chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hypotension, Hypothermia, Mechanical ventilation, Pneumonia, Pulse absent
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 1/26/2023  PRESENTING PROBLEM: Shock (HCC) [R57.9] Encephalopathy [G93.40] Acute on chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (HCC) [J96.20] Acute on chronic anemia [D64.9] Pressure injury of sacral region, stage 4 (HCC) [L89.154] Septic shock (HCC) [A41.9, R65.21] Enterococcus faecalis infection [B95.2]   HOSPITAL COURSE: 73yo M with hx multiple CVAs, chronic trach/PEG (not vent dependant), DMII, non-verbal, diastolic heart failure, Afib (Xarelto), resident who was admitted 1/26 with acute hypoxic respiratory failure and shock.  COVID +, suspected bacterial sepsis, RIGHT sided PNA (recently PSA PNA).  Placed on ventilator, given 3 L IVF with ongoing hypotension needing norepinephrine.  Empiric Vanco and Cefepime were started.  NE off 1/27. Enterobacter 1/2 BC, unclear if true bacteremia.  Palliative care c/s 1/27.  Hemoptysis 1/27, bronch without source, TXA Nebs x24hrs, resolved.  Heparin gtt started 1/29 for afib while holding Xarelto. Limited ECHO NEG vegetation but tricuspid and pulmonic valves not seen, considering TEE.  Worsening AKI, Renal US NEG, renal consulted.  T-piece since 1/28.  Stento growing in sputum felt to be colonizer. Renal function continued to worsening with decreasing urine output.   Case conference with family (son, daughter), guardian, hospitalist, Palliative Care Dr. on 1/30. Hospice informational meeting was arranged and family and guardian decided to make patient comfort measures.  Guarding decided initially to continue tube feeds as family was requesting.  Patient with large episode emesis with aspiration 2/10.  Tube feeds discontinued. Patient with seizure life activity switched to versed and fentanyl. However, did not require boluses and placement being sough however suctioning needs to high. He was transitioned to humidified air by flow meter. Patient noted to be hypothermic and bradycardic on 2/20 while seeking placement at facility switched to prn pushes.     Death Pronouncement: Called to patient's bedside to pronounce that patient has died. Patient was DNR/DNI/Comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 2/22/2023 at 05:09
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pupil fixed, Renal impairment, SARS-CoV-2 test positive, Seizure like phenomena, Septic shock
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 1/26/2023  PRESENTING PROBLEM: Shock (HCC) [R57.9] Encephalopathy [G93.40] Acute on chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (HCC) [J96.20] Acute on chronic anemia [D64.9] Pressure injury of sacral region, stage 4 (HCC) [L89.154] Septic shock (HCC) [A41.9, R65.21] Enterococcus faecalis infection [B95.2]   HOSPITAL COURSE: 73yo M with hx multiple CVAs, chronic trach/PEG (not vent dependant), DMII, non-verbal, diastolic heart failure, Afib (Xarelto), resident who was admitted 1/26 with acute hypoxic respiratory failure and shock.  COVID +, suspected bacterial sepsis, RIGHT sided PNA (recently PSA PNA).  Placed on ventilator, given 3 L IVF with ongoing hypotension needing norepinephrine.  Empiric Vanco and Cefepime were started.  NE off 1/27. Enterobacter 1/2 BC, unclear if true bacteremia.  Palliative care c/s 1/27.  Hemoptysis 1/27, bronch without source, TXA Nebs x24hrs, resolved.  Heparin gtt started 1/29 for afib while holding Xarelto. Limited ECHO NEG vegetation but tricuspid and pulmonic valves not seen, considering TEE.  Worsening AKI, Renal US NEG, renal consulted.  T-piece since 1/28.  Stento growing in sputum felt to be colonizer. Renal function continued to worsening with decreasing urine output.   Case conference with family (son, daughter), guardian, hospitalist, Palliative Care Dr. on 1/30. Hospice informational meeting was arranged and family and guardian decided to make patient comfort measures.  Guarding decided initially to continue tube feeds as family was requesting.  Patient with large episode emesis with aspiration 2/10.  Tube feeds discontinued. Patient with seizure life activity switched to versed and fentanyl. However, did not require boluses and placement being sough however suctioning needs to high. He was transitioned to humidified air by flow meter. Patient noted to be hypothermic and bradycardic on 2/20 while seeking placement at facility switched to prn pushes.     Death Pronouncement: Called to patient's bedside to pronounce that patient has died. Patient was DNR/DNI/Comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 2/22/2023 at 05:09
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Shock, Sputum culture positive, Ultrasound kidney normal, Unresponsive to stimuli, Urine output decreased
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 1/26/2023  PRESENTING PROBLEM: Shock (HCC) [R57.9] Encephalopathy [G93.40] Acute on chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (HCC) [J96.20] Acute on chronic anemia [D64.9] Pressure injury of sacral region, stage 4 (HCC) [L89.154] Septic shock (HCC) [A41.9, R65.21] Enterococcus faecalis infection [B95.2]   HOSPITAL COURSE: 73yo M with hx multiple CVAs, chronic trach/PEG (not vent dependant), DMII, non-verbal, diastolic heart failure, Afib (Xarelto), resident who was admitted 1/26 with acute hypoxic respiratory failure and shock.  COVID +, suspected bacterial sepsis, RIGHT sided PNA (recently PSA PNA).  Placed on ventilator, given 3 L IVF with ongoing hypotension needing norepinephrine.  Empiric Vanco and Cefepime were started.  NE off 1/27. Enterobacter 1/2 BC, unclear if true bacteremia.  Palliative care c/s 1/27.  Hemoptysis 1/27, bronch without source, TXA Nebs x24hrs, resolved.  Heparin gtt started 1/29 for afib while holding Xarelto. Limited ECHO NEG vegetation but tricuspid and pulmonic valves not seen, considering TEE.  Worsening AKI, Renal US NEG, renal consulted.  T-piece since 1/28.  Stento growing in sputum felt to be colonizer. Renal function continued to worsening with decreasing urine output.   Case conference with family (son, daughter), guardian, hospitalist, Palliative Care Dr. on 1/30. Hospice informational meeting was arranged and family and guardian decided to make patient comfort measures.  Guarding decided initially to continue tube feeds as family was requesting.  Patient with large episode emesis with aspiration 2/10.  Tube feeds discontinued. Patient with seizure life activity switched to versed and fentanyl. However, did not require boluses and placement being sough however suctioning needs to high. He was transitioned to humidified air by flow meter. Patient noted to be hypothermic and bradycardic on 2/20 while seeking placement at facility switched to prn pushes.     Death Pronouncement: Called to patient's bedside to pronounce that patient has died. Patient was DNR/DNI/Comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 2/22/2023 at 05:09
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Vomiting
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 1/26/2023  PRESENTING PROBLEM: Shock (HCC) [R57.9] Encephalopathy [G93.40] Acute on chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (HCC) [J96.20] Acute on chronic anemia [D64.9] Pressure injury of sacral region, stage 4 (HCC) [L89.154] Septic shock (HCC) [A41.9, R65.21] Enterococcus faecalis infection [B95.2]   HOSPITAL COURSE: 73yo M with hx multiple CVAs, chronic trach/PEG (not vent dependant), DMII, non-verbal, diastolic heart failure, Afib (Xarelto), resident who was admitted 1/26 with acute hypoxic respiratory failure and shock.  COVID +, suspected bacterial sepsis, RIGHT sided PNA (recently PSA PNA).  Placed on ventilator, given 3 L IVF with ongoing hypotension needing norepinephrine.  Empiric Vanco and Cefepime were started.  NE off 1/27. Enterobacter 1/2 BC, unclear if true bacteremia.  Palliative care c/s 1/27.  Hemoptysis 1/27, bronch without source, TXA Nebs x24hrs, resolved.  Heparin gtt started 1/29 for afib while holding Xarelto. Limited ECHO NEG vegetation but tricuspid and pulmonic valves not seen, considering TEE.  Worsening AKI, Renal US NEG, renal consulted.  T-piece since 1/28.  Stento growing in sputum felt to be colonizer. Renal function continued to worsening with decreasing urine output.   Case conference with family (son, daughter), guardian, hospitalist, Palliative Care Dr. on 1/30. Hospice informational meeting was arranged and family and guardian decided to make patient comfort measures.  Guarding decided initially to continue tube feeds as family was requesting.  Patient with large episode emesis with aspiration 2/10.  Tube feeds discontinued. Patient with seizure life activity switched to versed and fentanyl. However, did not require boluses and placement being sough however suctioning needs to high. He was transitioned to humidified air by flow meter. Patient noted to be hypothermic and bradycardic on 2/20 while seeking placement at facility switched to prn pushes.     Death Pronouncement: Called to patient's bedside to pronounce that patient has died. Patient was DNR/DNI/Comfort care. On bedside exam no spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were mid-dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses were palpable. No heart sounds appreciated.   Patient pronounced deceased 2/22/2023 at 05:09
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Resident was to begin the Covid vaccination series but was given the Bivalent instead.  He has had no s/e or reactions up to this time
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Inflammation, Laboratory test abnormal, Lymphadenopathy, Lymphoid tissue operation
Clinical narrative: Right axillary lymphadenopathy, body aches, fatigue, with left sided axillary lymphadenopathy forming within 21 days and persisting for 3-4 months. Required surgical resection due to concern for malignancy. Ruled out with a pathology of the specimen. Due to labs and presentation it is highly likely to be an inflammatory response from the booster COVID vaccine
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Pathology test
Clinical narrative: Right axillary lymphadenopathy, body aches, fatigue, with left sided axillary lymphadenopathy forming within 21 days and persisting for 3-4 months. Required surgical resection due to concern for malignancy. Ruled out with a pathology of the specimen. Due to labs and presentation it is highly likely to be an inflammatory response from the booster COVID vaccine
Age: 92.0
Sex: F
Vaccine: COVID19-2
Symptoms: Medication error, Product storage error
Clinical narrative: Medication error. Vaccine not viable due to improper temperature storage.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Proctalgia, Rectal spasm
Clinical narrative: After my 3rd vaccine I started experiencing severe rectal pain. I was diagnosed with rectal spasms and prescribed nitroglycerin cream. I feel that I have recovered at this time.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram normal, Blood test normal, Confusional state, Dizziness, Electrocardiogram normal
Clinical narrative: Sometime in May 2022 I woke up with the whole room spinning. In September I noticed I had changes in my vision and unable to focus and felt faint. They continued to get worse. Along with this I had blurry vision, confusion and feeling concussed. I fainted on October 24, 2022, and I went to the emergency department. Two days later my instability got worse, so I returned to the emergency department. Since I was not life-threatened I was released due to COVID-19 cases in the hospital. Since then, my symptoms come and go. I don't have vertigo. I had an EEG and was negative. On February 20, 2023, I got dizzy and ran into my shower door. The next day I went to the emergency room again on February 21, 2023, and stayed in the hospital one night. The emergency department states that I have syncope vertigo.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Electroencephalogram normal, Feeling abnormal, Magnetic resonance imaging head normal, Magnetic resonance imaging neck, SARS-CoV-2 test negative
Clinical narrative: Sometime in May 2022 I woke up with the whole room spinning. In September I noticed I had changes in my vision and unable to focus and felt faint. They continued to get worse. Along with this I had blurry vision, confusion and feeling concussed. I fainted on October 24, 2022, and I went to the emergency department. Two days later my instability got worse, so I returned to the emergency department. Since I was not life-threatened I was released due to COVID-19 cases in the hospital. Since then, my symptoms come and go. I don't have vertigo. I had an EEG and was negative. On February 20, 2023, I got dizzy and ran into my shower door. The next day I went to the emergency room again on February 21, 2023, and stayed in the hospital one night. The emergency department states that I have syncope vertigo.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope, Ultrasound scan normal, Vertigo, Vision blurred, Visual impairment
Clinical narrative: Sometime in May 2022 I woke up with the whole room spinning. In September I noticed I had changes in my vision and unable to focus and felt faint. They continued to get worse. Along with this I had blurry vision, confusion and feeling concussed. I fainted on October 24, 2022, and I went to the emergency department. Two days later my instability got worse, so I returned to the emergency department. Since I was not life-threatened I was released due to COVID-19 cases in the hospital. Since then, my symptoms come and go. I don't have vertigo. I had an EEG and was negative. On February 20, 2023, I got dizzy and ran into my shower door. The next day I went to the emergency room again on February 21, 2023, and stayed in the hospital one night. The emergency department states that I have syncope vertigo.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 91.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pulmonary embolism
Clinical narrative: Patient was admitted to hospital on 2/20 with a diagosis of pulmonary embolism.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Blood creatinine increased, Blood glucose increased, Blood urea increased, COVID-19
Clinical narrative: Discharge Provider: MD Primary Care Provider: PA-C Admission Date: 2/20/2023 Discharge Date: Feb 22, 2023  PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 67 y.o. male with history of ischemic cardiomyopathy, chronic systolic CHF, CAD, hyperlipidemia, hypertension, BPH, OSA, COPD, morbid obesity, venous insufficiency and type 2 diabetes mellitus who presented with worsening shortness of breath.   He was seen by Cardiologist on 2/13 for device check following ICD placement on 1/6/23.  He was noted at that time to have concern for LV lead displacement with low LV pacing due to atrial oversensing and loss of LV capture.  Chest x-ray done on 2/15 was reassuring, and patient was relatively asymptomatic at that time.  Outpatient follow-up was planned.  He states that over the last 5 days, however, he has developed worsening shortness of breath.  He has been gaining 1 lb per day and has felt more edematous.  He reports a chronic cough and sputum production (producing green phlegm), both of which are unchanged from his baseline.  He states that he has experience orthopnea, and shortness of breath, cough and sputum production have been worse in the morning over the last week.  He has been taking Nitro in the AM, with minimal relief.  He denies any fevers or chills.  No known sick contacts.  Denies sore throat, myalgias.  He has not had chest pain, but admits that current symptoms do feel similar to when he has had "heart attacks" in the past.  His shortness of breath worsens with any activity.  He reports compliance with medications and salt/fluid restrictions.   In the ED, he was noted to have borderline soft BPs (90s systolic), which he states is baseline for him.  COVID (+).  Labs with BUN 32, Cr 1.48, glucose 215, pro-BNP 2828, hsTnT 218 -- > 213.  Chest x-ray: moderate CHF/fluid overload.  He was given 40 mg IV Lasix in the ED, and started on heparin gtt per Cardiology recommendations.   Patient was evaluated by cardiology. Pacemaker was interrogated and reported no LV lead capture and that the LV lead is likely in the coronary sinus. Patient was evaluated by EP who felt patient's CHF was attributable to COVID and less likely from lead dislodgement. There was no urgency for LV lead revision and patient should follow up outpatient and have it done at a later date. Patient completed heparin for 48 hours. He resumed his home cardiac meds and was discharged home in stable condition. He received three doses of remdesivir and had no further complaints. He said his cough was at baseline.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Chest X-ray abnormal, Chest X-ray normal, Condition aggravated, Cough
Clinical narrative: Discharge Provider: MD Primary Care Provider: PA-C Admission Date: 2/20/2023 Discharge Date: Feb 22, 2023  PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 67 y.o. male with history of ischemic cardiomyopathy, chronic systolic CHF, CAD, hyperlipidemia, hypertension, BPH, OSA, COPD, morbid obesity, venous insufficiency and type 2 diabetes mellitus who presented with worsening shortness of breath.   He was seen by Cardiologist on 2/13 for device check following ICD placement on 1/6/23.  He was noted at that time to have concern for LV lead displacement with low LV pacing due to atrial oversensing and loss of LV capture.  Chest x-ray done on 2/15 was reassuring, and patient was relatively asymptomatic at that time.  Outpatient follow-up was planned.  He states that over the last 5 days, however, he has developed worsening shortness of breath.  He has been gaining 1 lb per day and has felt more edematous.  He reports a chronic cough and sputum production (producing green phlegm), both of which are unchanged from his baseline.  He states that he has experience orthopnea, and shortness of breath, cough and sputum production have been worse in the morning over the last week.  He has been taking Nitro in the AM, with minimal relief.  He denies any fevers or chills.  No known sick contacts.  Denies sore throat, myalgias.  He has not had chest pain, but admits that current symptoms do feel similar to when he has had "heart attacks" in the past.  His shortness of breath worsens with any activity.  He reports compliance with medications and salt/fluid restrictions.   In the ED, he was noted to have borderline soft BPs (90s systolic), which he states is baseline for him.  COVID (+).  Labs with BUN 32, Cr 1.48, glucose 215, pro-BNP 2828, hsTnT 218 -- > 213.  Chest x-ray: moderate CHF/fluid overload.  He was given 40 mg IV Lasix in the ED, and started on heparin gtt per Cardiology recommendations.   Patient was evaluated by cardiology. Pacemaker was interrogated and reported no LV lead capture and that the LV lead is likely in the coronary sinus. Patient was evaluated by EP who felt patient's CHF was attributable to COVID and less likely from lead dislodgement. There was no urgency for LV lead revision and patient should follow up outpatient and have it done at a later date. Patient completed heparin for 48 hours. He resumed his home cardiac meds and was discharged home in stable condition. He received three doses of remdesivir and had no further complaints. He said his cough was at baseline.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Device function test, Dyspnoea, Dyspnoea exertional, Fluid intake restriction, Hypervolaemia
Clinical narrative: Discharge Provider: MD Primary Care Provider: PA-C Admission Date: 2/20/2023 Discharge Date: Feb 22, 2023  PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 67 y.o. male with history of ischemic cardiomyopathy, chronic systolic CHF, CAD, hyperlipidemia, hypertension, BPH, OSA, COPD, morbid obesity, venous insufficiency and type 2 diabetes mellitus who presented with worsening shortness of breath.   He was seen by Cardiologist on 2/13 for device check following ICD placement on 1/6/23.  He was noted at that time to have concern for LV lead displacement with low LV pacing due to atrial oversensing and loss of LV capture.  Chest x-ray done on 2/15 was reassuring, and patient was relatively asymptomatic at that time.  Outpatient follow-up was planned.  He states that over the last 5 days, however, he has developed worsening shortness of breath.  He has been gaining 1 lb per day and has felt more edematous.  He reports a chronic cough and sputum production (producing green phlegm), both of which are unchanged from his baseline.  He states that he has experience orthopnea, and shortness of breath, cough and sputum production have been worse in the morning over the last week.  He has been taking Nitro in the AM, with minimal relief.  He denies any fevers or chills.  No known sick contacts.  Denies sore throat, myalgias.  He has not had chest pain, but admits that current symptoms do feel similar to when he has had "heart attacks" in the past.  His shortness of breath worsens with any activity.  He reports compliance with medications and salt/fluid restrictions.   In the ED, he was noted to have borderline soft BPs (90s systolic), which he states is baseline for him.  COVID (+).  Labs with BUN 32, Cr 1.48, glucose 215, pro-BNP 2828, hsTnT 218 -- > 213.  Chest x-ray: moderate CHF/fluid overload.  He was given 40 mg IV Lasix in the ED, and started on heparin gtt per Cardiology recommendations.   Patient was evaluated by cardiology. Pacemaker was interrogated and reported no LV lead capture and that the LV lead is likely in the coronary sinus. Patient was evaluated by EP who felt patient's CHF was attributable to COVID and less likely from lead dislodgement. There was no urgency for LV lead revision and patient should follow up outpatient and have it done at a later date. Patient completed heparin for 48 hours. He resumed his home cardiac meds and was discharged home in stable condition. He received three doses of remdesivir and had no further complaints. He said his cough was at baseline.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Implantable defibrillator insertion, Lead dislodgement, Oedema, Orthopnoea, Productive cough
Clinical narrative: Discharge Provider: MD Primary Care Provider: PA-C Admission Date: 2/20/2023 Discharge Date: Feb 22, 2023  PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 67 y.o. male with history of ischemic cardiomyopathy, chronic systolic CHF, CAD, hyperlipidemia, hypertension, BPH, OSA, COPD, morbid obesity, venous insufficiency and type 2 diabetes mellitus who presented with worsening shortness of breath.   He was seen by Cardiologist on 2/13 for device check following ICD placement on 1/6/23.  He was noted at that time to have concern for LV lead displacement with low LV pacing due to atrial oversensing and loss of LV capture.  Chest x-ray done on 2/15 was reassuring, and patient was relatively asymptomatic at that time.  Outpatient follow-up was planned.  He states that over the last 5 days, however, he has developed worsening shortness of breath.  He has been gaining 1 lb per day and has felt more edematous.  He reports a chronic cough and sputum production (producing green phlegm), both of which are unchanged from his baseline.  He states that he has experience orthopnea, and shortness of breath, cough and sputum production have been worse in the morning over the last week.  He has been taking Nitro in the AM, with minimal relief.  He denies any fevers or chills.  No known sick contacts.  Denies sore throat, myalgias.  He has not had chest pain, but admits that current symptoms do feel similar to when he has had "heart attacks" in the past.  His shortness of breath worsens with any activity.  He reports compliance with medications and salt/fluid restrictions.   In the ED, he was noted to have borderline soft BPs (90s systolic), which he states is baseline for him.  COVID (+).  Labs with BUN 32, Cr 1.48, glucose 215, pro-BNP 2828, hsTnT 218 -- > 213.  Chest x-ray: moderate CHF/fluid overload.  He was given 40 mg IV Lasix in the ED, and started on heparin gtt per Cardiology recommendations.   Patient was evaluated by cardiology. Pacemaker was interrogated and reported no LV lead capture and that the LV lead is likely in the coronary sinus. Patient was evaluated by EP who felt patient's CHF was attributable to COVID and less likely from lead dislodgement. There was no urgency for LV lead revision and patient should follow up outpatient and have it done at a later date. Patient completed heparin for 48 hours. He resumed his home cardiac meds and was discharged home in stable condition. He received three doses of remdesivir and had no further complaints. He said his cough was at baseline.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Prohormone brain natriuretic peptide increased, SARS-CoV-2 test positive, Sputum discoloured, Troponin T
Clinical narrative: Discharge Provider: MD Primary Care Provider: PA-C Admission Date: 2/20/2023 Discharge Date: Feb 22, 2023  PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 67 y.o. male with history of ischemic cardiomyopathy, chronic systolic CHF, CAD, hyperlipidemia, hypertension, BPH, OSA, COPD, morbid obesity, venous insufficiency and type 2 diabetes mellitus who presented with worsening shortness of breath.   He was seen by Cardiologist on 2/13 for device check following ICD placement on 1/6/23.  He was noted at that time to have concern for LV lead displacement with low LV pacing due to atrial oversensing and loss of LV capture.  Chest x-ray done on 2/15 was reassuring, and patient was relatively asymptomatic at that time.  Outpatient follow-up was planned.  He states that over the last 5 days, however, he has developed worsening shortness of breath.  He has been gaining 1 lb per day and has felt more edematous.  He reports a chronic cough and sputum production (producing green phlegm), both of which are unchanged from his baseline.  He states that he has experience orthopnea, and shortness of breath, cough and sputum production have been worse in the morning over the last week.  He has been taking Nitro in the AM, with minimal relief.  He denies any fevers or chills.  No known sick contacts.  Denies sore throat, myalgias.  He has not had chest pain, but admits that current symptoms do feel similar to when he has had "heart attacks" in the past.  His shortness of breath worsens with any activity.  He reports compliance with medications and salt/fluid restrictions.   In the ED, he was noted to have borderline soft BPs (90s systolic), which he states is baseline for him.  COVID (+).  Labs with BUN 32, Cr 1.48, glucose 215, pro-BNP 2828, hsTnT 218 -- > 213.  Chest x-ray: moderate CHF/fluid overload.  He was given 40 mg IV Lasix in the ED, and started on heparin gtt per Cardiology recommendations.   Patient was evaluated by cardiology. Pacemaker was interrogated and reported no LV lead capture and that the LV lead is likely in the coronary sinus. Patient was evaluated by EP who felt patient's CHF was attributable to COVID and less likely from lead dislodgement. There was no urgency for LV lead revision and patient should follow up outpatient and have it done at a later date. Patient completed heparin for 48 hours. He resumed his home cardiac meds and was discharged home in stable condition. He received three doses of remdesivir and had no further complaints. He said his cough was at baseline.
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Blood test, Chills, Computerised tomogram, Malaise, Pain
Clinical narrative: I was shaking severely, had a fever, was chilled, had pain in my body, felt like I was going to be physically ill (or throw-up.)
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Pyrexia, Tremor, X-ray
Clinical narrative: I was shaking severely, had a fever, was chilled, had pain in my body, felt like I was going to be physically ill (or throw-up.)
Age: 65.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: Aide inadvertently administered a vaccine which had expired on 1/5/2023. No additional stability information was available, and
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 63.0
Sex: F
Vaccine: COVID19-2, FLUR4
Symptoms: Medication error, Poor quality product administered, Product storage error
Clinical narrative: Medication error. Vaccine not viable due to improper temperature storage.
Age: 39.0
Sex: F
Vaccine: COVID19-2
Symptoms: No adverse event
Clinical narrative: Patient did not have a reaction.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 19.0
Sex: M
Vaccine: JEV1
Symptoms: Circumstance or information capable of leading to medication error, Extra dose administered, No adverse event
Clinical narrative: The event was a company wide shot. Pt was not due for a JEV shot. Pt was screened incorrectly by staff who's role was screening patients to see what vaccines are due. Staff relayed wrong information to the vaccinator (Staff 2), which resulted in vaccinating the patient to another unnecessary dose of JEV. Pt did not have a adverse reaction to the 3rd dose of JEV.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cardiac assistance device user, Catheterisation cardiac abnormal, Chest pain, Coronary artery bypass
Clinical narrative: 3RD DOSE PFIZER COVID VACCINE GIVEN 10/13/21, #EW0169; 8/7/22 pt initially taken to hospital with CP and SOB; reports had a positive COVID test approximately 1 month earlier; no O2 needed or hospitalization with COVID; "had a head cold"; pt still testing positive for COVID at hospital; sent to cath lab where discovered he had multivessel disease; balloon pump placed; transferred to other hospital; CAB x3; ICU; recovered and able to be dc'd to home on 8/17/22; pt passed away at home on 9/12/22
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Coronary artery disease, Death, Dyspnoea, Intensive care, Nasopharyngitis
Clinical narrative: 3RD DOSE PFIZER COVID VACCINE GIVEN 10/13/21, #EW0169; 8/7/22 pt initially taken to hospital with CP and SOB; reports had a positive COVID test approximately 1 month earlier; no O2 needed or hospitalization with COVID; "had a head cold"; pt still testing positive for COVID at hospital; sent to cath lab where discovered he had multivessel disease; balloon pump placed; transferred to other hospital; CAB x3; ICU; recovered and able to be dc'd to home on 8/17/22; pt passed away at home on 9/12/22
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 3RD DOSE PFIZER COVID VACCINE GIVEN 10/13/21, #EW0169; 8/7/22 pt initially taken to hospital with CP and SOB; reports had a positive COVID test approximately 1 month earlier; no O2 needed or hospitalization with COVID; "had a head cold"; pt still testing positive for COVID at hospital; sent to cath lab where discovered he had multivessel disease; balloon pump placed; transferred to other hospital; CAB x3; ICU; recovered and able to be dc'd to home on 8/17/22; pt passed away at home on 9/12/22
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 4.0
Sex: F
Vaccine: DTAPIPV, FLU4, MMR, VARCEL
Symptoms: Oropharyngeal pain, Pallor, Vomiting
Clinical narrative: Pt. received MMR, Kinrix, Varicella, and flu vaccines.  Within minutes she complained her throat hurt and she squated downa nd then went into a fetal type position, and vomitted (no blood).  Vomit was thick and color of her breakfast cereal.  Patient was talking and responsive during entire episode.  No loss of consciousness.  Pulse ox 98%, pulse 90-105, skin color pale.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 40.0
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered, No adverse event
Clinical narrative: Expired Vaccine Given. No adverse symptoms reported.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: 7 PATIENTS RECEIVED EXPIRED DOSES BEFORE NURSING REALIZED THE LOT NUMBER WAS EXPIRED.
Age: 59.0
Sex: F
Vaccine: COVID19-2
Symptoms: Medication error, Poor quality product administered, Product storage error
Clinical narrative: Medication error. Vaccine not viable due to improper temperature storage.
Age: 39.0
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered, Injection site nodule
Clinical narrative: expired vaccine given. Employee states knot at injection site.
Age: 46.0
Sex: F
Vaccine: UNK
Symptoms: Eye pain, Feeling cold, Migraine, Nausea, Neck pain
Clinical narrative: Day of injection i got pain i my neck on the left side.  I took a vicoden 325 mg. The next morning, i won't up feeling really cold, when i usually wake up sweating . Really bad pain in my arm, fatigue, pain in my neck, bad migraine, eyes hurt and nausea.  I took 2x vicodens 325mg when i woke up.
Age: 46.0
Sex: F
Vaccine: UNK
Symptoms: Pain in extremity
Clinical narrative: Day of injection i got pain i my neck on the left side.  I took a vicoden 325 mg. The next morning, i won't up feeling really cold, when i usually wake up sweating . Really bad pain in my arm, fatigue, pain in my neck, bad migraine, eyes hurt and nausea.  I took 2x vicodens 325mg when i woke up.
Age: 8.0
Sex: F
Vaccine: DTAPIPV
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Kinrix given to 8 year old. With regard to the mistaken administration of the DTaP in a child older than age 6 years, the dose can be counted and does not need to be repeated with Td.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 53.0
Sex: M
Vaccine: FLU4
Symptoms: Expired product administered, No adverse event
Clinical narrative: Expired Vaccine Administered. No Adverse symptoms reported.
Age: 29.0
Sex: M
Vaccine: FLU4
Symptoms: Expired product administered
Clinical narrative: Expired Vaccine Administered. No adverse symptoms reported.
Age: 16.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Patient was given a bivalent booster for 1st vaccination in series instead of the monovalent as indicated. No symptoms reported.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 20.0
Sex: M
Vaccine: HEPA
Symptoms: No adverse event, Underdose
Clinical narrative: No adverse event, but given pediatric dose of Hep A instead of adult dose
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, Colonoscopy, Condition aggravated, Heart rate abnormal
Clinical narrative: Not sure if it's due to vaccination. After getting a Colonoscopy, started going into Afib. Went to the ER and was given unknown medication to slow my heartrate back to normal. Was sent home after it stabilized. Was fine after this with no reoccurrences.
Age: 20.0
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered, No adverse event
Clinical narrative: Expired Vaccine Administered. No adverse symptoms reported.
Age: 47.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dizziness, Hypotension, Loss of consciousness
Clinical narrative: Patient became severe hypotensive and lightheaded and basically passed out
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Injection site pain, Joint noise, Musculoskeletal disorder, Pain
Clinical narrative: SORE ARM, PAIN ON LEFT SIDE OF BODY INCLUDING KNEE AND LOWER LEG; HAND AND FINGERS NOT WORKING CORRECTLY; 2ND 3RD AND 4TH FINGERS CLUNK AND MAKE NOISE; PAIN IN UPPER LEFT ARM
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity
Clinical narrative: SORE ARM, PAIN ON LEFT SIDE OF BODY INCLUDING KNEE AND LOWER LEG; HAND AND FINGERS NOT WORKING CORRECTLY; 2ND 3RD AND 4TH FINGERS CLUNK AND MAKE NOISE; PAIN IN UPPER LEFT ARM
Age: 49.0
Sex: F
Vaccine: FLU4
Symptoms: Expired product administered, No adverse event
Clinical narrative: Expired Vaccine Administered. No adverse symptoms reported.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Anticoagulant therapy, COVID-19, Chest X-ray abnormal, Cough
Clinical narrative: 3rd dose of MODERNA COVID VACCINE GIVEN 8/27/21, #052E21A; pt seen in ED on 8/7/22 and dx with COVID; given antitussives and sent home; 8/10/22 pt returned to ED with increasing SOB and Cough; hypoxic in ED; CXR showed multifocal pneumonia; O2 supplementation; dexamethasone, ABX, bronchodilators, Lovenox; ICU where intubation was required with mechanical ventilation; tracheostomy; fever; lost pulse; EKG showed ST MI; CPR done without success and pt passed away in the hospital
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Death, Dyspnoea, Electrocardiogram abnormal, Endotracheal intubation, Hypoxia
Clinical narrative: 3rd dose of MODERNA COVID VACCINE GIVEN 8/27/21, #052E21A; pt seen in ED on 8/7/22 and dx with COVID; given antitussives and sent home; 8/10/22 pt returned to ED with increasing SOB and Cough; hypoxic in ED; CXR showed multifocal pneumonia; O2 supplementation; dexamethasone, ABX, bronchodilators, Lovenox; ICU where intubation was required with mechanical ventilation; tracheostomy; fever; lost pulse; EKG showed ST MI; CPR done without success and pt passed away in the hospital
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Intensive care, Mechanical ventilation, Pneumonia, Pulse absent, Pyrexia
Clinical narrative: 3rd dose of MODERNA COVID VACCINE GIVEN 8/27/21, #052E21A; pt seen in ED on 8/7/22 and dx with COVID; given antitussives and sent home; 8/10/22 pt returned to ED with increasing SOB and Cough; hypoxic in ED; CXR showed multifocal pneumonia; O2 supplementation; dexamethasone, ABX, bronchodilators, Lovenox; ICU where intubation was required with mechanical ventilation; tracheostomy; fever; lost pulse; EKG showed ST MI; CPR done without success and pt passed away in the hospital
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Resuscitation, Tracheostomy
Clinical narrative: 3rd dose of MODERNA COVID VACCINE GIVEN 8/27/21, #052E21A; pt seen in ED on 8/7/22 and dx with COVID; given antitussives and sent home; 8/10/22 pt returned to ED with increasing SOB and Cough; hypoxic in ED; CXR showed multifocal pneumonia; O2 supplementation; dexamethasone, ABX, bronchodilators, Lovenox; ICU where intubation was required with mechanical ventilation; tracheostomy; fever; lost pulse; EKG showed ST MI; CPR done without success and pt passed away in the hospital
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 84.0
Sex: F
Vaccine: COVID19-2
Symptoms: Medication error, Product storage error
Clinical narrative: Medication error. Vaccine not viable due to improper temperature storage.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 29.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: patient received the bivalent as her 1st covid shot instead of the primary series.  no reaction
Age: 60.0
Sex: F
Vaccine: COVID19-2
Symptoms: Injection site erythema
Clinical narrative: Arm red  6 inches around vaccine site
Age: 80.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered, No adverse event
Clinical narrative: No reactions
Age: 0.75
Sex: M
Vaccine: PNC13
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Patient received third dose of Prevnar 13 at age 9 months, but it was too early since patient had received the second dose at 7 months old on 12/14/22. In this case, the patient must wait until 12 months of age to receive the third dose.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Accidental improper storage of vaccine leading to temperature excursion prior to vaccine administration
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Abnormal behaviour, Angiogram cerebral abnormal, Angiogram pulmonary abnormal, Areflexia, Brain oedema
Clinical narrative: Presented to  ED on 2/13/2023 with a two day history of body aches, vomiting, fevers, headache, and myalgias Pt noted to be awake and alert, however acting strangely; neurologic status acutely decompensated tachycardic in 180s-190s and hypotensive, emergently intubated and started on norepi infusion.  CT as noted below.  Loaded with 1g Keppra. Neurosurgery consulted, exam notable for nonreactive pupils, no corneal/cough/gag reflexes and no motor response to noxious stimuli. Pt was taken emergently for decompressive hemicraniectomy. She received 100g mannitol intraoperatively. no recovery of brainstem reflexes. Loaded with Keppra and started on maintenance. Post op CToH with expected diffuse cerebral edema and diminished grey-white. LP performed 2/14 to evaluate infectious etiology which was negative. Terminal extubation on 2/15/23
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Corneal light reflex test abnormal, Decompressive craniectomy, Endotracheal intubation, HIV test negative
Clinical narrative: Presented to  ED on 2/13/2023 with a two day history of body aches, vomiting, fevers, headache, and myalgias Pt noted to be awake and alert, however acting strangely; neurologic status acutely decompensated tachycardic in 180s-190s and hypotensive, emergently intubated and started on norepi infusion.  CT as noted below.  Loaded with 1g Keppra. Neurosurgery consulted, exam notable for nonreactive pupils, no corneal/cough/gag reflexes and no motor response to noxious stimuli. Pt was taken emergently for decompressive hemicraniectomy. She received 100g mannitol intraoperatively. no recovery of brainstem reflexes. Loaded with Keppra and started on maintenance. Post op CToH with expected diffuse cerebral edema and diminished grey-white. LP performed 2/14 to evaluate infectious etiology which was negative. Terminal extubation on 2/15/23
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Hypotension, Influenza A virus test negative, Influenza B virus test, Infusion
Clinical narrative: Presented to  ED on 2/13/2023 with a two day history of body aches, vomiting, fevers, headache, and myalgias Pt noted to be awake and alert, however acting strangely; neurologic status acutely decompensated tachycardic in 180s-190s and hypotensive, emergently intubated and started on norepi infusion.  CT as noted below.  Loaded with 1g Keppra. Neurosurgery consulted, exam notable for nonreactive pupils, no corneal/cough/gag reflexes and no motor response to noxious stimuli. Pt was taken emergently for decompressive hemicraniectomy. She received 100g mannitol intraoperatively. no recovery of brainstem reflexes. Loaded with Keppra and started on maintenance. Post op CToH with expected diffuse cerebral edema and diminished grey-white. LP performed 2/14 to evaluate infectious etiology which was negative. Terminal extubation on 2/15/23
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test, Lumbar puncture normal, Lung infiltration, Motor dysfunction, Myalgia
Clinical narrative: Presented to  ED on 2/13/2023 with a two day history of body aches, vomiting, fevers, headache, and myalgias Pt noted to be awake and alert, however acting strangely; neurologic status acutely decompensated tachycardic in 180s-190s and hypotensive, emergently intubated and started on norepi infusion.  CT as noted below.  Loaded with 1g Keppra. Neurosurgery consulted, exam notable for nonreactive pupils, no corneal/cough/gag reflexes and no motor response to noxious stimuli. Pt was taken emergently for decompressive hemicraniectomy. She received 100g mannitol intraoperatively. no recovery of brainstem reflexes. Loaded with Keppra and started on maintenance. Post op CToH with expected diffuse cerebral edema and diminished grey-white. LP performed 2/14 to evaluate infectious etiology which was negative. Terminal extubation on 2/15/23
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Neurological decompensation, Pain, Pupil fixed, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Presented to  ED on 2/13/2023 with a two day history of body aches, vomiting, fevers, headache, and myalgias Pt noted to be awake and alert, however acting strangely; neurologic status acutely decompensated tachycardic in 180s-190s and hypotensive, emergently intubated and started on norepi infusion.  CT as noted below.  Loaded with 1g Keppra. Neurosurgery consulted, exam notable for nonreactive pupils, no corneal/cough/gag reflexes and no motor response to noxious stimuli. Pt was taken emergently for decompressive hemicraniectomy. She received 100g mannitol intraoperatively. no recovery of brainstem reflexes. Loaded with Keppra and started on maintenance. Post op CToH with expected diffuse cerebral edema and diminished grey-white. LP performed 2/14 to evaluate infectious etiology which was negative. Terminal extubation on 2/15/23
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Streptococcus test negative, Tachycardia, Troponin, Unresponsive to stimuli, Vomiting
Clinical narrative: Presented to  ED on 2/13/2023 with a two day history of body aches, vomiting, fevers, headache, and myalgias Pt noted to be awake and alert, however acting strangely; neurologic status acutely decompensated tachycardic in 180s-190s and hypotensive, emergently intubated and started on norepi infusion.  CT as noted below.  Loaded with 1g Keppra. Neurosurgery consulted, exam notable for nonreactive pupils, no corneal/cough/gag reflexes and no motor response to noxious stimuli. Pt was taken emergently for decompressive hemicraniectomy. She received 100g mannitol intraoperatively. no recovery of brainstem reflexes. Loaded with Keppra and started on maintenance. Post op CToH with expected diffuse cerebral edema and diminished grey-white. LP performed 2/14 to evaluate infectious etiology which was negative. Terminal extubation on 2/15/23