chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory syncytial virus test negative, SARS-CoV-2 test negative, Upper respiratory tract infection
Clinical narrative: ED Discharged  3/14/2021 (1 hours) Hospital ED Treatment team Providers Exposure to COVID-19 virus +1 more Clinical impression Covid-19 Screening Chief complaint ED Provider Notes CRNP (Nurse Practitioner) ? ? Emergency Medicine Expand AllCollapse All        ED PROVIDER NOTE           This note was partially completed using voice recognition technology, and was scanned for gross errors; however some errors may still exist.  Please contact the author with any questions or requests for clarification.      Medical Decision Making     64 y.o. female patient who presents the emergency department with nasal congestion, cough, and malaise. Her husband, son and Father all have COVID-19. Patient denies PMH..  Vital signs are stable and reassuring.  Lung sounds are clear and equal bilaterally.  No other abnormality seen on exam.  I elected to get a for panel viral respiratory panel because patient was recently tested and tested negative.  I had concerns for influenza.  This panel was negative.   Differential diagnosis includes influenza, RSV, viral upper respiratory infection, COVID-19, pneumonia, or bronchitis.     Given clear lung sounds pneumonia and bronchitis seem unlikely. RSV, Influenza, and COVID-19 tests are all negative. Suspect a viral URI, but patient has had significant exposure to COVID-19, so I suggested quarantine.   Recommend symptomatic measures for treatment.  Recommend follow-up with primary care physician.  Recommended coming back to the emergency department with any worsening symptoms.      Chief Complaint      Chief Complaint Patient presents with ? Covid-19 Screening      History of Present Illness     Patient is an 64 y.o. female who presents to the ED with for COVID-19 screening.  Patient has been experiencing nasal congestion, cough, and malaise.    No specific aggravating or alleviating factors.  No treatments tried at home.  Reports sick contacts of husband, son, and father. Denies recent travel..     Diagnosis     1. Exposure to COVID-19 virus  2. Upper respiratory tract infection, unspecified type
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Anger, Anxiety, Depression, Irritability, Suicidal ideation
Clinical narrative: Increased irritability, depression, anxiety. Suicidal thoughts, angry outbursts. Ongoing.
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiomyopathy, Echocardiogram, Electrocardiogram ST segment elevation, Palpitations, Pericarditis
Clinical narrative: "The patient presented with symptoms of pericarditis and palpitations.  Evaluation revealed elevated troponin levels consistent with myocardial injury, ST elevation on ECG (consistent with pericardial inflammation) and short episodes of non-sustained ventricular tachycardia that were not hemodynamically significant.  Echocardiography revealed normal anatomy and normal ventricular / valvular function with no pericardial effusion.  He was observed in hospital on telemetry for 24 hours and transitioned to outpatient care with exercise restrictions as well as oral non-steroidal anti-inflammatory and colchicine therapy.  Clinical diagnosis was peri-/myocarditis without ventricular dysfunction."
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Ventricular tachycardia
Clinical narrative: "The patient presented with symptoms of pericarditis and palpitations.  Evaluation revealed elevated troponin levels consistent with myocardial injury, ST elevation on ECG (consistent with pericardial inflammation) and short episodes of non-sustained ventricular tachycardia that were not hemodynamically significant.  Echocardiography revealed normal anatomy and normal ventricular / valvular function with no pericardial effusion.  He was observed in hospital on telemetry for 24 hours and transitioned to outpatient care with exercise restrictions as well as oral non-steroidal anti-inflammatory and colchicine therapy.  Clinical diagnosis was peri-/myocarditis without ventricular dysfunction."
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: TINNITUS.
Age: 59.0
Sex: U
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Pfizer vaccine mixed incorrectly (used sterile water)
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Epistaxis
Clinical narrative: After the vaccine, I was told I was good to go. 10 minutes later, I started profusely bleeding from my nose. I was able to stop the bleed without medication but it continued into the night. I woke up choking on blood. Went to the ER, they could not find the source of the bleed. There was a total of 7 nosebleeds within approximately a 10-hour window. I do not have any history, or suffer from nosebleeds, high blood pressure, etc. At the ER, I ended-up with a rocket pack in the left nostril, which stopped the bleeding. I was referred to a specialist. Upon seeing a specialist the following day (or day after receiving the vaccine), the specialist was also unable to find the bleed and cauterized a small bleed they believe was due to the trauma of the rocket pack. I was given medical nasal spray. I was told to see what happened and respond as necessary.
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: PATIENT RECEIVED VACCINE 7 HOURS AFTER THE VIAL WAS FIRST PUNCTURED
Sex: U
Vaccine: COVID19
Symptoms: Chills, Decreased appetite, Diarrhoea, Fatigue, Feeling abnormal
Clinical narrative: Intense body aches, chills and severe fatigue.  Persistant vomitting and dirrahea for 8 hours on and off the night of my vaccine. 101-102 degree fever for 24 hours after onset in evening after vaccine. Severe exhaustion, nausea, and overall feeling terrible for 3 days.  I didn't recover and finally feel more like eating until Sunday May 16th, 4 days after my vaccine. Took tylenol, drank fluids as much as I could, and slept and soaked in warm bath.
Sex: U
Vaccine: COVID19
Symptoms: Nausea, Pain, Pyrexia, Vomiting
Clinical narrative: Intense body aches, chills and severe fatigue.  Persistant vomitting and dirrahea for 8 hours on and off the night of my vaccine. 101-102 degree fever for 24 hours after onset in evening after vaccine. Severe exhaustion, nausea, and overall feeling terrible for 3 days.  I didn't recover and finally feel more like eating until Sunday May 16th, 4 days after my vaccine. Took tylenol, drank fluids as much as I could, and slept and soaked in warm bath.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram, Dyspnoea exertional
Clinical narrative: SOB with exertion, Diagnosed PE in ED
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: INDIVIDUAL WAS 17 YEARS OLD AT THE TIME OF VACCINATION
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Client presented with CDC shot Record for 1st dose Pfizer on 1/19/21 by "AMR LIZ MMCP", LOT# EC3302. Requesting 2nd dose Pfizer, which was provided to the client in accordance with current CDC/manufacture guidance. Client was at 115 days between doses, in excess of 42 day recommendation.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pruritus, Pyrexia
Clinical narrative: Patient had Covid-19 last year. After the vaccine she began with expected side effects or body aches and low grade fever. Almost 24 hours later she had itching over her whole body. She went to the emergency room where they gave her an injection of Solu-Medrol and Benadryl. she followed up with her primary care office 5/20/21
Age: 34.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Pfizer vaccine mixed incorrectly (used sterile water)
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea
Clinical narrative: Pt felt nausea after first dose. Vitals were taken and were within normal limits. He was given water and his legs were elevated. Told to do deep breathing. Patient felt better and left with no more concerns
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Pain, Pain in extremity
Clinical narrative: My left arm became really sore I could barely move it, halfway through the day on the 18th I started feeling really tired and kind of woozy. On the morning of the 19th I woke up with extreme body aches and I wasn't able to sleep that night, I am dealing with fatigue and I'm now feeling sore everywhere. Soreness started out in neck and shoulder and is now all over body.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Adenovirus test, Alanine aminotransferase normal, Aspartate aminotransferase normal
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Atrial fibrillation, Atrial flutter, Atypical pneumonia, Blood alkaline phosphatase normal, Blood bilirubin normal
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Blood calcium decreased, Blood chloride decreased, Blood creatinine increased, Blood magnesium decreased, Blood potassium normal
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Blood sodium decreased, Blood urea increased, Bordetella test negative, COVID-19 pneumonia, Carbon dioxide normal
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiomyopathy, Chest X-ray abnormal, Chronic kidney disease, Coronavirus test negative, Cough
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Enterovirus test negative, Eosinophil percentage increased, Haematocrit decreased, Haemoglobin decreased
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Human metapneumovirus test, Human rhinovirus test, Hypoxia, Influenza A virus test negative, Influenza virus test negative
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Lymphocyte percentage decreased, Monocyte percentage, Mycoplasma test negative, Neutrophil percentage increased
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Platelet count normal, Protein total decreased, SARS-CoV-2 test positive, Tremor, Troponin I increased
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Type 2 diabetes mellitus, White blood cell count decreased
Clinical narrative: ED to Hosp-Admission Discharged  4/16/2021 - 4/20/2021 (4 days)    Last attending ? Treatment team Pneumonia due to COVID-19 virus Principal problem Discharge Summary  Internal Medicine         HOSPITAL INPATIENT DISCHARGE SUMMARY HOSPITALIST GROUP .   Patient:                                                             Date: 4/20/2021 DOB:  Admission Date: 4/16/2021 MRN:        Length of stay: 4 Days PCP:  Discharging provider:     Admission diagnosis:     Primary Admission Diagnosis    Medical Problems     Hospital Problems        POA    * (Principal) Pneumonia due to COVID-19 virus Unknown         Acute on chronic renal insufficiency Yes         Diabetes mellitus type 2 in nonobese (CMS/HCC) Yes         Cardiomyopathy (CMS/HCC) Yes    Overview Addendum 3/23/2021 10:42 AM       Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;   Formatting of this note might be different from the original. Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017; Note: TACHY-BRADY 1/2015; EMBOLIC CVA 1/2017; SYSTEMIC ANTICOAGULATION 1/2017; NEG REGADENOSIN STRESS 6/2017;            Persistent atrial fibrillation (CMS/HCC) Yes         Acute respiratory insufficiency Yes        Hospital Course   HPI: 66-year-old male admitted with COVID-19 infection on 4/15.   COVID-19 infection: In setting of immunosuppressive therapy.  Patient was hypoxic on admission.  He was treated with remdesivir?completed 5-day course on 4/20.  Was treated with convalescent plasma. Patient was weaned off oxygen during hospital stay?his saturation was 96% on room air.  He was not getting desaturation on activit during his hospital stay. He will not require dexamethasone on discharge.   Atrial fibrillation: Patient remained in atrial flutter?patient recent pacemaker placement done.  He was having tremors in extremities and so amiodarone was decreased to 200 mg once a day after discussing with cardiology team. He will follow-up next week for device check and subsequently with electrophysiologist. He was maintained on anticoagulation for stroke prophylaxis.   Hypertension: Remained stable?patient will be off clonidine. He was advised to continue with Imdur, carvedilol, nifedipine?blood pressure was ranging between 100?140s systolic.   History of renal transplant?renal function remained stable.  Patient was maintained on immunosuppressive therapy with CellCept and tacrolimus.   Patient will discharge on 4/20?agrees with plan of care.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Menstruation delayed, Weight increased
Clinical narrative: Two week overdue menstrual cycle and seven pound weight gain
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Ringing in the ears. Within a week I noticed very substantial ringing in my ears. It has not subsided.
Age: 35.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Interchange of vaccine products, No adverse event
Clinical narrative: Pt came to a second dose Moderna clinic, was unaware of which vaccine he had received for his first dose. Staff did not check CIIS for record of first dose, unknown if pt had vaccine record card with him. One dose of Janssen was given on 4/1/21 and One dose of Moderna was given on 5/6/21.  No known adverse reactions as of this date.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose, Blood pressure decreased, Confusional state, Electrocardiogram, Syncope
Clinical narrative: Pt passed out after receiving the shot.  The pharmacist helped him to the floor.  He was out for about a minute and seemed to tense up before coming to.  He was confused at first about where he was. It took several minutes for him to get his barring.  He was extreemly slow to recover and his blood pressure bottomed out several times while paramedics were here.  Because he was so slow to recover he agreed to transport to Hospital.
Age: 80.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cardiac telemetry, Dizziness, Dyspnoea, Nausea, Supraventricular tachycardia
Clinical narrative: The morning after the second vaccine, my pulse was over 150, I was short of breath, light headed and experienced nausea. This has persisted since with pulse more often in the 105 to 120 range, although it will go to the 150's at times. The feeling lasts anywhere to about five minutes to the entire day.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chest X-ray, Dyspnoea, Headache, Limb discomfort
Clinical narrative: Began experiencing throbbing  pain about 15 min after the injection that radiated down the entirety  of the arm along with a headache and tunnel vision. The headache dissipated about 4 hours later  and the tunnel vision dissipated about  30 min later. The pain and throbbing  the arm lessen but the days to follow I did notice a loss of strength to my forearm as with as the tricep and bicep although there was no swelling on the injection site.  The days to follow I applied heat, cbc, to try and heal alleviate the discomfort but have yet to fully gain the strength back in my arm. Some days are worse then others.  About 2 weeks after the injection I began experiencing  SOB and pain around my upper (r) ribcage, and shoulder.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Muscular weakness, Musculoskeletal chest pain, Pain, Pain in extremity, Tunnel vision
Clinical narrative: Began experiencing throbbing  pain about 15 min after the injection that radiated down the entirety  of the arm along with a headache and tunnel vision. The headache dissipated about 4 hours later  and the tunnel vision dissipated about  30 min later. The pain and throbbing  the arm lessen but the days to follow I did notice a loss of strength to my forearm as with as the tricep and bicep although there was no swelling on the injection site.  The days to follow I applied heat, cbc, to try and heal alleviate the discomfort but have yet to fully gain the strength back in my arm. Some days are worse then others.  About 2 weeks after the injection I began experiencing  SOB and pain around my upper (r) ribcage, and shoulder.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Diarrhoea
Clinical narrative: On April 18, 2021 approximately 48 hours after receiving dose 2 of the Pfizer COVID-19 vaccination, I experienced intermittent moderate abdominal cramping and liquid yellowish diarrhea which lasted approximately 12 hours.
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Alcohol withdrawal syndrome, Fall, Head injury
Clinical narrative: It is presumed pt waited the 15 minutes in the waiting room after his vaccine as instructed. However, he was found down in the parking lot - had hit his head on the sidewalk, and had a profusely bleeding head wound which required he be seen in the urgent care for wound care which included staples. He denies recalling the event, so it is unsure whether he fell, had a seizure, or if it was a syncopal event. Pt's partner reported he was likely in alcohol withdrawal d/t history of alcohol abuse and last drink 3 days prior.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Influenza like illness, Rash
Clinical narrative: Flu like symptoms occurred day after vaccination lasted 24 hrs. 48 hrs after vaccination experienced facial rash. Rash is still active 6 days later.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Computerised tomogram, Fatigue, Influenza like illness, Nephrolithiasis
Clinical narrative: Day after vaccine:  Severe flu like symptoms, achy, vomiting, exhaustion, weak 3 days after vaccine: Kidney stone 4mm
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Vomiting, X-ray
Clinical narrative: Day after vaccine:  Severe flu like symptoms, achy, vomiting, exhaustion, weak 3 days after vaccine: Kidney stone 4mm
Age: 43.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Electric shock sensation, Laboratory test normal, Magnetic resonance imaging abnormal, Magnetic resonance imaging head abnormal, Mass
Clinical narrative: On 2/21/21 both feet started tingling.  Went to an urgent care on 2/26/21 where they completed labs to rule out that possibility.  All labs were normal.  Did a brain MRI with and without contrast on 3/4/21. MRI showed a prominent active enhancing lesion in the right frontal centrum semiovale.  On 3/26/21, tingling moved from feet to torso and felt electrical sensations up and down torso and body.  Did a spine MRI on 4/6/21.  Spine MRI showed 3 lesions. Saw neurologist on 4/21/21 who thought this could be a vaccine injury  3/25, 4/14, 4/22, and 5/5/21 saw a naturopath who tested food allergies and heavy metals.  Suggested multiple supplements. 4/15 went to acupuncture  Tingling sensations still ongoing
Age: 43.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Paraesthesia, Scan with contrast
Clinical narrative: On 2/21/21 both feet started tingling.  Went to an urgent care on 2/26/21 where they completed labs to rule out that possibility.  All labs were normal.  Did a brain MRI with and without contrast on 3/4/21. MRI showed a prominent active enhancing lesion in the right frontal centrum semiovale.  On 3/26/21, tingling moved from feet to torso and felt electrical sensations up and down torso and body.  Did a spine MRI on 4/6/21.  Spine MRI showed 3 lesions. Saw neurologist on 4/21/21 who thought this could be a vaccine injury  3/25, 4/14, 4/22, and 5/5/21 saw a naturopath who tested food allergies and heavy metals.  Suggested multiple supplements. 4/15 went to acupuncture  Tingling sensations still ongoing
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Pfizer vaccine mixed incorrectly (used sterile water)
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram, Angiogram abnormal, Anticoagulant therapy, COVID-19, Chest X-ray abnormal
Clinical narrative: Pt admitted to facility on 5/18 with shortness of breath, chest tightness and was found to have bilateral pulmonary embolism and mild patchy scattered groundglass opacities . Pt reportedly received 1st dose of Moderna COVID vaccine '2 weeks ago' (not vaccinated at this facility). Pt reportedly tested positive for COVID 1 week later (also not at this facility) and was also COVID positive on presentation here on 5/18. Admitted to ICU and currently being treated with Remdesivir, dexamethasone and enoxaparin for anticoagulation. Pt reportedly does have history of DVT/PE in past in 2012.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Chest discomfort, Dyspnoea, Intensive care, Lung opacity, Pulmonary embolism
Clinical narrative: Pt admitted to facility on 5/18 with shortness of breath, chest tightness and was found to have bilateral pulmonary embolism and mild patchy scattered groundglass opacities . Pt reportedly received 1st dose of Moderna COVID vaccine '2 weeks ago' (not vaccinated at this facility). Pt reportedly tested positive for COVID 1 week later (also not at this facility) and was also COVID positive on presentation here on 5/18. Admitted to ICU and currently being treated with Remdesivir, dexamethasone and enoxaparin for anticoagulation. Pt reportedly does have history of DVT/PE in past in 2012.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Pt admitted to facility on 5/18 with shortness of breath, chest tightness and was found to have bilateral pulmonary embolism and mild patchy scattered groundglass opacities . Pt reportedly received 1st dose of Moderna COVID vaccine '2 weeks ago' (not vaccinated at this facility). Pt reportedly tested positive for COVID 1 week later (also not at this facility) and was also COVID positive on presentation here on 5/18. Admitted to ICU and currently being treated with Remdesivir, dexamethasone and enoxaparin for anticoagulation. Pt reportedly does have history of DVT/PE in past in 2012.