray performed on 02/09/2023.  An ultrasound of the lung was ordered that demonstrated bilateral pleural effusions.  A repeat chest x-ray on 02/12/2023 demonstrated worsening moderate pulmonary edema superimposed on bilateral pneumonia with increasing pleural effusion.  During this time, patient was also noted tab increasing oxygen requirements requiring venturi mask with FiO2 of 50%.  Diuresis was uptitrated with the assistance of Cardiology began patient on Lasix 80 mg twice a day.  Repeat complete blood count demonstrated leukocytosis with white blood cell count of 17.  Patient was also noted to have elevated inflammatory markers with CRP of 55.  Patient's COVID 19 PCR came back positive 2/11, and patient was subsequently started on remdesivir/Decadron for management of COVID-19.  Palliative Care also saw patient during his hospitalization and eventually contacted hospice in order to discuss goals of care with patient.  Patient eventually elected to sign on with home hospice after discharge from hospital. Patient's diuresis was continued Lasix 80 mg twice daily, and he was eventually able to wean completely off oxygen and tolerate ambulation on room air without oxygen desaturations.  He was subsequently discharged home with hospice on 02/15/2023 in stable condition.
Age: 100.0
Sex: M
Vaccine: COVID19
Symptoms: Ultrasound chest, White blood cell count increased
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/9/2023 Discharge Date: Feb 15, 2023  PRESENTING PROBLEM: Heart failure (HCC)  Acute systolic congestive heart failure (HCC) Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 101-year-old male with a past medical history of hypertension, hyperlipidemia, coronary artery disease, and severe aortic stenosis who presented with shortness of breath for the past couple of days.  He required 3 L of nasal cannula in the ER and was therefore started on Lasix 40 mg IV in the hospital with concern for acute on chronic diastolic heart failure exacerbation in the setting of severe aortic stenosis.  He was transitioned to lasix 40 mg PO on 02/11/2023.  He had good output on this regimen.  On 02/11/2023, patient was noted to have increased heart rates in the 120s to 130s.  His home dose of 12.5 mg Toprol was increased to 25 mg 2 times a day.  Chest x-ray in the morning of 12/11/2023 demonstrated decreased aeration, persistent mixed interstitial airspace opacities and small pleural effusions.  It appeared worse than prior x-ray performed on 02/09/2023.  An ultrasound of the lung was ordered that demonstrated bilateral pleural effusions.  A repeat chest x-ray on 02/12/2023 demonstrated worsening moderate pulmonary edema superimposed on bilateral pneumonia with increasing pleural effusion.  During this time, patient was also noted tab increasing oxygen requirements requiring venturi mask with FiO2 of 50%.  Diuresis was uptitrated with the assistance of Cardiology began patient on Lasix 80 mg twice a day.  Repeat complete blood count demonstrated leukocytosis with white blood cell count of 17.  Patient was also noted to have elevated inflammatory markers with CRP of 55.  Patient's COVID 19 PCR came back positive 2/11, and patient was subsequently started on remdesivir/Decadron for management of COVID-19.  Palliative Care also saw patient during his hospitalization and eventually contacted hospice in order to discuss goals of care with patient.  Patient eventually elected to sign on with home hospice after discharge from hospital. Patient's diuresis was continued Lasix 80 mg twice daily, and he was eventually able to wean completely off oxygen and tolerate ambulation on room air without oxygen desaturations.  He was subsequently discharged home with hospice on 02/15/2023 in stable condition.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: patient administered original monovalent moderna in error in place of the moderna bivalent for booster
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: When verifying patient in database it appeared they had only received 1st primary dose of Pfizer 1/30/2022 and then a Bivalent dose 10/27/2022. We gave a 2nd primary dose per our record of completing a primary series prior to receiving a bivalent. Record in our system showed a consent from 10/2022 noting a 2nd dose date from 05/2022 but was not otherwise documented anywhere as far as what, who, or where it was given.
Age: 28.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, Injection site swelling
Clinical narrative: Patient went to PCP to obtain second monovalent dose of primary COVID vaccine and was given Bivalent Booster instead on 2/3/23. Patient was unaware of this until she came into office for pre-employment appointment and immunization records were reviewed/confirmed on 2/17/23. Patient reports moderate localized swelling at site of injection x2 weeks starting a few hours after vaccination on 2/3/23.
Age: 4.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site discolouration, Injection site erythema, Injection site inflammation, Injection site swelling
Clinical narrative: Injection site became in flammed and swelled up her whole upper thigh.red and discolored and puffy
Age: 4.0
Sex: M
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Dose two of primary series was administered 1 week early by mistake. Vaccinator who administered the dose and lead nurse spoke with parents and let them know.
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Brain natriuretic peptide increased, COVID-19, Chest X-ray normal, Dyspnoea, Laboratory test
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/12/2023 Discharge Date:  February 16th 2023   PRESENTING PROBLEM: Shortness of breath Altered mental status, unspecified altered mental status type  Community acquired pneumonia, unspecified laterality Acute metabolic encephalopathy Metabolic encephalopathy    HOSPITAL COURSE: 80-year-old female with medical history of dementia, AFib, CKD, chronic obstructive pulmonary disease, CHF, type 2 diabetes presented to the hospital with shortness of breath and altered mental status.  Patient is from skilled nursing facility with reported deterioration in mentation over the last several days.  As a result patient was brought into the emergency department.  Patient presented tachypneic requiring BiPAP on arrival.  Patient was found to have leukocytosis, and elevated BNP.  Procalcitonin was within normal limits.  Troponins were elevated but overall somewhat flat.  Septic workup was initiated.  Chest x-ray did not show any signs of pneumonia.  No effusions or pneumothorax was also appreciated.  Patient was started on cap coverage and given a dose of Solu-Medrol.  Patient's viral testing did eventually come back positive for COVID-19.  Steroids were transitioned to Decadron.  Additionally patient found to have urinary tract infection likely contributing to current altered mental status.  Was treated with ceftriaxone and eventually transitioned to Ceftin.  Breathing did improve as patient was able to wean off of the BiPAP back to room air.  Antibiotics were eventually discontinued with patient doing well with steroids.  Patient is now currently breathing at her baseline and mentating at baseline as per family at bedside.  Patient will be discharged back to skilled nursing facility and finish off course of steroids and antibiotics
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Leukocytosis, Mental impairment, Mental status changes, Metabolic encephalopathy, Pneumonia
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/12/2023 Discharge Date:  February 16th 2023   PRESENTING PROBLEM: Shortness of breath Altered mental status, unspecified altered mental status type  Community acquired pneumonia, unspecified laterality Acute metabolic encephalopathy Metabolic encephalopathy    HOSPITAL COURSE: 80-year-old female with medical history of dementia, AFib, CKD, chronic obstructive pulmonary disease, CHF, type 2 diabetes presented to the hospital with shortness of breath and altered mental status.  Patient is from skilled nursing facility with reported deterioration in mentation over the last several days.  As a result patient was brought into the emergency department.  Patient presented tachypneic requiring BiPAP on arrival.  Patient was found to have leukocytosis, and elevated BNP.  Procalcitonin was within normal limits.  Troponins were elevated but overall somewhat flat.  Septic workup was initiated.  Chest x-ray did not show any signs of pneumonia.  No effusions or pneumothorax was also appreciated.  Patient was started on cap coverage and given a dose of Solu-Medrol.  Patient's viral testing did eventually come back positive for COVID-19.  Steroids were transitioned to Decadron.  Additionally patient found to have urinary tract infection likely contributing to current altered mental status.  Was treated with ceftriaxone and eventually transitioned to Ceftin.  Breathing did improve as patient was able to wean off of the BiPAP back to room air.  Antibiotics were eventually discontinued with patient doing well with steroids.  Patient is now currently breathing at her baseline and mentating at baseline as per family at bedside.  Patient will be discharged back to skilled nursing facility and finish off course of steroids and antibiotics
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Positive airway pressure therapy, Procalcitonin normal, SARS-CoV-2 test positive, Tachypnoea, Troponin increased
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/12/2023 Discharge Date:  February 16th 2023   PRESENTING PROBLEM: Shortness of breath Altered mental status, unspecified altered mental status type  Community acquired pneumonia, unspecified laterality Acute metabolic encephalopathy Metabolic encephalopathy    HOSPITAL COURSE: 80-year-old female with medical history of dementia, AFib, CKD, chronic obstructive pulmonary disease, CHF, type 2 diabetes presented to the hospital with shortness of breath and altered mental status.  Patient is from skilled nursing facility with reported deterioration in mentation over the last several days.  As a result patient was brought into the emergency department.  Patient presented tachypneic requiring BiPAP on arrival.  Patient was found to have leukocytosis, and elevated BNP.  Procalcitonin was within normal limits.  Troponins were elevated but overall somewhat flat.  Septic workup was initiated.  Chest x-ray did not show any signs of pneumonia.  No effusions or pneumothorax was also appreciated.  Patient was started on cap coverage and given a dose of Solu-Medrol.  Patient's viral testing did eventually come back positive for COVID-19.  Steroids were transitioned to Decadron.  Additionally patient found to have urinary tract infection likely contributing to current altered mental status.  Was treated with ceftriaxone and eventually transitioned to Ceftin.  Breathing did improve as patient was able to wean off of the BiPAP back to room air.  Antibiotics were eventually discontinued with patient doing well with steroids.  Patient is now currently breathing at her baseline and mentating at baseline as per family at bedside.  Patient will be discharged back to skilled nursing facility and finish off course of steroids and antibiotics
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Urinary tract infection, Viral test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 2/12/2023 Discharge Date:  February 16th 2023   PRESENTING PROBLEM: Shortness of breath Altered mental status, unspecified altered mental status type  Community acquired pneumonia, unspecified laterality Acute metabolic encephalopathy Metabolic encephalopathy    HOSPITAL COURSE: 80-year-old female with medical history of dementia, AFib, CKD, chronic obstructive pulmonary disease, CHF, type 2 diabetes presented to the hospital with shortness of breath and altered mental status.  Patient is from skilled nursing facility with reported deterioration in mentation over the last several days.  As a result patient was brought into the emergency department.  Patient presented tachypneic requiring BiPAP on arrival.  Patient was found to have leukocytosis, and elevated BNP.  Procalcitonin was within normal limits.  Troponins were elevated but overall somewhat flat.  Septic workup was initiated.  Chest x-ray did not show any signs of pneumonia.  No effusions or pneumothorax was also appreciated.  Patient was started on cap coverage and given a dose of Solu-Medrol.  Patient's viral testing did eventually come back positive for COVID-19.  Steroids were transitioned to Decadron.  Additionally patient found to have urinary tract infection likely contributing to current altered mental status.  Was treated with ceftriaxone and eventually transitioned to Ceftin.  Breathing did improve as patient was able to wean off of the BiPAP back to room air.  Antibiotics were eventually discontinued with patient doing well with steroids.  Patient is now currently breathing at her baseline and mentating at baseline as per family at bedside.  Patient will be discharged back to skilled nursing facility and finish off course of steroids and antibiotics
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, Blood creatinine increased, Blood magnesium decreased, Blood phosphorus decreased
Clinical narrative: Discharge Provider: MD  Primary Care Provider: MD Admission Date: 2/13/2023 Discharge Date: 02/14/2023   Admitting Diagnoses: Hypokalemia  PRESENTING PROBLEM:  Hypokalemia Hypoxia  COVID    HOSPITAL COURSE: 70-year-old lady with medical history of coronary artery disease status post CABG, chronic obstructive pulmonary disease, bipolar 1 disorder, ischemic cardiomyopathy, gastric ulcer, chronic opioid dependence, paroxysmal AFib on Xarelto presented to ER 2/13 with flu-like symptoms.  According to patient, she started experiencing generalized body weakness/body aches, dizziness, dry heaves, shortness of breath, cough occasionally productive of yellowish-green sputum about 4 days prior to presentation.  No fevers but she endorsed chills at home.  Patient endorsed poor appetite, low water intake at home.  Her symptoms worsened and she presented to ER 2/13.  On presentation vital signs stable.  Labs with sodium 132, potassium 2.5, creatinine 1.45.  Cardiac workup negative, pro BNP normal and troponin 27> 22. Patient tested positive for COVID-19.  Chest x-ray showed cardiomegaly but no acute cardiopulmonary process.  No consolidation.  Patient was given potassium supplements (30 mEq).  She had slight desaturation with ambulation (88% on room air).  Patient has home oxygen but uses it as needed.  When she started noticing difficulty breathing, she will use 2.5 L. Due to COVID infection, AKI, severe hypokalemia she was admitted for further management. Started on dexamethasone 6 mg for COVID 19 infection.  Patient was given potassium supplements, serum potassium improved.  Was given 1 L IV fluid bolus, renal functions also improved.  Serum magnesium low, replaced with IV magnesium sulfate.  Patient also found to have low phosphate (1.5), started daily phosphate tablets. 2/14:  Patient feeling significantly better.  No body aches or chills.  No nausea or vomiting.  Normal appetite.  No difficulty breathing.  No phlegm, very minimal cough.  No fevers. Supplemental oxygen weaned off.  Patient would like to go home today.  Labs showed resolution of AKI (serum creatinine 0.95), improvement in potassium (3.4).  Patient informed to get magnesium, phosphorus, BMP  checked next week. Will be discharged with dexamethasone course.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Blood potassium decreased, Blood sodium decreased, COVID-19, Cardiac function test normal, Cardiomegaly
Clinical narrative: Discharge Provider: MD  Primary Care Provider: MD Admission Date: 2/13/2023 Discharge Date: 02/14/2023   Admitting Diagnoses: Hypokalemia  PRESENTING PROBLEM:  Hypokalemia Hypoxia  COVID    HOSPITAL COURSE: 70-year-old lady with medical history of coronary artery disease status post CABG, chronic obstructive pulmonary disease, bipolar 1 disorder, ischemic cardiomyopathy, gastric ulcer, chronic opioid dependence, paroxysmal AFib on Xarelto presented to ER 2/13 with flu-like symptoms.  According to patient, she started experiencing generalized body weakness/body aches, dizziness, dry heaves, shortness of breath, cough occasionally productive of yellowish-green sputum about 4 days prior to presentation.  No fevers but she endorsed chills at home.  Patient endorsed poor appetite, low water intake at home.  Her symptoms worsened and she presented to ER 2/13.  On presentation vital signs stable.  Labs with sodium 132, potassium 2.5, creatinine 1.45.  Cardiac workup negative, pro BNP normal and troponin 27> 22. Patient tested positive for COVID-19.  Chest x-ray showed cardiomegaly but no acute cardiopulmonary process.  No consolidation.  Patient was given potassium supplements (30 mEq).  She had slight desaturation with ambulation (88% on room air).  Patient has home oxygen but uses it as needed.  When she started noticing difficulty breathing, she will use 2.5 L. Due to COVID infection, AKI, severe hypokalemia she was admitted for further management. Started on dexamethasone 6 mg for COVID 19 infection.  Patient was given potassium supplements, serum potassium improved.  Was given 1 L IV fluid bolus, renal functions also improved.  Serum magnesium low, replaced with IV magnesium sulfate.  Patient also found to have low phosphate (1.5), started daily phosphate tablets. 2/14:  Patient feeling significantly better.  No body aches or chills.  No nausea or vomiting.  Normal appetite.  No difficulty breathing.  No phlegm, very minimal cough.  No fevers. Supplemental oxygen weaned off.  Patient would like to go home today.  Labs showed resolution of AKI (serum creatinine 0.95), improvement in potassium (3.4).  Patient informed to get magnesium, phosphorus, BMP  checked next week. Will be discharged with dexamethasone course.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chills, Decreased appetite, Dizziness, Dyspnoea
Clinical narrative: Discharge Provider: MD  Primary Care Provider: MD Admission Date: 2/13/2023 Discharge Date: 02/14/2023   Admitting Diagnoses: Hypokalemia  PRESENTING PROBLEM:  Hypokalemia Hypoxia  COVID    HOSPITAL COURSE: 70-year-old lady with medical history of coronary artery disease status post CABG, chronic obstructive pulmonary disease, bipolar 1 disorder, ischemic cardiomyopathy, gastric ulcer, chronic opioid dependence, paroxysmal AFib on Xarelto presented to ER 2/13 with flu-like symptoms.  According to patient, she started experiencing generalized body weakness/body aches, dizziness, dry heaves, shortness of breath, cough occasionally productive of yellowish-green sputum about 4 days prior to presentation.  No fevers but she endorsed chills at home.  Patient endorsed poor appetite, low water intake at home.  Her symptoms worsened and she presented to ER 2/13.  On presentation vital signs stable.  Labs with sodium 132, potassium 2.5, creatinine 1.45.  Cardiac workup negative, pro BNP normal and troponin 27> 22. Patient tested positive for COVID-19.  Chest x-ray showed cardiomegaly but no acute cardiopulmonary process.  No consolidation.  Patient was given potassium supplements (30 mEq).  She had slight desaturation with ambulation (88% on room air).  Patient has home oxygen but uses it as needed.  When she started noticing difficulty breathing, she will use 2.5 L. Due to COVID infection, AKI, severe hypokalemia she was admitted for further management. Started on dexamethasone 6 mg for COVID 19 infection.  Patient was given potassium supplements, serum potassium improved.  Was given 1 L IV fluid bolus, renal functions also improved.  Serum magnesium low, replaced with IV magnesium sulfate.  Patient also found to have low phosphate (1.5), started daily phosphate tablets. 2/14:  Patient feeling significantly better.  No body aches or chills.  No nausea or vomiting.  Normal appetite.  No difficulty breathing.  No phlegm, very minimal cough.  No fevers. Supplemental oxygen weaned off.  Patient would like to go home today.  Labs showed resolution of AKI (serum creatinine 0.95), improvement in potassium (3.4).  Patient informed to get magnesium, phosphorus, BMP  checked next week. Will be discharged with dexamethasone course.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Fluid intake reduced, Hypokalaemia, Hypoxia, Influenza like illness, Laboratory test abnormal
Clinical narrative: Discharge Provider: MD  Primary Care Provider: MD Admission Date: 2/13/2023 Discharge Date: 02/14/2023   Admitting Diagnoses: Hypokalemia  PRESENTING PROBLEM:  Hypokalemia Hypoxia  COVID    HOSPITAL COURSE: 70-year-old lady with medical history of coronary artery disease status post CABG, chronic obstructive pulmonary disease, bipolar 1 disorder, ischemic cardiomyopathy, gastric ulcer, chronic opioid dependence, paroxysmal AFib on Xarelto presented to ER 2/13 with flu-like symptoms.  According to patient, she started experiencing generalized body weakness/body aches, dizziness, dry heaves, shortness of breath, cough occasionally productive of yellowish-green sputum about 4 days prior to presentation.  No fevers but she endorsed chills at home.  Patient endorsed poor appetite, low water intake at home.  Her symptoms worsened and she presented to ER 2/13.  On presentation vital signs stable.  Labs with sodium 132, potassium 2.5, creatinine 1.45.  Cardiac workup negative, pro BNP normal and troponin 27> 22. Patient tested positive for COVID-19.  Chest x-ray showed cardiomegaly but no acute cardiopulmonary process.  No consolidation.  Patient was given potassium supplements (30 mEq).  She had slight desaturation with ambulation (88% on room air).  Patient has home oxygen but uses it as needed.  When she started noticing difficulty breathing, she will use 2.5 L. Due to COVID infection, AKI, severe hypokalemia she was admitted for further management. Started on dexamethasone 6 mg for COVID 19 infection.  Patient was given potassium supplements, serum potassium improved.  Was given 1 L IV fluid bolus, renal functions also improved.  Serum magnesium low, replaced with IV magnesium sulfate.  Patient also found to have low phosphate (1.5), started daily phosphate tablets. 2/14:  Patient feeling significantly better.  No body aches or chills.  No nausea or vomiting.  Normal appetite.  No difficulty breathing.  No phlegm, very minimal cough.  No fevers. Supplemental oxygen weaned off.  Patient would like to go home today.  Labs showed resolution of AKI (serum creatinine 0.95), improvement in potassium (3.4).  Patient informed to get magnesium, phosphorus, BMP  checked next week. Will be discharged with dexamethasone course.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Mineral supplementation, Oxygen saturation decreased, Pain, Productive cough, Prohormone brain natriuretic peptide
Clinical narrative: Discharge Provider: MD  Primary Care Provider: MD Admission Date: 2/13/2023 Discharge Date: 02/14/2023   Admitting Diagnoses: Hypokalemia  PRESENTING PROBLEM:  Hypokalemia Hypoxia  COVID    HOSPITAL COURSE: 70-year-old lady with medical history of coronary artery disease status post CABG, chronic obstructive pulmonary disease, bipolar 1 disorder, ischemic cardiomyopathy, gastric ulcer, chronic opioid dependence, paroxysmal AFib on Xarelto presented to ER 2/13 with flu-like symptoms.  According to patient, she started experiencing generalized body weakness/body aches, dizziness, dry heaves, shortness of breath, cough occasionally productive of yellowish-green sputum about 4 days prior to presentation.  No fevers but she endorsed chills at home.  Patient endorsed poor appetite, low water intake at home.  Her symptoms worsened and she presented to ER 2/13.  On presentation vital signs stable.  Labs with sodium 132, potassium 2.5, creatinine 1.45.  Cardiac workup negative, pro BNP normal and troponin 27> 22. Patient tested positive for COVID-19.  Chest x-ray showed cardiomegaly but no acute cardiopulmonary process.  No consolidation.  Patient was given potassium supplements (30 mEq).  She had slight desaturation with ambulation (88% on room air).  Patient has home oxygen but uses it as needed.  When she started noticing difficulty breathing, she will use 2.5 L. Due to COVID infection, AKI, severe hypokalemia she was admitted for further management. Started on dexamethasone 6 mg for COVID 19 infection.  Patient was given potassium supplements, serum potassium improved.  Was given 1 L IV fluid bolus, renal functions also improved.  Serum magnesium low, replaced with IV magnesium sulfate.  Patient also found to have low phosphate (1.5), started daily phosphate tablets. 2/14:  Patient feeling significantly better.  No body aches or chills.  No nausea or vomiting.  Normal appetite.  No difficulty breathing.  No phlegm, very minimal cough.  No fevers. Supplemental oxygen weaned off.  Patient would like to go home today.  Labs showed resolution of AKI (serum creatinine 0.95), improvement in potassium (3.4).  Patient informed to get magnesium, phosphorus, BMP  checked next week. Will be discharged with dexamethasone course.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Renal impairment, Retching, SARS-CoV-2 test positive, Sputum discoloured, Troponin
Clinical narrative: Discharge Provider: MD  Primary Care Provider: MD Admission Date: 2/13/2023 Discharge Date: 02/14/2023   Admitting Diagnoses: Hypokalemia  PRESENTING PROBLEM:  Hypokalemia Hypoxia  COVID    HOSPITAL COURSE: 70-year-old lady with medical history of coronary artery disease status post CABG, chronic obstructive pulmonary disease, bipolar 1 disorder, ischemic cardiomyopathy, gastric ulcer, chronic opioid dependence, paroxysmal AFib on Xarelto presented to ER 2/13 with flu-like symptoms.  According to patient, she started experiencing generalized body weakness/body aches, dizziness, dry heaves, shortness of breath, cough occasionally productive of yellowish-green sputum about 4 days prior to presentation.  No fevers but she endorsed chills at home.  Patient endorsed poor appetite, low water intake at home.  Her symptoms worsened and she presented to ER 2/13.  On presentation vital signs stable.  Labs with sodium 132, potassium 2.5, creatinine 1.45.  Cardiac workup negative, pro BNP normal and troponin 27> 22. Patient tested positive for COVID-19.  Chest x-ray showed cardiomegaly but no acute cardiopulmonary process.  No consolidation.  Patient was given potassium supplements (30 mEq).  She had slight desaturation with ambulation (88% on room air).  Patient has home oxygen but uses it as needed.  When she started noticing difficulty breathing, she will use 2.5 L. Due to COVID infection, AKI, severe hypokalemia she was admitted for further management. Started on dexamethasone 6 mg for COVID 19 infection.  Patient was given potassium supplements, serum potassium improved.  Was given 1 L IV fluid bolus, renal functions also improved.  Serum magnesium low, replaced with IV magnesium sulfate.  Patient also found to have low phosphate (1.5), started daily phosphate tablets. 2/14:  Patient feeling significantly better.  No body aches or chills.  No nausea or vomiting.  Normal appetite.  No difficulty breathing.  No phlegm, very minimal cough.  No fevers. Supplemental oxygen weaned off.  Patient would like to go home today.  Labs showed resolution of AKI (serum creatinine 0.95), improvement in potassium (3.4).  Patient informed to get magnesium, phosphorus, BMP  checked next week. Will be discharged with dexamethasone course.
Age: 8.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dizziness, Lethargy, Pallor
Clinical narrative: 5 MINUTES POST-VACCINATION PATIENT FELT DIZZY, LIGHT HEADEDNESS, LETHARGIC, PALE TREATMENT: TRIED CHECKING BLOOD PRESSURE, LAID FLAT ON FLOOR, ELEVATED HIS LEGS OUTCOME: PATIENT WAS EVALUATED BY PARAMEDICS, WENT TO THE ER FOR FURTHER TRIAGE BUT DID NOT RECEIVE FURTHER TREATMENT, PATIENT SENT HOME`
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Culture urine, Fall, Lactic acidosis, Pneumonia aspiration
Clinical narrative: Hospital Course and Significant Findings: Patient is a 89 Y female with history of HTN, urinary incontinence, history of COVID-19 in January 2023, who presented with generalized weakness, fall, who was admitted with severe sepsis with lactic acidosis due to pneumonia/aspiration. Sepsis resolved with antibiotics, fluids. Will finish course of antibiotics for pneumonia. Urine culture contaminated. Weaned off oxygen. PT recommending SNF
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Sepsis
Clinical narrative: Hospital Course and Significant Findings: Patient is a 89 Y female with history of HTN, urinary incontinence, history of COVID-19 in January 2023, who presented with generalized weakness, fall, who was admitted with severe sepsis with lactic acidosis due to pneumonia/aspiration. Sepsis resolved with antibiotics, fluids. Will finish course of antibiotics for pneumonia. Urine culture contaminated. Weaned off oxygen. PT recommending SNF
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cerebrovascular accident, Chest X-ray, Electrocardiogram, Hemiparesis, Ischaemia
Clinical narrative: acute right hemiparesis r/t left parietal ischemic CVA
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Magnetic resonance imaging head
Clinical narrative: acute right hemiparesis r/t left parietal ischemic CVA
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Gait disturbance, Mobility decreased, Muscular weakness
Clinical narrative: Patient is a 69 Y  male with history of COPD, Afib on Xarelto, DM2, OSA on CPAP, HYPERTENSION, HYPERLIPIDEMIA, recent COVID diagnosis 1/29/23, now presents with progressive upper and lower extremity weakness.   Patient states that on 1/25/2023 he first noticed runny nose, generalized weakness fatigue and cough.  States his symptoms were progressive and he tested positive for COVID on 1/29/2023.  States that symptoms lasted for 5 days total before resolving.   Patient states that he was prescribed Augmentin, azithromycin, and prednisone by his primary care physician on 2/4/2023 for what they believed to be bacterial pneumonia with COPD exacerbation.  Patient states subsequently he returned to his normal state of health.   Patient states on 2/7/2023 while coming home from work he first noticed weakness in the bilateral upper extremities.  States that he went to bed and upon waking up on 2/8/2023 the weakness had spread to his lower extremities and he had difficulty getting out of bed.  States that he went to emergency room on 2/8/2023 and was thought at that time to have post viral generalized fatigue and sent home.  States that this morning when he woke up the weakness was significantly worse in both the upper and lower extremities so he decided to come to alternate emergency room.   Patient states that the weakness is so severe that he has difficulty getting out of bed or ambulating.  States that he has difficulty lifting his arms at all or manipulating objects.  Denies fevers chills nausea vomiting diarrhea.  Denies bowel or bladder incontinence denies changes in sensation.  Denies changes in vision difficulty with speech difficulty understanding speech.  Denies other complaints.
Age: 63.0
Sex: M
Vaccine: COVID19-2
Symptoms: Headache
Clinical narrative: Headache daily. No previous history of headaches ever.
Age: 57.0
Sex: F
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Patient received a second dose of Moderna Bivalent on 02/17/2023 initial one was received on 11/11/2022.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Pain in extremity, Peripheral swelling
Clinical narrative: Arm very sore. Large red circle and swollen. This is the third day.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Diarrhoea, Laboratory test, Parasitic test
Clinical narrative: diarrhea, daily ever since a few months receiving both vaccines.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Bladder catheterisation, COVID-19, Cardiac failure congestive, Culture urine positive, Endotracheal intubation
Clinical narrative: Patient is a 77 Y  male with history of A-fib with dual-chamber AICD on Pradaxa, coronary artery disease, diabetes, hypertension, heart failure with preserved ejection fraction, CKD stage III, morbid obesity, lymphedema, diabetes type 2 on insulin, epilepsy, hypothyroidism, hyperlipidemia, chronic low back pain on opiates repatriated to hospital from clinic on 2/13/2023.  Pt was admitted at hospital from 2/10-2/13 for hypoxemic resp failure due to covid and/or CHF.  Pt was briefly intubated, extubated 2/11/23.  Pt currently on RA.  Decadron stopped 2/14/23. Foley placed at hospital, removed 2/15/23 and pt able to urinate on own without difficulty Pt with stable vitals.  completed abx for UTI. Pt recommends daily PT.  Given that the patient is not sure of symptom onset, we will call his first test day 0, and should isolate for 20 days given hypoxemia.  Pt to be isolated through 4/2/23.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory failure, Urinary tract infection
Clinical narrative: Patient is a 77 Y  male with history of A-fib with dual-chamber AICD on Pradaxa, coronary artery disease, diabetes, hypertension, heart failure with preserved ejection fraction, CKD stage III, morbid obesity, lymphedema, diabetes type 2 on insulin, epilepsy, hypothyroidism, hyperlipidemia, chronic low back pain on opiates repatriated to hospital from clinic on 2/13/2023.  Pt was admitted at hospital from 2/10-2/13 for hypoxemic resp failure due to covid and/or CHF.  Pt was briefly intubated, extubated 2/11/23.  Pt currently on RA.  Decadron stopped 2/14/23. Foley placed at hospital, removed 2/15/23 and pt able to urinate on own without difficulty Pt with stable vitals.  completed abx for UTI. Pt recommends daily PT.  Given that the patient is not sure of symptom onset, we will call his first test day 0, and should isolate for 20 days given hypoxemia.  Pt to be isolated through 4/2/23.
Age: 76.0
Sex: F
Vaccine: VARZOS
Symptoms: Asthenia, Balance disorder, Blood glucose increased, Dizziness, Erythema
Clinical narrative: Pt felt unwell on the way home. Woozy and imbalanced. Dizziness and weakness. No swelling or difficulty breathing. No pain. Used the right arm because the left arm was affected by previous stroke. Redness left behind. Did not see PCP - blood sugar elevated from shot. Eventually regulated. Still not feeling the same.
Age: 76.0
Sex: F
Vaccine: VARZOS
Symptoms: Feeling abnormal, Malaise
Clinical narrative: Pt felt unwell on the way home. Woozy and imbalanced. Dizziness and weakness. No swelling or difficulty breathing. No pain. Used the right arm because the left arm was affected by previous stroke. Redness left behind. Did not see PCP - blood sugar elevated from shot. Eventually regulated. Still not feeling the same.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Confusional state, Cough, Mental status changes, Pyrexia
Clinical narrative: Hospital Course and Significant Findings: 73-year-old woman, presenting with subjective fevers and confusion (symptoms that were attributed to COVID). Patient has history of bipolar disorder, diabetes, CKD, hypothyroidism, hypertension, patient also presented with cough but no shortness of breath.   Patient was treated with IV remdesivir, her mental status quickly improved and she is now back to her baseline, she is not confused and is alert and oriented x3.  She does not have COVID symptoms at the present time, denies cough, shortness of breath, chest pain, fever, chills, nausea, vomiting.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration.
Age: 11.0
Sex: F
Vaccine: MENB
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Error giving Trumemba to 11 year old. Order was for MenQuadfi. Despite double check process, Trumemba was administered. Notification of family underway. Patient suffered no ill effects.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Expired Vaccine was administered, Patient was contacted and informed of situation. Staff offered a medical appointment to return to receive 2nd dose of the primary series but the patient decided to go to a pharmacy for this dose.
Age: 4.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event
Clinical narrative: the patient received moderna as primary vaccines in July 2022 and August 2022-- I failed to verify if they where given Pfizer vs Moderna vaccine and therefore I administer the Pfizer booster rather then the moderna, from which our facility does not have in stock. Mother was informed of this, I contracted the CDC and verified no adverse effect should occur the patient did no exhibit any signs of distress/experience adverse reactions.
Age: 8.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: The patient is 8 years old and the Pfizer vaccine administered was the "gray cap" 12 + dose ( 30mcg/0.3ml)  Pt weight is 104.0 lb  (47.27 kg)
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration.
Age: 2.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event
Clinical narrative: the patient received moderna as primary vaccines in July 2022 and August 2022-- I failed to verify if they where given Pfizer vs Moderna vaccine and therefore I administer the Pfizer booster rather then the moderna, from which our facility does not have in stock. Mother was informed of this, I contracted the CDC and verified no adverse effect should occur the patient did no exhibit any signs of distress/experience adverse reactions.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Feeling abnormal, Flushing, Heart rate irregular, Impaired driving ability
Clinical narrative: Flush all over body after about 20 minutes. Head started feeling peculiar. Heart started palpitating and beating in an odd rhythm. I had to pull over on the way home from the vaccination clinic. Within a few hours (3-4 hours), my arm was hurting from the shoulder all the way down to my fingers, aching and stiff. By the next morning, I could not lift my arm higher than parallel to the ground and it caused excruciating pain to attempt to lift it above that / sleep on that side. I could not lift anything of any weight - a couple of pounds at most. Frequently, shooting pains would run the length of my arm from shoulder down to arm, causing crippling pain. These symptoms lasted for 13 months, when they lessened considerably but have never fully gone away. I can still pinpoint the exact spot of the injection site. I would consider there to be permanent damage as I am still bothered by these symptoms.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site reaction, Mobility decreased, Musculoskeletal stiffness, Pain, Pain in extremity
Clinical narrative: Flush all over body after about 20 minutes. Head started feeling peculiar. Heart started palpitating and beating in an odd rhythm. I had to pull over on the way home from the vaccination clinic. Within a few hours (3-4 hours), my arm was hurting from the shoulder all the way down to my fingers, aching and stiff. By the next morning, I could not lift my arm higher than parallel to the ground and it caused excruciating pain to attempt to lift it above that / sleep on that side. I could not lift anything of any weight - a couple of pounds at most. Frequently, shooting pains would run the length of my arm from shoulder down to arm, causing crippling pain. These symptoms lasted for 13 months, when they lessened considerably but have never fully gone away. I can still pinpoint the exact spot of the injection site. I would consider there to be permanent damage as I am still bothered by these symptoms.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Palpitations, Weight bearing difficulty
Clinical narrative: Flush all over body after about 20 minutes. Head started feeling peculiar. Heart started palpitating and beating in an odd rhythm. I had to pull over on the way home from the vaccination clinic. Within a few hours (3-4 hours), my arm was hurting from the shoulder all the way down to my fingers, aching and stiff. By the next morning, I could not lift my arm higher than parallel to the ground and it caused excruciating pain to attempt to lift it above that / sleep on that side. I could not lift anything of any weight - a couple of pounds at most. Frequently, shooting pains would run the length of my arm from shoulder down to arm, causing crippling pain. These symptoms lasted for 13 months, when they lessened considerably but have never fully gone away. I can still pinpoint the exact spot of the injection site. I would consider there to be permanent damage as I am still bothered by these symptoms.
Age: 66.0
Sex: M
Vaccine: VARZOS
Symptoms: Blood test normal, Pain, Pain in extremity, X-ray normal
Clinical narrative: throbbing pain in pinky toe of left foot.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Blood lactic acid increased, Brain natriuretic peptide increased, COVID-19, Cardiac failure chronic, Chest X-ray abnormal
Clinical narrative: Patient presents to the ED for confusion, cough, congestion Found to have urinary retention Will place foley catheter UA neg Lactic acidosis at 2.2, hx of CHF with mild pulm edema on CXR with borderline oxygen saturations Will c/w monitoring Avoid aggressive fluid administration given COVID positive No orthopnea     The administration of 30 mL/kg of intravenous fluids would be detrimental or harmful for the patient despite having severe sepsis, hypotension, lactic acid ?4 mmol/L, or documentation of septic shock; AND the patient has one of the conditions below.  I am ordering 0  IV fluids (exact amount or mL/kg ordered is required) now and will reevaluate after given.   Condition(s) affecting decision to limit IV fluids: advanced or end stage heart failure with symptoms with minimal exertion or symptoms at rest or with an activity. Pulm edema on CXR   BNP elevated Will give IV lasix   Given confusion with borderline low oxygen sats with sitting up ~90%, likely benefit from diuresis and tx for COVID   HBS consulted
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Confusional state, Cough, Lactic acidosis, Oxygen saturation decreased, Pulmonary oedema
Clinical narrative: Patient presents to the ED for confusion, cough, congestion Found to have urinary retention Will place foley catheter UA neg Lactic acidosis at 2.2, hx of CHF with mild pulm edema on CXR with borderline oxygen saturations Will c/w monitoring Avoid aggressive fluid administration given COVID positive No orthopnea     The administration of 30 mL/kg of intravenous fluids would be detrimental or harmful for the patient despite having severe sepsis, hypotension, lactic acid ?4 mmol/L, or documentation of septic shock; AND the patient has one of the conditions below.  I am ordering 0  IV fluids (exact amount or mL/kg ordered is required) now and will reevaluate after given.   Condition(s) affecting decision to limit IV fluids: advanced or end stage heart failure with symptoms with minimal exertion or symptoms at rest or with an activity. Pulm edema on CXR   BNP elevated Will give IV lasix   Given confusion with borderline low oxygen sats with sitting up ~90%, likely benefit from diuresis and tx for COVID   HBS consulted