chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test normal, Tachycardia
Clinical narrative: I have a rescue medication that I have for when my heart rate is really high. On Wednesday I had an episode of tachycardia which was four days after my COVID-19 shot. I was out shopping and my heart rate jumped up into the typical tachycardia pattern, I felt this warmth around my head and then my heart rate shot up. I had my medication for when this happens on me, I took a half of the dose at that time. That resolved and I was able to make it home and I really forgot about it. The next day I was finishing lunch around 2:30PM in the afternoon. I had another episode, and my heart rate went up to about 230-240. I was able to get it down with a half a pill, but it went back up. I then took a whole dose and did the things I am supposed to do. I put ice on my neck on my face and lay down, but this kept happening. I would get it calmed down but about thirty minutes later it would be back up. It calmed down over Friday, I did take my medication again on Friday during the episode and I had upped my regular beta blockers that night as well. By Saturday night this was still happening I had gone to bed, but it was still happening, and I ended up going up and I ended up going to the ER around 1AM that morning. They did do lab work and took a chest x-ray at the ER but they did not see anything. I am following up with a cardiologist to see if we cannot figure out what is going on. My blood pressure has been fluctuating and I did cancel travel plans because of this. I have my tachycardia issues under control with medication for the last two years and getting this last COVID-19 shot seems to have caused it flare up and have issues.
Age: 69.0
Sex: F
Vaccine: COVID19-2, UNK
Symptoms: Anaemia, Biopsy cervix abnormal, Blood test abnormal, Cervix neoplasm, Dehydration
Clinical narrative: Since the middle of November, I've had post-menopausal uterine bleeding. I experienced heavy bleeding and clots. We were in another state for six weeks. During this time, I started feeling bad. When we got home, I laid low and stayed home. I felt tired. About a month ago, I continued bleeding heavily. Then, about January 13-14th, I was basically hemorrhaging. I tried to contact my Primary Care Physician. The next available appointment was April 4, 2023. I went to Emergency Room. They said I was severely anemic. They did a physical exam. The ER doctor found what she thought was a tumor on my cervix. I was also dehydrated. They gave me IV fluids. They contacted a GYN Oncologist for follow-up care. They also told me to contact my Primary Care Physician. The Oncologist did an exam and a biopsy of the mass. She scheduled me for a PET Scan and MRI. The biopsy showed the mass was a Uterine Serous Carcinoma. I have an appointment tomorrow to discuss further options. I'm still anemic, but I'm eating foods to try to help fix that.
Age: 69.0
Sex: F
Vaccine: COVID19-2, UNK
Symptoms: Endometrial hyperplasia, Fatigue, Feeling abnormal, Haemoglobin decreased, Lymphadenitis
Clinical narrative: Since the middle of November, I've had post-menopausal uterine bleeding. I experienced heavy bleeding and clots. We were in another state for six weeks. During this time, I started feeling bad. When we got home, I laid low and stayed home. I felt tired. About a month ago, I continued bleeding heavily. Then, about January 13-14th, I was basically hemorrhaging. I tried to contact my Primary Care Physician. The next available appointment was April 4, 2023. I went to Emergency Room. They said I was severely anemic. They did a physical exam. The ER doctor found what she thought was a tumor on my cervix. I was also dehydrated. They gave me IV fluids. They contacted a GYN Oncologist for follow-up care. They also told me to contact my Primary Care Physician. The Oncologist did an exam and a biopsy of the mass. She scheduled me for a PET Scan and MRI. The biopsy showed the mass was a Uterine Serous Carcinoma. I have an appointment tomorrow to discuss further options. I'm still anemic, but I'm eating foods to try to help fix that.
Age: 69.0
Sex: F
Vaccine: COVID19-2, UNK
Symptoms: Magnetic resonance imaging abnormal, Positron emission tomogram abnormal, Postmenopausal haemorrhage, Thrombosis, Ultrasound pelvis abnormal
Clinical narrative: Since the middle of November, I've had post-menopausal uterine bleeding. I experienced heavy bleeding and clots. We were in another state for six weeks. During this time, I started feeling bad. When we got home, I laid low and stayed home. I felt tired. About a month ago, I continued bleeding heavily. Then, about January 13-14th, I was basically hemorrhaging. I tried to contact my Primary Care Physician. The next available appointment was April 4, 2023. I went to Emergency Room. They said I was severely anemic. They did a physical exam. The ER doctor found what she thought was a tumor on my cervix. I was also dehydrated. They gave me IV fluids. They contacted a GYN Oncologist for follow-up care. They also told me to contact my Primary Care Physician. The Oncologist did an exam and a biopsy of the mass. She scheduled me for a PET Scan and MRI. The biopsy showed the mass was a Uterine Serous Carcinoma. I have an appointment tomorrow to discuss further options. I'm still anemic, but I'm eating foods to try to help fix that.
Age: 69.0
Sex: F
Vaccine: COVID19-2, UNK
Symptoms: Uterine cancer, Uterine haemorrhage, Uterine mass
Clinical narrative: Since the middle of November, I've had post-menopausal uterine bleeding. I experienced heavy bleeding and clots. We were in another state for six weeks. During this time, I started feeling bad. When we got home, I laid low and stayed home. I felt tired. About a month ago, I continued bleeding heavily. Then, about January 13-14th, I was basically hemorrhaging. I tried to contact my Primary Care Physician. The next available appointment was April 4, 2023. I went to Emergency Room. They said I was severely anemic. They did a physical exam. The ER doctor found what she thought was a tumor on my cervix. I was also dehydrated. They gave me IV fluids. They contacted a GYN Oncologist for follow-up care. They also told me to contact my Primary Care Physician. The Oncologist did an exam and a biopsy of the mass. She scheduled me for a PET Scan and MRI. The biopsy showed the mass was a Uterine Serous Carcinoma. I have an appointment tomorrow to discuss further options. I'm still anemic, but I'm eating foods to try to help fix that.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, Dyspnoea
Clinical narrative: trouble breathing a few hours after vaccine; afib dx
Age: 11.0
Sex: M
Vaccine: COVID19-2, HEP, HPV9, IPV, MNQ
Symptoms: Expired product administered
Clinical narrative: Patient was given Pfizer Bivalent 5-11 COVID vaccine that had a BUD of 01/25/2023. Vaccine was administered 1 day after BUD. Spoke to Pfizer, they stated there is an additional two-day stability period beyond the 10-week BUD. This is considered a valid administration and the patient is not at risk for any harm due to this.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac monitoring, Echocardiogram, Flushing, Heart rate increased, Laboratory test
Clinical narrative: I had just gotten my COVID-19 shot and was still sitting there waiting to be released. I suddenly got this flush feeling and I wear an apple watch and I got an alert that my heart rate was up at about 120-140. I got up and asked for help, they got me water and a snack, and it came down and then it went back up. This kept happening and it would not come down. They finally decided that I needed to go to the ER, and I was taken via an ambulance. At the hospital they did give me an IV and something to help me relax and a beta blocker. I then had a follow up with a cardiologist and they did an echocardiogram, they put me on 24-hour heart monitor and some other tests. I was diagnosed with tachycardia and given medications that I am now on to control my heart rate and avoid these heart rate spikes.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Tachycardia
Clinical narrative: I had just gotten my COVID-19 shot and was still sitting there waiting to be released. I suddenly got this flush feeling and I wear an apple watch and I got an alert that my heart rate was up at about 120-140. I got up and asked for help, they got me water and a snack, and it came down and then it went back up. This kept happening and it would not come down. They finally decided that I needed to go to the ER, and I was taken via an ambulance. At the hospital they did give me an IV and something to help me relax and a beta blocker. I then had a follow up with a cardiologist and they did an echocardiogram, they put me on 24-hour heart monitor and some other tests. I was diagnosed with tachycardia and given medications that I am now on to control my heart rate and avoid these heart rate spikes.
Age: 10.0
Sex: F
Vaccine: COVID19-2, HPV9, VARCEL
Symptoms: Expired product administered
Clinical narrative: Patient was given Pfizer Bivalent 5-11 COVID vaccine that had a BUD of 01/25/2023. Vaccine was administered 1 day after BUD. Spoke to Pfizer, they stated there is an additional two-day stability period beyond the 10-week BUD. This is considered a valid administration and the patient is not at risk for any harm due to this.
Age: 3.0
Sex: F
Vaccine: HEP, HIBV
Symptoms: No adverse event, Poor quality product administered, Product preparation error
Clinical narrative: On Friday Jan 27th, patient was administered ActHIB that was diluted with Sterile water instead of diluent that was provided with the vaccine. MA who diluted was unaware that this vaccine was paired with its own diluent. Mistake was caught the following Monday, Jan 30th. Dr was notified and manufacture was contacted. Manufacture stated that per CDC vaccine is invalid and needs to be re-administered. Dr will be contacting family shortly. As far as we know, no adverse reaction has been reported.
Age: 70.0
Sex: M
Vaccine: HEP, HEP
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine was expired. No Known Adverse effects
Age: 70.0
Sex: M
Vaccine: HEP, HEP
Symptoms: Expired product administered
Clinical narrative: Vaccine was expired. No Known Adverse effects
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cerebrovascular accident, Laboratory test
Clinical narrative: Had a stroke on January 8, 2023
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Herpes zoster, Pain
Clinical narrative: Shingles severe pain  24/7 for more than 2 years.  On my back, up my left side and over my left stomach.  No end in sight.
Age: 26.0
Sex: M
Vaccine: COVID19-2
Symptoms: Body temperature fluctuation, COVID-19, Chills, Cold sweat, Cough
Clinical narrative: Symptoms included fatigue, nasal congestion, runny nose, dry cough, chills briefly, and felt like my body had trouble controlling my temperature. I felt like my skin was clammy and I had some sweats and felt hot throughout the night. That lasted for about 12-24 hours on the day I tested positive. The day after I tested positive, my symptoms dramatically improved beside the nasal congestion and runny nose. Towards the end of the evening, I started to feel a little sick again and having the fatigue come back a bit. This morning, I woke up feeling much better with the exception of slight nasal congestion. I did take some ibuprofen the evening I tested positive and yesterday as well. Symptoms wise, I've recovered 90% except for the nasal congestion. I have not yet taken another COVID-19 test to see if I've come back negative yet.
Age: 26.0
Sex: M
Vaccine: COVID19-2
Symptoms: Fatigue, Feeling hot, Hyperhidrosis, Malaise, Nasal congestion
Clinical narrative: Symptoms included fatigue, nasal congestion, runny nose, dry cough, chills briefly, and felt like my body had trouble controlling my temperature. I felt like my skin was clammy and I had some sweats and felt hot throughout the night. That lasted for about 12-24 hours on the day I tested positive. The day after I tested positive, my symptoms dramatically improved beside the nasal congestion and runny nose. Towards the end of the evening, I started to feel a little sick again and having the fatigue come back a bit. This morning, I woke up feeling much better with the exception of slight nasal congestion. I did take some ibuprofen the evening I tested positive and yesterday as well. Symptoms wise, I've recovered 90% except for the nasal congestion. I have not yet taken another COVID-19 test to see if I've come back negative yet.
Age: 26.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pain, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: Symptoms included fatigue, nasal congestion, runny nose, dry cough, chills briefly, and felt like my body had trouble controlling my temperature. I felt like my skin was clammy and I had some sweats and felt hot throughout the night. That lasted for about 12-24 hours on the day I tested positive. The day after I tested positive, my symptoms dramatically improved beside the nasal congestion and runny nose. Towards the end of the evening, I started to feel a little sick again and having the fatigue come back a bit. This morning, I woke up feeling much better with the exception of slight nasal congestion. I did take some ibuprofen the evening I tested positive and yesterday as well. Symptoms wise, I've recovered 90% except for the nasal congestion. I have not yet taken another COVID-19 test to see if I've come back negative yet.
Age: 4.0
Sex: F
Vaccine: MMRV
Symptoms: Product storage error
Clinical narrative: It was discovered on 01/24/2023 that the clinic had been storing the ProQuad vaccine in the fridge instead of the freezer.  Patient that was identified as receiving a dose of ProQuad that was stored improperly.  Patient will be notified to come back to clinic for another ProQuad vaccine.  Patient had not contact clinic with any adverse reactions to initial dose given.
Age: 3.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood test, Discomfort, Swelling, Urticaria
Clinical narrative: Patient broke out in hives on both feet about seven days following vaccine administration. Hives lasted 5-6 weeks, were very swollen and uncomfortable.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Anticoagulant therapy, Atrial fibrillation, Cardiac monitoring, Palpitations
Clinical narrative: My heart started racing and my apple watch was saying I was an afib. My heart rate was at 150 BPM for 2 days. I went to the cardiologist but by then it had gone down. He saw the records on the phone and put me on a heart monitor and then put me on medication. I still take the medication but no more afib episodes have happened. Name of the medication is ELIQUIS and diltiazem hydrochloride.
Age: 4.0
Sex: M
Vaccine: MMRV
Symptoms: Product storage error
Clinical narrative: On 01/24/2023 the clinic staff discovered that the ProQuad vaccine had been stored in the vaccine fridge instead of the vaccine freezer.  This patient was identified as one of the patients that received the vaccine that was stored improperly.  Patient will be notified to come back to clinic to be revaccinated.  No other adverse reactions were reported after received the initial dose.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Death
Clinical narrative: WENT TO BED AT 9PM 6 HOURS AFTER 2ND PFIZER VACCINE. 7AM NEXT MORNING SHE WAS PRONPOUCED DECEASED AT HOME IN HER BED
Age: 35.0
Sex: M
Vaccine: MMR
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: 2nd dose was given too early by 5 days. At time of immunization no apparent side effects. Pt contacted and advise to return in 28 days.
Age: 4.0
Sex: F
Vaccine: MMRV
Symptoms: No adverse event, Product storage error
Clinical narrative: It was discovered on 01/24/2023 that the clinic had been storing the ProQuad vaccine in the vaccine fridge and not the vaccine freezer.  This patient was identified as having received a dose of the vaccine that was stored improperly.  The patient will be called back to clinic to receive another dose of ProQuad.  No adverse reactions were reported from initial dose.
Age: 58.0
Sex: F
Vaccine: PNC20
Symptoms: Cough, Fatigue, Injection site erythema, Injection site induration, Injection site reaction
Clinical narrative: Injection administered IM to R deltoid on 1/23/2023. Injection site reaction occurred shortly after administration (48 hours) and spread around 72 hours post-administration to a greater area of the upper arm, estimated 6 inch diameter. Injection site was firm, erythematous over a large portion of upper arm, with some clearing between the injection site and outer edges of the lesion. The lesion began to clear another 24 hours after to a small size, around 2 inch diameter. She came into the clinic for in person assessment today and the injection site remains firm, warm to touch, and erythema is greatly improved. There is R axillary adenopathy, and the patient reported rhinorrhea, cough, fatigue, and malaise during this episode. Her symptoms improved with Tylenol and she appeared well with a normal exam other than the injection site and lymphadenopathy of the right axilla. NO additional treatment was recommended and patient will continue to monitor.
Age: 58.0
Sex: F
Vaccine: PNC20
Symptoms: Lymphadenopathy, Malaise, Rhinorrhoea, Skin lesion
Clinical narrative: Injection administered IM to R deltoid on 1/23/2023. Injection site reaction occurred shortly after administration (48 hours) and spread around 72 hours post-administration to a greater area of the upper arm, estimated 6 inch diameter. Injection site was firm, erythematous over a large portion of upper arm, with some clearing between the injection site and outer edges of the lesion. The lesion began to clear another 24 hours after to a small size, around 2 inch diameter. She came into the clinic for in person assessment today and the injection site remains firm, warm to touch, and erythema is greatly improved. There is R axillary adenopathy, and the patient reported rhinorrhea, cough, fatigue, and malaise during this episode. Her symptoms improved with Tylenol and she appeared well with a normal exam other than the injection site and lymphadenopathy of the right axilla. NO additional treatment was recommended and patient will continue to monitor.
Age: 36.0
Sex: M
Vaccine: COVID19-2
Symptoms: Lymph node pain, Lymphadenopathy
Clinical narrative: Sudden swollen lymph node located in left armpit.  Very tender and hurts to touch.  Took Advil and applied ice pack.   Did not seek medical attention.  Waiting for issue to resolve on it's own (hasn't been 24 hours yet since the date of this entry).  It's uncomfortable, but would not categorize as severe.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Body temperature increased, COVID-19, Cough, Decreased appetite
Clinical narrative: On 12/15/2022 in the evening I started feeling bad. I felt weak and had no energy. I felt like I was getting the flu. On 12/16/2022 in the morning I was experiencing difficulty breathing. I had a temperature of 105, loss of appetite, headaches. I took TYLENOL to come the fever down. On Saturday I developed cough so, I took MUCINEX for cough. On Sunday 12/18/2022 I took a home COVID-19 test which was positive. On Monday 12/19/2022 I called my doctor's office they said my doctor won't be able to do telehealth for 2 days and they advised me to go to a different office which was 25 miles away from my house. I was so sick that I had no energy to drive there so I didn't go. On 12/24/2022 I took another COVID-19 test which was positive again. On 12/26/2022 I took another COVID-19 test which was positive. On 12/29/2022 I tested myself again with a home COVID-19 test this time it was negative. On 12/30/2022 and 12/31/2022 I tested negative for COVID-19. As of today I still experience difficulty breathing while doing daily activities.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Feeling abnormal, Headache, Impaired driving ability, Loss of personal independence in daily activities
Clinical narrative: On 12/15/2022 in the evening I started feeling bad. I felt weak and had no energy. I felt like I was getting the flu. On 12/16/2022 in the morning I was experiencing difficulty breathing. I had a temperature of 105, loss of appetite, headaches. I took TYLENOL to come the fever down. On Saturday I developed cough so, I took MUCINEX for cough. On Sunday 12/18/2022 I took a home COVID-19 test which was positive. On Monday 12/19/2022 I called my doctor's office they said my doctor won't be able to do telehealth for 2 days and they advised me to go to a different office which was 25 miles away from my house. I was so sick that I had no energy to drive there so I didn't go. On 12/24/2022 I took another COVID-19 test which was positive again. On 12/26/2022 I took another COVID-19 test which was positive. On 12/29/2022 I tested myself again with a home COVID-19 test this time it was negative. On 12/30/2022 and 12/31/2022 I tested negative for COVID-19. As of today I still experience difficulty breathing while doing daily activities.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: On 12/15/2022 in the evening I started feeling bad. I felt weak and had no energy. I felt like I was getting the flu. On 12/16/2022 in the morning I was experiencing difficulty breathing. I had a temperature of 105, loss of appetite, headaches. I took TYLENOL to come the fever down. On Saturday I developed cough so, I took MUCINEX for cough. On Sunday 12/18/2022 I took a home COVID-19 test which was positive. On Monday 12/19/2022 I called my doctor's office they said my doctor won't be able to do telehealth for 2 days and they advised me to go to a different office which was 25 miles away from my house. I was so sick that I had no energy to drive there so I didn't go. On 12/24/2022 I took another COVID-19 test which was positive again. On 12/26/2022 I took another COVID-19 test which was positive. On 12/29/2022 I tested myself again with a home COVID-19 test this time it was negative. On 12/30/2022 and 12/31/2022 I tested negative for COVID-19. As of today I still experience difficulty breathing while doing daily activities.
Age: 4.0
Sex: F
Vaccine: MMRV
Symptoms: No adverse event, Product storage error
Clinical narrative: It was discovered on 01/24/2023 that the ProQuad vaccine in clinic was being stored in the fridge and not the vaccine freezer.  This patient was identified as one of the patients that received a dose that had been stored improperly.  The patient will be brought back to clinic for another ProQuad vaccine.  No adverse reactions were reported since the first dose that was given.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Death, Dyspnoea
Clinical narrative: deceased 1-22-2023;   resident of a nursing home and transferred to hospital on 1-17-23 with 2 days of shortness of breath  and then transferred to Med Center where she passed away.   had covid pneumonia apparently a year prior per records that did not require hosp admisssion.  This admission had covid pneumonia.     Was placed on inpatient hospice.
Age: 22.0
Sex: M
Vaccine: COVID19
Symptoms: Blood prolactin increased, Gynaecomastia, Prolactin-producing pituitary tumour
Clinical narrative: Increased prolactin, prolactinoma, bilateral gynecomastia
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Electrocardiogram abnormal, Mitral valve prolapse, Palpitations
Clinical narrative: My Doctor ordered an Electrocardiogram for me and I found out that I have Mitral Valve Prolapse. I was having chest pains and heart palpitations prior to my Doctor ordering the testing.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Blood creatinine normal, Blood culture negative
Clinical narrative: Report on admission: History of Present Illness:  65-year-old male brought to ED for evaluation of generalized weakness, patient cannot hold himself up this morning.  He was diagnosed with COVID about a week ago.  He does not seem to be having any respiratory distress, chest x-ray is clear, oxygen saturation 97% on room air.  No signs of COVID-pneumonia, no hypoxia.  His serum glucose was only 46, D50 IV was ordered.  He looks dry clinically, his mucous membranes are dry, he is hypotensive, but renal function is essentially normal.  BUN is elevated at 42, but creatinine and GFR normal.  Lactate is elevated at 2.5, but he is not febrile and white blood cell count is normal.  Blood cultures were collected, was covered with initial doses of IV Zosyn and vancomycin pending blood culture results.  Urinalysis was has been ordered, urine specimen has not yet been collected by nursing.  Has elevated liver enzymes, AST 278, ALT 332.  Has had mildly elevated liver enzymes in the past.  Could potentially have some mild transaminitis secondary to the COVID infection.  Clinically he is not jaundiced, does not appear to be having any abdominal pain, abdomen nontender.  IV fluids started, blood pressure has improved to the upper 90s to over 100 systolic.  EKG shows no acute injury pattern, troponin negative, no evidence of acute myocardial infarction, cardiogenic shock.  CODE STATUS is comfort care.  We have tried to reach the patient's guardian/power of attorney to discuss what level of care they wish to be provided, but at this point have not heard back.  I discussed the case with Dr.'s PA, who accepted admission on Dr. service   On admission, patient with acute on chronic transaminitis likely elevated in the setting of COVID.  Home statin and Tylenol on hold.  Blood cultures no growth to date.  Decadron continued on admission.  Guardian interested in possible hospice services and instructed to pursue this outpatient with primary PCP.  Patient discharged back to group home in stable condition.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose decreased, Blood lactic acid, Blood urea increased, COVID-19, Chest X-ray normal
Clinical narrative: Report on admission: History of Present Illness:  65-year-old male brought to ED for evaluation of generalized weakness, patient cannot hold himself up this morning.  He was diagnosed with COVID about a week ago.  He does not seem to be having any respiratory distress, chest x-ray is clear, oxygen saturation 97% on room air.  No signs of COVID-pneumonia, no hypoxia.  His serum glucose was only 46, D50 IV was ordered.  He looks dry clinically, his mucous membranes are dry, he is hypotensive, but renal function is essentially normal.  BUN is elevated at 42, but creatinine and GFR normal.  Lactate is elevated at 2.5, but he is not febrile and white blood cell count is normal.  Blood cultures were collected, was covered with initial doses of IV Zosyn and vancomycin pending blood culture results.  Urinalysis was has been ordered, urine specimen has not yet been collected by nursing.  Has elevated liver enzymes, AST 278, ALT 332.  Has had mildly elevated liver enzymes in the past.  Could potentially have some mild transaminitis secondary to the COVID infection.  Clinically he is not jaundiced, does not appear to be having any abdominal pain, abdomen nontender.  IV fluids started, blood pressure has improved to the upper 90s to over 100 systolic.  EKG shows no acute injury pattern, troponin negative, no evidence of acute myocardial infarction, cardiogenic shock.  CODE STATUS is comfort care.  We have tried to reach the patient's guardian/power of attorney to discuss what level of care they wish to be provided, but at this point have not heard back.  I discussed the case with Dr.'s PA, who accepted admission on Dr. service   On admission, patient with acute on chronic transaminitis likely elevated in the setting of COVID.  Home statin and Tylenol on hold.  Blood cultures no growth to date.  Decadron continued on admission.  Guardian interested in possible hospice services and instructed to pursue this outpatient with primary PCP.  Patient discharged back to group home in stable condition.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Dry skin, Electrocardiogram normal, Glomerular filtration rate normal, Hepatic enzyme increased, Hypertransaminasaemia
Clinical narrative: Report on admission: History of Present Illness:  65-year-old male brought to ED for evaluation of generalized weakness, patient cannot hold himself up this morning.  He was diagnosed with COVID about a week ago.  He does not seem to be having any respiratory distress, chest x-ray is clear, oxygen saturation 97% on room air.  No signs of COVID-pneumonia, no hypoxia.  His serum glucose was only 46, D50 IV was ordered.  He looks dry clinically, his mucous membranes are dry, he is hypotensive, but renal function is essentially normal.  BUN is elevated at 42, but creatinine and GFR normal.  Lactate is elevated at 2.5, but he is not febrile and white blood cell count is normal.  Blood cultures were collected, was covered with initial doses of IV Zosyn and vancomycin pending blood culture results.  Urinalysis was has been ordered, urine specimen has not yet been collected by nursing.  Has elevated liver enzymes, AST 278, ALT 332.  Has had mildly elevated liver enzymes in the past.  Could potentially have some mild transaminitis secondary to the COVID infection.  Clinically he is not jaundiced, does not appear to be having any abdominal pain, abdomen nontender.  IV fluids started, blood pressure has improved to the upper 90s to over 100 systolic.  EKG shows no acute injury pattern, troponin negative, no evidence of acute myocardial infarction, cardiogenic shock.  CODE STATUS is comfort care.  We have tried to reach the patient's guardian/power of attorney to discuss what level of care they wish to be provided, but at this point have not heard back.  I discussed the case with Dr.'s PA, who accepted admission on Dr. service   On admission, patient with acute on chronic transaminitis likely elevated in the setting of COVID.  Home statin and Tylenol on hold.  Blood cultures no growth to date.  Decadron continued on admission.  Guardian interested in possible hospice services and instructed to pursue this outpatient with primary PCP.  Patient discharged back to group home in stable condition.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Hypotension, Mucosal dryness, Renal function test normal, Troponin normal, White blood cell count normal
Clinical narrative: Report on admission: History of Present Illness:  65-year-old male brought to ED for evaluation of generalized weakness, patient cannot hold himself up this morning.  He was diagnosed with COVID about a week ago.  He does not seem to be having any respiratory distress, chest x-ray is clear, oxygen saturation 97% on room air.  No signs of COVID-pneumonia, no hypoxia.  His serum glucose was only 46, D50 IV was ordered.  He looks dry clinically, his mucous membranes are dry, he is hypotensive, but renal function is essentially normal.  BUN is elevated at 42, but creatinine and GFR normal.  Lactate is elevated at 2.5, but he is not febrile and white blood cell count is normal.  Blood cultures were collected, was covered with initial doses of IV Zosyn and vancomycin pending blood culture results.  Urinalysis was has been ordered, urine specimen has not yet been collected by nursing.  Has elevated liver enzymes, AST 278, ALT 332.  Has had mildly elevated liver enzymes in the past.  Could potentially have some mild transaminitis secondary to the COVID infection.  Clinically he is not jaundiced, does not appear to be having any abdominal pain, abdomen nontender.  IV fluids started, blood pressure has improved to the upper 90s to over 100 systolic.  EKG shows no acute injury pattern, troponin negative, no evidence of acute myocardial infarction, cardiogenic shock.  CODE STATUS is comfort care.  We have tried to reach the patient's guardian/power of attorney to discuss what level of care they wish to be provided, but at this point have not heard back.  I discussed the case with Dr.'s PA, who accepted admission on Dr. service   On admission, patient with acute on chronic transaminitis likely elevated in the setting of COVID.  Home statin and Tylenol on hold.  Blood cultures no growth to date.  Decadron continued on admission.  Guardian interested in possible hospice services and instructed to pursue this outpatient with primary PCP.  Patient discharged back to group home in stable condition.
Age: 1.0
Sex: M
Vaccine: MMRV
Symptoms: No adverse event, Product storage error
Clinical narrative: On 01/24/2023 it was discovered by the clinic staff that our ProQuad vaccine was being stored in the vaccine fridge and not the vaccine freezer.  This patient was identified as a patient that received a dose of ProQuad that was stored improperly.  The patient will be brought back in to clinic to receive a subsequent dose of ProQuad.  There were no reports of an adverse reaction to the initial dose that was given.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Vomiting
Clinical narrative: Document Type: ED Physician Progress Note   Document Subject: ED Progress Note   Performed By: PRIVATE on January 31, 2023 12:42   Verified By: PRIVATE MD on January 31, 2023 15:30    Encounter Info: Local Hospital, Inpatient, 01/31/23 -     * Final Report *        Basic Information  Time Seen: PRIVATE, MD / 01/31/2023 11:52  Chief Complaint  Abdominal pain (Complaint of), Vomiting (Complaint of)  History of Present Illness     Pt seen: 01/31/23 12:41:22 A 33 year old female presents to the ED via private vehicle c/o upper right abdominal pain onset 0530 this morning. Pt describes as sharp. She reports a few hours after her pain began she had 1 episod
Age: 16.0
Sex: F
Vaccine: FLU4, PPV
Symptoms: Product administration error, Wrong product administered
Clinical narrative: When retrieving  vaccines from the refrigerator, the MA grabbed the Pneumovax syringe instead of the Bexsero syringe. The patient was given Pneumovax in error. The patient remained stable and her condition did not change
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Aggression, Agitation, Autonomic nervous system imbalance, COVID-19
Clinical narrative: Patient is a 85 y.o. female patient of DO with history of diabetes, hypothyroidism, hypertension, Lewy body dementia complicated with behavioral changes, rheumatoid arthritis, tuberculosis, Guillain-Barré syndrome,Who was brought by family for progressive dementia, agitation and possible placement.     Per ED, patient brought by family for placement, noted to have aggressive behavior and hallucinations, she was supposed to move to assisted living but they are unable to take her due to agitation.     Lewy body dementia with behavioral changes and hallucinations, improved Resume home Seroquel. Lexapro Donepezil ED placed consult for psychiatry, appreciate input No haldol per son, had bad reaction to it   Continue on Seroquel 25 in the morning and 50 in the afternoon.  Patient remains easily redirectable.   Presyncope Hypertension Orthostatic hypotension. Home blood pressure medications held (Coreg, amlodipine, hydrochlorothiazide) Midodrine was started and then discontinued. Likely problem is autonomic dysfunction.  She does not look clinically hypovolemic but I have to maintain hydration with her. Strict compression stockings bilaterally. Resume Norvasc at discharge per Discontinue hydrochlorothiazide and Coreg as it can exacerbate orthostasis. Patient's son was educated about issue, patient would have to slowly get out of bed and stand up, be careful with changing position. Nursing facility to be made aware.   Acute hypoxemic respiratory failure, resolved Pneumonia secondary to COVID, resolved Community-acquired pneumonia in the left lower lobe, resolved Chest x-ray noted left lower lobe airspace disease with mild left pleural effusion Status post antibiotics and steroids.   Covid-19 Virus Infection, resolved Date of covid positive test: 12/19/22 Oxygen requirements on admission: 2 L Current oxygen requirements: 2 L Medical therapy: steroids, remdesivir is done Anticipated special isolation end date: 12/29/22    Urinary tract infection, resolved Urine cultures are not significant, stop ceftriaxone   Rheumatoid arthritis, continue hydroxychloroquine
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chest X-ray abnormal, Compression garment application, Condition aggravated, Culture urine, Dementia
Clinical narrative: Patient is a 85 y.o. female patient of DO with history of diabetes, hypothyroidism, hypertension, Lewy body dementia complicated with behavioral changes, rheumatoid arthritis, tuberculosis, Guillain-Barré syndrome,Who was brought by family for progressive dementia, agitation and possible placement.     Per ED, patient brought by family for placement, noted to have aggressive behavior and hallucinations, she was supposed to move to assisted living but they are unable to take her due to agitation.     Lewy body dementia with behavioral changes and hallucinations, improved Resume home Seroquel. Lexapro Donepezil ED placed consult for psychiatry, appreciate input No haldol per son, had bad reaction to it   Continue on Seroquel 25 in the morning and 50 in the afternoon.  Patient remains easily redirectable.   Presyncope Hypertension Orthostatic hypotension. Home blood pressure medications held (Coreg, amlodipine, hydrochlorothiazide) Midodrine was started and then discontinued. Likely problem is autonomic dysfunction.  She does not look clinically hypovolemic but I have to maintain hydration with her. Strict compression stockings bilaterally. Resume Norvasc at discharge per Discontinue hydrochlorothiazide and Coreg as it can exacerbate orthostasis. Patient's son was educated about issue, patient would have to slowly get out of bed and stand up, be careful with changing position. Nursing facility to be made aware.   Acute hypoxemic respiratory failure, resolved Pneumonia secondary to COVID, resolved Community-acquired pneumonia in the left lower lobe, resolved Chest x-ray noted left lower lobe airspace disease with mild left pleural effusion Status post antibiotics and steroids.   Covid-19 Virus Infection, resolved Date of covid positive test: 12/19/22 Oxygen requirements on admission: 2 L Current oxygen requirements: 2 L Medical therapy: steroids, remdesivir is done Anticipated special isolation end date: 12/29/22    Urinary tract infection, resolved Urine cultures are not significant, stop ceftriaxone   Rheumatoid arthritis, continue hydroxychloroquine
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Disease progression, Hallucination, Hypertension, Lung disorder, Orthostatic hypotension
Clinical narrative: Patient is a 85 y.o. female patient of DO with history of diabetes, hypothyroidism, hypertension, Lewy body dementia complicated with behavioral changes, rheumatoid arthritis, tuberculosis, Guillain-Barré syndrome,Who was brought by family for progressive dementia, agitation and possible placement.     Per ED, patient brought by family for placement, noted to have aggressive behavior and hallucinations, she was supposed to move to assisted living but they are unable to take her due to agitation.     Lewy body dementia with behavioral changes and hallucinations, improved Resume home Seroquel. Lexapro Donepezil ED placed consult for psychiatry, appreciate input No haldol per son, had bad reaction to it   Continue on Seroquel 25 in the morning and 50 in the afternoon.  Patient remains easily redirectable.   Presyncope Hypertension Orthostatic hypotension. Home blood pressure medications held (Coreg, amlodipine, hydrochlorothiazide) Midodrine was started and then discontinued. Likely problem is autonomic dysfunction.  She does not look clinically hypovolemic but I have to maintain hydration with her. Strict compression stockings bilaterally. Resume Norvasc at discharge per Discontinue hydrochlorothiazide and Coreg as it can exacerbate orthostasis. Patient's son was educated about issue, patient would have to slowly get out of bed and stand up, be careful with changing position. Nursing facility to be made aware.   Acute hypoxemic respiratory failure, resolved Pneumonia secondary to COVID, resolved Community-acquired pneumonia in the left lower lobe, resolved Chest x-ray noted left lower lobe airspace disease with mild left pleural effusion Status post antibiotics and steroids.   Covid-19 Virus Infection, resolved Date of covid positive test: 12/19/22 Oxygen requirements on admission: 2 L Current oxygen requirements: 2 L Medical therapy: steroids, remdesivir is done Anticipated special isolation end date: 12/29/22    Urinary tract infection, resolved Urine cultures are not significant, stop ceftriaxone   Rheumatoid arthritis, continue hydroxychloroquine
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pleural effusion, Pneumonia, Presyncope, SARS-CoV-2 test positive, Urinary tract infection
Clinical narrative: Patient is a 85 y.o. female patient of DO with history of diabetes, hypothyroidism, hypertension, Lewy body dementia complicated with behavioral changes, rheumatoid arthritis, tuberculosis, Guillain-Barré syndrome,Who was brought by family for progressive dementia, agitation and possible placement.     Per ED, patient brought by family for placement, noted to have aggressive behavior and hallucinations, she was supposed to move to assisted living but they are unable to take her due to agitation.     Lewy body dementia with behavioral changes and hallucinations, improved Resume home Seroquel. Lexapro Donepezil ED placed consult for psychiatry, appreciate input No haldol per son, had bad reaction to it   Continue on Seroquel 25 in the morning and 50 in the afternoon.  Patient remains easily redirectable.   Presyncope Hypertension Orthostatic hypotension. Home blood pressure medications held (Coreg, amlodipine, hydrochlorothiazide) Midodrine was started and then discontinued. Likely problem is autonomic dysfunction.  She does not look clinically hypovolemic but I have to maintain hydration with her. Strict compression stockings bilaterally. Resume Norvasc at discharge per Discontinue hydrochlorothiazide and Coreg as it can exacerbate orthostasis. Patient's son was educated about issue, patient would have to slowly get out of bed and stand up, be careful with changing position. Nursing facility to be made aware.   Acute hypoxemic respiratory failure, resolved Pneumonia secondary to COVID, resolved Community-acquired pneumonia in the left lower lobe, resolved Chest x-ray noted left lower lobe airspace disease with mild left pleural effusion Status post antibiotics and steroids.   Covid-19 Virus Infection, resolved Date of covid positive test: 12/19/22 Oxygen requirements on admission: 2 L Current oxygen requirements: 2 L Medical therapy: steroids, remdesivir is done Anticipated special isolation end date: 12/29/22    Urinary tract infection, resolved Urine cultures are not significant, stop ceftriaxone   Rheumatoid arthritis, continue hydroxychloroquine
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus, Rash
Clinical narrative: Rash/severe itching all over the body.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Asthenia, COVID-19, Decreased activity, Fatigue
Clinical narrative: I started feeling tired and memory was kind of foggy; stomachaches; zero energy; limited activity. For a few days to a week and then I took an at home COVID-19 test and it was positive. I reached out to my doctor, and he sent a prescription for molnupiravir until it was gone. Within a few days I started to recover and get better. Throat irritation has been something I have been trying to get over.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling abnormal, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: I started feeling tired and memory was kind of foggy; stomachaches; zero energy; limited activity. For a few days to a week and then I took an at home COVID-19 test and it was positive. I reached out to my doctor, and he sent a prescription for molnupiravir until it was gone. Within a few days I started to recover and get better. Throat irritation has been something I have been trying to get over.
Age: 45.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Fatigue, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: Started feeling a scratchy throat, and feeling tired; Took a home COVID-19 test and it was positive; Had a Telehealth appointment next day and was prescribed PAXLOVID; Tested negative 2 weeks later.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: COVID vaccine breakthrough case.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: vaccine given after the bud date- no symptoms
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Bronchial wall thickening, Bronchiolitis, Bronchitis, COVID-19
Clinical narrative: Patient is a 71 years old male patient of local MD with history of COPD, CAD s/p numerous stents and PCI, PVD s/p stenting of L leg, HTN, TIA, PAF, chronic pain disorder, and HLD presented to a local Hospital with shortness of breath Admitted with Acute Hypoxic Respiratory failure,COVID-19 infection and Acute exacerbation of COPD CXR: Prominent bilateral infrahilar interstitial lung markings with scattered peribronchial cuffing.  This suggests small airways disease such as bronchitis/bronchiolitis or pneumonitis.  Patient responded to treatment with dexamethasone subsequently discharged on prednisone taper on baseline oxygen requirements   Discharge Diagnoses:   Acute Hypoxic Respiratory failure. COVID-19 infection Acute exacerbation of COPD Peripheral vascular disease s/p stenting CAD s/p numerous stent Essential HTN Pulmonary hypertension Obesity; BMI 37.33. Hypophosphatemia ___________________________________________________________________________
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Dyspnoea, Interstitial lung disease
Clinical narrative: Patient is a 71 years old male patient of local MD with history of COPD, CAD s/p numerous stents and PCI, PVD s/p stenting of L leg, HTN, TIA, PAF, chronic pain disorder, and HLD presented to a local Hospital with shortness of breath Admitted with Acute Hypoxic Respiratory failure,COVID-19 infection and Acute exacerbation of COPD CXR: Prominent bilateral infrahilar interstitial lung markings with scattered peribronchial cuffing.  This suggests small airways disease such as bronchitis/bronchiolitis or pneumonitis.  Patient responded to treatment with dexamethasone subsequently discharged on prednisone taper on baseline oxygen requirements   Discharge Diagnoses:   Acute Hypoxic Respiratory failure. COVID-19 infection Acute exacerbation of COPD Peripheral vascular disease s/p stenting CAD s/p numerous stent Essential HTN Pulmonary hypertension Obesity; BMI 37.33. Hypophosphatemia ___________________________________________________________________________
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonitis, Small airways disease
Clinical narrative: Patient is a 71 years old male patient of local MD with history of COPD, CAD s/p numerous stents and PCI, PVD s/p stenting of L leg, HTN, TIA, PAF, chronic pain disorder, and HLD presented to a local Hospital with shortness of breath Admitted with Acute Hypoxic Respiratory failure,COVID-19 infection and Acute exacerbation of COPD CXR: Prominent bilateral infrahilar interstitial lung markings with scattered peribronchial cuffing.  This suggests small airways disease such as bronchitis/bronchiolitis or pneumonitis.  Patient responded to treatment with dexamethasone subsequently discharged on prednisone taper on baseline oxygen requirements   Discharge Diagnoses:   Acute Hypoxic Respiratory failure. COVID-19 infection Acute exacerbation of COPD Peripheral vascular disease s/p stenting CAD s/p numerous stent Essential HTN Pulmonary hypertension Obesity; BMI 37.33. Hypophosphatemia ___________________________________________________________________________
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: vaccine given after the bud date- no symptoms
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: vaccine given after the bud date- no symptoms
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: vaccine given after the bud date- no symptoms
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: patient got COVID-19 Vaccines when he was under 18 y.